CTR050595_A5_Price_Sheet.pdf
PDF 111 KB Posted
- Attached to
- Master Agreement AZ|CTR050595
- Contract number
- CTR050595
- Issued by
- Arizona
About this file
This document is a Contract Amendment (Amendment No. 5) issued by the Arizona Department of Health Services (ADHS), Office of Procurement, for Contract No. CTR050595 with the Coconino County Health Department. The amendment is signed by Procurement Officer Karen D. Ingram and bears the official seal of the State of Arizona.
The amendment details a cost reimbursement line item budget totaling $158,661.00 for the fiscal period, broken down across several expense categories including Personnel ($90,162.00), Employee Related Expenses (ERE) ($38,602.00), Professional and Outside Services ($10,080.00), and Travel Expenses (In-State) ($11,692.00). The contract allows the contractor to transfer up to 10% between funded line items with prior written approval, and specifies that service purchases are authorized only through official ADHS Purchase Orders. The document emphasizes that ADHS has no legal obligation to pay for services exceeding the amount specified on the Purchase Order.
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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.: CTR050595 AMENDMENT NO.: 5 Procurement Officer:
Karen D. Ingram
Coconino County Health Department CTR050595 COST
REIMBURSEMENT LINE ITEM BUDGET:
ACCOUNT CLASSIFICATION AMOUNT
Personnel $90,162.00
ERE $38,602.00
Professional and Outside Services $10,080.00 Travel Expenses (In-State) $11,692.00 Out of State Travel $0.00 Occupancy $0.00 Other Operating $8,125.00 Capital Outlay $0.00 Indirect (if Authorized) $0.00 Other $0.00 TOTAL: Annual Amount Not To Exceed $158,661.00
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 .