CTR066193_Debarment_Checks.pdf

773 KB Posted

Attached to
Master Agreement AZ|CTR066193
Contract number
CTR066193
Issued by
Arizona

About this file

Written by GovTribe AI ·

The documents represent various official registrations and compliance records for Chrysalis Shelter for Victims of Domestic Violence, Inc., a domestic nonprofit corporation based in Phoenix, Arizona. The records include entity information from the Arizona Corporation Commission, a System for Award Management (SAM.gov) registration, an Office of Inspector General (OIG) Exclusions Search, and a State Procurement Office listing. The organization is registered as an active, tax-exempt corporate entity incorporated on April 9, 1981, with its primary location at 2055 W Northern Avenue in Phoenix, Arizona.

The organization is registered for federal assistance awards with an active registration expiring on December 2, 2025. Its unique entity identifier is JG1MYXAQLNJ5, and it has a CAGE code of 5PPR4. Chrysalis Shelter is classified as a non-profit organization with a domestic shelter qualifier. The entity accepts credit card payments and has key contacts including Patricia Klahr (CEO) and Angela Holland (Financial Leader). The organization's website is www.noabuse.org, and it is located in Arizona's 08 congressional district. Notably, the organization has no active exclusions records and is authorized for public search in the SAM system.

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Other files

File Type Posted
CTR066193_-_COI__1_.pdf PDF
CTR066193_Contract_Amendment_2.pdf PDF
CTR066193_Contract_Documents.pdf PDF
CTR066193_GL_WOS_-_State_of_AZ.pdf PDF
Exhibit_F_-_ADES_Domestic_Violence_Services_Quarterly_Report.xlsx XLSX spreadsheet
CTR066193_-_COI_and_Endorsements.pdf PDF
CTR066193_Contract_Amendment_3.pdf PDF
CTR066193_Debarrment_Checks.pdf PDF
CTR066193_Itemized_Service_Budget.pdf PDF
Exhibit_G_-_Labor_Activity_Report.xlsx XLSX spreadsheet
CTR066193-COI.pdf PDF
CTR066193_Contract_Amendment_1.pdf PDF
CTR066193_Contract_Amendment_6.pdf PDF
CTR066193_Exhibit_G.pdf PDF
CTR066193_GL_WOS_-_State_of_AZ__DAAS__Services.pdf PDF
CTR066193_ISB.pdf PDF
CTR066193_SOW_rev_via_A4.pdf PDF
Exhibit_B_-_Itemized_Service_Budget.xlsx XLSX spreadsheet
Exhibit_E_-__ADES_Domestic_Violence_Services_Monthly_Report.xlsx XLSX spreadsheet
CTR066193-WCWOS.pdf PDF
CTR066193_Contract_Amendment_4.pdf PDF
CTR066193_Contract_Amendment_5.pdf PDF
CTR066193_DES_COI_Liability_25-26_exp6.20.26.pdf PDF
CTR066193_GL_AI_-_State_of_AZ.pdf PDF
CTR066193_WC_7-15-2025_exp7.1.26.pdf PDF
Exhibit_C_-_Certification_of_De_Minimis_Indirect_Cost_Rate.pdf PDF
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CHRYSALIS SHELTER FOR VICTIMS OF DOMESTIC

VIOLENCE, INC.

Unique Entity ID

JG1MYXAQLNJ5

CAGE / NCAGE

5PPR4

Purpose of Registration

Federal Assistance Awards Only

Registration Status

Active Registration

Expiration Date

Dec 2, 2025

Physical Address

2055 W Northern AVE

Phoenix, Arizona 85021-5157

United States

Mailing Address

2055 W. Northern

Phoenix, Arizona 85021-5157

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 08

State / Country of Incorporation

Arizona / United States

URL

www.noabuse.org

Registration Dates

Activation Date

Dec 3, 2024

Submission Date

Dec 2, 2024

Initial Registration Date

Sep 14, 2009

Entity Dates

Entity Start Date

Apr 9, 1981

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 Patricia Klahr on Dec 02, 2024 at 12:04 PM CHRYSALIS SHELTER FOR VICTIMS OF DOMESTIC VIOLENCE, INC.

Mar 24, 2025 07:19:54 PM GMT https://sam.gov/entity/JG1MYXAQLNJ5/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.

Other Entity Qualifiers

Domestic Shelter

Financial Information

Accepts Credit Card Payments

Yes

Debt Subject To Offset

No

EFT Indicator

CAGE Code

5PPR4

Points of Contact

Electronic Business

Angela Holland, Financial Leader 2055 W. Northern Avenue

Phoenix, Arizona 85021

United States

Government Business

PATRICIA KLAHR, CEO

2055 W. Northern Avenue

Phoenix, Arizona 85021

United States

Angela Holland, Financial Leader 2055 W. Northern Avenue

Phoenix, Arizona 85021

United States

Service Classifications

NAICS Codes

Primary NAICS Codes NAICS Title

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Patricia Klahr on Dec 02, 2024 at 12:04 PM CHRYSALIS SHELTER FOR VICTIMS OF DOMESTIC VIOLENCE, INC.

Mar 24, 2025 07:19:54 PM GMT https://sam.gov/entity/JG1MYXAQLNJ5/coreData?status=null Page 2 of 2

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