Laserfiche WebLink
Docusign Envelope lD: CCD36BBF-645D-4579-9C75-F803991 1CF89 <br />CONTRACTOR SIGNATURE REQUIRED <br />TITLE: <br />sHrLt Ft= <br />DATE: <br />r- t 7 -/-r <br />Washington State <br />Health Care Authority <br />SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL: <br />PLETGE ALSO PRINT OR TYPE NAME <br />€t /1Y /14Y8-1L'J <br />ORGANIZATION NAME: (if applicable) <br />K t rrtTt? 9 €oqfirY S//EAaFFt g 6fFt <5: <br />23 HCA Contract#K7843