Procurement Request.pdf
PDF 100 KB Posted
- Attached to
- Master Agreement AZ|CTR064826
- Contract number
- CTR064826
- Issued by
- Arizona
About this file
This document is a Procurement Request Form from the Arizona Department of Health Services (AZDHS) for a new Intergovernmental Agreement (IGA) with Yavapai County. The contract, referenced as CTR042499, is for the EDC (Economic Development Commission) Bureau and represents a renewal of a previous agreement that expired in 2019. The request was initiated by Meagan Surgenor, with additional participants including Christine Wampler and Rebecca Scranton.
The IGA is a multi-year agreement with an estimated annual amount of $33,560.36, funded entirely through federal sources. The contract will require approximately 3-4 months to complete and is subject to 2 CFR 200.332 Form requirements. Funding is confirmed as available, and the estimated date needed was 9/1/2022. The procurement request notes that all necessary Program Determination Statement (PDS) forms have not yet been signed, indicating the document is in an early stage of the procurement process.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CTR061538_STD_Control_Services__Yavapai_County_fully_executed.pdf | ||
| CTR064826 STD Control Services, Yavapai County, A1 fully executed.pdf | ||
| CTR064826_Pricing.xlsx | XLSX spreadsheet | |
| CTR064826 A3.pdf | ||
| CTR064826 A2 Pricing.pdf | ||
| CTR064826 Contract Amendment No. 4.pdf | ||
| CTR064826 Pricing A3.pdf | ||
| CTR064826 Pricing.xlsx | XLSX spreadsheet | |
| CTR061538 A1 Pricing.xlsx | XLSX spreadsheet | |
| CTR064826 Pricing A4.pdf | ||
| CTR064826_A2_Executed.pdf |
Show all 11
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Text version
2/17/23, 3:10 PM Procurement Requests - CTR042499 Yavapai IGA https://sharepoint.hs.azdhs.gov/Procurement/SitePages/Assigned Officers.aspx 1/3
Procurement Request Form Arizona Department of Health Services | 150 N. 18th Avenue | Phoenix, AZ 85007
Please provide the following information to assist in the timely and accurate completion of the services requested.
Notes
Title CTR042499 Yavapai IGA
Reference #
FY23 - 2141
Bureau
EDC
Contract/Agreement Type IGA - Intergovernmental Agreements are cooperative agreements with other public agencies, state and local units of government. (Allow approximately 3-4 months for completion, depends largely on County)
See a list of Procurement Thresholds and timelines
Description Previous IGA expired in 2019 and was never renewed. New IGA.
Please ensure Scope of Work is attached to this request.
Existing Contract Number
CTR042499
Requestor Meagan Surgenor
Phone 480-407-9854
Estimated date needed 9/1/2022
Program contact Meagan Surgenor
Program contact phone 480-407-9854
Other Participants Christine Wampler; Rebecca Scranton
All PDS signed?
No https://drive.google.com/file/d/1qKobWLv-xadfXMROTQoQ_30keEUiRg6v/view https://sharepoint.hs.azdhs.gov/Procurement/_layouts/userdisp.aspx?ID=298&RootFolder=* https://sharepoint.hs.azdhs.gov/Procurement/_layouts/userdisp.aspx?ID=1163&RootFolder=* https://sharepoint.hs.azdhs.gov/Procurement/SitePages/Assigned Officers.aspx 2/3
If federal funds, are they for a sub-recipient
(6800/9111, ISA, IGA,
RFGA, etc.)?
2 CFR 200.332 Form
Please ensure all PDS forms are attached to this request. Click here for Procurement Forms.
Estimated annual amount 33,560.36
Funding Available?
Yes
Funding Type Federal
No
Yes
Select a contract Term Multi-year Agreement
Suggested suppliers
Informational Notice
Email this request to the following individuals for informational purposes only https://sites.google.com/azdhs.gov/financialservices/procurement/forms https://sharepoint.hs.azdhs.gov/Procurement/SitePages/Assigned Officers.aspx 3/3
File details come from the government source that posted it. Updated .