ContractCounty Program Agreement • July 14th, 2011
Contract Type FiledJuly 14th, 2011COUNTY PROGRAM AGREEMENTDDD County Services DSHS Agreement Number 1163-32398 This Program Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the County identified below, and is issued in conjunction with a County and DSHS Agreement On General Terms and Conditions, which is incorporated by reference. Administration or Division Agreement Number County Agreement Number DSHS ADMINISTRATION Aging and Disability Services Administration DSHS DIVISION Division of Developmental Disabilities DSHS INDEX NUMBER 1231 DSHS CONTRACT CODE 1769CS-63 DSHS CONTACT NAME AND TITLE Wendi WinchelRegional Business Manager DSHS CONTACT ADDRESS PO BOX 45315 Olympia, WA 98504 DSHS CONTACT TELEPHONE(360) 725-4264 DSHS CONTACT FAX(360) 586-6502 DSHS CONTACT E-MAILwinchwa@dshs.wa.gov COUNTY NAME Pacific County COUNTY ADDRESS PO Box 26 South Bend, WA 98586- COUNTY FEDERAL EMPLOYER IDENTIFICATION NUMBER 916001356 COUNTY CONTACT NAME Kathy Spoor COUNTY CONTACT TEL