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/óq£ ATTACHMENT 4-A TEXAS COMMUNITY DEVELOPMENT PROGRAM CONTRACT AMENDMENT REQUEST FORM Amendment No. I Contractor Name CITe¡ ()F ~N J1it,ee.os Contract Number TCJ 3 J ~ 2- i This amendment request form must be submitted for each type of contract amendment to include Budget Amendments, Program Amendments, and Contract Extension Requests. In addition to this form, a letter signed by the chief local elected official that outlines the proposed changes must be submitted with this request. This letter must include the following information: . A detailed description of the new or significantly altered activities; . Explanation of why the amendment is being proposed (Le., what circumstances led to the necessity of the amendment); . Description of the contract activities being altered or eliminated; . The effect of the changes on program beneficiaries with particular attention to changes in both the number and percentage of low/moderate income beneficiaries; . Any changes in resource leveraging (local and all other funds) including justification for these changes; . Additional information specific to the type of request being proposed. THE FOLLOWING CHANGES ARE REQUESTED FOR THE ABOVE REFERENCED CONTRACT: 1. BUDGET AMENDMENT (Transfers between budget categories greater YES NO than 5 percent of total contract amount or change in resource leveraging) [] M If YES, a CONTRACT BUDGET MODIFICATION FORM (ATTACHMENT 2-J) must be submitted. A. Are corresponding changes in contract activities or scope of [] [] contract activities proposed? If YES, a PROGRAM AMENDMENT is required. See Section 3, Page 2, of this form. 2. TIME EXTENSION YES NO JA;VÚÁ.2Y 2/, /997 [X] [] Proposed ending date of contract: Please explain the compelling and/or extenuating circumstances that are beyond the control of the local government in the cover letter submitted with this request. 4-7