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• <br />Kittitas County Public Health A Kinitas county <br />Public Health <br />Contract/Agreement Review Form N1111mor0up0,%me0[ <br />Today's Date: 01/08/2025 Legal Request #: <br />Fund/Department- 1/10th of 1% Mental Health Tax Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Cie Elum-Roslyn School District <br />Contract/Agreement Title: Providing Mental Heaith Services to the Students at Cle-Elum Roslyn School District <br />Begin Date: 01/01/2025 End Date: 12/31/2025 <br />Total $ Amount: $143,600 Contract/Agreement#: PHMH-011 <br />Contract/Agreement Summary: <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 A5 TO FORM: <br />of Proset:utor's <br />(,/avL <br />Signature of Auditor's <br />Budget Information <br />Revenue Code(s): / 06 — .S6 0. 3 r 3 Lt o a o <br />Expense Code(s): [o S — S60• Skl of <br />Agency is not suspended/disbarred l i Not Checked (reason) <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />Date <br />I -J r • act <br />Date <br />ADMIN Version: 0 5upersedes: 0 Date Adopted: 12/01/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />