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Today's Date <br />02/28/2017 <br />Fund/Department <br />116 -Public Health <br />' <br />lj <br />Kittitas County � <br />Review Form �-- <br />fl <br />Grants & Contract Agreement <br />Agenda Date <br />Contract/Grant Information <br />Contract /Grant Agency: CHCW KCHN Fiscal sponsorship Agreement <br />Period Begin Date: 02/01/2017 Period End Date: 06/30/2017 <br />Total Grant/Contract Amount: $1000.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The Fiscal Sponsorship Agreement between Community Health of Central Washington and Kittitas <br />County Health Network Steering Committee: Central Washington University, City of Ellensburg, <br />HopeSource, Kittitas County Public Health Department, Kittitas Valley Fire and Rescue, and Southeast <br />Washington Aging And Long Term Care. The Sponsor Board of Directors has approved the establishment <br />of a restricted fund to receive donations of cash from the Committee designated for support of the <br />project known as the Kittitas County Health Network and to make disbursements to Deborah Gauck <br />Consulting n the furtherance of the Project's purpose to improve population health through cross -sector <br />collaboration and systems integration. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: , Administrator Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office <br />Date <br />Signature of Board of Health member Date <br />Grant/Contract Review Page 1 <br />