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D'ocuSign <br />Gertificate Of Completion <br />Envelope ld : 48551 41 08673498A99CD0E49493F64AE <br />Subject: Please DocuSign: Amendment A Kittitas County CV2 <br />Division: <br />Local Government <br />Program: CDBG-CV CV2 <br />ContractNumber: 20-622'l C-| I 5 A <br />Source Envelope: <br />Document Pages: 5 Signatures: 2 <br />Certificate Pages: 5 lnitials: 2 <br />AutoNav: Enabled <br />Envelopeld Stamping: Enabled <br />Time Zone: (UTC-08:00) Pacific Time (US & Canada) <br />Record Tracking <br />Status: Original <br />711612021 l0:09:01 AM <br />Security Appliance Status: Connected <br />Storage Appliance Status: Connected <br />Holder: Josh Woodson <br />josh.woodson@commerce.wa.gov <br />Pool: StateLocal <br />Pool: Washington Stale Department of Commerce <br />Signature <br />Status: Completed <br />Envelope Originator: <br />Josh Woodson <br />1011 Plum Street SE <br />MS 42525 <br />Olympia, WA 98504-2525 <br />josh.woodson@commerce.wa.gov <br />lP Address: 147.55.149.155 <br />Location: DocuSign <br />Location: DocuSign <br />Timestamp <br />Senl: 7 /162021 1 0: 1 5:46 AM <br />Viewed: 711912021 10:55:41 AM <br />Signed: 719/2021 10:56:08 AM <br />Sent 7 11612021 1 0:1 5:46 AM <br />Resent: 7/19/2021 10:56:10 AM <br />Viewed: 711912021 11:07:53 AM <br />Signed: 7/19/2021 1 1 :09:18 AM <br />Sent: 7 11612021 1 0: 15:46 AM <br />Resent: 7/19/2021 1 1 :09:20 AM <br />Viewed: 7l1Sl2O2'l 12:05:17 PM <br />Signed: 7/1 9/2021 12:05:34 PM <br />Signer Events <br />Brett Wachsmith <br />brett.wachsmith.co@co. kift itas.wa.us <br />Security Level: Email, Account Authentication <br />None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 711912021 10:55:41 AM <br />lD: d7 91 a012-4526-4'l 90-ada7-ad03fc201 d8a <br />Tina Hochwender <br />tina. hochwender@commerce.wa. gov <br />Security Level: Email, Account Authenlication <br />None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Tony Hnason <br />tony.hanson@commerce.wa.gov <br />Washington State Department of Commerce <br />Security Level: Email, Account Authentication <br />None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 66.243.254.18 <br />Gi"sk* <br />e <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 147.55.134.79 <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 147.55.'134.'11 <br />@