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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />GontracUGrant lnformation <br />Recommendation for Board of Health Review on <br />Department Head Signature:h )z <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Today's Date <br />1 2022 PA Camas Request #:LWW <br />Fund/Department <br />116-Public Health Agenda Date: <br />Gontract iGrant Agency: PSA between Kittitas County and Ellensburg School District <br />Period Begin Date: Augusl l,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 support 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 />Kittitas Gounty Prosecutor, Auditor, and Board of Health Review and Gomment: <br />APPROVED AS TO FORM: <br />t /"rf''Signature Office <br />4 <br />Signature of Auditor's Office <br />n Agency is not suspended/disbarred f] Not Ghecked (reason) <br />Professional Services Agreement (rev . 09 I 24 I 201 8) <br />Page 1 of20