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Today's Date <br />12/13/2018 <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: PSA between Elmview and KCPHD (DD program) <br />Period Begin Date: 01/01/2019 1 1 Period End Date: 08/31/2019 <br />Total Grant/Contract Amount: Not to exceed $24,523.20 <br />Grant/Contract Number: <br />•��' nni s---•vM <br />fJX <br />Contract/Grant Summary: <br />The Professional Services Agreement is established to provide a coordinated and comprehensive local <br />program of services for persons with developmental disabilities and to fulfill the county's responsibilities <br />as outlined in attachments. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: <br />Kittitas County Prosecutor, Auditor, and Boa <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Di <br />Signature of Auditor's Office Dz <br />Signature of Board of Health member D; <br />Administrator Date: <br />Financial Information <br />Total Amount $ TBD State Funds $ TBD Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In -Kind $ <br />Explain <br />Grant/Contract Review Page 1 <br />