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!t <br />pocuSign Envelope lD: 248C4933-7876-4DAD-AF9C-6674F882D448 <br />THIS CONTRACT is made <br />County Sheriff, (Contractor) <br />by and between washington state Heatth care Authority, (HCA) and Kittitas <br />The parties signing below warrant that they have read and understand this Contract and have authority to <br />execute this Contract. This Contract will be binding on HCA only upon signature by both parties. <br />Washi <br />Hea <br />ngto <br />Irh <br />n State <br />Care thority <br />PROFESSIONAL SERVICES <br />CONTRACT for <br />MOUD in Jails <br />HCA Contract Number:K5885 <br />Resulting from Solicitation Number (lf <br />applicable: 2A21HCA42 <br />Contractor/Vendor Contract Number: <br />CONTRACTOR NAME <br />Kittitas County <br />CONTRACTO R DOrNc BUSTNESS AS (DBA) <br />Kittitas County Sheriff - Jail <br />Street <br />205 W 5rh Ave, Ste 1/Jail <br />City <br />Ellensburg <br />State <br />WA <br />Zip Code <br />98926 <br />CONTRACTOR CONTACT <br />Edward L. Buntin <br />CONTRACTOR TELEPHONE <br />509-962-7527 <br />coNTRAcroR E,MAIL ADDneSS <br />-edward. bu ntin@co.kift itas.wa. us <br />ls Contractor a Subrecipient under this Contract? <br />nvrs ENo <br />cFDA NUMBER(S) <br />N/A <br />FFATA Form Required <br />lYrs Xno <br />RAM <br />MOUD in Jails Program <br />HCA DIVISI <br />DBHR <br />HCA NAME AND <br />Rachel Meade, MOUD in Jails Program Administrator <br />HCA CONTACT <br />Health Care Authority <br />626 8th Avenue SE <br />PO Box 45330 <br />Olympia, WA 98504-5330 <br />HCA TELEPHONE <br />(360) 725-2009 <br />HCA CONTACT E.MAIL ADDRESS <br />rachel. meade@hca.wa.qov <br />DATE <br />March 1 ,2022 <br />CONTRACT <br />June 30, 2022 <br />END DATE TOTAL MAXIMUM <br />$271,035.00 <br />To develop and implement or continue to expand MouD in jails program <br />PURPOSE OF <br />IGNATURE <br />ete"" 'rry-cat- <br />PRINTED NAME AND TITLE <br />e.tj'r l4Y€lLt S4€lLt Ff <br />DATE SIGNED <br />3 -? -ar <br />HCA SI RE <br />tl"t lt- ]^--h- <br />PRINTED NAME AND TITLE <br />Rachelle Amerine <br />Contracts Administrator <br />DATE SIGNED <br />3t17t2022 <br />Rev 5/6/2019