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a <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />Public Health <br />Department <br />Today's Date:07123126 f legat Request#11781 <br />Fund/Department 116-Public Health I Agenda Date <br />Contract/lnformation <br />Contract/Agreement Agency: Elmview <br />Contract/Agreement Title: Agreement for Services between KC and Elmview <br />Begin Date: Upon Signature End Date: 09130126 <br />Contract/Agreement #: PHDD-007Total S Amount: 12,600.00 <br />Co ntract/Agreement Summa ry: <br />The purpose of this agreement is to provide school to work services, 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 />lnformation <br />Pass Th lnformation <br />105 - 568.02.334.04.68Revenue Code(s): <br />Expense Code(s)105 - 568.02.54122 <br />M ngency is not suspended/disbarred Not Checked (reason) <br />Agency to Pass Through <br />Amount to Pass Through Expense Code <br />Sub-Contract Approved Date <br />ADMIN Version:0 Supersedes: 0 Date Adopted : t2/ 0L / 2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers