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Order Form <br />Kittitas County, WA <br />Order #: Q-498823 <br />Prepared: 18 Nov 2025 <br />Page 5 of 5 <br />BILLING INFORMATION <br />Billing Contact:Purchase Order <br />Required? <br />[ ] - No <br />[ ] - Yes <br />Billing Address:PO Number: <br />If PO required <br />Billing Email:Billing Phone: <br />If submitting a Purchase Order, please include the following language: <br />The pricing, terms, and conditions of quote Q-498823 dated 18 Nov 2025 are incorporated into this Purchase <br />Order by reference and shall take precedence over any terms and conditions included in this Purchase Order. <br />AGREEMENT AND ACCEPTANCE <br />By signing this document, the undersigned certifies they have authority to enter the agreement. The <br />undersigned also understands the services and terms. <br />Kittitas County, WA <br />Signature: <br />\s1\ <br />Name: <br />\n1\ <br />Title: <br />\t1\ <br />Date: <br />\d1\