CTR058310 A4 Pricing.pdf
PDF 103 KB Posted
- Attached to
- Master Agreement AZ|CTR058310
- Contract number
- CTR058310
- Issued by
- Arizona
About this file
This document is an Interagency Service Agreement (ISA) Amendment from the Arizona Department of Health Services (ADHS), Office of Procurement, located in Phoenix, Arizona. The amendment is associated with Agreement No. CTR058310 and is specifically Amendment No. 04, with Brittany Manuel listed as the Procurement Officer.
The amendment outlines a cost reimbursement contract with an annual price sheet for the period of January 1, 2026 through December 31, 2026. The total annual budget is set at $286,000.00, with line-item allocations including $10,000 for Personnel Services & ERE, $50,000 for Professional and Outside Services, $15,000 for Supplies, and $185,000 for Other Expenses. The contract includes a 10% indirect cost rate of $26,000. The contractor is permitted to transfer up to 50% of the total budget between line items with written approval from an ADHS program representative, with transfers exceeding 50% or involving non-funded line items requiring a formal Agreement Amendment.
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Text version
INTERAGENCY SERVICE AGREEMENT (ISA)
AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007
AGREEMENT NO.: CTR058310 AMENDMENT NO.: 04 Procurement Officer:
Brittany Manuel
Revised 04/08/2024
Cost Reimbursement Contract
Annual Price Sheet
January 1, 2026 – December 31, 2026
ACCOUNT CLASSIFICATION LINE-ITEM TOTALS
Personnel Services & ERE* $10,000
Professional and Outside Services* $50,000
Travel Expenses* $0
Equipment* $0
Supplies* $15,000
Other Expenses* $185,000
INDIRECT COSTS* (10%) $26,000.00
Total Annual Not to Exceed: $286,000.00
If applicable, the Contractor is authorized to transfer up to a maximum of fifty percent 50% of the total budget amount between line items with the written approval from an ADHS program representative.
Transfers exceeding fifty percent 50% or to a non-funded line item shall require an Agreement Amendment.
*Indicated indirect rate calculation
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