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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />09/19/2017 <br />Fund/Department <br />116-Public Health <br />Contract/Grant Information <br />Agenda Date <br />Contract /Grant Agency: Kittitas County Health Network Letter of Agreement <br />Period Begin Date: July 1,2017 I I Period End Date: May 31,2018 <br />Total Grant/Contract Amount: $5000.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The letter summarizes the deliverable required and to be compensated for the in the HRSA Planning <br />Grant. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signatu ~~ , Administrator Date : col:s[ Il <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />A PPRO 0 AS TO FORM : <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $5,000 State Funds $ Federal Funds $5,000 <br />Percentage County Funds Matching Funds $ CFDA# 93.912 <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? Who owns equipment? <br />Grant/Contract Review Page 1