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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G rant lnformation <br />Recommendation for Board of Health Review on <br />Department Head Signature :Director Date z/pl>* <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPR ED <br />Signature of Prose r's Office Date <br />A * l./art-Ltln-a 1./4?/ <br />sign atu rb oinrditor'i 5rt." <br />Pwtnt-,-tld\ ZJ.jC- <br />( <br />Date <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Agency is not suspended/disbarred I Not Checked (reason) <br />Today's Date <br />otlosl2a24 PBK Reque't +' I D nD <br />Fund/Department <br />116-Public Health {t o)Agenda Date <br />Contract /Grant Agency: DSHS DDA Amendment l- <br />Period Begin Oate:171 <br />1 7-A Period End Date: \OIZO I2+ <br />Total Grant/Contract Amount: lncrease of 5263,603.00 for a revised max of SL,LI8,442.OO <br />G ra nt/Contract N umbe r : 2363-49241 <br />Contract/G rant Su m ma ry: <br />Funding for Kittitas County Developmental Disabilities programs including job foundations, program <br />administration, other consumer supports, and direct client services via subcontractors for Medicaid <br />funds. The amendment increases funds for the program, <br />Grant/Contract Review Page 1