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Is Equipment being purchased? <br />New Personnel beinp, hired? <br />Who owns equipment? <br />Contact HR hirin <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? <br />New Division Created? <br />Yes ❑ attach budget form <br />Revenue Code <br />105-568.334.40.68 - $12,500.00 (out of fund balance) <br />Pass Through Information <br />— reporting requirements <br />NO ❑x Why not <br />Included in 2017 budgeting process <br />Agency to Pass Through <br />$ <br />Amount to Pass Through <br />Sub -Contract Approved <br />Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes No ❑ <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />Signature: <br />Department: <br />ent of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Date: <br />Reviewer IDate 71 <br />Grant/Contract Review Page 2 <br />