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In -Kind $ <br />Is Equipment being purchased? No Who owns equipment? <br />New Personnel being hired? No Contact HR hiriniz — reporting reauirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes © attach budget form <br />New Division Created? No To be entered in budget center <br />Revenue Code 105.568.334.04.68 <br />Pass Throufth Information <br />No ❑ Why not <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: <br />Department: <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer _ 1 Date <br />Grant/Contract Review Page 2 <br />