HomeMy WebLinkAbout2025-0113 - Unknown - - GVL24913-8_City_of_Auburn_Auburn_Farmers_Market - Department of Health Docusign Envelope ID:58A4603B-E9AF-447C-AE97-25D21C7FD4E7
V . Washington State Department of
• H E A LT H CONTRACT AMENDMENT
1. NAME OF CONTRACTOR 2. CONTRACT NUMBER
City of Auburn GVL24913
Auburn Farmers Market
la. ADDRESS OF CONTRACTOR(STREET) 2a. AMENDMENT NUMBER
25 West Main Street
lb. CITY, STATE,ZIP CODE 8
Auburn,WA 98001
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 update the Scope of Work,section 2,
add funds and extend the period of performance.
5a. Statement of Work: SCOPE of WORK section 2: is revised as follows and incorporated herein.
2. Report SNAP transaction data,which includes:
2a. SNAP and incentive distribution for each SNAP/EBT transaction each month—including transaction date,
SNAP sale amount, and incentive distribution amount.
2b. At the conclusion of the contract period,DOH will determine how the disposition of DOH purchased materials
will occur,including but not limited to,DOH provided tablet used for data collection.
5b. Consideration: This amendment increases the Contract Consideration by$13,000;therefore,the revised maximum
consideration of this contract and all amendments shall not exceed$93,500.
Source of Funds for this Amendment: (FED) $8,000; (ST) $5,000; (Other) $0; Total$13,000.
Contractor agrees to comply with applicable rules and regulations associated with these funds.
5c. Period of Performance: is extended through February 28,2026.
5d. The Effective Date of this Amendment: is 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. CONTRACTOR SIGNATURE (also,please print/type your name) DATE
Br Initial
C Nancy Backus � ,,� 2/27/2025
FEC92ABU1]EO4]C Y
Mayor Nancy Backus
9. DOH CONTRACTING OFFICER SIGNATURE DATE
(—Signed by:
� w� 2/27/2025
�r
Tins document has been approved as to form only by the Assistant Attorney General.
DOH Amendment GVL24913-8 Page 1 of 1
Revision 04/2020