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KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2015 -2017 CONSOLIDATED CONTRACT CONTRACT NUMBER: C17114 AMENDMENT NUMBER: 12 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT hereinafter referred to as "LHJ", pursuant to the ModificationslWaivers clause, and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows : o Adds Statements of Work for the following programs: I:8J Amends Statements of Work for the following programs: • Office ofImmunization & Child Profile -Effective January 1, 2017 D Deletes Statements of Work for the following programs: 2. Exhibit B-12 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-11 Allocations as follows: o o Increase of Decrease of for a revised maximum consideration of __ for a revised maximum consideration of __ I:8J No change in the maximum consideration of $358,397. Exhibit B Allocations are attached only for informational purposes . 3. Exhibit C-10 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-9. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT Page 1 of 10 STATE OF WASHINGTON DEP ARTMENT OF HEALTH J]1M~lIDI I f"j Date APPROVED AS TO FORM ONLY Assistant Attorney General