Contract_Amendment_4.pdf
PDF 139 KB Posted
- Attached to
- Master Agreement AZ|CTR071443
- Contract number
- CTR071443
- Issued by
- Arizona
About this file
This document is a Contract Amendment issued by the State of Arizona's Department of Child Safety, Office of Procurement, located in Phoenix, Arizona. The amendment relates to Contract #CTR071443 and is specifically Amendment #4. The amendment involves Omar and Rose Leon doing business as A Kids Life Residential, who are requesting a change to their Arizona W-9 Entity legal name.
The amendment's primary purpose is to modify the legal business name from "Omar and Rose Leon dba A Kids Life Residential" to "A Kids Life Residential" for 1099 tax reporting purposes. The change is being made in accordance with the Uniform Terms and Conditions, Section 5, Contract Changes, and the Special Terms and Conditions, Section 9, Amendments. The effective date of this name change is set for July 24, 2025. All other contract requirements, specifications, terms, and conditions remain unchanged, and the amendment will be fully executed through the state's e-procurement system.
View the file
Other files
Show all 38
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Contract Amendment State of Arizona
Department of Child Safety Office of Procurement
3003 N. Central Ave, 20th Fl.
Phoenix, AZ 85012
Contract #: CTR071443
Amendment #: 4
ALL OTHER REQUIREMENTS, SPECIFICATIONS, TERMS AND CONDITIONS REMAIN UNCHANGED
This amendment shall be fully executed upon the approval electronically in the state approved e-procurement system by an authorized representative of the Contractor and applied to the contract within the e-procurement system by the Procurement Officer or delegate.
The purpose of this amendment is to change the Arizona W-9 Entity legal name on the contract.
Pursuant to the Uniform Terms and Conditions, Section 5, Contract Changes, Paragraph 5.1, Amendments, and the Special Terms and Conditions, Section 9, Amendments Omar and Rose Leon dba A Kids Life Residential has requested to change their Arizona W-9 Legal Name to A Kids Life Residential for the purpose of their 1099’s.
Attached is the updated Arizona W-9 Form.
The effective date of the change is July 24, 2025
File details come from the government source that posted it. Updated .