exv10w22w5



 





Exhibit 10.22.5




	 	 	 	 	 
	AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

	 	1. Contract Number
	 	Page of Pages
	

	 	POHC-2002-D-0003
	 	1                    6







	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	2. Amendment/Modification Number

	 	3. Effective Date
	 	 	4.	 	 	Requisition/Purchase Request No.
	 	 	5.	 	 	Project No. (If applicable)
	‘M00014

	 	SEE BLOCK 16C BELOW	 	 	 	 	 	 	 	 	 	 	 	 







	 	 	 	 	 
	6. Issued By

	 	Code’
	 	7. Administered By (If other than line 6)
	OFFICE OF CONTRACTING AND PROCUREMENT	 	DEPARTMENT OF HEALTH, OFFICE OF MANAGED 
	HUMAN CARE AND SERVICES
GROUP / DEPARTMENT OF HEALTH	 	CARE
	441 4TH STREET, N.W., SUITE 700 SOUTH	 	MADICAL ASSISTANCE ADMINISTRATION
	WASHINGTON, D. C. 20001	 	   825 NORTH CAPITAL STREET, N.E., 5TH FLOOR
	 	 	   ATTENTION: MS MAUDE HOLT
	

	 	 	 	   TELEPHONE: (202) 442-9074







	 	 	 	 	 	 	 
	8. Name and Address of Contractor (No. Street, city, country, state and ZIP
Code)	 	(X)	 	9A. Amendment of Solicitation No.
	

	 	AMERIGROUP MARYLAND, INC.	 	 	 	 
	

	 	AMANAGED CARE ORGANIZATION
	 	 	 	9B. Dated (See Item 11)
	

	 	D.B.A. AMERIGROUP DISTRICT OF COLUMBIA	 	 	 	 
	

	 	750 FIRST STREET, N.E., SUITE 1120
	 	 	 	10A. Modification of Contract/Order No.
	

	 	WASHINGTON, D. C. 20002
	 	 	 	   POHC-2002-D-0003
	

	 	ATTN: MS. JANE E. THOMPSON — TELEPHONE NO.: (202) 218-4901
	 	X
	 	10B. Dated (See Item 13)
	Code

	 	Facility
	 	 	 	   AUGUST 1, 2002







11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS





The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers o
extended. o is not extended.




Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by
one of the following methods: (a) By completing Items 8 and 15, and returning       copies of the amendment (b) By acknowledging
receipt of this
amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the
solicitation and
amendment number. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS
PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change
an offer already submitted, such change may be made by letter or telegram, provided each letter or telegram makes reference to
the
solicitation and this amendment, and is received prior to the opening hour and date specified.



12. Accounting and Appropriation Data (If Required)




13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14




	 	 	 
	(X)

	 	A. This change order is issued pursuant to: (Specify Authority)
The changes set forth in Item 14 are made in the contract/order no. in item 10A.
	 
	 	 
	X

	 	B. The above numbered contract/order is modified to reflect the administrative changes (such as changes In paying office,
appropriation date, etc.) set forth in item 14, pursuant to the authority of 27 dCMR, Chapter 36, Section 3601.2.
	 
	 	 
	

	 	C. This supplemental agreement is entered into pursuant to authority of:
	 
	 	 
	

	 	D. Other (Specify type of modification and authority)       AGREEMENT BETWEEN THE PARIES
	X
	 	 







E. IMPORTANT:       Contractor o is not,      
x is required to sign this document and
return      
2       copies to the Issuing office.




14. Description of amendment/modification (Organized by USC Section headings, including solicitation/contract subject matter where
feasible.)




     THE CONTRACTOR’S TRADE NAME LISTED IN BLOCK 8, ABOVE, IS HEREBY CHANGED AS NOTED ON PAGE 2 OF THIS MODIFICATION.



Except as provided herin, all terms and conditions of the document referenced in Item (9A or 10A as heretofore changed, remains
unchanged and in full force and effect




	 	 	 	 	 	 	 	 	 
	15A. Name and Title of Signer (Type or print)	 	16A. Name of Contracting Officer
	     Jane E. Thompson CEO	 	          ESTHER M. SCARBOROUGH
	 
	 	 	 	 	 	 	 	 
	15B Name of Contractor

	 	15C. Date Signed
	 	16B. District of Columbia
	 	 	 	16C. Date Signed
	 
	 	 	 	 	 	 	 	 
	

	 	7/7/04	 	 	 	 	 	 
	AMERIGROUP
District of
COLUMBIBA
	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 
	(Signature of person authorized

	 	 	 	 	 	(Signature of Contracting Officer)	 	 







					
	 	 	 	 	 
	* Government of the District of Columbia
	 	Office of Contracting & Procurement
	 	DC OCP 202 (7-99)





 









 






Exhibit 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003





1









 








Exhibit 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003




CONTRACTOR: AMERIGROUP MARYLAND, INC\ A

MANAGED CARE ORGINAZION

D.B.A. AMERIGROUP DISTRICT OF COLUMBIA




	A.	 	Contract number POHC-2002-D-0003 dated 4-1-02, Section AA, page la,
subsection A.2 ‘DOCUMENTS ATTACHED AND INCORPORATED BY REFERENCE”
are modified to reflect the correct corporate name.






	1.	 	Attachment 3 — Amendments Number 001 to.0001 (highest
to lowest), Block 15B “Name of Contractor” — AMERICAID Community
Care
	 
	2.	 	Attachment 4 — Proposal dated December 27, 2000
(Technical only) Submitted by AMERICAID Community Care
	 
	3.	 	Attachment — 5 — First Best And Final Offer
dated May 21, 2001 (Technical Proposal only) submitted by
AMERICAID Community Care
	 
	4.	 	Attachment — 5 — Second Best And Final Offer
dated May 21, 2001 (Technical Proposal only) submitted by
AMERICAID Community Care






	B.	 	The Contract POHC-2002-D-0003 and all Modifications documents listed
below
are modified to reflect the correct corporate name:






	1.	 	The Contractor’s corporate name identified in Block 7 of
page 1 of the Award/Contract form dated 4-1-02, is corrected
to read as follows:






AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	2.	 	The Contractor’s corporate name identified in Section B.6.2 on
the top of page 7 of the original contract is corrected to read as
follows:






AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




2










 





EXHIBIT 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003





	3.	 	The Contractor’s corporate name identified in Section B.6.2 on the top
of page 8 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	4.	 	The Contractor’s corporate name identified in Section B.6.2 on the top
of page 9 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	5.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 10 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	6.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 11 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	7.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 12 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	8.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 13 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia



3









 








EXHIBIT 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003





	9.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 14 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	10.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 15 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	11.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 16 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	12.	 	The Contractor’s corporate name identified in Section B.6.2 on the top of
page 17 of the original contract is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia




	13.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0001, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
form, dated 4-9-02, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

D.B.A AMERIGROUP District of Columbia



4









 








Exhibit 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003





	14.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0002, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
form, dated 4-9-02, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	15.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0003, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
form, dated 7-18-02, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	16.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0004, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
form, dated 7-17-02, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	17.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0005, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form
and on top of page 2 of Modification M0005, dated 9-19-02, are corrected
to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	18.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0006, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form
and top of page 2 of Modification M0006, dated 7-31-03, are corrected to
read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA



5









 








Exhibit 10.22.5




MODIFICATION NUMBER M0014




TO




CONTRACT NUMBER: POHC-2002-D-0003





	19.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0007, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form,
7-17-03, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	20.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0008, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form,
8-4-03, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	21.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0009, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form,
8-12-03, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	22.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0010, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form,
dated 8-8-03, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	23.	 	The Contractor’s corporate name identified in Block 8 of Modification
M0011, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form,
dated 8-18-03, is corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA



6









 








Exhibit 10.22.5




MODIFICATION NUMBER M0014

TO

CONTRACT NUMBER: POHC-2002-D-0003





	24.	 	The Contractor’s corporate name identified in Block 8 of
Modification M0012, page 1 of “AMENDMENT OF
SOLICITATION/MODIFICATION OF CONTRACT form, 3-12-04, is corrected to
read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	25.	 	The Contractor’s corporate name identified in Block 8 of
Modification M0013, page 1 of “AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT form, dated 5-17-04, is
corrected to read as follows:




AMERIGROUP MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA




	C.	 	Delivery Order POHC-2002-F-0001 to Contract POHC-2002-D-0003 and all
Modifications documents listed below are modified to reflect the correct
corporate name:




1. The Contractor’s corporate name identified in Block 17A of

Delivery Order POHC-2002-F-0001, page 1, dated 4-9-02, is

corrected to read as follows:



AMERIGROUP
MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA


2. The Contractor’s corporate name identified in Block 8 of

Modification M0001, page 1 of “AMENDMENT OF

SOLICITATION/MODIFICATION OF CONTRACT form, dated 4-9-02 to Delivery

Order POHC-2002-F-0001, is corrected to read as follows:



AMERIGROUP
MARYLAND, INC. A

Managed Care Organization

DBA AMERIGROUP DISTRICT OF COLUMBIA


7