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TotalAmount 5 State Funds S Federal Funds S <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <br />Explain <br />ls 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 />Budget lnformation <br />Budget Amendment Needed?Yes ! attach budget form No f] why not <br />New Division Created? <br />Revenue Code 1,1,6.6L2392354101, - ?xhrshn^ codr,-. <br />Pass Through lnformation <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract Approved Date <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement?Yes Zl-ttto <br />Coun De rtments lmpacted <br />BOCC Approval Needed? <br />Yes !Non <br />Staff Mem ber Presenting: <br />Assignment of Tracking lnformation <br />Auditor Facilities M aintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office 17\ r LLS4Y/|<)QA k'.4 6/zv7.u <br />Who Signed the grant application (I <br />Reviewer Date <br />Grant/Contract Review Page 2