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Signed DOH Amendment 1
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2022-10-18 10:00 AM - Commissioners' Agenda
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Signed DOH Amendment 1
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Entry Properties
Last modified
11/1/2022 2:27:13 PM
Creation date
11/1/2022 2:27:07 PM
Metadata
Fields
Template:
Meeting
Date
10/18/2022
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve a Resolution Authorizing an Interlocal Agreement Amendment between the Kittitas County Public Health Department and the Washington State Department of Health
Order
4
Placement
Consent Agenda
Row ID
95176
Type
Resolution
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trtii;;Tri;CONTRACT AMENDMENT <br />This document has been <br />DOH Anrendm ent GY L26649 - | <br />Revision 04/2020 <br />I. NAMEOFCONTRACTOR <br />Kittitas Public Health Department <br />2. CONTRACTNUMBER <br />GVL26649la. ADDRESS OF CONTRACTOR (STREET) <br />507 N Nanum St Ste 102 <br />2a. AMENDMENT NUMBER <br />I <br />Ib. CITY. STATE, ZIP CODE <br />Ellensburg, WA 98926 <br />Unique Entity Identifier: <br />WQ23XPBSAU44 <br />J I TUIS ITE,M APPLIES oNLY To BILATERAL AMENDMENTS. <br />The Contract identified herein, including any previous amendments thereto, is hereby amended as <br />set forlh in Item 5 below by mutual consent of all parties hereto. <br />4. LI THIS ITEM APPLIES ONLY TO UNILATERAL A MENDMENTS. <br />The Contract identified herein, including any previous amendments thereto, is hereby unilaterally <br />amended as set forth in Itern 5 below pursuant to that changes and modifications clause as <br />contained therein. <br />5. DESCRIPTION OF AMENDMENT: The purpose of this no-cost amendment is to extend the <br />Period of Performance from May 3 1,2023 to December 31,2023; to continue the work laid out in <br />the Original Contract. All other Tenns and Conditions rernain the same and in full effect. <br />5a. Statement of Work: Exhibit A is revised in accordance with Exhibit A-10 attached hereto and <br />incorporated herein. <br />5b. Consideration: This amendment neither increases nor decreases the Contract Consideration; <br />therefore, the maximuln consideration of this contract and all amendments shall remain the same <br />and not exceed $300,000.00. <br />Contractor agrees to comply with applicable rules and regulations associated with these funds <br />5c. Period of Performance: is extended through December 31,2023. <br />5d. The Effective Date of this Amendment: is the Date of Execution. <br />of the original contract and any subsequent amendments thereto6 <br />7 <br />All other terms and conditions <br />remain in full force and effect. <br />nfnis is a unilateral amendment. Signature of contractor is not required below. <br />Xl Contractor hereby acknowledges ind accepts the tenns and conditions of this amendment. <br />Signature is required below <br />Public Health <br />8.CONTRACTOR SIGNATURE (also, please prinr/type your name)DATE <br />Chelsey (Oct 08:46 PDT)Oct28,2022, <br />Chelsey Loeffers <br />DATE <br />Oct28,2022 <br />Department of Health Contract Specialist ttl <br />DOH CONTRACTING OFFICER SIGNATTJRE <br />WA Department of Health Contracts Office <br />Cfu *Dila&f <br />Frank L Webley <br />approved as to form only by the Assistant Attorney General. <br />Page 1 of4
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