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Kittitas County Public Health <br />Contract/Agreement Review Form <br />n <br />.r' i <br />1. $, <br />Kitliin:r C{rrrrlty <br />Public Health <br />'r, -..'. .' [)el]al1tilett1 <br />Today's Date 07122t25 Legal Request #11781 <br />Fu nd/De pa rtme nt:1 16-Public Health Agenda Date <br />Cont reement lnformation <br />Bu lnformation <br />Co ntract/Agreement Agency: AtWork! <br />contract/Agreement Title: Agreement for Services between KC and AtWork! <br />Begin Date: Upon Signature End Date: 09130126 <br />Total 5 Amount: $12,600.00 Contract/Agreement #: PHDD-005 <br />Contract/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 />F-n ss <br />sisnature oYFioS'ecrit{ sOitice ( <br />w /a.",c7>- <br />Date <br />f '- 7u c's'- <br />Signature of AudiQr's Office Date <br />Revenue Code(s)105 - 568.02.334.04.68 <br />Expense Code(s)105 - 568.02.54122 <br />17 ngency is not suspended/disbarred Not Checked {reason) <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Su b-Contract Approved Date: <br />Pass Thro lnformation <br />ADMIN Version:0 es: 0Su Date 12101,/2024 Katie OdiModified Approval By: Chelsey Loeffers