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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />Public Health <br />Department <br />Today's Date 05t05t25 Legal Request #:55 111 <br />Fund/Department 1 16- Public Health Agenda Date: <br />Contract/Agreement I nformation <br />Bu lnformation <br />Contract/Agreement Agency: HopeSource Ca pital I m provement Project <br />Contract/Agreement Title: PSA between HopeSource and Kittitas County Amendment 3 <br />Begin Date: 0711512021 End Date: 1213112026 <br />Total S Amount: $750,000.00 Contract/Agreement #: <br />Contract/Agreement Su m m a ry: <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 />PP AS TO FORM <br />.<-/s'J5 <br />Signatur"e-o'fpGiecutorhoffice / <br />A*"/^hn <br />Date <br />f'+t)r <br />Signature of Auditor's Offic'e Date <br />1 1 2-1 1 20231 327 I 34 126 a nd 1 1 4 -341 27 -34 1 27 0 1 -341 27 02Revenue Code(s) <br />Expense Code(s):114 and 112-54101 <br />Not Checked (reason)fl ngency is not suspended/disbarred <br />Agency to Pass Through <br />Expense CodeAmount to Pass Through <br />Sub-Contract Approved Date: <br />Pass Thro lnformation <br />roval By: Chelsey LoeffersADMINVersion: 0 Supersedes: 0 Date Adopted | 72/0I/2024 Modified Katie Odi