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Certificate Of Completion <br />Envelope Id: 03BADF22351A4319BF35EDC62D187726 Status: Completed <br />Subject: Please DocuSign: K5885-01 with Kittitas County Jail <br />Business Name: <br />Source Envelope: <br />Document Pages: 9 Signatures: 1 Envelope Originator: <br />Certificate Pages: 2 Initials: 0 MARY BETH SELLERS <br />AutoNav: Enabled <br />EnvelopeId Stamping: Enabled <br />Time Zone: (UTC-08:00) Pacific Time (US & Canada) <br />626 8th Ave SE <br />Olympia, WA 98501 <br />marybeth.sellers@hca.wa.gov <br />IP Address: 198.239.15.28 <br />Record Tracking <br />Status: Original <br /> 7/14/2022 1:14:15 PM <br />Holder: MARY BETH SELLERS <br /> marybeth.sellers@hca.wa.gov <br />Location: DocuSign <br />Signer Events Signature Timestamp <br />Rachelle Amerine <br />rachelle.amerine@hca.wa.gov <br />Contracts Administrator <br />CloudPWR OBO Washington State Health Care <br />Authority-Sub Account <br />Security Level: Email, Account Authentication <br />(None) <br />Signature Adoption: Pre-selected Style <br />Using IP Address: 147.55.194.42 <br />Sent: 7/14/2022 1:19:42 PM <br />Viewed: 7/19/2022 5:59:08 AM <br />Signed: 7/19/2022 6:00:01 AM <br />Electronic Record and Signature Disclosure: <br /> Not Offered via DocuSign <br />In Person Signer Events Signature Timestamp <br />Editor Delivery Events Status Timestamp <br />Agent Delivery Events Status Timestamp <br />Intermediary Delivery Events Status Timestamp <br />Certified Delivery Events Status Timestamp <br />Carbon Copy Events Status Timestamp <br />Rachel Meade <br />rachel.meade@hca.wa.gov <br />Security Level: Email, Account Authentication <br />(None) <br />Sent: 7/19/2022 6:00:02 AM <br />Electronic Record and Signature Disclosure: <br /> Not Offered via DocuSign <br />Sharrie McPherson <br />sharrie.mcpherson@co.kittitas.wa.us <br />Security Level: Email, Account Authentication <br />(None) <br />Sent: 7/19/2022 6:00:02 AM <br />Viewed: 7/19/2022 8:18:41 AM <br />Electronic Record and Signature Disclosure: <br /> Not Offered via DocuSign <br />HCA Financial Services <br />FINANCIALSVC@HCA.WA.GOV <br />Security Level: Email, Account Authentication <br />(None) <br />Sent: 7/19/2022 6:00:03 AM <br />Electronic Record and Signature Disclosure: