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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 />Verification the Contracting Agency is not Suspended/Disbarred: <br />ft-f ngency is not suspended/disbarred E Not Checked (reason) <br />PBK Request #:t003bToday's Date <br />Fund/Department <br />116-Public Health Agenda Date <br />Contract /Grant Agency: Elmview <br />Period Begin Date; 7.L.24 Period End Date: 6.30.25 <br />Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject <br />to fundi Only DDA roved services will be covered.p{ <br />Grant/Contract Nu r <br />The professional services agreement is to establish a subcontracted employment and day services <br />provider for people with developmental disabilities in Kittitas County per the county's responsibilities <br />outlined in attachments. <br />Department Head Signature:Director Date:€ltq ["t <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />AP D FORM: <br />Signature of ecutor'Office DateJ'A A*' 7't1'>'r <br />sie*trL of Auditor'r 6#i."Date <br />Grant/Contract Review Page 1