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DCYF Agreement Number <br />COUNTY PROGRAM AGREEMENT <br />2363-51827 <br />Evidence Based Expansion <br />rJiL rn,., ;d`�yX <br />This Program Agreement is by and between the State of Washington <br />Administration or Division <br />Department of Children, Youth & Families (DCYF) and the County identified <br />Agreement Number <br />below, and is issued in conjunction with a County and DCYF Agreement On <br />General Terms and Conditions, which is incorporated by reference. <br />County Agreement Number <br />DCYF ADMINISTRATION <br />I DCYF DIVISION <br />DCYF INDEX NUMBER <br />DCYF CONTRACT CODE <br />Departmentof Children, Youth, <br />Children, Youth and Families <br />1225 <br />2000CC-63 <br />and Families <br />DCYF CONTACT NAME AND TITLE <br />DCYF CONTACT ADDRESS <br />Karena McGovern <br />1115 Washington St SE <br />Contract Specialist <br />OI m is WA 98504 <br />DCYF CONTACT TELEPHONE <br />DCYF CONTACT FAX <br />DCYF CONTACT E-MAIL <br />360 870-5727 <br />Click here to enter text. <br />karena.mc overn do f.wa. ov <br />COUNTY NAME <br />COUNTY ADDRESS <br />Kittitas County <br />205 West 5th Ave <br />Juvenile Court Services Department <br />Suite 211 <br />Elie WA 98926 <br />COUNTY FEDERAL EMPLOYER IDENTIFICATION <br />COUNTY CONTACT NAME <br />NUMBER <br />Katrina Mankus <br />COUNTY CONTACT TELEPHONE <br />COUNTY CONTACT FAX <br />COUNTY CONTACT E-MAIL <br />(509) 962-7516 <br />katrina.mankus@co.ki titas.wa.us <br />15 THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM <br />CFDA NUMBERS <br />AGREEMENT? <br />No <br />PROGRAM AGREEMENT START DATE <br />PROGRAM AGREEMENT END DATE <br />MAXIMUM PROGRAM AGREEMENT AMOUNT <br />10/01/2023 <br />06/30/2025 <br />See Exhibit B <br />EXHIBITS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this <br />County Program Agreement by reference: <br />® Exhibits (specify): Exhibit A: Evidence -Based Expansion Contract Term, Reimbursement Procedures, and Program <br />Responsibilities; Exhibit B: Statement of Work; Exhibit C: Monthly Project Update Form; <br />Exhibit D: Monthly Reimbursement Request Form; and Exhibit E: Quarterly Target Update Form <br />The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive <br />understanding between the parties superseding and merging all previous agreements, writings, and communications, oral <br />orotherwise, regarding the subject matterof this Contract. The parties signing below represent that they have read and <br />understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DCYF only <br />upon signature by DCYF. <br />COUN IGNAT E(5) <br />PRINTED NAME(S) AND TITLE(S) <br />DATE(S)SIGNED <br />Ju� St mob►- K S�>wkit <br />(, <br />�u a I'vs J'AAte. <br />DCYF SIGNATURE <br />PRINTED NAME AND TITLE <br />DATE SIGNED <br />Department of Children, Youth & Families <br />2017CF County Program Agreement 6-24-20 Page 1 <br />