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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date <br />7.17.26 <br />Fund/Department <br />116-Public Health <br />Contract/Grant Information <br />F( <br />/Grant Agency: KCHN <br />Period Begin Date: 7.1.23 <br />PBK Request #: <br />Agenda Date: <br />Period End Date: 6.30.24 <br />rS`: E L� •�`� :�4b <br />yp ,s <br />I <br />zrr n rar r n r Y n <br />Total Grant/Contract Amount: $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 />F <br />Department Head Signature: Director Date: <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office Date <br />Signature of Auditor's Office 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 />