CTR056041 IG ADLER MAYO A2 FE.pdf
PDF 291 KB Posted
- Attached to
- Master Agreement AZ|CTR056041
- Contract number
- CTR056041
- Issued by
- Arizona
About this file
This document is a Grant Amendment from the Arizona Department of Health Services (ADHS) Office of Procurement, located in Phoenix, Arizona, involving Mayo Clinic Arizona as the contractor. The amendment is for Grant No. CTR056041, Amendment No. 2, specifically related to an Investigator Grant (IG) for an individual named Adler.
The primary purpose of this amendment is to extend the grant period to June 30, 2024, as specified in the Grant Terms and Conditions, Provision Two (2), Section 2.2, Term Extension. All other provisions of the original grant remain unchanged. The document was signed electronically on August 3, 2023, by the contractor's representatives, including Charles H. Adler, M.D., Ph.D., and Julie C. Johnson, Operations Manager, and was countersigned by the ADHS Procurement Officer on August 11, 2023.
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Text version
GRANT
AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
GRANT NO.: CTR056041 AMENDMENT NO.: 2 Procurement Officer Kailee Gray
Investigator Grant (IG) – Adler
1. Effective upon signature by both parties, it is mutually agreed that the Grant referenced in this amendment is amended as follows:
1.1. Pursuant to the Grant Terms and Conditions, Provision Two (2), Grant Period, Section 2.2, Term Extension, the Grant is hereby extended to June 30, 2024.
ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY
Contractor hereby acknowledges receipt and acceptance of above 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 ADHS Procurement Office)
Contractor Signature
Contractor Signature Date
Authorized Signatory’s Name and Title
MAYO CLINIC ARIZONA
Contractor’s Name Procurement Officer Signature
ARI-290450-02
DocuSign Envelope ID: 1B18EAA8-8F65-4237-9DF2-C1E7BC92C666
8/3/2023
8/3/2023
Julie C. Johnson, Operations Manager
8/11/2023 javascript:window.parent.navigate(%22/media_461531632/Arizona_State_Seal.html%22);
| 2023-08-24T10:19:30-0700 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .