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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date Agenda Date <br />10/10/2019 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />WN <br />Contract /Grant Agency: KCPHD and Walla Walla County Department of Community Health Amendment <br />1 <br />Period Begin Date: 07/01/2019 <br />Total Grant/Contract Amount: $10,000 <br />Grant/Contract Number: 19-33 Amendment #1 <br />Period End Date: 06/30/2020 <br />Contract/Grant Summary: <br />The Amendment to the agreement changes who the billings are submitted to. KCPHD is to submit <br />billings to Walfa Walla Community Health for services relative to the Youth Marijuana Prevention and <br />Education Program. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signatur Administrator Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />5 <br />Sippaure olt Pros cu is Office Date // <br />� L <br />Signat re of Auditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $10,000.00 State Funds $10,000.00 Federal Funds $0 <br />Percentage County Funds Matching Funds $ CFDA# N/A <br />Grant/Contract Review Page 1 <br />