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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kltlita: Courty <br />Public Health <br />Oepartrnsn: <br />Today's Date:07122t25 f tegat Request#:11781 <br />Fund/Department:116-Public Health ffi Agenda Date: <br />Contract/ent lnformation <br />lnformation <br />Pass lnformation <br />Contract/Agreement Agency: AtWork! <br />contract/Agreement Title: Agreement for Services between KC and Atwork! <br />Begin Date: Upon Signature End Date: 09130126 <br />Total S Amount: $12,600.00 Contract/Agreement #: PHDD-005 <br />Co ntract/Agreement Su m ma ry: <br />The purpose of this agreement is to provide school to work seryices, per contractual <br />requirements of the Washington State Department of Vocational Rehabilitation including but not <br />limited to intake, assessment, job placement along with required deliverables. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office Date <br />Revenue Code(s):105 - 568.02.334.04.68 <br />Expense Code(s)105 - 568.02.54122 <br />M Rgency is not suspended/disbarred ! ruot Checked (reason) <br />Agency to PassThrough <br />Amount to Pass Through Expense Code <br />Sub-Contract Approved Date <br />ADMIN Version:0 Supersedes:0 Date Adopted : L2/ 0!/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers