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Kittitas County�)4� <br />Review Form e-7= <br />Grants & Contract Agreement <br />Today's Date F' Agenda Date <br />09/12/2019 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Youth Services of Kittitas County and Kittitas County <br />Period Begin Date: July 1, 2019 Period End Date: June 30, 2020 <br />Total Grant/Contract Amount: $23,120.00 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The PSA is established to allow Youth Services of Kittitas County to implement the Community <br />Prevention Wellness Initiative (CPWI) community based mentoring program in Kittitas County. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: <br />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 />Financial Information <br />Total Amount $23,120.00 <br />State Funds $23,120.00 <br />Federal Funds $ 0 <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# n/a <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? no <br />I Who owns equipment? <br />Grant/Contract Review Page 1 <br />