CTR074347_A1.pdf
PDF 715 KB Posted
- Attached to
- Master Agreement AZ|CTR074347
- Contract number
- CTR074347
- Issued by
- Arizona
About this file
This document is a Request for Proposal Contract Amendment from the Arizona Department of Health Services, Office of Procurement, involving HRPP Community Health Nursing Services (CHN) and the Mohave County Department of Public Health. The contract amendment (Amendment No. 1 to Contract No. CTR074347) is specifically for the Mohave County jurisdiction, with Roy Vasel listed as the Procurement Officer.
The contract amendment extends the existing contract through November 12, 2026, pursuant to the Special Terms and Conditions, Provision Three (3), which allows for a 5-Year Maximum contract extension. The Mohave County entity is registered in the System for Award Management (SAM) with a Unique Entity ID of KKE6CJTM8CS1, classified as a U.S. Local Government entity, and located in Kingman, Arizona. The contract is for federal assistance awards, with an active registration status expiring on July 22, 2026, and no active exclusion records are noted. The amendment appears to be for community health nursing services, though specific service details are not explicitly outlined in the provided documents.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2025.07.01_COI.pdf | ||
| Contract_Summary_Document.xlsx | XLSX spreadsheet | |
| 2025.07.01 COI CGL AL WC SAM.pdf | ||
| CTR074347_Pricing.xlsx | XLSX spreadsheet | |
| Mistake Discovered After Award.pdf | ||
| CTR074347_Contract_Documents.pdf | ||
| 2026.07.01 COI CGL AL WC SAM.pdf |
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Text version
Gina Digitally signed by Gina Corwin Date:
2025.08.20 14:04:47 -07'00' Corwin
COUNTY OF MOHAVE
Unique Entity ID
KKE6CJTM8CS1
CAGE / NCAGE
37FX0
Purpose of Registration
Federal Assistance Awards Only
Registration Status
Active Registration
Expiration Date
Jul 22, 2026
Physical Address
700 W Beale ST
Kingman, Arizona 86401-5711
United States
Mailing Address
P.O. Box 7000
Kingman, Arizona 86402-7000
United States
Business Information
Doing Business as
(blank)
Division Name
(blank)
Division Number
(blank)
Congressional District
Arizona 09
State / Country of Incorporation
(blank) / (blank)
URL
(blank)
Registration Dates
Activation Date
Jul 24, 2025
Submission Date
Jul 22, 2025
Initial Registration Date
Mar 15, 2005
Entity Dates
Entity Start Date
Jul 1, 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
U.S. Government Entity
Entity Type
US Local Government
Organization Factors
(blank)
Profit Structure
(blank)
Last updated by Michael Smith on Jul 22, 2025 at 05:17 PM COUNTY OF MOHAVE
Aug 20, 2025 09:16:25 PM GMT https://sam.gov/entity/KKE6CJTM8CS1/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
Other Government Entities
Housing Authorities Public/Tribal
Financial Information
Accepts Credit Card Payments
No
Debt Subject To Offset
No
EFT Indicator
CAGE Code
37FX0
Points of Contact
Electronic Business
Michael Smith Mohave County Community Services
700 W. Beale Street
Kingman, Arizona 86402
United States
Government Business
Michael Smith Mohave County Community Services
700 W. Beale Street
Kingman, Arizona 86402
United States
Terry Baughn 700 W. Beale ST
P.O. Box 7000
Kingman, Arizona 86402
United States
Past Performance
Michael Smith Mohave County Community Services
700 W. Beale Street
Kingman, Arizona 86402
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 Michael Smith on Jul 22, 2025 at 05:17 PM COUNTY OF MOHAVE
Aug 20, 2025 09:16:25 PM GMT https://sam.gov/entity/KKE6CJTM8CS1/coreData?status=null Page 2 of 2
Gina
File details come from the government source that posted it. Updated .