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Federal Award Identification for Subrecipients (reference 2 CFR 200.331) <br />Substance Abuse Block Grant <br />(i) Subrecipient name (which must match the name <br />associated with its unique entity identifier); <br />(ii) Subrecipient's unique entity identifier; (DUNS) <br />(iii) Federal Award Identification Number (FAIN); <br />(iv) Federal Award Date (see §200 .39 Federal award <br />date); <br />(v) Subaward Period of Performance Start and End <br />Date; <br />(vi) Amount of Federal Funds Obligated by this action ; <br />(vii) Total Amount of Federal Funds Obligated to the <br />subrecipient; <br />(xiii) Total Amount of the Federal Award; <br />(ix) Federal award project description , as required to be <br />responsive to the Federal Funding Accountability <br />and Transparency Act (FFATA); <br />(x) Name of Federal awarding agency, pass-through <br />entity, and contact information for awarding official, <br />(xi) CFDA Number and Name ; the pass-through entity <br />must identify the dollar amount made available <br />under each Federal award and the CFDA number at <br />time of disbursement; <br />(xii) Identification of whether the award is R&D; and <br />(xiii) Indirect cost rate for the Federal award (including if <br />the de minimis rate is charged per §200.414 Indirect <br />(F&A) costs). <br />Washington State <br />Health Care Authority Page 82 of90 <br />Kittitas County <br />039756692 <br />TM010056 <br />09/27/2018 <br />7/1/19 to 6/30/21 <br />$159 ,858 <br />$159,858 <br />FY17 $37 ,785,106 FY18 $38 ,053,643 <br />Substance Abuse Prevention and <br />Treatment Block Grant <br />SAMHSA <br />WA State Health Care Authority <br />Keri Waterland , Assistant Director DBHR <br />626 8th Ave SE; Olympia, WA 98504-5330 <br />Keri . waterland(@hca .wa .gov <br />93 .959 <br />D Yes C8:1 No <br />5% <br />HCA Contract No . K3924