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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/Gra nt I nformation <br />Recommendation for Board of Health Review on <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />7LlO8/2021 PA Camas Request #:53074 <br />Fund/Department <br />116-Public Health Agenda Date: 11116 /202I <br />Contract /Grant Agency: Hopesource <br />Period Begin Date: 10/15/202L Period End Date: tO/tS/2O22 <br />Total Grant/Contract Amount: See Exhibit B <br />Grant/Contract N umber: <br />This PSA is to contract with HopeSource to coordinate housing in local hotels/motels and basic <br />needs for individuals and families who are under isolation or quarantine orders due to COVID-19 <br />and are not able to safely remain at their residence or are currently experiencing homelessness. <br />Contract/Grant Su mmary: <br />o <br />Department Head Sign *Director Darct le <br />Prosecutor's Office <br />ditor's Office Date <br />F <br />5u <br />si re <br />itorAud Boaand ofrd Heat Ith ewRevi and CommentKittitas County P <br />AP <br />[] Agency is not suspended/disbarred I Not Checked (reason) <br />Grant/Contract Review Page 1