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Budget Information <br />Budget Amendment Needed? <br />Yes❑ attach budget fonn <br />No M why not: Already in budget <br />New Division Created? No <br />Revenue Code: <br />Expense Code: <br />SH22-011 - SH3012-536/XXXX <br />Opioid Settlement — <br />Jail Resolution <br />N03000-200/XXXX <br />Opioid Settlement- Jail RFP <br />N03000-300/XXXX <br />Pass Through Information <br />A cnc to Pass Throu h <br />No <br />Amount to Pass Through <br />$0 <br />Sub -Contract Approved <br />Date: <br />Prosecutor Review <br />Has the Prosecutor reviewed this agreement? Yes® No ❑ CAMAS# 12721 <br />Countv Departments Impacted <br />Auditor <br />Facilities Maintenance <br />Information Services <br />Human Resource <br />Prosecutor <br />Treasurer <br />Submitted <br />Signature: <br />Date: q . 1,6;-- <br />De artment- Shydff <br />Assignment of Trackine Information <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office <br />APPROVED IN LRS #12721 <br />Who Si ed the grant application <br />Reviewer Date <br />Grant/Contract Review Page 2 <br />