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DSHS Central Contract Services Page 1 <br />6024PF Contract Amendment (1-26-2018) <br />CONTRACT AMENDMENT DSHS CONTRACT NUMBER: <br />1963-58859 <br />Amendment No. 01 <br />This Contract Amendment is between the State of Washington Department of <br />Social and Health Services (DSHS) and the Contractor identified below. <br />Program Contract Number <br />Click here to enter text. <br />Contractor Contract Number <br />CONTRACTOR NAME <br />Kittitas County <br />CONTRACTOR doing business as (DBA) <br />Kittitas County DDA County Services <br />CONTRACTOR ADDRESS <br />507 North Nanum Street Suite 102 <br />Ellensburg, WA 98926-2886 <br />WASHINGTON UNIFORM BUSINESS <br />IDENTIFIER (UBI) <br />192-002-673 <br />DSHS INDEX NUMBER <br />1225 <br />CONTRACTOR CONTACT <br />Kaesy Knutson <br />CONTRACTOR TELEPHONE <br />(509) 962-7090 <br />CONTRACTOR FAX <br />(509) 962-7581 <br />CONTRACTOR E-MAIL ADDRESS <br />Click here to enter text. <br />DSHS ADMINISTRATION <br />Developmental Disabilities Admin <br />DSHS DIVISION <br />Division of Developmental <br />Disabilities <br />DSHS CONTRACT CODE <br />1769CS-63 <br />DSHS CONTACT NAME AND TITLE <br />Seanna Woodard <br />Operations Manager <br />DSHS CONTACT ADDRESS <br />1611 W Indiana Ave <br />Spokane, WA 99205 <br />DSHS CONTACT TELEPHONE <br />(509)329-2952 <br />DSHS CONTACT FAX <br />(509)568-3037 <br />DSHS CONTACT E-MAIL ADDRESS <br /> <br />IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? <br />No <br />CFDA NUMBERS <br />AMENDMENT START DATE <br />07/01/2020 <br />CONTRACT END DATE <br />06/30/2021 <br />PRIOR MAXIMUM CONTRACT AMOUNT <br />$728,032.00 <br />AMOUNT OF INCREASE OR DECREASE <br />$683,011.00 <br />TOTAL MAXIMUM CONTRACT AMOUNT <br />$1,411,043.00 <br />REASON FOR AMENDMENT; <br />CHANGE OR CORRECT PERIOD OF PERFORMANCE AND MAX CONTRACT AMOUNT <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 /> Additional Exhibits (specify): Exhibit B <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