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I <br />Financial lnformation <br />Bu lnformation <br />Pass Thro lnformation <br />Prosecutor Review <br />TotalAmount State Funds $Federal Funds $ <br />Percentage County Funds Matching Funds $CFDA# <br />ln-Kind 5 <br />Explain <br />ls Equipment being purchased?Who owns equipment? <br />New Personnel being hired?Contact HR hiring - reporting re quirements <br />Future impacts or liability to Kittitas County: <br />Budget Amend ment Needed? <br />New Division Created? <br />Yes f] attach budgetform No E why nor <br />Revenue Code 105 - 568.334.04.68 \/ <br />Expense Code 105 - 568.54101 vry <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 De rtments lm <br />BOCC roval Needed? <br />ment of Tracki lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasu rer <br />Yes I Non <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