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DocuSign Envelope ID: 6A932202-7A68-44FB-89B1-53B1D8308834 <br />HCA Contract No.: K4649 <br />Washington State CONTRACT Amendment No.: 01 <br />Health Care uthority AMENDMENT <br />THIS AMENDMENT TO THE CONTRACT is between the Washington State Health Care Authority <br />and the party whose name appears below, and is effective as of the date set forth below. <br />CONTRACTOR NAME CONTRACTOR doing business as (DBA) <br />Kittitas County Health Department <br />CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER <br />507 North Nanum Street, Ste #102 (UBI) <br />Ellensburg, WA 98926 <br />WHEREAS, HCA and Contractor previously entered into a Contract to support Medicaid related <br />outreach and linkage activities performed by Local Health Jurisdictions to certain Washington State <br />Residents, and; <br />WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 7 to extend the term <br />and add/remove language; <br />NOW THEREFORE, the parties agree the Contract is amended as follows: <br />1. Section 3, Period of Performance, is amended to read: <br />3. PERIOD OF PERFORMANCE <br />Subject to its other provisions, the period of performance of this Contract will commence on <br />January 1, 2021, and be completed on December 31, 2025, unless terminated sooner or extended <br />upon written agreement between the parties. <br />This Contract may be extended through December 31, 2026, at HCA's sole discretion. No change <br />in terms and conditions will be permitted during these extensions unless specifically agreed to in <br />writing. <br />2. Attachment 4, Federal Funding Accountability and Transparency Act Data Collection Form, is <br />removed from the Contract. <br />3. Subsection 18.8 is removed from Section 18, Governance, and all remaining subsections within <br />that Section are renumbered accordingly. <br />4. Section 26, Federal Funding Accountability & Transparency Act (FFATA), is removed from the <br />Contract and all subsequent sections are renumbered accordingly. <br />5. This Amendment will be effective as of the last date of signature shown below ("Effective Date"). <br />6. All capitalized terms not otherwise defined herein have the meaning ascribed to them in the <br />Contract. <br />HCA Contract No. K4649-01 Page 1 of 2 <br />