YH23-0067_ASU_Amend_3_Executed__1_.pdf

CONTRACT AMENDMENT

1. AMENDMENT #:

2. CONTRACT #:

YH23-0067

CTR062538

3. EFFECTIVE DATE OF AMENDMENT:

Upon Final Signature

4. PROGRAM:

DGI

5. CONTRACTOR/PROVIDER NAME AND ADDRESS:

Arizona Board of Regents

Acting on Behalf of the Arizona State University (ASU) Office of Research & Sponsored Projects Administration

P.O. Box 876100 Tempe, AZ 85287-6011

To insert the attached SOR III Year 2 Price Sheet and Budget Narrative and Justification for the term September 30, 2023, through September 29, 2024. Increase the Contract amount by $217,000.

7. THE ABOVE REFERENCED CONTRACT IS HEREBY AMENDED AS FOLLOWS:

Contract YH23-0067 is hereby amended to insert the attached SOR III Year 2 Price Sheet and Budget Narrative and Justification for the term September 30, 2023, through September 29, 2024.

Increase the contract amount for Year 2 by $217,000.

All other portions of the Contract remain in effect.

NOTE: Please sign, date, and return one scanned copy to: Marie Horn, Senior Procurement Specialist at marie.horn@azahcccs.gov

Electronic Submission: An electronic or portable document file (PDF) copy of this amendment shall serve as the original.

8. IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.

9. NAME OF CONTRACTOR/PROVIDER:

Arizona Board of Regents, Acting on Behalf of the Arizona State University

10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

SIGNATURE OF AUTHORIZED INDIVIDUAL: SIGNATURE:

TYPED NAME:

Kristy Macdonald

TYPED NAME:

Tracey Thomas

ATTEST:

Assistant Director, Research Operations

TITLE:

Procurement Manager

DATE: DATE:

DocuSign Envelope ID: E4BD31FE-C9C8-4840-92D2-F98AED26DE1C

9/21/202309/22/2023 mailto:marie.horn@azahcccs.gov

PRICE SHEET

FUNDING / METHOD OF REIMBURSEMENT

SOR III Year 2 September 30, 2023, through September 29, 2024

ASU - SIRC

YH23-0067

ACCOUNT CLASSIFICATION TOTAL AWARD

Personnel $97,504

ERE/Fringe $32,636

Travel Expense $2,267

Equipment $0

Supplies $0

Contractual $0

Other Operating $17,870

Total Direct Charges $150,277

Indirect Charges or Admin (If Authorized)* $66,723

TOTAL $217,000

With prior written approval from the Program Manager, the contractor is authorized to transfer up to a maximum of 10% of the total budget amount between line items. Transfers of funds are only allowed between funded line items. Transfers exceeding 10% or to a non-funded line item shall require an amendment.

All travel related expenditures will require itemized receipts and will not exceed the State allowable rates which can be found at the State of Arizona Accounting Manual (SAAM) https://gao.az.gov/publications/saam

In compliance with 2 CFR Part 200, Grants & Agreements §200.331, Requirements for Pass Thru Entities (subrecipient), the information below is solely to comply with 2 CFR Part 200 and does not reflect the funding amount or period of performance of the contract. Please refer to the Contract & Cost Reimbursement Line-Item Budget for funding amount and Period of Performance.

Grantor: Substance Abuse & Mental Health Services Administration (SAMHSA) Grantee: Arizona Health Care Cost Containment System Grant Name: State Opioid Response III Grant (SOR III)

CFDA: 93.788

Federal Award Identification Number (FAIN)

Award Amount Issue Date Award Period Period of Performance (Project Performance

FFATA

(Y/N)

H79TI085739 $33,080,062 09/05/2023 09/30/23 –

09/29/24

09/30/2022 – 09/29/2024

Y https://gao.az.gov/publications/saam

COLLEGES AND UNIVERSITIES RATE AGREEMENT

EIN:

ORGANIZATION:

Arizona State University Fulton Center 410, Rm. 4478 P.O. Box 87705

Tempe, AZ 85287-7605

DATE:06/02/2022

FILING REF.: The preceding agreement was dated 04/20/2021

The rates approved in this agreement are for use on grants, contracts and other agreements with the Federal Government, subject to the conditions in Section III.

SECTION I: INDIRECT COST RATES

RATE TYPES: FIXED FINAL PROV. (PROVISIONAL) PRED. (PREDETERMINED)

EFFECTIVE PERIOD

TYPE FROM TO RATE(%) LOCATION APPLICABLE TO

PRED. 07/01/2020 06/30/2023 57.00 On-Campus Organized Research

PRED. 07/01/2020 06/30/2023 26.00 Off-Campus Organized Research

PRED. 07/01/2020 06/30/2023 48.00 On-Campus Instruction

PRED. 07/01/2020 06/30/2023 26.00 Off-Campus Instruction

PRED. 07/01/2020 06/30/2023 44.40 On-Campus Other Sponsored Activities

PRED. 07/01/2020 06/30/2023 26.00 Off-Campus Other Sponsored Activities

PROV. 07/01/2023 Until Amended

(1)

*BASE

Page 1 of 5 U21353

ORGANIZATION: Arizona State University

AGREEMENT DATE: 6/2/2022

Modified total direct costs, consisting of all salaries and wages, fringe benefits, materials, supplies, services, travel and subgrants and subcontracts up to the first $25,000 of each subgrant or subcontract (regardless of the period covered by the subgrant or subcontract). Modified total direct costs shall exclude equipment, capital expenditures, charges for patient care, participant support costs, student tuition remission, rental costs of off-site facilities, scholarships, and fellowships as well as the portion of each subgrant and subcontract in excess of $25,000.

(1) Use same rates and conditions as those cited for fiscal year ending June 30, 2023.

SECTION I: FRINGE BENEFIT RATES**

TYPE FROM TO RATE(%) LOCATION APPLICABLE TO

FIXED 7/1/2022 6/30/2023 25.60 All (A) Faculty

FIXED 7/1/2022 6/30/2023 34.00 All (A) Staff

FIXED 7/1/2022 6/30/2023 10.60 All (A) Part Time

FIXED 7/1/2022 6/30/2023 2.00 All (A) Students

FIXED 7/1/2022 6/30/2023 10.70 All (A) RA/TA

FIXED 7/1/2022 6/30/2023 21.40 All (A) Post Doc

PROV. 7/1/2023 6/30/2025 (B)

** DESCRIPTION OF FRINGE BENEFITS RATE BASE:

(A) Salaries and wages including vacation, holiday, sick leave pay and other paid absences.

(B) Use same rates and conditions as those cited for fiscal year ending June 30, 2023.

TREATMENT OF FRINGE BENEFITS:

The fringe benefits are charged using the rate(s) listed in the Fringe Benefits Section of this Agreement. The fringe benefits included in the rate(s) are listed below.

TREATMENT OF PAID ABSENCES

Vacation, holiday, sick leave pay and other paid absences are included in salaries and wages and are claimed on grants, contracts and other agreements as part of the normal costs for salaries and wages. Separate claims for the costs of these paid absences are not made except for paid absences that have been earned but not taken when an individual separates from the university prior to the completion of the grant, contract or other agreement.

OFF-CAMPUS DEFINITION

An off-campus rate is applicable to those projects conducted in facilities not owned or operated by the University, which include charges for facility rental as a direct expenditure, and for which more than 50% of the project salaries and wages are for effort conducted in the rental facility.

DEFINITION OF EQUIPMENT

Equipment means tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost which equals or exceeds $5,000.

The following fringe benefits are included in the fringe benefit rate(s):

FICA, WORKERS COMPENSATION, HEALTH/DENTAL/LIFE INSURANCE, UNEMPLOYMENT

INSURANCE, DISABILITY INSURANCE, ACCIDENTAL DEATH, RETIREMENT PLANS (STATE

RETIREMENT PROGRAMS AND TIAA/CREF), FLEXIBLE SPENDING PLAN, RETIREE

ACCUMULATIVE SICK LEAVE, AND EMPLOYEE TUITION REMISSION, EMPLOYEE WELLNESS,

SABBATICAL PAYMENTS, EMPLOYEE ASSISTANCE, AND TERMINAL LEAVE.

This agreement updates fringe benefits only.

NEXT PROPOSAL DUE DATE

Your next indirect cost and fringe benefits proposals based on actual costs for FYE 06/30/22 are due by 12/31/22.

SECTION II: SPECIAL REMARKS

SECTION III: GENERAL

A. LIMITATIONS·

The rates in this Agreement are subject to any statutory or administrative limitations and apply to a given grant, contract or other agreement only to the extent that funds are available. Acceptance of the rates is subject to the following conditions: (1) Only costs incurred by the organization were included in its facilities and administrative cost pools as finally accepted: such costs are legal obligations of the organization and are allowable under the governing cost principles; (2) The same costs that have been treated as facilities and administrative costs are not claimed as direct costs; (3) Similar types of costs have been accorded consistent accounting treatment; and (4) The information provided by the organization which was used to establish the rates is not later found to be materially incomplete or inaccurate by the Federal Government. In such situations the rate(s) would be subject to renegotiation at the discretion of the Federal Government.

B. ACCOUNTING CHANGES:

This Agreement is based on the accounting system purported by the organization to be in effect during the Agreement period. Changes to the method of accounting for costs which affect the amount of reimbursement resulting from the use of this Agreement require prior approval of the authorized representative of the cognizant agency. Such changes include, but are not limited to, changes in the charging of a particular type of cost from facilities and administrative to direct.

Failure to obtain approval may result in cost disallowances.

C. FIXED RATES:

If a fixed rate is in this Agreement, it is based on an estimate of the costs for the period covered by the rate. When the actual costs for this period are determined, an adjustment will be made to a rate of a future year(s) to compensate for the difference between the costs used to establish the fixed rate and actual costs.

D. USE BY OTHER FEDERAL AGENCIES·

The rates in this Agreement were approved in accordance with the authority in Title 2 of the Code of Federal Regulations, Part 200 (2 CFR 200), and should be applied to grants, contracts and other agreements covered by 2 CFR 200, subject to any limitations in A above. The organization may provide copies of the Agreement to other Federal Agencies to give them early notification of the Agreement.

E. OTHER·

If any Federal contract, grant or other agreement is reimbursing facilities and administrative costs by a means other than the approved rate(s) in this Agreement, the organization should (1) credit such costs to the affected programs, and (2) apply the approved rate(s) to the appropriate base to identify the proper amount of facilities and administrative costs allocable to these programs.

BY THE INSTITUTION:

Arizona State University

(INSTITUTION)

ON BEHALF OF THE FEDERAL GOVERNMENT:

DEPARTMENT OF HEALTH AND HUMAN SERVICES

(AGENCY)

Digitally signed by Arif M. Karim -

(SIGNATURE)

Heather Clark

(NAME)

Arif M. Karim -5

(SIGNATURE)

Arif Karim

(NAME)

s Date:2022.06.14 14:03:38-0500'

Executive Director, Research Operations

(TITLE)

6.28.2022

(DATE)

Director, Cost Allocation Services

(TITLE)

6/2/2022

(DATE) 1353

HHS REPRESENTATIVE: Jeanette Lu

Telephone: (415) 437-7820

Certificate Of Completion Envelope Id: E4BD31FEC9C8484092D2F98AED26DE1C Status: Sent

Subject: Complete with DocuSign: YH23-0067 ASU Amend 3

Source Envelope:

Document Pages: 7 Signatures: 1 Envelope Originator:

Certificate Pages: 5 Initials: 0 marie horn

AutoNav: Enabled

EnvelopeId Stamping: Enabled

Time Zone: (UTC-07:00) Arizona

801 E. Jefferson St.

Phoenix, AZ 85034 marie.horn@azahcccs.gov

IP Address: 20.245.184.185

Record Tracking Status: Original

9/21/2023 4:01:21 PM

Holder: marie horn marie.horn@azahcccs.gov

Location: DocuSign

Security Appliance Status: Connected Pool: StateLocal

Storage Appliance Status: Connected Pool: Arizona Health Care Cost Containment

System

Location: DocuSign

Signer Events Signature Timestamp Tracey Thomas

Tracey.Thomas@azahcccs.gov

Procurement Manager

Arizona Health Care Cost Containment System

(AHCCCS)

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 98.161.254.128

Sent: 9/21/2023 4:02:56 PM

Viewed: 9/21/2023 4:51:10 PM

Signed: 9/21/2023 4:51:25 PM

Electronic Record and Signature Disclosure:

Not Offered via DocuSign kristy Macdonald

Kristy.Macdonald@asu.edu

Assistant Director

Security Level: Email, Account Authentication (None)

Sent: 9/21/2023 4:51:26 PM

Viewed: 9/22/2023 6:52:57 AM

Electronic Record and Signature Disclosure:

Accepted: 5/26/2023 11:14:25 AM ID: 830f9f0b-2abb-4b5c-857c-2c39995e9d78 Company Name: Carahsoft OBO Arizona Health Care Cost Containment System

In Person Signer Events Signature Timestamp

Editor Delivery Events Status Timestamp

Agent Delivery Events Status Timestamp

Intermediary Delivery Events Status Timestamp

Certified Delivery Events Status Timestamp

Carbon Copy Events Status Timestamp Budget

BUDGET@azahcccs.gov

Security Level: Email, Account Authentication (None)

Electronic Record and Signature Disclosure:

Not Offered via DocuSign

Witness Events Signature Timestamp

Notary Events Signature Timestamp

Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 9/21/2023 4:02:56 PM

Certified Delivered Security Checked 9/22/2023 6:52:57 AM

Payment Events Status Timestamps

Electronic Record and Signature Disclosure

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Electronic Record and Signature Disclosure created on: 2/9/2023 8:44:33 AM Parties agreed to: kristy Macdonald

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