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Total Amount $13,104 State Funds $5,400 Federal Funds $7,704 <br />Percentage County Funds Matching Funds $ CFDA#93.069 <br />In-Kind $ <br />Explain <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 0 attach budget form No []I Why not <br />New Division Created? Already in budget center or in 2016 budget <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 />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub-Contract Approved Date: <br />Prosecutor Review <br />I Has the Prosecutor reviewed this agreement? I YesD No D <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />I Signature: <br />Department: <br />I Date: <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Grant/Contract Review Page 2