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Financial Information <br />Total Amount $ State Funds $ Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In -Kind $ <br />Is Equipment being purchased? <br />Who owns equipment? <br />New Personnel being hired? <br />Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Budget Information <br />Budget Amendment Needed? Yes ❑ attach budget form No ® why not <br />New Division Created? <br />Budgeted, & not using some funds till 2024) <br />will be in budget <br />612.39.29.333.210.27 <br />— COVID GAP Funding <br />Revenue Code 611.17.333.93.35 <br />— Workforce Development <br />612.02.02.346.264/265 <br />— Group A Water Sanitary Surveys <br />_612.94.333.10.56 <br />—SNAP Ed <br />[Expense Code 51001 <br />/ 52001 / 50098 / 54199 / 54101 / 53115 <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />Sub -Contract Approved <br />Prosecutor Review <br />Date: <br />Has the Prosecutor reviewed this agreement? <br />County Departments Impacted <br />Auditor <br />Information Services <br />Prosecutor <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 />Expense Code: <br />Yes ❑ No u <br />Facilities Maintenance <br />Human Resource <br />Treasurer <br />Reviewer � Date <br />Grant/Contract Review Page 2 <br />