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KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2015 — 2017 CONSOLIDATED CONTRACT CONTRACT NUMBER: C17114 AMENDMENT NUMBER: 5 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT hereinafter referred to as "LHJ", pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows: ® Adds Statements of Work for the following programs: Office of Immunization & Child Profile - Effective January 1, 2016 OICP-Prevention & Public Health Funds (PPHF) VTrckS-IIS - Effective January 1, 2016 ❑ Amends Statements of Work for the following programs: ❑ Deletes Statements of Work for the following programs: 2. Exhibit B-5 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-4 Allocations as follows: ® Increase of $8,840 for a revised maximum consideration of $209,287. ❑ Decrease of for a revised maximum consideration of ❑ No change in the maximum consideration of Exhibit B Allocations are attached only for informational purposes. 3. Exhibit C-5 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-4. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Date Date APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of 10