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r <br />Kittitas County Public Health K'`` "5 III <br />Public Health <br />Contract/Agreement Review Form O`a,1, ..,r_It <br />Today's Date: 12/04/2024 Legal Request #: l <br />Fund/Department: 1/10th of Mental Health Tax�..Agenda Date: <br />_.: <br />Contract/Agree men t Information _ <br />Contract/Agreement Agency: Damman School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Damman School District <br />Begin Date: 01/01/2025 End Date: 12/31 /2025 <br />Total $ Amount: $9,250.00 Y Contract/Agreement #: PHMH-005 <br />Contract/Agreement Summary: <br />1/10th funding to Damman School district to contract with a licensed mental health care provider <br />to provide mental health services to the students in Damman School District. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVE TO FORM: / <br />Signature f Prosec ors Office Date <br />44.4. .r ra <br />Signature of Auditor's O fiee Date <br />Information <br />Revenue Code(s): 105 - 560.3134000 <br />Expense Code(s): 105 - 560.54101 <br />7 Agency is not suspended/disbarred <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved Date: <br />Not Checked (reason) <br />Expense Code: <br />j Approval By: Chelsey Loeffers <br />ADMIN Version: 0 Supersedes: 0 Date Adopted: 12/01/2024 Modified By: Katie Odiaga <br />