Laserfiche WebLink
Service Agreement #17-76 <br />between <br />WALLA WALLA COUNTY DEPARTMENT OF COMMUNITY HEALTH <br />and <br />KITTITAS COUNTY PUBLIC HEALTH <br />The Agreement is entered into by and between Walla Walla County Department of Community <br />Health, hereinafter "County," and Kittitas County Public Health Department, hereinafter <br />"Contractor," for engagement and participate with Greater Columbia Accountable Community of <br />Health, as outlined in the attached Statement of Work. The rights and obligations of both parties <br />are governed by the General Terms and Conditions, and the following Exhibits, copies of which <br />are attached hereto and incorporated herein by this reference as fully as if set forth herein: <br />Exhibit A — Statement of Work <br />Exhibit B — Budget <br />Exhibit C — Expenditure Report Form <br />Exhibit D — Participation Report Form <br />Performance Period: The terms of this Agreement shall commence on July 1st, 2017 and shall, <br />unless terminated or renewed as provided elsewhere in the Agreement, <br />terminate on December 31, 2017. <br />Compensation: Payment to Contractor for services rendered under this Agreement shall be <br />as set forth in Exhibit B — Budget. The allocation of funding is currently <br />awarded for Calendar Year 2017. The amount of payment for the <br />performance period of this Agreement shall not exceed $1,374. <br />By their signatures below, the parties agree to the terms and conditions of this Agreement and all <br />documents incorporated by reference. The parties signing below certify that they are authorized <br />to sign this Agreement. <br />IN WITNESS WHEREOF, the parties hereto have signed this Agreement. <br />COUNTY: <br />Jim Duncan Date <br />Chair, Board of County Commissioners <br />Walla Walla County <br />314 W. Main <br />2"d Floor — Room 203 <br />PO Box 1506 <br />Walla Walla, WA 99362 <br />Phone: (509) 524-2505 Fax: (509) 524-2512 <br />Telephone Number / Email Address: <br />Mailing Address (Street address required in addition to PO Box.): <br />CFDA# (if applicable): <br />CONTRACTOR: <br />Authorized By <br />Print Name & Title of Person Signing <br />Social Security or Business Tax ID#: <br />UBI#: <br />State Industrial Account ID # (if applicable): <br />Date <br />#17-76 ACH Engagement Columbia Co— General Terms and Conditions Page 1 of 10 <br />