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t <br />Kiltita! (e!nty <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Public Health <br />Dep.rt$enl <br />Today's Date:2t27t2025 fl Legal Request #:11362 <br />Fund/Department 1/1Oth of Mental Health Tax Agenda Date: <br />Contract/Agreement Agency: Th orp School District <br />ct/Agreement CountyndaKiftitasDiskictSchoolTitle:1 PSAto betweenAmendment ThorpContra <br />End Date: 1213112025Begin Date: 0110112025 <br />Contract/Agreement *: P H M H-008Total S Amount: $54,350.00 <br />Contract/Agreement SummarY: <br />1/1Oth funding to Thorp School district to contract with a licensed mental health care provider to <br />provide mentil health services to the students in Thorp School District- <br />ent lnformation <br />lnformation <br />Pass Th lnformation <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract APProved Date <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />3.t o'er <br />Dates <br />DateSignature of Auditor's <br />Revenue Code(s)105 - 560.3134000 <br />Expense Code(s):105 - 560.54101 <br />./Agency is not suspended/disbarred Not Checked (reason) <br />ADMIN Version:0 Supersedes;0 Date Adopted: 12 | Ot | 2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers