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Is Equipment being purchased? Who owns equipment? <br />New Personnel being hired? Contact HR hiring — 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 105.568.334.04.68 $10,000.00 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Dat <br />ng requiremer <br />NO ❑ Why not <br />I <br />1 <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? I Yes No ❑ <br />County Departments Imnacted <br />Auditor _ <br />Facilities Maintenance <br />Information Services <br />Human Resource <br />Prosecutor <br />L <br />Treasurer <br />Submitted <br />' Signature: _ _Date: <br />Department: <br />Reviewer I Date <br />Grant/Contract Review Page 2 <br />