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a <br />JKL <br />'HIIt <br />V'/ash!ngtoil Slale <br />Department of Social <br />& Health Services <br />Transforming lives <br />CONTRACT AMENDMENT <br />DSHS CONTMCT NUMBER: <br />2463-57835 <br />Amendment No. 01 <br />This Contract Amendment is between the State of Washington Department of <br />Socialand Health Services (DSHS) and the Contractor identified below. <br />Program Contract Number <br />Click here to enter texi. <br />Contractor Contract Number <br />CONTRACTOR NAME <br />Kittitas County <br />CONTRACTOR doing business as (DBA) <br />CONTRACTOR ADDRESS <br />507 North Nanum Street Suite 102 <br />Ellensburq, WA 98926-2886 <br />WASHINGTON UNIFORM BUSINESS <br />TDENTIFTER (UBr) <br />192-002-673 <br />DSHS INDEX NUMBER <br />1225 <br />CONTRACTOR CONTACT <br />Chelsey Loeffers <br />CONTRACTOR TELEPHONI <br />(509) 962-7515 <br />CONTRACTOR FAX <br />(509) 962-7581 <br />CONTRACTOR E.MAIL ADDRESS <br />Chelsey. loeffers@co. kittitas.wa. <br />US <br />DSHS ADMINISTRATION <br />Division of Vocational Rehabilitation <br />DSHS DIVISION <br />Division of Vocational <br />Rehabilitation <br />DSHS CONTMCT CODE <br />8500cc-63 <br />DSHS CONTACT NAME AND TITLE <br />Austin Diaz-Munoz <br />Contracts Specialist <br />DSHS CONTACT ADDRESS <br />4565 7th Ave SE <br />Lacev, WA 98503 <br />DSHS CONTACT TELEPHONE <br />(564) 200-2812 <br />DSHS CONTACT FAX <br />Click here to enter text, <br />DSHS CONTACT E-MAIL ADDRESS <br />Austi n. DiazMunoz@dshs.wa. gov <br />IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? <br />No <br />CFDA NUMBERS <br />AMENDMENT START DATE <br />03t3112025 <br />CONTRACT END DATE <br />06t30t2025 <br />PRIOR MMIMUM CONTRACT AMOUNT <br />$101 ,700.00 <br />AMOUNT OF INCREASE OR DECREASE <br />$-75,700.00 <br />TOTAL MMIMUM CONTRACT AMOUNT <br />$26,000.00 <br />REASON FOR AMENDMENT; <br />CHANGE OR CORRECT CHOOSE ONE <br />ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into <br />this Contract Amendment by reference: <br />X Rdditional Exhibits (specifu): Exhibit B - Estimated Bi-Annual Budget <br />This Contract Amendment, including all Exhibits and other documents incorporated by reference, contains all of the terms <br />and conditions agreed upon by the parties as changes to the original Contract. No other understandings or <br />representations, oral or otherwise, regarding the subject matter of this Contract Amendment shall be deemed to exist or <br />bind the parties. All other terms and conditions of the original Contract remain in full force and effect. The parties signing <br />below warrant that they have read and understand this Contract Amendment, and have authority to enter into this Contract <br />Amendment. <br />CONTRACTOR SIGNATURE PRINTED NAME AND TITLE DATE SIGNED <br />DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED <br />DSHS Central Contract Services <br />6O24PF Contract Amendment (1 -26-20 1 8) <br />Page 1