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o <br />P,i!trtdj atuoty <br />Kittitas CountY Public Health <br />Contract/Agreement Review Form <br />Public Health <br />;ep-rr:rrreit <br />Today's Date lffi regar2t27t2025 Request #:11362 <br />Fund/Department 1/1Oth of Mental Health <br />lnformation <br />(D)ESoolDistrictSchEllensbumentrgAgreeAgencyContract/ <br />CoKittitasSEand untyDTitlentPSAtobetweenentmendmAmntract/Co Agree <br />End Date: 1213112026Begin Date: 0110112025 <br />Contract/Agreement r: PHMH-01 0Total 5 Amount: $313,750.00 <br />ill1thfunding to Ellensburg School district to contract with a licensed mental health care <br />provider to pr6vide mental [ea[h services to the students in Ellensburg School District. <br />Contra nt Summary: <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />7 <br />3- lo -2S. <br />DaterosecuSignature <br />DateSignature of Auditor's <br />B lnformation <br />Pass lnformation <br />Revenue Code(s):105 - 560.3134000 <br />Expense Code(s):105 - 560.54101 <br />t/Agency is not suspended/disbarred Not Checked (reason) <br />Agency to Pass Through <br />Expense Code:Amount to Pass Through <br />Sub-Contract APProved Date <br />ADMIN Version:0 I Supersedes:0 oate AOopteO' Lzlol-/2o24 l,Modified BY: Katie Odiaea Approval By: Chelsey Loeffers _