FE_16-05-ED_Amendment_8.pdf
PDF 407 KB Posted
- Attached to
- Master Agreement AZ|CTR043817
- Contract number
- CTR043817
- Issued by
- Arizona
About this file
This document is a Contract/Agreement Amendment from the Arizona Department of Education's Procurement Section, involving Northern Arizona University (NAU) as the contractor. The amendment is for Agreement No. 16-05-ED, specifically Amendment No. 8, related to an Evidence Based Practice (EBP) Conference. The document is dated 11/9/2021 and becomes effective upon execution, with key signatories including Kerwin Lawrence (Assistant Director) and Steven Paulson (Chief Procurement Officer).
The amendment updates the budget for a co-sponsored Annual Evidence Based Practice Conference with NAU, increasing the total budget from $45,000 to $49,217.96. The budget modifications include increases in Supplies and Materials (from $808 to $2,760.76), Printing and Reproduction (from $100 to $2,052.76), and corresponding adjustments to indirect costs. The budget period covers 10/01/2021 to 9/30/2022, with the funding source identified as Index No. 8. The budget categories include Non-Instructional Salaries ($12,656.80), Employee Benefits ($8,223.41), Purchase Services/Consultant Fees ($19,878.46), and other miscellaneous expenses, reflecting a collaborative approach to hosting the conference.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 16-05-ED_AMD_5_FE.pdf | ||
| 16-05-ED_FE_Amendment11.pdf | ||
| FE_16-05-ED_Amendment_10.pdf | ||
| 16-05-ED_FE_Amendment_4.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_12.pdf | ||
| FE_16-05-ED_Amendment_7.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 AMENDMENT
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):
(SIGNATURE)
NAME: Steven Paulson TITLE: TITLE: Chief Procurement Officer
DATE: DATE:
1. AGREEMENT NO.:
16-05-ED
2. AMENDMENT NO.:
3. EFFECTIVE DATE:
Upon Execution
4. PROGRAM:
EBP Conference
5. CONTRACTOR NAME:
Northern Arizona University P.O. Box 4130 Flagstaff, AZ 86011-4130
6. AUTHORITY FOR AMENDMENT: Paragraph 7, “Changes”
7. PURPOSE OF AMENDMENT: 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:
a. In accordance with paragraph 7, Changes, the budget is hereby replaced by Attachment B:
Kerwin Lawrence
Assistant Director
11/9/2021
ARIZONA DEPARTMENT OF EDUCATION
Procurement Section
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 : 10/01/2021 TO: 9/30/2022
1. Applicant Agency:
IHD/NAU
2. Contact Person: Jill Pleasant Phone No: 602-728-9532
3. Agreement No.: 16-05-ED
Index No.: 8 4. Funding Source (Chapter 1, etc.)
ADE
5. Date submitted 9/21/2021
6. Proposal Name (if any):
IHD/AT Disability 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
9. Salaries – Non-Instructional $12,656.80 $12,656.80
10. Employee Benefits $8,223.41 $8,223.41
11. Travel
12. Supplies and Materials $808 $1,952.76 $2,760.76
13. Purch Services/Consultant Fees $19,878.46 $19,878.46
14. Tuition
15. Printing and Reproduction $100 $1,952.76 $2,052.76
16. Utilities and Communications
17. Other:
18. SUBTOTAL $41,666.67 $3,905.52 $45,572.19
19. Indirect Cost (8% of Line 18) $3,333.33 $312.44 $3,645.77
20. Capital Outlay
21. TOTAL $45,000 $4,217.96 $49,217.96
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
| 2021-11-10T15:35:53-0700 | |
| Steven Paulson |
File details come from the government source that posted it. Updated .