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Financial Information <br />Total Amount <br />State Funds $ Federal Funds $ <br />Percentage County Funds <br />Matching Funds $ CFDA# <br />In -Kind $ <br />Explain <br />Is Equipment being purchased? <br />Who owns equipment? <br />I <br />New Personnel being hired? <br />Contact HR hiring — reporting requirements <br />Future impacts or liability to Kittitas County: <br />Information <br />Budget Amendment Needed? I Yes ❑ attach budget form <br />New Division Created? I <br />Revenue Code 1 105 — 568.334.04.68 <br />Expense Code 1 105 — 568.54101 <br />No ❑ Why not <br />_Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through Expense Code: <br />Sub -Contract Approved Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes ❑ No <br />County Departments Impacted <br />Auditor. <br />Facilities Maintenance <br />Human Resource <br />Information Services <br />Prosecutor <br />Treasurer <br />BOCC Aooroval Needed? <br />No <br />Staff Member Presenting: <br />Assignment of Tracking Intormation <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer <br />Grant/Contract Review Page 2 <br />