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o <br />J(r!l.l)t (c.rrt! <br />Kittitas CountY Public Health <br />Contract/Agreement Review Form <br />Public Health <br />lJ:p r::ti..t <br />Today's Date 12t04t2024 Legal Request #:\l4I <br />Fund/Department:Ll1/1Oth of Mental Health Tax Agenda Date <br />Contract/lnformation <br />Contract/Agreement Agency: Damman School District <br />DistrictSchoolmanatDamtoServicesStudentstheMentaIrhHeaTitlePCorovidingAgreementntract/ <br />End Date: 1213112025Begin Date: A1lO1l2O25 <br />Contract/Agreement *: P H M H-005Total S Amount: $9,250.00 <br />Contract/Agreement Sum marY: <br />1/1Oth funding to Damman School district to contract with a licensed mental health care provider <br />to provide mental health services to the students in Damman School District. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />Date <br />l'Jr.> <br />s OfficeProsSignature <br />DateSignature of Auditor's <br />Bu lnformation <br />Pass Thro lnformation <br />Revenue Code(s)10s - s60.3134000 <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 />Sub-Contract ApProved Date: <br />ADMIN Version:0 Supersedes:0 Date Adopted : 12 | 07 / 2024 Modified By:Katie odiaBa Approval By: ChelseY Loeffers