Laserfiche WebLink
Financial Information <br />Total Amount $15,000.00 per year State Funds $ Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In -Kind $ <br />Explain _ <br />Is Equipment being purchased? Who owns equipment? _ <br />New Personnel being hired? Contact HR hiring_ —_reporting requirements _ <br />Future impacts or liability to Kittitas County: <br />Tacoma- Pierce County Health Department will retain $3.00 per food handler's card taken via the online <br />test and $1.00 per replacement card. The remaining $7.00 of the food handler's card and $5.00 per <br />replacement card fee will be paid to the Kittitas County Health Department on a quarterly basis. <br />Budget Information <br />Budget Amendment Needed? Yes ❑ <br />New Division Created? <br />Revenue Code <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />attach budget form No ❑x Why not <br />Estimation for payments received from Tacoma - <br />Pierce County Health Department has been <br />included in the 2022-2023 budgeting process. <br />116-615.56.1.321.20 <br />7 <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes❑ No [] 1 <br />County Departments Impacted <br />Submitted <br />Signature: Date. <br />Department: J1 <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 />Auditor <br />Facilities Maintenance <br />Information Services <br />Human Resource <br />Prosecutor <br />Treasurer <br />Submitted <br />Signature: Date. <br />Department: J1 <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 />