HomeMy WebLinkAboutCon Con Amendment 23 (2)Today's Date
11/09/2021
Fund/Department
116 -Public Health
Kittitas County
Review Form
Kn ri r.tis s•�is•r7r
Grants & Contract Agreement
PA Camas Request #:
Agenda Date:
Contract/Grant Information
Contract /Grant Agency: Consolidated Contract Amendment 23
Period Begin Date: 01/01/2018 1 Period End Date: 12/31/2021
Total Grant/Contract Amount: Increase of $649,409.00 for a revised maximum of $4,434,110.00
Grant/Contract Number:
Contract/Grant Summary:
The Consolidate Contract Amendment 23 Amends the following Statements of Work for the following
programs:
• Climate & Health Wildfire Smoke Indoor Air Quality Pilot Study - Effective September 1, 2020
• COVID-19 Coordinated Response - Effective July 1, 2020
• Foundational Public Health Services (FPHS) - Effective July 1, 2021
• OI -Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2021
• Supplemental Nutrition Assistance Program -Education - Effective October 1, 2020
Adds an increase of $649,409.00 for a revised maximum of $4,434,110.00.
Recommendation for Board of Health Review on
Department Head Signature: , Director 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
Verification the Contracting Agency is not Suspended/Disbarred:
® Agency is not suspended/disbarred ❑ Not Checked (reason)
Grant/Contract Review Page 1
Financial Information
Total Amount $
State Funds $
Federal Funds $
Percentage County Funds
Matching Funds $
CFDA#
116.612.94.346.26.65 SNAP Ed
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?
New Division Created?
Yes ® attach budget form
No ❑ why not
Revenue Code
Sub -Contract Approved
$15,409.00
$5,600.00
116.612.94.346.26.65 SNAP Ed
116.612.32.01.346.26.65 VFC Ops
116.612.39.23.346.26.65
116.612.39.17.346.26.65
ELC #4
FPHS
$270,807.00
$605,000.00
Pass Through Information
Agency to Pass Through
Auditor
Amount to Pass Through
$
Sub -Contract Approved
Date:
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes ❑ No ❑
County Departments Impacted
BOCC Approval Needed?
Yes ® No ❑
Staff Member Presenting:
ment of Tracking Intormation
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer Date
Grant/Contract Review Page 2
Auditor
Facilities Maintenance
Information Services
Human Resource
Prosecutor
Treasurer
BOCC Approval Needed?
Yes ® No ❑
Staff Member Presenting:
ment of Tracking Intormation
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Reviewer Date
Grant/Contract Review Page 2
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2018 — 2021 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH18249
AMENDMENT NUMBER: 23
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT, a Local Health Jurisdiction, hereinafter referred to as "LHP', 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:
® Amends Statements of Work for the following programs:
■ Climate & Health Wildfire Smoke Indoor Air Quality Pilot Study - Effective September 1, 2020
■ COVID-19 Coordinated Response - Effective July 1, 2020
■ Foundational Public Health Services (FPHS) - Effective July 1, 2021
OI -Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2021
Supplemental Nutrition Assistance Program -Education - Effective October 1, 2020
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-23 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-22 Allocations as follows:
® Increase of $649,409 for a revised maximum consideration of $4,434,11 U.
❑ 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-20 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-19.
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 39
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