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Amend No 1
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02. February
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2019-02-19 10:00 AM - Commissioners' Agenda
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Amend No 1
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Last modified
3/25/2019 3:27:38 PM
Creation date
3/25/2019 3:27:30 PM
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Meeting
Date
2/19/2019
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Alpha Order
j
Item
Request to Approve an Amendment No. 1 to a Contract between the Washington State Health Care Authority and the Kittitas County Public Health Department for Prevention Services
Order
10
Placement
Consent Agenda
Row ID
51515
Type
Contract
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This Contract between the State of Washington Health Care Authority (HCA) and the Contractor is hereby <br />amended as follows: <br />1. Amend the following by deleting and replacing: <br />Federal Award Identification for Subrecipients (reference 2 CFR 200.331) -Substance Abuse <br />Block Grant <br />(i) Subrecipient name (which must match the Kittitas County <br />name associated with its unique entity <br />identifier); <br />(ii) Subrecipient's unique entity identifier; (DUNS) 010202547 <br />(iii) Federal Award Identification Number (FAIN); SM010056 <br />(iv) Federal Award Date (see §200.39 Federal 04/17/2015 <br />award date); <br />(v) Subaward Period of Performance Start and 4/1/18 to 6/30/19 <br />End Date; <br />(vi) Amount of Federal Funds Obligateq by this -$2,956 <br />action; <br />(vii) Total Amount of Federal Funds Obligated to $86,145 <br />the subrecipient; <br />(xiii) Total Amount of the Federal Award; FY14 $37,271,989 <br />FY15 $37,296,186 <br />FY16 $38,042,110 <br />(ix) Federal award project description, as required Substance Abuse Prevention and Treatment Block <br />to be responsive to the Federal Funding Grant <br />Accountability and Transparency Act (FFATA); <br />(x) Name of Federal awarding agency, pass-SAMHSA, <br />through entity, and contact information for Washington State DSHS, awarding official, <br />Chris Imhoff, Director <br />PO Box 45330 <br />Olympia , WA 98504-5330 <br />lmhofc@dshs.wa.gov <br />(xi) CFDA Number and Name; the pass-through 93.959 <br />entity must identify the dollar amount made <br />available under each Federal award and the <br />CFDA number at time of disbursement; <br />(xii) Identification of whether the award is R&D; and [8J Yes D No <br />(xiii) Indirect cost rate for the Federal award 5% <br />(including if the de minimis rate is charged per <br />§200.414 Indirect (F&A) costs). <br />HCA Contract Services Page2 <br />7024PF HCA Custom Contract Amendment (5-2-2018)
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