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O docusign <br />Gertificab Of ComPletion <br />Envelope ld : F24ED3D0-D4DG499A-9588-1 246949365D1 <br />Subject: Complete with Docusign: Kittitas- DRF Backfill SFY 2026 Contract pdf <br />Division: <br />Community Services and Housing <br />Program: chg <br />ContractN umbe r: 26-461 O8-207 <br />DocumentType: Contract <br />Source Envelope: <br />Document Pages: 15 Signatures: 2 <br />Certificate Pages: 5 lnitials: 2 <br />AutoNav: Enabled <br />Envelopeld Stamping: Enabled <br />Time Zone: (UTC-08:00) Pacific Time (US & Canada) <br />Record Traeking <br />Status: Original <br />81412025 1:49:01 PM <br />Security Appliance Status: Connected <br />Storage Appliance Status: Connected <br />Signer Events <br />Julie Montgomery <br />julie. montgomery@commerce.wa. gov <br />Washington State Department of Commerce <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via Docusign <br />Kathy Kinard <br />Kathy. Kinard@commerce.wa. gov <br />Managing Director <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure <br />Not Offered via Docusign <br />Chelsey Loeffers <br />Chelsey.loeffers@co.kittitas.wa. us <br />Public Health Director <br />Security Level : Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 81512025 8:07:46 AM <br />I D: e4927969-d all-46e1 -bb2o-Zdcc29eaca78 <br />Ho[der: Esmeralda Zavala-Montalvo <br />esmeralda.zavala-montalvo@commerce.wa.gov <br />Pool: StateLocal <br />Pool: Washington State Department of Commerce <br />Signature <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 147.55.149.237 <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 147.55.149.143 <br />Status: Completed <br />Envelope Originator: <br />Esmeralda Zavala-Montalvo <br />1011 Plum Street SE <br />MS 42525 <br />Olympia, WA 98504-2525 <br />esmeralda.zavala-montalvo@commerce.wa gov <br />lP Address: 1 98.238.75.1 63 <br />Location: DocuSign <br />Location: Docusign <br />Timestamp <br />Sent: 8/4/2025 1 :58:10 PM <br />Viewed: 81412025 3:30:23 PM <br />Signed: 8/4/2025 3:30:42 PM <br />Sent: 8/4/2025 3:30:43 PM <br />Viewed: 81412025 4:05:41 PM <br />Signed: 8/4/2025 4:06:39 PM <br />Sent: 8/5/2025 8:01:20 AM <br />Viewed: 81512025 B:07:46 AM <br />Signed: 91212O25 1 2:36:43 PM <br />B <br />G <br />Gr*il (/,ffi"\ <br />Signature Adoption: Pre-selected Style <br />Using lP Address: 66.243.254.18 <br />CEc..F