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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Xittitai Co{rIty <br />Public Health <br />f)epartnrert <br />Today's Date 01113126 I Legal Request #:12126 <br />Fund/Department:1/1Oth of Mental Health Tax I Agenda Date <br />Contract/nt lnformation <br />Contract/Agreement Agency: Kittitas School District <br />Contract/Agreement Title: PSA between Kittitas County and Kittitas School District Amend 1 <br />End Date: OG|3U2A26Begin Date: 1213112025 <br />Contract/Agreement r: P H M H-007Total S Amount: $41,200.00 <br />Contract/Agreement Su m ma rY: <br />1/1gth funding to Kittitas School district to contract with a licensed mental health care provider to <br />provide mentil health services to the students in Kittitas School District. The Amendment <br />provides 6 month amended compensation budget of unspent original funding of $41,200'00 <br />Original contract was for $83,750.00. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APP <br />/.rs.zL <br />dateSignatu <br />Auditor's OfficeSignature <br />Office <br />,L <br />Date <br />Bu lnformation <br />Pass Th lnformation <br />Revenue Code(s)105 - 560.3134000 <br />Expense Code(s):105 - 560.54101 <br />Agency is not suspended/disbarred Not Checked (reason) <br />Agency to Pass Through <br />Expense CodeAmount to Pass Through <br />Su b-Contract ApProved Date <br />ADMIN Version: 0 Supersedes: 0 Date Adopted 1 1"2/OLl2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers