HomeMy WebLinkAboutGrant Related - BOCCRN
WASHINGTON STATE
DEPARTMENT OF COMMERCE
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
0021
Commerce Contract Number
18-62210-005
A19 VOUCHER DISTRIBUTION
AGENCY NAME INSTRUCTION
DEPARTMENT OF COMMERCE;
ATTN: CDBG
PO BOAC 42525
OLYMPIA, PIA, NVA 98504-2525
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: March 2019
TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise or services fumished to the State of Washington, and
that all goods furnished and/or services rendered have been provided without discrimination
because of age, sex, marital status, race, creed, color, national origin, handicap, religion or
Vietnam era or disabled veterans status.
By:
(SIGN IN BLUE INK)
Tom Taylor, BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
7714
05 Public Services 117,597.00 25,083.58 10,645.35 $81,868.07
$0.00
$0.00
7717
21A General Admin 3,500.00 3,500.00 $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $121,097.00 $28,583.58 10,645.35 $81,868.07
Everything below this line is for Dept of Commerce
FED TAX to#
PROGRAM APPROVAL
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDORNUMBER
SWV0002426-03
ACCOUNT NO.
ASD NUMBER
34112
VENDOR MESSAGE
CDBG P mt #
M SUB
TRANS 0 MASTER SUB SUB
CODE D INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
62280320 NZ
18-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
STATE OF WASHINGTON 2018 COMMUNITY DEVELOPMENT BLOCK GRANT- PUBLIC SERVICES GRANTS
DEPT OF COMMERCE
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing counseling, credit coaching,
foreclosure services, business start-up, financial education workshops and high school classes. Free tax -prep.
ATTN: CDBG PROGRAM
CDBG amount requested for these program activities this period: $0.00
PO BOX 42525
CERTIFICATION: I certify that the information on this form is a
OLYMPIA. WA 98504-2525
true and accurate report of the tach status and that all reported
expenditures are properly chargeable to the referenced grant.
COMMUNITY ACTION AGENCY
CONTRACT NO:
Signature:
OIC OF WASHINGTON 18-62210-005
815 FRUITVALE BLVD REPORT PERIOD:
Printed Name: RITA DEBORD
YAKIMA WA 98902 Mar -19
REPORT NUMBER:
Title: CFO
9
rq f * I
TOTAL AMOUNT REQUES EDT IS
Date: 4/18/2019
$10,645.35
I. Name of Service Activity: Asset Development 36 CDBG amount requested for these program activities this period: $10.645.35
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing counseling, credit coaching,
foreclosure services, business start-up, financial education workshops and high school classes. Free tax -prep.
2. Name of Service Activity: Energy Assistance 237
CDBG amount requested for these program activities this period: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Assist Admin -Indirect Admin
CDBG amount requested for these program activities this period: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: General administration expenses associated
with managing energy assistance and asset development activities oversight and assessments. Indirect admin.
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Contract 18-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 09
MARCH 2019
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
1:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 264 2018-19\Subrecipient Checklist 2018-19.docPage
OIC OF WASHINGTON
For User: INGRID FRANK
RW Expenditure report for: 264 - 264 CDBG
Report year: 7/1/2018 thru 6/30/2019
Account
Admn Admin - Asset Dev/Energy Asst
Asst Asset Development
Ener Energy Assistance
Report Totals
General Ledger System
Page:
Page 1 of 1
Date:
4/18/2019
Period ending:
March 2019
Time:
3:38:28 PM
--------------- Moirtlrly--------------
-----------------
To Dale ---------------
Budget
Expenditures
Pct
Budget
Expenditures
Pct
Annual budget
Unexpended
$1,958.00
$0.00
0.00%
$17,622.00
$4,536.28
25.74%
$23,519.00
$18,982.72
$6,503.00
$10,645.35
t4.70%
$58,527.00
$31,046.95
53.05%
$78,085.00
$47,038.05
$1,328.00
$0.00
0.00%
$11,952.00
$145.70
1.22%
$15,993.00
$15,847.30
$9,789.00
$10,645.35
108.75%
$88,101.00
$35,728.93
40.55%
$117,597.00
$81,868.07
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active)
Report year: 7/1/2018 thru 6/30/2019 Period ending: March 2019
Account
Department:
Department:
009 INDIRECT ADMIN
Program:
02 ADMIN. POOL -BASE
5312
SALARY ADM. ALLOCATION
5354
P/R TAX & BEN. ADM ALLOC.
5999
NON PERSONNEL ADM. ALLOC.
Total for sub program ----->
Total for program 02 ----->
Program: 03 ADMIN POOL -OTHER
5312 SALARY ADM. ALLOCATION
5354 P/R TAX & BEN. ADM ALLOC.
5999 NON PERSONNEL ADM. ALLOC.
Total for sub program ----->
Total for program 03 ----->
Total for department 009 ---->
Department:
010 PROGRAM
Program:
25 PROGRAM SUPPORT
5311
SALARIES,WAGES EXPENSE
5351
FICA,OIC EXP
5352
L AND I,OIC SHARE
5353
STATE UCI(ES),OIC EXP
5355
PAID FAMILY MEDICAL LEAVE
5360
DISABILITY OIC EXPENSE
5361
MEDICAL INSURANCE,OIC EXP
5362
LIFE INSURANCE,OIC EXP
5363
PENSION,OIC EXP
5399
FRINGE
,_,� "r\-,
Page: Page 1 of 2
Date: 4/18/2019
Time: 3:37:58 PM
----Monthly--------------
-----------------To Date ---------------
Budget
Expenditures
Pct
Budget
Expenditures
Pct
Annual budget
Unexpended
c�
cel Evl 6r, � -L, 1
C /%1 / Z
- ,
9
$1,234.00
$0.00
0.00%
$11,106.00
$2,770.62
24.95%
$14,817.00
$12,046.38
$509.00
$0.00
0.00%
$4,581.00
$1,245.94
27.20%
$6,115.00
$4,869.06
$215.00
$0.00
0.00%
$1,935.00
$519.72
26.86%
$2,587.00
$2,067.28
$1,958.00
$0.00
0.00%
$17,622.00
$4,536.28
25.74%
$23,519.00
$18,982.72
$1,958.00
$0.00
0.00%
$17,62�2�00
$4,536.28
25.74%
$23,519.00
$18,982.72
$0.00
$0.00
0.00%
$0.00
$1,075.19
0.00%
$0.00
($1,075.19)
$0.00
$0.00
0.00%
$0.00
$483.72
0.00%
$0.00
($483.72)
$0.00
$0.00
0.00%
$0.00
$195.69
0.00%
$0.00
($195.69)
$0.00
$0.00
0.00%
$0.00
$1,754.60
0.00%
$0.00
($1,754.60)
$0.00
$0.00
0.00%
$0.00
$1,754.60
0.00%
$0.00
($1,754.60)
$1,958.00
$0.00
0.00%
$17,622.00
$6,290.88
35.70%
$23,519.00
$17,228.12
$4,249.00
$7,026.67
165.37%
$38,241.00
$20,126.67
52.63%
$50,988.00
$30,861.33
$313.00
$511.16
163.31%
$2,817.00
$1,467.22
52.08%
$3,757.00
$2,289.78
$30.00
$63.43
211.43%
$270.00
$154.96
57.39%
$370.00
$215.04
$88.00
$146.16
166.09%
$792.00
$418.64
52.86%
$1,061.00
$642.36
$0.00
$28.11
0.00%
$0.00
$80.51
0.00%
$0.00
($80.51)
$74.00
$125.44
169.51%
$666.00
$360.47
54.12%
$897.00
$536.53
$1,022.00
$1,754.88
171.71%
$9,198.00
$5,218.80
56.74%
$12,269.00
$7,050.20
$16.00
$36.64
229.00%
$144.00
$105.15
73.02%
$203.00
$97.85
$221.00
$491.87
222.57%
$1,989.00
$1,408.87
70.83%
$2,656.00
$1,247.13
$490.00
$460.99
94.08%
$4,410.00
$1,705.66
38.68%
$5,884.00
$4,178.34
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active)
Report year: 7/1/2018 thru 6/30/2019 Period ending: March 2019
Page: Page 2 of 2
Date: 4/18/2019
Time: 3:37:59 PM
3Y.9�,
----MonfhlV--------------
----------------- To Date ---------------
Account
Budget
Expenditures
Pct
Budget
Expenditures
Pct
Annual budget
Unexpended
Total for sub program ----->
$6,503.00
$10,645.33.70%
$58,527.00
$31,046.95
53.05%
$78,085.00
$47,038.05
Sub program: ( 54 ENERGY ASSISTANCE _ 1
5311 SA LA RIEZ:WN��LS�---'"939.00
5351 FICA,OIC EXP $70.00
5352 LAND I,OIC SHARE $8.00
5353 STATE UCI(ES),OIC EXP $19.00
5360 DISABILITY OIC EXPENSE $9.00
5361 MEDICAL INSURANCE,OIC EXP $131.00
5362 LIFE INSURANCE,OIC EXP $2.00
5363 PENSION,OIC EXP $54.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$8,451.00
$630.00
$72.00
$171.00
$81.00
$1,179.00
$18.00
$486.00
$114.00
$8.72
$1.20
$2.37
$1.88
$0.14
$0.56
$7.98
1.35%
1.38%
1.67%
1.39%
2.32%
0.01%
3.11%
1.64%
$11,270.00
$846.00
$107.00
$233.00
$119.00
$1,577.00
$35.00
$652.00
$11,156.00
$837.28
$105.80
$230.63
$117.12
$1,576.86
$34.44
$644.02
5399 FRINGE
$96.00
$0.00
0.00%
$864.00
$8.85
1.02%
$1,154.00
$1,145.15
Total for sub program 54 ----->
$1,328.00
$0.00
0.00%
$11,952.00
$145.70
1.22%
$15,993.00
$15,847.30
Total for program 25 ----->
$7,831.00
$10,645.35
135.94%
$70,479.00
$31,192.65
44.26%
$94,078.00
$62,885.35
Total for department 010 ----->
$7,831.00
$10,645.35
135.94%
$70,479.00
$31,192.65
44.26%
$94,078.00
$62,885.35
Fund Totals
$9,789.00
$10,645.35
108.75%
$88,101.00
$37,483.53
42.55%
$117,597.00
$80,113.47
3Y.9�,