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Financial Information <br />Total Amount $2,000 <br />Percentage County Funds <br />Is Equipment being purchased? <br />State Funds $ <br />Matching Funcs $ <br />in -Kind $ <br />=plain <br />vVho owns equipment? <br />Federal Funds $2,000.00 <br />CFDA# <br />New Personnel being hired? j --cntact HR hiring— reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes ❑ <br />New Division Created? <br />attach budget form I No ® Why not <br />I Revenue Code 10-9-368.-34.04.E8 <br />Expense Code 105-568.34101 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved Date: <br />Expense Code: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes 0 No ❑ <br />County Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />BOCC Approval Needed? <br />Yes ❑ <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 I Date I <br />Grant/Contract Review Page 2 <br />