Executive/Council Action Form (ECAF)
ITEM TITLE:
Title
Motion 25-229, approving Department of Social and Health Services Contract Signature Authorization Form within the Department of Human Services
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DEPARTMENT: Human Services
ORIGINATOR: Laura White
EXECUTIVE RECOMMENDATION: Approved by Lacey Harper 5/1/25
PURPOSE: The purpose of this action is to update the DSHS Contract Signature Authorization Form.
BACKGROUND: The Human Services Department contracts with Department of Social and Health Services/Aging and Disability Services Administration (DSHS/ADSA) to provide a variety of services to Snohomish County residents. DSHS requires one (1) Contract Signature Authorization Form per contracting agency. A revised form is needed to reflect changes in County elected officials and department personnel.
The Signature Authorization Form is for DSHS use only; it grants no authority for County personnel. It is to ensure that the contracts received at DSHS from the County are signed by an authorized person.
FISCAL IMPLICATIONS:
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EXPEND: FUND, AGY, ORG, ACTY, OBJ, AU |
CURRENT YR |
2ND YR |
1ST 6 YRS |
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n/a |
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TOTAL |
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REVENUE: FUND, AGY, ORG, REV, SOURCE |
CURRENT YR |
2ND YR |
1ST 6 YRS |
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n/a |
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TOTAL |
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DEPARTMENT FISCAL IMPACT NOTES: There is no impact to County General Revenues because of this action. The action updates Signature Authorization Forms for all contracts with DSHS. Separate actions are requested to authorize those service contracts and their respective expenditures and revenues.
CONTRACT INFORMATION:
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ORIGINAL |
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CONTRACT# |
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AMOUNT |
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AMENDMENT |
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CONTRACT# |
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AMOUNT |
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Contract Period
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ORIGINAL |
START |
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END |
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AMENDMENT |
START |
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END |
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OTHER DEPARTMENTAL REVIEW/COMMENTS: Reviewed/approved by Finance - Nathan Kennedy 4/30/25