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Financial lnformation <br />B lnformation <br />Pass Th h lnformation <br />Prosecutor Review <br />TotalAmount $State Funds S Federal Funds S <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bein hired?Contact HR hirin rting uirements-re <br />Future impacts or liability to Kittitas County: <br />Budget Amendment Needed? <br />New Division Created? <br />Yes ! attach budgetform No E Why not <br />ln-Budget <br />Revenue Code <br />10s-55854r0I <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract Approved Date: <br />Has the Prosecutor reviewed this agreement?27"t.bYesNo <br />Cou D rtments lm <br />BOCC A proval Needed? <br />Assi ment of Tracki ng lnformation <br />Auditor Facilities Maintenance <br />lnformation Servlces Human Resource <br />Prosecutor Treasurer <br />Yes !NoE <br />Staff Member Presenting: <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office 11 .*-b"L\- ; -{"(-+a"-.. <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2