CTR076896_Veterans-_Off_Contract_Determination.pdf

Page 1 of 5 SPO Form 106A Standard Word (Rev 11/22)

Owner

Form Number

Process

1 Agency Name of the requesting agency

2 Requestor Name of the requestor 3 Email Email of the requestor 4 Title Job title of the requestor 5 Telephone Telephone number of the requestor

6 Description

7 Contractor Name of the contractor

8 Contract ID eProcurement contract number (if available)

9 Purchase Type

Select applicable option:

- One Time Purchase

- Full Use of Contract

- Partial Use of Contract

10 Contracting Agency Agency that awarded the Contract

11 Maximum End Date Select from the drop-down calendar the maximum end date of the contract

12 Estimated Total Current Contract Spend Forecasted expenditures for the current contract if State Agency contract.

Description of service(s)/material(s) or Contract title (eProcurement Label)

State Procurement Office, Compliance Unit

Version 11/12/2024

Standard Work / Instruction for completion of the

SPO 106A - Single-Agency Cooperative Contract Purchase Authorization

SPO Form 106A

Form Completion Process

No. Action Action Detail / Key Points

Sections I through II to be completed by the requesting State Governmental Unit:

SECTION I - Agency Request

SECTION II A and B - Background

Page 2 of 5 SPO Form 106A Standard Word (Rev 11/22)

13 Estimated Cost of Increase (if applicable)

Forecasted expenditures for the duration of the Cooperative purchase , including the current

14 Description 15 Solicitation ID eProcurement solicitation number (if available)

16 Estimated Spend of Contract Forecasted expenditures for the duration of the Cooperative purchase, including the lead Agency

17 Lead Agency Agency that is running the solicitation 18 Maximum Term Maximum term allowed by the the contracts terms (including all renewals)

A and B: Detail the efforts made to secure a contract for the specific Materials or Services requested and explain why purchasing from a Cooperative Contract (piggyback) is in the best interest of the State per Technical Bulletin 005.

Detail the efforts made to secure a contract for the specific Materials or Services requested and explain why purchasing from a Cooperative Contract (piggyback) is in the best interest of the State per Technical Bulletin 005.

A and B: Was the contract awarded through the competitive process?

A.A.C. R2-7-1003(B)(1)

Select applicable option:

- Yes

- No

- Solicitation Pending

A: The Estimated Cost of the Increase (for added agency) exceeds 25% of the estimated cost of the existing contract. In accordance with A.A.C.

R2-7-1003(C) and R2-7-702, the increase is determined fair and reasonable based on adequate price competition and is determined advantageous to the state based upon the justification provided in box 19.

Check the if the Estimated Cost of the Increase (for added agency) exceeds 25% of the estimated cost of the existing contract. In accordance with A.A.C. R2-7-1003(C) and R2-7-702, the increase is determined fair and reasonable based on adequate price competition and is determined advantageous to the state based upon the justification provided in box 19.

22 Date of request Select the date of request from the drop-down calendar

23 Requester Signature Signature of the authorized requestor

Description of service(s)/material(s) or Contract title (eProcurement Label)

Requester: Upon completion of Section I and II, send this signed form to Contract Owner listed in the eProcurement System for review

Page 3 of 5 SPO Form 106A Standard Word (Rev 11/22)

SECTION III - Contract Owner Review

25 Comments, conditions, and restrictions (as applicable) Complete as needed

I acknowledge that upon approval of SPO Form 106A, the Contract will require an amendment to add the additional agency and the additional agency will need to be added as a user in the state’s eProcurement System.

This completed form will be included in the request to the help desk.

Click the box to acknowledge that upon approval of SPO Form 106A, the Contract will require an amendment to add the additional agency and the additional agency will need to be added as a user in the state’s eProcurement System. This completed form will be included in the request to the help desk.

27 Print Name Name of the Contract Owner

28 Title Job title of the Contract Owner 29 Signature Signature of the contract owner

30 Date of Review Select the date of review from the drop-down calendar

Determination

Select applicable option in accordance with A.A.C. R2-7-1001:

- Request Authorized

- Request Authorized with Conditions/Restrictions

- Request Returned for Additional Information

- Request Denied

Approved Expiration Date Select the date from the drop-down calendar

Comments, conditions or restrictions (as applicable) Complete as needed

Print name Printed name of the approver

Date Select the date of approval from the drop-down calendar Title Job title of the approver Signature Signature of the approving authority

39 Use this additional section as necessary

Section may be used by requesting agency or SPO, in case the fields within the document were insufficient

Contract Owner: Upon completion of Section III, send this signed form to SPOCompliance@azdoa.gov and cc Requestor for processing

Section IV to be completed by SPO:

Use this addition section as necessary

Page 1 of 4 SPO Form 106A Standard Word (Rev 11/22)

Procurement Determination:

Authorization A.A.C. R2-7-1001 and R2-7-1003 Single-Agency Cooperative Purchase

SECTIONS I-II MUST BE COMPLETED BY THE REQUESTOR

SECTION I - Agency Request*

SECTION II.A - Background (if contract is in place)

SECTION II.B - Background (if prior to contract award)

1. Agency

2. Requestor 3. Email

4. Title 5. Telephone

6. Description

7. Contractor

8. Contract ID 9. Purchase Type

10. Contracting Agency

11. Maximum End Date

13. Estimated Cost of Increase (if applicable)

14. Description

15. Solicitation

ID

16. Estimated Spend of Contract

17. Lead Agency 18. Maximum Term

* For limited delegation agencies, please work with your Enterprise Procurement Services (EPS) liaison.

12. Estimated Total Current Contract Spend

Arizona Department of Veterans' Services

Tracy Chisler tchisler@azdvs.gov

Chief Procurement Officer 602-359-6099

Temporary Nursing Services

Temporary Nursing Services

All About People, Baraka House, LanceSoft, LifeNest, Worldwide Staffing

CTR076894CTR076896CTR076897CTR076898

Arizona Department of Economic Security 6/30/2030

$43,000,000 $10,000,000

- Full Use of Contract

Page 2 of 4 SPO Form 106A Standard Word (Rev 11/22)

19. A and B: Detail the efforts made to secure a contract for the specific Materials or Services requested and explain why purchasing from a Cooperative Contract (piggyback) is in the best interest of the State per Technical Bulletin 005.

20. A and B: Was the contract awarded through the competitive process? A.A.C. R2-7-1003(B)(1)

21. A: The Estimated Cost of the Increase (for added agency) exceeds 25% of the estimated cost of the existing contract. In accordance with A.A.C. R2-7-1003(C) and R2-7-702, the increase is determined fair and reasonable based on adequate price competition and is determined advantageous to the state based upon the justification provided in box 19.

22. Date of request 23. Requester Signature

24. Requester: Upon completion of Section I and II, send this signed form to Contract Owner listed in the eProcurement System for review

Approval of this request does not allow for agencies to exceed their delegated authority.

9/19/2025

- Yes

Page 3 of 4 SPO Form 106A Standard Word (Rev 11/22)

TO BE COMPLETED BY THE CONTRACT OWNER

SECTION III - Contract Owner Review

25. Comments, conditions, and restrictions (as applicable)

26. I acknowledge that upon approval of SPO Form 106A, the Contract will require an amendment to add the additional agency and the additional agency will need to be added as a user in the state’s eProcurement System. This completed form will be included in the request to the .

27. Print Name 28. Title

29. Signature 30. Date of Review help desk

31. Contract Owner: Upon completion of Section III, send this signed form to SPOCompliance@azdoa.gov and cc Requestor for processing

X

ADES currently has five contractors under the Nursing Services Contract and don't foresee of having any issues with allowing Veterans Services in utilizing the Nursing Contracts. ADES approves this request.

Nicole Marquez Senior Procurement Specialist

9/24/25

Page 4 of 4 SPO Form 106A Standard Word (Rev 11/22)

SECTION IV - Approval

TO BE COMPLETED BY PROCUREMENT AUTHORITY

32. Determination

33. Approved Expiration Date

34. Comments, conditions or restrictions (as applicable)

35. Print name 36. Date

37. Title 38. Signature

39. Use this additional section as necessary

AGENCY NOTICE: This is an official written determination in response to a procurement authorization request. The original request shall be maintained in the State Procurement Office.

6/30/30

J. Renee Uliassi (Oct 1, 2025 14:29:53 PDT) J. Renee Uliassi

- Request Authorized

Deputy Assistant Director

J. Renee Uliassi 10/01/2025 https://azadoagov.na1.echosign.com/verifier?tx=CBJCHBCAABAAVt2MITd7FCzWgzcVUcQtrMKCSaLmhCNc