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Kittitas County Public Health ` , I <br />Public Heath <br />Contract/Agreement Review Form CeP3.cm�M1t <br />Today's Date: 12/04/2024 1 Legal Request #: <br />Fund/Department: 1/10th of Mental Health Tax I Agenda Date:_ <br />Contract/Agreement Information <br />Contract/Agreement Agency: Thorp School District <br />Contract/Agreement Title: Providing Mental Health Services to the Students at Thorp School District <br />I Begin Date: 01/01/2025 End Date: 12/31/2025 <br />Total $Amount: $54,350.00 ✓ I Contract/Agreement #: PHMH-008 <br />Contract/Agreement Summary: <br />1/10th funding to Thorp School district to contract with a licensed mental health care provider to <br />provide mental health services to the students in Thorp School District_ <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />/ r 17 - r1 SI- <br />of P o ecutor's 6-MV1 f Date <br />of Auditor's <br />Budget Information <br />Revenue Code(s): 1105 - 560.3134000 <br />Expense Code(s): 1105 - 560.54101 <br />V] Agency is not suspended/disbarred n 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 />. -2, J. 1 I — <br />ADMIN I Version: 0 Supersedes: 0 1 Date Adopted: 12/0/12024 I Modified By: Katie Qdiaga I AppraYai By: Ch0I ey Loeffers <br />