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TotalAmount State Funds S Federal Funds S <br />Percentage County Funds Matching Funds S CFDA# <br />ln-Kind S <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 />Bu 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?Yes ! attach budget form No E Why not <br />New Division Created? <br />10s - s58.334.04.68Revenue Code <br />VO10s - s5854101Expense Code <br />Has the Prosecutor reviewed this agreement?Yes No <br />Cou ments lmpacted <br />BOCC A I Needed? <br />ment of Tracking lnformation <br />Facilities MaintenanceAuditor <br />Human Resourcelnformation Services <br />TreasurerProsecutor <br />NoEYes ! <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