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Kittitas County
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Review Form
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Grants & Contract Agreement
Today's Date Agenda Date
January 30, 2023 February 21, 2023
Fund/Department
30 / Sheriff
Contract/Grant Information
Contract /Grant Agency: Public Safety Psychological Services
Period Begin Date: March 3, 2023
Federal Funds $0
Period End Date: March 3, 2024
Total Grant/Contract Amount: Variable
Grant/Contract Number: SH23-003
Contract/Grant Summary: This agreement is between Kittitas County and Public Safety Psychological
Services for conducting fitness -for -duty evaluations, conducting psychological evaluations of applicants
for employment or reserve service, and preparing and conveying reports of psychological findings and
applicant evaluations for the Kittitas County Sheriff's Office.
Financial Information
Total Amount = Variable
State Funds $0
Federal Funds $0
Percentage County Funds 100%
Matching Funds $0
CFDA# NA
Expense Code
In -Kind $0
Explain
Is Equipment being purchased? NO
I Who owns equipment?
New Personnel being hired? NO
I Contact HR hiring — NA
Future impacts or liability to Kittitas County: Vendor to carry full insurance per contract.
Budget Information
Budget Amendment Needed?
Yes ❑ attach budget form
NoEN Why not—Already budgeted
New Division Created? NO
Revenue Code NA
Date:
Expense Code
Object code 4101
Pass Through Information
Agency to Pass Through
NA
Amount to Pass Through
$0
Sub -Contract Approved
Date:
Grant/Contract Review Page 1
Prosecutor Review
Has the Prosecutor reviewed this agreement? Yes nX No ❑ CAMAS# 55304
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature:
Date: ,2 -13-13
Department: She iff
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office
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Who Signed the grant application
L
Reviewer =1Date
Grant/Contract Review Page 2