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Financial lnformation <br />Budget lnformation <br />Pass Throu lnformation <br />Prosecutor Review <br />Total Amount $300,000.000 State Funds $Federal Funds S300,000.000 <br />Percentage County Funds Matching Funds 5 CFDA# <br />ln-Kind S <br />tn <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bein hired?Contact HR hirin - reporti uirementsre <br />Future impacts or liability to Kittitas County: <br />Budget Amendment Needed?Yes ! attach budget form No E why not <br />No cost amendmentNew Division Created? <br />Revenue Code 7bv,q3 3q, <br />Expense Code <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract Approved Date: <br />Has the Prosecutor reviewed this agreement?Yes No <br />Coun Departments lmpacted <br />BOCC Approval Needed? <br />Ass nment of Tracki lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes I No El <br />Staff Mem ber Presenting <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