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Home My WebLink AboutCon Con Amendment 11Kittitas County Review Form Grants &Contract Agreement Today's Date PA Camas Request #:12/29/2022 Fund/Department Agenda Date:116-Public Health Contract/Grant Information Contract /Grant Agency:Consolidated Contract Amendment 11 Period Begin Date:01.01.2022 Period End Date:12.31.2024 Total Grant/Contract Amount:Increase of $25,878.00 for a revised maximum consideration of $3,732,244.00 rant/Contract Number:CHL31015 Contract/Grant Summary: The Consolidated Contract Amendment 10 Amends Statements of Work for the following programs: Amends the Statements of Work for the following Programs: •DCHS -ELC COVID-19 Response -Effective January 1,2022 •Office of Drinking Water Group B Programs -Effective January 1,2022 •Office of Immunization COVID-19 Vaccine -Effective January 1,2022 Exhibit B-10 Allocations,attached and incorporated by this reference,amends,and replaced Exhibit B-8 Allocation as follows: •Increase of $25,878.00 for a revised maximum consideration for $3,732,244.00 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 O Not Checked (reason) Grant/Contract Review Page 1 Financial Information Total Amount $25,878.00 State Funds $Federal Funds $25,878.00 rcentage County Funds 100%Matching Funds $CFDA# 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?Yes attach budgetform No why not New Division created?Already Budgeted Revenue Code 612.39.27.333.21.02 /615.02.03.334.4.9|612.39.24.333.93.268 Expense Code 51001,52001,50098 Pass Through Information Agency to Pass Through ount to Pass Through Expense Code: Sub-Contract Approved Date: Prosecutor Review Hanhe Prosecutor reviewed this agreement?Yes No County Departments Impacted Auditor Facilities Maintenance Information Servici Human Resource Prosecutor Treasurer BOCC Approval Needed? Yes No [X] Staff Member Presenting: Assignment of Tracking Information 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 2022-2024 CONSOLIDATED CONTRACT CONTRACT NUMBER:CLH31015 AMENDMENT NUMBER:11 PURPOSE OF CHANGE:To amend this contract between the DEPARTMENT OF HEALTH hereinafterreferred to as "DOH",and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT,a Local Health Jurisdiction,hereinafterreferred 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: I.Exhibit A Statements of Work,includes the following statements of work,which are incorporatedby this reference and located on the DOH Finance SharePoint site in the Upload Center at the following URL: https://starcofwa.sharepointcom/sites/doh-ofstimdineresources/sitepaucs/home.aspx?-cl:9a94688da2d94d3caS0ac7tbc32e4d7c Adds Statements of Work for the following programs: Amends Statements of Work for the following programs: DCHS -ELC COVID-19 Response -Effective January 1,2022 Office of Drinking Water Group B Programs -Effective January 1,2022 Office of Immunization COVID-19 Vaccine -Effective January 1,2022 Deletes Statements of Work for the following programs: 2.Exhibit B-11 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-10 Allocations as follows: Increase of $25,878 for a revised maximum consideration of $3,732,244. Decrease of for a revised maximum consideration of 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/her signature in execution thereof. STATE OF WASHINGTONKITTITASCOUNTYPUBLICHEALTHDEPARTMENTDEPARTMENTOFHEALTH Signature:Signature: Date:Date: APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of 1 EXHIBITB-11KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:December1,2022IndirectRateJanuary1,2022throughDecember31,2022:21%PublicHealthDept&15%CountyCentralSvcsDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentification#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalTotalFFY23IARSNAPEdProgMgnt-Region2NGANotReceivedAmd910.561333.10.5610/01/2209/30/2310/01/2209/30/23$29,934$29,934566,942FFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd710.561333.10.5601/01/2209/30/2210/01/2109/30/22(55,900)537,008FFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903Amd410.561333.10.5601/01/2209/30/2210/01/2109/30/22$12,090FFY22IARSNAPEdProgMgnt-Region2207WAWA5Q3903AmdI10.561333.10.5601/01/2209/30/2210/01/2109/30/22530,818CSFRFCTSLHJAllocationNGANotReceivedAmd5,1121.027333.21.0201/01/2206/30/2301/01/2206/30/23$217,313$217,31352l7,313LHJVaccinationARPANGANotReceivedAmd1021.027333.21.0211/01/2206/30/2311/01/2206/30/23$32,977$32,977$32,977FFY22PHEPBP4LHJFundingNU90TP922043Amd793.069333.93.0607/01/2206/30/2307/01/2206/30/23549,133$49,133$78,625FFY21PHEPBP3LHJFundingNU90TP922043Amd293.069333.93.0601/01/2206/30/2207/01/2106/30/22529,492$29,492FFY22CDCEHCEHRSupplementalNGANotReceivedAmdl,793.070333.93.0701/01/2212/31/2209/01/2012/31/22$83,000$83,000$83,000FFY20EnvirHealthCapacity-C(CDC)NCENUElEH001445Amd293.070333.93.0701/01/2208/31/2209/01/2008/31/22$14,719$35,719$35,719FFY20EnvirHealthCapacity-C(CDC)NCENUElEHOOl445Amd193.070333.93.0701/01/2208/31/2209/01/2008/31/22$21,000COVIDI9VaccinesNH23TP922619Amd493.268333.93.2601/01/2206/30/2407/01/2006/30/245225,125$225,125$225,125COVIDl9VaccinesR4NH23IP922619Amd193.268333.93.2601/01/2206/30/2407/01/2006/30/24$359,803$359,803$359,803FFY22VFCOpsNH23IP922619Amd393.268333.93.2601/01/2206/30/2207/01/2106/30/22$4,980$4,980$4,980FFYl9COVIDCARESNU50CK000515Amd293.323333.93.3201/01/2204/22/2204/23/2007/31/2451745174$174FFYl9ELCCOVIDEdLHJAllocationNU50CKOOO5l5Amd793.323333.93.3201/01/2210/18/2205/19/2010/18/22$1,54757,23857,238FFYl9ELCCOVIDEdLHJAllocationNU50CKOOO515Amd493.323333.93.3201/01/2210/18/2205/19/2010/18/22($8,897)FFYl9ELCCOVIDEdLHJAllocationNU50CK000515Amd293.323333.93.3201/01/2210/18/2205/19/2010/18/22$14,588FFY20ELCEDELHJAllocationNU50CK000515Amd7,993.323333.93.3201/01/2207/31/2301/15/2107/31/24($34,245)$720,249$720,249FFY20ELCEDELHJAllocationNU50CKOOO515Amd2,993.323333.93.3201/01/2207/31/2301/15/2107/31/24$754,494FFY22PhysActvty&NutritionProgNGANotReceivedAmd793.439333.93.4309/30/2209/29/2309/30/2209/29/23$80,000580,0005133,470FFY21PhysActvty&NutritionProgNU58DPOO6504Amd493.43933393.4301/01/2209/29/2209/30/2109/29/22$19,470$53,470FFY21PhysActvty&NutritionProgNUS8DP006504Amd193.439333.93.4301/01/2209/29/2209/30/2109/29/22$34,000FFY23MCHBGLHJContractsNGANotReceivedAmd793.994333.93.9910/01/2209/30/2310/01/2209/30/23$44,196$44,196579,474FFY22MCHBGLHJContractsB04MC4525lAmd493.994333.93.9901/01/2209/30/2210/01/2109/30/22$2,131535,278FFY22MCHBGLHJContractsBO4MC4525LAmdl93.994333.93.9901/01/2209/30/2210/01/2109/30/22$33,147GFS-GroupB(FO-E)Amd11N/A334.04.9001/01/2306/30/2307/01/2206/30/23$25,878$25,878$51,755GFS-GroupB(FO-E)Amd1N/A334.04.9001/01/2206/30/2207/01/2106/30/22525,877$25,877Page1of2 EXHIBITB-11KittitasCountyPublicHealthDepartmentALLOCATIONSContractNumber:CLH31015ContractTerm:2022-2024Date:December1,2022IndirectRateJanuary1,2022throughDecember31,2022:21%PublicHealthDept&15%CountyCentralSvcsDOHUseOnlyBARSStatementofWorkChartofAccountsFundingChartofFederalAwardAssistRevenueLHJFundingPeriodFundingPeriodPeriodAccountsChartofAccountsProgramTitleIdentification#Amend#List#*Code**StartDateEndDateStartDateEndDateAmountSubTotalTotalFPHS-LHJ-Proviso(YR2)Amd6N/A336.04.2507/01/2206/30/2307/01/2106/30/23$1,018,000$1,018,000$1,623,000FPHS-LHJ-Proviso(YR2)Amd7N/A336.04.2507/01/2206/30/2307/01/2106/30/23($605,000)$0FPHS-LHJ-Proviso(YR2)Amd1N/A336.04.2507/01/2206/30/2307/01/2106/30/23$605,000FPHS-LHJ-Proviso(YRI)Amd1N/A336.04.2501/01/2206/30/2207/01/2106/30/23$605,000$605,000YR24SRF-LocalAsst(15%)(FO-E)SSAmd4N/A346.26.6401/01/2212/31/2207/01/2106/30/23$1,600$5,200$5,200YR24SRF-LocalAsst(15%)(FO-E)SSAmd1N/A346.26.6401/01/2212/31/2207/01/2106/30/23$3,600SanitarySurveyFees(FO-E)SS-StateAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,600$5,200$5,200SanitarySurveyFees(FO-E)SS-StateAmd1N/A346.26.6501/01/2212/31/2207/01/2106/30/23$3,600YR24SRF-LocalAsst(l5%)(FO-E)TAAmd4N/A346.26.6501/01/2212/31/2207/01/2106/30/2351,000$2,000$2,000YR24SRF-LocalAsst(15%)(FO-E)TAAmd1N/A346.26.6501/01/2212/31/2207/01/2106/30/23$1,000TOTAL$3,732,244$3,732,244Totalconsideration:$3,706,366GRANDTOTA1$3,732,244$25,878GRANDTOTAL$3,732,244TotalFed$2,045,089TotalState$1,687,155*CatalogofFederalDomesticAssistance**Federalrevenuecodesbeginwith"333".Staterevenuecodesbeginwith"334".Page2of2