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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 — rep, <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment <br />Needed? <br />New Division Created? <br />Revenue Code <br />lExpense Code <br />rting requirements <br />Yes ❑ attach budget form No ❑ Why <br />116.612.90.369.40 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved Date: <br />116.612.90.54101 <br />Expense Code: <br />Prosecutor Review <br />L�mthe Prosecutor reviewed this agreement? Yes No ❑ <br />County Departments Impacted <br />Auditor <br />Information Services <br />Prosecutor <br />BOCC Approval Needed? <br />Yes <br />Staff Member Presenting: Chelsey Loeffers <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant <br />application <br />IReviewer <br />Facilities Maintenance <br />Human Resource <br />Treasurer <br />No ❑ <br />Date <br />Grant/Contract Review Page 2 <br />