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G <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitai Couil!y <br />Public Health <br />Depa.tment <br />Today's Date:12t0412024 Legal Request #:\]*r t <br />Fun d/Depa rtment:'l11Oth of Mental Health Tax Agenda Date <br />f <br />Contract/Agreement Agency: Ellensburg School District <br />Contract/Agreernent Title: Providing Mental Health Services to the Students at Ellensburg School District <br />End Date: 1213112026Begin Date: 0110112025 <br />Contract/Agreement *: PHMH-01 0Total 5 Amount: $313,750.00 <br />Contract/Agreement Summ ary: <br />1/1gth funding to Ellensburg School districtto.contractwith a licensed mental health care <br />provider to provide mental health services to the students in Ellensburg School District. <br />Contra ent lnformation <br />lnformation <br />Pass lnformation <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract APProved Date <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />AP <br />l'sr.rr <br />Dater'sSignature ce <br />Dateof Auditor'ss <br />Revenue Code{s)105 - 560.3134000 <br />Expense Code(s)105 - 560.54101 <br />Agency is not suspendedldisbarred Not Checked (reason) <br />ADMIN Version: 0 Supersedes:0 Date Adopted: I2l or/2o24 Modified By: Katie Odiaga Approval By: Chelsey Loeffers