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o <br />Kittittrs CourltY <br />Kittitas CountY Public Health <br />Contract/Agreement Review Form <br />Public Health <br />Department <br />Today's Date 12tO412024 Legal Request #:\7 i.Yl t <br />Fun d/D e pa rtment:1/1Oth of Mental Health Tax Agenda Date <br />Contr nt lnformation <br />Kittitas County Prosecutor and Auditor Review an d Comment <br />APP <br />Signature r's ce <br />Bud lnformation <br />10s - 560.3134000 <br />105 - 560.54101 <br />Contract/Agreement Agency: Ellensburg School District <br />Contract/Agreeme DistriSchool ctElensatStudentstocesburgethntalMedHeServiIthTitleroviPdnng <br />End Date: 1213112026Begin Date: 01lUDA25 <br />Contract/Agreement +: PHMH-0 1 0Total $ Amount: $313,750.00 <br />Contract/Agreement SummarY: <br />1/1gth funding to Eltensburg Schooldistrictto contractwith a licensed mental health care <br />provider to pr6vide mental [ealth services to the students in Ellensburg School District' <br />I ;r'rr <br />Date <br />Dateof Auditor/sSignat <br />Revenue Code(s) <br />Expense Code(s) <br />Not Checked (reason)r'Agency is not suspended/disbarred <br />Agencyto PassThrough <br />Expense Code: <br />5ub-Contract APProved Date <br />Amount to Pass Through <br />Pass Thro lnformation <br />Date Ado e* 12/ot/2124 Modified Katie Od Chelsey LoeffersAprova IVersion: 0 5upersedes:0ADMIN