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Kittitas County <br />Review Form <br />Grants &Contract Agreement <br />Today's Date PA Camas Request #:9/20/2022 <br />Fund/Department Agenda Date:116-Public Health <br />Contract/Grant Information <br />Contract /Grant Agency:DOH Interagency Agreement Contract Amendment 1 (GVL26649-Health <br />Equity) <br />Period Begin Date:March 15,2021 Period End Date:December 31,2023 <br />Total Grant/Contract Amount:Not to Exceed $300,000.000 <br />Grant/Contract Number: <br />Contract/GrantSummary: <br />The purpose of the no-cost amendment to the DOH Interagency Agreement is to extend the period of <br />performance from May 31,2023,to December 31,2023.The statement of work remains the same as in <br />the original contract and is attached and no increases or decreases in contractual consideration. <br />Recommendation for Board of Health Review on <br />Department Head Signature:,Director Date: <br />Kittitas County Prosecutor,Auditor,and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office Date <br />Verification the contracting Agency is not Suspended/Disbarred: <br />O Agency is not suspended/disbarred Not Checked (reason) <br />Grant/Contract Review Page 1