HomeMy WebLinkAbout25-046 - Amendment A - Department of Social and Health Services - Interlocal Agreement: Olympic Heritage Hospital Police Servicecs25-046(a)
Council Approval 12/15/25
APPROVED AS TO FORM:
Signed by:
'-�. Sand.
i569b'' KLEtity Attorney
DSHS Central Contract Services Page 1
6024PF Contract Amendment (1-26-2018)
DSHS CONTRACT NUMBER:
nVwasiiifgtan State
Department of Social
CONTRACT AMENDMENT
2464-55580
/// & Health Services
Police Services
Amendment No. 01
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.'Iluc
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Contractor Contract Number
CONTRACTOR NAME
CONTRACTOR doing business as (DBA)
City of Tukwila
CONTRACTOR ADDRESS
WASHINGTON UNIFORM BUSINESS
DSHS INDEX NUMBER
6200 Southcenter Blvd
IDENTIFIER (UBI)
65776
Tukwila, WA 98188 -
CONTRACTOR CONTACT
CONTRACTOR TELEPHONE
CONTRACTOR FAX
CONTRACTOR E-MAIL ADDRESS
Jake Berry
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I Cq ick Iluere 1Jci eMilear I� xt
j.berry@tukwilawa.gov
DSHS ADMINISTRATION
DSHS DIVISION
7
DSHS CONTRACT CODE
Behavioral Health Administration
Division of State Hos itals
80001-C-64
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Blessing Guillermo
Olympic Heritage BH
Contracts Manager
12844 Military Rd S
Tukwila, WA 98168
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX
DSHS CONTACT E-MAIL ADDRESS
(253)355-4813
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blessin uillermo1 dshs.wa. ov
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?
CFDA NUMBERS
No
I
AMENDMENT START DATE
CONTRACT END DATE
01/01/2026
12/31/2030
PRIOR MAXIMUM CONTRACT AMOUNT
AMOUNT OF INCREASE OR DECREASE
TOTAL MAXIMUM CONTRACT AMOUNT
$213,090.00
$1,065,450.00
$1,278,540.00
REASON FOR AMENDMENT;
CHANGE OR CORRECT PERIOD OF PERFORMANCE AND MAX 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.
CONTRACTOR SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
Signed by:
UM&S k4uj
rD
Thomas McLeod Mayor
12/17/2025 15:54 PM P
E
PRINTED NAME AND TITLE
DATE SIGNED
`
Mara Lake, BHHA Contracts Administrator
12/19/2025
APPROVED AS TO FORM:
Signed by:
'-�. Sand.
i569b'' KLEtity Attorney
DSHS Central Contract Services Page 1
6024PF Contract Amendment (1-26-2018)
This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
1. The Contract End Date is extended as set forth on Page 1 of this Amendment.
2. The Total Maximum Contract Amount is increased as set forth on Page 1 of this Amendment.
All other terms and conditions of this Contract remain in full force and effect.
DSHS Central Contract Services Page 2
6024PF Contract Amendment (1-26-2018)