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In -Kind $ <br />Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring β€”rep <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes ❑ attach budget form <br />New Division Created? <br />Revenue Code <br />105-568.334.04.68 - $820,341.00 <br />.... ........ _ <br />Pass Through Information <br />Agency to Pass Through 4 <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? <br />requirements <br />No ❑ Why not <br />Will only need if actual amount billed exceeds <br />lcontract amount β€” will do at year end. <br />I Yes No <br />County DepartmentsImpacted <br />Auditor _ Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />Signature: <br />Department: <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />