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In -Kind $ <br />Explain <br />Is Equipment being purchased? No 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 Ej attach budget form No 0 Why not, already budgeted <br />New Division Created? <br />_... <br />Revenue Code <br />116.615.03.8.334.03.10 $57,811.67 <br />116.615.03.6.334.03.10 $25,123.00 <br />Pass Through Information <br />Agency to Pass Through <br />.......... <br />Amount to Pass Through <br />$ <br />Sub -Contract Approved <br />Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes Ll No ❑ <br />County Departments Impacted <br />Submitted <br />Signature: Date: <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 I Date <br />Grant/Contract Review Page 2 <br />Auditor <br />Facilities Maintenance <br />Information Services <br />Human Resource <br />Prosecutor <br />Treasurer <br />Submitted <br />Signature: Date: <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 I Date <br />Grant/Contract Review Page 2 <br />