CTR057882 A3.pdf

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

CONTRACT NO.: CTR057882 AMENDMENT NO.: THREE (3) PROCUREMENT OFFICER:

NATHANIEL THOMAS

Revised 04.29.2024

Certified Paper Stock and Warehousing for Birth and Death Certificates

Effective upon signature by both parties it is mutually agreed that the Contract is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3), Contract Extension Five (5) Year Maximum, the Contract is hereby extended through November 7, 2025.

2. Pursuant to the Uniform Terms and Conditions, Provision Five (5), Contract Changes, Section 5.1, Amendments, the Price Sheet is revised and replaced.

ALL CHANGES ARE REFLECTED IN RED

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 Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

VeriTrace Inc.

Contractor’s Name Procurement Officer Signature

10/10/2024

Wayne P. Krueger Jr. V.P. Operations

Jacqueline S.

Ortega-Avila

Digitally signed by Jacqueline S. Ortega-Avila Date: 2024.10.11 16:22:55 -07'00'

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

CONTRACT NO.: CTR057882 AMENDMENT NO.: THREE (3) PROCUREMENT OFFICER:

NATHANIEL THOMAS

Revised 04.29.2024

PRICE SHEET

DESCRIPTION QTY UNIT AMOUNT

Carton of Certified Paper as required in the Scope of Work. Cartons are to contain 2,000 certified sheets with engraved intaglio printed blue ink border based on 500,000 sheets.

1 Carton $655.00

VERITRACE, INC

Unique Entity ID

Q4SXZ623PRH3

CAGE / NCAGE

7WLG1

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Oct 9, 2024

Physical Address

9487 Dry Fork RD

Harrison, Ohio 45030-2900

United States

Mailing Address

9487 Dry Fork RD

Harrison, Ohio 45030-2900

United States

Business Information

Doing Business as

VERITRACE INC

Division Name

(blank)

Division Number

(blank)

Congressional District

Ohio 08

State / Country of Incorporation

Illinois / United States

URL

https://www.veritrace.com

Registration Dates

Activation Date

Oct 11, 2023

Submission Date

Oct 10, 2023

Initial Registration Date

Jun 28, 2017

Entity Dates

Entity Start Date

Aug 25, 2015

Fiscal Year End Close Date

Dec 31

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 (Not Tax Exempt)

Entity Type

Business or Organization

Organization Factors

Subchapter S Corporation

Profit Structure

For Profit Organization

Last updated by Patricia Dehne on Oct 10, 2023 at 04:52 PM VERITRACE, INC

Jul 22, 2024 10:49:49 PM GMT https://sam.gov/entity/Q4SXZ623PRH3/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

7WLG1

Points of Contact

Electronic Business

Brian D'Angelo, Security Projects Mgr 9487 Dry Fork RD

Harrison, Ohio 45030

United States

Government Business

Brian D'Angelo, Security Projects Mgr 9487 Dry Fork RD

Harrison, Ohio 45030

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

323111

NAICS Title

Commercial Printing (Except Screen And Books)

323120 Support Activities For Printing

541330 Engineering Services

541614 Process, Physical Distribution, And Logistics Consulting Services

Product and Service Codes

PSC PSC Name

T016 Photo/Map/Print/Publication- Audio/Visual

T099 Photo/Map/Print/Publication- Other

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Patricia Dehne on Oct 10, 2023 at 04:52 PM VERITRACE, INC

Jul 22, 2024 10:49:49 PM GMT https://sam.gov/entity/Q4SXZ623PRH3/coreData?status=null Page 2 of 2

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Katie Hobbs | Governor Jennifer Cunico, MC | Director

150 North 18th Avenue, Suite 500, 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: October 1, 2024

To: Procurement File

From: Nathaniel Thomas, Procurement Specialist

Regarding: CTR057882 – VeriTrace Inc.

Subject: Determination of Fair and Reasonable Price (R2-7-702)

In accordance with Arizona Revised Statute (ARS) § 41-2534 R2-7-702 Determination of Fair and Reasonable Price, the price increase request by VeriTrace, Inc. has been determined to be fair and reasonable based upon the following factors:

VeriTrace Inc was awarded the current contract in November of 2021 via Request for Proposal (RFP) for Certified Paper Stock and Warehousing for Birth and Death Certificates and has had prior increases to line item Two (2) in 2022 under Amendment One (1) and in 2023 under Amendment Two (2). They have made a request to increase line item Two (2) by $15.00 per box of 2,000 due to increases in shipping and fuel costs.

LINE ITEM LINE ITEM DESCRIPTION QTY UOM OLD

PRICE

NEW

PRICE

Carton of Certified Paper as required in the Scope of Work. Cartons are to contain 2,000 certified sheets with engraved intaglio printed blue ink border based on 500,000 sheets.

1 Carton $640.00 $655.00

This updated pricing structure reflects the shipping and fuel cost which is a 0.23% increase in price as there is no changes in raw materials. This is a 19.5% increase from the original amount of $584.00 per box of 2000.

Current pricing is $0.32 each, shipping and warehouse included. That’s $640.00 per box of 2000. The new price moves to $0.3275 which captures the additional shipping costs. That’s $655.00 per box of 2000. The document price is $0.2976, the shipping price is $0.0299. Please refer to attached documentation from Supplier as their justification for the increase.

Therefore, it is in the best interest of the State to approve this price increase to ensure the continuation of vital services required by the ADHS Bureau of Vital Records.

Prepared by: Nathan Thomas, Procurement Specialist Date

Approved by: Gina Corwin, Chief Procurement Officer Date

Nathaniel Thomas Digitally signed by Nathaniel Thomas Date: 2024.10.01 10:05:45 -07'00'

Gina Corwin Digitally signed by Gina Corwin Date: 2024.10.01 10:39:23 -07'00'

9487 Dry Fork Road Harrison, OH 45030 USA

Ph. +1 513.202.0790 Fax +1 513.202.0593 www.veritrace.com

August 12, 2024

Arizona Department of Health Services Attn: Nathaniel Thomas 150 N. 18th Avenue, Suite 530 Phoenix, AZ 85007

Reference: Contract Amendment / Extension Contract NO: CTR057882

Dear Mr. Thomas, The State currently has an estimated 5 months’ supply secured in our vault ready for future call outs. This inventory carries the State beyond the contract expiration without an extension. We have also accepted/received PO 00000685840 for 500,000 vital record documents which we will honor under the current terms and pricing. That gives you an estimated 11 to 12 months’ supply once they are produced and placed in the vault.

Although raw materials have somewhat stabilized, we continue to see increases in shipping/fuel costs. Therefore, we are requesting the following as part of the amended contract/extension.

Current pricing is $0.32 each shipping and warehouse included. That’s $640.00 per box of 2000

The new price moves to $0.3275 which captures our additional shipping costs. That’s $655.00 per box of 2,000.

Doc Price: $0.2976 Ship Price: $0.0299 Total Price $0.3275 each

We consider it a privilege to partner with The Great State of Arizona and look forward to continuing our relationship. Unlike raw materials where we receive increase letters that’s not the case with shipping as rates just go up. It’s basically like going to a gas pump you don’t receive prior notice. I have asked the plant if they had anything tangible to show. In the event they go in the downward direction prior to the next PO we will communicate that to the State. I anticipate that to be around July of 2025.

Thank you for your consideration

Best Regards, James D. Columbus V.P. Document Security

CTR057882 A3 - Pricing Determination - Executed

Veritrace Letter to ADHS