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21- CIS - Amendment Contract - GIbson Brands, Inc. - BIg Sky Trust Fund Grant MT-BSTF-1-20-25A
DocuSign Envelope ID: 1B3BDDA6-OB77-4CDA-B591-15A655CAC061 Contract Information Sheet Division staff are required to complete the items in blue print. Extension of terms and increase in funding. Contract Number: MT-BSTF-1-20-25A Division: Contractor's Name: City of Bozeman MOTBD Contractor (Signee) Name: Cyndy Andrus Contractor's Email: candrus(ftozeman.net Contractor's Address: P 0 Box 1230 Vendor Number: Contractor's Address 2: Bozeman, MT 59771-1230 23437 Clerk Mike Mass Cleark's Email: mmaas@bozeman.net Begin Date: 1/14/2020 Duns Number: N/A End Date: (Federal Funds Required) 1/14/2022 Current Term Amount: 405,000.00 Absolute End Date: Total Contract Value: 405,000.00 N/A Organization Number: 535301 Original Contract FY: RFP Number(if applicable): N/A FY_20 Program Number: 51 Funding Source: Contract Type: Grant State (Standard,Sole Source, Exigency,Term Contract, Lease, MOU,PO,Grant) (State,Federal,Both,Other) Contract Usage: As Needed (As Needed, Fixed, No Cost) Liaison: Annmarie Robinson Program Manager: Annmarie Robinson Liaison Email: arobinson3@mt.gov Bureau Chief: Wayne Johnston Liaison Phone: 406-841-2250 Additional Email: Brit Frontenot bfontenot(sbbozeman.net Alexa Freeburg afreeburg afprosperamt.org mmaas@bozeman.net Signatures: Carbon Copies: Division Adminstrator YWIA F r P!, j 1/21/2021 Liaison: 17 Fiscal Review sawtrwu 1/21/2021 Director (> $200K): ❑2 Legal Counsel �t,SSI(� l �Ur� 1/21/2021 Deputy Director (<$25K): ❑ Deputy Director Q S&u aAz 1/21/2021 Liaison: ❑� OBPP QIMIn CaSSAln b 1/21/2021