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. r' Y• yi.\ <br />Kittitas County <br />Review Form 1--- -- -_ <br />Grants & Contract Agreement <br />Today's Date <br />05/18/2016 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Agenda Date <br />Contract /Grant Agency: Interagency Agreement #16-81 for Youth Marijuana Prevention Education <br />Program <br />Period Begin Date: May 10, 2016 <br />Total Grant/Contract Amount: Maximum of $5000.00 <br />Grant/Contract Number: 16-81 <br />Contract/Grant Summary: <br />Period End Date: June 30, 2016 <br />The Interagency Agreement is entered into between Walla Walla County Department of community <br />Health and Kittitas County that provides a mechanism for the completion of deliverables and transfer of <br />funds necessary to complete a needs assessment for Kittitas County. <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 />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office <br />Date <br />Signature of Board of Health member Date <br />Financial Information <br />Total Amount $5000.00 <br />Percentage County Funds <br />State Funds $5000.00 <br />Matching Funds $ <br />Federal Funds $ <br />CFDA# <br />Grant/Contract Review Page 1 <br />