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Is Equipment being purchased? <br />New Personnel being hired? <br />Who owns equipment? <br />Contact HR hiring-- reporting requirement <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? � Yes E]attach budget form <br />New Division Created? <br />Revenue Code 116.615.03.8.334.03.10 <br />116.615.03.6.334.03.10 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />$64,691.33 <br />$12,200.00 <br />s <br />No ❑x Why not, already budgeted <br />LSWFA General Task 1 <br />LSWFA Syringe Exchange Task 2 <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: Date: <br />Department: <br />Assignment of Tracking Information <br />F <br />uditor's Office <br />uman Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />Submitted <br />Signature: Date: <br />Department: <br />Assignment of Tracking Information <br />F <br />uditor's Office <br />uman Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />