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Today's Date <br />08/16/2019 <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: Universal Agreement for Facility Use <br />Period Begin Date: 07/01/2019 Period End Date: Until terminated by either <br />party <br />Total Grant/Contract Amount: None <br />Grant/Contract Number: PH001-2019 <br />Contract/Grant Summary: <br />The purpose of this agreement is to document mutual understanding and respective obligations of the <br />parties to facilitate the successful completion of the identified project or objective. The Agreement is by <br />and between Kittitas County, and the Community partner identified in the agreement. <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 />Signature of Board of Health member <br />Financial Information <br />Date <br />Date <br />Total Amount $ State Funds $ <br />Federal Funds $ <br />Percentage County Funds Matching Funds $ <br />CFDA# <br />In -Kind $ <br />Grant/Contract Review Page 1 <br />