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Financial Information <br />Total Amount $750,000 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 />Information <br />Budget Amendment Needed? Yes ❑ attach budget form No ❑ why not <br />New Division Created? <br />Revenue Code <br />Expense Code <br />112—1120231327/34126 <br />114 — 34127/3412701/3412702 <br />114 & 112 - 54101 <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? 71 Yes ❑ No ❑ <br />Countv Departments Impacted <br />Auditor Facilities Maintenance <br />Information Services Human Resource <br />Prosecutor Treasurer <br />BOCC Approval Needed? <br />Yes ❑ No F <br />Staff Member Presenting: <br />Assignment of Tracking Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />Who Signed the grant application <br />Reviewer I Date <br />Grant/Contract Review Page 2 <br />