CTR066290_Contract_Amendment_4.pdf

CONTRACT AMENDMENT

Arizona Department of Economic Security

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

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR066290 Four (4)

DESCRIPTION/ LABEL: Housing Support Services – Pima County and Balance of State

CONTRACTOR NAME: Old Concho Community Assistance Center

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

1. In accordance with the Special Terms and Conditions, Section 13.0, Contract Term and Option to Extend, the contract term is extended from July 1, 2025, through June 30, 2026.

2. In accordance with the Uniform Terms and Conditions, Section 5.0, Contract Changes, Subsection 5.1

Amendments, the Scope of Work, Section 8, Reporting Requirements, subsection 8.2.10 is deleted in its entirety.

3. In accordance with the Uniform Terms and Conditions, Section 5, Contract Changes, the Special Terms and

Conditions Section 6, Background Checks for Employment through Central Registry is being revised and replace in its’ entirety, as follows:

6. Background Checks for Employment through the Central Registry.

If providing direct services to children or vulnerable adults, the following shall apply:

6.1 The provisions of A.R.S. § 8-804 (as may be amended) are hereby incorporated in its entirety as provisions of this Contract.

6.2 Central Registry Background Checks are processed through the Arizona Centralized Backgrounds Checks (CBC) portal (https://cbc.az.gov/). Contractor’s employee, subcontractor, prospective employee or volunteer of the contractor or subcontractor who provide direct services to children or vulnerable adults requiring assistance in the registration process or navigating the CBC portal may find information on the Arizona Department of Economic Security website, Arizona Centralized Background Checks web portal (https://des.az.gov/cbc).

6.3 Before being employed or volunteering in a position that provides direct services to children or vulnerable adults, persons shall certify within the CBC portal to obtain a completed certification. The Contractor shall keep the certification on file for each employee, prospective employee, or volunteer whether an allegation of abuse or neglect was made against them and was substantiated. The certification shall remain confidential.

6.4 Central Registry Background Check will be used as a factor to determine qualifications for positions that provide direct service to children or vulnerable adults for:

6.4.1 Any person who applies for a contract with this State and that person’s employees;

6.4.2 All employees of a contractor;

6.4.3 A subcontractor of a contractor and the subcontractor’s employees; and

6.4.4 Prospective employees of the contractor or subcontractor at the request of the prospective employer.

https://cbc.az.gov/ https://des.az.gov/cbc

6.5 Volunteers who provide direct services to children or vulnerable adults shall complete a Central Registry Background Check which is to be used as a factor to determine qualifications for volunteer positions.

6.6 A person who is disqualified because of a Central Registry Background Check may apply to the Board of

Fingerprinting for a Central Registry exception pursuant to A.R.S. § 41-619.57. A person who is granted a Central Registry exception pursuant to A.R.S. § 41-619.57 is not entitled to a contract, employment, licensure, certification or other benefit because the person has been granted a Central Registry exception.

6.7 If the Central Registry Background Check specifies any disqualifying act and the person does not have a

Central Registry exception, the person shall be prohibited from providing direct services to ADES clients.

6.8 The Contractor shall require each employee to submit a Central Registry Background Check, maintain and retain certifications in a confidential file for five (5) years after termination of this Contract.

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.

OLD CONCHO COMMUNITY ASSISTANCE CENTER INC

Unique Entity ID

HWLXHJGJFC19

CAGE / NCAGE

6TRG3

Purpose of Registration

Federal Assistance Awards Only

Registration Status

Active Registration

Expiration Date

Mar 3, 2026

Physical Address

35432 HWY 180A

Concho, Arizona 85924

United States

Mailing Address

P.O. Box 50

Concho, Arizona 85924-0050

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 02

State / Country of Incorporation

Arizona / United States

URL

(blank)

Registration Dates

Activation Date

Mar 5, 2025

Submission Date

Mar 3, 2025

Initial Registration Date

Jul 18, 2012

Entity Dates

Entity Start Date

Mar 4, 1998

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)

Profit Structure

Non-Profit Organization

Last updated by Kevin Davis on Mar 03, 2025 at 12:45 PM OLD CONCHO COMMUNITY ASSISTANCE CENTER INC

Jun 12, 2025 03:26:23 PM GMT https://sam.gov/entity/HWLXHJGJFC19/coreData?status=null Page 1 of 2

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

6TRG3

Points of Contact

Electronic Business

Kevin Davis, Executive Director P.O. Box 50

Concho, Arizona 85924

United States

Kevin Davis, Case Manager P.O. Box 50

Concho, Arizona 85924

United States

Government Business

Kevin Davis, Executive Director P.O. Box 50

Concho, Arizona 85924

United States

Past Performance

Marilyn Johnson, Executive Director P.O. Box 50

Concho, Arizona 85924

United States

Jessica Hancock, Bookkeeper P.O. Box 50

Concho, Arizona 85924

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 Kevin Davis on Mar 03, 2025 at 12:45 PM OLD CONCHO COMMUNITY ASSISTANCE CENTER INC

Jun 12, 2025 03:26:23 PM GMT https://sam.gov/entity/HWLXHJGJFC19/coreData?status=null Page 2 of 2

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