HomeMy WebLinkAboutDepartment of Health Amendment # 2DOH Amendment GVL28360-2 Page 1 of 1
Revision 09/2023
CONTRACT AMENDMENT
1. NAME OF CONTRACTOR
Mason County Public Health
2. CONTRACT NUMBER
GVL28360
1a. ADDRESS OF CONTRACTOR (STREET)
411 N 5th Street
2a. AMENDMENT NUMBER
1b. CITY, STATE, ZIP CODE
Shelton, WA 98584
2
3. THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS.
The Contract identified herein, including any previous amendments thereto, is hereby amended as set forth in Item 5 below by
mutual consent of all parties hereto.
4. THIS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS.
The Contract identified herein, including any previous amendments thereto, is hereby unilaterally amended as set forth in Ite m 5
below pursuant to that changes and modifications clause as contained therein.
5. DESCRIPTION OF AMENDMENT: The purpose of this amendment is to extend the period of performance to
continue staff training I preparation for this agency to provide WID Nutrition Program services.
5a. Consideration: This amendment neither increases nor decreases the Contract Consideration; therefore, the d
maximum consideration of this contract and all amendments shall not exceed $116,938.00.
5d. Period of Performance: is extended through February 29, 2024.
5e. The Effective Date of this Amendment: is January 1, 2024.
6. All other terms and conditions of the original contract and any subsequent amendments thereto remain in full force and
effect.
7. This is a unilateral amendment. Signature of contractor is not required below.
Contractor hereby acknowledges and accepts the terms and conditions of this amendment. Signature is required below.
8. CONTRACTOR SIGNATURE (also, please print/type your name)
{{Sig_es_:signer1:signature}}
DATE
{{Dte_es_:signer1:date}}
9. DOH CONTRACTING OFFICER SIGNATURE
{{Sig_es_:signer2:signature}}
DATE
{{Dte_es_:signer2:date}}
This document has been approved as to form only by the Assistant Attorney General.
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9 K D U R Q : U D V N Dec 5, 2023
Dec 11, 2023