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I <br />Financial lnformation <br />Bu lnformation <br />Pass Thro lnformation <br />Prosecutor Review <br />Federal Funds 5State Funds $TotalAmount <br />CFDA#Matching Funds SPercentage CountY Funds <br />ln-Kind $ <br />Who owns equiPment?sedurcha ?bent neiElsu pobpmq <br />Contact HR hi irementsnhired?New Personnel bei <br />Future imPacts or liabilitY to Kittitas CountY <br />Amendment Needed?No n why notYes I attach budget form <br />New Division Created? <br />105 - 558.334.04.58Revenue Code <br />t}s -568.54L22Expense Code <br />Central Washington Disability ResourcesAgency to Pass Through <br />S 101,7oo.oo Code: 105 - 568.54101ExpenseAmount to Pass Through <br />DateSub-Contract APProved <br />Yes NoHas the Prosecutor revi ewed this agreement? <br />County rtments lmPacted <br />BOCC Needed? <br />ent of Tracki lnformation <br />Facilities MaintenanceAuditor <br />Human Resourcelnformation Services <br />TreasurerProsecutor <br />NonYes ! <br />Staff Member Presenti ng: <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant aPPlication <br />DateReviewer <br />Grant/Contract Review Page 2