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Kittitas CountY <br />Review Form <br />Grants & Contract Agreement <br />Contract/Grant lnformation <br />Recommendation for Board of Health Review on <br />Verification the Contracting Agency is not Suspended/Disbarred: <br />PBK Request #:03Today's Date <br />Agenda Date:Fund/Department <br />116-Public Health <br />Contract /Grant AgencY: At Work! <br />Period End Date: 6.30.25Period Begin Dale; 7 .L.2024 <br />Compensation shall be based on actualservices provid ed and is subject <br />to fundin On D <br />Total Grant/Contract Amou nt <br />roved services will be covered tof <br />G rant/Contract N umber: <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 />Department Head Signatu re: <br />zzloDirector Date <br />Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: <br />D <br />a <br />Signature of P or's Office Date <br />7')3,sV <br />Signatu e of Auditor's Date <br />! Not Checked (reason)Agency is not suspended/disbarred <br />Grant/Contract Review Page 1