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C-22-15-063-3-03 Amendment No. 3 AMENDMENT NO. 3 TO THE CONTRACT BETWEEN MARICOPA COUNTY ADMINISTERED BY ITS HUMAN SERVICES DEPARTMENT AND LODESTAR DAY RESOURCE CENTER I. Maricopa County entered in to Contract C-22-15-063-3-00 with Lodestar Day Resource Center on April 15, 2015, for the provision of homeless emergency shelter and coordination of social services. The parties executed Amendment No. 1 on or about June 24, 2015, increasing funding from $302,892 to $350,000. The parties entered into Amendment No. 2 on or about October 21, 2015, increasing funding from $350,000 to $540,789. II. The Parties mutually desire to amend the Contract to: a. Increase Contract amount by $225,000 from $540,789 to $765,789 for use during the limited period of July 1, 2015 to June 30, 2016. b. Replace Attachment B Monthly Payment Request. c. Amendment No. 3 is effective immediately upon signature of the parties. III. This Amendment No. 3 is subject to A.R.S.§38-511. The foregoing paragraphs contain all the changes to the Agreement. All other terms of the original Agreement and Amendments not amended hereby, remain in full force and effect. IN WITNESS THEREOF, the Parties have signed this Amendment: FOR AND ON BEHALF OF LODESTAR DAY FOR AND ON BEHALF OF MARICOPA RESOURCE CENTER: COUNTY: ____________________________________ _____________________________________ Executive Director Steve Chucri, Chairman of the Board __________________ __________________ Date Date Attested To: _________________________________________ Fran McCarroll, Clerk of the Board Date This Amendment has been reviewed by the undersigned Attorney who has determined that is proper in form and within the power and authority granted under the laws of the State of Arizona. ________________________________________ Deputy County Attorney Date C-22-15-063-3-03 Amendment No. 3 ATTACHMENT B Maricopa County Human Services Department Community Development Division Payment Request Claim Form TIME STAMP ABOVE Subrecipient: Lodestar Day Resource Center Month & Year Address: 1125 W. Jackson Contract # C-22-15-063-3-00 City/State/Zip: Phoenix, AZ 85007 Contract Start Date April 15, 2015 Contact Person: David Bridge Contract End Date June 30, 2016 Phone Number: 602-223-3419 Date Submitted E-mail Address: dbridge@hsc-az.org B. Amount D. New Total A. Contract Budget Requested YTD C. Amount of this E. New Balance in Line Item Expenditures Requested YTD Amount (from D. previous Request Budget (A-D) (B+C) claim) 1. Shelter Operations (4/15/15-5/14/15) $26,907 $ - $ - $ - 26,907 2. Shelter Operations (5/15/15-6/30/15) $168,681 $ - $ - $ - 168,681 3. Shelter Operations (7/1/15-11/15/15) $154,412 $ - $ - $ - 154,412 4. Shelter Operations (7/1/15-6/30/16) $415,789 $ - $ - $ - 415,789 TOTALS: 765,789 0.00 765,789 Signature certifies that all activities performed with contracted funds have been carried out in accordance with the contract to the best of the signer's knowledge. Authorized Signature Title Date Payment Requirements: An authorized signature is required. After signature, please SCAN AND EMAIL this form . An incomplete or incorrect payment request will be returned for correction and may delay payment. Supporting documentation MUST be submitted with this claim. From 4/15-5/14 available funds shall be $26,907. Starting 5/15-6/30/15 Operating Costs total of $168,681. Starting 07/01-11/15/15 operating costs will be in four equal payments of $38,603/month. Amendment #2 and Amendment #3 funding of $415,789 is for expenses for the time period of 07/1-06/30 that were not previously reimbursed and will only be reimbursed with correct supporting documentation. MCHSD/CD USE ONLY Project Manager Date Assistant Director Date Grants Accountant Date