HomeMy WebLinkAboutMOU Becca Petitions Project 615 Sheridan Street
Port Townsend, WA 98368
�e vison www.JeffersonCountyPublicHealth.org
Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: Apple Martine, Public Health Director
Anna McEnery, DD & BH County Coordinator
DATE: Ikk;- `
SUBJECT: Agenda Item — a Memorandum of Understanding Agreement with Jefferson
County Juvenile Court; January 1, 2025 — December 31, 2026; $30,000.00;
($15,000 in 2025 and $15,000 in 2026)
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH), as the fund manager of the 1/10th of 1% Behavioral Health Sales Tax
Treatment Funds, is requesting Board approval of a Memorandum of Understanding (MOU) with the Jefferson
County Juvenile Court; for the Referred-Becca Petition Project; January 1, 2025 — December 31, 2026;
$30,00.00 ($15,000 in 2025 and $15,000 in 2026).
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
This Memorandum of Understanding, is with the Jefferson County Juvenile Court; for the Referred-Becca
Petition Project; for Jefferson County youth with behavioral or emotional problems affected by substance
abuse, chemical dependency and mental health issues.
This Memorandum of Understanding, results from an RFP process and is recommended by the Behavioral
Health Advisory Committee.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This is sales tax revenue raised by the County in the 1/10th of 1% Behavioral Health Sales Tax Treatment
Funds and is allocated by the Board of County Commissioners, with advice from the Behavioral Health
Advisory Committee.
The Memorandum of Understanding states, if the sales tax revenue decreases; the Court will be contacted
and the agreement may be renegotiated.
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
AD-24-046
RECOMMENDATION:
Jefferson County Public Health, as the fund manager of the 1/101h of 1% Behavioral Health Sales Tax
Treatment Funds, is requesting Board approval of a Memorandum of Understanding Agreement with the
Jefferson County Juvenile Court; for the Referred-Becca Petition Project; January 1, 2025 — December 31,
2026; $30,00.00 ($15,000 in 2025 and $15,000 in 2026).
REVIEWED BY:
a�4
Mark McCauley, unty Administrator Date
Community Health Environmental Public Health
Developmental Disabilities '360-385-9444
360-385-9400 (f) 360-379-4487
Always working for a safer and healthier community
MEMORANDUM OF UNDERSTANDING
Between
Jefferson County Juvenile Court
and
Jefferson County Board of County Commissioners as Administrator of
1/10' of 1% Behavioral Health Sales Tax Fund—2025-2026
WHEREAS,this Memorandum of Understanding (MOU) is between Jefferson County Juvenile
Court (Court) and the Jefferson County Board of County Commissioners (County) which administers
the 1/l Oth of 1% Behavioral Health Sales Tax; (Fund 131); through Jefferson County Public Health;
and
WHEREAS,this Memorandum of Understanding describes the mutually-agreed conditions under
which 1/1 oth of 1% Behavioral Health Sales Tax; (Fund 131); is being allocated to Jefferson County
Juvenile Court for the Referred/Becca Petition Project for youth with behavioral or emotional
problems affected by substance abuse, chemical dependency and mental health issues; and
WHEREAS,the Jefferson County Behavioral Health Advisory Committee voted to recommend the
1/10th of 1% Behavioral Health Sales Tax; (Fund 131); be allocated for Functional Family Therapy
Services or Individual Counseling in 2025-2026 as follows; January 1, 2025 —December 31, 2026;
$30,000.00; ($15,000.00 in 2025 and $15,000.00 in 2026); for Therapeutic Prevention Services for
Referred/Becca Youth in Jefferson County Juvenile Court; and
WHEREAS,the Board of County Commissioners approved a 2025-2026 County Budget that
allocates funding from the 1/IOth of 1% Behavioral Health Sales Tax; (Fund 131); the consistent with
the Jefferson County Behavioral Health Advisory Committee's recommendations; and
WHEREAS,the Juvenile Court will administer the contracts and expenditures to provide the
Functional Family Therapy Services pursuant to this MOU from January 1, 2025 to December 31,
2026; and
WHEREAS, Work performed between January 1, 2025 and December 31, 2026 the execution of this
Agreement that is consistent with the provisions of this Agreement is hereby ratified; and
WHEREAS, all funds from the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); may only be
used for their intended purpose within that budget year, and any unexpended funds remaining at the
end of a budget year must be retained in the 1/1 oth of 1% Behavioral Health Sales Tax; (Fund 131);
fund balance, to be available for allocation for eligible services in future years; and
WHEREAS,Juvenile Court agrees to regularly report deliverables and metrics to Jefferson County
through the Jefferson County Public Health as specified under this MOU as a condition of receiving,
1/101h of 1% Behavioral Health Sales Tax; (Fund 131); and to facilitate overall management of the
Fund;
NOW, THEREFORE, it is mutually agreed that:
1. The County, as administrator of the 1/1 oth of 1% Behavioral Health Sales Tax; (Fund 131);
Jefferson County Juvenile Court mutually agrees for the Court to provide case management
services and other services to individuals enrolled in the Truancy Reform Project in Juvenile
Court, as described in this MOU,
1 of 11
AD-24-046
including EXHIBIT A: Scope of Work: Family Functional Therapy or Individual
Counseling to provide Therapeutic Prevention Services for Referred/Becca Petition Project
and EXHIBIT B: Referred/Becca Petition Project, Logic Model and Performance Measures
and EXHIBIT C: Jefferson County, 1/101h of 1% Behavioral Health Sales Tax, (Fund 131);
Spreadsheet attached hereto and incorporated herein.
2. Funding from the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131); to the Juvenile Court
for the services pursuant to this MOU shall be up to $15,000.00 in 2025 and up to $15,000.00 in
2026 as described in the following Budget Table; on page two; subject to modification pursuant
to Section 8 of this MOU.
3. Juvenile Court will use the 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); for direct
services (e.g. Functional Family Therapy or Individual Counseling) for participants in the
Referred/Becca Petitions Project; per the following Budget Table;
Description Service Period Amount from Fund
131
Family Functional Therapy Cost per January 1, 2025- $15,000
Family: $3000.00 December 31,2025
Projected # of Families Served: 3
Individual Counseling
$120 an hour
Subtotal-2025 $15,000
Family Preservation Services Cost per January 1,2026-
Family: $3000.00 December 31,2026 $15,000
Projected # of Families Served: 3
Individual Counseling
$120 an hour
Subtotal-2026 $15,000
Total Funding for Juvenile Court for $30,000
2025- 2026
4. Funding approved pursuant to this MOU will be included in the 2025 and 2026 expenditure
appropriation budgets of Juvenile Court. In addition, a quarterly transfer from the 1/IOth of 1%
Behavioral Health Sales Tax; (Fund 131); for a total equal to the amount expended during the
YTD period minus previous expenditure reimbursements from this award not to exceed the
authorized annual amounts in the Budget Table above, will be made to the Juvenile Court
revenue budget upon timely submittal of required reports. Funds provided pursuant to this MOU
will be tracked separately by the Court and may only be used for its intended purpose within that
budget year. At the end of each budget year, if documented actual authorized expenditures
pursuant to this MOU services related to/for the Referred/Becca Petition Project are less than the
authorized budgeted amount, the difference will be transferred back to the 1/10th of 1%
Behavioral Health Sales Tax; (Fund 131); Juvenile Court will not exceed the amount provided by
the 1/loth of 1% Behavioral Health Sales Tax; (Fund 131); without obtaining an appropriation.
2of11
5. Funding provided by the 1/IOth of 1% Behavioral Health Sales Tax; (Fund 131); will be used to
monitor participant compliance and as well as help participants improve psychiatric symptoms
and functioning, reduce substance use, reduce hospitalizations, increase housing stability, reduce
arrests, and improve quality of life. Funding will be used to assist participants with the above
areas. Funding listed in the table on page two are approximations for each line item and may be
shared between the descriptions, with budget updates given to Public Health.
6. Juvenile Court will use the 1/1 oth of 1% Behavioral Health Sales Tax; (Fund 131) Spreadsheet;
see EXHIBIT C -Jefferson County, 1/1011 of 1% Behavioral Health Sales Tax; (Fund 131);
Spreadsheet for actual paid monthly expenses that have incurred.
7. Provide monthly financial reports per EXHIBIT C -Jefferson County, 1/101h of 1%
Behavioral Health Sales Tax; (Fund 131); Spreadsheet for actual paid monthly expenses that
have incurred and email them quarterly to the Auditor's Chief Accountant and to Public Health.
8. Juvenile Court and any Contractors it may use to provide Case Management with the 1/loth of 1%
Behavioral Health Sales Tax; (Fund 131); shall comply with the following:
ATTACHMENT A-Jefferson County 1/1011 of 1% Behavioral Health Sales Tax Match
Policy.
a. The County reserves first right to use as match, the Chemical Dependency or Mental Health
Treatment Sales and Use Tax, (now known as the 1/loth of 1% Behavioral Health Sales Tax)
and the services funded by them for purposes of qualifying for additional funding and grants.
The County may allow the Contractor to use the 1/loth of 1% Behavioral Health Sales Tax
funds as match, at the County's sole discretion. Should the County decline to use the 1/10th
of 1% Behavioral Health Sales Tax funds as match for additional funding and/or grants, then
the County may authorize the Contractor to use such funds for match consistent with this
MOU; as required by ATTACHMENT A - Jefferson County 1/10t' of 1% Behavioral
Health Sales Tax Funding Match Policy.
b. Where the Court or its Contractor proposes to use 1/101h of 1% Behavioral Health Sales Tax;
(Fund 131); funds for match,the Court or its Contractor shall be solely responsible for
compliance with all state and federal laws and regulations, including but not limited to DSHS,
CMS and DBHR funding rules, applicable to the use of 1/loth of 1% Behavioral Health Sales
Tax funds as match. The Court or its Contractor shall document it has met this responsibility
by submitting in writing to the Juvenile Court and County Administrator their match formula,
allocation plan and any other documentation required of them by ATTACHMENT A -
Jefferson County 1/10th of 1% Behavioral Health Sales Tax Funding Match Policy. The
County may withhold authorization to utilize the 1/1 oth of 1% Behavioral Health Sales Tax as
match. The Court's or its Contractor's failure to provide adequate documentation does not
relieve the Court or its Contractor of their responsibility to comply with all state and federal
laws and regulations related to match.
3of11
9. This MOU may be amended by mutual written agreement of both parties. The basis for
amending this agreement includes, but is not limited to, an increase or decrease in sales tax
funding, or addition of required tasks not addressed in this agreement.
10. This MOU shall remain in effect from January 1, 2025 until December 31, 2026, unless
terminated before then by either party with 30 days' prior written notice, except that the
requirements to provide financial and program reports and other documentation required
pursuant to EXHIBIT A, EXHIBIT B,EXHIBIT C and ATTACHMENT A shall remain in
effect until fulfilled. All work performed in 2025 and 2026 consistent with this MOU prior to its
adoption is hereby ratified.
Jefferson County Board of Commissioners Jefferson County Juvenile Court
Kate Dean, Chair Date Shannon Burns, Date
Juvenile Courts Administrator
Attest: mr
orm Only:
for 09/30/2024
Carolyn Gallaway, Date hilip Hunsucker, Date
Clerk of the Board Chief Civil Deputy Prosecuting Attorney
4of11
EXHIBIT A
Scope of Work: Referred/Becca Petitions Project
Jefferson County Juvenile Court agrees to utilize the 1/101h of 1% Behavioral Health Sales Tax; (Fund
131); provided through this MOU to provide the following services and provide tracking reports as
follows:
1. Provide the intervention of Family Functional Therapy Services to youth who are referred
via: Jefferson County through a Referred/Becca Petition such as: At Risk Youth Petition,
Child In Need of Services Petition, or youth referred through community partners
including self-referrals. All referrals will be in writing by Jefferson County Juvenile
Services, in accordance with the FFT model, which shall include but is not limited to:
a) Concepts and practice contained in the most recent Blueprints for Violence
Prevention: Functional Family Therapy;
b) General Precepts/Practice/Assessment practices contained in FFT initial 3-Day
Training and 1-Day Systems Training;
c) Clinical Guidance as supplied by:
➢ FFT, Inc.; Local FFT Supervisor in formal consultation and any FFT site
visits.
2. Provide Individual Counseling, for youth who are referred via: Jefferson County
Referred/Becca Petitions, for example: At Risk Youth Petition, Child in Need of Services
Petition, or youth referred through community partners, including self-referrals. All
referrals will be in writing, using referral form specific for this funding, by Jefferson
County Juvenile Services. The Individual Counseling will have an emphasis on Cognitive
Behavioral Treatment and Motivational Interviewing.
3. Make referrals to Functional Family Therapy and Individual Counseling services "in
conjunction" with any current treatment program, and require a mutual exchange of
information release to increase the effectiveness of all co-occurring treatment modalities.
4. Assure that all youth referred, undergo a Positive Assessment Change Tool prescreen and
pre/posttests. This assessment identifies risk factors that are related to family discourse
and truant behaviors. A database will be utilized to summarize information and the
therapeutic intervention that specific responsively matches the youth/family.
5. Collect and share data statistics; school attendance data, court and school referral data,
PACT assessment data, court collection of referral dates, start dates and completion dates,
and school outcome data for school attendance, for the administration of the Truancy, At
Risk Family for reporting purposes.
6. EXHIBIT B: Referred/Becca Petitions Project Logic Model and Performance
Measures are attached hereto and incorporated herein.
5of11
7. The 1/101h of 1% Behavioral Health Sales Tax; (Fund 131); provides support
needed to operate the Referred/Becca Petitions Project and will support those youth
that are referred through non-court involved means. This protects public safety
while reducing the student's risk for future justice involvement and placement in a
higher, more restrictive level of care or incarceration. Funds provide Functional
Family Therapy Intervention and Individual Counseling to referred youth and their
families that otherwise would only qualify under an official "court involved"
referral.
8. If the Court utilizes funds under this MOU to hire a Contractor to provide case
management services or administration and billing services subject to this MOU, the Court
agrees to prepare for BoCC approval a professional services agreement with the
Contractor, which Agreement has been approved by the County's Risk Management and
Legal review, and which requires Contractor's compliance with the provisions of this
MOU, including compliance with the provisions of Section 8 of this MOU, and requires
the Contractor to timely provide all financial and program reports and other
documentation necessary for the Court to comply with this MOU.
9. Provide at least the following for the referrals for FFT and Individual Counseling; so the
Behavioral Health Advisory Committee is able to review usage of allocated funds in order
to assure access to appropriate treatments and services:
a) Provide monthly financial reports per EXHIBIT C -Jefferson County, 1/10th of 1%
Behavioral Health Sales Tax; (Fund 131); Spreadsheet for actual paid monthly
expenses that have incurred and email them quarterly to the Auditor's Chief
Accountant and to Public Health.
b) Juvenile Court will provide an estimate of projected expenditures under this MOU for
the remainder of the year at the end of October of 2025 and at the end of October 2026
to Public Health.
c) Juvenile Court will provide all invoices to the Auditor's office for processing during
the Open Period, (a.k.a. 131h Month, in January); and the final reporting by Jan 20,
2025 and Jan 19, 2026.
d) Provide to Jefferson County through Jefferson County Public Health a copy of any
service contracts (and all amendments associated therewith)with the 1/10'h of 1%
Behavioral Health Sales Tax; (Fund 131); under this MOU.
e) Jefferson County Juvenile Court will provide quarterly statistics in an electronic form
that is developed and may be revised by Jefferson County Public Health and the Kitsap
Health District, in consultation with the Court, for statistical and program data
collection.
f) Jefferson County Juvenile Court will ensure that quarterly electronic reports are sent
to Lolinthea Hinkley at LHinkleykco.jefferson.wa.us
o Quarterly reports will be reviewed by Public Health for accuracy. Any questions
will be referred back to the Court.
6of11
Jefferson County 1/101h of 1% Sales Tax- EXHIBIT B
2025-2026 Request for Proposal
Becca Petitions Project: Truancy/At-Risk/CHINS Referred Youth: FFT and Individual Counseling
PROCESS FFT; Patty Oden OUTPUT OUTCOMES
INPUT (already under contract with Truancy: 1.Youth has developed Truancy: 1 Youth is participating and
skills to address behaviors related
Juvenile Services engaged in appropriate educational
Truancy: 1. Student meets legal to truancy; program,communication at home is
"truant"definition and truancy referral 1. Referred youth and their families 2•Action plan created to improved;Youth anxiety or MH
by school receive FFT,moving through all specifically address barriers to symptoms subsided.
2. Interview and PACT assessment phases successfully: educational success;including 2.Factors leading to truant behavior
completed. Determination of risk factors Engagement anxiety and mental health/SUD. are addressed;
in areas of MH/CD and family discourse Motivation Participates in post referrals for 3.Youth has improved education
3. If family/student willing,referral continued services. outcomes such as better attendance and
$ Relational Assessment
made for early intervention to FFT or Behavior Change 3.Youth has realistic goals and is educational progress;No longer meetTruancy definition.
Individual Counseling based on need. Generalization moving towards those. Education
2.Becca Counselor is notified of plan developed At-Risk Family: 1.Factors leading to
At-Risk Family: 1. Prevention referral progress through the phases; At-Risk Family: 1.At-risk family distress are addressed;
received from law enforcement,school, 3. Family completes FFT;pre and behaviors reduced and/or better 2.Youth is not exhibiting same risky
parent or child;2. Interview and PACT posttests go to Becca Counselor. specific management of family's behaviors and is following appropriate
assessment completed.Determination of 4. Database updated identified issues; household rules,and is successfully
risk factors in areas of MH/CD and 2.Overall improvement of family addressing substance use or mental
family discourse functioning;and reduced at-risk health issues;
5.Youth&Family no longer meet At
3. If family/youth willing,referral made behaviors; Risk definition and services
for early intervention to FFT or Process: Individual Counseling 3.Behavior change successful; terminated.
Individual counseling based on need. CBT centered; Claire Chambers family environment improved to
(already under contract with preserve family unit. CHINS/Referred Youth:Youth and
CHINS/Referred Youth: 1.Youth Juvenile Services CHINS/Referred Youth: Youth parents have agreed on alternative
referred by school per Referral of 1. Referred youth will receive and family have reduced incidents living or treatment plan. Youth/family
Concern or possible Threat Assessment. Individual Counseling with related to family dysfunction and engaged in follow-up services. Youth
2. Youth seeks help through CHINS Claire Chambers steeped in CBT violence. Mental Health/SUD has destress tolerance increased;MH/SUD
Petition (8 session average) been addressed and mitigated. symptoms mitigated. No longer
3. Interview and PACT assessment 2. Becca Counselor is notified of Next steps and referrals made. seeking court services
completed. Determination of risk factors progress throughout.
in areas of MH/CD and family discourse 3. Youth completes Individual
4. If family/student willing,referral Counseling. Pre& posttests are
made for early intervention to FFT or given to Becca counselor. Data Entry pre referral and upon completion of intervention.
Individual counseling based on need. 4. Database updated.
Qualifying factors of MH,SUD,and/or family violence and
acuity will be tracked post and upon completion. Non
successful completion will be noted and reason. All
demographics will be included with PACT assessment.
7ofII
EXHIBIT C:
JEFFERSON CO 1/101h of 1% Behavioral Health Sales Tax; (Fund 131)
SPREADSHEET
Referred/Becca Petitions Project-2025
TRUANCY REFORM PROJECT TOTAL AWARD: $15,000
Month of
Vendor Svc Date Paid Amount Description/Service
Total FTC Court YTD
Expended $0.00
Total FTC Court Remaining $0.00
8of11
EXHIBIT C:
JEFFERSON CO 1/10' of 1% Behavioral Health Sales Tax; (Fund 131)
SPREADSHEET
ReferredBecca Petitions Project-2026
TRUANCY REFORM PROJECT AWARD: $15,000
Month of
Vendor Svc Date Paid Amount Description/Service
Total FTC Court YTD
Expended $0.00
Total FTC Court Remaining $0.00
9ofII
ATTACHMENT A
JEFFERSON COUNTY 1/10th of 1% BEHAVIORAL HEALTH SALES TAX FUNDING
MATCH POLICY
Definitions:
Match: is a requirement for the grantee to provide contributions of a specified amount or
percentage to match funds provided by another grantor. Matching can be in the form of cash
or in-kind contributions.
Regulations: The specific requirements for matching funds are unique to each federal or state
program. The A-102 Common Rule provides criteria for acceptable costs and contributions in
regard to match.
Jefferson County Policy:
In 2005, the Washington State Legislature created an option for counties to raise the local sales tax by
0.1 percent, (the 1/1 Oth of 1% sales tax initiative) to augment state funding for behavioral health
treatment. Jefferson County collects and distributes the 1/101h of 1% Behavioral Health Sales Tax
fund. Services purchased by the County are allocated through a formal Request for Proposal (RFP)
process, review and contracting; staffed by Jefferson County Public Health, overseen by Jefferson
County Behavioral Health Advisory Committee and adopted by the Board of County Commissioners,
(BOCC). BOCC does not assume any fiscal responsibility/liability for any of the Contractors they
contract for services with.
Jefferson County reserves the first right to use as match the 1/I Oth of 1% Behavioral Health Sales Tax
funds and the services funded by them for purposes of qualifying for additional funding and grants.
County may make available to the Contractor the 1/1 Oth of 1% Behavioral Health Sales Tax funds for
the Contractor to propose as match to state, federal or other entities, at the County's sole discretion.
Contractor shall not use the 1/10`h of 1% Behavioral Health Sales Tax funds for match without prior
authorization by the Jefferson County Administrator and County fiscal team. To request
authorization of availability of the funds for match, Contractor must apply to the County
Administrator in writing, and include their match formula and allocation plan and may include other
documentation to support their request. The County Administrator will authorize or deny the
availability of match funds in writing within 30 days of the application.
If the County informs the Contractor of the availability of the 1/I O'h of 1% Behavioral Health Sales
Tax funds for match, then the Contractor shall be solely responsible for compliance with all state and
federal laws and regulations, including, but not limited to DSHS, CMS and BIRR funding rules,
applicable to the use of 1/IOth of 1%Behavioral Health Sales Tax funds as match. Following state,
federal and local guidelines for match is the responsibility of the Contractor.
10 of 11
For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.50.02 or 42CFR
430.30)they are required by those rules to actually bill Medicaid for the services at the same time. If
no Medicaid billing exists, the match would not comply with state and federal guidelines for match.
Concurrent with its request for authorization of the availability of match, Contractor shall document it
has met its responsibility to follow state, federal and local guidelines for match by submitting in
writing to the County Administrator their match formula, allocation plan, and other documentation
made mandatory pursuant to this Agreement and this Attachment A. At a minimum, the Contractor
shall also provide the following to the County Administrator:
1. DSHS requires contractors to complete and submit a"Local Match Certification" form
(DSHS 06-155) or a form that has equivalent data elements prior to any agreement for
DSHS services. Submit a copy of this application and form when requesting match
availability from the County and at each monthly billing.
2. Submit the current administrative policy within WA State regulating your services and
the use of local match.
3. Submit to the County your last financial audit showing your use of match, County
funds and tracking systems.
4. Submit to the County the terms of the agreement showing the 1/1 Oth of 1% Behavioral
Health Sales Tax fund allocation is an allowable source of match.
5. Provide documentation that your financial reporting system tracks matching funds at a
level that meets the level of documentation required by federal or state statutes.
The County may reject permission for Contractor to utilize the 1/IOth of 1%Behavioral Health Sales
Tax funding as match.
11 of 11
CONTRACT REVIEW FORM clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Juvenile Court Contract No: AD-24-046
Contract For: Referred/Becca Petition Project Term: January 1,2025 to December31,2026
COUNTY DEPARTMENT: Public Health
Contact Person: Anna Mc Enery
Contact Phone: 360-385-9410
Contact email: amcenery@co.jeffersonma.us
AMOUNT: $30,000.00; ($15,000 in 2025 and$15,000 in 2026) PROCESS: Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
Fund 4 #131 RFP or RFQ
Munis Org/Obj 13156400 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMP E W 55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: R N/A:RE Sept.26,2024
'/7
Signal re Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRI;4 BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: ® N/A: Sept. 26,2024
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 9/27/2024.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 9/30/2024.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1