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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G ra nt I nformation <br />Recommendation for Board of Health Review on <br />Department Head Signature Director Date <br />Kittitas county Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPR ED AS TO FORM <br />J a1 +?("t ,'( (r- <br />Signature of Prosec r's Office Date <br />Signature of Audi o r's Office Date <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />t0/1.0/2022 PA Camas Request #6qqhK <br />Fund/Department <br />11"6-Public Health Agenda Date <br />Contract lGrantAgency: lnterlocal Agreement between Kittitas County Public Health Department and <br />Kittitas Valle Hospital <br />Period Begin Date: Date of Execution Period End Date: 2 years from Date of <br />Execution <br />Total Grant/Contract Amount: None <br />G rant/Contract N umber: <br />The lnterlocal Agreement between KCPHD and KVH is established to promote efficiency in providing <br />health services to the citizens of Kittitas County, The agreement allows KCPHD emergency storage of <br />vaccine should the need arise at the health department because of power outage or storage failure. <br />Contract/G ra nt Summary: <br />I Agency is not suspended/disbarred I Not Checked (reason) <br />Grant/Contract Review Page L