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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />ContracUGrant I nformation <br />Recommen dation for Board of Health Review on <br />Verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />ust 1 2022 PA Camas Request #: <br />Fund/Department <br />'l 16-Public Heatth Agenda Date <br />Co ntra ct /Grant SAP nbetweeAge SKittita cncy:ou and oThnty Sch ol0 D istrictrp <br />riPe do Be n Dat Aue 1ust 2022 Period End Date; Ju 31 2023Total Grant/Contract Amount: g12 ,500.00 <br />Grant/Contract Number: <br />Cont ract/G ntra Summa ry <br />eTh P SA S e stabl ished to uS rt D-COVI I1pp recove nd dry advan heace Ith u for heqitv ighflskUorndeerSrvedtons.lat eThpopu wil lizeuti nrojectp on n-cli cal tn terve tontions add rCSShavbeoraItheaconhrncerSlaetotedD-COVI oI aAS d d ressed on 6th mState nte of Wo rk. <br />DateDepartment Head Signature: <br />Kittitas Co unty Prosecutor , Auditor, and Board of Health Revi ew and Comment: <br />R <br />Signature of Prosecutor's Office Date <br />S ignature of Auditor's Office Date <br />tr Agency i s not suspended/d isbarred tl Not Checked (reason) <br />Financial lnformation <br />P rofess i on,a I Se rvices Ag ree me nt (r ev . 0g I 24 I 20 1 g) <br />Page 1 of 20