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Financial Information <br />Total Amount $ <br />State Funds $ <br />Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ <br />CFDA# 93.994 <br />I <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? <br />Who owns equipment? <br />New Personnel being hired? <br />Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Need <br />Yes ❑ attach budget form <br />No ❑x why not <br />Included in 2021 budget <br />New Division Created? n <br />Revenue Code: 116.612.22.14.333.93.994 <br />Information Services <br />I <br />Human Resource <br />Pass Through Information <br />Agency to Pass Through I <br />Amount to Pass Through $ <br />Sub -Contract Approved Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes No <br />County Departments Impacted <br />BOCC Approval Needed? <br />Yes ❑x <br />Staff Member Presenting: Chelsey Loeffers <br />Assignment of Tracking Information <br />Auditor's Office <br />Auditor <br />Human Resource <br />Facilities Maintenance <br />Prosecutor's Office <br />Information Services <br />Who Signed the grant application <br />Human Resource <br />Prosecutor <br />Treasurer <br />BOCC Approval Needed? <br />Yes ❑x <br />Staff Member Presenting: Chelsey Loeffers <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />r z� £ ` ,] -n- %G <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />