HomeMy WebLinkAboutGrants and Contract CLH31015 Amendment 10Kittitas County
Review Form
Grants & Contract Agreement
Contract/G ra nt I nformation
Recommendation for Board of Health Review on
Department Head Signature:Director Date:
verification the contracting Agency is not suspended/Disbarred:
Today's Date
1.1./17 /2022 PA camas Request #: t"fh} t fa
Fund/Department
116-Public Health Agenda Date
Contract /Grant Agency: Consolidated Contract Amendment L0
Period Begin Date: 01.01.2022 Period End Date: 1,2.3L2024
Total Grant/Contract Amount: lncrease of 532,977.00 for a revised maximum consideration of
s3,706,366.00
Grant/Contract N umber: CH L3 10L5
Contract/Grant Su mmary:
The Consolidated Contract Amendment 1-0 Amends Statements of Work for the following programs:
Adds Statement of Work for the following program:
o COVIC 19 LHJ Vaccination-ARPA-Effective November L,2OZ2
Exhibit B-10 Allocations, attached and incorporated by this reference, amends, and replaced Exhibit B-B
Allocation as follows:
o lncreas e of 532,97 7.00 for a revised maximum consideration for 53,706,366.00
Kittitas county Prosecutor, Auditor, and Board of Health Review and comment:
PROVED AS F
v
Signature of se r's Date
Signature of tor's e Date
Grant/Contract Review Page 1
Agency is not suspended/disbarred I Not Checked (reason)
Financial lnformation
Budget lnformation
Pass Through lnformation
Agency to Pass Through
Amount to Pass Through Expense Code:
Sub-Contract Approved Date
Prosecutor Review
TotalAmount $20,940 State Funds S Federal Funds S
Percentage County Funds LOO%Matching Funds S CFDA#
ln-Kind 5
Explain
ls Equipment being purchased? No Who owns equipment? Cannon Solutions
New Personnel being hired? No Contact HR hiring -reporting requirements
Future impacts or liability to Kittitas County:
Budget Amendment Needed?Yes ! attach budget form No E why not
Already BudgetedNew Division Created?
Revenue Code L1,6.612.39 .28.333.21.027
Expense Code 612.39.2851001 / s2OO1./ s0098
Has the Prosecutor reviewed this agreement?Yes LJ No
County Departments lm ed
BOCC roval Needed?
Assi ment of Trackin
Auditor Facilities Maintenance
lnformation Services Human Resource
Prosecutor Treasu rer
Yes !NoE
Staff Mem ber Presenting:
Auditor's Office
Human Resource
Grant/Contract Review
lnformation
Page 2
Prosecutor's Office
Who Signed the grant application
Reviewer Date
Grant/Contract Review page 3
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31015 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, a Local Health Jurisdiction, 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
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:
https://stateofina.sharepoint.com/sites/doh-ofsfundingresources/sitepages/home.aspx?:e I :9a94688da2d94d3ea80ac7fbc32e4d7c
X Adds Statements of Work for the following programs:
COVID-19 LHJ Vaccinalion-ARPA - Effective November 1,2022
I Amends Statements of Work for the following programs:
n 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:
X Increase of 532,977 for a revised maximum consideration of $3.706.366.
n Decrease of
-
for a revised maximum consideration of
-.n No change in the maximum consideration of _.
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein, the effective date of this amendment is the date of execution
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/trer signature in execution thereof.
APPROVED AS TO FORM ONLY
Assistant Attorney General
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature:kw%Signature:
Bret)o llwt/am
sreid.H?rninioKr r02r1:! Psr)
Date:
Dec27,2022
Date:
Dec2I,2022
Page I of 1
EXHIBTT B.TOKittitas County Public Health Department ALLOCATIONSContract Term: 2022-2024Indirect Rate January 1, 2022 through December 31, 2022: 2lVo Public Health Dept & l5%o County Central SvcsDOH UseOnlyBARS Statement of Work Chart ofAccountsFederal Award Assist Revenue LHJ Funding Period Funding PerbdChart of Accounts Program Title Identilication # Amend # List #* 6o4.** Start Date End Date Stgri Dat€ End DaleNGA Not Received207WAWA5Q3903207WAWA5Q3903207WAWA5Q3903NGA Not ReceivedNGA Not ReceivedNU90TP922043NU90TP922043NGA Not ReceivedNUEI EHOOI445NtJEI EH001445NH23IP922619NH23tP9226 t9NH23W922619NUs0cK000slsNU50CK0005 I sNU50CK0005 r 5NUs0cK000s15NU50CK000515NU50CK0005 I 5NGA Not ReceivedNU58DP006504NU58DP006504NGA Not ReceivedB04MC452sl804MC4525110 561l0.s6l10.56110.561333.1 0.56333 10 56333. I 0.56333.10 56Amounts29,934($s,eoo)$12,090$30,81 8$49, I 33$29,492$14,719$21,000$1,s47($8,8e7)$14,s88($34,24s)$754,494$80,000$19,470$34,000$44,196$2,r31$33,147Contract Number:Date:FundingPeriodSubTotal{rq q1/.$37,008$217,ft3s32,977$49, l 33$29,492$83,000$3s,7 l 9$22s,t25$3s9,803$4,980$174$7,238$720,249$80,000ss3,470$44,196s3s,278cLH3r0l5November l,2022Chart ofAccountsTotal$66.942$217,313s32,977978,62s$83,000$3s,719922s,12s$3s9,803$4,980$1 74s7,238$720,249$133,470$79,474FFY23 LA.R SNAP Ed Prog Mgnt-Region 2FFY22 LA.R SNAP Ed Prog Mgnt-Region 2FFY22 IAR SNAP Ed Prog Mgnt-Region 2FFY22 tAR SNAP Ed Prog MgnrRegion 2CSFRF CTS LHJ AllocationLI{J Vaccination ARPAFFY22 PHEP BP4 LHJ FundingFFY2I PHEP BP3 LHJ FundingFFY22 CDC EHC EHR SupplementalFFY20 Envir Health Capacity-C (CDC) NCEFFY20 Envir Health Capacity-C (CDC) NCECOVIDI9 VaccinesCOVIDl9 Vaccines R4FFY22 VFC OpsFFY19 COVID CARESFFY19 ELC COVID Ed LHJ AllocationFFYI9 ELC COVID Ed Lru AllocationFFYI9 ELC COVID Ed LHJ AllocationFFY20 ELC EDE LHJ AllocationFFY20 ELC EDE LHJ AllocationFFY22 Phys Actvty & Nutrition ProgFFY2I Phys Actvty & Nutrition ProgFFY2I Phys Acwty & Nutrition ProgFFY23 MCHBG LHJ ContractsFFY22 MCHBG LHJ ContractsFFY22 MCHBG LHJ ContractsAmd 9Amd 7Amd 4Amd IAmd 5Amd l0Amd 7Amd2Amd 1. 7Amd 2Amd IAmd 4Amd 1Amd 3Amd 2Amd 7Amd 4Amd 2Amd 7,9Amd2,9Amd 7Amd 4Amd 1Amd 7Amd 4Amd It0/01/220t/0u2201101/2201101/2209/30/2309t30D209/30t2209t30t22t0101t22tontDlrcmntrcntDl09B,0D309B0n209/3,0f2209/30n206t30D3MRo/2221.027 333.21.02 0r/01t22 12t31t22 01nt22 t2t3tD2 5217,31321.027 333.21.02 ttnl/2z 06A,0t23 tv0tzz 0680/23s32,97793.069 333.93.06 07/01D2 06t30D3 07mn293 069 333.93.06 0U0r/22 06t30t22 07ntD193.070 333.93.07 0t/Ol/22 t2B1/22 09nla0 tu3tn2s83,00093.07093.070333.93.07 0t/01/22 08/31/22 @ntn'333.93.07 0v01t22 08/31/22 @nlDO08BtD2o8t31D293.268 333.9326 0t/O1t22 06/30/24 07n1n0 MBO|24 922s,12s93268 333.9326 0tn1n2 06/30t24 0710u20 MB0D4 $3s9,80393.268 333.9326 0t/0v22 06/30/22 07t01Dl 6tnn2$4,98093.323 333.9332 01t01/22 04D2/22 04D3t20 A7BLD4$ 17493.32393.32393.323333 93 32333.93.32333.93.3201/otD20lnl/220t/01D210t18t22tot18D2rcn8n210/18/22 05n9DAt0/18/22 05t19t20t0/18/22 05lt9a093.32393.323333.93.32 0v0tD2 07t31t23 0v15t2r333.93 32 0r/01D2 07t31t23 0ln5t21o'il31D407Btn493.43993.43993 439333.93.43 09/30/22 09D9/23 WB0t22333.93.43 01/0t/22 09/29/22 WROU333.93.43 01n1/22 09D9/22 @BoDt09n9n309/29D209t29n293.99493.99493.994333.93.99333.93.99333.93.9910/01t2201/01n201/01/2209t30D309130t2209/30t22tontn2lototDlrcntm09/30D3wBon2wBor22N/A 334.0490 0v01/22 06t30122 01rc1x 0f,i30122 $2s,877GFS-Group B (FO-E)Amd IPage I of 2925,877$25,877
EXHIBIT B-10Kittitas County Public Health Department ALLOCATIONSContract T er m:. 2022-202 4Indirect Rate January 1, 2022 through December 31, 2O22: 2lVo Public Health Dept & 157o County Central SvcsContract Number:Date:FundingPeriodSubTotal$1,018,000$o$605,000$s,200$5,200cLH3r0lsNovember 1,2022Chart ofAccountsTotal$ 1,623,000$5,200$5,200$2,000$3,706,366s2,045,089s1,661,277AssistList #*IX)H UseonlyBARS Statement of Work Cbafi of AeonntsRevenue LHJ Funding Period I'unding PeriodCode** StartDate End DateStartllrte EndDatcChart ofAccounts Program TitleFPHS-LHJ-Proviso (YR2)FPHS-LHJ-Proviso (YR2)FPHS-LHJ-Proviso (YR2)FPHS-LHJ-Proviso (YRl)YR24 SRF - Local Asst (l 5%) (FO-E) SSYR24 SRF - tocal Asst (15%) (FO-E) SSSanitary Survey Fees (FO-E) SS-StateSanitary Suwey Fees (FO-E) SS-StateYR24 SRF - Local Asst (15%) (FO-E) TAYR24 SRF - Local Asst (15%) (FO-E) TATOTALTotal consideration:GRANDTOTALFederal AwardIdentification #Amend #Amd 6Amd 7Amd 1Amd IAmd 4Amd IAmd 4Amd IAmd 4Amd IN/AN/AN/AN/A336.04.2s336.04.25336.04.25336.04.25o'1/01t2207t01/2207/01/22o1/01D206/30n306/30/2306t30/2306t30t22ffinLntunlnl07m1210ft|nlMBot23MBON3MBON3MBON3Amount$1,018,000($60s,000)$605,000$60s,000$ 1,600$3,600s l,600$3,600N/AN/AN/AN/AN/AN/A346.26.64 0lnlD2346.26 64 0r/0rD212/31/22 07t01Dtt2RU22 07t0y2lMBON3MBON3346.26.6s 01t01/22346.26.6s 01/01/22t2/31t22 07ntnl12t3tD2 07t0u2tMBOl23Ml30D3346.26.6s 0t/01/22346.26.65 01/01/2212/3U22 o7nt?l12/31/22 07t0v2l$2,000s3,706,366 $3,706,366GRAND TOTATTotal FedTotal State06,/30r23MBON3$ 1,000$ 1,000$3,673,389s32,977$3,706,366+Catalog of Federal Domestic Assistance**Federal revenue codes begin with "333". State revenue codes begin with "334"Page 2 of2