CTR050602 A5.pdf
PDF 869 KB Posted
- Attached to
- Master Agreement AZ|CTR050602
- Contract number
- CTR050602
- Issued by
- Arizona
About this file
This is a Contract Amendment (Amendment No. Five) issued by the Arizona Department of Health Services' Office of Procurement for Contract No. CTR050602, involving the Pima County Health Department as the contractor. The amendment is for the Health Start Program and is associated with the state of Arizona, specifically located in Phoenix, with Ryan Garcia listed as the Procurement Officer.
The contract amendment extends the current contract through July 5, 2025, which represents the fourth year of a five-year maximum extension. The total annual contract amount is $221,773.00, broken down across several budget categories including Personnel ($145,325.00), Employer-Related Expenses (ERE) ($39,237.00), Professional and Outside Services ($1,000.00), Travel Expenses ($10,350.00), Other Operating expenses ($5,700.00), and Indirect costs ($20,161.00). The contractor is authorized to transfer up to 10% (9.32%) between funded line items with prior written approval, and any transfers exceeding this threshold or to non-funded line items will require a contract amendment. Purchase of services is contingent upon ADHS issuing a signed Purchase Order specifying the authorized dollar amount.
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Text version
Gina Corwin
Digitally signed by Gina Corwin Date: 2024.05.30 15:52:56 -07'00'
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530
Phoenix, Arizona 85007
CONTRACT NO.: CTR050602 AMENDMENT NO.: 5
PROCUREMENT OFFICER:
RYAN GARCIA
Revised 04.29.2024
Price Sheet
ACCOUNT CLASSIFICATION AMOUNT
Personnel* $145,325.00
ERE* $39,237.00
Professional and Outside Services* $1,000.00
Travel Expenses (In-State)* $10,350.00
Other Operating* $5,700.00
Indirect (if Authorized) $20,161.00
TOTAL Annual Amount Not to Exceed $221,773.00
With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum of ten percent (9.32%) of the total budget amount between funded line items. Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (9.32%) 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.
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PIMA COUNTY
Unique Entity ID
JBMBVGUK5LF1
CAGE / NCAGE
31PJ4
Purpose of Registration
Federal Assistance Awards Only
Registration Status
Active Registration
Expiration Date
Dec 5, 2024
Physical Address
115 N Church AVE
2ND FLOOR, Suite 231
Tucson, Arizona 85701-1316
United States
Mailing Address
130 W Congress ST FL 6
Tucson, Arizona 85701-1317
United States
Business Information
Doing Business as
(blank)
Division Name
(blank)
Division Number
(blank)
Congressional District
Arizona 07
State / Country of Incorporation
(blank) / (blank)
URL
(blank)
Registration Dates
Activation Date
Dec 11, 2023
Submission Date
Dec 6, 2023
Initial Registration Date
Sep 20, 2004
Entity Dates
Entity Start Date
Jul 1, 1864
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.gov) 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 displayed in the responsibility/qualification section of SAM.gov. Maintaining an active registration in SAM.gov 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 JEANNETTE MONTANO on Dec 06, 2023 at 09:58 AM PIMA COUNTY
May 31, 2024 07:01:25 PM GMT https://sam.gov/entity/JBMBVGUK5LF1/coreData?status=null 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
Local Government Owned
Financial Information
Accepts Credit Card Payments
Yes
Debt Subject To Offset
No
EFT Indicator
CAGE Code
31PJ4
Points of Contact
Electronic Business
Andy Welch 97 E Congress ST.
1ST Floor
Tucson, Arizona 85701
United States
Jeannette Montano 97 E Congress
Tucson, Arizona 85701
United States
Government Business
Regina Kelly, GMI Director 97 E. Congress ST.
Tucson, Arizona 85701
United States
Sandy Rotter 97 W. Congress ST.
Tucson, Arizona 85701
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 JEANNETTE MONTANO on Dec 06, 2023 at 09:58 AM PIMA COUNTY
May 31, 2024 07:01:25 PM GMT https://sam.gov/entity/JBMBVGUK5LF1/coreData?status=null Page 2 of 2
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