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New Personnel being hired? I Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes ❑ attach budget form <br />New Division Created? <br />Revenue Code <br />116-611.81.2.333.93.912 - $5000.00 <br />I <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved . Date: <br />NOx❑ Why not <br />Not an increase in bottom line <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes El No <br />Countv Departments Impacted <br />Auditor <br />Information Services <br />Facilities Maintenance <br />Human Resource <br />Prosecutor <br />Treasurer <br />Submitted <br />Signature: <br />Department: <br />Assignment of Tracking Intormation <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />