ContractInterlocal Agreement • June 17th, 2020 • Washington
Contract Type FiledJune 17th, 2020 JurisdictionINTERLOCAL AGREEMENTRespite in Community Settings DSHS Agreement Number:2064-81954 This Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below, and is issued pursuant to the Interlocal Cooperation Act, chapter39.34 RCW. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME City of Mountlake Terrace CONTRACTOR doing business as (DBA) CITY OF MOUNTLAKE TERRACE - 01 CONTRACTOR ADDRESS 5303 228th Street SW Mountlake Terrace, WA 98043 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) DSHS INDEX NUMBER 1437 CONTRACTOR CONTACT Renee Norton CONTRACTOR TELEPHONE (425) 776-9173 CONTRACTOR FAX (425) 775-2365 CONTRACTOR E-MAIL ADDRESS rnorton@ci.mlt.wa.us DSHS ADMINISTRATION Developmental Disabilities Admin DSHS DIVISION Division of Developmental Disabilities DSHS CONTRACT CODE 1803LP-64 DSHS CONTACT NAME AND TITLE Gina M. Thomas Contract Specialist DSHS CONTACT ADDRESS 840 N Broadway 540 Everett, WA 9820