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Total Amount $8,840 <br />State Funds $ Federal Funds $8,840 <br />Percentage County Funds <br />Matching Funds $ CFDA# <br />Sub -Contract Approved <br />93.268 <br />93.733 <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? <br />Who owns equipment? <br />New Personnel being hired? <br />Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Information <br />Budget Amendment Needed?' Yes © enter VTRCKS in budget <br />New Division Created? center <br />Revenue Code <br />116-612.32.2.333.93.268 - $1,232 <br />116-612.32.3.333.93.268 - $828 <br />116-612.32.11.333.93.268 - $4,293 <br />116-612.32.14.333.93.268 - $1,400 <br />116-612.32.7.333.93.733 - $1,087 <br />Pass Through Information <br />No ❑x Why not <br />Imms contract included in 2016 budget <br />Agency to Pass Through <br />Amount to Pass Through <br />$ <br />Sub -Contract Approved <br />Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes El No ❑ <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />Signature: <br />Department: <br />Date: <br />Assignment of Tracking Information <br />Auditor's Office <br />Grant/Contract Review Page 2 <br />