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3 <br />Kiltitas CcuntY <br />Kittitas CountY Public Health <br />Contract/Agreement Review Form <br />Public Health <br />Department <br />Today's Date 01to\t2a25 1,,Legal Request $:!\ tlqV <br />Fund/Department:1/1 Oth of 1% Mental Health Tax |:Agenda Date <br />Contract/ement Information <br />lnformation <br />Pass Th lnformation <br />DistrictSchooluEIm-R oClentraCo slynAgreemenAgency:ct/ <br />DistrictSchoolnCle-EIumat RoslythetoStudentsalthHeServicesnlVlentalTitle:nt ProvidintraCo sAgreemect/ <br />End Date: 1213112025Begin Date: O1lO1l2O25 <br />contract/Agreement #: PHMH-01 1Iotal $ Amount: $143,600 <br />1/1oth funding to cle Elum -Roslyn school District to provide mental health services to the <br />students in Cle Elum-Roslyn School District' <br />Co ntract/Agreement Summa ry: <br />Kittitas CountY Prosecutor and Auditor Review and Comment: <br />-2s <br />I 'a t'lr- <br />Dateof Pro offi <br />Date <br />Signature of Auditor's ce <br />05 - 5L0.1t3qoooIRevenue Code(s) <br />lo{s6o 7Vt o1Expense Code{s) <br />Not Checked (reason)Agency is not suspended/disbarred <br />Agency to PassThrough <br />Expense Code:Amount to Pass Through <br />Sub-Contract APProved Date <br />ADMIN Version: O Supersedes: 0 Date Adopted 12/o!7a?4 Modified BY: Katie Odiaga Approval BV: Chelsey Loeffers