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Home My WebLink AboutGrant Related - BOCCFace Sheet — Amendment A Contract Number: 18-96616-032 Amendment Number: A Washington State Department of Commerce Local Government Division K20-065 Local and Community Projects 1. Contractor 2. Contractor Doing Business As (optional) Grant County 3. Contractor Representative (only if updated) 4. Commerce Representative (only if updated) Chuck Hunter Community Capital Facilities Program Manager P.O. Box 42525 (360) 725-2924 1011 Plum Street SE chuck.hunter@commerce.wa.gov Olympia, WA 98504-2525 5. Original Contract Amount 6. Amendment Amount 7. New Contract Amount $159,457.00 $ 83,043.00 $242,500.00 8. Amendment Funding Source 9. Amendment Start Date 10. Amendment End Date Federal: ❑ State: ❑ Other: ❑ N/A: ❑ Upon final signature. 6/30/2021 11. Federal Funds (as applicable) Federal AEency CFDA Number None None None 12. Amendment Purpose: The grantee desires to increase the amount of state funds available for the Project and modify the Project working papers (Attachments A, B and C)accordingly. Commerce, defined as the Department of Commerce, and the Contractor acknowledge and accept the terms of this Contract As Amended and have executed this Contract Amendment on the date below to start as of the date and year referenced above. The rights and obligations of both parties to this Contract As Amended are governed by this Contract Amendment and all other documents incorporated by reference. A copy of this Contract Amendment shall be attached to and made a part of the original Contract between Commerce and the Contractor. Any reference in the original Contract to the "Contract" shall mean the "Contract as Amended". FOR THE CONTRACTOR FOR COMMERCE Mark K. Barkley See Page 6, Signature Page Assistant Director Date Date 1/7/09 Amendment A This Contract is amended as follows: (Include all sections of the contract that will be changed by this amendment.) Box 5 of the face sheet is hereby revised to $242,500.00. Attachment A, is hereby revised to add indoor painting of facility and furnishings. The project is scheduled to be completed in June 2020. Attachment B, Architecture & Engineering line item is hereby revised to $4,200.00, Construction line item is revised to $238,300.00, Capitalized Equipment line item is revised to $135,000.00 and the total project budget is revised to $377,500.00 Attachment C, Total State Capital Budget is hereby revised to $242,500.00 and the Total Non -State and State Sources is revised to $377,500.00 ALL OTHER TERMS AND CONDITIONS OF THIS CONTRACT INCLUDING ANYAMENDMENTS AND ATTACHMENTS, REMAIN IN FULL FORCE AND EFFECT. 1/28/13 Face Sheet — Amendment A Contract Number: 18-96616-032 Amendment Number: A Washington State Department of Commerce Local Government Division Local and Community Projects 1. Contractor 2. Contractor Doing Business As (optional) Grant County 3. Contractor Representative (only if updated) 4. Commerce Representative (only if updated) Chuck Hunter Community Capital Facilities Program Manager P.O. Box 42525 (360) 725-2924 1011 Plum Street SE chuck.hunter@commerce.wa.gov Olympia, WA 98504-2525 5. Original Contract Amount 6. Amendment Amount 7. New Contract Amount $159,457.00 i $83,043.00 $242,500.00 8. Amendment Funding Source 9. Amendment Start Date 10. Amendment End Date Federal: ❑ State: ❑ Other: ❑ N/A: ❑ Upon final signature. 6/30/2021 11. Federal Funds (as applicable) Federal Agency CFDA Number None None None 12. Amendment Purpose: The grantee desires to increase the amount of state funds available for the Project and modify the Project working papers (Attachments A, B and C)accordingly. Commerce, defined as the Department of Commerce, and the Contractor acknowledge and accept the terms of this Contract As Amended and have executed this Contract Amendment on the date below to start as of the date and year referenced above. The rights and obligations of both parties to this Contract As Amended are governed by this Contract Amendment and all other documents incorporated by reference. A copy of this Contract Amendment shall be attached to and made a part of the original Contract between Commerce and the Contractor. Any reference in the original Contract to the "Contract" shall mean the "Contract as Amended". FOR THE CONTRACTOR FOR COMMERCE v Mark Y/Barkley See Page 6, Signature Page Assistant Director b 6—Z V Date Date 1/7/09 Amendment A Scope of Work Funds for this grant will be used for the Cityview Conversion to Residential Treatment Facility located at 838 East Plum Street, Moses Lake, WA. Work will include, but not be limited to: Renovation of an existing assisted living facility to residential treatment facility. The project includes a converted exam room, flooring, sleeping room lights and outlets in the kitchen and great room, plus a walk-in cooler, indoor painting the facility, furnishing and freezer which requires a generator that needs electrical panel changes. Project will become a 10 bed residential treatment facility. It will be the only residential facility in Grant County for people experiencing persistent mental illness, needing step down services in recovery. Project is scheduled to be completed in June 2020. All project work completed with prior legislative approval. The "Copyright Provisions", Section 12 of the General Terms and Conditions, are not intended to apply to any architectural and engineering design work funded by this grant. CERTIFICATION PERFORMANCE MEASURE The GRANTEE, by its signature, certifies that the declaration set forth above has been reviewed and approved by the GRANTEE's governing body as of the date and year written below. DATE 1/28/13 GRANTEE TITLE DATE 1/28/13 Amendment A Budget Line Item Amount Architecture & Engineering $4,200.00 Construction $238,300.00 Capitalized Equipment $135,000.00 Total Contracted Amount: $377,500.00 CERTIFICATION PERFORMANCE MEASURE The GRANTEE, by its signature, certifies that the Project Budget set forth above has been reviewed and approved by the GRANTEE's governing body or board of directors, as applicable, as of the date and year written below. GRANTEE TITLE - DATE 1/28/13 4 Amendment A Certification of the Availability of Funds to Complete the Project Non -State Funds Amount Total Beacon Health Options $135,000.00 Total Non -State Funds $135,000.00 State Funds State Capital Budget $242,500.00 $242,500.00 Total Non -State and State Sources $377,500.00 CERTIFICATION PERFORMANCE MEASURE The GRANTEE, by its signature, certifies that project funding from sources other than those provided by this contract and identified above has been reviewed and approved by the GRANTEE's governing body or board of directors, as applicable, and has either been expended for eligible Project expenses, or is committed in writing and available and will remain committed and available solely and specifically for carrying out the purposes of this Project as described in elsewhere in this contract, as of the date and year written below. The GRANTEE shall maintain records sufficient to evidence that it has expended or has access to the funds needed to complete the Project, and shall make such records available for COMMERCE'S review upon reasonable request. GRANTEE TITLE �Jo DATE 1/28/13 5 Amendment A DATED this day of 2020 Grant C Board of issioners: By Tom Taylor, --Chair By Cindy Carter, )fir Chair By d _ Ric and Stevens, Member 1/28/13