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ATTACHMENT A, DOC CONTACT INFORMATION is hereby replaced in its entirety by <br />ATTACHMENT A-1, DOC CONTACT INFORMATION, which is attached hereto and <br />incorporated by reference herein. <br />ATTACHMENT B, PREAUTHORIZATION AND MEDICAL BILLING INSTRUCTIONS iS <br />hereby replaced in its entirety by ATTACHMENT B-1, PREAUTHORIZATION AND MEDICAL <br />BILIING INSTRUCTIONS, which is attached hereto and incorporated by reference herein. <br />Additions to this text are shown by underline and deletions by ((s*ikeeu+)) AU other terms and conditions <br />remain in full force and effect. The effective date of this Amendment is January 7,2027. <br />THIS AMENDMENT, consisting of nine (9) page(s) and two (2) attachments is executed by the persons <br />signing below who warrant that they have the authority to execute this Amendment. <br />KITTITAS COUNTY SHERIFF'S OFFICE WASHINGTON STATE DEPARTMENT OF <br />CORRECTIONS <br />,-jI rlt : \l-.iffi'*;-oit;'"''btu*t December 20,2020 <br />Clay rteyers, Sil"rifi <br />BOARD OF <br />Date <br />GTON <br />Chairperson Date <br />Vice-Chairman Date <br />Debra Eisen <br />Contracts Administrator <br />3ltta l,t I <br />zltul,t t <br />eliul; I <br />Date <br />Page 9 of 9 <br />208352 <br />Commissioner Date <br />ATTEST: <br />S lttt lP t <br />A. Kjorsvik,of the Board Date <br />Approved as to Form: This Amendment format was approved by the office of the Attorney General. <br />Approval on file. <br />State of Washington <br />Department of Corrections <br />K9s51(6)