CTR057399_Contract_Amendment_8.pdf

624 KB Posted

Attached to
Master Agreement AZ|CTR057399
Contract number
CTR057399
Issued by
Arizona

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Written by GovTribe AI ·

This document is a Contract Amendment issued by the Arizona Department of Economic Security, specifically Amendment Eight to Contract Number CTR057399. The contract is with Maricopa County Special Health Care District, doing business as Valleywise Health Grants, for the Refugee Program-Health Promotion.

The amendment adds an Itemized Service Budget for the period of October 1, 2025, through September 30, 2026, with a total contract reimbursement ceiling of $250,000. The budget breakdown includes $150,378.79 for Personnel and Employee Related Expenses (ERE), $1,500.00 for Travel, and $50,000.00 for Indirect Costs. The revenue source is the ADES Refugee Program, with the total allocation matching the total costs. The budget primarily supports a CHN (Community Health Nurse) and an Administrative Assistant, with mileage reimbursement included, and indirect cost rates ranging from 25.00% to 25.50% across different cost categories.

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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:

CTR057399 Eight [8]

DESCRIPTION/ LABEL: Refugee Program-Health Promotion

CONTRACTOR NAME: Maricopa County Special Health Care District, DBA Valleywise Health Grants

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions, Section 28, Levels of Service, the purpose of this amendment is to add the Itemized Service Budget for the period of October 1, 2025, through September 30, 2026. The contract reimbursement ceiling is $250,000.

The Itemized Service Budget is attached as part of this amendment.

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.

ITEMIZED SERVICE BUDGET

File details come from the government source that posted it. Updated .