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Grant County Vendor Agreement
Agreement Period: July 1, 2019— June 30, 2021
Organization Name: EnTrust Community Services
Vendor Contact Person: Tom Gaulke, Chief Executive Officer
Email: gaulket@entrustcs.org
Telephone: (509) 834-2961
Signatory Authority: Tom Gaulke, Chief Executive Officer
Email: gaulket@entrustcs.org
Telephone: (509) 834-2961
Address: PO Box 9727
Yakima, WA 98909-0727
IRS Tax No. (Employer I.D.) 91-0862938
Qualified Provider Services Individual Supported Employment
Community Access
Additional terms of this agreement are set out in and governed by the following
which are incorporated herein by reference:
General Terms and Conditions — Exhibit A
Special Terms and Conditions — Exhibit B
Data Security — Exhibit C
BOARD OF COUNTY COMMISSIONERS
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Tom Taylor, Chair Date
Cindy CarteR, Vice Chair Date
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Richard Stevens, Member Date
Attest:
Ba a J. Vasquez Date
Cie of the Board
Approved as o form:
Kevin M rae Date
Deputy Prosecuting Attorney
EnTrust Community Services
To e r Date
GRANT INTEGRATED SERVICES
DEVELOPMENTAL DISABILITIES
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Gail Goodwin, Program Director Date