HomeMy WebLinkAboutSH21-019 - Grant and Contract Review Form for Amended AgreementP pDES �p N
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Kittitas County
Review Form
Grants & Contract Agreement
Today's Date Agenda Date
November 22, 2021 December 7, 2021
Fund/Department
30 / Sheriff
Contract/Grant Information
Contract/Grant Agency: Comprehensive Healthcare
Period Begin Date: upon signature
Federal Funds $0
Period End Date: TBD
Total Grant/Contract Amount: $128,024.00
Grant/Contract Number: SH21-019
Contract/Grant Summary: On May 4, 2021, the BOCC approved a Professional Services Agreement
between Comprehensive Healthcare and Kittitas County for a full-time mental health counselor at the
Kittitas County Jail. It has been determined that a mathematical error was made on "Exhibit B" when
totaling the budget breakdown, and was subsequently transferred to Section V, Subsection E. The contract
amount is being amended to correct this error, bringing the stated contract total from $124,024.00 to
$128,024.00, with a 3% increase each year.
Financial Information
Total Amount $128,024.00
State Funds $0
Federal Funds $0
Percentage County Funds
Matching Funds $0
CFDA# na
Expense Code 001-30070154101
In -Kind $
Explain
Is Equipment bein urchased? No
Who owns equipment? na
New Personnel being hired? No
Contact HR hiring — reporting requirements - na
Future impacts or liability to Kittitas County: Vendor will provide proof of insurance as required by the
PSA.
Budget Information
Budget Amendment Needed?
Yes❑ attach budget form
No EWhy not
Already budgeted for.
New Division Created? No
Revenue Code N/A
Expense Code 001-30070154101
Pass Through Information
Agency to Pass Through NA
Amount to Pass Through $0
Sub -Contract Approved Date:
Grant/Contract Review Page 1
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes ® No AMAS4 51734 & 53123
Coun Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature:
Date: Z�
Department: Sher
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office Z z
Who Signed the grant application
Reviewer I Date
Grant/Contract Review Page 2