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ATTACHMENT "E'' <br />DSHS <br />WASdINIGTCN STATE <br />Department ofSoalal <br />and Health Seruices <br />COUNTY <br />PROGRAM AGREEMENT <br />DDA County Services <br />DSHS Agreement Number <br />2563-6431 0 <br />Th Progra m Agreement IS by an d betwee n th State of Wash ngton Depa rtm e nt of <br />Socialand Health Services (DSHS) <br />conjunction with a CountY and DSH <br />which is incorporated by reference. <br />an d th e Cou nty iden tified below nd IS issued in <br />S Agreement o n Gene la I Terms an d Con d tion s, <br />Administration or Division <br />Agreement Number <br />County Agreement Number <br />DSHS ADMINISTRATION <br />Developmental Disabilities <br />Admin <br />DSHS DIVISION <br />Division of Developmental <br />Disabilities <br />DSHS INDEX NUMBER <br />1225 <br />DSHS CONTRACT CODE <br />1769CS-63 <br />DSHS CONTACT NAME AND TITLE <br />Seanna Woodard <br />Operations Manager <br />DSHS CONTACT ADDRESS <br />1611 W lndiana Ave <br />Sookane, WA 99205 <br />DSHS TELEPHONE DSHS CONTACT DSHS CONTACT <br />329-2952 509 8-3037 wood wa.OV <br />U NAME ADDRESS <br />Kittitas County <br />Kittitas County DDA County Services <br />507 N NANUM ST STE 102 <br />Ellensbu wA 98926 <br />UNTY FEDEML EM NTIFICATION CONTACT NAME <br />NUMBER <br />Kasey Knutson <br />COUNTY TELEPHONE <br />(509) 962-7090 <br />COUNTY CONTACT FAX <br />(509) 962-5883 <br />COUNTY CONTACT E.MAIL <br />kasev. kn utson@co. kittitas.wa. us <br />IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM <br />AGREEMENT? <br />No <br />ASSISTANCE LISTING NUMBERS <br />PROGRAM AGREEMENT START DATE <br />07t01t2025 <br />AGREEMENT END DATE <br />06t30t2026 <br />AMOUNTMAXIMUM PROGRAM AGREEMENT <br />$1,123,083.00 <br />EXHIBITS. The following Exhibits are attached Exhibit A - Data Security Requirements; Exhibit B -Budget and <br />Spendinq Plan <br />By their signatu res below, the parties agree to the terms and conditi ons of this County Program Agreement and all <br />documents incorporated by reference. No other understandings or representations,oral or otherwise, regarding the <br />subject matter of this Program Agreement shall be deemed to exist or bind the parties The parties signing below certifY <br />that they are authorized to sign this P ram nt. <br />COUNTY SIGNATURE(S)PRINTED NAME(S) AND TITLE(S)DATE(S)SIGNED <br />DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED <br />DSHS Central Contract Services <br />1 769CS County Agreement (05-06-2025) <br />Page 1