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Kittitas County Public Health Kittitas County <br />Public Health <br />Contract/Agreement Review Form De <br />Today's Date: 01/08/2025 1 1 Legal Request#: I j G Ll; <br />Fund/Department: 11110th of 1% Mental Health Tax I I Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Cle Elum-Roslyn School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Cle-Elum Roslyn School District <br />Begin Date: 01/01/2025 <br />Total $ Amount: $143,600 <br />Contract/Agreement Summary: <br />End Date: 12/31/2025 <br />Contract/ARreement#: PHMH-011 <br />1/10th funding to Cle Elum -Roslyn School District to provide mental health services to the <br />students in Cle Elum-Roslyn School District. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS TO FORM: <br />ture of Prosetukor's <br />Signature of Auditor's O ice <br />L <br />Budget Information <br />Revenue Code(s): 105 — S(, 0. 3 r3 v,d o 0 <br />Expense Code(s): (o S - 5-60' _�-Lf t Lo I <br />Agency is not suspended/disbarred D Not Checked (reason) <br />Pacc Thrmiuh Infnrmatinn <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />Date <br />/.-I,-)d— <br />Date <br />ADMIN I Version: 0 1 Supersedes: 0 1 Date Adopted: 12/01//2024 1 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers <br />