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STATE OF HAWAII <br /> SUPPLEMENTAL AGREEMENT NO. 2 <br /> TO AGREEMENT HA-2004-1 (N) <br /> (EOA's Primary Contract <br /> This Supplemental Agreement No. 2 ,executed on the respective dates indicated <br /> <br /> below, is effective as of June 30 2004 ,between the Department of Health <br /> State <br /> of Hawaii (the "STATE"), by its Executive Director Executive Office on Aging , <br /> (Insert title of State officer executing agreement) <br /> whose address is 250 South Hotel Street Suite 406 Honolulu Hawaii 96813 <br /> and County of Hawaii by and through its County Council and its <br /> Manaaino Director (the "PROVIDER"), <br /> a oovernment entity <br /> business address and taxpayer identification number are: Hawaii County Office of <br /> A in 101 Au uni St. Room 342 Hilo Hawaii 96720 TIN 99-6000567 <br /> RECITALS <br /> A. WHEREAS, the STATE and the PROVIDER entered into an Agreement No. <br /> HA-2004-1(N) , <br /> (Insert agreement number or other identifying information) <br /> dated July 1 200 3 ,which was amended by Supplemental Agreement <br /> No(s) 1 dated September 30 2003 (hereinafter collectively referred to as <br /> "Agreement") whereby the PROVIDER agreed to provide the goods or services described <br /> HA-2004-1(N), Supplemental Agreement No. 2 <br /> I <br /> <br />