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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/Grant I nformation <br />Recommendation for Board of Health Review on <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />E Agency is not suspended/disbarred ! Not Checked (reason) <br />Today's Date <br />06/30/2022 PA camas Request ot '6 U4 t C <br />Fund/Department <br />116-Public Health Agenda Date <br />Contract /GrantAgency: Kittitas County Health Network <br />Period Begin Date: 07/0I/2022 Period End Date: 06/30/2023 <br />Total Grant/Contract Amount: Not to exceed 530,000 <br />Grant/Contract Number <br />Contract/G rant Su mma ry: <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 />>LDepartment Head Signature <br />q BDirector Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment <br />4r <br />Signature of or's Office Date <br />? <br />Signature of Audi Date <br />Grant/Contract Review Page 1