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Washington State Department of <br />Toor H E A LT H CONTRACT AMENDMENT <br />I. NAME OF CONTRACTOR <br />2. CONTRACT NUMBER <br />Kittitas County Public Health Department <br />GVL26649 <br />1 a. ADDRESS OF CONTRACTOR (STREET) <br />2a. AMENDMENT NUMBER <br />507 N Nan um St Ste 102 <br />2 <br />lb. CITY, STATE, ZIP CODE <br />Unique Entity Identifier: <br />Ellensburg, WA 98926 <br />W 23XPBSAU44 <br />3. ® THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS. <br />The Contract identified herein, including any previous amendments thereto, is hereby amended as <br />set forth in Item 5 below by mutual consent of all parties hereto. <br />4. ❑ THIS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS. <br />The Contract identified herein, including any previous amendments thereto, is hereby unilaterally <br />amended as set forth in Item 5 below pursuant to that changes and modifications clause as <br />contained therein. <br />DESCRIPTION OF AMENDMENT: The purpose of this non -cost amendment is to revise the <br />Statement of Work and to extend the Period of Performance. <br />5a. Statement of Work: Exhibit A-1 is revised in accordance with Exhibit A-2, attached hereto <br />and incorporated herein. <br />5b. Consideration: This amendment neither increases nor decreases the Contract Consideration; <br />therefore, the maximum consideration of this contract and all amendments shall not exceed <br />$300,000.00. <br />Contractor agrees to comply with applicable rules and regulations associated with these funds. <br />5d. Period of Performance: is extended through May 31, 2024. <br />5e. The Effective Date of this Amendment: is the Date of Execution. <br />6. All other terms and conditions of the original contract and any subsequent amendments thereto <br />remain in full force and effect. <br />7. ❑This is a unilateral amendment. Signature of contractor is not required below. <br />® Contractor hereby acknowledges and accepts the terms and conditions of this amendment. <br />Signature is required below <br />8. CONTRACTOR SIGNATURE (also, please prinUtype your name) <br />DATE <br />'9. DOH CONTRACTING OFFICER SIGNATURE <br />DATE <br />This document has been approved as to form only by the Assistant Attorney General. <br />DOH Amendment GVL26649-2 Page 1 of 4 <br />Revision 04/2020 <br />