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HomeMy WebLinkAbout03/18/2002 Item 031 ~~1!6.~""J:;6IT~~~~~t~i~irei.~'Mt(;"~~i~~~~~~~.fll<.l'&~.~~:r<~;,.,~~iIr%~'E'!\-'tl~t')Il:'.:':~~~~-'mm~.>I:q.~.:tI:j,"ii:'~fi'~~tm,e~~~:&"""~~'.N8"~:r<<>.;,'':'If'.....M..._;'o<IJ<'IM..~,~t..~:~o(.m ~ifff~.l!.'!'.3:x.1.~~i1.,~~'t!~j,~ .~ .c Mohave County Department of Health and Social Services Budget Change Request 02/22/2002 MCH-Prenatal Block Grant 236-04-5145 g :\hea Ithde\ad msha re\bud~et02\PBG-MC H Bud .xls IAcct FY01/02 FY01/02 Total Adopted Adjustment Adjustment Number Description Budget Request To Base 331.40 Federal Grants (540,011.00) ($37,743.50) 52,267.50 399.00 Transfer from General Fund $0.00 Total Revenues ($40,011.00) ($37,743.50) 52,267.50 401.10 Salaries/Wages $0.00 401.20 Overtime 50.00 401.30 Temporary Employees 57,105.00 $7,105.00 $0.00 401.40 Short Term Disability 50.00 401.90 Market Study Adjustment $000 401.95 Split Fund Salary Allocation 59,382.00 $9,382.00 $0.00 402.00 Employee Benefits $000 402.10 FICA $544.00 $544.00 $000 402.20 Unemployment Compensation $0.00 402.30 Health Insurance $0.00 402.40 Workers Compensation $39.00 $39.00 $0.00 402.60 State Retirement $000 402.95 Split Fund Benefit Allocation $2,002.00 $2,002.00 $0.00 PERSONAL $19,072.00 519,072.00 $000 41100 Office Supplies $50.00 550.00 $0.00 411.40 Copies Duplicating Supplies $000 412.60 Fuel, Oil & Lubricants $000 412.90 Misc. Operating Supplies 5500.00 $50000 50.00 414.00 Minor Small Tools 50.00 SUPPLIES 555000 $550.00 SO.OO I 431.00 Professional Services 51.60000 51,600,00 50.00 I 431.50 Health Services Examinations 50.00 : 431.80 Training Costs 5000 I 431.90 Other Outside Services 516,939.00 $16,939.00 $0.00 432.10 Telephone $50000 5500.00 50.00 432.30 Postage 55000 $50.00 50.00 433.10 Travel Expenses $750.00 5750.00 5000 433,20 Motor Pool Crlarges 5500.00 $50000 $000 433.30 Freight Charges 50.00 434.30 Job Advertising 50.00 434.50 Publicity 5000 435.10 Printing Expenses 50.00 435.30 Duplicating Expense 550.00 550.00 SOoO 479.30 Dues, Subscriptions, Mbrship $000 479.60 Prior Year (Deficit/Contingency) $18,512.00 516,245.00 (52,267.00) 479,91 Out of State Tax $000 OTHER CHARGES $38,901.00 536,634,00 (52,26700) I 485.30 Furniture & Equipment 50.00 I 485.50 Data Processing Equipment 5000 485.52 Computer Software 5000 485.70 Minor Capital 5100-5999 SO.OO CAPITAL EXPENDITURES SO.OO SO.OO SO.OO TOTAL EXPENDITURES S58,523,00 $56,25600 ($2.267.00) Revenue less Expenditures :318,512.00 $18,512::>0 I I Beginning Fund Balance I Fund Balance 518.512.00 $18,512,50 I " ?~""-"''1'f!!tl!llJt:>.il~~-iiii!i.~~l~~''''''''.~~~;;;,:,''r..v~~~~~,J!;Ht!!>~~''li:~~~:llJ!5.'\l'i:\'.~ ~ ~ J ARIZONA DEPARTMENT OF iJ INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES 1740 West Adams, Room 303 , . ~- AMENDMENT Phoenix, Arizona 85007 , . (602) 542-1040 .. .,. Contract Management Specialist Contract N2: 961091 Amendment Nil: 3 Joe Castro County Prenatal Block Grant 1. Amendment Begin Date: 2/9/02 2. Ending Date: 6/30/02 It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 3. The contract budgeted amount is being reduced by $2,267.00 4. The Price Sheet page 11 for Amendment # 2, is replaced by Price Sheet page 2 for Amendment #3, which reflects the decrease in the Unit Rate for the last two Quarterly Reports for the fiscal year. All other provisions of this agreement remain unchanged. Mohave County Health Department CONTRACTOR NAME AUTHORIZED SIGNATURE DATE PO Box 7000 Patty Mead ADDRESS PRINTED NAME: Kingman, AZ 86402 Director CITY, STATE, ZIP CODE TITLE Pursuant to A.R.S. ~ 11.952, the undersigned public agency attorney This Intergovernmental Agreement Amendment shall be effective the has determined that this Intergovernmental Agreement is in proper form date indicated. The Public Agency is hereby cautioned not to and is within the powers and authority granted under the laws of the commence any billable work or provide any material, service or State of Arizona. construction under this IGA until the IGA has been executed by an authorized ADHS signatory. State of Arizona d~~ -, .2 _? ,,,-_ () '<" Sig"d <hi, _~ d,y of ,2002 SIm:JATUAE DATE {fAl/cUI/!. . t Ir &-14 '1l7 c hat,.J/; 11/ PRINTED NAME AND TITLE / Procurement Officer ,I n01- - C\ 1 f{; Attorney General Contract NO T\l\ which is an Agreement between RESERVED FOR USE BY THE SECRETARY OF STA TE public agencies, has been reviewed pursuant to A.R.S. ~ 11-952 by the undersigned Assistant Attorney General, who has determined that it is in proper form and is within the powers and authority granted under the laws of the State of Arizona, SIGNATURE DATE Assistant Attorney General PRINTED NAME L - .. -. ..-. INTERGOVERNMENTAL AGREEMENT (lGA) ARIZONA DEl>'>\. 'iTMENT OF HEAL TH ~;-<::VICES 1740 West A;""'h,S, Room 303 AMENDMENT Phoenix, A:':'-"':1a 85007 (602) ::. <, -1040 Contract NQ: 961091 Amendment No. 3 Contract Ma'-~':'~"""".'._""l?'..,t Specialist Joe ,'\i:.stro PRICE SHEET SERVICE DELIVERY FREQUENCY NUMBER PER BUDGET UNIT RATE AN~lAl COST PERIOD ... QUARTERLY PROGRAM ACTIVITIES 1st and 2nd TWO Reports $10,002.75 $.:;.'\', ;\05.50 QUARTERS NTE: -'-'\.~_O06.00 QUARTERLY PROGRAM ACTIVITIES 3"' and 41n TWO Reports $8,869.00 NTE: :$ ~ 7,738.00 QUARTERS .-- . .-- NTE = Not to exceed BUDGET TERM: 7/1/02 TO 6/30/02 Page 2 I