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Today's Date <br />11/20/2015 <br />Fund/Department <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />J Agenda Date <br />_1I._ <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Kittitas County and Kittitas County Community Network and <br />Coalition <br />Period Begin Date: January 1, 2016 <br />Total Grant/Contract Amount:$1950.00 <br />I Period End Date: June 1, 2016 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The PSA between Kittitas County and Kittitas County Community Network and Coalition is established to <br />clarify the scope of work for both parties involved as outlined in Exhibit "A" Scope of Work. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signatur4�,Administrator Date:,[(–L-5 <br />: (5 <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Sign ature�of fry ecut 's fice <br />Signature Of/AudiYor's Office <br />Signature of Board of Health member <br />Financial Information <br />0 <br />Date <br />Date <br />Total Amount $1950.00 State Funds $1950.00 Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# N/A <br />In -Kind $ <br />Explain <br />Grant/Contract Review Page 1 <br />