CTR061004_Senior_In_Home_Care_Amendment_5.pdf

130 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) for Contract Number CTR061004, Amendment Number Five. The amendment involves Senior In Home Care LLC, doing business as A Country Retreat, which appears to be a contractor providing services related to an Assisted Living Facility.

The amendment extends the contract term from May 01, 2025, through April 30, 2026, with no adjustments to the existing rates. All other requirements, specifications, and terms and conditions remain unchanged from the previous contract period. The amendment will be executed through electronic approval in an application (APP), and it maintains the same contractual framework as the prior term, essentially providing a one-year extension for the assisted living facility services.

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CTR061004_Certificate_of_Insurance.pdf PDF
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CTR061004_Contract_Amendment_4.pdf PDF
CTR061004_PDS_Assisted_Living_Home.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 Five (5)

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:

1. In accordance with the Special Terms and Conditions, Section 13. Contract Term & Option to Extend, the Contract term is extended from May 01, 2025 through April 30, 2026. 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 .