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Financial lnformation <br />Bu lnformation <br />Pass Through lnformation <br />5ub-Contract Approved Date: <br />Prosecutor Review <br />Total Amount 515,000.00 per year State Funds $Federal Funds $ <br />Percentage Countv Funds Matching Funds $CFDA# <br />In-Kind S <br />Explain <br />ls 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 />Tacoma- Pierce County Health Department will retain 53,OO per food handler's card taken via the online <br />test and 51.00 per replacement card. The remaining $2.00 of the food handler's card and 55.00 per <br />replacement card fee will be paid to the Kittitas County Health Department on a quarterly basis. <br />Budget Amendment Needed? <br />New Division Created? <br />YesI attach budgetform No [8 why not <br />Estimation for payments received from Tacoma- <br />Pierce County Health Department has been <br />included in the 2022-2023 budeeting process. <br />Revenue Code 1_16-615.56.t.321.20 <br />Agency to Pass Through <br />Amount to Pass Through s <br />Has the Prosecutor reviewed this agreement?Yes l!ffruo Ll <br />Cou rtments <br />Submitted <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Signature:Date: <br />Department: <br />Ass ment of Tracki lnformation <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