CTR075575_Pre-Contract_Documents.pdf

2/16/24, 11:13 AM State of Arizona Mail - Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=0fd4f98358&view=pt&search=all&permthid=thread-f:1791080121380745322%7Cmsg-f:1791080121380745322&… 1/3

Myla Eldredge <meldredge@azdes.gov>

Significant Procurement Notification Form 1 message

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Significant Procurement Notification Form The following information is required to be provided to the State Procurement Administrator by all state governmental units (SGU; agencies, boards, and commissions) as per Standard Procedure 003 - Significant Procurement Role (SP 003 link).

Notes about this Google Form to provide notification of a SPR:

• You will receive a copy of your response via email

• You may edit your response after it is submitted in two ways. To ensure there's no duplication of efforts, please do one of the following:

1) Once you submit the form, you may click on "Edit you response" in the same browser; or

2) If some time has passed and it's necessary to make edits, please check your email for the original submission as it will have an "Edit response" link. If you don’t remember when you originally submitted your SPR notification, you may check the date and time on the spreadsheet via https://spo.az.gov/contracts/significant-procurement-roles and match it to the email.

• If your entry needs to be deleted, email SPOCompliance@azdoa.gov to provide an explanation for the deletion. If accepted, SPO Compliance will delete the entry.

Please contact the State Procurement Office (SPO) at SPOCompliance@azdoa.gov for any questions.

Email * https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?usp=mail_form_link https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnueM2pnD4U0SkvH6IPLEeoOlPvXZ5SB2tzO8MRi2cueg40IQnM4tyBnrzeP2jki418g https://spointra.az.gov/resources/standard-procedures https://spo.az.gov/contracts/significant-procurement-roles https://spo.az.gov/contracts/significant-procurement-roles mailto:SPOCompliance@azdoa.gov mailto:SPOCompliance@azdoa.gov https://mail.google.com/mail/u/0/?ik=0fd4f98358&view=pt&search=all&permthid=thread-f:1791080121380745322%7Cmsg-f:1791080121380745322&… 2/3 meldredge@azdes.gov

What is the name of the person leading the procurement? *

Myla Eldredge

Which agency is the procurement for? If it is a mandatory statewide contract, select your agency. *

Economic Security, Department of

What is the title of the procurement? *

Emergent Services - Adult Protective Services

What is the procurement type? *

RFQ - Request for Quotation

IFB - Invitation for Bid

RFP - Request for Proposal

✓ CI - Competition Impracticable (SPO Form 101)

Emergency Procurement (SPO Form 102)

SS - Sole Source (SPO Form 103)

NPTQ - Not Practical to Quote (Determination Template D301(4))

Other:

mailto:meldredge@azdes.gov https://mail.google.com/mail/u/0/?ik=0fd4f98358&view=pt&search=all&permthid=thread-f:1791080121380745322%7Cmsg-f:1791080121380745322&… 3/3

What is the date when the first procurement disclosure statement (PDS) was signed (i.e. SPO Form 120 or SPO Form 130)? *

MM

02 /

DD

13 /

YYYY

What is the actual date or estimated date that the purchased materials will be delivered or the purchase of services or construction will begin, per A.R.S. § 41- 753(D)? *

MM

03 /

DD

01 /

YYYY

What is your name (if different from above)?

What is your e-mail address (if different from above)?

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Page 1 of 2PUR-1031A FORFF (5-24) ARIZONA DEPARTMENT OF ECONOMIC SECURITY Division of Financial Operations

Office of Procurement

PROCUREMENT ASSISTANCE (PA) REQUEST

1. PROCUREMENT UNIT NAME: 2. PA NUMBER/SUB-NUMBER: 3. REQUEST DATE:

4. DIVISION/ADMINISTRATION/PROGRAM: 5. DIVISION CONTACT PERSON: 6. TELEPHONE NUMBER:

7. TYPE OF REQUEST/AGREEMENT (check all that apply):

Scope of Work Review

Solicitation

CI /SS /NPTQ Review

Amendment

Extension Yrs/Mos

Corrective Action

Assignment

Contract (Competitive Award)

Direct Contract

Intergovernmental Agreement (IGA)

Interagency Service Agreement (ISA)

Memorandum of Understanding (MOU)

Task Order

IT Agreement/EULA

Set-Aside

COOP

Grant Agreement

If Exempt by Statute A.R.S. No.:

Other

8. DETAILED DESCRIPTION OF REQUEST OR NEED:

9. OTHER DOCUMENTS AND INFORMATION:

Certificate of Insurance (COI) Compliant and Included If CI /SS /NPTQ, No.:

Business Associate Agreement/Data Sharing Agreement Central Registry Check/Fingerprinting Sign and Date when Checked

10. FUNDING SOURCE & AMOUNT (check the appropriate boxes):

Federal State Grant Other Estimated aggregate spend $499K or less

Estimated aggregate spend $500K or more

11. DESCRIPTION OF SERVICES OR CONTRACT TITLE: 12. CONTRACT NUMBER:

13. CONTRACTOR NAME/DBA: 14. FEIN NUMBER:

15. CONTRACTOR CONTACT PERSON’S NAME AND TITLE:

16. E-MAIL ADDRESS/TELEPHONE NO.:

17. CONTRACT ORIGINAL START DATE: 18. MAXIMUM END DATE:

19. CONTRACT CURRENT END DATE: 20. AMENDED END DATE:

21. SINGLE AUDIT STATUS:

Contractor/Vendor

Subrecipient N/A

22. LEGAL AD AUTHORIZATION:

FUNCTION CODE: OBJECT CODE: DEPARTMENT OBJECT CODE:

BA SIGNATURE FOR APPROVAL (Legal Ads):

23. AUTHORIZATIONS (Signatures, NO Initials) & DATES:

24. AUTHORIZED DIVISION REQUESTOR: 25. FINANCIAL SERVICES ADMINISTRATION:

26. ATTORNEY GENERAL (IGA, 3rd Party, etc.): 27. PROCUREMENT OFFICER:

28. PROCUREMENT OFFICER COMMENTS:

Team Nate DAAS-25-159 08/21/2025

DAAS/APS Deb Rhodes (602) 796-0710

Emergent services, Combo new direct contract Charlie Manco, IV0000081818

CI24010

8/6/2025

Emergent Services

Charlie Manco IV0000081818

Charlie Manco chumanco66@gmail.com

12/31/2026

12/31/2026

ARIZONA SECRETARY OF STATE

(https://azsos.gov)

(https://azsos.gov) Elections (https://azsos.gov/elections) Business (https://azsos.gov/business)

Services (https://azsos.gov/services) Rules (https://azsos.gov/rules) About (https://azsos.gov/about)

Entity Search Back

File ID:

9443388

Name:

Manco Services

Business Address:

2286 Huntington Drive Lake Havasu City, Arizona 86403

Mailing Address:

2286 Huntington Drive Lake Havasu City, Arizona 86403

Phone:

928-362-1966

Nature of Business:

Home services and repairs

Date of First Use:

January 11, 2024

8/21/25, 12:35 PM Public Search - Arizona Secretary of State https://apps.azsos.gov/apps/tntp/se.html 1/2 https://azsos.gov/ https://azsos.gov/ https://azsos.gov/ https://azsos.gov/ https://azsos.gov/ https://azsos.gov/ https://azsos.gov/ https://azsos.gov/elections https://azsos.gov/business https://azsos.gov/services https://azsos.gov/rules https://azsos.gov/about v0.2025.0624.10558 b13

Date Registered:

August 21, 2025

Expiration Date:

August 21, 2030

Applicants:

Charlie Wayne Manco Person

Registration Information:

Registration Received:

August 21, 2025 Expires: August 21, 2030

Correspondence History:

Trade Name Application: Filed: August 21, 2025

Back

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Debarred and Suspended Firms

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Debarred and Suspended Firms SPO is responsible for maintaining a list of firms that are suspended or debarred from doing business with the State of Arizona.

THERE ARE NO SUSPENDED OR DEBARRED FIRMS AT THIS TIME.

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