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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G rant I nformation <br />Recommendation for Board of Health Review on <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />70/2A/202L PA Camas Request #: 5296L <br />Fund/Department <br />116-Public Health Agenda Date: ft{ a /;f <br />Contract /Grant Agency: Ellensburg United Methodist Church <br />Period Begin Date: O4IOLIZO2L Period End Date: 0313112022 <br />Total Grant/Contract Amount: $3,300 total <br />Grant/Contract Number <br />r Rental agreement for Classroom 2 of the Ellensburg United Methodist Church to be used by <br />KCPHD for the Nexus Project. <br />o Amendment extends the end date of the agreement until March ZI,2OZZ. <br />Contract/Grant Summa ry: <br />ure:Department Head Sig 2q /) <br />L?Director Date <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />/.{ .r*ro, <br />1"')l t\ <br />Sign ature of s Office Date <br />Sign itor's Office Date <br />E Agency is not suspended/disbarred ! Not Checked (reason) <br />Grant/Contract Review Page 1