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TotalAmount State Funds $Federal Funds $ <br />Percentage County Funds Matching Funds $CFDA# <br />ln-Kind $ <br />Expla in <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel being hired?Contact HR hiring - reporting requirements <br />Future impacts or liability to Kittitas County: <br />Financial lnformation <br />Bud lnformation <br />Pass Through lnformation <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub-Contract Approved Date: <br />Prosecutor Review <br />Budget Amendment Needed? <br />New Division Created? <br />Yes I attach budgetform No E why not <br />Revenue Code 10s - 568.334,04.68 <br />Expense Code 105 - 56854122 <br />Has the Prosecutor reviewed this agreement?Yes No <br />Cou De rtments lmpacted <br />BOCC al Needed? <br />nment of Trackin lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Yes I No[] <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