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ra, , <br />DCYF CONTRACT NUMBER: <br />CONTRACTAMENDMENT <br />2163-22205 <br />4t"`�'� `r <br />Consolidated Contract <br />`!%sra <br />Amendment No. 01 <br />This Contract Amendment is between the State of Washington <br />Program Contract Number <br />Department of Children, Youth & Families (DCYF) and the Contractor <br />Click here to enter text. <br />identified below. <br />Contractor Contract Number <br />CONTRACTOR NAME <br />CONTRACTOR doing bus now as (DBA) <br />Kittitas County <br />CONTRACTOR ADDRESS <br />WASHINGTON UNIFORM BUSINESS <br />DCYF INDEX NUMBER <br />Rm 211 Kittitas Cc Courthouse <br />IDENTIFIER(UBI) <br />1225 <br />205 W Fifth St <br />192-002-673 <br />Ellensburg, WA 98926 <br />CONTRACTOR CONTACT <br />CONTRACTOR TELEPHONE <br />CONTRACTOR-AX <br />CONTRACTORE-MAIL ADDRESS <br />Katrina Mankus <br />(509)962-7516 <br />Click here to enter text. <br />katrina.mankus&o.kittitas.wa. <br />us <br />DCYF ADMINISTRATION <br />DCYF DIVISION <br />DCYF CONTRACT CODE <br />Department of Children, Youth, and Families <br />Children, Youth and Families <br />2072CS-63 <br />Karena McGovern <br />1115 Washington St SE <br />Contract Specialist <br />OI mia, WA 98504 <br />DCYF CONTACT TELE PH NE DCYF CONTACT FAX DCYF CONTACT E-MAIL ADDRESS <br />360870-5727 Click hereto enter text. karena.mcgio\ern@dcyf.wa.gov <br />IS THE GUN IR UI URA SUBRECIPI NT FOR PURPOSE OF THIS CONTRACT? CFDA NUMBERS <br />No <br />AMENDMENTSTART DATE. CONTRACT FIND DATE <br />06/13/2022 06/30/2023 <br />$0.00 $2,000.00 $2,000:00 <br />REASON FOR AMENDMENT; <br />CHANGE ORCORRECTOTHER: SEE PAGE TWO <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: <br />® Additional Exhibits (specify): Exhibit D-Concrete Goods Guidance; Exhibit E-Concrete Goods Reporting Template <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 />CONTRACTOR SIGNATURE <br />PRINTED NAME AND TITLE <br />DATE SIGNED <br />tj Rvt� L C <br />-s� <br />{ <br />7 <br />DCYF SIGNATURE <br />PRINTEDNAME qND ITLES <br />DATE SIGNED <br />Department of Children, Youth & Families <br />2024 PF Contract Amendment (8-1-2019) Page 1 <br />