CTR066282_Contract_Amendment_1.pdf

CONTRACT AMENDMENT

Arizona Department of Economic Security

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

CONTRACT NUMBER: AMENDMENT NUMBER:

CTR066282 One (1)

DESCRIPTION/ LABEL: Housing Support Services - Pima County and Balance of State

CONTRACTOR NAME: Catholic Charities Community Services, Inc.

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions, Section 13., Contract Term and Option to Extend, the Contract term is extended from July 1, 2024, through June 30, 2025.

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.

3/27/24, 5:31 PM Arizona Corporations Commission https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=00797263 1/3

ENTITY INFORMATION

Search Date and Time: 3/27/2024 5:31:32 PM

Entity Details

Entity Name:

CATHOLIC CHARITIES COMMUNITY SERVICES, INC.

Entity ID:

00797263

Entity Type:

Domestic Nonprofit Corporation

Entity Status:

Active

Formation Date:

6/30/1970

Reason for Status:

In Good Standing

Approval Date:

6/30/1970

Status Date:

10/11/2019

Original Incorporation Date:

6/30/1970

Life Period:

Perpetual

Business Type:

Health Care and Social Assistance

Last Annual Report Filed:

Domicile State:

Arizona

Annual Report Due Date:

10/22/2024

Years Due:

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Title Name Attention Address Date of Taking Office

Last Updated

Director

DEACON TOM

KLEIN

4747 N. 7TH AVE,

PHOENIX, AZ, 85013,

Maricopa County, USA

7/1/2017 10/11/2019

Director

SCOTT

MACDONALD

4747 N 7TH AVE,

PHOENIX, AZ, 85013,

Maricopa County, USA

7/1/2016 10/11/2019

Director MARK WEBER

4747 N 7TH AVE,

PHOENIX, AZ, 85013,

Maricopa County, USA

9/19/2015 10/11/2019

Director

ANGELA

DUCEY

4747 N 7TH AVE,

PHOENIX, AZ, 85013,

Maricopa County, USA

7/1/2015 10/11/2019

Original Publish Date:

8/11/1970

Statutory Agent Information

Name:

Stephen Capobres

Appointed Status:

Active 2/24/2022

Attention:

Address:

5151 N 19th Avenue, PHOENIX, AZ 85015, USA

Agent Last Updated:

10/16/2023

E-mail:

Attention:

Mailing Address:

County:

Maricopa

Principal Information

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Title Name Attention Address Date of Taking Office

Last Updated

Chairman of the Board of Directors

MARY

PERMODA

4747 N 7TH AVE,

PHOENIX, AZ, 85013,

Maricopa County, USA

7/1/2014 10/7/2022

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Attention:

Address: 5151 N 19th Avenue, PHOENIX, AZ, 85015, USA

County: Maricopa

Last Updated: 10/16/2023

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CATHOLIC CHARITIES

COMMUNITY SERVICES,

INC.

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Unique Entity ID

D7RJACF7GJU6

CAGE/NCAGE

51TH9 Jul 18, 2024

Physical Address

5151 N 19TH AVE

Phoenix, Arizona 85015-3224, United States

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