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LJUI.0 J,y„ G,, VC,upr, uj. +uoo9ao , ti! Jr-•4OVCy0D , -, , C , r0.4Dtl'F 10 <br />Freeze Exemption/Exception Request Form for Service <br />Contracts Under Directive 24-19 <br />DEPARTMENT OF Exemption/Exception requests REQUIRE Deputy Director's signature and approval <br />ECOLOGY <br />State of Washington BEFORE processing. <br />Instructions: Program completes this form and emails it to the Chief Financial Officer's Executive Assistant, <br />Chrystal Witham. Subject line: ECY Exemption/Exception Request Form, Program Name. <br />Request Information <br />Requesting Program/Office/Division: HWTR / ERO / PPA <br />Program Contact(s): <br />Name: Andrew Maher <br />Name: Elaine Snouwaert <br />Email: anma461 @ecy.wa.gov <br />Email: esno461@ecy.wa.gov <br />Service Contracts or Amendments Exemption/Exception Request <br />Exemption/Exception Information <br />This form seeks Service Contract exemption/exception under the following condition: <br />Related to the protection of life or public safety (Safety) <br />Tax collection or other revenue -generating activities (Tax/Rev) <br />Approved information technology projects (IT) <br />Emergency Contracts as defined in RCW 39.26.130 (Emergency) <br />0 Deputy Director approval for essential non-exempt Service Contracts (DD) <br />Contract Information <br />Contractor/Agency: Multiple Agencies throughout Washington State <br />New Contract: 17 Yes ❑ No <br />Total estimated cost of contract/amendment: $8,400,000 spread across 31 IAA / <br />Budget(s) used to fund this contract/amendment: 170perating <br />Fund Source Account Number: MTCA Funding 23N; 23P <br />Term of contract: July 1, 2025 - June 30, 2027 <br />WCapital ❑ Transportation <br />ECY Internal Form - Freeze Exemption/Exception Request Form for Service Contracts. Rev. 1/14/25 <br />