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UUL,U,IIy. II GI Ivrlupu ILl. 4U00.4D01 J (Jr-40UL-.700 I - I I C I ro-tov-} 10 <br />CONTRACT FACE SHEET <br />For Internal Routing Use <br />D E PART N ENi OF (Instructions on Instructions Tab) <br />ECOLOGY <br />6 <br />Type: Contract <br />CGP System #: <br />Contract#: C2500178 <br />Amendment #: <br />Work Assignment M <br />Contractor Statewide Vendor - SWV #: <br />SWV0010475-07 <br />EIN: <br />Contractor Name: <br />Kittitas County Public Health <br />Contract Title / Description / Bid M <br />Pollution Prevention Assistance (PPA) - technical assistance and education outreach to small businesses. <br />Program: <br />MOO-HWTR <br />Project Officer: <br />Andrew Maher <br />Phone: 509-329-3612 <br />Secondary Project Officer (i.e., Budget Analyst): <br />Ellen Hafer <br />Phone: 564-233-8638 <br />Staff completed DES Contract Training <br />Yes <br />(check all that apply) <br />❑1 Goads/Services RCW 39.26 <br />❑ Decision to Contract <br />n Interagency RCW 39.34 <br />I —I DES State Contract # <br />❑ IT RCW 39.26 <br />❑ Competitive Bid # <br />F-I Public Works RCW 39.04 <br />I —I Sole Source # <br />Arch./Eng. RCW 39.80 <br />❑ Direct Buy <br />❑ Other: <br />OWMBE: (check all that apply) <br />❑ OMWBE <br />n WA Small Bus. <br />I-1 WA Veteran Bus. <br />Subcontractor: <br />❑ Uses Sub Contractor <br />AMENDMENT: (check all that apply) <br />❑ Time Extension <br />❑ Increase <br />❑ Decrease <br />Amount of Amendment: <br />❑ Other: <br />Total of Contract after <br />Amendments: <br />TERM: <br />Start Date: <br />7/1/2025 <br />End Date: <br />6/30/2027 <br />How To Encumber and Disburse: <br />Program Budget Manager Completes <br />Contract Cost: <br />$ 125,608.84 <br />Sales Tax (PW only): <br />$ <br />Total Eligible Cost: <br />$ 125,608.84 <br />Required information: <br />MIC (8 char) Fund/EAI Project - Sub-Proj <br />9M997D10 23N/D10 <br />(Required for Single -year Operating Appropriations & <br />contracts extending beyond current biennium) <br />Prior Bien's <br />Current BI <br />FY: 2026 <br />Current BI <br />FY: 2027 <br />Totals <br />62,804.42 <br />62,804.42 <br />125,608.84 <br />Fiscal Staff: <br />BudgetTatal $ 125,608.84 <br />Budget Total must equal Total Eligible Cost <br />Federally Funded? No Federal Amount $ <br />IGL: <br />Subsidiary: <br />Misc: <br />Remarks: <br />Mark T. Gaffney (signed electronically) 6/23/2025 CZ <br />Fiscal / Contracts Approval Date Sub -Object <br />717, Giz61Z6?s <br />Program Budget Manager Approvai Date <br />ECY 010-53 Rev 2/2024 <br />