CTR061468 A3.pdf

INTERAGENCY SERVICE AGREEMENT (ISA)

AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

AGREEMENT NO.: CTR061468 AMENDMENT NO.: THREE (3) Procurement Officer:

Kristine Yaw

Revised 04/08/2024

UNIVERSITY OF ARIZONA RURAL TRANSFER LINE

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

1. Pursuant to the Uniform Terms and Conditions, Provision Two (2) Renewal of Agreement, the agreement is hereby extended through June 30, 2025.

2. Pursuant to the Uniform Terms and Conditions, Provision Twelve (12), Miscellaneous, Section 12.4, the Agreement is hereby amended as follows:

2.1. The Price Sheet is revised and replaced.

2.2. Exhibit B – 2 CFR 200.332 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 ADHS Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

Arizona Board of Regents, on behalf of the University of Arizona

Contractor’s Name Procurement Officer Signature

Elisha Johnson, JD., Sr. Director, Clinical Trials and Contracting

6/28/2024 javascript:window.parent.navigate(%22/media_461531632/Arizona_State_Seal.html%22);

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

AGREEMENT NO.: CTR061468 AMENDMENT NO.: THREE (3) Procurement Officer:

Kristine Yaw

Revised 04/08/2024

PRICE SHEET

July 1, 2024 to June 30, 2025

FOR BUDGET PURPOSES

Maintain AzREACH line for an additional year (July 2024 - June 2025)

Quarterly Invoices with supporting documentation to support costs incurred up to the amount indicated

Blackbox Management Blackbox Analytics, Marketing & Conferences, RN Dir, Informatics Lead, Exec Oversight

Phones Zoom Phone and e-fax

Staffing Hire UA REACH Staff Temp Labor

Equipment & Supplies PC-Equipment (15 FTEs)

Space Adjustments to PC

PC Oversight

4 quarterly payments

$325,000.00

TOTAL ANNUAL NOT TO EXCEED $1,300,000.00

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ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

AGREEMENT NO.: CTR061468 AMENDMENT NO.: THREE (3) Procurement Officer:

Kristine Yaw

Revised 04/08/2024

EXHIBIT B - 2 CFR 200.332

Workforce Development § 200.332 Requirements for pass-through entities.

All pass-through entities must:

(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass-through entity must provide the best information available to describe the Federal award and subaward.

Prime Awardee: Arizona Department of Health Services

UEI # QMWUG1AMYF65

Federal Award Identification (Grant Number): 1 NU90TP922172-01-00

Subrecipient name (which must match the name associated with its unique entity identifier): University of Arizona

Subrecipient's unique entity identifier (UEI#): ED44Y3W6P7B9 Federal Award Identification Number (FAIN, sometimes it’s the same as the Grant Number): NU90TP922172 Federal Award Date (see the definition of Federal award date in §

200.1 of this part) of award to the recipient by the Federal agency; 05/19/2020

Subaward Period of Performance Start and End Date; 07/01/2021–06/30/2025

Subaward Budget Period Start and End Date: 07/01/2021–06/30/2025

Amount of Federal Funds Obligated by this action by the pass-through entity to the subrecipient (this is normally the contract amount): $1,300,000.00

Total Amount of Federal Funds Obligated to the subrecipient by the pass-through entity including the current financial obligation (how much is available for contracts): $1,300,000.00

Total Amount of the Federal Award committed to the subrecipient by the pass-through entity $1,300,000.00

Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA)

Cooperative Agreement for Emergency Response:

Public Health Crisis Response – 2018: COVID-19 Crisis Funding for Workforce Development

Name of Federal awarding agency, pass-through entity, and contact information for awarding official of the Pass-through entity CDC Assistance Listings number and Title; the pass-through entity must identify the dollar amount made available under each Federal award and the Assistance Listings Number at time of disbursement:

93.354 – Cooperative Agreement for Emergency Response – Public Health Crisis Response - 2018

Identification of whether the award is R&D No Indirect cost rate for the Federal award (including if the de minimis rate is charged) per § 200.414 10% javascript:window.parent.navigate(%22/media_461531632/Arizona_State_Seal.html%22);