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Today's Date <br />11/07/2017 <br />Fund/Department <br />116-Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />II Agenda Date <br />Contract/Grant Information <br />1~/f1]l+- <br />Contract /Grant Agency: DSHS Developmental Disabilities Admin Amendment 1 <br />Period Begin Date: qlr !l~77 I 1 Period End Date: &;2:/L-t5( r <br />Total Grant/Contract Amount: $835,289.00 (increase of $14,948.00) <br />Grant/Contract Number: 1763-98187 Amendment 1 <br />Contract/Grant Summary: <br />Contract amendment increases the amount of contract by $14,948.00 for a new revised maximum of <br />$835,289.00. The attached shows the amended spend plan. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature:¢;M ~ ,Administrator Date :~~~:....I . <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROV ED AS TO FORM: <br />Sign ature of Prosecuto r's Office <br />,>.9t~~ <br />uditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $835,289.00 State Funds $835,289.00 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