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Total Amount $13,104 <br />State Funds $5,400 <br />Federal Funds $7,704 <br />Percentage County Funds <br />Matching Funds $ <br />CFDA#93.069 <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 />Budget Information <br />Budget Amendment Needed? Yes ❑ attach budget form <br />New Division Created? <br />Revenue Code <br />116-612.88.5.333.93.069 - $7,704 <br />116-615.02.2.346.26.64 - $2,200 <br />116-615.02.2.346.26.65 - $2,200 <br />116-615.02.2.346.26.66 - $1,000 <br />Pass Through Information <br />No ❑x Why not <br />Already in budget center or in 2016 budget <br />Agency to Pass Through <br />Amount to Pass Through <br />$ <br />Sub -Contract Approved <br />Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes❑ No <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />Signature: Date: <br />Department: <br />NDDIr,IIFI1CIll UI 1 UdLKlflg If11UUMdUVf1 <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Grant/Contract Review Page 2 <br />