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DocuSign Envelope ID:E551209245F9-4E53-AB5E-BAD7CA81408F Agreement#SL052 4. Section 6.2 of the Scope of Work is hereby deleted in its entirety and Is replaced with the following: 6.2 Invoices must contain the Grantee's name, address, federal employer identification number or other applicable Grantee identification number,the Agreement number, the invoice number, and the Invoice period. Grantee shall submit the following documents with the itemized invoice: 6.2.1 A cover letter signed by the Grantee's Agreement Manager certifying that the costs being claimed in the invoice package:(1)are specifically for the project represented to the State In the budget appropriation; (2) are for one or more of the components as stated in Section 4, Dellverables, of this Scope of Work; (3) were incurred during the Agreement Period. 6.2.2 Grantee's invoices shall include the date, period in which work was performed, amount of reimbursement,and work completed to date; 6.2.3 A certification by a licensed engineer using AIA forms G702 and G703, or their substantive equivalents, certifying that the project, or a quantifiable portion of the project,is complete.(if applicable) 6.2.4 Grantee's subcontractoriconsultant invoices(if applicable) 6.2.5 A copy of all supporting documentation for vendor payments. 5. All other terms and conditions of the Agreement remain in full force and effect. IN WITNESS THEREOF, by signature below, the Parties agree to abide by the terms, conditions, and provisions of Agreement SL052 as amended. This Amendment is effective as of June 29,2019. CITY OF ZEPHYRILLS DEPARTMENT OF ECONOMIC OPPORTUNITY SI ED, -' SIGNED- Ken Offiess ` Ken Lawson CitVCounYll President Executive Director DATE: ®! P 9®� Q DATE: f r Approved as to form and legal sufficiency,subject only to full and proper execution by the Parties. OFFICE OF GENERAL COUNSEL DEPARTMEN ._7MIC OPPORTUNITY By: Approved Date: Page 2 of 2