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Amendment 10
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: 1. 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 of $275.932 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. 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E )!| ))) a � � & Lb cm IL C )) k9� �\0 ! r e r2 k § §� lz 0 § §§9L a ■ § § 2a] ( § § ( 0 0 k � � & Lb cm IL Kittitas County Review Form Grants & Contract Agreement Today's Date 09/16/2019 Fund/Department 116 -Public Health Contract/Grant Information Agenda Date Contract /Grant Agency: Consolidated Contract Amendment 10 Period Begin Date: January 1, 2018 Period End Date: December 31, 2020 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: a 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 a 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 Board of Health Review on Department Head Sigature: Administrator Date:] ' Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: APPROVED AS TO FORM: Signat a of ProseEutor's oWe Date Signatur of Au or'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? j Contact HR hiring — reporting requirements Future impacts or liability to Kittitas County: Budget Information ....... -.......... - Budget Amendment Neede�V?j Yes ❑ attach budget form No ® why not New Division Created? Consolidated Contract Amendment #10 ....... — ... Revenue Code see below 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 Through Information Agency to Pass Through Amount to Pass Through '$ I Sub -Contract Approved I Date: Prosecutor Review Has the Prosecutor reviewed this agreement? Yes El No ❑ rtments Im Auditor Information Services Prosecutor Facilities Maintenance Human Resource Treasurer =--._ Grant/Contract Review Page 2 Submitted Signature: Date: Department: ment of Tracking Intormation Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer Date Grant/Contract Review Page 3