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In -Kind $ <br />Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />L. <br />Budget Information <br />Budget Amendment Needed? <br />New Division Created? <br />Revenue Code <br />105-568.334.04.68 - $19,000.00 <br />Yes ❑ attach budget form <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />No D Why not <br />Included in the budgeting process <br />l _ <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes ❑ No ❑ <br />County Departments Impacted <br />Auditor <br />Information Services <br />Prosecutor <br />Submitted <br />Signature: <br />partment: <br />Facilities Maintenance <br />Human Resource <br />Treasurer <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />...... .... -_ <br />Who Signed the grant aaolication <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />