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In-Kind$ <br />Explain <br />ls.-Equipment being purchased? No Who owns equipment? <br />New Personnel being hired? No Contact HR hiring -reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes • attach budget form No[]] Why not <br />New Division Created? Pass thru funds <br />Revenue Code: 105.568.334.04.68 <br />Expense Code: 105.568.54122 (Pass Thru) <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? I YesB No 0 <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />Submitted <br />I Signature: <br />Department: <br />I Date: <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource ---"" ~ <br />Prosecutor's Office <br />,c <br />\ \ ±t ~I,,..~·~ ·-ic \ C\ I '1,,"--w <br />Who Signed the grant application " <br />I Reviewer I Date <br />Grant/Contract Review Page 2