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Kittitas County <br />Review Form <br />AI I Ill AN {SII I V <br />Grants & Contract Agreement <br />Today's Date Agenda Date <br />8/29/2019 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between Elmview and Kittitas County (19-20) <br />Period Begin Date: July 1, 2019 Period End Date: June 30,2020 <br />Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject to <br />funding. Only DDA approved services will be covered. <br />Grant/Contract Number: Elmview 19-20 <br />Contract/Grant Summary: <br />The professional services agreement is to establish subcontracted employment and day services for <br />people with developmental disabilities in Kittitas County per the county's responsibilities as outlined in <br />attachments. <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 />Total Amount $TBD <br />Percentap,e Countv Funds <br />Date <br />Date <br />State Funds $TBD Federal Funds $ <br />Matching Funds $ CFDA# <br />Grant/Contract Review Page 1 <br />