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6.Q. - Page 6 of 45 <br />5. <br />6. <br />Exhibit C — Performance Reporting is hereby amended to include item C. Lifeline <br />Transportation Program Reporting as follows: <br />LTP Control Log to include: <br />1. <br />Date issued <br />2. <br />Bus ticket/token/pass serial number <br />3. <br />Number of tickets/tokens/passes distributed <br />4. <br />Client name <br />5. <br />Clarity ID number <br />6. <br />Specific Purpose <br />7. <br />Authorized by/title <br />8. <br />Disability factor (Y/N) <br />9. <br />Signature of recipient <br />10. <br />Income level <br />LTP Summary Report to include: <br />1. <br />Number of each type of assistance provided <br />2. <br />Summary data on income levels of recipients <br />3. <br />Monthly total and cumulative total for the contract year-to-date <br />4. <br />A minimum of one client success story <br />All other terms and conditions of the agreement dated November 15, 2016, between <br />the County and Contractor shall remain in full force and effect. <br />This change is effective as of: 7/1/2019 <br />ALL OTHER PRICES, TERMS AND CONDITIONS OF THE AGREEMENT REMAIN UNCHANGED <br />Contractor Signature <br />Date <br />Contractor Name (please print) <br />Purchasing Agent Signature Date Purchasing Agent Name (please print) <br />(Department Head or Authorized (Department Head or Authorized <br />Designee) Designee) <br />County of San Mateo County of San Mateo <br />1:7��/[IF �IG,bZly�lli1 <br />Purchasing Agent or Authorized Designee <br />Title (please print) <br />ATTY/AGR.Amend. No. 2/County of San Mateo (Page 3 of 3) <br />181 <br />