CTR063972 A1_EXECUTED w Debarments.pdf

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

CONTRACT NO.: CTR063972 AMENDMENT NO.: 1 PROCUREMENT OFFICER

Karla Varela

ACCELERATED NURSING PROGRAM COMPONENT B - SCHOLARSHIPS

Effective upon signature by both parties it is mutually agreed that the Contract referenced in this Amendment One (1) is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3), Contract Extensions 5 Year Maximum, the Contract is hereby extended through June 30, 2024; and

2. Pursuant to the Uniform Terms and Conditions, Provision Five (5), Contract Changes, Section 5.1, Amendments, the Contract is hereby revised with the following:

2.1 The Price List 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 Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

The ABOR for and on behalf of Northern Arizona University

Contractor’s Name Procurement Officer Signature

Monique B Harris

Digitally signed by Monique B Harris Date: 2023.10.03 17:30:06 -07'00'

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

CONTRACT NO.: CTR063972 AMENDMENT NO.: 1 PROCUREMENT OFFICER

Karla Varela

PRICE LIST

Account Classification Qty Unit Totals

Maximum Scholarship Award a Student can receive Total Scholarship funds NTE $5,963,241.00 1 Each $52,435.00

Scholarship Management Services Hourly Rate Total Costs NTE $1,281,603.00 1 Hour $462.00

ACCELERATED NURSING PROGRAM COMPONENT B - SCHOLARSHIPS

TOTAL CONTRACT NTE $7,244,844.00

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NORTHERN ARIZONA UNIVERSITY

Unique Entity ID

MXHAS3AKPRN1

CAGE / NCAGE

2F318

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Jan 6, 2024

Physical Address

601 S Knoles DR

Room 220

Flagstaff, Arizona 86011

United States

Mailing Address

601 S Knoles DR.

PO Box 4069

Flagstaff, Arizona 86011

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 01

State / Country of Incorporation

(blank) / (blank)

URL

(blank)

Registration Dates

Activation Date

Jan 10, 2023

Submission Date

Jan 6, 2023

Initial Registration Date

Dec 18, 2001

Entity Dates

Entity Start Date

Jan 1, 1899

Fiscal Year End Close Date

Jun 30

Immediate Owner

CAGE

(blank)

Legal Business Name

(blank)

Highest Level Owner

CAGE

(blank)

Legal Business Name

(blank)

Executive Compensation

Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of

P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant responded to the questions.

Proceedings Questions

Registrants in the System for Award Management (SAM.gov) respond to proceedings questions in accordance with FAR 52.209-7, FAR 52.209-9, or 2. C.F.R. 200 Appendix XII. Their responses are displayed in the responsibility/qualification section of SAM.gov. Maintaining an active registration in SAM.gov demonstrates the registrant responded to the proceedings questions.

Exclusion Summary

Active Exclusions Records?

No

SAM Search Authorization

I authorize my entity's non-sensitive information to be displayed in SAM public search results:

Yes

Entity Types

Business Types

Entity Structure

U.S. Government Entity

Entity Type

US State Government

Organization Factors

(blank)

Profit Structure

(blank)

Last updated by Wendy Swartz on Jan 06, 2023 at 12:00 PM NORTHERN ARIZONA UNIVERSITY

Oct 17, 2023 11:12:21 PM GMT https://sam.gov/entity/MXHAS3AKPRN1/coreData?status=null Page 1 of 3

Socio-Economic Types

Check the registrant's Reps & Certs, if present, under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small business concern. Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the

SBA supplemental pages during registration.

Government Types

U.S. State Government

Other Entity Qualifiers

Hispanic Servicing Institution

Educational Institution

State Controlled Institution of Higher Learning

School of Forestry

Financial Information

Accepts Credit Card Payments

Yes

Debt Subject To Offset

No

EFT Indicator

CAGE Code

2F318

Points of Contact

Electronic Business

Nicky Jurgens, Asst Director PO Box 4130

525 West Beaver ST

Flagstaff, Arizona 86011

United States

Thomas Champagne, Assoc VP PO Box 4130

525 West Beaver ST

Flagstaff, Arizona 86011

United States

Government Business

Nicky Jurgens, Asst Director PO Box 4130

525 West Beaver ST

Flagstaff, Arizona 86011

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

611310

NAICS Title

Colleges, Universities, And Professional Schools

111421 Nursery And Tree Production

541380 Testing Laboratories And Services

541519 Other Computer Related Services

541690 Other Scientific And Technical Consulting Services

541714 Research And Development In Biotechnology (Except

Nanobiotechnology)

541715 Research And Development In The Physical, Engineering, And Life

Sciences (Except Nanotechnology And Biotechnology)

541720 Research And Development In The Social Sciences And

Humanities

541990 All Other Professional, Scientific, And Technical Services

561410 Document Preparation Services

Product and Service Codes

Last updated by Wendy Swartz on Jan 06, 2023 at 12:00 PM NORTHERN ARIZONA UNIVERSITY https://sam.gov/entity/MXHAS3AKPRN1/coreData?status=null Page 2 of 3

PSC PSC Name

8730 Seeds And Nursery Stock

B504 Special Studies/Analysis- Chemical/Biological

B509 Special Studies/Analysis- Endangered Species: Plant/Animal

B529 Special Studies/Analysis- Scientific Data

B532 Special Studies/Analysis- Soil

R499 Support- Professional: Other

R707 Support- Management: Contract/Procurement/Acquisition Support

T013 Photo/Map/Print/Publication- Technical Writing

W066 Lease Or Rental Of Equipment- Instruments And Laboratory Equipment

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Wendy Swartz on Jan 06, 2023 at 12:00 PM NORTHERN ARIZONA UNIVERSITY https://sam.gov/entity/MXHAS3AKPRN1/coreData?status=null Page 3 of 3