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Today's Date <br />09/12/2019 <br />Fund/Department <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Agenda Date I I ) On <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Youth Services of Kittitas County and Kittitas County <br />Period Begin Date: July 1, 2019 FFIPeriod End Date: June 30, 2020 <br />Total Grant/Contract Amount: $23,120.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The PSA is established to allow Youth Services of Kittitas County to implement the Community <br />Prevention Wellness Initiative (CPWI) community based mentoring program in Kittitas County. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head 6ignature: <br />Administrator Date: kv E I <br />Kittitas County Prosecutor, Auditor, and Board of Health Review <br />APPROVED AS TO FORM: <br />Signatre of Pr ecutor's Oce Date <br />Signatu e f #uditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $23,120.00 State Funds $23,120.00 Federal Funds $ 0 <br />Percentage County Funds Matching Funds $ _ I CFDA#_n/_a <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? no Who owns equipment? <br />Grant/Contract Review Page 1 <br />