HomeMy WebLinkAboutGrant Related - BOCC (010)DSHS Central Contract Services
6024PF Contract Amendment (1-26-2018)
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DSHS CONTRACT NUMBER:
nVWashingtoa State
Department of Social
CONTRACT AMENDMENT
1912-61860
7
& Health Services
Onsite Family Violence Services
Amendment No. 02
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
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 CONTRACT?
CFDA NUMBERS
No
I
AMENDMENT START DATE
CONTRACT END DATE
07/10/2020
06/30/2021
PRIOR MAXIMUM CONTRACT AMOUNT
AMOUNT OF INCREASE OR DECREASE
TOTAL MAXIMUM CONTRACT AMOUNT
$31,000.00
$31,000.00
$62,000.00
REASON FOR AMENDMENT;
CHANGE OR CORRECT MAXIMUM CONTRACT AMOUNT
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.
CONT 1 OR SI NATUR
PRINTED NAME AND TITLE
DATE SIGNED
Cindy Carter, BOCC Chair
7_
DSHS SIGNATU RPRINTED
NAME AND TITLE
DATE SIGNED
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kN(i r
Charley Barron
CSD Contracts Officer
07/14/20
DSHS Central Contract Services
6024PF Contract Amendment (1-26-2018)
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This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
The Maximum Contract Amount is increased by $31,000 to a new Maximum Contract Amount of
$62,000.
Special Terms and Conditions, Section 4, Consideration is replaced with the following language:
Total consideration payable to Contractor for satisfactory performance of the work under this Contract,
shall be paid in accordance with the fees set forth in the attached Exhibit(s).
Total consideration payable for the contract period to the Contractor for satisfactory work performance
including any and all expenses under this Contract is up to a maximum of $ 62,000.
Unspent funds designated for any State Fiscal Year shall remain unspent and may not be carried
forward into the following State Fiscal Year.
Consideration payable per State Fiscal Year:
State Fiscal Year 2020 (July 1, 2019 through June 30, 2020) = $31,000
State Fiscal Year 2021 (July 1, 2020 through June 30, 2021) = $31,000
All other terms and conditions of this Contract remain in full force and effect.
DSHS Central Contract Services Paye 2
6024PF Contract Amendment (1-26-2018)