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Financial Information <br />Total Amount State Funds $ Federal Funds $ <br />Percentage County Funds Matching Funds $ CFDA# <br />In -Kind $ <br />Is 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 />Budget Information <br />_Budget Amendment Needed? Yes ❑ attach budget form <br />New Division Created? <br />Revenue Code <br />Expense Code <br />Pass Through Information <br />Agency to Pass Through <br />Amount to Pass Through <br />105 — 568.334.04.68 <br />105 — 568.54122 <br />Sub -Contract Approved I Date: <br />No U Why not <br />Expense Code: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes ❑ No ❑ <br />County departments Impacted <br />Auditor <br />Information Services <br />Prosecutor <br />BOCC Approval Needed? <br />TCb U <br />Lstaff Member Presenting: <br />Assignment of Tracking Information <br />Facilities Maintenance <br />Human Resource <br />Treasurer <br />I Reviewer I Date <br />Grant/Contract Review Page 2 <br />