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Financial lnformation <br />Bu lnformation <br />Pass Through lnformation <br />Prosecutor Review <br />TotalAmount State Funds S6,t62.3+Federal Funds $ <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <br />lain <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bein hired?Contact HR hirin - reporti u irementsre <br />Future impacts or liability to Kittitas County: <br />Budget Amendment Needed? <br />New Division Created? <br />Yes I attach budget form No E why not <br />Revenue Code 105.568.334.04.68 <br />Expense Code 105.568.54101 <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 No <br />Cou D artments lm acted <br />BOCC A roval Needed? <br />Ass nment of Trackin lnformation <br />Auditor Facilities Mai ntenance <br />lnformation Services Human Resource <br />Prosecutor Treasu rer <br />Yes I NoI <br />Staff Mem ber Presenting: <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