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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G rant lnformation <br />Recommendation for Board of Health Review on <br />Department Head Signature Director Date 8 la 'zL <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />Agency is not suspended/disbarred ! Not Checked (reason) <br />Today's Date <br />06/30/2022 PA Camas Request #S{rtl <br />Fund/Department <br />116-Public Health Agenda Date <br />Contract /Grant Agency: WISE / <br />Period Begin Date: 07101./2022 /Period End Date: 06/30/2023 ,/ <br />Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject <br />to funding. Only DDA approved services will be covered. <br />Grant/Contract Number <br />Contract/Grant Su m mary: <br />Allow consultant to provide training and technical assistance specific to developmental disabilities <br />programs. <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />t e2\?)+Lt-&*(+(u(zt- <br />Signature of secutor's Office Date <br />Signature of s Da <br />Grant/Contract Review Page 1