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11 <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Today s Date: 07/02/26 Legal Request #: 12583 <br />Fund/Department: 116-Public Health Agenda Date: <br />Contract/Agreement Information <br />Contract/Agreement Agency: AtWork! <br />itas County <br />Public Health <br />Department <br />Contract/Agreement Title: AFS between Kittitas County and AtWork! <br />Begin Date: 05/01/26 End Date: 09/30/27 <br />Total $ Amount: $12,600.00 Contract/Agreement #: PHMH26-016 <br />Contract/Agreement Summary: <br />The purpose of this agreement is to provide school -to -work services, per the contractual <br />requirements of the Washington State Department of Vocational Rehabilitation (DVR) including <br />but not limited to intake, assessment, job placement along with required deliverables. <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />APPROVED AS TO FORM: <br />Signature of Prosecutor's Office <br />Signature of Auditof'kOffice <br />Budget InformatioR- <br />Revenue Code(s): 105-568.334.04.68 <br />Expense Code(s): HA1000-101/4122 <br />✓I Agency is not suspended/disbarred <br />Date <br />7`S/`;�.c <br />Date <br />f d� <br />❑ Not Checked (reason) I <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />ADMIN I Version: 0 Supersedes: 0 I Date Adopted: 12/01/2024 Modified By: Katie Odiaga Approval By: Chelsey Loeffers <br />