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Total Amount $88,882.67 State Funds $66,662.00 Federal Funds $ <br />Percentage County Funds 25% Matching Funds $22,220.67 CFDA# <br />In-Kind $ <br />Explain <br />Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring -reporting req uirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes 0 attach budget form No IKI Why not <br />New Division Created? Total grant included in annual budget <br />Revenue Code <br />116-615.03.334.03.10 -$49,693.97 <br />116-615.03.4.334.03.10 -$0.00 <br />116-615.03.6.334.03.10 -$39,188.70 <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 Yes 0 No 0 <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted 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