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Financial Information <br />Total Amount State Funds $Federal Funds $ <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 [X]why not <br />New Division created? <br />Revenue Code 105.568.334.04.68 <br />Expense Code 105.568.54101/54122 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />M-Contract Approved Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement?Yes No <br />County Departments impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />BOCC Approval Needed? <br />Yes O No O <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