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Financial lnformation <br />B lnformation <br />Pass Through lnformation <br />Prosecutor Review <br />TotalAmount State Funds $Federal Funds $ <br />Percentage Cou nty Funds Matching Funds $CFDA# <br />ln-Kind $ <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel bei hired?Contact HR hirin orting uirements-re <br />Future impacts or liability to Kittitas County <br />Bud Amendment Needed? <br />New Division Created? <br />Yes I attach budget form No El why not <br />Revenue Code 10s.568.334.04.68 <br />Expense Code 105,568,541O1" / 54L22 DD Peoe qvc PAsi, ril f.u._ <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 rtments lmpacted <br />BOCC Approval Needed? <br />Ass ment of Tracki lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes !Non <br />Staff Mem ber Presenting: <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office { zr8r'} <br />Who Signed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2