CTR069657 ACPMTP uofa A1 EXECUTED.pdf
PDF 565 KB Posted
- Attached to
- Master Agreement AZ|CTR069657
- Contract number
- CTR069657
- Issued by
- Arizona
About this file
This document is an Interagency Service Agreement (ISA) Amendment between the Arizona Department of Health Services (ADHS) and the Arizona Board of Regents for the University of Arizona. The amendment is specifically for the University of Arizona College of Pharmacy Medication Therapy Management program, with the Centers for Disease Control and Prevention (CDC) as the federal awarding agency. The agreement is identified by Contract No. CTR069657 and Amendment No. 1, issued by ADHS's Office of Procurement in Phoenix, Arizona.
The amendment extends the funding and budget for the National Cardiovascular Health Program, adding expanded authority funding through 2025. The total budget for the federal fiscal year is $119,192.00, with a new Year 1 Expanded Authority Funding Budget of $110,000.00, primarily allocated to Personnel Services and Employee Related Expenses. The subaward period runs from 06/30/2023 to 06/29/2028, with the current budget period from 06/30/2024 to 06/29/2025. The total amount of federal funds committed to the subrecipient is $1,105,715.00, with the current financial obligation being $836,427.00. The federal award is identified by Grant Number 5 NU58DP006557-05-00 and has an Assistance Listings Number of 93.426.
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Other files
| File | Type | Posted |
|---|---|---|
| CTR069657_Pricing.pdf | ||
| PRS-33664252.pdf | ||
| ISA_CTR069657_UOFACOPMTM_Fully_Executed.pdf |
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Text version
INTERAGENCY SERVICE AGREEMENT (ISA)
AMENDMENT
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530
Phoenix, Arizona 85007
AGREEMENT NO.: CTR069657 AMENDMENT NO.: 1
Procurement Officer:
Brandon Durick
Revised 04/08/2024
UNIVERSITY OF ARIZONA COLLEGE OF PHARMACY MEDICATION THERAPY MANAGEMENT
Effective upon signature by both parties it is mutually agreed that the Agreement is amended as follows:
1. Pursuant to the Uniform Terms and Conditions, Provision Twenty-five (25), Miscellaneous, Section 25.3 the Agreement is hereby revised with the following:
1.1 The Price Sheet is revised and replaced by adding the expanded authority funding through 2025.
1.2 Exhibit One (1), 2CFR is added.
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 Agreement Amendment is hereby executed this _____ day of __________ 2025_____ at Phoenix, Arizona.
(TO BE FILLED OUT BY ADHS PROCUREMENT OFFICE)
Contractor Signature
Contractor Signature Date
Authorized Signatory’s Name and Title
ARIZONA BOARD OF REGENTS
UNIVERSITY OF ARIZONA
Contractor’s Name Procurement Officer Signature
Elisha Johnson, JD Sr. Director, Clinical Trials and Contracting
Elisha Johnson (Apr 28, 2025 14:45 PDT) Elisha Johnson
04/28/2025
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530
Phoenix, Arizona 85007
AGREEMENT NO.: CTR069657 AMENDMENT NO.: 1
Procurement Officer:
Brandon Durick
Revised 04/08/2024
REVISED PRICE SHEET
COST REIMBURSEMENT PRICE SHEET
ANNUAL BUDGET
Account Classification Total Budget Personnel and Employee Related Expenses* $108,356.00
Professional and Outside Services* $0.00
Travel Expenses* $0.00
Other Operating Expenses* $0.00
Capital Outlay Expenses* $0.00
*Other (Indirect Cost, not to Exceed 10% of Total Sum of Lines 1 through 5) $10,836.00
TOTAL (PER FEDERAL FISCAL YEAR ANNUAL NOT TO EXCEED) $119,192.00
Year 1 Expanded Authority Funding Budget June 30, 2024 – June 29, 2025
Account Classification Total Budget
Personnel Services & Employee Related Expenses* $100,000.00
Professional and Outside Services $0.00
Travel Expenses $0.00
Other Operating Expenses $0.00
Capital Outlay Expenses $0.00
Indirect Cost (10%) $10,000.00
TOTAL (PER FEDERAL FISCAL YEAR ANNUAL NOT TO EXCEED) $110,000.00
*Indicated indirect rate calculation
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530
Phoenix, Arizona 85007
AGREEMENT NO.: CTR069657 AMENDMENT NO.: 1
Exhibit One (1)
2 CFR 200.332
§ 200.332 Requirements for pass-through entities.
All pass-through entities must:
(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass-through entity must provide the best information available to describe the Federal award and subaward.
Prime Awardee: Arizona Department of Health Services
UEI # QMWUG1AMYF65
Federal Award Identification (Grant Number): 5 NU58DP006557-05-00
Subrecipient name (which must match the name associated with its unique entity identifier): Arizona Board of Regents, University of Arizona
Subrecipient's unique entity identifier (UEI #): ED44Y3W6P7B9 (UofA)
Federal Award Identification Number (FAIN, sometimes it’s the same as the Grant Number): NU58DP007439
Federal Award Date (see the definition of Federal award date in § 200.1 of this part) of award to the recipient by the Federal agency; 06/26/2024
Subaward Period of Performance Start and End Date: 06/30/2023-06/29/2028
Subaward Budget Period Start and End Date: 06/30/2024-06/29/2025
Amount of Federal Funds Obligated by this action by the pass-through entity to the subrecipient (this is normally the contract amount): $229,192.00
Total Amount of Federal Funds Obligated to the subrecipient by the pass-through entity including the current financial obligation (how much is available for contracts): $836,427.00
Total Amount of the Federal Award committed to the subrecipient by the pass-through entity $1,105,715.00
Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA) The National Cardiovascular Health Program
ARIZONA DEPARTMENT OF
HEALTH SERVICES
OFFICE OF PROCUREMENT
150 N 18th Ave., Ste. #530
Phoenix, Arizona 85007
AGREEMENT NO.: CTR069657 AMENDMENT NO.: 1
Name of Federal awarding agency, pass-through entity, and contact information for awarding official of the Pass-through entity
Centers for Disease Control and Prevention (CDC)
Assistance Listings number and Title; the pass-through entity must identify the dollar amount made available under each Federal award and the Assistance Listings Number at time of disbursement: 93.426
Identification of whether the award is R&D No
Indirect cost rate for the Federal award (including if the de minimis rate is charged) per § 200.414
97982_ISA Amd_CTR069657 A1_Axon_VR Final Audit Report 2025-04-28
Created: 2025-04-28
By: Vassupradha Rengarajan (vassupradhar@arizona.edu)
Status: Signed
Transaction ID: CBJCHBCAABAA27odgO5KWh2t0ASLuCVEjQRADnxI841V
"97982_ISA Amd_CTR069657 A1_Axon_VR" History Document created by Vassupradha Rengarajan (vassupradhar@arizona.edu) 2025-04-28 - 9:08:32 PM GMT- IP address: 136.63.5.159
Document emailed to Elisha Johnson (elishajohnson@arizona.edu) for signature
2025-04-28 - 9:09:25 PM GMT
Email viewed by Elisha Johnson (elishajohnson@arizona.edu) 2025-04-28 - 9:44:59 PM GMT- IP address: 161.123.30.137
Document e-signed by Elisha Johnson (elishajohnson@arizona.edu) Signature Date: 2025-04-28 - 9:45:15 PM GMT - Time Source: server- IP address: 69.242.232.70
Agreement completed.
2025-04-28 - 9:45:15 PM GMT
| 2025-05-01T12:09:45-0700 | |
| Jacqueline S. Ortega-Avila |
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