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Today's Date <br />11/06/2018 <br />Fund/Department <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />nF�•rrr.w��n�Yn- <br />4u59.39 <br />Agenda Date � J-1 f � 9 <br />Contract/Grant Information _ <br />Contract /Grant Agency: Interlocal Agreement between Kittitas County Public Health Department and <br />Kittitas County Hospital District No.2 <br />Period Begin Date: ;j_) 0 -7 Zj! 1 Period End Date: 05/01/2020 <br />Total Grant/Contract Amount: $None <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The Interlocal Agreement between Kittitas County Public Health Department (KCPHD) and Kittitas <br />County Hospital District No 2 to authorize KCPHD to park a mobile unit on property owned by Medic One <br />and to operate community health outreach services to residents in Upper County out of the mobile unit <br />on a weekly basis and establishes statements of work for both parties. <br />Recommendation for Board of Health and Board of Health Review on <br />Date: <br />e-- � <br />Department Head Signat re: Administrator <br />I <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED A5 TO FORM: <br />/,/U— <br />Sig a of Prosecutor's U€' c Date <br />Signat o uditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ <br />State Funds $ <br />Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />