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Kittitas Co unty Prosecutor, Auditor, and Board of Health Review and comment <br />APPROVED AS TO FORM <br />rf .L '/'f-Signature of P utor's Office Date <br />a2 <br />Signature of Au ce te <br />fl Agency is not suspended/disbarred I Not Checked (reason) <br />verification the contracting Agency is not suspended/Disbarred: <br />Financial lnformation <br />Budget lnformation <br />Pass Thro ugh lnformation <br />Prosecutor Review <br />los 5b85 0l - /fienfa] P1to41', r.ntll ^1e' <br />TotalAmount $State Funds S Federal Funds S <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind $ <br />aln <br />ls Equipment being pu rchased?Who owns equipment? <br />New Personnel bein hired?Contact HR hirin u irements-re ortin <br />F uture impacts or liability to Kittitas County: <br />et Amendment Needed?Bu <br />New Division Created? <br />Yes ! attach budget form No tr Why not <br />Revenue Code <br />Expense Code <br />t <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract Approved Date <br />secutor reviewed this agreement?Has the Pro Yes No <br />County Departments lmpacted <br />Grant/Contract Review <br />Page 2