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{9 <br />(i1t.!:: ii!'ill <br />Kittitas CountY Public Health <br />Contract/Agreement Review Form <br />Public Health <br />D:p,;iimenl <br />Today's Date:212712025 Legal Reguest #:'11362 <br />Fund/DePartment 1/1Oth of 1% Mental Health Tax Agenda Date: <br />ment lnformation <br />Bud lnformation <br />Pass Th lnformation <br />ntract/Agreement ctooistriDch (c ERSD)SEClelum-RoslynCoAgency: <br />ntract/Agree CouKittitasERSc ntyDandbetweene:1ment PSAtoentmTitlAmdenCo <br />End Date: 1213112025Begin Date: 011o112025 <br />Contract,/Agreement *: PHMH-01 1Total $ Amount: $143,600 <br />1/1Oth funding to cle Elum -Roslyn school District to provide mental health services to the <br />Contract/Agreement 5um ma rY: <br />students in Cle Elum-Roslyn School District. <br />FD <br />Kittitas CountY Prosecutor and Au ditor Review and Commentl <br />Date <br />3 .ro'zr <br />Signature of <br />DateSignature of Audito/5 Office <br />105 - 560.3134000Revenue Code(s) <br />105 - 560.54101 <br />Not Checked (reason)./Agency is not susPended/dis barred <br />Expense Code{s); <br />Agency to Pass Through <br />Expense Code:Amount to Pass Through <br />5ub-Contract APProved Date <br />ADMIN Version; 0 Supersedes: 0 Date Adopted : L2/gIlzou Modified BY:Katie Odiaga Approval BY:Chelsey Loeffers