SIGNED FINAL Qualitative Data for Capacity Building and Alignment Program Additional Funding (Profile 155815) 8-12-2024

DHS Grant Agreement No.: 435100-G24-DPHCC24-66 M5
DPH Contract No.: 62158-5 Agreement Amount: $8,731
Agreement Term Period: 10/1/2023 to 9/30/2025 GEARS Pre-Packet No: 27134
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: We are adding funding for the Qualitative Data for Capacity Building and 
Alignment Program (Profile 155815). Please see attached scope(s) 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.