Laserfiche WebLink
FFATA FORM <br />Subreciplent Agency: Kittitas County <br />Grant and Year: 2019 <br />Agreement Number-, E20-168 <br />Completed Darren Higashiyama <br />Commander <br />(509) 933-8206 <br />Name <br />-------------- <br />Title <br />Telephone <br />Date Completed: 11/08/19 <br />STEP 1 <br />YES <br />STOP, no further <br />NO <br />Is your grant agreement less than $25,000? <br />D <br />analysis needed, <br />GO to Step 2 <br />GO to Step 6 <br />STEP 2 <br />In your preceding fiscal year, did YOUr <br />YES <br />NO <br />STOP, no further <br />organization receive 80% or more of its annual <br />E] <br />GO to STEP 3 <br />analysis needed, GO to <br />gross revenues from federal funding? <br />Step 6 <br />STEP 3 <br />In your preceding fiscal year, did your <br />YES <br />NO <br />STOP, no further <br />organization receive $25,000,000 or more in <br />1:1 <br />GO to STEP 4 <br />L-1 <br />analysis needed, GO to <br />federal funding? <br />Step 6 <br />STEP 4 <br />Does the public have access to information about <br />YES <br />STOP, no further <br />NO <br />the total compensation* of senior executives in <br />D <br />analysis needed, <br />GO to STEP 5 <br />your organization? <br />GO to step 6 <br />STEP 5 <br />Executive #1 <br />Name: <br />-Total Compensation amount: $ <br />Name: <br />Executive #2 <br />Total Compensation amount: $ <br />Executive #3 <br />Name: <br />Total Compensation amount: $ <br />Executive #4 <br />Name: <br />Total Compensation amount: $ <br />Executive #5 <br />Name: <br />Total Compensation amount: $ <br />STEP 6 <br />If your organization does not meet these criteria, specifically <br />identify below each criteria that is not met for your <br />organization: For Example: "Our organization received less than $25,000.". <br />Kittitas County did not receive 80% or more annual gross revenues from federal funding <br />Signature: <br />Date: 11/08/19 <br />~Total compensation refers to: <br />• Salary and bonuses <br />^ Awards nfstock, stock options, and stock appreciation rights <br />° Other compensation including, but not limited to, severance and termination payments <br />• Life insurance value paid onbehalf ofthe employee <br />Additional Resources: <br />Page 1of3 <br />