CTR074912 Contract Amendment 1.pdf
PDF 764 KB Posted
- Attached to
- Master Agreement AZ|CTR074912
- Contract number
- CTR074912
- Issued by
- Arizona
About this file
This is an Intergovernmental Agreement (IGA) Amendment between the Arizona Department of Health Services (ADHS) Office of Procurement and Yavapai County Government, specifically Yavapai County Community Health Services. The amendment involves the CDC Overdose Data to Action - OD2A-S program and is associated with Contract No. CTR074912 (previously CTR070154), which was revised due to an administrative error with the Supplier Identification in the APP Portal.
The contract appears to be for public health services related to overdose data collection and analysis, with Yavapai County located in Prescott, Arizona. The amendment maintains all other original provisions of the agreement unchanged. The document includes digital signatures from key personnel including Nathaniel Thomas (Procurement Officer), Elise Phalen (Assistant Attorney General), Colby Morris, and Leslie Horton (County Director). The contract is registered in the System for Award Management (SAM) with a Unique Entity ID of FBXDMQUBMWV6, and is classified as a U.S. Local Government entity focused on federal assistance awards, with an active registration expiring on November 22, 2025.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 07-09-24 Debarment SAM CTR070154.pdf | ||
| CTR074912 A3.pdf | ||
| CTR074912 Contract Amendment 2.pdf | ||
| PRS-184467bc.pdf | ||
| 07-09-24 Debarment OIG CTR070154.pdf | ||
| CTR070154_Yavapai_County_EXECUTED.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
01/24/25
Colby Morris
Elise Phalen Digitally signed by Elise Phalen DN: cn=Elise Phalen, o, ou=Arizona Attorney General's Office, email=elise.phalen@azag.gov, c=US Date: 2025.03.24 11:28:53 -07'00'
Nathaniel Thomas
Digitally signed by Nathaniel Thomas Date: 2025.03.24 13:23:11 -07'00'
YAVAPAI COUNTY GOVERNMENT PRESCOTT
Unique Entity ID
FBXDMQUBMWV6
CAGE / NCAGE
431P1
Purpose of Registration
Federal Assistance Awards Only
Registration Status
Active Registration
Expiration Date
Nov 22, 2025
Physical Address
1090 Commerce DR
Prescott, Arizona 86305-3700
United States
Mailing Address
1090 Commerce Drive
Prescott, Arizona 86305-3700
United States
Business Information
Doing Business as
(blank)
Division Name
Yavapai County Community Health Services
Division Number
(blank)
Congressional District
Arizona 02
State / Country of Incorporation
(blank) / (blank)
URL
(blank)
Registration Dates
Activation Date
Nov 26, 2024
Submission Date
Nov 22, 2024
Initial Registration Date
Aug 8, 2005
Entity Dates
Entity Start Date
Jul 1, 1864
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 Kathy Yancy on Nov 22, 2024 at 02:19 PM YAVAPAI COUNTY GOVERNMENT PRESCOTT
Feb 25, 2025 05:19:00 PM GMT https://sam.gov/entity/FBXDMQUBMWV6/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
Yes
Debt Subject To Offset
No
EFT Indicator
CAGE Code
431P1
Points of Contact
Electronic Business
Willa Miller, Asst Director 1090 Commerce Drive
Prescott, Arizona 86305
United States
Government Business
Leslie Horton, Director 1090 Commerce Drive
Prescott, Arizona 86305
United States
Past Performance
Daniel Rusing, Business/Finance Manager 1090 Commerce Drive
Prescott, Arizona 86305
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 Kathy Yancy on Nov 22, 2024 at 02:19 PM YAVAPAI COUNTY GOVERNMENT PRESCOTT
Feb 25, 2025 05:19:00 PM GMT https://sam.gov/entity/FBXDMQUBMWV6/coreData?status=null Page 2 of 2
������������������ !"#$%&'$�()*+!,�-)$#".$/�0123456785�9:;<2=�>:543?5@��'.%.%)$08?6?6:5��A��B��� �����������������C
��D������D���������E�
���F��������GH�IJ�KLMNOPM�QKL�HJNIRS�PTUM�UIRUVURNQO�JK�LIPUPW�XUH�UP�UM�QI�LIPUPW�MLQKYTZ�UM�IJP�YNKKLIPOW�L[YONRLR\�]KUIP�PTUM�̂ L_�̀QaL�HJK�WJNKRJYNbLIPQPUJIF� ����c� ��F� ��������������dedfedgdf�hdihjikl�mn��Fo����p�q�r������� ���F������� �������dehgedgdf�lighigg�cn��FoB���������F� c��������
����������������s������F� ����������������E���t����������u����v
| CTR074912 A1 - Executed |
| Sam.gov |
| OIG Search Results |
File details come from the government source that posted it. Updated .