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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittitas County <br />Public Health <br />Departrilent <br />Today's Date 1211012025 I Legal Request #:12085 <br />Fund/Department I Rgenda Date <br />Contract/Agreement Agency: Kittitas County Health Network (KCHN) <br />Contract/Agreement Title: Agree ment for Services between Kittitas County and KCHN <br />End Date: 1213112027Begin Date: 0110112026 <br />Contract/Agreement #: PH MH-01 7TotalS Amount: See Attachement B <br />Contract/Agreement Su mma ry: <br />The agreement for services funds KCHN's Thrive Mentoring Program as recommended by the <br />1/1Oth of 1o/o Mental Health and Chemical Dependency Advisory Board. <br />Co ntract/Agreement I nformatio n <br />Budget lnformation <br />Revenue Code(s)105 560.313.4000 <br />Expense Code(s): <br />Agency is not suspended/disbarred Not Checked (reason) <br />Pass Thro lnformation <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />AP <br />/:rq.>r <br />DateSignature of <br />CI[1 g 2fi?5 <br />RffiGffiIVffi{:] <br />DateSiCnatu r{tAu d itor's off ice'I <br />t{i++i+-c f,anr rnlrr 4.r;r{ilnr <br />Agency to Pass Through <br />Expense CodeAmount to Pass Through <br />Sub-Contract Approved Date <br />ADMIN Version: 0 Supersedes: 0 Date Adopted: fl/AU2o2a Modified By: Katie Odiaga Approval By: Chelsey Loeffers