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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Other files

File Type Posted
Attachment 01 Request for Proposals Signature Page v.2.pdf PDF
Attachment 02 SNAP Cash Requirements v.2.docx DOCX document
Attachment 04 and 05 Written Inquiry Responses.docx DOCX document
Attachment 09 SNAP Cash Interfaces.pdf PDF
CTR060124_FIS_WSEA_EBT_Services_Amendment_2_-_FE.pdf PDF
FIS Waiver of Subrogation GL.pdf PDF
US GCL Additional Insured.pdf PDF
Attachment 02 and 03 Written Inquiry Responses.docx DOCX document
Attachment 07 WSEA Waivers.docx DOCX document
Attachment 11 Alaska DHSS Sample Security Authorization.pdf PDF
Attachment 12 Written Inquiry Responses.docx DOCX document
CTR060124_FIS_WSEA_EBT_Services_Amendment_01-FE.pdf PDF
State of Arizona.pdf PDF
1 WSEA EBT Services RFP v.8.4.docx DOCX document
1 WSEA RFP Written Inquiry Responses.docx DOCX document
Attachment 04 WIC Requirements v.2.docx DOCX document
Attachment 08 State Contract Terms and Conditions v.2.pdf PDF
Attachment 08 Written Inquiry Responses - Idaho.docx DOCX document
Attachment 10 WIC Interface Configurations.pdf PDF
Attachment 12 WSEA EBT Pricing Schedules v.2.docx DOCX document
Attachment 13 Federal Procurement Provisions.docx DOCX document
CTR060124-Contract_Documents.pdf PDF
CTR060124_FISParticipatingAddendum_WSEAEBTServices_Amendment4.pdf PDF
SPO_Approval_to_Request_to_Enter_Co-op_and_Contract_Beyond_5_years_-_WSEA_EBT_7..pdf PDF
CTR060124_COI_2026-2-1_Cyber__2026-4-1_CGL_AL_WC.pdf PDF
Addendum 1 Written Inquiries Responses re WSEA Supplemental Call Center Statistics Tables.docx DOCX document
Attachment 03 SNAP Cash Written Responses.docx DOCX document
Attachment 05 WIC Written Responses v.2.docx DOCX document
Attachment 06 ALERT AMA STARS and REDE file formats.pdf PDF
Attachment 08 Written Inquiry Responses.docx DOCX document
Attachment_A_-FIS_Cost_Proposal.pdf PDF
Attachment_B_-_FIS_Technical_Proposal.pdf PDF
CTR060124-Debarrment_Checks_1.27.23.pdf PDF
CTR060124_A5_FE_4.14.25.pdf PDF
FIS Waiver of Right to Recover WC.pdf PDF
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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 .