HomeMy WebLinkAboutWashington State Department of Commerce Amendment # A DocuSign Envelope ID: BFCF378C-COF4-424F-83C7-C2FECC63F577 ..mendment
Contract Number: 21-461OC-111
Amendment Number: A
Washington State Department of Commerce
Housing Division
Homelessness Assistance Unit
Shelter Program Grant
1.Contractor 2.Contractor Doing Business As(optional)
Mason County Health Services
415 N 6TH ST
SHELTON, WA 98584
3.Contractor Representative (only if updated) 4.CONIlgERCE Representative (only if updated)
Casey Bingham Megan Kendig PO Box 42525
Fiscal Manager Grant Manager 1011 Plum St SE
360427-9670 ev. 562 360-401-5149 Olympia, WA 98504-2525
caseyb@co.mason.wa.us megan.kendig@commerce.wa.gov
5.Original Contract Amount 6.Amendment Amount 7.New Contract Amount
(and any previous amendments)
$344,428 $121,000 $465,428
8.Amendment Funding Source 9.Amendment Start Date 10.Amendment End Date
Federal: State: X Other: N/A: March 15, 2023 June 30, 2023
11.Federal Funds (as applicable): Federal Agency: CFDA Number:
N/A N/A N/A
12.Amendment Purpose: Adding additional funding to SPG award.
COMMERCE, defined as the Department of Commerce, and the Contractor,as defined above,acknowledge and accept the terms
of this Contract As Amended and attachments 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 the following otherdocuments incorporated by reference: Contractor Temps and Conditions including Attachment
"A"—Scope of Work,Attachment"B"—Budget and Shelter Program Grant Guidelines. 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 CONTRACTOR FOR CONEWERCE
DS
L�D—Sign,d
�b/y: gDocuSigned/by: I'U/� VO?itwL� GfLL902e6Y 11.M1'L o v
Sharon Trask, Commissioner, BOCC Chair Corina Grigoras, Assistant Director
Housing Division
4/20/2023 1 1:50 PM PDT 4/20/2023 1 4:52 PM PDT
Date Date
APPROVED AS TO FORM ONLY
Sandra Adix
Assistant Attorney General
3/20/2014
Date
Department of Commerce
DocuSign Envelope ID: BFCF378C-COF4-424F-83C7-C2FECC63F577
Amendment
This Contract is amended as follows:
Attachment B Budget
Budget Category Amount Amendment A
Pre-Occupancy $34,578 $0 $34,578
Up to$10,000 per bed prior
to occupancy
Post-Occupancy $309,850 $121,000 $430,850
Operations
Total $344,428 $121,000 $465,428
ALL OTHER TERMS AND CONDITIONS OF THIS CONTRACT REMAIN IN FULL FORCE
AND EFFECT.
2