CTR054521 Contract Amendment #6.pdf

COMPETITION IMPRACTICAL CONTRACT

AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007

CONTRACT NO.: CTR054521 AMENDMENT NO.: 6 Procurement Officer:

Ryan Garcia

Revised 06/24/2024

TB TREATMENT SERVICES

Effective May 1, 2025 it is mutually agreed that the Contract is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3) Contract Extensions (5 Year Maximum), the Contract is hereby extended through April, 30, 2026.

ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY

Contractor hereby acknowledges receipt and acceptance of this amendment and that a signed copy must be filed with the Procurement Office before the effective date.

The above referenced Contract Amendment is hereby executed this _____ day of __________ 20______ at Phoenix, Arizona

(To be filled out by Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

American Lung Association of Arizona

Contractor’s Name Chief Procurement Officer Signature or Designee

Gina Corwin

Digitally signed by Gina Corwin Date: 2025.05.22 11:13:02 -07'00'

Katie Hobbs | Governor Jennifer Cunico, MC | Director

150 North 18th Avenue, Suite 530, Phoenix, AZ 85007-3247 P | 602-542-1025 F | 602-542-0883 W | azhealth.gov

Health and Wellness for all Arizonans

Memorandum | Office of Procurement

Date: May 9, 2025

To: Memo to Procurement File

From: Ryan Garcia, Procurement Specialist

Regarding: CTR054521, TB Treatment Services

Subject: Amendment Six (6) - Extension

CTR054521, TB Treatment Services Program was established through a Competition Impracticable and became effective on May 1, 2021 for an initial one (1) year period, with the option to renew annually, not to exceed five (5) years.

Due to a program oversight the Procurement Request System request was not submitted in a timely manner. The PRS request was submitted April 4, 2025 with a Contract expiration date of April 30, 2025.

Due to this oversight, the contract expired prematurely. As the program requires ongoing services and the intent was to extend, it is in the best interest of the State to reinstate this Contract.

Prepared By: Ryan Garcia, Procurement Specialist Date

Approved By: Gina Corwin, CPPB, NIGP-CPP, Chief Procurement Officer Date

Ryan Garcia Digitally signed by Ryan Garcia Date: 2025.05.09 14:49:06 -07'00'

Gina Corwin Digitally signed by Gina Corwin Date: 2025.05.16 08:51:59 -07'00'

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AMERICAN LUNG ASSOCIATION

Unique Entity ID

KNWDMEVEDXL3

CAGE / NCAGE

8L399

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Jan 6, 2026

Physical Address

55 W Wacker DR STE 1150

Chicago, Illinois 60601-1796

United States

Mailing Address

55 W Wacker DR STE 1150

Chicago, Illinois 60601-1796

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Illinois 07

State / Country of Incorporation

Maine / United States

URL

(blank)

Registration Dates

Activation Date

Jan 8, 2025

Submission Date

Jan 6, 2025

Initial Registration Date

Apr 28, 1999

Entity Dates

Entity Start Date

Jan 1, 1904

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 Laura Scott on Jan 06, 2025 at 11:51 PM AMERICAN LUNG ASSOCIATION

May 27, 2025 04:39:53 PM GMT https://sam.gov/entity/KNWDMEVEDXL3/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

No

Debt Subject To Offset

No

EFT Indicator

CAGE Code

8L399

Points of Contact

Electronic Business

Laura Scott, CFO 3000 Kelly Lane

Springfield, Illinois 62711

United States

Government Business

Joy Meyer 3001 Gettysburg Road

Camp Hill, Pennsylvania 17011

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

813212

NAICS Title

Voluntary Health Organizations

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Laura Scott on Jan 06, 2025 at 11:51 PM AMERICAN LUNG ASSOCIATION

May 27, 2025 04:39:53 PM GMT https://sam.gov/entity/KNWDMEVEDXL3/coreData?status=null Page 2 of 2

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