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Percentage County Funds Matching Funds$ ] CFDA# 93.778 <br />In-Kind$ <br />Explain <br />Is Equipment being purchased? 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 • attach budget form No []j Why not <br />New Division Created? Included in budget process <br />Revenue Code 116.612.95.333.93.778---no max <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 D <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />- <br />Submitted I Signature: <br />Department: <br />I Date : <br />Assignment of Tracki ng Information <br />- <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