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Sample Amendment to Agreement
Sample Amendment to Agreement
THIS AMENDMENT, is made and entered into this ________ day of ______________,
between __________________ University of Pennsylvania of the State System of Higher
Education (address), (hereinafter “University”),
________________________________________, (Affiliated Entity’s full name, which must be
in its legally recognized form, i.e., corporate registration, full legal name if an individual and
must be the same throughout this Contract. Deviations must be satisfactorily explained, except
that the party may be referred to as “Affiliated Entity” within this document from this point
forward) at (address) acting through its proper officials, hereinafter referred to as “__________”,
Federal I.D. #___________________ (or if an individual, Social Security Number).
WHEREAS, this agreement is for the amendment of the original affiliation agreement
between the _________________ (i.e., “Site, Clinic, Hospital, School, School District”) dated
__________________________; and
WHEREAS, the original affiliation agreement identified above, together with any
previously executed amendments, is attached hereto, and incorporated herein and marked
Attachment A, and all its terms and conditions remain unchanged except as modified in this
amended agreement.
WHEREAS, subsequent to its execution an error (or state need for amendment other
than error) was discovered as to the terms of the affiliation agreement; and
WHEREAS, the parties mutually agree to amend the contract to reflect the correct (or
new/additional information depending on reason for amendment) information as to the term of
the agreement and the number of participants.
NOW THEREFORE, the parties hereto, intending to be legally bound, hereby do agree
to the following amendment:
1. Term of Agreement
. The term of this agreement shall be amended to December
1, 2000 through November 30, 2001.
2. Number of Participants
. The number of participants in this program at any given
time shall not exceed 5 students per semester.
3. Terms of Original Agreement
. All other terms and conditions of the original
agreement not modified in this amendment shall remain in full force and effect
and be considered incorporated herein as part of the amended agreement. Said
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Sample Amendment to Agreement