Laserfiche WebLink
Washinglon Slate <br />Department of social <br />& Health services <br />Transforming lives <br />DSHS Agreement Number <br />COUNTY PROGRAM AGREEMENT , 2463-57835 <br />STW Program Development <br />This Program Agreement is by and between the State of Washington <br />Department of Social and Health Services (DSHS) and the County identified <br />below, and is issued in conjunction with a County and DSHS Agreement On <br />General Terms and Conditions, which is incorporated by reference. <br />DSHS AD -MINISTRATION DSHS DIVISION DSHS INDEX NUK <br />Division of Vocational Division of Vocational 1225 <br />RRhabi litati on Rehabilitation <br />D5HS CONTACT NAME AND <br />Austin Diaz -Munoz <br />Contracts Specialist <br />DSHS CONTACT TELEPHONE <br />(564) 200-2812 <br />COUN7YNAME <br />Kittitas County <br />COUNTY <br />NUMBER <br />DSHS CONTACT AC <br />4565 7th Ave SE <br />Lacey. WA 98503 <br />DSHS CONTACT FAX DSHS <br />C.iick here to enter text. Austi <br />COUNTY ADDRESS <br />507 North Nanum Street Suite 102 <br />Ellensburg, WA 98926-2886 <br />COUNTY CONTACT NAME <br />Chelsey Loeffers <br />Administration or Division <br />Agreement Number <br />County Agreement Number <br />DSHS CONTRACT CODE <br />850OCC-63 <br />)NTACT EMAIL <br />lin7U L mmF0dshs.wa. aoU <br />CONTACT E-MAIL <br />509) 962-7515 509 962-7581 _.._._ loefiers ca.kittitas.wa.us <br />IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM ASSISTANCE LISTING NUMBERS <br />AGREEMENT? <br />No <br />PROGRAM AGREEMENT START DATE PROGRAM AGREEMENT END DATE MAXIMUM <br />00 GRAM AGREEMENT AMOUNT <br />08/01 /2024 03/31 /2025 <br />EXHIBITS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this <br />County Program Agreement by reference: <br />M Exhibits (specify): Exhibit A - Data Security Requirements Exhibit B - Estimated Bi-Annual Budget <br />FJ No Exhibits. <br />The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive <br />understanding between the parties superseding and merging all previous agreements, writings, and communications. oral <br />or otherwise, regarding the subject matter of this Contract The parties signing below represent that they have read and <br />understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DSHS only <br />u on si nature b DSHS. DAT�(S) SICINI.❑ <br />COUNTY SIGNATURES PRINTED N�''E(S) AND T1TLE(S <br />C.��eL�-� CAP U /l7� <br />l L <br />DSHS SIGNATURE <br />LlL- YL <br />TELEPHONE COUNTY CONTACT FAX <br />N <br />PRINTED NAME AND TITLE r�C, C DATE SIGNED <br />�JsS "n ID60 1'V�,yf1c .�t1► ��� 13 �� <br />DSHS Central Contract Services Page 1 <br />6017CF County Program Agreement (10-31-2017) <br />