CTR053289 A3.pdf

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007

CONTRACT NO.: CTR053289 AMENDMENT NO.: Three (3) Procurement Officer:

Ryan Johnstone

Emergency Medical Services (EMS) and Hospital Information Registry System

Effective upon signature by both parties it is mutually agreed that the Contract referenced in this Amendment Three (3) is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3), Contract Extensions Five (5) Year Maximum, the Contract is hereby extended through August 16, 2024.

ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY

Contractor hereby acknowledges receipt and acceptance of above amendment and that a signed copy must be filed with the Procurement Office before the effective date

The above referenced Contract Amendment is hereby executed this _____ day of __________ 20______ at Phoenix, Arizona

(To be filled out by Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

ImageTrend, Inc.

Contractor’s Name Chief Procurement Officer Signature

Gina Corwin

Digitally signed by Gina Corwin Date:

2023.08.15 08:16:03 -07'00'

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