HomeMy WebLinkAboutDOE Amendment 1 to the St of WA DOE and KCPHD agreementToday's Date
06/08/2017
Fund/Department
116 -Public Health
Kittitas County
Review Form
Grants & Contract Agreement
Agenda Date
Contract/Grant Information
Contract /Grant Agency: DOE amendment 1 to the State of Washington DOE and KCPHD
Period Begin Date: June 5, 2017 Period End Date: June 30, 2017
Total Grant/Contract Amount: $58,100.00
Grant/Contract Number: C1600148
Contract/Grant Summary:
The Department of Ecology Amendment 1 allows for a shift of up to $8,000.00 between payroll items
and non -payroll items, subject to ecology's written approval per budget table provided.
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 $58,100.00
Percentage County Funds
State Funds $58,100.00
Matching Funds $
In -Kind $
Explain
Federal Funds $
CFDA#
Is Equipment being purchased? Who owns equipment? i
Grant/Contract Review Page 1
New Personnel being hired? Contact HR hiring — reporting requirements
Future impacts or liability to Kittitas County:
_Budget Information
Budget Amendment Needed? Yes ❑
New Division Created?
Revenue Code
116-615.08.04.334.03.1_0.3 - $58,100.00
Pass Through Information
Agency to Pass Through
Amount to Pass Through $
Sub -Contract Approved Date:
Why No x ❑ not
Total grant isn't changing, just expend shift
Prosecutor Review
Has the Prosecutor reviewed this agreement? esEl No ❑
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature: Date:
Department:
Assignment OT i racKing intOrmation
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 2
&;ONW
DEPARTMENT OF
ECOLOGY
State of Washington
AMENDMENT NO. 1
TO
CONTRACT NO. C1600148
BETWEEN THE
STATE OF WASHINGTON DEPARTMENT OF ECOLOGY
AND
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
PURPOSE: To amend the Agreement between the state of Washington, Department of Ecology, hereinafter referred
to as "ECOLOGY," and Kittitas County Public Health Department, hereinafter referred to as
"KCPHD" or "CONTRACTOR."
WHEREAS, it is mutually agreed that KCPHD's requestfor flexibility within the budget, with Ecology's prior written
approval, is beneficial and should therefore be permitted.
IT IS MUTUALLY AGREED the Agreement is amended as follows:
1) BUDGET
The budget has been amended TO ALLOW FOR A SHIFT OF UP TO $8, 000 BETWEEN Payroll items and non -
payroll items, subject to Ecology's written approval, see Project Budget Table:
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All other terms and conditions of the original Agreement including any other Amendments remain in full force and
effect, except as expressly provided by this Amendment.
This Amendment is signed by persons who represent that they have the authority to execute this Amendment and
bind their respective organizations to this Amendment.
This Amendment is effective on June 5, 2017.
IN WITNESS WHEREOF: the parties below, having read this Amendment in its entirety, including all
attachments, do agree in each and every particular and have thus set their hands hereunto.
State of Washington
Department of Ecology
By: _
Signature Date
Stuart A. Clark
Air Quality Program Manager
Approved as to form only.
Assistant Attorney General
Kittitas County
Public Health Department
By:
Signature Date
Print Name:
Title: