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Today's Date <br />01.30.24 <br />Fund/Department <br />116-Public Health <br />Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />PBK Request #: <br />Agenda Date: <br />�f `FyL FOLS..._Q <br />KI T 5 iTA5 4' 0 FY7 7v� <br />Contract/Grant Information <br />Contract /Grant Agency: At Work! <br />Period Begin Date: 03.01.24 Period End Date: 06,30.24 <br />Total Grant/Contract Amount: Compensation shall be based on actual services provided and is subject <br />to funding. Only DDA approved services will be covered. <br />Grant/Contract Number_ D -Ul• Mo I <br />The professional services agreement is to establish a subcontracted employment and day services <br />provider for people with developmental disabilities in Kittitas County per the county's responsibilities <br />outlined in attachments. <br />Recommendation for Board of Health Review on <br />Department Head Signature: <br />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 <br />Date <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />❑ Agency is not suspended/disbarred <br />Not Checked (reason) <br />Grant/Contract Review Page 1 <br />