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DSHS CONTRACT NUMBER: <br />CONTRACT AMENDMENT 1763-98187 ft~~~~· DDA Employment & Day O£"bR ENT OF soc AL O1EAl:TH Amendment No. 01 SER ICES <br />I <br />This Contract Amendment is between the State of Washington Department of Program Contract Number <br />Social and Health Services (DSHS) and the Contractor identified below. Click here to enter text. <br />Contractor Contract Number <br />CONTRACTOR NAME CONTRACTOR doing business as (DBA) <br />Kittitas Cou nty Kittitas County DDA County Services <br />CONTRACTOR ADDRESS WASHINGTON UNIFORM DSHS INDEX NUMBER <br />BUSINESS IDENTIFIER (UBI) <br />507 North Nanum Street Suite 102 <br />Ellensburg, WA 98926-192-002-673 1225 <br />CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS <br />Joann Schaan (509) 933-8233 Click here to enter tex t. Click here to enter text. <br />DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE <br />Developmental Disabilities Admin Division of Developmental 1769CS-63 <br />Disabilities <br />DSHS CONTACT NAME AND TITLE DSHS CO NT ACT ADDRESS <br />Seanna Woodard 1611 W Indiana Ave <br />Operations Manager <br />Spokane, WA 99205 <br />DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS <br />(509)329-2952 (509)568-3037 woodas@dshs.wa.gov <br />IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBERS <br />No <br />AMENDMENT START DATE CONTRACT END DATE <br />09/01/2017 06/30/2018 <br />PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT <br />$820 ,341.00 $14,948.00 $835 ,289.00 <br />REASON FOR AMENDMENT; <br />CHANGE OR CORRECT MAXIMUM CONTRACT AMOUNT <br />ATTACHMENTS. When the box below is marked with an X , the following Exhibits are attached and are incorporated into <br />this Contract Amendment by reference: o Additional Exhibits (specify): <br />This Contract Amendment , including all Exhibits and other documents incorporated by reference, contains all of the terms <br />and conditions agreed upon by the parties as changes to the original Contract. No other understandings or <br />representations, oral or otherwise , regarding the subject matter of this Contract Amendment shall be deemed to exist or <br />bind the parties. All other terms and conditions of the original Contract remain in full force and effect. The parties signing <br />below warrant that they have read and understand this Contract Amendment, and have authority to enter into this Contract <br />Amendment. <br />~~h <br />DSH ~~ /J;;hA:I- <br />DSHS Central Contract Services <br />6024PF Contract Amendment (3-31 -06) <br />~~MEAW \ ~~\fr)\ll) \S~~~ <br />PRINTED NAME AND TITLE <br />Melissa Diebert. Contract Specialist <br />R i,;\ 9 <br />o 13 t611 ~1 <br />II <br />DDASPOKANE <br />DATE SIGNED <br />I (0(1(( '7 <br />DATE SIGNED <br />;)-6 ~/cf <br />Page 1