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Today's Date <br />12/19/2017 <br />Fund/Department <br />116-Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Agenda Date <br />Contract/Grant Information <br />Contract /Grant Agency: HCA and KCPHD Amendment 3 <br />-- <br />Period Begin Date: 01/01/2018 II Period End Date: 06/30/2018 <br />Total Grant/Contract Amount: $4750.00 <br />Grant/Contract Number: K763 <br />Contract/Grant Summary: <br />- <br />The HCA and KCPHD Amendment 3 to extend the term ofthe agreement from January 1, 2018-June 30, <br />2018 and add funding for that period. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature ~4f'S:::1 • Administrator Date:M Ir- <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 $4,750 State Funds $2,375 Federal Funds $2,375 <br />Percentage County Funds Matching Funds $ CFDA#93.778 <br />In-Kind $ <br />Explain <br />Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring -reporting requirements <br />Grant/Contract Review Page 1