HCA Amendment for ABCD Kittitas County (K2747 Amendment 1)

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WHEREAS, HCA and Contractor previously entered into a Contract to provide 'Access to Baby and Child Dentistry' services to detect and prevent early childhood dental decay by engaging dentists in seeing birth to six (6) year old Medicaid eligible children and engaging local public health departments in outreach and case management, and; WHEREAS, HCA and Contractor wish to amend the Contract to provide clarification of 2nd Quarter for Year One 2018-2019 Exhibit A, titled ABCD Quarterly Outreach and Case Management Contract Report, by replacing in its entirety, the Exhibit A for 2nd Quarter contract period; NOW THEREFORE, the parties agree the Contract is amended as follows: 1. Exhibit A. Titled ABCD Quarterly Outreach and Case Management Contract Report. Replace in its entirety, the below revised 2nd Quarter for Year One 2018-2019 Exhibit A form, for the 10/1/18 through 12/31/18 time period. There are no fiscal allocation changes for this amendment. 2. This Amendment will be effective as of the last date of signature shown below ("Effective Date"). 3. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract. 4. All other terms and conditions of the Contract remain unchanged and in full force and effect. The parties signing below warrant that they have read and understand this Amendment and have authority to execute the Amendment. This Amendment will be binding on HCA only upon signature by HCA. CONTRACTOR SIGNATURE PRINTED NAME AND TITLE CONTRACT HCA Contract No.: U747 Washington State AMENDMENT Amendment No.: 01 Health Care HCA SIGNATURE For DATE SIGNED uthority ABCD DENTAL SERVICES Contracts Administrator Kittitas County THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority and the party whose name appears below, and is effective as of the date set forth below. CONTRACTOR NAME CONTRACTOR doing business as (DBA) Kittitas County Public Health Network CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER 507 North Nanum Street, Suite 201 (UBI) Ellensburg, WA 98926 WHEREAS, HCA and Contractor previously entered into a Contract to provide 'Access to Baby and Child Dentistry' services to detect and prevent early childhood dental decay by engaging dentists in seeing birth to six (6) year old Medicaid eligible children and engaging local public health departments in outreach and case management, and; WHEREAS, HCA and Contractor wish to amend the Contract to provide clarification of 2nd Quarter for Year One 2018-2019 Exhibit A, titled ABCD Quarterly Outreach and Case Management Contract Report, by replacing in its entirety, the Exhibit A for 2nd Quarter contract period; NOW THEREFORE, the parties agree the Contract is amended as follows: 1. Exhibit A. Titled ABCD Quarterly Outreach and Case Management Contract Report. Replace in its entirety, the below revised 2nd Quarter for Year One 2018-2019 Exhibit A form, for the 10/1/18 through 12/31/18 time period. There are no fiscal allocation changes for this amendment. 2. This Amendment will be effective as of the last date of signature shown below ("Effective Date"). 3. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Contract. 4. All other terms and conditions of the Contract remain unchanged and in full force and effect. The parties signing below warrant that they have read and understand this Amendment and have authority to execute the Amendment. This Amendment will be binding on HCA only upon signature by HCA. CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED zv; S+�v► Lit w► b Administrator HCA SIGNATURE PRINTED NAME AND TITLE DATE SIGNED James W. Gayton Contracts Administrator HCA Contract No. K2747 Page 1 of 2 Amendment #01