CTR067927 Amendment 2.pdf

1 MB Posted

Attached to
Master Agreement AZ|CTR067927
Contract number
CTR067927
Issued by
Arizona

About this file

Written by GovTribe AI ·

This document is an Intergovernmental Agreement (IGA) Amendment No. 2 from the Arizona Department of Health Services, Office of Procurement, involving Greenlee County Health Department. The contract (No. CTR067927) pertains to WIC (Women, Infants, and Children) and Breastfeeding Peer Counseling Services, with the amendment dated for the period from October 1, 2024 to September 30, 2025.

The amendment includes a revised Price Sheet for WIC Services with a total budget of $119,624.00, broken down across various expense categories including Personnel Expenses ($76,119.00), Employee Related Expenses ($18,316.00), Professional & Outside Services ($16,800.00), and Other Operating Expenses ($4,717.00). The contract specifies a federal award through the 10.557 Special Supplemental Nutrition Program, with an assigned casload of 200 participants for FFY 2025. The amendment allows for potential budget adjustments with prior written approval, and ADHS reserves the right to adjust awards based on federal funding availability.

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Other files

File Type Posted
CTR067927 Amendment 1.pdf PDF
CTR067927 Pricing A2.pdf PDF
Greenlee County Debarments.pdf PDF
CTR067927 Pricing A1.pdf PDF
CTR067927 - Greenlee County WIC Services (Executed).pdf PDF
CTR067927 A1.pdf PDF
CTR067927 A2.pdf PDF
CTR067927 Pricing.pdf PDF
PRS-ed1f343e.pdf PDF
CTR067927 A3.pdf PDF
CTR067927 Pricing A3.pdf PDF
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Shawna R RogersBai ley

Digitally signed by Shawna R RogersBailey Date: 2025.07.11 08:04:48 -07'00'

Visit our tips page to learn how to best use the Exclusions Database. If you experience technical difficulties, please email the webmaster at webmaster@oig.hhs.gov.

Exclusions Search Results: Exclusions Search Results: EntitiesEntities

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Greenlee County

If no results are found, this individual or entity (if it is an entity search) is not currently excluded. Print this Web page for your documentation

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Search conducted 8/8/2025 11:45:40 AM EST on OIG LEIE Exclusions database.

Source data updated on 8/8/2025 10:01:00 AM EST

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An official website of the United States government. Here's how you know >

8/8/25, 8:45 AM OIG Search Results https://exclusions.oig.hhs.gov/SearchResults.aspx 1/1 https://oig.hhs.gov/exclusions/exclusions-help.asp#generalSearch mailto:webmaster@oig.hhs.gov https://oig.hhs.gov/exclusions/exclusions-help.asp#entitySearch https://oig.hhs.gov/exclusions/exclusions-help.asp#entitySearch javascript:__doPostBack('ctl00$cpExclusions$lbGridBackToSearch','') javascript:__doPostBack('ctl00$cpExclusions$lbBackToSearch','') https://oig.hhs.gov/notices/official-site.asp

BOARD OF SUPERVISORS OF GREENLEE COUNTY

Unique Entity ID

EN23K4DJHWK8

CAGE / NCAGE

3LCS1

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Feb 27, 2026

Physical Address

253 5TH ST

Clifton, Arizona 85533

United States

Mailing Address

P. O. Box 908

Clifton, Arizona 85533-0908

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 06

State / Country of Incorporation

(blank) / (blank)

URL

(blank)

Registration Dates

Activation Date

Mar 3, 2025

Submission Date

Feb 27, 2025

Initial Registration Date

Oct 29, 2003

Entity Dates

Entity Start Date

Jan 2, 1911

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 Local Government

Organization Factors

(blank)

Profit Structure

(blank)

Last updated by Stephen Rutherford on Feb 27, 2025 at 06:03 PM BOARD OF SUPERVISORS OF GREENLEE COUNTY

Aug 08, 2025 03:41:41 PM GMT https://sam.gov/entity/EN23K4DJHWK8/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.

Government Types

U.S. Local Government

County

Financial Information

Accepts Credit Card Payments

No

Debt Subject To Offset

No

EFT Indicator

CAGE Code

3LCS1

Points of Contact

Electronic Business

Matt Bolinger, Greenlee County P. O. Box 936

Clifton, Arizona 85533

United States

Rene Ontiveros Ontiveros P. O. Box 908

Clifton, Arizona 85533

United States

Government Business

Matt Bolinger, Greenlee County P.O. Box 936

Clifton, Arizona 85533

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

923120

NAICS Title

Administration Of Public Health Programs

Disaster Response

This entity does not appear in the disaster response registry.

Last updated by Stephen Rutherford on Feb 27, 2025 at 06:03 PM BOARD OF SUPERVISORS OF GREENLEE COUNTY

Aug 08, 2025 03:41:41 PM GMT https://sam.gov/entity/EN23K4DJHWK8/coreData?status=null Page 2 of 2

SEARCH CRITERIA

SEARCH RESULTS

Entity Name:

Greenlee County

Entity Type:

All

Statutory Agent Name:

N/A

Entity Status:

All

Principal Name:

N/A

Name Type:

All

Entity Number:

N/A

Entity County:

All

Entity ID Entity Name Entity Type Entity

County Agent Name

Agent

Type

Entity

Status

01009099

BROMM CHEVROLET,

OLDSMOBILE, BUICK, INC.

(/BusinessSearch/BusinessInfo?

entityNumber=01009099)

Domestic For-Profit (Business) Corporation

Maricopa

STAT AGENT

LTD

Statutory Agent

Inactiv

01009099

GRAHAM/GREENLEE

COMMUNITY SERVICE CENTER,

INC.

(/BusinessSearch/BusinessInfo?

entityNumber=01009099)

Domestic For-Profit (Business) Corporation

Maricopa

STAT AGENT

LTD

Statutory Agent

Inactiv

Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)

8/8/25, 10:01 AM Arizona Corporation Commission https://ecorp.azcc.gov/EntitySearch/Index 1/4 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01009099 http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts http://azcc.gov/corporations/corporation-contacts http://azcc.gov/corporations/corporation-contacts

Entity ID Entity Name Entity Type Entity

County Agent Name

Agent

Type

Entity

Status

L19897682

GREEN LEE COUNTY ROLLER

DERBY

(/BusinessSearch/BusinessInfo?

entityNumber=L19897682)

Unidentified Inactiv

S9236411

Greenlee County Ambulance

Service

(/BusinessSearch/BusinessInfo?

entityNumber=S9236411)

Trade Name Active

00784090

GREENLEE COUNTY ARC

(/BusinessSearch/BusinessInfo?

entityNumber=00784090)

Domestic Nonprofit Corporation

Greenlee

ARCHIE L

STEPHENS

Statutory Agent

Inactiv

00673227

GREENLEE COUNTY AREA

DEVELOPMENT COMMITTEE,

INC.

(/BusinessSearch/BusinessInfo?

entityNumber=00673227)

Domestic Nonprofit Corporation

Inactiv

00784090

GREENLEE COUNTY

ASSOCIATION FOR RETARDED

CHILD

(/BusinessSearch/BusinessInfo?

entityNumber=00784090)

Domestic Nonprofit Corporation

Greenlee

ARCHIE L

STEPHENS

Statutory Agent

Inactiv

01103519

GREENLEE COUNTY

ASSOCIATION POP WARNER

FOOTBALL, INC.

(/BusinessSearch/BusinessInfo?

entityNumber=01103519)

Unidentified Inactiv

07906720

GREENLEE COUNTY CHAMBER

OF COMMERCE

(/BusinessSearch/BusinessInfo?

entityNumber=07906720)

Domestic Nonprofit Corporation

Greenlee

MARY ARLENE

BEAGER

Statutory Agent

Inactiv

01011341

GREENLEE COUNTY CHAMBER

OF COMMERCE

(/BusinessSearch/BusinessInfo?

entityNumber=01011341)

Domestic Nonprofit Corporation

Greenlee JACKIE QUINN Statutory Agent

Inactiv

16072838

GREENLEE COUNTY CHAMBER

OF COMMERCE

(/BusinessSearch/BusinessInfo?

entityNumber=16072838)

Domestic Nonprofit Corporation

Greenlee

IAN

MCGAUGHEY

Statutory Agent

Active

Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)

8/8/25, 10:01 AM Arizona Corporation Commission https://ecorp.azcc.gov/EntitySearch/Index 2/4 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=L19897682 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=L19897682 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=L19897682 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=L19897682 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=S9236411 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=S9236411 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=S9236411 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=S9236411 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00673227 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00673227 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00673227 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00673227 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00673227 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00784090 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01103519 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01103519 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01103519 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01103519 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01103519 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=07906720 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=07906720 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=07906720 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=07906720 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01011341 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01011341 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01011341 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01011341 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=16072838 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=16072838 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=16072838 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=16072838 http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts http://azcc.gov/corporations/corporation-contacts

Entity ID Entity Name Entity Type Entity

County Agent Name

Agent

Type

Entity

Status

06011860

GREENLEE COUNTY

DEVELOPMENT CORPORATION

(/BusinessSearch/BusinessInfo?

entityNumber=06011860)

Domestic For-Profit (Business) Corporation

Greenlee

CJAMR;ES D

BITNER III

Statutory Agent

Active

00422872

GREENLEE COUNTY

DEVELOPMENT CORPORATION

(/BusinessSearch/BusinessInfo?

entityNumber=00422872)

Domestic For-Profit (Business) Corporation

Inactiv

23154631 Greenlee County Dispensary LLC

(/BusinessSearch/BusinessInfo?

entityNumber=23154631)

Domestic

LLC

Maricopa

ROCKET

LAWYER

CORPORATE

SERVICES LLC

Statutory Agent

Inactiv

00637915

GREENLEE COUNTY FARM

BUREAU

(/BusinessSearch/BusinessInfo?

entityNumber=00637915)

Domestic Nonprofit Corporation

Maricopa Philip C Bashaw

Statutory Agent

Active

21681336

GREENLEE COUNTY GIRLS

YOUTH FAST PITCH SOFTBALL

LEAGUE INC.

(/BusinessSearch/BusinessInfo?

entityNumber=21681336)

Domestic Nonprofit Corporation

Greenlee

UNITED

STATES

CORPORATION

AGEN

Statutory Agent

Inactiv

21066991

GREENLEE COUNTY GIRLS

YOUTH FAST-PITCH SOFTBALL

LEAGUE

(/BusinessSearch/BusinessInfo?

entityNumber=21066991)

Foreign Nonprofit Corporation

Inactiv

00411151

GREENLEE COUNTY GOLF AND

COUNTRY CLUB

(/BusinessSearch/BusinessInfo?

entityNumber=00411151)

Unidentified Inactiv

01291350

GREENLEE COUNTY GOLF AND

COUNTRY CLUB

(/BusinessSearch/BusinessInfo?

entityNumber=01291350)

Domestic Nonprofit Corporation

Greenlee

CHARLES D

BITNER III

Statutory Agent

Active

00965415

GREENLEE COUNTY HISTORICAL

SOCIETY, INC.

(/BusinessSearch/BusinessInfo?

entityNumber=00965415)

Domestic Nonprofit Corporation

Greenlee

ESPERANZA

CASTANEDA

Statutory Agent

Active

Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)

8/8/25, 10:01 AM Arizona Corporation Commission https://ecorp.azcc.gov/EntitySearch/Index 3/4 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=06011860 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=06011860 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=06011860 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=06011860 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00422872 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00422872 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00422872 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00422872 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=23154631 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=23154631 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=23154631 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00637915 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00637915 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00637915 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00637915 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21681336 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21681336 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21681336 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21681336 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21681336 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21066991 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21066991 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21066991 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21066991 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=21066991 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00411151 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00411151 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00411151 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00411151 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01291350 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01291350 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01291350 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01291350 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00965415 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00965415 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00965415 https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00965415 http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts http://azcc.gov/corporations/corporation-contacts

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