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Today's Date <br />Fund/Department <br />116-Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Agenda Date <br />Contract/Grant Information <br />Contract /Grant Agency: DSHS DDA County Services Agreement <br />LP/l/110 <br />Period Begin Date: 04/18/2016 I I Period End Date: 06/30/2016 <br />Total Grant/Contract Amount: $738,941.00 <br />Grant/Contract Number: 1563-44899 <br />Contract/Grant Summary: <br />The amendment to the contract between the State of Washington Department of Social and Health <br />Services and Kittitas County is established to increase the original contract amount of $689,190.00 by <br />$49,751.00. The new contract total maximum is $738,941.00. The agreement allows the county to <br />provide services and allow staff to administer DO services within the county as set in the agreement. <br />Recommendation for Board of Health and Board of Health Review on <br />, Administrator Date :~ f.Q <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $738,941.00 State Funds $738,941.00 Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />Grant/Contract Review Page 1