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Home My WebLink AboutAgreements/Contracts - New Hope DV/SADSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018) DSHS CONTRACT NUMBER: Washington S'a'e Department of Social CONTRACT AMENDMENT 1912-61860 7TV&Health Senices WorkFirst Onsite Family Violence 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. C ick here to enter text. Contractor Contract Number CONTRACTOR NAME CONTRACTOR doing business as (DBA) Grant County New Hope Domestic Violence and Sexual Assault Sery CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS DSHS INDEX NUMBER PO Box 37 IDENTIFIER (UBI) 1221 136-000-784 Ephrata, WA 98823 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Suzi Fode 509 764-8402 I 509 766-6574 1 sfode@co.grant.wa.us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Economic Services Administration Community Services Division 3003XS-12 DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS John Vasquez 8517 E Trent Ave WorkFirst Coordinator Ste 202 S okane Valley, WA 992122329 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS (509)961-1688 (509)2 7-2822 1 vasquja@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBERS No I AMENDMENT START DATE CONTRACT END DATE 03/31/2020 06/30/2021 PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT $31,000.00 $0.00 $31,000.00 REASON FOR AMENDMENT; CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO 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): 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 Cindy Carter, BOCC Chair 3.3C) DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED Charley Barron CSD Contracts Officer DSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018) DSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018) DSHS CONTRACT NUMBER- flffWasn ento Stern Department of Social CONTRACT AMENDMENT 1912-61860 &Health Services WorkFirst Onsite Family Violence 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) Grant County New Hope Domestic Violence and Sexual Assault Sery CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS DSHS INDEX NUMBER PO Box 37 IDENTIFIER (UBI) 1221 136-000-784 Ephrata, WA 98823 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Suzi Fode 509 764-8402 I 509 766-6574 sfode@co.grant.wa.us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Economic Services Administration Community Services Division 3003XS-12 DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS John Vasquez 8517 E Trent Ave WorkFirst Coordinator Ste 202 Spokane Valley, WA 992122329 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS (509)961-1688 (509)227-2822 1 vasquja@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS C777 FDA NUMBERS No AMENDMENT START DATE CONTRACT END DATE 03/31/2020 06/30/2021 PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT $31,000.00 $0.00 $31,000.00 REASON FOR AMENDMENT; CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO 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): 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 AmendmgRt. CONT OR SIG TURE ! !IJ PRINTED NAME AND TITLE DATE SIGNED Cindy Carter, BOCC Chair DSHS,SICNATURE PRINTED NAME AND TITLE DATE SIGNED hn' r r -J Charley Barron 03/31/2020 CSD Contracts Officer DSHS Central Contract Services Page 1 6024PF Contract Amendment (1-26-2018) This Contract between the State of Washington Department of Social and Health Services (DSHS) and the Contractor is hereby amended as follows: Effective March 16, 2020: Exhibit B, Statement of Work, Section 1, Purpose, is amended to read as follows: Provide a qualified Domestic Violence Advocate to provide on-site or telephone Family Violence Services for the DSHS Community Services Office to: a. Assist DSHS staff in determining appropriate WorkFirst activities for referred clients who experience family violence b. Provide referred clients community resource referrals and linkages appropriate to the family's needs. c. Provide empowerment -based advocacy to referred clients who experience family violence. 2. Exhibit B, Statement of Work, Section 4, Staffing is amended to read as follows: a. The Contractor shall provide the services of a qualified Domestic Violence Advocate to the Moses Lake Community Service Office for up to 14.88 hours per week and 774 hours per year. b. The services may be provided in person at a Community Service Office or by telephone. c. If the Contractor cannot provide in person services they shall notify the Community Service Office and the DSHS Contact. d. If the Contractor can provide the services by telephone they shall notify the Community Service Office and the DSHS Contact. e. Actual scheduling and manner in which the services will be provided will be negotiated between the Contractor and the Community Service Office. 3. Exhibit B, Statement of Work, Section 8, Compensation is amended to read as follows: a. DSHS shall pay $40.00 per hour for the Family Violence Services provided for a Community Service Office. b. Payment will be limited to actual hours worked by Domestic Violence Advocates and shall be prorated to 30 -minute intervals. All other terms and conditions of this Contract remain in full force and effect. DSHS Central Contract Services Page 2 6024PF Contract Amendment (1-26-2018)