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Kittitas CountY <br />Review Form <br />Grants & Contract Agreement <br />Contract/G ra nt I nformation <br />Recomm endation for Board of Health Review on <br />Department Head Signature Director Date <br />L( <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Today's Date <br />0 212024 <br />PBK Request #:ID'D I <br />Fund/Department <br />1L6-Public Health <br />Agenda ort", rf [ ] <br />Contract /G rant AgencY:PSA Between KCPHD and Ability Employment Services <br />Period End Date: 06130/2024Period Begin Date: 03/01/2024 <br />Total Grant/Contract Amount: Compensation is based on actual services provided and is subject to <br />fun <br />Grant/Contract Number: DD-24-0002 <br />Contract/G ra nt Su m m a rY: <br />The professional services agreement is to establish a subcontracted employment and day services <br />provider for people with developmental disabilities in Kittitas county per the county's responsibilities <br />outlined in attachments' <br />Kittitas County Prosecutor, Auditor, and Boa rd of Health Review and Comment: <br />APPROVE D AS TO FORM <br />ll zq <br />Sign ure of P se r's Office Date <br />aft4 <br />si re of Audi s Office Date <br />! Not Checked (reason)Agency is not suspended/disbarred <br />L.L\, Tq. <br />Grant/Contract Review Page 1