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Grants and Contract Form
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2023
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06. June
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2023-06-20 10:00 AM - Commissioners' Agenda
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Grants and Contract Form
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Last modified
6/28/2023 10:34:44 AM
Creation date
6/28/2023 10:34:41 AM
Metadata
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Template:
Meeting
Date
6/20/2023
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve Amendment No. 2 to the Rural Health Equity Grant
Order
11
Placement
Consent Agenda
Row ID
104780
Type
Agreement
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Financial lnformation <br />Budget lnformation <br />Pass Through lnformation <br />Prosecutor Review <br />TotalAmount State Funds $Federal Funds S 0 roo@ <br />Percentage County Funds Matching Funds $CFDA#q <br />ln-l(ind $ <br />tnEx <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bei ng hired?-reContact HR hir rti n uirementsre <br />F uture impacts or liability to Kittitas County: <br />Budget Amendment Needed? <br />New Division Created? <br />Revenue Code <br />Yes ! attach budget form <br />1,1"6.612.39. 26, 333, 93. 39 1 ( Covrdtq Yut,"at l.l@tU4 0rtp4^.lrS) <br />No ! Why not <br />Expense Code 116.612.39.26.s1001 / s2oor/ so098 Covi4lq tOC Qu-,n) <br />Agency to Pass Through <br />Amount to Pass Through Expense Code <br />Sub-Contract Approved Date: <br />e Prosecutor reviewed this agreement?Has th Yes No <br />Cou Departments lm cted <br />BOCC A proval Needed? <br />Assi ment of Tracking lnformation <br />Auditor Facilities Ma intenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes I Nol <br />Staff Member Presenting: <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office {tarb* c- t)4* ({," <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2
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