FE_16-05-ED_Amendment_12.pdf
PDF 550 KB Posted
- Attached to
- Master Agreement AZ|CTR043817
- Contract number
- CTR043817
- Issued by
- Arizona
About this file
This document is an Amendment (No. 12) to an existing Interagency Service Agreement between the Arizona Department of Education (ADE) and Northern Arizona University (NAU), located in Flagstaff, Arizona. The agreement is for Agreement No. 16-05-ED, specifically focused on the Evidence Based Practice (EBP) Conference, and is being renewed for the period of October 1, 2025 to September 30, 2026.
The amendment includes revisions to the Scope of Work, adding new responsibilities for NAU such as developing a specific strand for Special Education personnel within each conference track and ensuring ADE/ESS staff are included in conference planning activities. The budget for the agreement is $30,000, with line items including $25,000 for Purchase Services/Consultant Fees, $2,500 for Supplies and Materials, $278 for Printing and Reproduction, and $2,222 for Indirect Costs. Additional expenses include $24,000 for Rent of Facilities (at 25% of total) and $5,000 for Capital Outlay (Computer and Monitor at 100%). The agreement maintains the original terms and conditions with these specific updates and extensions.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 16-05-ED_FE_Amendment11.pdf | ||
| FE_16-05-ED_Amendment_10.pdf | ||
| 16-05-ED_AMD_5_FE.pdf | ||
| 16-05-ED_Amendment_6_FE.pdf | ||
| 16-05-ED_FE_Amendment_9.pdf | ||
| 16-05-ED_Fully_Executed.pdf | ||
| FE_16-05-ED_Amendment_7.pdf | ||
| 16-05-ED_FE_Amendment_4.pdf | ||
| FE_16-05-ED_Amendment_8.pdf |
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Text version
ARIZONA DEPARTMENT OF EDUCATION
Procurement Section
1535 West Jefferson Street, Bin #37 Phoenix, Arizona 85007-3209
CONTRACT/AGREEMENT ATTACHMENT B
1. AGREEMENT NO.:
16-05-ED
2. AMENDMENT NO.:
3. EFFECTIVE DATE:
10/1/2025
4. PROGRAM:
EBP Conference
5. CONTRACTOR NAME:
Northern Arizona University P.O. Box 4130 Flagstaff, AZ 86011-4130 Email: jie.kunkel@nau.edu & osp-invoices@nau.edu
6. AUTHORITY FOR AMENDMENT: Paragraph 3 “Renewal of Agreement”, Paragraph 7, “Changes”
7. PURPOSE OF AMENDMENT: Renewal, Scope of Work Revision, Updated Budget
8. DESCRIPTION OF THE SERVICE: Co-Sponsor Annual Evidence Based Practice Conference with NAU
9. THE ABOVE REFERENCED AGREEMENT IS HEREBY AMENDED AS FOLLOWS:
9.1. In accordance with the provisions of the agreement, Paragraph 3 “Renewal of Agreement”, I hereby extend the agreement for the periods of October 1, 2025 to September 30, 2026.
9.2. In accordance with the provisions of the agreement, Paragraph 7 “Changes”, the following sections have been revised as follows:
9.2.1 Attachment A – Scope of Work is revised with the following:
The following is added to Section 2:
2. Contractor Responsibilities:
D. NAU will develop a specific strand for Special Education personnel (e.g., educators, related service providers, administrators, etc.) within each conference track.
E. NAU will ensure ADE/ESS staff are included in conference planning activities.
The following is revised in Section 3:
3. ADE Responsibilities
Section 3A is replaced with:
A. Provide financial support for conference infrastructure.
9.3 Attachment B Price Sheet is revised and replaced.
10. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL
CONTRACT/AGREEMENT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED
AND IN FULL EFFECT.
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.
CONTRACTOR ARIZONA DEPARTMENT OF EDUCATION
(SIGNATURE OF AUTHORIZED INDIVIDUAL)
NAME (Typed/Printed): Nicky Jurgen
(SIGNATURE)
NAME: Braulio Garcia
TITLE: TITLE: Chief Procurement Officer
DATE: DATE:
ABOR for an on behalf of Norther Arizona University
Assistant Director, Pre-Award Research Administration
10/03/2025
1535 West Jefferson Street, Bin #37 Phoenix, Arizona 85007-3209
CONTRACT/AGREEMENT ATTACHMENT B
ARIZONA DEPARTMENT OF EDUCATION INTERAGENCY
SERVICE/INTERGOVERNMENTAL AGREEMENT BUDGET/
ESTIMATED NEEDS PAYMENT SCHEDULE FOR
INSTITUTIONS OF HIGHER EDUCATION, STATE AGENCIES
AND OTHER AGENCIES
INSTRUCTIONS
Submit original to ADE Contracts Management Unit as part of proposed Agreement/amendment. Final Agreement will contain instructions for submission of periodic/completion reports
A. AGREEMENT IDENTIFICATION FOR THE BUDGET PERIOD FROM : 10/1/2025 TO: 9/30/2026
1. Applicant Agency:
Northern Arizona University
2. Contact Person: Adi Schaeffer Phone No: 602.728.9537
3. Agreement No.: 16-05-ED Index No.:
4. Funding Source (Chapter 1, etc.)
ADE
5. Date submitted: 9/11/2025
6. Proposal Name (if any): Evidence Based Practice Conference
7. Check ONE ☐ New ☒ Renewal Application ☐ Completion Report ☐ Amendment ☐ADE Revision
B. AGREEMENT BUDGET
*EXPENDITURE CATEGORIES
BUDGET
(1)
REQUEST
CHANGES
(2)
AMENDED
BUDGET
(3)
EXPENDITURE
TO DATE
(4)
BUDGET
BALANCE
(5)
8. Salaries – Instructional 0
9. Salaries – Non-Instructional 0
10. Employee Benefits 0
11. Travel 0
12. Supplies and Materials 2,500
13. Purch Services/Consultant Fees 25,000
14. Conference Registration 0
15. Printing and Reproduction 278
16. Utilities and Communications
17. Other: 0
18. SUBTOTAL 27,778
19. Indirect Cost (8% of Line 18) 2,222
20. Capital Outlay 0
21. TOTAL 30,000
22. Administrative Costs
23. Cash Balance (For Completion Purposes)
*SEE INSTRUCTIONS ON REVERSE SIDE
C. COMPLETION REPORT SIGNATURE (Blue Ink Only)
I hereby certify that this is a reasonable statement of total expenditures for this contract.
Applicant Authorized Agent Date
D. SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE
Prior FY C/O + FY State C/O + FY (New)+ Other = TOTAL FY
E. ESTIMATED NEEDS PAYMENT SCHEDULE ☐Original ☐Revised Date:
FY_____ State C/O FY______ FY_______
Jul: Jan: Jul: Jan: Jul: Jan:
1535 West Jefferson Street, Bin #37 Phoenix, Arizona 85007-3209
CONTRACT/AGREEMENT ATTACHMENT B
Aug: Feb: Aug: Feb: Aug: Feb:
Sep: Mar: Sep: Mar: Sep: Mar:
Oct: Apr: Oct: Apr: Oct: Apr:
Nov: May: Nov: May: Nov: May:
Dec: Jun: Dec: Jun: Dec: Jun:
TOTAL TOTAL TOTAL
17 Other Expenses Rent of Facilities $24,000.00 25% $ 6,000.00 20 Capital Outlay Computer and Monitor $ 5,000.00 100% $ 5,000.00
| 5 CONTRACTOR NAME Northern Arizona University PO Box 4130 Flagstaff AZ 860114130 Email jiekunkelnauedu ospinvoicesnauedu: | |
| SIGNATURE NAME Braulio Garcia: | |
| TITLE Assistant Director PreAward Research Administration: | |
| DATE 10032025: | |
| DATE: 10/6/2025 | |
| 1012025: | |
| TO: | |
| 9302026: | |
| 1 Applicant Agency Northern Arizona University: | |
| 2 Contact Person Adi Schaeffer Phone No 6027289537: | |
| 5 Date submitted 9112025: | |
| 3 Agreement No 1605ED Index No: | |
| 6 Proposal Name if any Evidence Based Practice Conference: | |
| fill_87: | |
| undefined: Off | |
| undefined_2: Off | |
| undefined_3: Off | |
| undefined_4: Off | |
| REQUEST CHANGES 20: | |
| AMENDED BUDGET 30: | |
| EXPENDITURE TO DATE 40: | |
| BUDGET BALANCE 50: | |
| REQUEST CHANGES 20_2: | |
| AMENDED BUDGET 30_2: | |
| EXPENDITURE TO DATE 40_2: | |
| BUDGET BALANCE 50_2: | |
| 10 Employee Benefits: | |
| REQUEST CHANGES 20_3: | |
| AMENDED BUDGET 30_3: | |
| EXPENDITURE TO DATE 40_3: | |
| BUDGET BALANCE 50_3: | |
| 11 Travel: | |
| REQUEST CHANGES 20_4: | |
| AMENDED BUDGET 30_4: | |
| EXPENDITURE TO DATE 40_4: | |
| BUDGET BALANCE 50_4: | |
| REQUEST CHANGES 22500: | |
| AMENDED BUDGET 32500: | |
| EXPENDITURE TO DATE 42500: | |
| BUDGET BALANCE 52500: | |
| REQUEST CHANGES 225000: | |
| AMENDED BUDGET 325000: | |
| EXPENDITURE TO DATE 425000: | |
| BUDGET BALANCE 525000: | |
| REQUEST CHANGES 20_5: | |
| AMENDED BUDGET 30_5: | |
| EXPENDITURE TO DATE 40_5: | |
| BUDGET BALANCE 50_5: | |
| REQUEST CHANGES 2278: | |
| AMENDED BUDGET 3278: | |
| EXPENDITURE TO DATE 4278: | |
| BUDGET BALANCE 5278: | |
| 27816 Utilities and Communications: | |
| REQUEST CHANGES 216 Utilities and Communications: | |
| AMENDED BUDGET 316 Utilities and Communications: | |
| EXPENDITURE TO DATE 416 Utilities and Communications: | |
| BUDGET BALANCE 516 Utilities and Communications: | |
| 17 Other: | |
| REQUEST CHANGES 20_6: | |
| AMENDED BUDGET 30_6: | |
| EXPENDITURE TO DATE 40_6: | |
| BUDGET BALANCE 50_6: | |
| 18 SUBTOTAL: | |
| REQUEST CHANGES 227778: | |
| AMENDED BUDGET 327778: | |
| EXPENDITURE TO DATE 427778: | |
| BUDGET BALANCE 527778: | |
| REQUEST CHANGES 22222: | |
| AMENDED BUDGET 32222: | |
| EXPENDITURE TO DATE 42222: | |
| BUDGET BALANCE 52222: | |
| 20 Capital Outlay: | |
| REQUEST CHANGES 20_7: | |
| AMENDED BUDGET 30_7: | |
| EXPENDITURE TO DATE 40_7: | |
| BUDGET BALANCE 50_7: | |
| 21 TOTAL: | |
| REQUEST CHANGES 230000: | |
| AMENDED BUDGET 330000: | |
| EXPENDITURE TO DATE 430000: | |
| BUDGET BALANCE 530000: | |
| 3000022 Administrative Costs: | |
| REQUEST CHANGES 222 Administrative Costs: | |
| AMENDED BUDGET 322 Administrative Costs: | |
| EXPENDITURE TO DATE 422 Administrative Costs: | |
| BUDGET BALANCE 522 Administrative Costs: | |
| 23 Cash Balance For Completion Purposes: | |
| SEE INSTRUCTIONS ON REVERSE SIDE: | |
| Applicant Authorized Agent: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1_2: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1_3: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1_4: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1_5: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow1_6: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2_2: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2_3: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2_4: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2_5: | |
| D SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE Prior FY CO FY State CO FY New Other TOTAL FYRow2_6: | |
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| Other Expenses: | |
| Rent of Facilities: | |
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| Computer and Monitor: | |
| TOTAL TOTAL TOTALRow1: | |
| 2025-10-06T07:31:49-0700 | |
| Braulio Garcia |
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