SIGNED FINAL 6-10-2025- DHS _PH Modification IMMUZ (155020) ENDING 6-30-25 & Adding Funding to WIC PEER (154760)

DHS Grant Agreement No.: 435100-G25-DPHCC25-65 M1
DPH Contract No.: 65445-1 Agreement Amount: $41,955
Agreement Term Period: 10/1/2024 to 9/30/2026 GEARS Pre-Packet No: 567, 29931
DHS Division: Division of Public Health DHS Grant Administrator: Anna Benton
DHS Email: DHSGACMail@dhs.wisconsin.gov
Grantee Grant Administrator: Ms Jennifer Weitzel Grantee Address: 505 BROADWAY STREET, BARABOO, WI, 
539132496
Grantee Email: jennifer.weitzel@saukcountywi.gov

Modification Description: This modification ends the Immunization funding for profile 155020 on 
6/30/2025 instead of 12/31/2025. The overall Boundary Statement and Program Quality Criteria do not change with this modification. The originally negotiated objective also remains the same; however, the end date for these activities is now 6/30/2025 with a new evaluation date and run date of 7/1/2025, and End-of-Year Report and GEARS final expense report on profile 155020 by 8/15/2025. 
Please note the GEARS profile end date on the GEARS table will still show the original end date of 
12/31/2025; however, funding on profile 155020 for contract year 2025 will end early on 6/30/2025. 
This modification is required so that Bureau of Communicable Diseases can bring these agreements in alignment with the federal award cycle which is July 1 thru June 30. A new agreement for the 
timeframe of 7/1/2025 – 6/30/2026 will be issued on a new profile number. We are also adding 
funding for the Women, Infants and Children Program (Profile 154760). Please see attached scope of 
work. Final reports are due 45 days from the end of the designated contract period for any included 
profiles.
This is a Modification of an existing Agreement, as specified above. This Modification of Agreement 
encompasses both Amendments and Addendums to an existing Grant Agreement. This Modification is entered into by and between the State of Wisconsin Department of Health Services (DHS) and the 
Grantee listed above. With the exception of the terms being modified by this Grant Agreement 
Modification, ALL OTHER TERMS AND CONDITIONS OF THE EXISTING AGREEMENT, INCLUDING FUNDING, REMAIN 
IN FULL FORCE AND EFFECT. This Modification, including any and all attachments herein and the 
existing agreement, collectively, are the complete agreement of the parties and supersede any prior 
agreements or representations. DHS and the Grantee acknowledge that they have read the Modification and understand and agree to be bound by the terms and conditions of the existing agreement as modified by this action. This Modification becomes null and void if the time between the earlier dated signature and the later dated signature exceeds sixty (60) days, unless waived by DHS.