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Today's Date <br />01/31/2018 <br />Tuna/uepartment <br />116 -Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Agenda Date <br />t��s obis.. +syr <br />f� P <br />Contract/Grant Information <br />Contract /Grant Agency: PSA between KCPHD and Yakima Specialties, Ind <br />Period Begin Date: January 1, 2018 Period End Date: June 30, 2018 <br />Total Grant/Contract Amount: $ To Be Determined <br />Grant/Contract Number: <br />q 2- <br />Contract/Grant Summary: <br />The purpose of the agreement is to provide coordinated and comprehensive local program services for <br />persons with developmental disabilities and to fulfill the County's responsibilities outlined in Attachment <br />D. <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 />"Sig n ure of Prosecut )'s Office Date <br />Signatr of . uditor's Office Date <br />Signature of Board of Health member <br />Financial Information_ <br />Total Amount $ TBD <br />Percentage County Funds <br />Date <br />State Funds $ TBD Federal Funds $ <br />Matching Funds $ CFDA# <br />Grant/Contract Review Page 1 <br />