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In-Kind $ <br />EXplai n <br />Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring-reportin g 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? Expenditures included in 2017 budget <br />Revenue Code <br />116-612.34.397 -$58.96 or $71.14 per xray as needed <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub-Contract Approved Date: <br />Prosecutor Review <br />1 Has the Prosecutor reviewed this agre ement? I Yes 0 No D <br />County Depa rtments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted I Signature: <br />Department: <br />I Date: <br />Assig nment of Tracki ng Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />I Reviewer I Date <br />Grant/Contract Review Page 2