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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G ra nt I nformation <br />Recommendation for Boar d of Health Review on <br />Department Head Signature Director Date q (t z3 <br />Verification the Contracting Agen cy is not Suspended/Disbarred: <br />Today's Date <br />7.17.26 PBK Request #:1.14 ltPoFund/Department <br />116-Public Health Agenda Date <br />Contract /GrantAgency: KCHN <br />Period Begin Date: 7.1.23 Period End Date: 6.30.24 <br />Total Grant/Contract Amount:$go,ooo <br />Grant/Contract Number <br />The professionalservices agreement outlines contractor's scope of workforthe needs of general public,parents, and children or adults diagnosed with developmental disabilities. <br />Contract/G ra nt Su m ma ry <br />Kittitas County prose cutor, Auditor, and Board of H ealth Review and Comment:APP TO <br />Signature of prosec r's Offi Date <br />/o <br />Signature of Auditor,s Office Dat <br />s not suspended/disbarredAgency i I Not Checked (reason) <br />Grant/Contract Review <br />Page 1