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Kittitas County Public Health <br />Contract/Agreement Review Form <br />Public Health <br />Today's Date: <br />06/24/26 <br />Legal Request #: <br />111655 <br />Fund/Department: <br />116- Public Health <br />Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: Washington State DSHS <br />Contract/Agreement Title: DSHS/DVR School to Work Direct Service Pilot <br />Begin Date: 05/01/2026 End Date: 09/30/27 <br />Total $ Amount: Fee for Service Contract/Agreement #: <br />Contract/Agreement Summary: <br />The contract is an agreement that outlines the School to Work Direct Service Pilot Program. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />Signature of P <br />I <br />pr� <br />Signature of Auditor's Offi <br />Budget Information <br />Revenue Code(s): 105 - 568.334.04.68 <br />Expense Code(s): � HS1000-101/4101 <br />❑✓ Agency is not suspended/disbarred <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved Date: <br />HS2000-101 /4101 <br />Not Checked (reason) <br />Expense Code: <br />Date <br />rv'3o'2::6 <br />Date <br />ADMIN I Version: 0 j Supersedes: 0 Date Adopted: 12/01/2024 1 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />