WA ST Dept of Licensing 5/5/2016

Rev. 09-29-2014 CITY CONTRACT AMENDMENT WASHINGTON STATE DEPARTMENT OF 411. LICENSING Contract No. K5155 LICENSING BETWEEN THE DEPARTMENT OF LICENSING AND Amendment No. 1 TBD Amendment Amendment Purpose The purpose of this amendment is to: 1. Update the DOL Contract Manager; 2. Amends Section 1 Definitions; 3. Adds Assignment Clause; and 4. Update Attachment A, STATEMENT OF WORK, by replacing in its entirety with an updated version Attachment A, STATEMENT OF WORK. Contractor Contract manager (Area code)Telephone E-Mail Richard Tarry 425-257-8922 rtarry@everettwa.gov Department of Licensing (DOL) Contract manager (Area code)Telephone E-Mail Debra Dunn, Data Sharing Contracts (360) 902-0136 ddunn(cdol.wa.gov Manager Attachments(when applicable) This Contract consists of the following attachment(s) and all document(s) incorporated herein or by reference: None The execution of this Amendment shall constitute a ratification of any earlier agreement between the parties, hereto, the terms and conditions of which are contained herein. The intent of the parties is that the effective date of this Agreement shall be on the date of last signature. All other terms and conditions of the original Contract and any subsequent amendments thereto remain in full force and effect. The parties hereby acknowledge and accept the terms and conditions of this amendment which is executed by the persons signing below who warrant that they have the authority to execute it on behalf of DOL and the Contractor. Contractor signature I D to DOL signature Date 1 i Acrityeuvvtotol$7 16 i / 1 - /, /P- 47?p/4, PRINT coni- name ame Ray St•• :nson Tamara L. Do• ma Print Title Print Title Mayor Assistant Director Administrative Services Division E-Mail E-Mail rstephanson@everettwa.gov tdohrmancc dol.wa.gov Phone Phone 425-257-7115 360-902-4044 :: O V ,D AS TO FORM -,-,v7S D. KIS, City Attorney ./ i ATT T / i. _ - City Clark K.docx Page 1 of 1 date