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Kittitas County <br />Review Form ja TTITA 1i k77 n, <br />Grants & Contract Agreement <br />Today's Date <br />06/30/2022 <br />Fund/Department <br />116 -Public Health <br />Contract/Grant Information <br />Contract /Grant Agency: Kittitas County Health Network <br />1 PA Camas Request #: tiu g 10 <br />Agenda Date: <br />Period Begin Date: 07/01/2022 ! Period End Date: 06/30/2023 <br />Total Grant/Contract Amount: Not to exceed $30,000 <br />Grant/Contract Number: <br />Contract/Grant Summary: <br />The professional services agreement outlines contractor's scope of work for the needs of general public, <br />parents, and children or adults diagnosed with developmental disabilities. <br />Recommendation for Board of Health Review on <br />Department Head Signature: Director Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />AX6�14,tvl� " 4/4z� <br />Signature of rosecu or's Office Date <br />Signature of Audit Date <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />® Agency is not suspended/disbarred ❑ Not Checked (reason) <br />Grant/Contract Review Page 1 <br />