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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />[To—day's Date <br />/30/2018 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Contract /Grant A <br />Agenda Date <br />rhe°•&COS <br />ILI <br />4 <br />PSA Amendment between Youth Services of Kittitas County and Kittitas Cou <br />Period Begin Date: April 1, 2018 Period End Date: June 30, 2018 <br />Total Grant/Contract Amount: $28,151.88 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The original agreement between Youth Services of Kittitas County and Kittitas County was established to <br />allow Youth Services of Kittitas County to implement the Community Prevention Wellness Initiative <br />(CPWI) community based mentoring program in Kittitas County. The amended agreement amends <br />Exhibit "B" Budget Expenditures <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 Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ <br />State Funds $ <br />Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />