HomeMy WebLinkAbout2017 CWU Food Inspections.docGrant/Contract Review Page 1
Kittitas County
Review Form
Grants & Contract Agreement
Today’s Date
March 17, 2017
Agenda Date
Fund/Department
116-Public Health
Contract/Grant Information
Contract /Grant Agency: Agreement between Central Washington University and Kittitas County Public
Health Department to provide food service inspections and training.
Period Begin Date: April 1, 2017 Period End Date: June 30, 2018
Total Grant/Contract Amount: $150.00 per hour, not to exceed $4000.00 for the term of the agreement
Grant/Contract Number: 671
Contract/Grant Summary:
The agreement between Central Washington University and Kittitas County Public Health Department
allows the county to provide food inspections and training at the rate of $150.00 per hour, with a
maximum allowable of $4000.00 for the entire term of the agreement.
Recommendation for Board of Health and Board of Health Review on _____
Department Head Signature: ______________________ , Administrator Date:________
Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment:
APPROVED AS TO FORM:
_________________________________________
Signature of Prosecutor’s Office Date
________________________________________________
Signature of Auditor’s Office Date
________________________________________________
Signature of Board of Health member Date
Financial Information
Total Amount $4,000.00 max State Funds $ Federal Funds $
Percentage County Funds Matching Funds $ CFDA#
Grant/Contract Review Page 2
In-Kind $
Explain
Is Equipment being purchased? Who owns equipment?
New Personnel being hired? Contact HR hiring – reporting requirements
Future impacts or liability to Kittitas County:
Budget Information
Budget Amendment Needed? Yes attach budget form No x Why not
Included in 2016 budget New Division Created?
Revenue Code
116-615.06.346.22 - $4000.00 max
Pass Through Information
Agency to Pass Through
Amount to Pass Through $
Sub-Contract Approved Date:
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes No
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature: Date:
Department:
Assignment of Tracking Information
Auditor’s Office
Human Resource
Prosecutor’s Office
Who Signed the grant application
Reviewer Date