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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />70/07/202L PA Camas Request #:53539 <br />Fund/Department <br />116-Public Health Agenda Date: ?/rs e) <br />Contract/G rant I nformation <br />Recommendation for Boa on <br />verification the contracting Agency is not suspended/Disbarred: <br />ncy:ntCo ctra rant/e mCom unAge ofHealth alCentrity sWa h CYSCH Nington( <br />Period Begin Date: LO/OL/2OZL Period End Date: 09/30/2022 <br />Total G rant/Contract Amount: S 13,259.00 <br />G rant/Contract N umber: <br />o The agreement is in place between Community Health of Central washington and the Kittitas <br />County Public Health Department. The contract provides a scope of work for Community Health <br />of Central Washington to be able to provide services for the Children with Special Health Care <br />Needs program which is a part of the Maternal Child Health Block Grant.o Amendment 1 extends the expiration dates and funding allowance based on the new <br />Consolidated Contract. <br />Contract/Grant Summary: <br />Department Head Signat Director Date: <br />Prosecutor's Office <br />re of Auditor's Office <br />I rL <br />Sign <br />t <br />Kittitas County Prosecutor, Auditor,and Board of Health Review and Comment: <br />Signatu <br />APPROVED AS TO FORM: <br />! Agency is not suspended/disbarred ! Not Checked (reason) <br />Grant/Contract Review Page 1