CTR078966_Pre-Contract_Documents.pdf
PDF 12 MB Posted
- Attached to
- AZ|CTR078966
- Contract number
- CTR078966
- Issued by
- Arizona
About this file
The document is a Procurement Assistance (PA) Request and Competition Impracticable Authorization from the Arizona Department of Economic Security (ADES), specifically the Division of Aging and Adult Services (DAAS), for a new direct contract with Catholic Charities Community Services Phoenix. The procurement is being processed by Team Hudson within the DAAS/RRP (Refugee Resettlement Program) and involves case coordination services. The contract will be funded federally and is being processed through the Arizona State Procurement Office.
The contract is for a Refugee Program-Case Coordination service, with an estimated aggregate spend of $8 million, covering the period from 10/01/2025 to 09/30/2027. The scope involves providing critical stop-gap support for eligible beneficiaries through Arizona's Local Resettlement Agencies (LRAs), specifically targeting refugees with increasing risk factors and potential loss of federally-funded support. The procurement is being pursued as a Competition Impracticable (CI) authorization, with two anticipated contracts in Maricopa County and potentially one in Pima County. The services are aimed at supporting refugee clients' safety, self-sufficiency, and family stability, with a focus on case management, employment authorization, and navigation of critical social services.
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Other files
| File | Type | Posted |
|---|---|---|
| CTR078966_Contract_Amendment_1.pdf | ||
| CI26003_Determination.pdf | ||
| CTR078966__Contract_Documents.pdf | ||
| myCOI_Instructions.pdf |
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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:
Page 2 of 2PUR-1031A FORFF (5-24) INSTRUCTIONS
1. PROCUREMENT UNIT NAME – enter name of the assigned procurement team.
2. PA NUMBER / SUB-NUMBER – enter the Program-assigned Procurement Assistance (PA) number, and Sub-number number, if applicable.
Examples: After the SOW is finalized, if there are multiple contracts / agreements awarded for the same service; or a solicitation results in multiple awards, the procurement officer adds /1, /2, /3, etc.
3. REQUEST DATE – enter date program contracts officer begins processing.
4. DIVISION / ADMINISTRATION / PROGRAM – enter abbreviations for the division, administration and program submitting the request to OP.
5. DIVISION CONTACT PERSON – enter the name of the program contracts officer associated with this request.
6. TELEPHONE NUMBER – enter the telephone number of the of the contact person.
7. TYPE OF REQUEST / AGREEMENT – Check ALL applicable boxes considering there should be one PA per procurement action from the moment a need has been identified, until the action is completed i.e. solicitation awarded, contract fully executed, assignment completed.
Examples:
a) For a new solicitation, under section seven (7), the following boxes should be checked:
Scope of Work Review Solicitation
b) For new direct contract, under section seven (7), the following boxes should be checked:
Cl /SS /NPTQ Review Scope of Work Review Direct Contract
c) For new task order, under section seven (7), the following boxes should be checked:
Scope of Work Review Task Order
d) For a direct contract amendment which requires SOW revision, under section seven (7), the following boxes should be checked:
Cl /SS /NPTQ Review Scope of Work Review Amendment Direct Contract
e) For an IGA extension, under section seven (7), the following boxes should be checked:
Extension Yrs/Mos Intergovernmental Agreement (IGA)
f) For a contract action against competitively awarded contract, under section seven (7), the following boxes should be checked:
Contract Action Contract (competitive award)
g) For a competitively awarded contract amendment, under section seven (7), the following boxes should be checked:
Amendment Contract (competitive award)
8. DETAILED DESCRIPTION OF REQUEST OR NEED – provide details of the request. Use memo to expand if necessary.
9. OTHER DOCUMENTS & INFORMATION:
Certificate of Insurance (COI) Compliant and Included – Mark that the certificate of insurance is included and compliant, if applicable.
Business Associate Agreement / Data Sharing Agreement – Check if BAA / DSA is required for the request.
If CI / SS / NPTQ, No – If there is an existing limited competition determination, specify the number and provide electronic copy.
Central Registry Check / Fingerprinting – Division’s contracts officer shall sign and date when check has been completed, if applicable.
10. FUNDING SOURCE & AMOUNT – check the appropriate funding source(s) for the request & check if the total value of the Agreement/Contract. Is estimated aggregate spend $499K or less OR $500K or more?
11. DESCRIPTION OF SERVICES OR CONTRACT TITLE – provide service description or title of contract, as defined in the SOW.
12. CONTRACT NUMBER – enter the contract number, if applicable. If multiple contracts, create separate PAs for each contract.
13. CONTRACTOR NAME / DBA – enter the Contractor name and the doing business as (DBA) name, if applicable.
14. FEIN NUMBER – enter the Federal Employer Identification Number of the contractor, if applicable.
15. CONTRACTOR CONTACT PERSON’S NAME AND TITLE – enter the name and title of the contractor’s designated contact person.
16. E-MAIL ADDRESS / TELEPHONE NUMBER – enter the e-mail address and telephone number of the contractor’s designated contact person.
17. CONTRACT ORIGINAL START DATE – enter the first date when services can be rendered against the contract, if applicable.
18. MAXIMUM END DATE – enter the last possible date that service can be rendered against the contract, if applicable.
19. CONTRACT CURRENT END DATE – enter the last date of the current contract term, if applicable.
20. AMENDED END DATE – enter the amended term end date, if applicable.
21. SINGLE AUDIT STATUS – division staff check the appropriate box. Required only for service/taxonomy contracts
22. LEGAL AD AUTHORIZATION – function code, object code, and department object code provide from the Business Administrator (BA) and BA’s signature for funding approval
23. AUTHORIZATIONS & DATES – signatures of authorized individuals from the respective areas & dates of authorized individuals from the respective areas.
24. AUTHORIZED DIVISION REQUESTOR – signatures and dates of authorized individuals from the respective areas.
25. FINANCIAL SERVICES ADMINISTRATOR (IGA, ISA, IT Projects (including agreements, software, hardware, contractors (Non- FTE)), and non IT procurements with an aggregated spend of $500K and more) - signatures and dates of authorized individuals from the respective areas.
26. ATTORNEY GENRAL (IGA, 3rd PARTY, ETC) – signatures and dates of authorized individuals from the respective areas.
27. PROCUREMENT OFFICER – signatures and dates of authorized individuals from the respective areas.
28. PROCUREMENT OFFICER COMMENTS – Complete as needed.
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