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Kittitas County <br />Review Form <br />Grants & Contract Agreement <br />Today's Date Agenda Date <br />June 10th, 2025 July 1st, 2025 <br />Fund/Department <br />30 / Sheriff <br />Contract/Grant Information <br />Contract /Grant Agency: Rosauers/Super 1 Pharmacy <br />Period Begin Date: 5/21/2025 <br />Period End Date: Until further notice. <br />Total Grant/Contract Amount: Billed per occurrence. <br />Grant/Contract Number: SHJ25-005 <br />Contract/Grant Summary: The purpose of this contract is to allow Super 1 Pharmacy to receive medication <br />orders from KCSO providers and fill prescriptions. <br />Financial Information <br />Total Amount: See above <br />State Funds $0 <br />Federal Funds $0 <br />Percentage County Funds 0% <br />Matching Funds $0 <br />CFDA# NA <br />In -Kind $0 <br />Explain <br />Is Equipment being purchased? NO <br />Who owns equipment? <br />New Personnel being hired? NO <br />Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? <br />Yes ❑ attach budget form <br />No ® Why not —Already in budget <br />New Division Created? NO <br />Revenue Code <br />Expense Code 001-30093130 <br />NA <br />Pass Through Information <br />Agency to Pass Through <br />NA <br />Amount to Pass Through <br />$0 <br />Sub -Contract Approved <br />Date: <br />Grant/Contract Review Page 1 <br />