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HomeMy WebLinkAboutCon Con Amendment 13(1)Nt- L ... u Kittitas County Review Form lCf7l'f I'ly l'�II :"1'S Grants & Contract Agreement Today's Date 09/19/2017 Fund/Department 116 -Public Health Contract/Grant Information Agenda Date Contract /Grant Agency: Consolidated Contract Amendment #13 Period Begin Date: January 1, 2015 rPeriod End Date: December 31, 2017 Total Grant/Contract Amount: A new reviewed maximum consideration of $440,480.00 Grant/Contract Number: C17114 Contract/Grant Summary: The Amendment 13 Adds Statements of Work Emergency Preparedness & Response- Effective July 1, 2017 • FPHS Communicable Disease & Support Capabilities- Effective July 1, 2017 • Supplemental Nutrition Assistance Program- Education -Effective October 1, 2017 Exhibit B-13 Allocations: • Increases of $82,051 for a revised maximum consideration of $440,448.00 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 Grant/Contract Review Page 1 Total Amount $82,051.00 State Funds $ Federal Funds $82,051 Percentage County Funds Matching Funds $ CFDA# various (see below) 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 New Division Created? Revenue Code 116-612.88.3.333.93.069 - $29,749 116.612.32.9.336.04.25 - $42,000 116.612.94.333.10.561- $10,302 Pass Through Information Agency to Pass Through Amount to Pass Through $ Sub -Contract Agoroved Date: No 0 Why not Not an increase in bottom line Prosecutor Review Has the Prosecutor reviewed this agreement? Yes ❑ No ❑ County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted Signature: Department: Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Date: Who Signed the grant application I I Grant/Contract Review Page 2 Reviewer Date Grant/Contract Review Page 3 KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2015 — 2017 CONSOLIDATED CONTRACT CONTRACT NUMBER: C17114 AMENDMENT NUMBER: 13 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT hereinafter referred to as "LHJ", pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows: ® Adds Statements of Work for the following programs: + Emergency Preparedness & Response - Effective July 1, 2017 • FPHS Communicable Disease & Support Capabilities - Effective July 1, 2017 • Supplemental Nutrition Assistance Program -Education - Effective October 1, 2017 ❑ Amends Statements of Work for the following programs: ❑ Deletes Statements of Work for the following programs: 2. Exhibit B-13 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-12 Allocations as follows: ® Increase of $82,051 for a revised maximum consideration of 544[],448. ❑ Decrease of for a revised maximum consideration of ❑ No change in the maximum consideration of Exhibit B Allocations are attached only for informational purposes. Exhibit C-11 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-10. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Date Date APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of 17 M 00 M U i z U U . ry � O N O r N ti Q Q F U > ' cq O W W O cd a zwwUCd wa w� Cd o o OR N cn . cC U H H F 0 0 0 3 r, O N zzz �� 000 AAA ww R ICdo N 0 A U .` O 00 is M ar k y r' 00 O ,may q a� rn O M ai x V M q O � H y Cd ° S�i +�• Cl �G+Cd 0 N � a ^ A N � O 0 0 0 F y N N N N N N Cd A Q Q Q � T w � d ' �.. VJ > d Q, 0 M > O Pr .. ', "... .." .. O N .'" O �. p. .>. 00 4••� N 0 N m a> 7 a� 0 0 q � x � N � cd > 3 0a o '21 p v y N .� U N 6' En 0. 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