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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />08/17/2017 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Agenda Date <br />Contract /Grant Agency: Heritage University Department of Nursing <br />Period Begin Date: Upon execution Period End Date: Three years from signature <br />Total Grant/Contract Amount: None _ <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The agreement between Heritage University Department of Nursing is to establish a training site to have <br />BSN students participate in their clinical learning experience at a training site. The agreement sets forth <br />the duties and responsibilities of the training site (KCPHD) with respect to the clinical learning <br />experience. <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 />APMgMED AS TO FORM: <br />1 ' . I _-- <br />Signature of Prosecutor's Ocke Date <br />[[�� c <br />. (:A- e� - <br />1 Z, - <br />Sig a r& Auditor's Office Dat <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $ <br />State Funds $ <br />Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />