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Percentage County Funds Matching Funds $ I CFDA# <br />In-Kind$ <br />Explain <br />Is Equipment being purchased? NO Who owns equipment? <br />New Personnel being hired? NO Contact HR hiring -reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes • attach budget form No~ Why not <br />New Division Created? Included in 2019 budget <br />Revenue Code 116.612.93.337.04 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub-Contract Approved Date: <br />Prosecutor Review I Has the Prosecutor reviewed this ag reement? [Yes D No D <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />I S ignature: <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 11 <br />I Reviewer I Date <br />Grant/Contract Review Page 2