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DocuSign Envelope lD 6A9322O2-7468-44F8-8981-S3Bj D8308834 <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 StateResidents, and; <br />WHEREAS, HCA and Contractor wish to amend the Contract pursuant to Section 7 to extend the termand 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 PERFORMANEE <br />Subject,o,,,ffiperiodofperformanceofthisContractwillcommenceon <br />January 1, 2021, and be completed on December 31, 2025, unless terminated sooner or extended <br />upon written agreement between the parlies. <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 thecontract and all subsequent sections are renumbered accordingiy. <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 />Washington State <br />Health Care ority <br />CONTRACT <br />AMENDMENT <br />HCA Contract No.: K4649 <br />Amendment No.: 01 <br />TH S A M E N D M E N T TO TH E co N T RACT S b etween t h e W a sh tn gton S tate H e al th Care A u th ority <br />and the d wh o SE name a ears be low a nd IS effect VE AS of t h e da te set fo rth below <br />CONTRAGTOR NAME <br />Kittitas County Health Department <br />CONTRACTOR doing business as (DBA) <br />GONTRAGTOR ADDRESS <br />507 North Nanum Street, Ste #102 <br />Ellensburg, WA 98926 <br />WASHINGTON UNIFOR M BUSINESS IDENTIFIER <br />(uBr) <br />HCA Contract No. K4649-01 Page 1 of 2