043-14 - WA State Public Works Board - Contract Amendment 4Wiisiliik�liui Stab, Dq rfi� ew d
� He a I t h
CONTRACT AMENDMENT
1. NAME OF CONTRACTOR
2. CONTRACT NUMBER
City of Port Orchard
DOH Contract DWL24355
Commerce Contract #DM13-952-185
Ia. ADDRESS OF CONTRACTOR (STREET)
2a. AMENDMENT NUMBER
216 Prospect Street
4
lb. CITY, STATE, ZIP CODE
Port Orchard, WA 98366-5326
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 Item 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 project completion date from
December 31, 2020 to December 31, 2021.
5a. Period of Performance: remains unchanged through 10/01/2037.
5b. The Effective Date of this Amendment: is the Date of Execution.
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. ONTRACTOR S U (also, please print/type your name)
DATE
9. DOH CONTRACTING O FICER SIGNATURE
DATE
&-aw I`Wf�eaw
03/30/2020
Brad Halstead (Mar30, 2020)
l his document has been approved as to form only by the Assistant Attorney General.
DOH Amendment # 4
Commerce Contract # DM13-952-185 Page 1 of 1
Revision 11/17
DWL24355-4 City of Port Orchard
Final Audit Report 2020-03-30
Created:
2020-03-30
By:
Tonja Christensen (tonja.christensen@doh.wa.gov)
Status:
Signed
Transaction ID:
CBJCHBCAABAAFahOCwZDMc85LBP1ZactFkmokBAec3cB
"DWL24355-4 City of Port Orchard" History
Document created by Tonja Christensen (tonja.christensen@doh.wa.gov)
2020-03-30 - 5:56:57 PM GMT- IP address: 192.230.13.151
Document emailed to Brad Halstead (Brad. Halstead@DOH.WA.GOV) for signature
2020-03-30 - 5:57:17 PM GMT
Email viewed by Brad Halstead (Brad. Halstead@DOH.WA.GOV)
2020-03-30 - 8:40:47 PM GMT- IP address: 192.230.13.151
dp Document e-signed by Brad Halstead (Brad.Halstead@DOH.WA.GOV)
Signature Date: 2020-03-30 - 8:41:36 PM GMT - Time Source: server- IP address: 192.230.13.151
Signed document emailed to Brad Halstead (Brad. Halstead@DOH.WA.GOV) and Tonja Christensen
(tonja.christensen@doh.wa.gov)
2020-03-30 - 8:41:36 PM GMT
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