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New Personnel being hired? NO I Contact HR hiring -reporting requirements <br />Future impacts or liability to Kittitas County : <br />Budget Information <br />Budget Amendment Needed? Yes D attach budget form No D Why not <br />New Division Created? <br />Revenue Code 116.612.47 Behavorial Health <br />Expense Code 116.612.47.54101 Professional Services <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 • No ·• <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />1: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 />I Reviewer I Date <br />Grant/Contract Review Page 2