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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />r <br />Agenda Date <br />07/11/2017 <br />Fund/Department <br />116-Public Health <br />Contract/Grant Information <br />Contract /Grant Agency: Consolidated Contract Amendment 12 <br />eJ31/rt- <br />Period Begin Date:Ja", lutvLA \,21)1S I I Period End Date: O(UWI J:iY b l f 1JJ 1':.)- <br />Total Grant/Contract Amoun~ $ ·65e:>;?pn . CD <br />Gran t/Contract Number: C17114 <br />Contract/Grant Summary: The Consolidated Contract Amendment 12 is amending the Statements of <br />Work for the Office of Immunization & Child Profile. It also amends and replaces Exhibit C-9 with Exhibit <br />C-10 Schedule of Federal Awards. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature : ~ , Administrator <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ State Funds $ Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In-Kind $ <br />Explain <br />Is Equipment being purchased? Who owns equipment? <br />Grant/Contract Review Page 1