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In -Kind $ <br />Is Equipment being purchased? No Who owns equipment? <br />New Personnel being hired? No Contact HR hiring — re <br />Future impacts or liability to Kittitas County: <br />ng requirements <br />Budget Information <br />Budget Amendment Needed? Yes[M attach budget form No ❑ why not <br />New Division Created? (To be entered in budget center) <br />Revenue Code 116.6129133406902 $10,000.00 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes ❑ No <br />County Deoartments Imnacted <br />F Auditor <br />Facilities Maintenance <br />Information Services <br />Human Resource <br />Prosecutor <br />Treasurer <br />Submitted <br />Signature: Date: <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 />