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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G ra nt I nformation <br />Recommendation for Board of H ealth Review on <br />Department Head Signature Director Date 5 1S ZL <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />7 /22/2022 PA Camas Request #: <br />Fund/Depa rtment <br />116-Public Health Agenda Date: <br />Contract /Grant Agency University of Washington Nexus Amendment <br />Period Begin Date: 9/30 /2020 Period End Date: 9/29/2OZz <br />T ota G ra c o tn ctra mAnt/uo nt 0 4 0081 rfo na W5z atot a om u nt of 9I 437s 008. <br />Grant/Contract Number <br />The amendment is established to correct for contract mistake to allow KCpHD to access previouslyguaranteed rollover funds from the projects first program year. <br />Contract/G ra nt Sum mary: <br />Kittitas County Prosecutor, Audit or, and Board of Health Review and Comment: <br />APPR AS TO <br />41^?_" <br />gna reofP secutor's Date <br />\/ <br />Signature of S ce D <br />E Agency is not suspended/disbarred ! Not Checked (reason) <br />Grant/Contract Review Page 1