CTR053289 A5.pdf

COMPETITION IMPRACTICAL

CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

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

CONTRACT NO.: CTR053289 AMENDMENT NO.: FIVE (5) PROCUREMENT OFFICER:

NATHANIEL THOMAS

Revised 06/24/2024

Emergency Medical Services (EMS) and Hospital Information Registry System

Effective August 17, 2024 it is mutually agreed that the Contract is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3), Contract Extenstions (5 Year Maximum) the

Contract is hereby extended through August 16, 2025.

ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY

Contractor hereby acknowledges receipt and acceptance of this 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 or Designee

Jon Sachs (Aug 14, 2024 23:48 CDT) Jon Sachs

Aug 14, 2024 Gina Corwin

Digitally signed by Gina Corwin Date:

2024.08.15 10:10:35 -07'00'

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