CTR075436_Contract_Amendment_1.pdf
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- Attached to
- Master Agreement AZ|CTR075436
- Contract number
- CTR075436
- Issued by
- Arizona
About this file
This is a contract amendment between the Arizona Department of Economic Security (DES) and Portable Practical Education Preparation Inc. (PPEP) for the Community Action Services Program. The amendment is associated with contract number CTR075436 and is Amendment Number One, covering services to be provided during the period of July 1, 2025 through June 30, 2026.
The amendment modifies the contract to add new case management reporting requirements, specifically mandating a Monthly Service Log submission by the 25th of each month. It also introduces an initial Itemized Service Budget totaling $167,713.83, which includes $114,511.58 in one-time funding specifically for Homeless Youth services that must be fully expended by June 30, 2026. The budget covers various program costs including personnel, employer-related expenses, professional services, travel, space, materials and supplies, operating services, and indirect costs. The funding sources are diverse, including allocations from DES, LIHEAP, SSBG, TANF, NHN, CSBG, and other discretionary funds, with a focus on community services, case management, and homeless youth outreach.
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CONTRACT AMENDMENT
Arizona Department of Economic Security
1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007
CONTRACT NUMBER: AMENDMENT NUMBER:
CTR075436 One (1)
DESCRIPTION/ LABEL: Community Action Services Program
CONTRACTOR NAME: Portable Practical Education Preparation Inc.
THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:
The purpose of this Amendment is to revise the Case Management Reporting Requirements within the Scope of Work and add the initial Itemized Service Budget for the period of July 1, 2025 through June 30, 2026.
1) In accordance with the Uniform Terms and Conditions, Section 5.0, Contract Changes, Subsection 5.1, Amendments, the Scope of Work is being revised to add Section 9.4.5 as follows:
9.4.5 Submit a Monthly Service Log (Exhibit E, as may be amended) by the 25th day following the end of each reporting period.
2) Pursuant to the Uniform Terms and Conditions, Section 5, Contract Changes, and in accordance with the Scope of Work, Section 8, Payment, the initial Itemized Service Budget in the amount of $167,713.83 is added for the period of July 1, 2025 through June 30, 2026. This includes one-time funding for Homeless Youth services in the amount of $114,511.58, that must be fully expended by June 30, 2026.
Therefore, the Itemized Service Budget and Exhibit E are attached as part of this amendment.
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.
Exhibit E - Monthly Service Log
Contract No.: CTR075436
Description: Community Action Services Program
Exhibit E - Monthly Service Log
TYPE OF SERVICE
● Youth Outreach = YO
● Drop-In Services = DO
● Supportive Services = SS
NUMBER OF
YOUTH
SERVED
Service Location
Name
MONTH
SERVED
COMMENTS/
FOLLOW UP
ITEMIZED SERVICE BUDGET
1 PERSONNEL Total Cost DES Cost
TOTAL LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
# of FTE Total Salary for the TOTAL DES Discretionary
Positions Level Position Title Contract Period COST COST COST COST Cost Cost Cost Cost Cost COST COST COST
1 1.00 Program Director $73,863 $8,304.00 $2,000.00 $1,000.00 $1,000.00
1 1.00 Case Manager $38,501 $34,491.00 $4,959.00 $1,675.00 $3,284.00
1 1.00 MIS Director $55,037 $7,936.00 $3,000.00 $1,000.00 $2,000.00
2 2.00 Data Specialists $63,960 $18,470.00 $0.00
5 1.00 Workforce Develop $207,690 $41,600.00 $0.00
1 1.00 case manager $31,200 $31,200.00 $0.00
1 1.00 Program Director $73,863 $2,285.00 $0.00
1 1.00 Case Manager $38,501 $38,501.00 $0.00
1 1.00 MIS/Human Services $55,037 $2,429.00 $0.00
5 1.00 Workforce Develop $207,690 $41,600.00 $0.00
6 1.00 Social Workers $297,720.00 $297,720.00 $31,200.00 $31,200.00
$0.00
TOTAL PERSONNEL $524,536.00 $41,159.00 $0.00 $0.00 $1,675.00 $0.00 $33,200.00 $0.00 $0.00 $6,284.00 $0.00 $0.00
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
FICA 24% of Total Personnel Service Cost $23,154.96 $9,878.16 $402.00 $7,968.00 $1,508.16
Unemployment Insurance $0.00
Worker's Compensation $0.00
Health Benefits $0.00
FICA 24% of Total Personnel Service Cost $18,192.72 $0.00
Unemployment Insurance $0.00
Worker's Compensation $0.00
Health Benefits $0.00
FICA Social workers 24% of Total Personnel Service cost $7,145.00 $0.00
TOTAL EMPLOYER RELATED EXPENSES . $48,492.68 $9,878.16 $0.00 $0.00 $402.00 $0.00 $7,968.00 $0.00 $0.00 $1,508.16 $0.00 $0.00
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
$0.00 $0.00
Yuma Community Food Bank 591.25 x 12 $8,219.00 $2,055.00 $2,055.00
Yuma Community Food Bank for Drop in Center Food Services 8333 x 6 $30,000.00 $30,000.00 $30,000.00
$0.00
$0.00
$0.00
$0.00
TOTAL PROFESSIONAL AND OUTSIDE SERVICES $38,219.00 $32,055.00 $0.00 $0.00 $0.00 $0.00 $30,000.00 $0.00 $0.00 $2,055.00 $0.00 $0.00
4 TRAVEL
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
Vehicle fuel and 492.00x12 $0.00
Mileage reimbursement for client outreach 206 miles per mo x 12 $238.00 $383.16 $0.00 $383.16
$0.00
Travel for staff development training @ 3 trips at 750 each $3,275.98 $2,000.00 $2,000.00
Street outreach mileage and fuel 333.00 x 9x.062 = 1858.14$2,000.00 $1,858.14 $1,858.14
Travel for Homeless youth program staff for set up and monitoring 8 night hotel room x 206.00$1,352.00 $1,648.00 $1,648.00 per night $0.00
TOTAL TRAVEL $6,865.98 $5,889.30 $0.00 $0.00 $0.00 $0.00 $3,506.14 $0.00 $0.00 $2,383.16 $0.00 $0.00
Homeless Youth Outreach
Homeless Youth Outreach
Agency: PPEP
Contract Period: 07/01/2025 - 06/30/2026 with Homeless Youth Funding
Contract No.: CTR075436
Amendment No.
Case Management Case Management - Intake
Community Service
EMPLOYER RELATED EXPENSES
BASIS
PROFESSIONAL AND OUTSIDE SERVICES
Homeless Youth Outreach
Homeless Youth Outreach
BASIS
BASIS
5 SPACE
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
Office Space 167.00 x 9 $13,020.68 $4,758.00 $1,503.00 $3,255.00
Office Space 167.00 x 3 $5,313.14 $500.00 $500.00
$0.00
$0.00
$0.00
$0.00
TOTAL SPACE $18,333.82 $5,258.00 $0.00 $0.00 $500.00 $0.00 $1,503.00 $0.00 $0.00 $3,255.00 $0.00 $0.00
6 EQUIPMENT
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
$0.00
$0.00
$0.00
TOTAL EQUIPMENT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHNHomeless Youth Outreach TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
125.75x12 $1,509.00 $377.25 $377.25
31.75 x 12 $95.25 $95.25 $95.25
General Office supplies 42.75 per qtr. $731.80 $336.00 $216.00 $120.00
$0.00
Street outreach on hand supplies for Homeless Youth $30,000.00 $30,000.00 $30,000.00
(clothing, transportation (bus pass), hygine items, food, other services) 2500x12 months
TOTAL MATERIALS AND SUPPLIES $32,336.05 $30,808.50 $0.00 $0.00 $216.00 $0.00 $30,000.00 $0.00 $0.00 $592.50 $0.00 $0.00
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
Telephone services (land line) 33.23 x 12 $398.76 $0.00
Cell phone 59.00x12 $708.00 $1,396.44 $916.44 $480.00
Telephone services (land line) 33.50 x 12 $777.00 $100.50 $100.50
Cell phone 59.00 x 12 $708.00 $708.00 $708.00
$0.00
$0.00
$0.00
TOTAL OPERATING EXPENSES $2,591.76 $2,204.94 $0.00 $0.00 $0.00 $0.00 $916.44 $0.00 $0.00 $1,288.50 $0.00 $0.00
9 INDIRECT COSTS
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
Indirect cost 18.02% approved by DOL for Salaries and Fringe $21,602.00 $1,404.15 $1,404.15 $0.00
Indirect cost 18.02% approved by DOL for Salary & Fringe Homless Youth $9,552.00 $7,418.00 $7,418.00 TOTAL INDIRECT COSTS $31,154.00 $8,822.15 $0.00 $0.00 $0.00 $0.00 $7,418.00 $0.00 $0.00 $1,404.15 $0.00 $0.00
10 SUBTOTAL ADMIN COST $702,529.29 $136,075.05 $0.00 $0.00 $2,793.00 $0.00 $114,511.58 $0.00 $0.00 $18,770.47 $0.00 $0.00
Homeless Youth Outreach
Homeless Youth Outreach
Homeless Youth Outreach
BASIS
BASIS
MATERIALS AND SUPPLIES
BASIS
Supplies
Postage
OPERATING SERVICES
BASIS
BASIS
Homeless Youth Outreach
11 VOUCHERS
TOTAL TOTAL DES LIHEAP A16 SSBG TANF NHN TANF NHN CSBG CSBG FERC
Discretionary
ITEM COST COST Cost COST COST COST Cost Cost Cost COST COST COST
$124,999.14 $15,811.78 $15,811.78
CSBG Carryover = Allocated for Community Needs Assessment $0.00
YouthBuild Training - Discretionary Award Carryover $0.00 $0.00
$0.00
$8,217.96 $9,159.58 $6,785.53 $2,374.05
Cell phone for client contact 79.61x12 $956.04 $956.04 $956.04
Personel $6,980.00 $4,605.95 $4,605.95
Fringe Benefits x 24% $1,675.00 $1,105.43 $1,105.43
$0.00
$0.00
TOTAL VOUCHERS $142,828.14 $31,638.78 $0.00 $0.00 $13,452.95 $0.00 $0.00 $2,374.05 $0.00 $15,811.78 $0.00 $0.00
12 TOTAL SERVICE COST/DES TOTAL COST: $845,357.43 $167,713.83 $0.00 $0.00 $16,245.95 $0.00 $114,511.58 $2,374.05 $0.00 $34,582.25 $0.00 $0.00
$845,357.43 $167,713.83 $0.00 $0.00 $9,008.96 $0.00 $114,511.58 $2,374.05 $0.00 $34,582.25
DES-CSA
DES-CSBG
$845,357.43 $167,713.83 $0.00 $0.00 $9,008.96 $0.00 $114,511.58 $2,374.05 $0.00 $34,582.25 $0.00 $0.00
DES - CCSD
DES - CCSD - Intake
TOTAL REVENUE:
Note: Please ensure your Total Revenues equal your Total Service Costs. If the Total Revenue items light up red, your budget is not balanced, and the Costs/Revenues need to be adjusted.
DES - CCSD - Intake Costs
Homeless Youth Outreach
CSBG
TANF Vouchers
Note: Please ensure your Total Costs are more than or equal to your DES Costs. If the Total Costs light up red, your Total Costs need to be adjusted. See column AD
REVENUE SOURCES:
DES - CCSD
| CONTRACT AMENDMENT.pdf |
| Exhibit E Monthly Service Log Fillable.pdf |
| ISB.pdf |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow1: |
| NUMBER OF YOUTH SERVEDRow1: |
| Service Location NameRow1: |
| MONTH SERVEDRow1: |
| COMMENTS FOLLOW UPRow1: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow2: |
| NUMBER OF YOUTH SERVEDRow2: |
| Service Location NameRow2: |
| MONTH SERVEDRow2: |
| COMMENTS FOLLOW UPRow2: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow3: |
| NUMBER OF YOUTH SERVEDRow3: |
| Service Location NameRow3: |
| MONTH SERVEDRow3: |
| COMMENTS FOLLOW UPRow3: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow4: |
| NUMBER OF YOUTH SERVEDRow4: |
| Service Location NameRow4: |
| MONTH SERVEDRow4: |
| COMMENTS FOLLOW UPRow4: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow5: |
| NUMBER OF YOUTH SERVEDRow5: |
| Service Location NameRow5: |
| MONTH SERVEDRow5: |
| COMMENTS FOLLOW UPRow5: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow6: |
| NUMBER OF YOUTH SERVEDRow6: |
| Service Location NameRow6: |
| MONTH SERVEDRow6: |
| COMMENTS FOLLOW UPRow6: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow7: |
| NUMBER OF YOUTH SERVEDRow7: |
| Service Location NameRow7: |
| MONTH SERVEDRow7: |
| COMMENTS FOLLOW UPRow7: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow8: |
| NUMBER OF YOUTH SERVEDRow8: |
| Service Location NameRow8: |
| MONTH SERVEDRow8: |
| COMMENTS FOLLOW UPRow8: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow9: |
| NUMBER OF YOUTH SERVEDRow9: |
| Service Location NameRow9: |
| MONTH SERVEDRow9: |
| COMMENTS FOLLOW UPRow9: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow10: |
| NUMBER OF YOUTH SERVEDRow10: |
| Service Location NameRow10: |
| MONTH SERVEDRow10: |
| COMMENTS FOLLOW UPRow10: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow11: |
| NUMBER OF YOUTH SERVEDRow11: |
| Service Location NameRow11: |
| MONTH SERVEDRow11: |
| COMMENTS FOLLOW UPRow11: |
| TYPE OF SERVICE Youth Outreach YO DropIn Services DO Supportive Services SSRow12: |
| NUMBER OF YOUTH SERVEDRow12: |
| Service Location NameRow12: |
| MONTH SERVEDRow12: |
| COMMENTS FOLLOW UPRow12: |
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