CTR050592 A6 Pricing.pdf
PDF 178 KB Posted
- Attached to
- Master Agreement AZ|CTR050592
- Contract number
- CTR050592
- Issued by
- Arizona
About this file
This document is a Contract Amendment (Amendment No. 6) issued by the Arizona Department of Health Services (ADHS), Office of Procurement, located in Phoenix, Arizona. The contract is identified by the number CTR050592 and is being amended for the period of July 1, 2025 through September 30, 2025.
The amendment details a cost reimbursement line-item budget with a total annual amount not to exceed $25,500.00. The budget breakdown includes $18,923.00 for Personnel, $3,406.25 for Employee Related Expenses (ERE), $993.75 for In-State Travel Expenses, $1,967.00 for Other Operating expenses, and $210.00 for Capital Outlay. The contractor is authorized to transfer up to 10% between funded line items with prior written approval from the Program Manager. Any purchases under this contract will require an official Purchase Order signed by an authorized ADHS agent, which will specify the exact dollar amount authorized for services.
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Text version
REQUEST FOR PROPOSAL
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
CONTRACT NO.: CTR050592 AMENDMENT NO.: 6 PROCUREMENT OFFICER:
Lucas Terry
Revised 06.18.2024
COST REIMBURSEMENT LINE-ITEM BUDGET
Price Sheet for July 1, 2025 - September 30, 2025
ACCOUNT CLASSIFICATION
Personnel $18,923.00
ERE $3,406.25
Professional and Outside Services $0.00
Travel Expenses (In-State) $993.75
Out of State Travel $0.00
Occupancy $0.00
Other Operating $1,967.00
Capital Outlay $210.00
Indirect (if Authorized) $0.00
Other $0.00
TOTAL: Annual Amount Not to Exceed $25,500.00
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.
Docusign Envelope ID: 5F54C653-F07B-4546-8B3C-3C7D02968A71
File details come from the government source that posted it. Updated .