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Financial lnformation <br />Budget lnformation <br />Pass Through lnformation <br />Prosecutor Review <br />Total Amount S25,000 State Funds $Federal Funds S25,000 <br />Percentage County Funds Matching Funds $CFDA# <br />ln-Kind S <br />tn <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bein g hired?Contact HR hiring - re requirementsrti <br />Future impacts or liability to Kittitas County <br />Budget Amendment Needed? <br />New Division Created? <br />Yes I attach budget form No E why not <br />Revenue Code L16,61.2.39. 26.333. 93.39 1 <br />Expense Code 1,16. 672.39 .26.5 4 1,0L <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 ng lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasu rer <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