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Home My WebLink AboutConsolidated Contract Amendment 6Kittitas CountY Review Form Grants & Contract Agreement Contract/G rant I nformation Recommendation for Board of Health Review on Department Head Signature Director Date qlulLz- Verification the Contracting Agency is not Suspended/Disbarred: Financial lnformation Today's Date 7126/2022 PA Camas Request #: #/ {& Fu nd/Depa rtment 116-Public Health Agenda Date: Contract /Grant Agency: Consolidated Contract Amendment 6 Period End Date: 12/3I/2024Period Begin Date: t/L/2O22 Total Gra nt/Contract Amount 18,000.00 for a new revised maximum of 54,113,724.0Olncrease of 5L,0 Grant/Contract Number Contract/G rant Su mmarY: The Consolidated Contract Amendment 6 adds the following Statement of Work: . Foundational Public Health Services- Effective July t,2022 Exhibit 8-6 Allocations: lncrease of Sl-,018,000.00 for a revised maximum consideration of 54,I13,724'OO Kittitas County Prosecutor, Auditor, and Board of Health Review an l-1-- r's OfficeSignature of Au Date Da /.,1 ti Signatu r .V*t I v# TO FORM:APPROVED of Prosecutor's Office d Comment I Not Checked (reason)f, Agency is not suspended/disbarred Grant/Contract Review Page 1 Federal Funds SState Funds S1,0t8,000.00Total Amount S1,o18,ooo,oo CFDA#Matching Funds $Percentage CountY Funds ln-Kind 5 Ex Who owns equipment?ls Equipment being Purchased? Contact HR hiri - reportin re uirementshired?New Personnel bein Future impacts or liability to Kittitas County: Budget lnformation Pass Throug h lnformation Prosecutor Review Budget Amendment Needed?Yes I attach budget form No E why not Already BudgetedNew Division Created? Revenue Code 6L1..336.04.25 Expense Code 61.1,.O7 61_1.81.6 611..81.4 612.39.17 612.96 615.40 Agency to Pass Through Expense CodeAmount to Pass Through DateSub-Contract APProved NoYesHas the Prosecutor reviewed this agreement? Cou Depa rtments lmPacted BOCC A I Needed? nment of Trackin lnformation Auditor Facilities Maintenance lnformation Services Human Resource Prosecutor Treasurer NoEYes I Staff Member Presenting Auditor's Office Human Resource J #Prr (Prosecutor's Office Who Signed the grant aPPlication DateReviewer Grant/Contract Review Page 2 KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2022.2024 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH31015 AMENDMENT NUMBER: 6 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter refened to as "DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT, a Local Health Juriscliction, hereinafter referued to as "LHJ", pursuant to the ModificationsAVaivers clause, and to make llecessary changes within the scope of this contl'act and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference and located on the DOH Finance SharePoint site in the Upload Center at the following URL: lrttps://stateofwa.sharepoint.cornisites/doh-ofsfundineresources/sitepaees/horne.aspx?=e I :9a94688d[a2d94d3ea80ac?fbr 3Ze4d7 c X Adds Statements of Work for the following programs: Foundational Public Health Services (FPHS) - Effective luly 1,2022 ! Arrrends Statements of Work for the following programs: [| Deletes Statements of Work for the following programs: 2. Exhibit 8-6 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-5 Allocations as follows: X Increase of $1.018.000 for a revised maximum consideration of $4.113.724. n Decrease of _ for a revised rnaximurn consideration of ;1 No change in the maximum consideration of _. Exhibit B Allocations are attached only for infonnational purposes. Unless designated othetwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments renain in fuIl force arrd effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. APPROVED AS TO FORM ONLY Assistant Attol'ney General KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Signature: (helrett loegeH chdrrLaErikoe,l0r lo.$roD Signature: M Date: Sep 9, 2022 Date: Sep 12,2022 Page I of I EXHIBIT 8-6Kittitas County Public Health Department ALLOCATIONSContract Term: 2022-2024Indirect Rate January 1, 2022 through December 31, 20222 2lo/o Public Health Dept & 15% County Central SvcsDOH Use OnlyBARS Statement of Work Chart of AccountsFederalAward Assist Revenue LHJFundingPeriod FundingPeriodChartofAccountsProgramTitle ldentification# Amend# List#* 6o6.** StartDateEndDateStartDate EndDatea9B0t22 t0/01/2109130122 10/01/21Amounts 12,090s30,8 1 8$217,3139)O 4q)$83,000$r4,719$21,000s225,125$3s9,803s4,980s174(s8,897)$ 14,588qa\a loa$ r 9,470s34,000$2,r 3 1$33,147925,877$1,018,000$605,000$605,000$1,600$3,600Contract Number:Date:FundingPeriodSubTotal$42,908$217,313$29,492s83,000$35,7 I 9$225,125$3s9,803$4,980$174$5,69 1s754,494$53,470s35,278$25,877$1,018,000$605.000$605,000cLH3l0rsJuly 1,2022Chart ofAccountsTotals42,908$21 7,313{ro 10,$83,000$3s,71 9s225,t25$3s9.803s4,980sr74$5,69 l$,a <a aqas53,470s35,778925,877$2,228,000FFY22 IAR SNAP Ed Prog Mgnt-Region 2FFY22 IAR SNAP Ed Prog Mgnt-Region 2CSFRF CTS LHJ AllocationFFY2 I PHEP BP3 LHJ FundingFFY22 CDC EHC EHR SupplementalFFY20 Envir Health Capacity-C (CDC) NCEFFY20 Envir Health Capacity-C (CDC) NCECOWDl9 VaccinesCOVIDI9 Vaccines R4FFY22 VFC OpsFFYI9 COVID CARESFFYI9 ELC COVID Ed LHi AllocationFFYI9 ELC COVID Ed LHJ AllocationFFY20 ELC EDE LHJ AllocationFFY2I Phys Actvry & Nutrition ProgFFY21 Phys Acwty & Nutrition ProgFFY22 MCHBG LHJ ContractsFFY22 MCHBG LHJ ConhactsGFS-Group B (FO-E)FPHS-LHJ-Proviso (YR2)FPHS-LHJ-Ploviso (YR2)FPHS-LHJ-Proviso (YRl )YR24 SRF - Local Asst (15%) (FO-E) SSYR24 SRF - Local Asst (15%) (FO-E) SS207WAWA5Q3903207wAwAsQ3903NGA Not ReceivedNU90TP922043NGA Not ReceivedNUEIEHOO1445NruE1EHo01445NH23IP922619NHZ3TP9226r9NH23[P922619NU50CK000515NU50CK000515NU50CK000515NU50CK000515NU58DP006504NU58DP0065048044525180445251Amd4Arnd IAmd 5Amd 2Amd IAmd 2Amd iAmd 4Amd IAmd 3Amd 2Amd 4Amd 2Amd 2Amd 4Anrd IAmd 4Amd IAmd IAmd 6Amd 1Amd IArnd 4Arnd I10.56110.561333. I 0.56333. r 0.56333.21.02333.93.06333.93.070t/01/220r/011220t/0v220r/0112201/0U2201/0|220110112201/011220t/0t/2201/01/2201/011220t/0r/220l/01/220t/01/220r/01/2201/0112209/30/2209/30/2221.02793.06993.07012/31/2206t30/2208/3112201/01/220'7/0r/2109/0U201213112206/30/2208/31/2293.0'70 333.93.0793.070 333.93.0708/3t/22 09t01/2008/31/22 09t01/2008/31/2208/31/2293.26893.26893.26893.32393.32393.32393.323333.93.26333.93.26333.93.26333.93.32333.93.32333.93.32333.93.320613012406t3012406/3012204/2212210il8t22t0/L8/22143v220912912209/2912209/3012209/30/2206t30D2o'7/01/2007/0't/2007/0"U2104/23/2005/19/2005t19/2001/ts/2109/30t2109/3012110101121t0/01/2107/01/2106/301240613012406/3012207/31/2410/18/2210/18/2207/3112409t29/2209/29/2209/30/2209130/2206/30/2293.43993.439333.93.43333.93.4393.994 333.93.99 0t/0t/2293.994 333.93.99 0t/01122N/A 334.04.90 01/01122N/AN/AN/AN/ANiA336,04.25336.04.25336.04.2507JOu2207/07t220t/0112206t30n306t30t2306t30/2207/0ll2t07laU2107/01121x6J30t2306/30/2306/30/23346.26.64 0r/0V22346.26.64 01/01/22t2J3Il22 07/0Lt2Lr2t3r/22 0't/0r/2106/30/2306/30/23Page I of2$5,200s5,200 EXHIBIT 8.6Kittitas Counry Public tlealth Department ALLOCATIONSContract Term: 2022:2024lndirect Rate January 1, 2022 through December 31, 7022:.2lo/o Public Health Dept & 15% County Central SvcsContract Number:Date:FundingPeriodSubTotalCLFI3lOI5July 1,2022Chrrt ofAccountsTotal$5,200$2,000$4,113,724st,847,447$2,266,277Federal AlvardIdentification #DOH Use OnlyBARS Statement of Work Chart of AccountsAssist Revenue LHJ Funding Period Funding PeriodList #* 6o6u** Start Date End Date Start Date End DateChart of Accounts Program TitleSanitary Survey Fees (FO-E) SS-StateSanitary Survey Fees (FO-E) SS-StateYR24 SRF - Local Asst (15%) (FO-E) TAYR24 SRF - Local Asst ( l5%) (FO-E) TATOTAI,Total consideration:GRAND TOTALAmend #Amd 4Amd IAmd 4Amd IAmounfNiAN/AN/AN/A0v011720t/01t22346.26.65346.26.6sIZ/3t/22 07/0v21r2/3t/22 07/01/21346.26.65 0t/01t22346.26.65 01t01t22t2l3t/22 07t0L12tl2/31/22 07/01121$ r.600$3.600$s,200s 1,000$ r,000$2,000s4,113,724 54,113,724GRAND TOTALTotal FedTotal State06/30/2306/30/2306130t2306/30/2393,095,724$1,0r8,000s4,113,724+Catalog of Federal Domestic Assistance**Federal revenue codes begin with "333". State revenue codes begin with "334"Page2 of2