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1-1 <br />Kittitas County Public Health A Kittitas County <br />Public Health <br />Contract/Agreement Review Form Department <br />Today's Date: <br />12/04/2024 <br />Legal Request #: <br />I i <br />Fund/Department: <br />1/10th of Mental Health Tax <br />Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Thorp School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Thorp School District <br />Begin Date: 01/01/2025 1 End Date: 12/31/2025 <br />Total $ Amount: $54,350.00 ✓ Contract/Agreement #: PHMH-008 <br />Contract/Agreement Summary: <br />1/10th 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 />APPROVEQ AS TO FORM: <br />.S"_ <br />Signatu of Pro ecutor's Offi Date <br />Signal re of Auditor's Oftfcd Date <br />Revenue Code(s): <br />105 - 560.3134000 <br />Expense Code(s): <br />105 - 560.54101 <br />❑� Agency is not suspended/disbarred I0Not <br />Checked (reason) <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />ADMIN Version: 0 1 Supersedes: 0 1 Date Adopted: 12/01/2024 1 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />