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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Contract/G rant lnformation <br />Recommendation for Board of Health Review on <br />Department Head Signature Director Date: lO t>/29 <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />7.17.26 PBK Request #: W4V4 <br />Fund/Department <br />116-Public Health Agenda Date q n\b <br />Contract /Grant Agency: Elmview <br />Period Begin Date: 07.01.23 Period End Date: 06.30.24 <br />Tot a raG n nCo acttr Com et/uAmo nt nsa oti sn ah eb bp as de no aactu servt Sce rovt ed ad n d suIS ectpbj <br />ot nfu d n o n D DA a r soved ervt ces covebe red <br />Grant/Contract N umber: <br />The professional services agreement isto establish a subcontracted employment and dayservices <br />provider for people with developmental disabilities in Kittitas County per the county's responsibilities <br />outlined in attachments. <br />Contract/G rant Su mmary <br />Kittitas Co unty Prosecutor, Auditor, and Board of Health Review and comment <br />APPR TOF <br />Signatu re Prose or's Dat <br />lo <br />Signature of Auditor's Office D <br />I Agency is not suspended/disbarred I Not Checked (reason) <br />Grant/Contract Review Page 1