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I <br />Kittitas County Public Health A Kittitas County <br />Public Health <br />Contract/Agreement Review Form 0 11111111111105011,Department <br />Today's Date: 01/08/2025 I Legal Request#: � <br />Fund/Department: 1/10th of 1% Mental Health Tax I Agenda Date: <br />f'nntrart/APreement Information <br />Contract/Agreement Agency: Cle Elum-Roslyn School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Cie-Elum Roslyn School District <br />Begin Date: 01/01/2025 End Date: 12/31/2025 <br />Total $ Amount: $143,600 <br />Contract/Agreement Summary: <br />Contract/Agreement#: PHMH-011 <br />1110th 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 />APPROVED AS TO FORM: <br />of P rosetL&ri Off! cq4 Date <br />CI t r_ /•-2f•),T— <br />Signature of Auditor's O ice Date <br />Budget Information <br />Revenue Code(s): / 06 — 56 0. 313 (4,0 o 0 <br />Expense Code(s): /D S — s6o' _�-Ltl o I <br />11 Agency is not suspended/disbarred ❑ Not Checked (reason) <br />Pacc Thmugh Informatinn <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />ADMIN I Version: 0 1 supersedes: 0 1 Date Adopted: 12/01/2024 1 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers <br />