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Wash ingtoa Stale <br />COUN1 <br />rDepartment of Social <br />l & Health Services <br />ST <br />Transforming lives <br />This Program Agreement is by and betty <br />Department of Social and Health Servic( <br />below, and is issued in conjunction with <br />General Terms and Conditions, which is <br />DSHS ADMINISTRATION DSHS DIMS <br />Division of Vocational Division of <br />Rehabilitation Rehabilita <br />DSHS CONTACT NAMF1 AND TITLE <br />Austin Diaz -Munoz <br />Contracts Specialist <br />DSHS CONTACT TELEPHONE D, <br />564 200-2812 CI <br />COUNTY NAME <br />Kittitas County <br />COUNTY FEDERAL. EMPLOYER IDENTIFICATION <br />NUMBER <br />COUNTY CONTACT TELEPHONE C( <br />509) 962-7515 5 <br />IS THE COUNTY ASUBRECIPIENT FOR PURPOSE! <br />AGREEMENT? <br />No <br />PROGRAM AGREEMENT START DATE PROG <br />08/01 /2024 1 03131 <br />EXHIBITS. When the box below is marked <br />County Program Agreement by reference_ <br />® Exhibits (specify): Exhibit A - Data S <br />❑ No Exhibits. <br />The terms and conditions of this Contract a <br />understanding between the parties superse <br />or otherwise, regarding the subject matter ( <br />understand this Contract, and have the autl <br />u on si nature b DSHS. <br />COUNTY SIGNATURE(S) <br />DSHS SIGNATURE <br />DSHS Central Contract Services <br />6017CF County Program Agreement (10-31-2017) <br />DSHS Agreement Number <br />Y PROGRAM AGREEMENT 2463-57835 <br />W Program Development <br />een the State of Washington <br />Is (DSHS) and the County identified <br />a County and DSHS Agreement On <br />incorporated by reference. <br />Vocational 1225 <br />ion <br />DSHS CONTACT ADDRESS <br />4565 7th Ave SE <br />Administration or Division <br />Agreement Number <br />County Agreement Number <br />DSHS CONTRACT CODE <br />850OCC-63 <br />Lacey, WA 98503 <br />HS CONTACT FAX OSHS COI <br />ck here to enter text. Austin.D <br />COUNTY ADDRESS <br />507 North Nanum Street Suite 102 <br />Ellensburg, WA 98926-2886 <br />COUNTY CONTACT NAME <br />Chelsey Loeffers <br />)UNTY CONTACT FAX COUNTY CONTACT E-MAIL <br />a9 962-7581 1 Chelsey.loeffers@co.kittitas.wa.us <br />i OF THIS PROGRAM ASSISTANCE LISTING NUMBERS <br />RAM AGREEMENT END DATE MAXIMUM PROGRAM AGREEMEN I AMUUN 1 <br />/2025 $101.700.00 <br />with an X, the following Exhibits are attached and are incorporated into this <br />3curity Requirements Exhibit B - Estimated Bi-Annual Budget <br />-e an integration and representation of the final, entire and exclusive <br />ding and merging all previous agreements, writings, and communications, oral <br />f this Contract. The parties signing below represent that they have read and <br />lority to execute this Contract. This Contract shall be binding on DSHS only <br />PRINTED IVC. � r� (vu i i s L_etal *e rS <br />CIA <br />0�7,(2H <br />PRINTED NAME AND TITLE DATE SIGNED <br />Page 1 <br />