CTR050592_A4_Price_Sheet.pdf
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- Attached to
- Master Agreement AZ|CTR050592
- Contract number
- CTR050592
- Issued by
- Arizona
About this file
This document is a Contract Amendment (Amendment No. 4) issued by the Arizona Department of Health Services (ADHS), Office of Procurement, for a contract with Adelante Healthcare. The contract is identified by the number CTR050592 and is located in Phoenix, Arizona. The procurement officer for this amendment is Lucas Terry.
The amendment details a cost reimbursement line-item budget for State Fiscal Year 2024 (7/1/23-6/30/24), with a total authorized budget of $102,000.00. The budget is broken down across several categories, including $75,692.00 for Personnel, $13,625.00 for Employer Related Expenses (ERE), $3,975.00 for In-State Travel Expenses, $7,868.00 for Operating Expenses, and $840.00 for Capital Outlay Expense. The contract allows for up to a 10% transfer between funded line items with prior written approval, and emphasizes that services are only authorized through specific purchase orders issued by ADHS, with no legal obligation to pay beyond the amount specified in those orders.
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Text version
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
CONTRACT NO.: CTR050592 AMENDMENT NO.: 4 Procurement Officer:
Lucas Terry
Adelante Healthcare CTR050592
COST REIMBURSEMENT LINE-ITEM BUDGET: SFY 2024 (7/1/23-6/30/24)
ACCOUNT CLASSIFICATION AMOUNT
Personnel $75,692.00
ERE $13,625.00
Professional & Outside Services $0.00
Travel Expense (In-State) $3,975.00
Out of State Travel $0.00
Occupancy $0.00
Operating Expenses/ Other Operating $7,868.00
Capital Outlay Expense $840.00
Indirect (if authorized) $0.00
Other $0.00
TOTAL $102,000.00
With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum of ten percent (10%) of the total budget amount between funded line items. Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to a non-funded line item shall require an amendment.
Authorization for purchase of services under this Contract shall be made only upon ADHS issuance of a Purchase Order that is signed by an authorized agent. The Purchase Order will indicate the Contract number and the dollar amount of funds authorized. The Contractor shall only be authorized to perform services up to the amount on the Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless a.) the Purchase Order is modified with an official ADHS Procurement Change Order, and/or b.) an additional Purchase Order is issued for purchase of services under this Contract.
File details come from the government source that posted it. Updated .