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Kittitas Cou nty <br />Review Form <br />Grants & Contract Agreement ·40CJo3 <br />Today's Date I Agenda Date I;) I F} Ir=t 11/18/2017 <br />Fund/Department <br />116-Public Health <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Wise and Kittitas County <br />Period Begin Date: July 1,2017 I I Period End Date: August 31, 2017 <br />Total Grant/Contract Amount: Not to exceed $13,250.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The PSA between Wise and KC to allow Wise and/or third party consultant to provide individualized <br />technical assistance (ITA) services to qualified clients to address existing barriers to employment. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature :~ Administrator <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment : <br />APPROVED AS TO FORM : <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ 13250.00 State Funds $13250.00 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