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Docusign Envelope lD' Dl MAE83-FC1 F-483D-BCEC-A848D08F9363 <br />State olWashington Deparlment of Ecology <br />Agreement No: AQOBC-2024-KiCPHD-00010 <br />Project Title: Community-Led Air Qualify Improvement for Ellensburg <br />RecipientName: Kilt;tas County - Public Health Department <br />Page 17 of28 <br />Fundins Distribution Summarv <br />Recipient / Ecology Share <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. Informalion about the CCA is available at https://climate.wa.gov. <br />Department of Ecology received funding liom 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 CommitmentAct" logo and funding acknowledgment make it easy for consumers and the public to see how the <br />state is using ccA fi.rnds to reduce climate poliution, 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, subconttactorso 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 r-rnder 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. cERTtrrcATtoN REGARDINC SUSPENSTON. DEBARMENT.INELIOIBILITY OR yQLUNTARY <br />EXCLUSION: <br />1. The RECIPIENT/CONTRACTOR, by signing this agreement, cerlifies that it is not suspended, debarred, proposed for <br />debannent, declared ineligible or otherwise excluded from contracting with the federal govemment, or from receiving <br />contracts paid for with federal funds. Ifthe RECIPIENT/CONTRACToR is unable to certi8 to the statements <br />contained in the certification, they must provide an explanation as to why they cannot. <br />Template Ycrsion 12/ I 012024 <br />Funding Distribution Name Recipient Match o/o Recipient Share Ecology Share Total <br />Improving Air Qualify in <br />Overburdened Communities <br />0.00 %$0.00 $ 104,625.00 $ 104,625.00 <br />Total $0.00 $ 104,625.00 $ 104,625.00