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WA ST Military Dept 4/7/2025 Amendment 1
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WA ST Military Dept 4/7/2025 Amendment 1
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Last modified
5/16/2025 10:22:35 AM
Creation date
5/16/2025 10:05:59 AM
Metadata
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Template:
Contracts
Contractor's Name
WA ST Military Dept
Approval Date
4/7/2025
Council Approval Date
4/16/2025
End Date
4/30/2026
Department
Public Works
Department Project Manager
Shaun Bridge
Subject / Project Title
Evergreen Pump Station Permanent Generator
Public Works WO Number
D22-024
Amendment/Change Order
Amendment
Amendment/Change Order Number
1
Tracking Number
0003456
Total Compensation
$0.00
Contract Type
Agreement
Contract Subtype
Grant Agreement (City as Grantee)
Retention Period
6 Years Then Destroy
Imported from EPIC
No
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Provide a complete copy of the audit report electronically to contracts.office@mil.wa.gov or provide the <br />state audit number [1035614]. <br />SECTION C: Federal Funding Accountability and Transparency Act (check the corresponding answer) <br />In your preceding fiscal year, did your organization receive 80% or more of its gross revenues from federal <br />funding? ❑ Yes n No <br />In your preceding fiscal year, did your organization receive $25,000,000 or more in federal funding? <br />Yes X No <br />If you answered yes to the previous questions, you must report the names and total compensation of the <br />top 5 highly compensated officials of your organization. <br />1. <br />2. <br />3. <br />5. <br />hereby certify that I am an individual authorized by the above identified entity (subrecipient) to complete this <br />form. Further, I certify that the above information is true and correct, and all material findings contained in the <br />audit report/statement have been disclosed. Additionally, I understand this form is to be submitted every fiscal <br />year for which this entity is a subrecipient of federal award funds from the Department until the grant agreement <br />is closed. <br />Signature of Authorized Financial Representative• Date: 4/2/2025 <br />Page 2of2 <br />
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