LODESTAR DAY RESOURCE CENTER AMEND 2.PDF

C-22-15-063-3-02 Amendment No. 2
AMENDMENT NO. 2 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. Amendment No. 1 was
approved on June 24, 2015, increasing funding from $302,892 to $350,000.
II. The Parties mutually desire to amend the Contract to:
A. Extend the Contract term from November 15, 2015 to June 30, 2016
B. Increase Contract amount by $190,789 from $350,000 to $540,789 for use during the limited period of July 1,
2015 to June 30, 2016.
C. Replace Attachment B Monthly Payment Request
III. The foregoing paragraphs contain all the changes to the Agreement. All other terms of the original Agreement
and Amendment No. 1 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-22-15-063-3-02 Amendment No. 2
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) $190,789 $ - $ - $ - 190,789
TOTALS: 540,789 0.00 540,789
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 funding of $190,789 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