CTR074350_A1.pdf

PDF 586 KB Posted Nov 13, 2024

Attached to: Master Agreement AZ|CTR074350
Contract number: CTR074350
Issued by: Arizona

About this file

Written by GovTribe AI · Sep 25, 2025

This document is a Contract Amendment Request from the Arizona Department of Health Services, Office of Procurement, for the HRPP Community Health Nursing Services (CHN) contract with Maricopa County Department of Public Health. The contract involves the Maricopa County government, specifically its Public Health Department, which is registered as a U.S. Local Government entity with a unique entity ID of LM85MG1513K5 and is located in Phoenix, Arizona.

The amendment extends the existing contract (Contract No. CTR074350) through November 12, 2026, in accordance with the Special Terms and Conditions, Provision Three (3), Contract Extensions, 5 Year Maximum. The Maricopa County Department of Public Health is classified under NAICS codes for Administration of Public Health Programs (923120) and General Medical and Surgical Hospitals (622110). The entity is registered for All Awards, has an active registration status until August 20, 2026, and appears in the disaster response registry. The contract's primary service classification is categorized under Product and Service Code Q999 for Medical - Other services.

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2025.06.30 COI PEL AL WC MML PL SAM.pdf	PDF	Nov 13, 2024
2026.06.30 COI PEL AL WC MML PL SAM.pdf	PDF	Nov 13, 2024
COI_CTR074350_HRPP_Community_Health_Nursing_Services.pdf	PDF	Nov 13, 2024
Contract_Summary_Document.xlsx	XLSX spreadsheet	Nov 13, 2024
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FILTER BY

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Entity Name:

maricopa county of public health

Statutory Agent Name:

Principal Name:

Entity ID:

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Entity Type:

Domestic

Entity Status:

All

Name Type:

All

County:

Maricopa

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MARICOPA, COUNTY OF

Unique Entity ID

LM85MG1513K5

CAGE / NCAGE

3QJA2

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Aug 20, 2026

Physical Address

4041 N Central AVE STE 1400

Phoenix, Arizona 85012-3314

United States

Mailing Address

4041 N Central AVE STE 1400

Phoenix, Arizona 85012-3314

United States

Business Information

Doing Business as

Maricopa County Department of Public Health

Division Name

(blank)

Division Number

(blank)

Congressional District

Arizona 03

State / Country of Incorporation

(blank) / (blank)

URL

www.maricopa.gov

Registration Dates

Activation Date

Aug 26, 2025

Submission Date

Aug 20, 2025

Initial Registration Date

Feb 2, 2004

Entity Dates

Entity Start Date

Jul 1, 1957

Fiscal Year End Close Date

Jun 30

Immediate Owner

CAGE

3PZS5

Legal Business Name

MARICOPA COUNTY

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?

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 Cheryl Bucalo on Aug 20, 2025 at 05:44 PM MARICOPA, COUNTY OF

Sep 04, 2025 04:02:49 PM GMT https://sam.gov/entity/LM85MG1513K5/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

Debt Subject To Offset

EFT Indicator

CAGE Code

3QJA2

Points of Contact

Electronic Business

Cheryl Bucalo, Purchasing and Contracts

Supervisor

4041 N. Central AVE. Suite 1400

Phoenix, Arizona 85012

United States

John Lick, Grant Unit Manager 4041 N Central AVE Suite 1400

Phoenix, Arizona 85012

United States

Government Business

John Lick, Grant Unit Manager 4041 N Central AVE Suite 1400

Phoenix, Arizona 85012

United States

Cheryl Bucalo, Purchasing and Contracts

Supervisor

4041 N. Central AVE. Suite 1400

Phoenix, Arizona 85012

United States

Past Performance

John C Lick, Grant Unit Manager 4041 N. Central AVE.

Phoenix, Arizona 85012

United States

Service Classifications

NAICS Codes

Primary

Yes

NAICS Codes

923120

NAICS Title

Administration Of Public Health Programs

622110 General Medical And Surgical Hospitals

Product and Service Codes

PSC PSC Name

Q999 Medical- Other

Disaster Response

Yes, this entity appears in the disaster response registry.

Bonding Levels Dollars

(blank) (blank)

States

Arizona

Counties

(blank)

Metropolitan Statistical Areas

(blank)

Last updated by Cheryl Bucalo on Aug 20, 2025 at 05:44 PM MARICOPA, COUNTY OF

Sep 04, 2025 04:02:49 PM GMT https://sam.gov/entity/LM85MG1513K5/coreData?status=null Page 2 of 2

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File details come from the government source that posted it. Updated Sep 25, 2025.