CTR066189_Contract_Amendment_3.pdf

1 MB Posted

Attached to
Master Agreement AZ|CTR066189
Contract number
CTR066189
Issued by
Arizona

About this file

Written by GovTribe AI ·

This document is a contract amendment from the Arizona Department of Economic Security, specifically Amendment Three for Contract Number CTR066189, involving the Area Agency on Aging Region One Inc. The contract is labeled as a "Domestic Violence - Statewide" contract and pertains to services within Arizona. The amendment document originates from the Arizona Department of Economic Security, located in Phoenix, Arizona.

The amendment adds an initial Itemized Service Budget for the period of July 1, 2024 through June 30, 2025, with a total budget amount of $163,868.00. The amendment is being executed in accordance with the Special Terms and Conditions, Section 27, Levels of Service. All other requirements, specifications, terms, and conditions of the original contract remain unchanged. The amendment will be fully executed through electronic approval in an application system referred to as APP.

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CONTRACT AMENDMENT

Arizona Department of Economic Security

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

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR066189 Three (3)

DESCRIPTION/ LABEL: Domestic Violence - Statewide

CONTRACTOR NAME: Area Agency on Aging Region One Inc.

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions, Section 27., Levels of Service, the purpose of this amendment is to add the initial Itemized Service Budget for the period of July 1, 2024 through June 30, 2025 in the amount of $163,868.00.

Therefore, the initial Itemized Service Budget for the period of July 1, 2024 through June 30, 2025 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.

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AREA AGENCY ON AGING, REGION ONE,

INCORPORATED

Unique Entity ID

L72PL5CGJMQ9

CAGE / NCAGE

3Z9L4

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Nov 20, 2024

Physical Address

1366 E Thomas RD

STE 108

Phoenix, Arizona 85014-5739

United States

Mailing Address

1366 E Thomas RD, STE 108

Phoenix, Arizona 85014-5739

United States

Business Information

Doing Business as

AREA AGENCY ON AGING REGION ONE INC

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 03

State / Country of Incorporation

Arizona / United States

URL

http://www.aaaphx.org

Registration Dates

Activation Date

Nov 23, 2023

Submission Date

Nov 21, 2023

Initial Registration Date

Sep 3, 2004

Entity Dates

Entity Start Date

Nov 20, 1984

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

Corporate Entity (Tax Exempt)

Entity Type

Business or Organization

Organization Factors

(blank)

Last updated by Mary Lynn Kasunic on Nov 21, 2023 at 03:58 PM AREA AGENCY ON AGING, REGION ONE, INCORPORATED

Jul 24, 2024 06:02:13 PM GMT https://sam.gov/entity/L72PL5CGJMQ9/coreData?status=null Page 1 of 2

Profit Structure

Non-Profit Organization

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.

Financial Information

Accepts Credit Card Payments

Yes

Debt Subject To Offset

No

EFT Indicator

CAGE Code

3Z9L4

Points of Contact

Electronic Business

MARY LYNN KASUNIC, PRESIDENT & CEO

1366 East Thomas ROAD, Suite 108

Phoenix, Arizona 85014

United States

MARY LYNN KASUNIC 1366 East Thomas ROAD, Suite 108

Phoenix, Arizona 85014

United States

Government Business

MARY LYNN KASUNIC, PRESIDENT & CEO

1366 East Thomas ROAD, Suite 108

Phoenix, Arizona 85014

United States

MARY LYNN KASUNIC 1366 East Thomas ROAD, Suite 108

Phoenix, Arizona 85014

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

624120

NAICS Title

Services For The Elderly And Persons With Disabilities

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Mary Lynn Kasunic on Nov 21, 2023 at 03:58 PM AREA AGENCY ON AGING, REGION ONE, INCORPORATED

Jul 24, 2024 06:02:13 PM GMT https://sam.gov/entity/L72PL5CGJMQ9/coreData?status=null Page 2 of 2

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