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9 <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Today's Date: 05/05/25 Legal Request #: 11551 <br />Fund/Department: 116- Public Health Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: HopeSource Capital Improvement Project <br />/{ Kittitas County <br />r Public Health <br />Contract/Agreement Title: PSA between HopeSource and Kittitas County Amendment 3 <br />Begin Date: 07/15/2021 End Date: 12/31/2026 <br />Total $ Amount: $750,000.00 Contract/Agreement #: <br />Contract/Agreement Summary: <br />Department <br />The PSA amendment between HopeSource and Kittitas County is established for distribution of <br />homelessness surcharge funds awarded up to $750,000.00 and will be used solely for the <br />purposes described in the original contract exhibit A (attached). <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS TO FORM_ <br />Signature of P(osecutorts Office <br />Signature of Auditor's <br />Date <br />Budget Information <br />Revenue Code(s): 112-1120231327/34126 and 114-34127-3412701-3412702 <br />Expense Code(s): 1 114 and 112-54101 <br />Agency is not suspended/disbarred <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through L <br />Sub -Contract Approved Date: <br />Not Checked (reason) <br />Expense Code: <br />-J."5- - as <br />5 -d- ( s <br />ADMIN I Version: 0 Supersedes: 0 Date Adopted: 12/01/2024 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers <br />