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Financial lnformation <br />Bu lnformation <br />Pass Through lnformation <br />Prosecutor Review <br />Total Amount S25,000 State Funds $Federal Funds SZ5,OOO <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bei hired?Contact HR hirin orting uirements <br />Future impacts or liability to Kittitas County: <br />Bud Amendment Needed? <br />New Division Created? <br />Yes I attach budgetform No X Why not <br />Revenue Code 116.612.39. 26. 33 3. 93. 39 1 <br />Expense Code 1"16. 612.39 .26.5 41,01 <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 />Cou De artments lm acted <br />BOCC Approval Needed? <br />nment of Tracking lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes !NoE <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