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Financial lnformation <br />Budget lnformation <br />Pass Thro lnformation <br />Prosecutor Review <br />TotalAmount State Funds 5 Federal Funds S <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <br />tn <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bei hired?Contact HR hiri - reporti uirementsre <br />Future impacts or liability to Kititas County: <br />Bu Amendment Needed? <br />New Division Created? <br />Yes f] attach budget form No K why not <br />Revenue Code 105.568.33 4.04.68 <br />Expense Code ' (9-s(e.t, nrd-- VAri(E:,105.568.5410L <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 De rtments lm <br />BOCC Approval Needed? <br />ment of Tracking lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes I NoX <br />Staff Member 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