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Kittitas County <br />Review Form <br />'Grants & Contract Agreement <br />Contract/G ra nt lnformation <br />Recommendation for Board of Health Review on <br />Department Head Signature Director Date:€3 <br />verification the contracting Agency is not suspended/Disbarred: <br />Today's Date <br />04/17 /2023 PA Camas Request #:\IUK <br />Fund/Depa rtment <br />116-Public Health Agenda Oate: ['[v Lv <br />Contract /Grant Agency: DSHS DDD Services Agreement Amendment 2 <br />Period Begin Date: 01/0I/2023 Period End Date: 0G/30/2023 <br />otaT G nra Co fant Act om n ct/nu t rease of 79 6.5Ss fo00 ar CWn m axt um ofm I 53 04 0005L, <br />Grant/Contract Number <br />This amendment is for a budget increase of $89,756.00 for a new maximum of $1,3s,|,040.00 <br />Contract/G rant Summary: <br />Kittitas County Prosecutor, Auditor,and Board of Health Review and Comment: <br />APP ROVED AS TO RM <br />t 49 H.t 7r7 <br />Signature of P ecutor's Office D <br />h <br />Signature of Auditor's Office Date <br />Agency is not suspended/disbarred I Not Checked (reason) <br />Grant/Contract Review <br />Page 1