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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kitlita5 Couirly <br />Pulolic Health <br />Department <br />Today's Date 12t04t2024 ffi Legal Request #:lllJ-Dt n <br />Fund/Department 1/1Oth of Mental Health Tax ffi Agenda Date: <br />Contract/Agreement I nformation <br />Bu lnformation <br />Pass Th h lnformation <br />Contract/Agreement Agency: Thorp School District <br />Contract/Agreement Title: Providing Mental Health services to the students at Thorp school District <br />End Date: 1213112025Begin Date: 0110112025 <br />Contract/Agreement *: PH M H-008TotalS Amount: $54,350.00 '/ <br />Contract/Agreement Summa rY: <br />1/1oth funding to Thorp School district to contract with a licensed mental health care provider to <br />provide mental health services to the students in Thorp School District. <br />Kittitas County Prosecutor and Auditor Review and Comment <br />)/,J( <br />eutor'sofgn <br />Dateof Auditor'sSignat <br />Revenue Code(s)105 - 560.3134000 <br />Expense Code(s)105 - 560.54101 <br />Agency is not suspended/disbarred Not Checked (reason) <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 : 721 ot / 2O2a Modified By: Katie Odiaga Approval By: Chelsey Loeffers