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Service Agreement #19-33 <br />between <br />WALLA WALLA COUNTY DEPARTMENT OF COMMUNITY HEALTH <br />and <br />KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT <br />The Agreement is entered into by and between Walla Walla County Department of Community <br />Health, hereinafter "County," and Kittitas County Public Health Department, hereinafter <br />"Contractor," for services relative to the Youth Marijuana Prevention and Education Program as <br />outlined in the attached Statement of Work. The rights and obligations of both parties are <br />governed by the General Terms and Conditions, and the following Exhibits, copies of which are <br />attached hereto and incorporated herein by this reference as fully as if set forth herein: <br />Exhibit A — Statement of Work <br />Exhibit B — Budget <br />Exhibit C — Contractor Certification Form <br />Exhibit D — Contractor Report Form <br />Performance Period: The terms of this Agreement shall commence on July 1, 2019, and shall, <br />unless terminated or renewed as provided elsewhere in the Agreement, <br />terminate on June 30, 2020. <br />Compensation: Payment to Contractor for services rendered under this Agreement shall be <br />as set forth in Exhibit B — Budget. The amount of payment for the <br />performance period of this Agreement shall not exceed $10,000. <br />By their signatures below, the parties agree to the terms and conditions of this Agreement and all <br />documents incorporated by reference. The parties signing below certify that they are authorized <br />to sign this Agreement. <br />IN WITNESS WHEREOF, the parties hereto have signed this Agreement. <br />COUNTY: <br />f - yul L -4 l <br />eghan DeBolt, A/MPH Date <br />Director <br />Department of Community Health <br />314 W. Main <br />P.O. Box 1753 <br />Walla Walla, WA 99362 <br />Phone: (509) 524-2650 Fax: (509) 524-2642 <br />CONTRACTOR: <br />a. J2AVI <br />Au[ orixeed By ate <br />" VI <br />TristA Lamb, Administrator <br />Print Name & Title of Person Signing <br />Telephone Number / Email Address: 509.962.7515 <br />Mailing Address (Street address required in addition to PO Box.): 507 N. Nanum, # 102 <br />CFDA# (if applicable): <br />Ellensburg, WA 98926 <br />Social Security or Business Tax ID#: 91-6001349 <br />UBI#: 192002673 <br />State Industrial Account ID # (if applicable): <br />004.093-00 <br />#19-33 GT&C.KITTITAS COUNTY PUBLIC HEALTH DEPT.YR 3.YMPEP Page 1 of 11 <br />