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DocuSign Envelope lD: A8551410-E673-49BA-99CD-6E49493F64AE <br />3[hffiffiffir DocuSign Routing Form <br />Local Government Division <br />Contract Number: 20-5221C-L1-5 Amendment A <br />Grantee Name: Kittitas Countv <br />Project Name: CDBG-CV CV2 <br />Contract Total: <br />qry,BO <br />Contract End Date: 6130/23 <br />The amendment has been approved by the CV2 Project Manager and the CDBG-CV Section <br />Manager. <br />r"* This form is completely customizable. You can edit or remove the information above. Note: this <br />is for DocuSign recipients with the Recipient action of NEEDS TO SIGN can initial that they have <br />reviewed and approved the document in DocuSign. This is the only way they will be able to void <br />stop) the DocuSign envelope if an error is found. x** <br />This document is set up to be merged out of CMS, if you choose to use it as is. Click here for lqu <br />to Merge Documents from CMS lnstructions. ** <br />Review bv Fitlel:Name:Date:lnitials: <br />Managing Director <br />Tina Hochwender <br />7/L9/202L I L:oe AM ,o&. <br />Operations/Budget <br />Manager <br />before AD signature) <br />Tony Hanson <br />7/Le/202L I L', <br />t-1; <br />05 PM pot- <br />Updated February 2O2L