Laserfiche WebLink
3 <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas Caunty <br />Public Health <br />Departmeflt <br />Today's Date:01t0812025 [,, <br />'l <br />Leeal Request #I\?QtP <br />Fund/Department:1/'1Oth of 1% Mental freaftfr fax [' ; .l Agenda Date <br />Contract/lnformation <br />Contract/Agreement Agency: Cle Elum-Roslyn School District <br />Districtle-Eluc SchoolnmthetoatStudentsMentaIthHeaServicesRoslyleTitProvidContramentngct/Agree <br />End Date: 1213112025Begin Date: U|A12O25 <br />Contract/Agreement *: PHMH-01 1Total S Amount: $1 43,600 <br />Co ntract/Agreem ent Summa rY: <br />1/1gth funding to Cle Elum -Roslyn School District to provide mental health services to the <br />students in Cle Elum-Roslyn School District. <br />Date <br />I 'J t.){- <br />Kittitas Gounty Prosecutor and Auditor Review and Comment: <br />-2{ <br />Signatu of <br />R <br />r's offi <br />DateSignature of Auditor's ce <br />lnformation <br />Pass Through lnformation <br />Revenue Code(s)105 - 5C0.Vt3Ltoao <br />Expense Code{s}/o! -€60' 9vt o1 <br />Agency is not suspended/disbarred Not Checked (reason) <br />Agency to Pass Through <br />Expense CodeAmount to Pass Through <br />Sub-Contract Approved Date <br />ADMIN Version:0 Supersedes: 0 Date Adopted : L?./OL/2924 Modified By: Katie Odiaga Approval By: ChelseY Loeffers