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AOIS .T <br />Kittitas County <br />Review Form <br />Grants &Contract Agreement <br />udasts1Da20e22 PA Camas Request #: <br />Fund/Department Agenda Date:116-Public Health <br />Contract/Grant Information <br />Contract /Grant Agency:PSA between Kittitas County and Ellensburg School District <br />Period Begin Date:August 1,2022 Period End Date:July 31,2023 <br />Total Grant/Contract Amount:$21,085.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The PSA is established to suppod COVID-19 recovery and advance health equity for high- <br />risk or underserved populations.Utilize non-clinical interventions to address behavioral health <br />concerns related to COVID-19.Activities may include,but are not limited to,healthy activity, <br />coping mechanisms,and/or resiliency to enhance social connectivity lost during the Covid-19 <br />pandemic as addressed on the Statement of Work. <br />Recommendation for Board of Health Review on <br />Department Head Signature:,Date: <br />Kittitas County Prosecutor,Auditor,and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature rosecutor's Office D <br />Signature of Auditor's Office Ddte <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Agency is not suspended/disbarred Not Checked (reason) <br />Professional Services Agreement (rev.09/24/2018) <br />Page 1 of 20