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In -Kind $ <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 ❑ why not <br />New Division Created? <br />Revenue Code <br />116.615.2.2.346.26.64 <br />116.615.2.2.346.26.65 <br />116.615.2.2.346.26.66 <br />$2,800 <br />$2,800 <br />$2,000 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />EH Sanitary Survey — FS SS <br />EH Sanitary Survey — SS -State <br />EH Sanitary Survey — FS Tech Asst <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes ❑ No <br />rtments Impacted <br />Auditor <br />Information Services <br />Prosecutor <br />Submitted <br />Signature: <br />Department: <br />Assignment OT i racKing inrormation <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Facilities Maintenance <br />Human Resource <br />Treasurer <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />