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Llul.u.3jyl mivV iuyu IV. LJI/1/'V1COYrl�lr-4�JL!'OI,CI''MOY000Or.7JOJ <br />State of Washington Department of Ecology <br />Page 17 of 28 <br />Agreement No: AQOBC-2024-KiCPHD-00010 <br />Project Title: Community -Led Air Quality Improvement for Ellensburg <br />Recipient Name: Kittitas County - Public Health Department <br />Funding Distribution Summary <br />Recipient / Ecology Share <br />Funding Distribution Name <br />Recipient Match % <br />Recipient Share <br />Ecology Share <br />Total <br />Improving Air Quality in <br />Overburdened Communities <br />0.00 % <br />$ 0.00 <br />$ 104,625.00 <br />$ 104,625.00 <br />Total <br />$ 0.00 <br />$ 104,625.00 <br />$ 104,625.00 <br />AGREEMENT SPECIFIC TERMS AND CONDITIONS <br />This agreement is supported with funding from Washington's Climate Commitment Act (CCA). The CCA supports <br />Washington's climate action efforts by putting cap -and -invest dollars to work reducing climate pollution, creating jobs, and <br />improving public health. Information about the CCA is available at https:Hclimate.wa.gov. <br />Department of Ecology received funding from Washington's Climate Commitment Act (CCA) for the work under this <br />agreement. To strengthen public awareness of how CCA funding is used, the Office of the Governor is directing state agencies <br />that administer funding or manage a CCA-supported program to ensure consistent logo branding and funding acknowledgments <br />are used in all communications and included in grant agreements. <br />The "Climate Commitment Act" logo and funding acknowledgment make it easy for consumers and the public to see how the <br />state is using CCA funds to reduce climate pollution, create jobs, and improve public health and the environment, particularly for <br />low-income and overburdened populations. <br />The logo branding and funding acknowledgments requirements apply to all contractors, subcontractors, service providers, and <br />others who assist the RECIPIENT in implementing this agreement. The RECIPIENT is to contact ECOLOGY if unsure about <br />how to apply CCA requirements to the work under this agreement. <br />SPECIAL TERMS AND CONDITIONS <br />GENERAL FEDERAL CONDITIONS <br />If a portion or all of the funds for this agreement are provided through federal funding sources or this agreement is <br />used to match a federal grant award, the following terms and conditions apply to you. <br />A. CERTIFICATION REGARDING SUSPENSION, DEBARMENT, INELIGIBILITY OR VOLUNTARY <br />EXCLUSION: <br />1. The RECIPIENT/CONTRACTOR, by signing this agreement, certifies that it is not suspended, debarred, proposed for <br />debarment, declared ineligible or otherwise excluded from contracting with the federal government, or from receiving <br />contracts paid for with federal funds. If the RECIPIENT/CONTRACTOR is unable to certify to the statements <br />contained in the certification, they must provide an explanation as to why they cannot. <br />Template Version 12/10/2020 <br />