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HomeMy WebLinkAboutCONSENT Youth tobacco and cannabis prevention 615 Sheridan Street Port Townsend, WA 98368 aefefison www.JeffersonCountyPublicHealth.org Public HealthConsent Agenda JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Josh Peters, County Administrator FROM: Apple Martine, Community Health Director Denise Banker, Community Health Division Director DATE: Ser4eYvv6-& /S� 2o2S- SUBJECT: Agenda Item — Professional Services Agreement with Kitsap Public Health District; July 1, 2025 — June 30, 2026; $77,000.00 STATEMENT OF ISSUE: Jefferson County Public Health is requesting Board approval of Professional Services Agreement with Kitsap Public Health District, to provide Youth Cannabis and Commercial Tobacco prevention in Jefferson County; July 1, 2025 — June 30, 2026; $77,000.00 ANALYSIS/STRATEGIC GOALS/PROS and CONS: The purpose of this ongoing contract is to extend the timeframe and adjust the funding to reflect fiscal period 2025-2026, as well as to update the statement of work. This agreement, for $77,000.00, is to pay for direct labor, direct material, and other direct costs. The other provisions of the Contract remain unchanged. FISCAL IMPACT/COST BENEFIT ANALYSIS: This agreement is funded by the Kitsap Public Health District through regional funding received from the WA State Department of Health. There is no impact to the General Fund. RECOMMENDATION: JCPH management request approval of the Professional Services Agreement with Kitsap Public Health District to provide Youth Cannabis and Commercial Tobacco prevention; July 1, 2025 — June 30, 2026; $77,000.00 REVIEWED BY: E174Z2 q/sa - Jos Peters, County Administrator Date Community Health Environmental Public Health Developmental Disabilities 360-385-9444 360-385-9400 (f) 360-379-4487 360-385-9401 (f) Always working for a safer and healthier community N-25-064 CONTRACT REVIEW FORM Clear Form (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: Kitsap Public Health District Contract No: N-25-064 Contract For: Prevention of Tobacco, Vapor... Youth "berm: 7/1/2025 - 6/30/2026 COUNTY DEPARTMENT: Jefferson County Public Health Contact Person: Denise Banker Contact Phone: X 438 • Contact email: debanker@co.jefferson.wa.us AMOUNT: $77,000.0o PROCESS: V Exempt from Bid Process Revenue: $77,000.00 Cooperative Purchase Expenditure: Competitive Sealed Bid Matching Funds Required: , Small Works Roster Sources(s) of Matching Funds Vendor List Bid Fund # 127 RFP or RFQ Munis Org/Obj 12756800 _ Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES COMPL W J 55.080 AND CHAPTER 42.23 RCW. CERTIFIED: N/A: ■ .__ Sept. 2, 2025 Signature Date STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL AGENCY. CERTIFIED: r N/A: Gc•. Sept. 2,2025 Signature Date STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche): Electronically approved by Risk Management on 9/4/2025. STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche): Electronically approved as to form by PAO on 9/4/2025. Thank you for the notes re non-standard language. Non-standard PSA language is acceptable. STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY(IF REQUIRED). STEP 6: CONTRACTOR SIGNS STEP 7: SUBMIT TO BOCC FOR APPROVAL 1 KPHD 2483 Page 1 of 12 PROFESSIONAL SERVICES AGREEMENT Between KITSAP PUBLIC HEALTH DISTRICT And JEFFERSON COUNTY PUBLIC HEALTH This Professional Services Agreement ("Agreement") is made and entered into between the Kitsap Public Health District, a Health District organized pursuant to chapter 70.46 Revised Code of Washington and Section 9.52 Kitsap County Code,hereinafter referred to as"District,"and Jefferson County Public Health, hereinafter referred to as "Subcontractor." The parties mutually agree as follows: I. Period of Performance: The period of performance of this Agreement shall begin July 1, 2025 and be completed no later than June 30, 2026, unless terminated sooner or extended as provided for herein. 2. Purpose: The District requires the expertise of this Subcontractor to develop and implement coordinated tobacco, vapor product, and marijuana intervention strategies to prevent and reduce commercial tobacco, vapor, and marijuana use by youth in Jefferson County. 3. Oualifications/Eligibility: Subcontractor shall have the qualifications necessary to successfully complete the objectives of this Agreement. The Subcontractor hereby affirms that he/she is eligible to work in the United States as set forth in the Immigration Reform and Control Act (IRCA). 4. Statement of Work and Budget: Subcontractor shall furnish the necessary personnel, equipment material,and/or services and otherwise do all things necessary for or incidental to the performance of the work set forth in ATTACHMENT A, attached hereto and incorporated herein. ATTACHMENT A contains the Scope of Work and Budget. 5. Compensation: This Agreement is funded by state funds. The District agrees to pay Subcontractor a total sum of$77,000 in state funds during this Agreement. The District shall reimburse Subcontractor for travel as applicable at the federally approved rate. Compensation will he based on invoices submitted by Subcontractor itemizing a detailed description of services performed per the agreed upon Scopes of Work and Budgets set forth respectively in ATTACHMENTS A. Subcontractor shall submit a Monthly Expenditure Report and Request for Reimbursement (Form A-19) invoice voucher, hereto attached and herein incorporated as ATTACHMENT B, to the District for payment. 6. Performance Requirements and Notices: The assigned District staff shall monitor the performance of this Agreement, approve billings submitted by Subcontractor,and determine the acceptability of any reports provided by Subcontractor. District staff shall provide and facilitate assistance and guidance to Subcontractor as necessary. The District reserves the right to conduct periodic performance and billing reviews after the execution of this Agreement in order to evaluate unspent/unclaimed funds.The District reserves for itself the authority to reallocate funding pending the outcome of such a review. JCPH:N-25-064 KPHD 2483 Page 2 of 12 Subcontractor shall send programmatic communications, such as reports, via the communication method established by the District.Formal notices pursuant to this Agreement shall be sent to the staff responsible for project coordination as follows: If to the District: If to the Subcontractor: Kitsap Public Health District Jefferson County Public Health Attn: Yolanda Fong Attn: Denise Banker 345 6th Street, Suite 300 615 Sheridan Street Bremerton, WA 98337 Port Townsend,WA 98368 (360) 728-2275 (360)385-9400 Yolanda.Fonaakitsappublichealth.org dbankerna co Jefferson.wa.us 7. Special Billing Requirements: Billings to the District shall be submitted no more frequently than every 30 days. and shall be quarterly at a minimum. Billings for services on a monthly fraction of the budget will not be accepted or approved.Billings shall be sent to: Kitsap Public Health District Melissa Laird 345 6th Street, Suite 300 Bremerton, WA 98337 (360) 728-2283 Authorized and allowable program expenditures will be reimbursed upon receipt and approval of the monthly A-19 must be provided to the District by the 20th of each month in order to receive reimbursement for the previous month.If the District does not receive the A-19 by the 20th of the month with the required deliverables, the District may withhold approval and payment at its discretion. The District will pay Subcontractor all allowable costs incurred as evidenced by proper invoice of Subcontractor submitted to the District on a timely basis, insofar as those allowable and allocable costs do not exceed the amount appropriated or otherwise available for such purposes as stated herein or in subsequent amendments. Backup documentation will be provided to the District with invoice.Backup documentation can include, but is not limited to: receipts, invoices, billing records,work orders,positive time and attendance records (timesheets),travel vouchers and accounting expense reports. Failure to provide the required information may result in nonpayment of invoices or termination of this Agreement. This is a subcontractor contract. All expenditures incurred,and reimbursements made for performance under this Agreement will be based on actual allowable costs.Costs can include direct labor,direct material,and other direct costs specific to the performance of activities or achievement of deliverables under this Agreement. Unexpended funds in each fiscal year may not be carried forward into the new budget period unless otherwise approved by the District. KPHD 2483 Page 3 of 12 Email submission of invoices, electronic reports, and deliverables is encouraged. However, original hardcopy of the A-19 is required and shall be mailed to the District. Upon expiration of this Agreement, any claim for payment not already made shall be submitted to the District within 20 days after the expiration date. 8. Independent Capacity: Subcontractor and its employees or agents who are engaged in the performance of this Agreement shall continue to be employees or agents of Subcontractor and shall not be considered to be employees or agents of the District for any purpose. 9. jtivitts in Data: Unless otherwise provided,data which originates from this Agreement shall be "works for hire" as defined by the U.S. Copyright act of 1976 and shall be owned by the District. Data shall include, but not limited to, reports, documents, pamphlets, advertisements,books, magazines, surveys, studies, computer programs, films, tapes, and/or sound reproductions. Ownership includes the right to copyright,patent,register, and the ability to transfer these rights. The District maintains all rights to the license to publish,translate, reproduce, modify,deliver, dispose of the data, and to authorize others to do so. 10. jademnification: Subcontractor shall defend, indemnify and hold the District, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the Subcontractor in performance of this Agreement, except for injuries and damages caused by the sole negligence of the District. However, that in the case of negligence of both the District and the Subcontractor, any damages allowed shall be levied in proportion to the percentage of negligence attributable to each party. Solely for the purposes of this provision, Subcontractor waives its immunity under Title 51 (Industrial Insurance) of the Revised Code of Washington and acknowledges that this waiver was mutually negotiated by the parties. This provision will survive the expiration or termination of this Agreement. 11. Insurance: Subcontractor shall procure and maintain for the duration of this Agreement, coverage against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Subcontractor, its agents, representatives,or employees. No Limitation. Subcontractor's maintenance of coverage as required by this Agreement shall not be construed to limit the liability of Subcontractor to the coverage provided by such coverage, or otherwise limit the District's recourse to any remedy available at law or in equity. A. Minimum Scope of Coverage Subcontractor shall obtain coverage of the types described below: 1. Automobile Liability coverage covering all owned, non-owned, hired and leased vehicles. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability coverage shall shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury.The District shall be named as an additional insured under KPHD 2483 Page 4 of 12 Subcontractor's Commercial General Liability coverage with respect to the work performed for the District. 3. Workers'Compensation coverage as required by the Industrial Insurance laws of the state of Washington. 4. Professional Liability coverage appropriate to the Subcontractor's profession. Subcontractor shall provide the District with proof of liability coverage or professional errors and omissions coverage as appropriate. B. Minimum Amounts of coverage Subcontractor shall maintain the following coverage limits: 1. Automobile Liability coverage with a minimum combined single limit for bodily injury and property damage of$1,000,000 per accident 2. Commercial General Liability coverage shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability coverage shall be written with limits no less than$1,000,000 per claim and$1,000,000 policy aggregate limit. C. Other Coverage Provisions The coverages are to contain, or be endorsed to contain, the following provisions for Automobile Liability, Professional Liability and Commercial General Liability coverage: 1. Subcontractor's coverage shall be primary coverage as respect the District. Any coverage maintained by the District shall be excess of Subcontractor's coverage and shall not contribute with it. 2. Subcontractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party,except after thirty(30)days prior written notice by certified mail,return receipt requested, has been given to the District. D. Acceptability of Coverage Subcontractor has a memorandum of liability coverage with the Washington Counties Risk Pool, which the District agrees is acceptable. E. Verification of Coverage Subcontractor shall furnish the District with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional coverage endorsement, evidencing the coverage requirements of Subcontractor before commencement of the work. F. Insurance Compliance: In the alternative,either party to this agreement may fulfill the insurance obligations contained herein by maintaining membership in a joint self-insurance program authorized by RCW 48.62.In this regard,the parties understand that the party to this agreement who is a member of such a program is not able to name the other party as an"additional insured"under the liability coverage provided by the joint-insurance program. 12. Safeguarding j Information and Privacy: The use or disclosure by any party of any KPHD 2483 Page 5 of 12 information concerning a client obtained in providing service under this Agreement shall be subject to Chapter 42.56 RCW and Chapter 70.02 RCW, as well as 45 CFR Parts 160 and 164 and any other applicable federal and state statutes and regulations. Personal information collected, used or acquired in connection with this Agreement shall be used solely for the purposes of this Agreement. Subcontractor agrees not to release, divulge, publish, transfer, sell or otherwise make known to unauthorized persons personal information without the express written consent of the agency or as provided by law. Subcontractor agrees to implement physical, electronic, and managerial safeguards to prevent unauthorized access to personal information.Any unauthorized access or use of confidential information must be reported to the District Privacy Officer at (360) 728-2232. The notification must be made in the most expedient time possible (usually within 24 hours of discovery) and without unreasonable delay, consistent with the legitimate needs of law enforcement, or any measures necessary to determine the scope of the breach and restore the reasonable integrity of the data system. The District reserves the right to monitor, audit, or investigate the use of personal information collected, used, or acquired by Subcontractor through this Agreement. The monitoring, auditing, or investigating may include but is not limited to "salting" by the District. Salting is the act of placing a record containing unique but false information in a database that can be used later to identify inappropriate disclosure of data contained in the database. Subcontractor shall certify the return or destruction of all personal information upon expiration of this Agreement. 13. Records Retention and Inspection: The parties to this Agreement shall each maintain books, records, documents, and other evidence which sufficiently and properly reflect all direct and indirect costs expended by either party in the performance of the services described herein. These records shall be subject to the inspection, review or audit by personnel of both parties, other personnel duly authorized by either party, the Office of the State Auditor, and federal officials so authorized by law. All books, records, documents, and other material relevant to this Agreement will be retained for six years after expiration and the Office of the State Auditor, federal auditors, and any persons duly authorized by the parties shall have full access and the right to examine any of these materials during this period. Records and other documents, in any medium, furnished by one party to this Agreement to the other party, will remain the property of the furnishing party, unless otherwise agreed. The receiving party will not disclose or make available this material to any third parties without first giving notice to the furnishing party and giving that party a reasonable opportunity to respond. Each party will utilize reasonable security procedures and protections to assure that records and documents provided by the other party are not erroneously disclosed to third parties. 14. Written Policies and Procedure/Documents on File: Written policies and procedures, consistent with federal and state regulations, as applicable, will be kept on file in the office of the Subcontractor and available for review at the request of District staff. Such policies and procedures will include, but not be limited to, as appropriate: A. Job Descriptions B. Confidentiality Policy C. Community Needs Assessment D. 5-Year Regional Strategic Plan (includes biennial work plan) KPHD 2483 Page 6 of 12 Special Instructions: a. Subcontractor must conduct criminal background checks for those staff, volunteer, contractor, or subcontractor working directly with youth (ages 0- 17). b. Subcontractor must prohibit any staff,volunteer,contractor,or subcontractor with a felony conviction related to their duties from supervising and interacting with minors while performing the duties of this Agreement. This requirement is consistent with existing RCW 9.96A.020. In addition, Subcontractor will keep on file and make available for review by District staff documents consistent with federal and state regulations that will include but are not limited to the latest agency audit and Subcontractor agreements. Subcontractor will include these requirements in all approved subcontracts. 15. Required Reports: Subcontractor will submit required reports using required forms according to procedures issued by the District. Subcontractor will be obligated to submit required reports after the close of the contract period, during the transfer of obligations to another contractor, or upon termination of the contract for any reason. Subcontractor will include all requirements listed above in all approved subcontracts. Due dates outside the Budget Period are for reporting only. Subcontractor may not bill for work done outside the Budget Period. 16. Statutory and Regulatory Compliance: Subcontractor shall comply with all applicable federal, state,and local laws,regulations,guidelines,and standards in the performance of this Agreement. 17. Compliance with_State and Federal Confidentiality Laws: Subcontractor shall not use protected health information created or shared under this Agreement in any manner that would constitute a violation of RCW 70.02, RCW 42.56,the Health Information Portability and Accountability Act, commonly known as HIPAA, or any regulations enacted pursuant to its provisions. 18. ,Suspension_of Performance and Resumption of Performance: In the event contract funding from state,federal,or other sources is withdrawn, reduced,or limited in any way after the effective date of this Agreement and prior to normal completion,the District may give notice to Subcontractor to suspend performance as an alternative to termination. The District may elect to give written notice to Subcontractor to suspend performance when the District determines that there is a reasonable likelihood that the funding insufficiency may be resolved in a timeframe that would allow performance to be resumed prior to the end date of this Agreement. Notice may occur by facsimile or email to Subcontractor's representative. Subcontractor shall suspend performance on the date stated in the written notice to suspend. During the period of suspension of performance, each party may inform the other party of any conditions that may reasonably affect the potential for resumption of performance. KPHD 2483 Page 7 of 12 When the District determines that the funding insufficiency is resolved,the District may give Subcontractor written notice to resume performance and a proposed date to resume performance. Upon receipt of written notice to resume performance, Subcontractor will give written notice to the District as to whether it can resume performance, and if so,the date upon which it agrees to resume performance. If Subcontractor gives notice to the District that it cannot resume performance, the parties agree that this Agreement will be terminated retroactive to the original date of termination. If the date Subcontractor gives notice it can resume performance is not acceptable to the District,the parties agree to discuss an alternative acceptable date. If an alternative date is not acceptable to the District, the parties agree that this Agreement will be terminated retroactive to the original date of termination. 19. Non-Discrimination: Subcontractor shall not discriminate against any employee or applicant for employment because of race, color, sex,religion, national origin, creed, marital status, age, Vietnam era or disabled veteran status, sexual preference, or the presence of any sensory mental or physical handicap. 20. Waiver: A failure by either party to exercise its rights under this Agreement shall not preclude that party from subsequent exercise of such rights and shall not constitute a waiver of any other rights under his Agreement unless stated to be such in writing, signed by an authorized representative of the party and attached to the original Agreement. 21. Assignment: The work to be provided under this Agreement and any claim arising thereunder, is not assignable or delegable by either party in whole or in part without the express prior written consent of the District, which consent shall not be unreasonably withheld. 22. Amendments and Changes in Work: This Agreement may be modified only by a written amendment executed by authorized representatives of both parties. In the event of any errors or omissions by Subcontractor in the performance for any work required under this Agreement, Subcontractor will make all necessary corrections without additional compensation. All work submitted by Subcontractor will be certified by Subcontractor and checked by Subcontractor for errors and omissions. Subcontractor will continue to be responsible for the accuracy of work even after the work is accepted by the District. 23. Termination: This Agreement may be terminated by either party upon giving at least 30 days advance written notice to the other party. If this Agreement is so terminated, the parties shall be liable only for performance rendered or costs incurred in accordance with the terms of this Agreement prior to the effective date of termination. 24. Termination for Cause: If for any cause, either party does not fulfill in a timely and proper manner its obligations under this Agreement, or if either party violates any of these terms and conditions, the aggrieved party will give the other party written notice of such failure or violation.The responsible party will be given the opportunity to correct the violation or failure within 15 working days. If the failure or violation is not corrected, this Agreement may be terminated immediately by written notice of the aggrieved part to the other. KPHD 2483 Page 8 of 12 25. Termination for Funding:If funding for this Agreement or matter is withdrawn, reduced or limited in any way after this Agreement is signed or becomes effective,the Parties may summarily terminate this Agreement notwithstanding any other termination provision in this Agreement. Termination under his provision will be effective upon the date specified in the written notice of termination. No costs incurred after the effective date of the termination will be paid. 26. Choice of Law: This Agreement is entered into pursuant to and under the authority granted by the laws of the State of Washington and applicable federal laws,both as to its interpretation and performance. The provisions of this Agreement shall be construed to conform to those laws.Any action at law, suit in equity, or judicial proceeding arising out of this Agreement shall be instituted and maintained only in any of the courts of competent jurisdiction in Kitsap County, Washington. 27. Dispute Resolution: In the event that a dispute or conflict arises under this Agreement that the Parties are unable to resolve with good faith efforts, they shall allow the dispute to be decided by a Dispute Panel in the following manner: A Mediator shall be mutually appointed by both parties,and each party shall appoint an additional member to the Dispute Panel. The Dispute Panel shall review the facts, contract terms and applicable statutes and rules and make a determination of the dispute. The determination of the Dispute Panel shall be final and binding on the Parties hereto. The Parties shall equally share the costs, if any, for the services of the Dispute Panel. 28. $everability: If any provision of this Agreement or any provision of any document incorporated by reference shall be held invalid, such invalidity shall not affect the other provisions of this Agreement which can be given effect without the invalid provision, if such remainder conforms to the requirements of applicable law and the fundamental purpose of this Agreement, and to this end the provisions of this Agreement are declared to be severable. 29, Survival: Those provisions of this Agreement that by their sense and purpose should survive expiration or termination of this Agreement shall so survive.Those provisions include,but are not necessarily limited to,the following: Indemnification,Termination, Disputes, Confidentiality, Choice of Law, Waiver, Records Inspection and Retention, and Severability. 30. Subcontracting: Subcontractor shall not enter into subcontracts for any of the work contemplated under his Agreement without prior written approval of the District. In no event shall the existence of the subcontract operate to release or reduce the liability of Subcontractor to the Department for any breach in the performance of Subcontractor's duties. This clause does not include contracts of employment between Subcontractor and personnel assigned to work under this Agreement. Subcontractor is responsible for ensuring that all terms,.conditions, assurances and certifications set forth in this Agreement are carried forward to any subcontracts. Subcontractor agrees not to release, divulge, publish, transfer, sell or otherwise make known to unauthorized persons personal information without the express written consent of the District or as provided by law. If at any time during the progress of the work,the District determines in its sole judgment that any contractor is incompetent,the District shall notify Subcontractor, and Subcontractor shall take immediate steps to terminate its Subcontractor's involvement in the work.The rejection or approval by the District of any Subcontractor or the termination of a Subcontractor shall not relieve Subcontractor of any of its responsibilities under this Agreement, nor be the basis for additional charges to the District. KPHD 2483 Page 9 of 12 31. Entire Agreement: This Agreement constitutes the entire agreement between the parties regarding its subject matter. Any oral or written representations not expressly incorporated in this Agreement are specifically excluded. KITSAP PUBLIC HEALTH DISTRICT BOARD OF COUNTY COMMISSIONERS JEFFERSON COUNTY, WASHINGTON YoGan'lan 1• Ynlanda mnng(Sop 7,7075 1 77 PDT) Heidi Eisenhour, Chair Date Yolanda Fong,Administrator ATTEST: Carolyn Galloway, Clerk of the Board APPROVED S TO FORM: 2272 for 09/04/2025 Philip C.Hunsucker, Date Chief Civil Deputy Prosecuting Attorney Funding Source Program: CH Contract/Grant: DOH CON CON CLH32054 (KPHD 2441) KPHD 2483 Page 10 of 12 ATTACHMENT A-SCOPE OF WORK AND BUDGET Jefferson County Public Health July 1,2025- June 30,2026 As a subrecipient of KPHD under the Washington Department of Health funded Youth Cannabis & Commercial Tobacco Prevention Program (YCCTPP), Jefferson County Public Health agrees to the following activities funded in full or part by the associated budget. Activity Coordinate and maintain the Olympic Prevention Partnership steering Planning& committee and network. Coordination of • Invite new community partners to join the Olympic Prevention Regional Partnership Steering Committee. Network • Attend regional networking meetings as outlined by the regional lead (June 2025 - June 2026) 2025-2026 Strategies for Youth Cannabis & Commercial Tobacco Prevention: • Social Norms: Media&Health Communications • Youth Empowerment&Engagement Implementation • Decision-maker Engagement • Policy,System, Environmental Changes Specific Jefferson County activities are described in the 2025-2026 YCCTPP workplan. Please refer to the workplan for guidance on which activities fall under each funding source. Workplans are subject to change. Any changes will be approved by both parties. Monitor progress for each activity as appropriate; submit monthly Monitoring and narrative and data reports as requested by KPHD on the 5th of every Reporting month. By February 1, 2026, report progress to CTPP Regional Coordinator. If Midterm needed, adjust activities to ensure spend down. Conduct a mid-year Evaluation workplan re-evaluation. Participate in monthly conference call with KPHD and attend webinars as scheduled; respond to correspondences related to CTPP from the Calls/Meetings Department of Health; respond to activity assessments/surveys administered by KPHD as appropriate per scope of work. Submit monthly invoices by the 20th of the month following the month in which costs were incurred, except for the Final Expenditure Report and Invoicing Request for Reimbursement in each federal fiscal year (due July 1, 2025). Invoices must include supporting documentation such as timecards for staff time and copies of invoices paid for goods and services. KPHD 2483 Page 11 of 12 Budget July 1,2025 -June 30,2026 DCA Cost Description Staffing costs $22,425 Staff salaries + indirect WSPHA conference $2,700 1 JCPH staff and 3 students attend WSPHA to present JC Prevention Summit $1,500 Rental, AV, and snacks Seattle Prey Summit $200 1 JCPH and 3 students attend Seattle prevention summit Mini grants $8,850 Mini grants for youth serving organizations in rural JC General travel, Booth registration fees for County picnic tabling event and etc. $2,825 general travel for activities Total Jefferson $38,500 NAPE Cost Description Staffing costs $22,424 Staff salaries + indirect Peer to Peer $16,076 Training 20+ students to teach prevention classes. Includes program rental for training, stipends, prizes for classroom, and end of year report activity. Total Jefferson $38,500 Funding Source Chart of Accounts Program Name or Title BARS Code 7/1/25- 6/30/26 SFY26 DEDICATED CANNABIS ACCOUNT (DCA) 334.04.93 $38,500 SFY26 NICOTINE ADDICT PREV & ED PRO (NAPE) 334.04.93 $38,500 Total to Jefferson = $77,000 KPHD 2483 Page 12 of 12 FORM STATE OF WASHINGTON Attachment B Page A-11 A 19-IA INVOICE VOUCHER (Rev.1/91) T AGENCY NO. LOCATION CODE P.R.OR AUTH NO. AGENCY NAME INSTRUCTION TO VENDOR OR CLAIMANT Submit this form to claim payment for materials,merchandise or services. Kitsap Public Health District Show complete detail for each item. Attn:Melissa Laird 345 6th St,Suite 300 VENDOR'S CERTIFICATE.I hereby certify under penalty Bremerton, WA 98337-1866 of perjury that the items and totals listed herein are proper charges for materials,merchandise or services furnished to the State of Washington,and that allgoods furnished and/or services rendered have been provided without VENDOR OR CLAIMANT(Warrant is to be payable to) discrimination on the grounds of race,creed,color, national origin,sex,or age. BY (DATE) FEDERAL1.D.NO.ORSOCIALSECURITY NO RECEIVED BY DATE RECEIVED UNIT FOR AGENCY DATE DESCRIPTION QUANTITY UNIT PRICE AMOUNT USE Services provided in performance of contract Billing period' to Total Tobacco Expenses YMPEP Expenses TOTAL DUE: $ - PREPARED BY TELEPHONE NUMBER DATE AGENCY APPROVAL DATE DOC.DATE PMT DUE DATE CURRENT DOC.NO. REF.DOC.NO. VENDOR NUMBER VENDOR MESSAGEIUSETAX UBI NUMBER REF M MASTERINDEX SUB WKCLAS COUNT CITY ' AMOUNT INVOICE NUMBER DOC TRANI 0 FUND APPN PROGRAM SUB SUB ORG BDGT SUB PRO. SUF CODE D INDEX INDEX OBJ INDEX ALLOC UNIT MOS PRJT PROJ PH ACCOUNTING APPROVAL FOR PAYMENT DATE WARRANT TOTAL WARRANT NO.