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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 />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />04/28/2022 PA camas Request o, h-4 0 4L <br />Fund/Department <br />116-Public Health AgendaDate: 5ltl lazz, h <br />Contract /Grant Agency: Consolidated Contract Amendment 4 <br />Period Begin Date: UL/2022 Period End Date: L2/3L/2024 <br />nt/Contract s 52,mount:GTotal ra A ln acre es of !254 91 rfo revtsa med AX um com stn ratde ofton 87 4 LL8, <br />Grant/Contract Number: C1H31015 <br />r Amends Statements of Work for the following programs: <br />COVID-19 Mass Vaccination-FEMA - Effective January t, ZO22 <br />DCHS-ELC COVID-19 Response - Effective January L, ZO2Z <br />LSPAN-Local Strategies for Physical Activity & Nutrition - Effective January I, ZOZ1 <br />Maternal & Child Health Block Grant - Effective January L, ZOZI <br />office of Drinking water Group A program - Effective January r,2022 <br />office of lmmunization covlD-19 vaccine - Effective January L,2oz2 <br />o <br />o <br />o <br />o <br />o Su lemental Nutrition Assistance p m-Education - Effective Janua 2022 <br />Contract/Grant Sum mary: <br />Department Head Sign Director Date <br />Kittitas County rd of Health Review and Comment: <br />r's <br />Signatu Date <br />/l- <br />Date <br />of <br />Auditor, and <br />S reatu Pign <br />I Agency is not suspended/disbarred fl Not Checked (reason) <br />Grant/Contract Review Page 1