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Financial Information <br />Total Amount $1,300.00 <br />Percentage Countv Funds <br />State Funds $ <br />Matching Funds $ <br />In -Kind $ <br />Federal Funds $ <br />CFDA# <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 />Budget Information <br />Budget Amendment Needed? Yes ❑ attach budget form <br />New Division Created? <br />Revenue Code <br />116- 611.81.346.25 — Assessment Fee for Service <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />No ❑x Why not <br />No new expenditures being added, revenue <br />switch <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes 0 No 0 <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor 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 />Grant/Contract Review Page 2 <br />