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Kittitas County Public Health <br />Contract/Agreement Review Form <br />Today's Date: 1 12/04/2024 <br />Legal Request #: <br />Fund/Department: 1 1/10th of Mental Health Tax I Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Kittitas School District <br />Contract/Agreement Title: <br />Begin Date: 01 /01 /2025 <br />Kittitas County <br />Public Health <br />If <br />NNMO Department <br />Providing Mental Health Services to the Students in Kittitas School District <br />End Date: 12/31 /2025 <br />Total $ Amount: $83,734.00 Contract/Agreement #: PHMH-007 <br />Contract/Agreement Summary: <br />1/10th funding to Kittitas School district to contract with a licensed mental health care provider to <br />provide mental health services to the students in Kittitas School District. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office Date <br />Budeet Information <br />Revenue Code(s): <br />105 - 560.3134000 <br />Expense Code(s): <br />105 - 560.54101 <br />Agency is not suspended/disbarred EJ <br />Not Checked (reason) <br />Pars Thrnu¢h Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />ADMIN I Version: 0 1 Supersedes: 0 1 Date Adopted: 12/01/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />