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Is Equi ment bei hg p urchased? _~ho owns equ ~~ent? <br />Ne ~ersonnel bei n~hired ~ _ _ Contact_~~ __ ~i!~~~_-=-E~port_~ng_ r~q_Lli~~--,--n~_nts___ ___ _ <br />I <br />I <br />[ture impacts or liability to Kijtitas County : <br />___ 1 <br />Bu dget Information <br />j No []I Why not Budget Amendment Needed? Yes 0 attach budget form <br />New Division Created? <br />1--------------- <br />Will only need if actual amount billed exceeds <br />contract amount -will do at yea.!:..~n ~ __ <br />Revenue Code <br />105-568.334.Q4.68 --$689,190 <br />Ag e ncy to Pass Throu h <br />Amoun!.to Pass Through <br />Sub-Contract Approved <br />$ . - <br />Date: ~---~------------ <br />--------- <br />--j <br />Prosecutor Review <br />I Has the Pros ~utor reviewed t his agreement? . --~--~----, _.,-,----, .. "-,---.",--.-.~~.- <br />i Yes O No 0 <br />Cou'nty De partme,nts Impacted <br />I Auditor I Facilities Maintenance -=-J Human Resource j <br />l~ .. ____ _ Information Services <br />----------------~ <br />Prosecutor Treasurer <br />Submitted <br />r Signatu re: -I Date: <br />r De.,p-a rtment: __________ ~ ___ ~_-.l. ___ ~ <br />-----------, <br />Assignment of Tra~ing I nformation <br />A_u_d_it_o_r_'s_Of_f,_ic_e _______ -lI ___ _ <br />Human Resource <br />Prosecut or'-s -Office ---=r --------~------------------- <br />Who Sign ed th ~ant a p licatio~ - ----- <br />L Reviewer --] <br />Grant/Contract Review Page 2