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Total Amount$ 58,500 State Funds$ {1,500) Federal Funds $ 60,000 <br />Percentage County Funds Matching Funds$ CFDA# 93.439 <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 D attach budget form NoO Whynot <br />New Division Created? <br />Revenue Code LSPAN 612.31.333.93.43 $60,000 <br />Lead Environment 612.334.04.93 (-$1,500) <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 YesD No D <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted I Signature: <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 <br />I Reviewer ] Date <br />Grant/Contract Review Page 2