Common use of Purpose of Amendment Clause in Contracts

Purpose of Amendment. This Amendment shall be used to increase or decrease the approved Allocation Agreement Budget Plan or to modify the approved Performance Period end date due to approved revisions to the original Work Plan and/or Goals and Objectives. Revisions may be due to the following: a. Modifications to work plan activities due to the impacts of COVID-19 and the need to reassess outreach opportunities. b. Additions or reductions to targeted population(s). c. Addition of new activities due to creative workarounds during the pandemic, such as review of Cal-Fresh in-reach cases. d. Addition of new Community-Based Organization (CBO) partnerships. e. Updates to goals and objectives. f. Revisions to projected enrolled and retained numbers. g. Requests for additional funding due to work plan revisions or other necessary considerations. II. Amended Allocation Agreement Documents: a. Revised Budget Plan – A3 – Attachment 1 b. Revised Work Plan – A3 – Attachment 2 III. Changes made in this amendment must be made as bold and underline for new additions, while deletions must be made as strikethrough text (i.e. strike). REVISED ALLOCATION AMOUNT NOT TO EXCEED $1,686,038.00 ONE MILLION, SIX HUNDRED EIGHTY SIX THOUSAND, THIRTY-EIGHT DOLLARS The General and Special Provisions attached are made a part of and incorporated into the Agreement. COUNTY OF PLACER DEPARTMENT OF HEALTH CARE SERVICES STATE OF CALIFORNIA 0000 XXXXXX XXXXXX XXXXX, #000 XXXXXX, XX 00000 Xxxxxx X. Xxxxxx Xxxxxx X. Xxxxxx (Jun 16, 2022 13:29 PDT) ATTN: HEALTH ENROLLMENT NAVIGATORS SECTION MEDI-CAL ELIGIBILITY DIVISION XX XXX 000000, XX 0000 XXXXXXXXXX, XX 00000-0000 BY (AUTHORIZED SIGNATURE): ⮱ Xxxxxx X. Xxxxxx, Director BY (AUTHORIZED SIGNATURE): ⮱ PRINTED NAME AND TITLE OF PERSON SIGNING: Jun 16, 2022 PRINTED NAME AND TITLE OF PERSON SIGNING: Xxxxxx Xxxxxxxx, Division Chief DATE SIGNED: DATE SIGNED:

Purpose of Amendment. This Amendment shall be used to increase or decrease the approved Allocation Agreement Budget Plan or to modify the approved Performance Period end date due to approved revisions to the original Work Plan and/or Goals and Objectives. Revisions may be due to the following: a. Modifications to work plan activities due to the impacts of COVID-19 and the need to reassess outreach opportunities. b. Additions or reductions to targeted population(s). c. Addition of new activities due to creative workarounds during the pandemic, such as review of Cal-Fresh in-reach cases. d. Addition of new Community-Based Organization (CBO) partnerships. e. Updates to goals and objectives. f. Revisions to projected enrolled and retained numbers. g. Requests for additional funding due to work plan revisions or other necessary considerations. II. Amended Allocation Agreement Documents: a. Revised Budget Plan – A3 A1 – Attachment 1 b. Revised Work Plan – A3 A1 – Attachment 2 III. Changes made in this amendment must be made as bold and underline for new additions, while deletions must be made as strikethrough text (i.e. strike). REVISED ALLOCATION AMOUNT NOT TO EXCEED $1,686,038.00 1,765,639 ONE MILLION, SEVEN HUNDRED SIXTY-FIVE THOUSAND, SIX HUNDRED EIGHTY SIX THOUSAND, THIRTY-EIGHT NINE DOLLARS The General and Special Provisions attached are made a part of and incorporated into the Agreement. ORANGE COUNTY OF PLACER DEPARTMENT OF HEALTH CARE SERVICES STATE OF CALIFORNIA 0000 XXXXXX XXXXXX XXXXX000 X. XXXXX XXXXXXX XXXX., #XXX. 000 XXXXXX, XX 00000 Xxxxxx X. Xxxxxx Xxxxxx X. Xxxxxx (Jun 16, 2022 13:29 PDT) ATTN: HEALTH ENROLLMENT NAVIGATORS SECTION MEDI-CAL ELIGIBILITY DIVISION XX XXX 000000PO BOX 997417, XX 0000 XXXXXXXXXXMS 4607 SACRAMENTO, XX 00000CA 95899-0000 7417 BY (AUTHORIZED SIGNATURE): ⮱ Xxxxxx X. Xxxxxx, Director BY (AUTHORIZED SIGNATURE): ⮱ PRINTED NAME AND TITLE OF PERSON SIGNING: Jun 16, 2022 PRINTED NAME AND TITLE OF PERSON SIGNING: Xxxxxx Xxxxxxxx, Division Chief DATE SIGNED: DATE SIGNED:: Approved as to Form 11/01/21 Page 1

Purpose of Amendment. This Amendment shall be used to increase or decrease the approved Allocation Agreement Budget Plan or to modify the approved Performance Period end date due to approved revisions to the original Work Plan and/or Goals and Objectives. Revisions may be due to the following: a. Modifications to work plan activities due to the impacts of COVID-19 and the need to reassess outreach opportunities. b. Additions or reductions to targeted population(s). c. Addition of new activities due to creative workarounds during the pandemic, such as review of Cal-Fresh in-reach cases. d. Addition of new Community-Based Organization (CBO) partnerships. e. Updates to goals and objectives. f. Revisions to projected enrolled and retained numbers. g. Requests for additional funding due to work plan revisions or other necessary considerations. II. Amended Allocation Agreement Documents: a. Revised Budget Plan – A3 A2 – Attachment 1 b. Revised Work Plan – A3 A2 – Attachment 2 III. Changes made in this amendment must be made as bold and underline for new additions, while deletions must be made as strikethrough text (i.e. strike). REVISED ALLOCATION AMOUNT NOT TO EXCEED $1,686,038.00 1,915,774.00 ONE MILLION, SIX NINE HUNDRED EIGHTY SIX FIFTEEN THOUSAND, THIRTYSEVEN HUNDRED SEVENTY-EIGHT FOUR DOLLARS The General and Special Provisions attached are made a part of and incorporated into the Agreement. COUNTY OF PLACER ORANGE DEPARTMENT OF HEALTH CARE SERVICES STATE OF CALIFORNIA 0000 XXXXXX XXXXXX XXXXX000 X. XXXXX XXXXXXX XXXX., #XXX. 000 XXXXXX, XX 00000 Xxxxxx X. Xxxxxx Xxxxxx X. Xxxxxx (Jun 16, 2022 13:29 PDT) ATTN: HEALTH ENROLLMENT NAVIGATORS SECTION MEDI-CAL ELIGIBILITY DIVISION XX XXX 000000, XX 0000 XXXXXXXXXX, XX 00000-0000 BY (AUTHORIZED SIGNATURE): ⮱ Xxxxxx X. Xxxxxx, Director BY (AUTHORIZED SIGNATURE): ⮱ PRINTED NAME AND TITLE OF PERSON SIGNING: Jun 16, 2022 PRINTED NAME AND TITLE OF PERSON SIGNING: Xxxxxx Xxxxxxxx, Division Chief DATE SIGNED: DATE SIGNED:: Approved as to Form

Purpose of Amendment. This Amendment shall be used to increase or decrease the approved Allocation Agreement Budget Plan or to modify the approved Performance Period end date due to approved revisions to the original Work Plan and/or Goals and Objectives. Revisions may be due to the following: a. Modifications to work plan activities due to the impacts of COVID-19 and the need to reassess outreach opportunities. b. Additions or reductions to targeted population(s). c. Addition of new activities due to creative workarounds during the pandemic, such as review of Cal-Fresh in-reach cases. d. Addition of new Community-Based Organization (CBO) partnerships. e. Updates to goals and objectives. f. Revisions to projected enrolled and retained numbers. g. Requests for additional funding due to work plan revisions or other necessary considerations. II. Amended Allocation Agreement Documents: a. Revised Budget Plan – A3 A1 – Attachment 1 b. Revised Work Plan – A3 A1 – Attachment 2 III. Changes made in this amendment must be made as bold and underline for new additions, while deletions must be made as strikethrough text (i.e. strike). REVISED ALLOCATION AMOUNT NOT TO EXCEED $1,686,038.00 1,765,639 ONE MILLION, SEVEN HUNDRED SIXTY-FIVE THOUSAND, SIX HUNDRED EIGHTY SIX THOUSAND, THIRTY-EIGHT NINE DOLLARS The General and Special Provisions attached are made a part of and incorporated into the Agreement. ORANGE COUNTY OF PLACER DEPARTMENT OF HEALTH CARE SERVICES STATE OF CALIFORNIA 0000 XXXXXX XXXXXX XXXXX000 X. XXXXX XXXXXXX XXXX., #XXX. 000 XXXXXX, XX 00000 Xxxxxx X. Xxxxxx Xxxxxx X. Xxxxxx (Jun 16, 2022 13:29 PDT) ATTN: HEALTH ENROLLMENT NAVIGATORS SECTION MEDI-CAL ELIGIBILITY DIVISION XX XXX 000000, XX 0000 XXXXXXXXXX, XX 00000-0000 BY (AUTHORIZED SIGNATURE): ⮱ Xxxxxx X. Xxxxxx, Director  BY (AUTHORIZED SIGNATURE): ⮱  PRINTED NAME AND TITLE OF PERSON SIGNING: Jun 16, 2022 PRINTED NAME AND TITLE OF PERSON SIGNING: Xxxxxx Xxxxxxxx, Division Chief DATE SIGNED: DATE SIGNED:: Approved as to Form 11/01/21 Page 1