CTR070044_A1.pdf
PDF 198 KB Posted
- Attached to
- AZ|CTR070044
- Contract number
- CTR070044
- Issued by
- Arizona
About this file
This is Amendment Number 1 to Contract CTR070044 between the Arizona Department of Economic Security and Desierto Psychological PLLC for Health Assessment – Consultative Examinations (CE) services.
The amendment modifies the contract by updating Exhibit E – Fee Schedule to reflect Special Projects May 2024 Travel rates and adds Dr. Ruby Howard as an authorized subcontractor to perform consultative examinations and psychological testing. Attachment 6 – Facility Location Chart has been revised to include Dr. Ruby Howard's location information. All other contract requirements, specifications, terms, and conditions remain unchanged.
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Text version
CONTRACT AMENDMENT
Arizona Department of Economic Security
1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007
CONTRACT NUMBER: AMENDMENT NUMBER:
CTR070044 1
DESCRIPTION/ LABEL: Health Assessment – Consultative Examinations (CE)
CONTRACTOR NAME: Desierto Psychological PLLC
THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:
1. In accordance with the Uniform Terms and Conditions, Section 5 Contract Changes, Sub-Section
5.1 Amendments, Exhibit E – Fee Schedule shall be updated and replaced with Exhibit E - Fee
Schedule Special Projects May 2024 Travel
2. In accordance with the Uniform Terms and Conditions, Section 5.0 Contract Changes, Subsection
5.1 Amendments and Subsection 5.2 Subcontracts, the contract shall be amended as follows:
a. Add Dr. Ruby Howard as a subcontractor to perform consultative examinations and psychological testing as requested.
b. Attachment 6 - Facility Location Chart is revised and replaced to include Dr. Ruby Howard.
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.
File details come from the government source that posted it. Updated .