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Is Equipment being purchased?! Who owns equipment? <br />New Personnel being hired? If Contact HR hirinp, — reportins reauirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? <br />New Division Created? <br />Revenue Code <br />Expense Code <br />Yes ❑ attach budget form No ❑ Why not <br />Included in budget process <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved 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 />JJ1r,11111C11L VI 110MU11r, 1111VF111d4lvn <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer j Date <br />Grant/Contract Review Page 2 <br />