AMENDMENT NO. 4 TO 2017 Mental Health Substance Use Disorder Fund Agreement Temporary Young Adult Shelter Pierce County THIS AMENDMENT is made and entered into effective as of the June 1* day of 2017 (‘Effective Date"), by and between the CITY OF TACOMA (hereinafter called the "CITY") and Community Youth Services (hereinafter called the CONTRACTOR’). WHEREAS the CITY and the CONTRACTOR entered into a Contract for sheltering young adults and offering a drop-in center (herein “Contract’) effective January 1, 2017, and WHEREAS the CITY and the CONTRACTOR desire to amend the Contract in order to extend the term of the contract for an additional 120 days, increase the compensation allowed under the Contract, and to amend the original scope of work, and NOW, THEREFORE, in consideration of the mutual promises and obligations hereinafter set forth, the parties agree as follows: 1, The sum authorized for services under the Contract in paragraph 3 is hereby increased by $132,254.00 from $165,317.05 to $297,571.06. 2. The termination date of the Contract in paragraph 2 is hereby extended from May 31, 2017 to September 29, 2017. 3. The Project Reimbursement Request, Exhibit "B" of the Contract, is hereby amended to reflect the sum of authorized services to be $297,571.05 attached as Exhibit A to this Amendment and incorporated herein. 4, Allother terms of the Contract, together with all exhibits, are hereby ratified and shall remain in full force and effect, unaltered by this Amendment. Amendment No. 1 to TO 2017 Mental Health Substance Use Disorder Fund Agreement ‘Temporary Young Adult Shelter Pierce County Page 1 of 3 Form Date: 8/19/13IN WITNESS WHEREOF, the Parties hereto have executed this Amendment effective as of the Effective Date first written above. CITY OF TACOMA Elizabeth A. Pauli City Manager Approved Finance Director Approved as to Form Deputy City Attomey Approved! City Clerk COMMUNITY YOUTH SERVICES Authorized Representative of Contractor Print Name: Title’ Tax ID. ‘Amendment No. 1 to TO 2017 Mental Health Substance Use Disorder Fund Agreement ‘Temporary Young Adult Shelter Pierce County Page 2 of 3 Form Date: 8/19/13AMENDMENT NO. 4 Exhibit A 2017 MHSUD Homelessness & Household Stability Cost Reimbursement eject Young Adit Shator-Aronded Operating Ageney: Commurity Youth Senieea PROJECT REIMBURSEMENT REQUEST Pract Term: January 1, 2017 trough September 25,2077 Gy Umbra Dep: NEIGHBORHOOD & COMM, SERVICES @ @ @ @ Payment Numbo: Payment to: Community Youh Senices Total Funds Bild Reimbursable costs through {mart Reimbusemert | preous Funds | bY Agency Budget ia a Request | PHB TIM | reusing this | Remaining (Funds Bled) request) 25) Budget tem 2017 Budget cra) Personnel aniston — $39,506 3000 so00__| $0.00 TEA Diet Serves Sia $184,352.40 50.00 0.00 51.00 $184 352.00, Non Personnel Cemmuriesions 300 5000 ‘si00 25.08 Consumable Supls $0.00 $0.00 $0.00 $570.00 Trrspotaton/Mieage $383.0 5000 $0.00 $0.00 5583.40 Ciert Support bus passes ae) $5,62500 50.00 $0.00 $0.00 35 125.00 Meals $15,336.00 S000 $0.00 $0.00 515,336.00 unary hoor badaing any) — $9.458,00 $0.00 $0.00 $0.00 58,458.00, insect Coste $26,152.19 s0.00 $0.00 $0.00 $26,192.18 ‘Space [rent to TEA fr Drop + launday) $9,696.60 S00 $0.00 $0.00 $9,596.60 ‘Sta Ting $2,700.00 $0.00 30.00 30.00 52,700.00 TOTAL S297 571.00, $0.00 $0.00 $0.00 | $297,571.00 [AGENCY: | cory thatthe materials have been furnished, the services rendered or the labor performed as described, and that the clam is Just, due and unpaid obligation against he City of Tacoma. MOTE: Supporting financial documentation required fo all requested reimbursement. Prepared by: Date Prepared: Director's Signature: City of Tacoma Contract & Program Auditor: City of Tacoma Accountant: City of Tacoma Management: Amendment No. 1 to TO 2017 Mental Heaith Substance Use Disorder Fund Agreement Temporary Young Adult Shelter Pierce County Page 3 of 3 Form Date: 8/19/13