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Kittitas county Prosecutor, Auditor, and Board of Health Review and comment: <br />APPROVED TO FORM: <br />.r ot ufi, f-- <br />Signature of utor's Office Date <br />0/a2 <br />Signature of Au e e <br />verification the contracting Agency is not suspended/Disbarred: <br />! Agency is not suspended/disbarred I Not Checked (reason) <br />Financial lnformation <br />TotalAmount $State Funds S Federal Funds $ <br />Percentage Cou nty Funds Matching Funds S CFDA# <br />ln-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 />Bu lnformation <br />Pass Throu lnformation los 5t'85 0t - lltenfal ftsq$h ,nl Ae- <br />Prosecutor Review <br />Budget Amendment Needed? <br />New Division Created? <br />Yes ! attach budgetform No f] why not <br />Revenue Code <br />Expense Code ) <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 Ll tuo l_l <br />County Departments lmpacted <br />Grant/Contract Review Page 2