CTR061004_Contract_Amendment_Summary_One__1_.pdf

272 KB Posted

Attached to
Master Agreement AZ|CTR061004
Contract number
CTR061004
Issued by
Arizona

About this file

Written by GovTribe AI ·

This document is a Contract Amendment issued by the Arizona Department of Economic Security (DES), located in Phoenix, Arizona. The amendment pertains to Contract Number CTR061004 and involves Senior In Home Care LLC, doing business as A Country Retreat, which appears to be a contractor providing assisted living facility services.

The contract amendment extends the current contract term from July 1, 2023, through June 30, 2024, with no changes to the existing rates. The extension is executed in accordance with the contract's Special Terms and Conditions, specifically Section 13 on Contract Term & Option to Extend. All other requirements, specifications, and terms remain unchanged, and the amendment will be finalized through electronic approval in an application system (APP).

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Other files

File Type Posted
CTR061004_Certificate_of_Insurance.pdf PDF
CTR061004_Contract_Documents.pdf PDF
CTR061004_-_Debarment_Check.pdf PDF
CTR061004_Contract_Amendment_Summary_Two__2_.pdf PDF
CTR061004_Senior_In_Home_Care_Amendment_5.pdf PDF
CTR061004_Senior_In_Home_Care_LLC_Amendment_3__.pdf PDF
CTR061004_Senior_In_Home_Care_LLC_dba_A_Country_Retreat_Assisted_Living_Facility_A6.pdf PDF
CTR061004__Debarement_Check.pdf PDF
CTR061004_Contract_Amendment_4.pdf PDF
CTR061004_PDS_Assisted_Living_Home.pdf PDF
CTR061004_-_Certificate_of_Insurance_Exp_6.30.2024.pdf PDF
CTR061004_COI_2025-6-30_GL_AL_WC_PL_SAM.pdf PDF
CTR061004_COI_2026-06-30_AL_GL_PEO_SAM_WC.pdf PDF
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CONTRACT AMENDMENT

Arizona Department of Economic Security

1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR061004 One (1)

DESCRIPTION/ LABEL: Assisted Living Facility

CONTRACTOR NAME: Senior In Home Care LLC dba A Country Retreat

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions, Section 13, Contract Term & Option to Extend, the Contract term is extended from July 01, 2023, through June 30, 2024. The rates are not adjusted for the extension period and shall remain the same as the previous Contract term.

ALL OTHER REQUIREMENTS, SPECIFICATIONS, AND TERMS AND CONDITIONS REMAIN UNCHANGED

ACKNOWLEDGEMENT AND AUTHORIZATION

This Amendment shall be fully executed by means of electronic approval in APP.

File details come from the government source that posted it. Updated .