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DSHS CONTRACT NUMBER: rWashington State CONTRACT AMENDMENT 2463-57835 Department of Social 7 1 & Health Services Amendment No. 01 Transforming lives This Contract Amendment is between the State of Washington Department of Program Contract Number Social and Health Services (DSHS) and the Contractor identified below. Click here to enter text. Contractor Contract Number CONTRACTOR NAME CONTRACTOR doing business as (DBA) Kittitas County CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS DSHS INDEX NUMBER 507 North Nanum Street Suite 102 IDENTIFIER (UBI) 1225 192-002-673 Ellensburg, WA 98926-2886 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Chelsey Loeffers (509) 962-7515 (509) 962-7581 Chelsey.loeffers@co.kittitas.wa. us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Division of Vocational Rehabilitation Division of Vocational 850OCC-63 Rehabilitation DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS Austin Diaz -Munoz 4565 7th Ave SE Contracts Specialist Lacey, WA 98503 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS (564) 200-2812 Click here to enter text I Austin. DiazMunoz dshs.wa. ov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? I CFDA NUMBERS No AMENDMENT START DATE CONTRACT END DATE 03/31 /2025 06/30/2025 PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT $101,700.00 $-75,700.00 $26,000.00 REASON FOR AMENDMENT: CHANGE OR CORRECT CHOOSE ONE: ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this Contract Amendment by reference: ® Additional Exhibits (specify): Exhibit B - Estimated Bi-Annual Budget This Contract Amendment, including all Exhibits and other documents incorporated by reference, contains all of the terms and conditions agreed upon by the parties as changes to the original Contract. No other understandings or representations, oral or otherwise, regarding the subject matter of this Contract Amendment shall be deemed to exist or bind the parties. All other terms and conditions of the original Contract remain in full force and effect. The parties signing below warrant that they have read and understand this Contract Amendment, and have authority to enter into this Contract Amendment. CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED DSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018)