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a <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />Public Health <br />Department <br />Today's Date 01t08t2025 ffi Legal Request# <br />Fund/Department 1/1Oth of 1% Mental Health Tax ptil ngenda Oate 7 t,?5 <br />Contra ent lnformation <br />Bu lnformation <br />Pass Th lnformation <br />Contract/Agreement Agency: Cle Elum-Roslyn School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Cle-Elum Roslyn School District <br />Begin Date: 011O112025 End Date: 1213112025 <br />Total S Amount: $143,600 Contract/Agreement *: PHMH-01 1 <br />Contract/Agreement Summary: <br />1/1Oth funding to Cle Elum -Roslyn School District to provide mental health services to the <br />students in Cle Elum-Roslyn School District. <br />Kittitas County Prosecutor and Auditor Review and Comment <br />P DAS F <br />.r )/'/7-*S <br />Siff aturd of Prosefuto /; offi! <br />A-r-- u4^ €u,o:- <br />Date <br />| 'J t')s- <br />Signature of Auditor's Otfite Date <br />Revenue Code(s)l05 - 5L0.Vr3qooo <br />Expense Code(s)(o; -s60. 9\t ot <br />f ngency is not suspended/disbarred Not Checked (reason) <br />Agency to Pass Through <br />Amount to Pass Through Expense Code <br />Sub-Contract Approved Date <br />ADMIN Version: 0 Supersedes: 0 Date Adopted : 72 / O7/2O2a Modified By: Katie Odiaga Approval By: Chelsey Loeffers