CTR052592_Contract_Amendment_10.pdf
PDF 910 KB Posted
- Attached to
- Master Agreement AZ|CTR052592
- Contract number
- CTR052592
- Issued by
- Arizona
About this file
This document is a Contract Amendment issued by the Arizona Department of Economic Security (DES) for Contract Number CTR052592, Amendment Number Ten (10), with Community Food Bank, Inc. The amendment pertains to the Hunger Relief Program – Commodity Senior Food Program (CSFP), a state-level contract serving senior populations in Arizona.
The amendment extends the contract term from July 1, 2025 through September 30, 2025 and adds a new requirement for the contractor to maintain CSFP Recipient Organization data with Vivery.org. Specifically, the contractor must update distribution site/agency information, including the site name, distribution address, dates and times of distributions, and public contact information. All other contract terms and conditions remain unchanged. The document includes supplementary supporting documentation such as the contractor's System for Award Management (SAM) registration, which confirms Community Food Bank, Inc. is a non-profit organization based in Tucson, Arizona, with an active registration valid through February 5, 2026.
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CONTRACT AMENDMENT
Arizona Department of Economic Security
1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007
CONTRACT NUMBER: AMENDMENT NUMBER:
CTR052592 Ten (10)
DESCRIPTION/ LABEL:
Hunger Relief Program – Commodity Senior Food Program (CSFP)
CONTRACTOR NAME: Community Food Bank, Inc.
THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:
1. In accordance with the Special Terms and Conditions, Section 12., Contract Term and Option to Extend, the Contract term is extended from July 1, 2025 through September 30, 2025.
2. In accordance with the Uniform Terms and Conditions, Section 5., Contract Changes, the Scope of
Work is being revised as follows:
Scope of Work, Section 6. Contractor Requirements, Subsection 6.3.2 is added as follows:
6.3.2 Maintain CSFP Recipient Organization (aka distribution site or agency) data with Vivery.org.
CSFP distribution site/agency information must, at a minimum, include the distribution site/agency name, distribution address, dates and time of CSFP distributions(s), and public contact information.
ALL OTHER REQUIREMENTS, SPECIFICATIONS, AND TERMS AND CONDITIONS REMAIN UNCHANGED
ACKNOWLEDGEMENT AND AUTHORIZATION
This Amendment shall be fully executed by means of electronic approval in APP.
COMMUNITY FOOD BANK, INC
Unique Entity ID
VJ77ET83ALV5
CAGE / NCAGE
3R5M2
Purpose of Registration
Federal Assistance Awards Only
Registration Status
Active Registration
Expiration Date
Feb 5, 2026
Physical Address
3003 S Country Club RD
Tucson, Arizona 85713-4082
United States
Mailing Address
3003 S Country Club RD
Tucson, Arizona 85713-4082
United States
Business Information
Doing Business as
(blank)
Division Name
(blank)
Division Number
(blank)
Congressional District
Arizona 07
State / Country of Incorporation
Arizona / United States
URL
http://www.communityfoodbank.org
Registration Dates
Activation Date
Feb 7, 2025
Submission Date
Feb 5, 2025
Initial Registration Date
Mar 5, 2004
Entity Dates
Entity Start Date
Aug 20, 1975
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
Corporate Entity (Tax Exempt)
Entity Type
Business or Organization
Organization Factors
(blank)
Profit Structure
Non-Profit Organization
Last updated by NADIA KHATIB on Feb 05, 2025 at 02:08 PM COMMUNITY FOOD BANK, INC
Jun 24, 2025 05:02:46 PM GMT https://sam.gov/entity/VJ77ET83ALV5/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.
Financial Information
Accepts Credit Card Payments
Yes
Debt Subject To Offset
No
EFT Indicator
CAGE Code
3R5M2
Points of Contact
Electronic Business
Shanika Noel 3003 S Country Club Road
Tucson, Arizona 85713
United States
Government Business
Shanika Noel 3003 S. Country Club RD
Tucson, Arizona 85713
United States
Past Performance
Hannah DeAlto, Mrs.
3003 S. Country Club RD
Tucson, Arizona 85713
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 NADIA KHATIB on Feb 05, 2025 at 02:08 PM COMMUNITY FOOD BANK, INC
Jun 24, 2025 05:02:46 PM GMT https://sam.gov/entity/VJ77ET83ALV5/coreData?status=null Page 2 of 2
| CTR052592 Contract Amendment 10.pdf |
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