CTR062833_Contract_Amendment_2.pdf

CONTRACT AMENDMENT

Arizona Department of Economic Security

1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR062833 Two (2)

DESCRIPTION/ LABEL: Homeless Youth Street Outreach and Drop-In Center Services

CONTRACTOR NAME: Native American Connections, Inc.

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

Pursuant to the ADES Special Terms and Conditions, Section 26, Levels of Service, the purpose of this amendment is to add the initial contract reimbursement ceiling for the period of July 1, 2023 through June 30, 2024 in the amount of $483,746.00.

Therefore, the Itemized Service Budget for the period of July 1, 2023 through June 30, 2024 is added and attached.

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.

TOTAL FTE Level (i.e., 1.0, 0.5, 0.25)

Service Code (O or D) Position Title TOTAL COST ADES COST

2 O Outreach Driver 90,000.00 90,000.00

2 D Case Manager 90,000.00 90,000.00

2 O Outreach & Engagement Specialist 90,000.00 90,000.00

ERE D ERE 25% of gross salary 22,500.00 22,500.00

ERE O ERE 25% of gross salary 45,000.00 45,000.00

5 337,500.00 337,500.00

Service Code (O or D) Basis TOTAL COST ADES COST

O Cell phone service/usage, food & water, fuel, hygiene items, insurance, vehicle lease, water 104,738.00 104,738.00

116,238.00 116,238.00

Service Code (O or D) Basis TOTAL COST ADES COST

29,408.00 29,408.00

Basis TOTAL COST ADES COST

HMIS License, laptop 600.00 600.00

TOTAL:

3) TOTAL DROP-IN CENTER OPERATIONS EXPENSES

Maintenance, rent, security, fuel, equipment, insurance, utilities, phones, internet, shower, laundry, storage lockers, pet cages, furnishings, food, cell phone charging stations, staff training, supplies necessary for operation of a Drop-in Center.

TOTAL:

4) HMIS EXPENSES

Purchasing or leasing computer system equipment, obtaining technical support; paying a portion of utilities, and high-speed data transmission necessary to operate or contribute data to the HMIS; paying salaries for operating HMIS, i.e. data entry, monitoring and reviewing data quality, and data analysis

Food, Metro passes, Hygiene items, water

TOTAL:

2) TOTAL ESSENTIAL CLIENT SERVICES FOR STREET OUTREACH AND/OR DROP-IN CENTER

Case Management, child care, education services, employment assistance (i.e., fingerprint clearnance card, uniforms, ID), life skills training, transportation, mileage, vehicle lease (vehicles cannot be purchased with these funds), emergency health services, emergency mental health services, hygiene items, food, water, pet food, clothing, cell phone service/usage charges, and services for special populations (e.g., services for people living with HIV/AIDS and victim services). These are non-employee expenses.

11,500.00 11,500.00D

Equipment leases, laundry supplies, maintenance, operation supplies, shower supplies, utilitiesD 29,408.00 29,408.00

CONTRACT NUMBER: CTR062833CONTRACT PERIOD: 07/01/2023 - 06/30/2024

SERVICE CODES: O = Street Outreach D = Drop-in Center

1) TOTAL PERSONNEL & EMPLOYEE RELATED EXPENSES FOR DIRECT SERVICES (One Service Code Per Line) Compensation directly related to carrying out the activities of the identified Service Code as well as other costs such as insurance, workers compensation, etc.

EXHIBIT A

Homeless Youth Outreach and Drop-in Center Services

PROPOSED ITEMIZED SERVICE BUDGET

CONTRACT SERVICE PROVIDED: HML Youth Street Outreach and Drop-In Center Services ORGANIZATION: Native American Connections

TOTAL: 600.00 600.00

Indirect Cost Rate (i.e. 10% de minimus rate or

Federally negotiated rate)

Service Code (O or D) Basis TOTAL COST ADES COST

0.00 0.00

0.00 0.00

483,746.00 483,746.00

TOTAL COST ADES COST

6) 329,738.00 329,738.00

7) 153,408.00 153,408.00

8) Calculate total HMIS COST 600.00 600.00

9) TOTAL COSTS BY SERVICE CODES: 483,746.00 483,746.00

* If red, ensure the total matches the Total Cost above

* If red, ensure the total matches the ADES Cost above

10) REVENUE SOURCES: TOTAL COST ADES COST

ADES-HOMELESS 483,746.00 483,746.00

Government Funding - City

Government Funding - County

Gov. Funding - Federal

Foundation & Corporate Support

United Way

Contributions / Donations

Special Events / Fundraising

Legacies / Bequests / Investments

Program Service Fees & Reimbursements

In-Kind Support

Other Revenue*

* Identify Other Revenue Sources Here TOTAL REVENUE: 483,746.00 483,746.00 Bingo Proceeds

Manually Calculate Total Street Outreach (O) COST

Manually Calculate Calculate Total Drop-in Center (D) COST

Government Funding – State (Do not include ADES Homeless Program funding listed above)

5) INDIRECT COSTS

Costs incurred for the benefit of multiple programs, functions, or other cost objectives, and therefore, cannot be identified readily and specifically with a particular program or other cost objective. Indirect costs typically support administrative overhead functions such as fringe benefits, accounting, payroll, purchasing, facilities management, utilities, etc. If the subrecipient elects to use a federally negotiated indirect cost rate, they must provide a copy of the rate agreement with the ISB. If the federally approved indirect cost rate changes or is allowed to expire within the contract period, the subrecipient must notify DES of the changes. If the subrecipient elects to use the 10% de Minimus rate for indirect costs, they must complete and submit the Exhibit B Certification of De Minimus Indirect Cost Rate form.

TOTAL:

Total Costs by Above Budget Categories