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Fully executed contract
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05. May
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2026-05-05 10:00 AM - Commissioners' Agenda
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Fully executed contract
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Last modified
5/29/2026 11:17:19 AM
Creation date
5/29/2026 11:17:10 AM
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Meeting
Date
5/5/2026
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 1 to a Contract between Department of Ecology and the Kittitas County Public Health Department
Order
5
Placement
Consent Agenda
Row ID
144005
Type
Contract
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Docusign Envelope lD: 45542800-F078-88E3-B2CC-B1CBA3BDE84C <br />Face Sheet <br />CONTRACT INSTRUCTIONS <br />General: <br />Do not use this form for Grant or Loan Agreements. See the EAGL Face Sheet. <br />project Officer, Program Budget Analyst, or Program Budget Manager familiar with the content of <br />the contract or amendment fills out the Face Sheet' <br />program Budget Manager provides complete information in the Budget section' <br />program sends final draft documents for review and approval by Contracts/Fiscal staff' <br />Contracts/Fiscal staff reviews and assigns a Contract number (if new), enters sub-object on Face <br />Sheet and signs their approval, then returns to the Program. <br />Obtain contractor signature and then appropriate Ecology signature. <br />When all parties have signed the contract-or amendment, Program sends the Face Sheet with the <br />signed contract or amendment to Fiscalfor filing. <br />Line Specific: <br />Type: Contract - can be an IAA or contract. Moster - generally has an RFQQ, Work Assignment - will <br />be related to a convience contract. <br />Total Eligible Cost: This line always shows the total eligible Ecology amount of the Contract. <br />Sales Tax: This line is lF the sales tax is not included in the contract cost but must be paid (usually <br />for public works contracts). <br />program Budget Manager completes the Fund lnformation (Master lndex Code (MlC), Fund, <br />Expenditure Authority lndex (EAl), and Project & Sub-Project)' <br />Encumbrance/Disbursement Section: See Exomples tab for examples <br />ln the fiscalyear (FY)columns enter amounts, by MlC, fund/EAl, and project coding (if applicable)l <br />Sptit codes must be split on separate lines on the face sheet <br />A. Original Contract - Enter the total amount for each fiscal year in the FY columns. <br />-oR- <br />B. Amendment - Leave oriSlnalAnoQu_n_tg OR sum pior bien amounts and on new rows enter <br />ONLY the inc ase/decre ase amounts for each fiscal Year <br />Sum prior bien omounts poid ond enter in the "Prior Bien's" column' <br />Remarks: lf descriptions for "other" fields above are too long, then enter here' Enter general <br />comments, note which MIC to pay from first, J code info, etc. <br />Federally Funded: Please select Yes or No and enter the federal dollars for the contract.
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