CTR060124_FIS_WSEA_EBT_Services_Amendment_3_-_FE.pdf
PDF 1 MB Posted
- Attached to
- Master Agreement AZ|CTR060124
- Contract number
- CTR060124
- Issued by
- Arizona
About this file
This document is a Contract Amendment between the Arizona Department of Economic Security (ADES) and Fidelity National Information Services, LLC (FIS), part of the Western States EBT Alliance (WSEA). The amendment, numbered 03 to the original contract CTR060124, is a Customer Authorization (CA) specifically focused on the Electronic Benefit Transfer (EBT) services.
The amendment authorizes FIS to continue the special short-use food program (PEBT) for the 2022/2023 school year ending September 2023, targeting childcare children and school-going children on free/reduced meal programs. The pricing structure includes a $4.95 PEBT-Only Setup Fee and monthly fees ranging from $1.45 to $0.20 depending on the issuance schedule and benefit type. The contract covers various operational aspects such as using existing benefit types, file transfer processes, card issuance, and benefit distribution schedules for different semesters (Fall, Spring, Summer) across multiple months in 2023. Payment terms stipulate 100% of monthly fees will be invoiced and due with Arizona's monthly invoices, with additional provisions for card stock and storage fees.
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Text version
CONTRACT AMENDMENT
Arizona Department of Economic Security
1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007
CONTRACT NUMBER: AMENDMENT NUMBER:
CTR060124 03
DESCRIPTION/ LABEL: Electronic Benefit Transfer Services for Western States EBT Alliance (WSEA)
CONTRACTOR NAME: Fidelity National Information Services, LLC (FIS)
THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:
1. Pursuant to the Uniform Terms and Conditions, Section 5 Contract Changes, 5.1 Amendments, the purpose of this Contract Amendment is to include the following Customer Authorization (CA) Agreement:
a. No. EBTGOVS-13765 AZ CA PEBT 4/0
i. This CA is authorization for FIS to continue the special short use food program (PEBT) for the
2022/2023 school year ending September 2023 for childcare children and/or school-going children on free/reduced meal programs.
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.
Nila L. Henson
Procurement Manager
April 20, 2023
| CTR060124_FIS Participating Addendum_WSEA EBT Services_Amendment 3 |
| AZ CAGOVS-13765 PEBT 4.0 |
| 2023-04-20T14:38:11-0700 | |
| Henson, Nila L |
File details come from the government source that posted it. Updated .