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Today's Date <br />June 7, 2018 <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: PSA between Entrust Community Services and Kittitas County <br />Period Begin Date: July 1, 2018 Period End Date: June 30, 2019 <br />Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject to <br />funding. Only DDA approved services will be covered. <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The agreement is entered into between the contractor and the county to provide a coordinated and <br />comprehensive local program of services for persons with developmental disabilities and to fulfill the <br />county's responsibilities as outlined in attachments. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: Administrator Date:_ <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ TBD <br />State Funds $ TBD <br />Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />