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Kittitas County <br />Review Form <br />Grants & Contract Agreement -# 45=131 <br />Today's Date Agenda Date H ',} \ 0\ 03/12/2019 I <br />Fund/Department I <br />116-Public Health <br />Co nt ract/Grant Information <br />Contract /Grant Agency: Professional Services Agreement between KVH and KCPHD (TB xrays) <br />Period Begin Date: 04/01/2019 I I Period End Date: 04/01/2020 <br />Total Grant/Contract Amount: $70.00 for each single-view or double view Tuberculosis image performed <br />by contractor <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The f:'rofessional Services Agreement between Kittitas County (KCPHD) and Kittitas Valley Healthcare <br />(KVH) is an·agreement entered into that allows the health department to send clients to KVH for <br />screening x-rays. The agreement includes a set fee for these services. <br />Recommendation for Board of Health and Board of Health Review on <br />Date:1-M1 <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $70.00 State Funds $ Federal Funds $ <br />Percentage County Funds 100% Matching Funds $ CFDA# <br />Grant/Contract Review Page 1