CTR066285_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:

CTR066285 One (1)

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

CONTRACTOR NAME: Community Bridges, Inc.

THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:

In accordance with the Special Terms and Conditions, Section 13.0, Contract Term and Option to Extend, the Contract term is extended from July 1, 2024, through June 30, 2025. 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.

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COMMUNITY BRIDGES, INC

Entity Information

Unique Entity ID

TM6ECH6UD6K9

CAGE/NCAGE

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EXCLUSIONS

Active Exclusions There are no active exclusion records associated to this entity by its Unique Entity ID.

Physical Address 1855 W Baseline RD STE 101 Mesa, Arizona 85202-9098, United States

Mailing Address 1855 W. Baseline RD STE 101 Mesa, Arizona 85202, United States

Purpose of Registration All Awards

Version

Current Record

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ENTITY INFORMATION

Search Date and Time: 3/27/2024 10:18:19 AM

Entity Details

Entity Name: COMMUNITY BRIDGES, INC. Entity ID: 01526793

Entity Type: Domestic Nonprofit Corporation Entity Status: Active

Formation Date: 12/29/1982 Reason for Status: In Good Standing

Approval Date: 1/7/1983 Status Date: 10/28/2019

Original Incorporation Date:

12/29/1982 Life Period: Perpetual

Business Type: Other -

HOSPITAL/HEALTH

CARE

Last Annual Report Filed:

Domicile State: Arizona Annual Report Due Date:

10/29/2024

Years Due:

Original Publish Date: 2/4/1983

Statutory Agent Information

Name: Benjamin C. Runkle Appointed Status: Active 10/28/2019

Attention:

Address: Gammage & Burnham PLC, 40 N Central Avenue, 20th Floor, PHOENIX, AZ 85004, USA

Agent Last Updated: 10/3/2023 E-mail:

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< Previous ... 1 2 3 ... Next > Page 1 of 3, records 1 to 5 of 15 Go to Page

Title Name Attention Address Date of Taking Office

Last Updated

Director JOHN MEZA

1855 W BASELINE RD STE

101, MESA, AZ, 85202,

Maricopa County, USA

9/12/2016 5/9/2019

CFO (Chief Financial Officer)

RAMON

DOMINGUEZ

1855 W BASELINE RD STE

101, MESA, AZ, 85202,

Maricopa County, USA

5/24/2018 10/1/2020

President/CEO

JOHN F

HOGEBOOM

1855 W BASELINE RD STE

101, MESA, AZ, 85202,

Maricopa County, USA

5/9/2019

COO (Chief Operating Officer)

SCOTT HATLEN

1855 W BASELINE RD STE

101, MESA, AZ, 85202,

Maricopa County, USA

10/1/2020

Director MARY CAMELI

1855 W BASELINE RD

#101, MESA, AZ, 85202,

Maricopa County, USA

10/1/2020

County: Maricopa

Principal Information

Address

Attention: Address: 1855 W BASELINE RD #101, MESA, AZ, 85202, USA

County:

Maricopa

Last Updated:

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