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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G ra nt I nformation <br />Recommendation for Board of Health Review on <br />Department Head Signature:Director Date 6 ls LL <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />06/30/2022 <br />pA camas Request o' 5q LID\ <br />Fund/Department <br />116-Public Health Agenda Date: <br />Contract /Grant Agency: KVO <br />Period Begin Date: 07/O1./2O22 Period End Date: 06/30/2023 <br />Total Grant/Contract Amou nt: 526,360.00 <br />Grant/Contract N umber: <br />Contract/G rant Su mmary: <br />The professional services agreerrent outlines contractor's scope of work for the needs of general public, <br />parents, and children or adults diagnosed with developmental disabilities. <br />Kittitas county Prosecutor, Auditor, and Board of Health Review and comment: <br />Signature <br />Signature of Au <br />4. <br />D <br />?V <br />S Dat <br />TO FORMAPPROVED <br />Prosecutor's Office <br />Agency is not suspended/di;barred I Not Checked (reason) <br />Page L <br />g\a\ <br />Grant/Contract Review <br />7 ?