CTR050595_Health_Start_Program_Coconino_A2_Fully_Executed.pdf

Diana Landeros

Digitally signed by Diana Landeros Date: 2022.05.26 10:15:45 -07'00'

COCONINO, COUNTY OF

Unique Entity ID

VHPBMTKAPS83

CAGE / NCAGE

4JYZ9

Purpose of Registration

Federal Assistance Awards Only

Registration Status

Active Registration

Expiration Date

Dec 21, 2022

Physical Address

2625 N King ST

Flagstaff, Arizona 86004-1884

United States

Mailing Address

219 E Cherry AVE

Flagstaff, Arizona 86001

United States

Business Information

Doing Business as

COCONINO COUNTY DEPT OF HEALTH

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 01

State / Country of Incorporation

(blank) / (blank)

URL

www.coconino.az.gov/health

Registration Dates

Activation Date

Jan 3, 2022

Submission Date

Dec 21, 2021

Initial Registration Date

Sep 25, 2006

Entity Dates

Entity Start Date

Jan 1, 1967

Fiscal Year End Close Date

Jun 30

Immediate Owner

CAGE

(blank)

Legal Business Name

(blank)

Highest Level Owner

CAGE

(blank)

Legal Business Name

(blank)

Executive Compensation

Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of

P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant responded to the questions.

Proceedings Questions

Registrants in the System for Award Management (SAM) respond to proceedings questions in accordance with FAR 52.209-7, FAR 52.209-9, or

2.C.F.R. 200 Appendix XII. Their responses are not displayed in SAM. They are sent to FAPIIS.gov for display as applicable. Maintaining an active registration in SAM demonstrates the registrant responded to the proceedings questions.

Exclusion Summary

Active Exclusions Records?

No

SAM Search Authorization

I authorize my entity's non-sensitive information to be displayed in SAM public search results:

Yes

Entity Types

Business Types

Entity Structure

U.S. Government Entity

Entity Type

US Local Government

Organization Factors

(blank)

Profit Structure

(blank)

Last updated by Yasmine Sealy on Dec 21, 2021 at 03:53 PM COCONINO, COUNTY OF https://sam.gov/entity/VHPBMTKAPS83/coreData?status=Active Page 1 of 2

Socio-Economic Types

Check the registrant's Reps & Certs, if present, under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small business concern. Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the

SBA supplemental pages during registration.

Government Types

U.S. Local Government

County

Financial Information

Accepts Credit Card Payments

Yes

Debt Subject To Offset

No

EFT Indicator

CAGE Code

4JYZ9

Points of Contact

Electronic Business

Monita Scott 2625 N King Street

Flagstaff, Arizona 86004

United States

Tammy Rauschenbach 219 E Cherry AVE

Flagstaff, Arizona 86001

United States

Government Business

Michele Axlund 2625 N King Street

Flagstaff, Arizona 86004

United States

Chyenne Schmidt 219 E Cherry AVE

Flagstaff, Arizona 86001

United States

Service Classifications

NAICS Codes

Primary NAICS Codes NAICS Title

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Yasmine Sealy on Dec 21, 2021 at 03:53 PM COCONINO, COUNTY OF https://sam.gov/entity/VHPBMTKAPS83/coreData?status=Active Page 2 of 2

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