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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />11/20/2015 <br />Agenda Date V511 <br />Fund/Department <br />116 -Public Health <br />rant Information <br />Contract /Grant Agency: PSA between Kittitas County and Kittitas County Community Network and <br />Coalition <br />Period Begin Date: January 1, 2016 i Period End Date: June 1, 2016 <br />Total Grant/Contract Amount:$1950.00 <br />Grant/Contract Number: <br />Contract/Grant Summary - <br />The PSA between Kittitas County and Kittitas County Community Network and Coalition is established to <br />clarify the scope of work for both parties involved as outlined in Exhibit "A" Scope of Work. <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 />Signatu ro ecut 's Tice DW <br />r _ <br />Signature f ud' or's Office Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $1950.00 <br />State Funds $1950.00 Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ CFDA# N/A <br />In -Kind $ <br />Explain <br />Grant/Contract Review Page 1 <br />