CTR057882 A4.pdf
PDF 502 KB Posted
- Attached to
- Master Agreement AZ|CTR057882
- Contract number
- CTR057882
- Issued by
- Arizona
About this file
This document is a Contract Amendment issued by the Arizona Department of Health Services, Office of Procurement, for VeriTrace Inc., a commercial printing and logistics services company. The amendment extends Contract No. CTR057882, specifically for Certified Paper Stock and Warehousing for Birth and Death Certificates. The contract amendment is signed by the Procurement Officer and the contractor's authorized representative, with Amendment Number Four (4) extending the contract through November 7, 2026.
VeriTrace Inc. is a for-profit Subchapter S Corporation based in Harrison, Ohio, with active registrations in the System for Award Management (SAM) and the Ohio Secretary of State's office. The company's primary NAICS codes include Commercial Printing, Support Activities for Printing, Engineering Services, and Process/Physical Distribution and Logistics Consulting Services. The contract appears to be for specialized printing and warehousing services related to vital records documentation, with the current amendment providing a contract extension under the original contract's Special Terms and Conditions, specifically Provision Three (3) regarding Contract Extension, which allows for a maximum 5-year extension period.
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Text version
REQUEST FOR PROPOSAL
CONTRACT AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
CONTRACT NO.: CTR057882 AMENDMENT NO.: FOUR (4)
PROCUREMENT OFFICER:
MICHELLE FINK, CPPB
Revised 06.18.2024
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 (5 Year Maximum) the Contract is hereby extended through November 7, 2026.
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
VeriTrace Inc.
Procurement Officer Signature
VERITRACE, INC
Unique Entity ID
Q4SXZ623PRH3
CAGE / NCAGE
7WLG1
Purpose of Registration
All Awards
Registration Status
Active Registration
Expiration Date
Sep 30, 2025
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 2, 2024
Submission Date
Sep 30, 2024
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 Sep 30, 2024 at 04:27 PM VERITRACE, INC
Mar 20, 2025 08:40:45 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 Sep 30, 2024 at 04:27 PM VERITRACE, INC
Mar 20, 2025 08:40:45 PM GMT https://sam.gov/entity/Q4SXZ623PRH3/coreData?status=null Page 2 of 2
Entity#:
Filing Type:
Original Filing Date:
Location:
Business Name:
Status:
Exp. Date:
4211119
FOREIGN CORPORATION
07/19/2018
VERITRACE, INC
Active
Agent/Registrant Information
CT CORPORATION SYSTEM
4400 EASTON COMMONS WAY, SUITE 125
COLUMBUS OH 43219
07/19/2018 Active
Filings
Filing Type Date of Filing Document ID
FOREIGN LICENSE/FOR-PROFIT 07/19/2018 201820002088
Thu Mar 20 2025
UNITED STATES OF AMERICA
STATE OF OHIO
OFFICE OF SECRETARY OF STATE
I, Frank LaRose, Secretary of State of the State of Ohio, do hereby certify that this is a list of all records approved on this business entity and in the custody of the Secretary of State.
Witness my hand and the seal of the Secretary of State at Columbus, Ohio this 20th of March, A.D. 2025
Ohio Secretary of State
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| CTR057882 A4 Executed |
| EntityInformation_20250320-014043 |
| Ohio Corporations Commission_VeriTrace |
| OIG Search Results |
File details come from the government source that posted it. Updated .