HomeMy WebLinkAbout2022-2024 Consolidated Contract Amendment 11Kittitas County
Review Form
Grants & Contract Agreement
Contract/G rant lnformation
Recommendation for Board of Health Review on
Department Head Signature:Director Date
(n L3
verification the contracting Agency is not suspended/Disbarred:
Today's Date
1.212s/2022 PA camas Request o,66LDb
Fund/Department
116-Public Health Agenda Date
Contract /Grant Agency: Consolidated Contract Amendment L1
Period Begin Date: O1..0L2O22 Period End Date: L2.31.2O24
Total Grant/Contract Amount: lncrease of S 25,878.00 for a revised maximum consideration of v53,732,244.00
Grant/Contract Number: CH131015
The Consolidated Contract Amendment L0 Amends Statements of Work for the following programs:
Amends the Statements of Work for the following programs:o DCHS - ELC COVTD-19 Response - Effective January 1",2022
o office of Drinking water Group B programs - Effective January i-,2022o office of lmmunization coVlD-19 Vaccine - Effective January L,2ozz
Exhibit B-l-0Allocations, attached and incorporated bythis reference, amends, and replaced Exhibit B-g
Allocation as follows:
o lncrease of 525,828.00 for a revised maximum consideration for 53,732,24q,00
Contract/G ra nt Su m mary
Kittitas County Prosecutor, Aud itor, and Board of Health Review and Comment:
APP FO
Signature of rosecu r's Offi Date
J
Signature of Auditor's ce Dat
Agency is not suspended/disbarred I Not Checked (reason)
Grant/Contract Review Page 1
Financial Information
Budget lnformation
Pass Throu lnformation
Prosecutor Review
Total Amou nt S25,878.00 State Funds S Federal Funds S25,878.00
Percentage County Funds 10O%Matching Funds $CFDA#
ln-Kind S
ls Equipment being purchased?Who owns equipment?
New Personnel bein hired?Contact HR hiri ortin requirements
Future impacts or liability to Kittitas County:
Budget Amendment Needed?Yes I attach budget form No E why not
Already BudgetedNew Division Created?
Revenue Code 61.2.39.27 .333.2L.02 / 67s.02.03.334.4.9 / 612.39.24.333.93. 268
Expense Code 5 1001,52001,50099
Agency to Pass Through
Amount to Pass Through Expense Code:
Sub-Contract Approved Date
Has the Prosecutor reviewed this agreement?Yes No
Auditor Facilities Maintenance
lnformation Services Human Resource
Prosecutor Treasurer
County Departments lm pacted
BOCC roval Needed?
Assign ment of Tracking I nformation
Auditor's Office
Human Resource
Prosecutor's Office
Who Signed the grant application
Yes I NoK
Staff Mem ber Presenting:
Reviewer Date
Grant/Contract Review Page 2
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31015 AMENDMENT NUMBER: 11
PURPOSE OF CIIANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter refened to as"DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT, a Local Health Jurisdiction, hereinafter refened
to as "LHJ", pnrsuant to the Modifications/Waivers clause, and to make uecessary changes within the scope of this
coutract and any snbsequent amendrnents 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 ou the DOH Finance SharePoint site in the Upload Center at the following URL:
httPs://stateofua,sharepoint.corn/sites/doh-ofsfundingresoulceVsitepaees/horne.aspx?:e l:9a9i688da2d94d3eag0^.7fb.32.4d7.
n Adds Statements of Wor.k for the following programs:
X Amends Statements of Work for tire following programs:
DCHS - ELC COVID-19 Response - Effective January 1,2022
office of Drinking water Group B progmms - Effective January 1,2022
Office of Immunization COVID-19 Vaccine - Effective January 1,2022
I Deletes Statements of Work for the following programs:
2. Exhibit B-11 Allocations, attached and incotpolated by this reference, amends and replaces Exhibit B-10 Allocations
as follows:
X Increase of $25.878 for a revised maximurn consideration of 53,732,244.
f, Decrease of _ for a revised rnaximum consideration of
I No change in the maximum consideration of _.
Exhibit B Allocations are attached only for infonnational purposes.
Unless designated othetwise helein, the effective date of this arnendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent arnendrnents remain in fulI force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof.
APPROVED AS TO FORM ONLY
Assistant Attorney General
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT STATE OF WASHINCTON
DEPARTMENT OF HEALTH
Signature:
(lalrau bp4en
.hdqtdiEuillhrdro!hrF!r!
Signature:
kru2aHwtlw
sr.idr k.ndki.n lrrn t6, lo2! D:zr pst
Date:
Jan 18, 2023
Date:
Jan 18, 2023
Page 1 of 1
EXHIBIT B-TIKittitas County Public Health Department ALLOCATIONSContract Termr 2022-2024Indirect Rate January l, 2022 through December 31, 2022:21o/o Public Health Dept & 15% Counfy Central SvcsDOH Use OntyBARS Statement of Work Chart of AccountsFederal AwardAssistChart of Accounts Program TitleIdentilication #Amend #List #{'Revenue LIIJ Funding Period Funding PeriodCode** Start Date End Date Start Date End DateContract Number:Date:FundingPeriodSubTotal929,934$37,008$2 I 7,3 t3s32.977s49,133s?o 40')$83,000$35,7 1 9qrt< rr($359,803$4,980$174q7 r?e$720,249$80,000$53,470$44,196$35,278$25,878$25,877cLH3t015December 1, 2022Chart ofAccountsTotal$66,942$217,3 l3$32,977$78,62s$83,000$35,71 99225,tLs$359,803$4,980sL74$7,238s720,249$133,470s79,474FFY23 IAR SNAP Ed Prog Mgnt-Region 2FFY22 IAR SNAP Ed Prog Mgnt-Region 2FFY22 LA.R SNAP Ed Prog Mgnt-Region 2FFY22 LA,R SNAP Ed Prog Mgnt-Region 2CSFRF CTS LHJ AllocationLHJ Vaccination ARPAFFY22 PHEP BP4 LHJ FundingFFY2I PHEP BP3 LHJ FundingFFY22 CDC EHC EHR SupplernentalFFY20 Envir Health Capacity{ (CDC) NCEFFY20 Envir Health Capaciry-C (CDC) NCECOVlDl9 VaccinesCOVIDI9 Vaccines R4FFY22 VFC OpsFFYI9 COITD CARESFFY19 ELC COVID Ed LHJ AllocationFFYI9 ELC COVID Ed LHJ AllocationFFYl9 ELC COVID Ed LHJ AllocationFFY20 ELC EDE LHJ AllocationFFY20 ELC EDE LHJ AllocationFFY22 Phys Actlty & Nutrition ProgFFY2] Phys Achty & Nutrition ProgFFY2I Phys Acwly & Nutrition ProgFFY23 MCHBG LHJ ContractsFFY22 MCHBG LHJ ContractsFFY22 MCHBG LHJ ContractsGFS-Group B (FO-E)GFS-Croup B (FO-E)NGA Not Received207WAWA5Q3903207WAWA5Q3903207WAWA5Q3903NGA Not RcceivedNGA Not ReceivedNU9OTP922043NU90TP922043NGA Not ReceivedNUEIEHOOl445NUE l EHOO I445NH23rP9226l9NH23tP9226l9NH23[P9226t9NU50CK0005 tsNU50CK0005l5NU50CK00051sNU50CK000515NU50CK000515NUs0cK000slsNGA Not ReceivedNUs8DP006504NU58DP006504NGA Not Received804MC45251B04MC452'tAmd 9Amd 7Amd 4Amd I.Amd 7Amd 2Amd2Amd IAmd 7Amd 4tund 2Amd 7,9Amd 2, 9Amd 7Amd 4tund IAmd 7Amd4Arnd IAmd 1lAmd I10.s6110.56 r10.56 I10.56109/30/2309130t2209t30/2209130/22r0/o1tzzt0/0v2t10/01/2rt0/0il2109/30/2309/30/2209/30/2209/30/2210118t22t0/1812210/18/22Amounts29,934($5,900)s r2,090$30,8 r 8333.10.56 10/01t22333.10.56 0U0U22333.r0.56 0U01/?2333. r0.56 0U0rt22Amd 5, 1l21.027 333.2t.02 0U0!22 06t30t23 0t/0v22 06/30/23Amd t02r.027 333.21.02 llt0t/22 06/30/23 nt0v22 06/30/23t0/r8t22 05/19/2010/t8t22 05^9t20t0/18122 05/19/20s2 17,3 l3s32,97'l$49, I 33qto 10at$83"000s14,'7 t9$2 I,000q))i ! )(s359,803$4,980$174$ 1,547($8,897)$14,588(934,24s)s7s4,494$80,000$r9,470s34,000$44,196$2,131$33,147$25,878$2s,877Amd 1,793.070 333.93.07 01/01122 t2t3v2z 09t01/20 t2/3v2293.069 333.93.06 07t0r/22 06/30/23 07t\v22 06/30/2393.069 333.93.06 07/01/22 06/30/22 07/O1/2t 06/30/2293.070 333.93.07 01t01/22 08t3t/22 o9/01t20 08/31t2293.070 333.93.07 01t01/22 08/31/22 09tOU20 08/31/22Amd 493.268 333.93.26 0t/0t/22 06/30124 07101t20 06/30/24Amd 193.268 333.93.26 0I/0U22 06/30/24 07/0v20 06BA/24Amd 393.268 333.93.26 0I/01/22 06/30/22 07tou2r 06/30/22Arnd 293.323 333.93.32 0r/0r/22 04/22t22 04/23t20 o7/31/2493.32393.32393.323333.93.32 01/01t22333.93.32 0t/01/22333.93.32 01t0112293.32393.32393.439 333.93.43 09/30/22 09/29t23 09/30/2293.439 333.93.43 0r/01t22 09/29/22 09t30/2193.439 333.93.43 0t/01/22 A9/29/22 09/30/21333.93.32 01/01t22 07t3U23 01/1s/2t 07/31/24333.93.32 01/01/22 07/3v23 0t/15/2r 07/31/2409/29/2309/29/2209/29/2293.99493.99493.994333.93.99 t0/0il22 0980n3333.93.99 0t/01t22 09/30t22333.93.99 01t01t22 09/30t22t0/0t/22l0/01/21l0/01/2109/30/2309/30/2209/30/22N/ANiAs34.04.90 0U0u23 06ts0t23 07/0U22 06/30/23334.04.90 01/0v22 06/30/22 07/0v2t 06/30/22Page I of2$51,755
EXHIBIT B.1IKittitas County Public Health Department ALLOC.A.TIONSContract Term: 2022-2024Indirect Rlte January 1,2022 through Decemb er 31,2022: 2lo/o Public Heatth Dept & 15% County Central SvcsI2/3t/22 07/01121t2/31/22 07t01/2rAmount$ 1,0 1 8,000($60s,000)$60s,000$605,000s 1,600$3,600$ 1,600$3,600$ r,000$ 1,000$3,732,244Contract Number:Date:FundingPeriodSubTotal$ 1,018.000$0$60s,000s5,200ss,200$2,000s3,732,244GRAND TOTAI,Total FedTotal StateCLII3IOI5December 1,2022Chart ofAccountsTotals I,623.000$5,200$5,200$2,000s3,732,244s2,04s,089$1,687,1s5Chart ofAccountsProgram TitleFederal AwardIdentitication #FPHS-LHJ-Proviso (YR2)FPHS-LHJ-Proviso (YR2 )FPHS-LHJ-Proviso (YR2)FPHS-LHJ-Proviso (YRl)YR24 SRF - Local Asst ( I 5%) (FO-E) SSYR24 SR-F - Local Asst (15%) (FO-E) SSSaritary Survey Fees (FO-E) SS-StateSadtary Survey Fees (FO-E) SS-StateYR24 SRI - Local Asst (15%) (fO-E) TAYR24 SRF - Local Asst (15%) (FO-E) TATOTALTotal consideration$3,706,366$25,878s3,732,244GRAND TOTAL*Catalog olFederal Domestic Assistance**Federal revenue codes begin with ,'333". State revenue codes begin with ,'334"AssistList #*EARSRevenueDOH Use OntyStatenrent of Work Chart of AccountsLHJ Funding Period Funding periodStart Date End Date Start Date End DateAmend #Amd 6Amd 7Amd 1Amd IAmd4Amd IAmd 4Amd IAmd 4Amd ICode**N/AN/AN/AN/A336.04.2s 07t0v22 06/30/23 07tOt/21336.04.25 07t0u2z 06t30t23 07t01/21336.04.25 07t0u22 06/30123 07/01/21336.04.25 01/01/22 06t30/22 07/01/2t06/30t2306/30t2306/30t2306/30123N/AN/A346.26.64 01/01/22346-26.64 AI|0U22t2/31t22 07/0t/21I2/31t22 07/01/2106/30t2306/30/23N/AN/A346.26.6s OLt0t/22346.26.65 01t01t22346.26.65 0U01/22346.26.65 0t/01/22t2/31t22 07/01/2112/31122 07/0t/2r06/30/2306/30t23N/AN/A06/30/2306/30t23Page2 of2