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Financial Information <br />Total Amount $25,000 State Funds $Federal Funds $25,000 <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 />Budget Information <br />Budget Amendment Needed?Yes attach budget form No why not <br />New Division Created? <br />Revenue Code 116.612.39.26.333.93.391 <br />Expense Code 116.612.39.26.54101 <br />Pass Through Information <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 No O <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />BOCC Approval Needed? <br />Yes No [K] <br />Staff Member Presenting: <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