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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 />Department Head Signature Date:2-I <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Today's Date <br />7 <br />PBK# 10957 <br />Fund/Department <br />116-Public Health <br />Agenda Date: I I tq l0Ll <br />Contract /Grant Agenda: PSA between Kittitas County and HopeSource <br />Shelter <br />for 2024-2025 Cold Weather <br />Period End Date: O3l3t/2O25Period Begin Date : 09 /ot/2o24 <br />Total Grant/Contract Amount: S178,989.30 <br />Grant/Contract Number <br />Contract/G ra nt Su m ma ry: <br />The pSA between KC and HopeSource is established forthe implementation of the Cold Weather Shelter <br />for Kittitas County from November L5, 2124,to March L5,2024. The agreement outlines and includes <br />the following: <br />o General Conditions * l*.,-.t DRF sr'gpcr-l- <br />Kktz-s Grun &\r scope of work lt S,8'rt Atloco-f or' +oWqatw1n*' u <br />o Compensation lq, t 8.1 <br />r Cold Weather Shelter P ram Guide <br />$ t.lg, qSl ,3a T" Ffef€.5c:cevt-(- <br />o Proof of lnsurance <br />o Washington State Dept. of Commerce Guidelines <br />r Reporting Form <br />Kitti unty Prosecutor, Auditor, and Board of Health Review and comment: <br />DAST <br />si gn reofP or's Date <br />L <br />Sign re of Aud Office Date <br />! Not Checked (reason)E Agency is not suspended/disbarred <br />Grant/Contract Review Page L