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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />Public Health <br />Department <br />Fund/Department: <br />Today's Date <br />1 16-Public Health [,'il ngenOa oate <br />07t21t2025 [i'i'l regar Request #:11 777 <br />Total S Amount: lncrease of 56,419. for new max 2,448,030.0o <br />Begin Date: 0110112025 <br />Contract/Agreement Summary: <br />The Consolidated Contract Amendment 4 <br />Adds Statements of Work for the following programs: <br />lnfectious Disease Syndemic Prevention Services-SSP- Effective July 1,2025 <br />Office of Drinking Water Group B Program-Effective July 1 ,2025 <br />Amends Statements of Work for the following programs: <br />Office of Drinking Water Group A Program-Effective January 1,2025 <br />Exhibit B-4 Allocations, attached and incorporated by this reference, amends and replaces <br />Exhibit B-3 Allocations as follows: <br />lncrease e of $56,419.00 for a revised maximum consideration of $2,448,030.00. <br />Contract/Agreement #: CLH32055 <br />End Date: 1213112027 <br />Contract/Agreement Title: Consolidated Contract Amendment 4 <br />Contract/Agreement Agency: Department of Health <br />Cont ent Information <br />Budget lnformation <br />I ngency is not suspended/disbarred <br />Expense Code(s) <br />Revenue Code(s)61 2.40.03.334. 04. I 1 I 61 5.02.3.334.04.09 I 61 5.02.2.346.26.64 <br />Not Checked (reason) <br />Pass Through lnformation <br />Sub-Contract Approved Date: <br />Amount to Pass Through <br />Agency to Pass Through <br />Expense Code: <br />Signature of Auditor's Office <br />Sign at u re-of <br />-P <br />rdsecuto r's Qff i ie 4 <br />a4L "-r,e <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />/'er' 25 <br />Date <br />Date <br />?4( z* <br />ADMIN Version: 0 Supersedes: 0 Date Adopted : t2/ o!/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers