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Today's Date <br />8/29/2019 <br />Fund/Department <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />rr 'yi•t,Fs.. <br />�2 <br />__ y <br />H73�LI <br />Agenda Date <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Yakima Valley Memorial Association (Virginia Mason Memorial) <br />and Kittitas County <br />Period Begin Date: July 1, 2019 <br />Total Grant/Contract Amount: $10,000 <br />Grant/Contract Number: YVMA 19-20 <br />Period End Date: June 30,2020 <br />Contract/Grant Summary - <br />The professional services agreement outlines contractor's scope of work for the needs of general public, <br />parents, and children or adults diagnosed with developmental disabilities. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signat re: , Administrator Date:W/ 1 <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED A5 TO FORM: <br />do <br />-r <br />Stpatmqe ofosecutor' Office Date <br />Sig4a,p&Af Auditor's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $10,000.00 <br />Percentage County Funds <br />State Funds $10,000.00 <br />Matching Funds $ <br />In -Kind $ <br />Exofain <br />Federal Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />