HomeMy WebLinkAboutConsolidated Contract Amendment 10Kittitas County
Review Form
KS f-ri l'•iy CII I'!'1 V
Grants & Contract Agreement
Today's Date Agenda Date
09/16/2019
Fund/Department
116 -Public Health
Contract/Grant Information
Contract /Grant Agency: Consolidated Contract Amendment 10
Period Begin Date: January 1, 2018 Period End Date: December 31, 2020 i
Total Grant/Contract Amount: $665,415.00
Grant/Contract Number: CLH18249
Contract/Grant Summary:
The Consolidated Contract Amendment 10
Exhibit A Statements of Work
Adds Statement of Work for the following:
• Foundational Public Health Services -Effective July 1, 2019
• Office of Emergency Preparedness and Response -Effective July 1, 2019
Amends Statements of Work for the following programs:
• LSPAN-Local Strategies for Physical Activity and Nutrition- Effective February 19, 2019
• Maternal and Child Health Block Grant- Effective January 1, 2018
• Office of Drinking Water Group A Program- Effective January 1, 2018
• Office of Drinking Water Group B Program- Effective January 1, 2018
Exhibit B-10 Allocations, amends and replaces Exhibit B-9 Allocations
■ Increase of $275,932 for a revised maximum consideration of $665,415.00
Recommendation for Board of Health and
Department Head Signature:
Board of Health Review on
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
Grant/Contract Review Page 1
Signature of Board of Health member Date
Financial Information
Total Amount $ 665,415 State Funds $ 223,200 Federal Funds $ 442,215
Percentage County Funds Matching Funds $ CFDA# 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 No ® why not
New Division Created?
Amount to Pass Through
Consolidated Contract Amendment #10
Revenue Code see below
Date: {
116.612.94.333.10.561
$
20,603
FFY20 SNAP ED PROGRAM
116.612.88.3.333.93.069
$
49,133
FFY19 PHEPR LHJ FUNDING
116.612.31.333.93.439
$
60,000
FFY19 LSPAN PROGRAM
116.615.02.333.40.490
$
20,000
GFS GROUP B (FO -E) (7/20-12/20)
116.612.39.17.336.04.25
$
42,000
FPHS FUNDING LHJ's (7/20-12/20)
116.612.39.17.336.04.25
$
42,000
FPHS FUNDING LHJ's (7/19-6/20)
116.615.02.2.346.26.64
($-3,200)
YR21 SRF (FS) SS (END 06/30/19)
116.615.02.2.346.26.64
$
3,200
YR22 SRF (FO -E) SS (1/19-12/19)
116.615.02.2.346.26.66
($-4,000)
YR21 SRF (FS) TA (END 06/30/19)
116.615.02.2.346.26.66
$
2,000
YR22 SRF (FO -E) TA (01/19-12/19)
Pass Throueh Information
Agency to Pass Through
Amount to Pass Through
$
Sub -Contract Approved
Date: {
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes❑ NoEj
county uepartments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Grant/Contract Review Page 2
Submitted
Signature:
Department:
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 3
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2018 — 2020 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH18249
AMENDMENT NUMBER: 10
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:
L. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows:
® Adds Statements of Work for the following programs:
+ Foundational Public Health Services (FPHS) - Effective July 1, 2019
■ Office of Emergency Preparedness & Response - Effective July 1, 2019
® Amends Statements of Work for the following programs:
• LSPAN-Local Strategies for Physical Activity & Nutrition - Effective February 19, 2019
• Maternal & Child Health Block Grant - Effective January 1, 2018
+ Office of Drinking Water Group A Program - Effective January 1, 2018
+ Office of Drinking Water Group B Program - Effective January 1, 2018
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-10 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-9 Allocations as follows:
® Increase of27$ 5.932 for a revised maximum consideration of $665.415.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C-9 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-8.
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
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 40
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