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2017-2018 DSHS Advance Funds program agreement
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2017-04-18 10:00 AM - Commissioners' Agenda
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2017-2018 DSHS Advance Funds program agreement
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Last modified
1/16/2018 2:42:56 PM
Creation date
1/16/2018 11:47:30 AM
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Meeting
Date
4/18/2017
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
j
Item
Request to Approve County Program - Long Term Payable Agreement #1763-88879 with the Department of Social & Health Services
Order
10
Placement
Consent Agenda
Row ID
36014
Type
Contract
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<br /> <br />DSHS Central Contract Services <br />8030CS County Long-Term Payable (3-28-2017) Page 1 <br /> <br />COUNTY <br />PROGRAM AGREEMENT <br />Working Advance Long-Term Payable <br />DSHS Agreement Number <br /> <br />1763-88849 <br />This Program Agreement is by and between the State of Washington Department of <br />Social and Health Services (DSHS) and the County identified below, and is issued in <br />conjunction with a County and DSHS Agreement On General Terms and Conditions, <br />which is incorporated by reference. <br />Administration or Division <br />Agreement Number <br /> <br />County Agreement Number <br /> <br />DSHS ADMINISTRATION <br /> <br />Executive Administration <br />DSHS DIVISION <br /> <br />Operation Support and <br />Services Division <br />DSHS INDEX NUMBER <br /> <br />1225 <br />DSHS CONTRACT CODE <br /> <br />8030CS-63 <br />DSHS CONTACT NAME AND TITLE <br /> <br />Angela Williams <br />Contracts Supervisor <br />DSHS CONTACT ADDRESS <br /> <br />1115 S Washington St <br /> <br />Olympia WA 98504-5811 <br />DSHS CONTACT TELEPHONE <br />(360) 664-6046 <br />DSHS CONTACT FAX <br />(360) 664-6184 <br />DSHS CONTACT E-MAIL <br />williah@dshs.wa.gov <br />COUNTY NAME <br /> <br />Kittitas County <br /> <br />COUNTY ADDRESS <br /> <br />County Auditors Office <br />205 West 5th Ave County Courthouse Ste 105 <br />Ellensburg WA 98926 <br />COUNTY CONTACT NAME <br /> <br /> <br />Judy Pless <br />COUNTY CONTACT TELEPHONE <br />(509) 962-7502 <br />COUNTY CONTACT FAX <br />(509) 962-7687 <br />COUNTY CONTACT E-MAIL <br />judy.pless@co.kittitas.wa.us <br />IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM <br />AGREEMENT? <br /> <br />No <br />CFDA NUMBERS <br /> <br /> <br />PROGRAM AGREEMENT START DATE <br />07/01/2017 <br />PROGRAM AGREEMENT END DATE <br />06/30/2018 <br />MAXIMUM PROGRAM AGREEMENT AMOUNT <br />Based on Annual Review <br />The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive <br />understanding between the parties superseding and merging all previous agreements, writings, and communications, oral <br />or otherwise, regarding the subject matter of this Contract. The parties signing below represent that they have read and <br />understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DSHS only <br />upon signature by DSHS. <br />COUNTY SIGNATURE(S) <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />PRINTED NAME(S) AND TITLE(S) <br /> <br /> <br /> <br /> <br /> <br />DATE(S) SIGNED <br />DSHS SIGNATURE <br /> <br /> <br />PRINTED NAME AND TITLE <br /> <br />Angie Williams, Contract Manager <br />DSHS Central Contracts and Legal Services <br />DATE SIGNED
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