SH19-038 FFY19 HSGP - fully signed agreement

Home Browse Search

wffu Subrecipient Agency: Kittitas County Grant and Year: 2019 Agreement Number: E20-156 Completed Darren Higashiyama Commander y (509) 933-8206 Name) Title Telephone Date Completed: 11/08/19 STEP 1 YES STOP, no further NO Is your grant agreement less than $25,000? analysis needed, I GO to Step 2 GO to Step 6 - STEP 2 In your preceding fiscal year, did your YES NO STOP, no further organization receive 80% or more of its annual GO to STEP 3 from federal funding? Z analysis needed, GO to gross revenues .....----_----------._._______ Step 6 STEP 3 T_ - In your preceding fiscal year, did your YES NO _ STOP, no further _ organization receive $25,000,000 or more in GO to STEP 4 analysis needed, GO to federal funding? U Step 6 STEP 4 - _ ......._....._---..-- Does the public have access to information about YES STOP, no further NO the total compensation* of senior executives in analysis needed, GO to STEP 5 your organization? GO to step 6 Ll STEP 5 Executive #1 Name: Total Compensation amount: $ Executive #2 Name: Total Compensation amount: $ -- -�- Executive #3 Name: Total Compensation amount: $ Executive #4 Name: Total Compensation amount: $ -- Executive #5 Name: Total Compensation amount: $ STEP 6 If your organization does not meet these criteria, specifically identify below each criteria that is not met for your organization: For Example: "Our organization received less than $25,000.". Kittitas County did not receive 80% or more annual gross revenues from federal funding Signature: Date: 11 /08/19 * Total compensation refers to: • Salary and bonuses • Awards of stock, stock options, and stock appreciation rights • Other compensation including, but not limited to, severance and termination payments • Life insurance value paid on behalf of the employee Additional Resources: http://www.whitehouse.gov/omb/open http://mvw.hrsa.gov/grants/ffata.html http_flvvwyv.gpo.:gov/fdsys/pkq/FR-2010-09-14/pdf/2010-22705. pdf http://www.grants.gov/ Page 1 of 3