HomeMy WebLinkAboutReimbursable Work Request - BOCCFarm State of We
I 1.70 1763-94250
Invoice Voucher
Health Care Authority
PO Box 42691 Vendor'iiCertificate. I hereby certify under penally of perjury that the items and touts listed herein are proper charges for materials. merchandise or services furnished
Olympia WA 98504 to Une State of Waslington, and hat al goods fwnW*d and/or services rendered ham been provided wilthout discrrnination because of age, aes marital staft., race
creed, wi national origin, handicap, religion. or Vietnam em or disabled veterans status.
Grant County
840 E Plum Street
Moses Lake, WA 98837
TAX IDENTIFICATION NUMBER
OF SERVICE (RECEIVED BY
uary 2019- Supplemental
4,1
Tom Taylor, 6OCC Chair
DATE RECEIVED
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(data)
21
lCommunity-Based Coordination-Px
Community -Based Process
Un—mal-Indinsa
PA,
k"'WAN115--'A t-Atly"'Al-z".T" ""m
22.5
Community Coalition Coordinator
Community -Based Process
Universal -Direct
-66-1-Omet
22.5
Community Coalition
Commundy-Based Process
7�7- -777,0
5t,77 7-7 -77 ;'.''X,. . . . .
22r561
Community Coalition Coordinator - ML
Community -Based Process
Universal -Direct
2265.1
Community Coalition -ML
Community -Based Process
Universal -Direct
221.1
CADCA Boat Camp- Hotel -ML
Other
Universal -Direct
519 90 r ,
519,90
22.5.1 1 Community Coaddion Coordinator -Quincy Community -Based Process Universal-Direct12
33.5�j IE—AmtyCoalition- 11-1y, C.mmunity-Baaed Process
22 7 1 AO7 Boat
Camp -Hotel -Quincy Other jLJni--I-Oim.t I F -P-,", - '0"�' A"I I I I I 1 1 519.90 519.90
PREPARED IJYf UAlh
Rayne Gonzales April 25/2019 (509) 764-2660 A19 Effective 7/11/117 through W30119 REVISED 17/31/18
CURR DOC NO DOC DATE VENDOR NO. JAGENCY APPROVAL:
VCA i SWV0002426-19 Sarah Mariani 360-725-3774 sarah.mariani@hca.wa.gov
ACCOUNTING APPROVAL FOR PAYMENT/ DATE
19 Biar—rn conly., Peg' 1 R.311118