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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittiia5 Cou.ty <br />Public Health <br />Depd{t!nett <br />Today's Date:1210412024 f Legat Request#:\ \ i_l- <br />Fund/Department:1/1Oth of Mental Health fax I Agenda Date <br />Contract/ment lnformation <br />Bu lnformation <br />Pass lnformation <br />Contract/Agreement Agency: Kittitas School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students in Kittitas School District <br />End Date: 1213112025Begin Date: O1lO1l2O25 <br />Contract/Agreement *: P H M H-007Total$ Amount: $83,734.00 / <br />Contract/Agreem ent Summa ry: <br />1i1Oth funding to Kittitas School district to contract with a licensed mental health care provider to <br />provide mental health services to the students in Kittitas School District. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APP <br />/- /7 -2 5- <br />Signat of s Date <br />/ ) r,;> t- <br />Date <br />Revenue Code(s)105 - 560.3134000 <br />Expense Code(s)105 - 560.54101 <br />fl ruot Checked (reason)Agency is not suspended/disbarred <br />Agency to Pass Through <br />Expense Code:Amount to Pass Through <br />Sub-Contract Approved Date <br />ADMIN Version:0 Supersedes: 0 Date Adopted : 72/Ou2O24 Modified By: Katie Odiaga Approval By: Chelsey Loeffers