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Docusign Envelope lD: 45542800-F078-88E3-82CC-81 C8A3BDE84C <br />CONTRACT FACE SHEET <br />For lnternal Routing Use <br />(lnstructions on lnstructions Tab) <br />-- <br />T;TF <br />ECOLOCY <br />Type: <br />CGP System #: <br />Contract #: <br />Amendment #: <br />Work Assignment #: <br />Contract <br />21938 <br />c2500r78 <br />1 <br />Contractor Statewide Vendor - SWV #:swv 0010475-07 EIN: <br />Public HealthKittitas Cou <br />pollution prevention Assistance (PPA) - technical assistance and education outreach to small businesses. <br />Contractor Name: <br />Contract Title / Description / Bid #: <br />Program:MOO-HWTR <br />Project Officer:Andrew Maher Phone s09-329-3672 <br />Secondary Project Officer (i.e., Budget Analyst):Ellen Hafer Phone s54-233-8638 <br />Staff DES ControdTroining Yes <br />(check all that apPlY)E Goods/Services ncw rg.ze I Decision to Contract <br />E lnteragency RCW 39.34 E oEs state contract # <br />!tr RCW 39.26 I Competitive Bid # <br />E Public works RCW 39.04 I sole source # <br />n Arch./Eng.RCW 39.80 tr Direct Buy <br />E other: <br />OMWBE: (check allthat aPPlyl OMWBE WA Small Bus WA Veteran Bus <br />Uses Sub Contractor <br />I Time Extension ! lncrease <br />E Decrease <br />Amount of Amendment: <br />Subcontractor: <br />AMENDMENT: (check allthat aPPIY) <br />Other: Deliverable <br />Reduction <br />Total of Contract after <br />Amendments:s116,959.5 <br />TERM:Start Date:7/t/2o2s End Date 6/30/2027 <br />How To Encumber and Disburse: <br />m M Completes <br />Contract Cost:S116,9s9.s1 <br />Sales Tax (PW onlY)s <br />Total Eligible Cost:5 116,959.51 <br />(Required for Single-year Operating Appropriations & <br />uired information:contracts extendi current bienni <br />Prior Bien's Current Bl Current Bl <br />MIC (8 char)Fund/EAl <br />ffi <br />23N/p10 <br />Project - Sub-Proj FY:2026 FY:2027 Totals <br />M723r7HO 38,921.94 93 77,843.87 <br />9M997D10 7.82 82 3 15.64 <br />Staff;Budget 5 116,959.51 <br />Subsidiary:Budget Total must equal Total Eligible Cost <br />Funded? No Federol Amount ( <br />Remarks:Am total and MlCs nd <br />Contract Freeze form in <br />3/23/20 <br />'s contract file. <br />23 before ca ital (23 <br />Approval Date <br />ECY 010-53 Rev 2/2024