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Kittitas County <br />Review Form <br />Grants & Contract Agreen <br />Today's Date <br />July 7, 2018 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />-F�Agencla D <br />ROM <br />r� <br />Contract /Grant Agency: PSA between Elmview and Kittitas County <br />Period Begin Date: July 1, 2018 FT—Penod End Date: June 30, 2019 <br />'Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject to <br />funding. Only DDA approved services will be covered. <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The Professional Services Agreement is established to provide a coordinated and comprehensive local <br />program of services for persons with developmental disabilities and to fulfill the county's responsibilities <br />as outlined in attachments. <br />Recommendation for Board of Health and Board of Health Review on <br />Department Head Signature: <br />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 $ TBD <br />Percentage County Funds <br />State Funds $ TBD Federal Funds $ <br />Matching Funds $ CFDA# <br />Grant/Contract Review Page 1 <br />