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HomeMy WebLinkAboutReimbursable Work Request --il4 Farm .Stale O1 WashOytan A1S1A Invoice Voucher HesM Cam Authority _ PO BOX 42881 _ _ OlyDpta. WA 9&%4-2691 _ ran -6 - mY._. 1 Moses PlumSt A 98837 18 -- �a --- --- 7 - i - --✓- .__-_ F a•ea+c -_,T.=- _- Ap(eemant IDbrCaCraet Number -. .::' _ - m0 1763-94250 Ventlar's Cen;ficate. 1 hereby certify -der penalty of Perjury,that Ihe�_ � � - are roper char es f r 1 merchandise or sehAce fum shed to the State of Wa nngton antl that all goods turn shed anNor services rendered have been proud 'bout e o age, m al stows, race, creed, color, nations] origin. handicap rel g an. m Vietnam era or disabled veterans statosG . Iaign in ink) Tom Taylor, BOCC Chair 2-11 Noel _ (date) TAX IDENTIFICATION NUMBER 91-6001319 -- E -19 RVICE MONTH/YEAR OF S- dun - RECEIVED BY DATE RECEIVED .EARS _ FROGRnl1 AC11YrIY NIDE - - cane STRATEGY' - _ SAGFS PFS NCE - PFS201S �A STR NCE SOBS ECR SuIq aW ESP - FP Galleral 11.1 Admin 510.87 18149 - 487.48 1,179.84 21 Commun4y-Based Coordination -P, Community-Sesed Process Universal -Indirect 0.00 22.5 Community Coalition Coordinator Community -Based Process UmiersabDirect 0 00 225 Community Coalition Community -Based Process Universal -Direct 0.00 000 2251 Community Coalition Coortlinator-ML Community -Based Process Universal -Direct 6A36 95 6.436.95 22.5.1 Community Coalition Supplies - ML Community -Based Process Universal -Direct 1.15927 1.159.27 22 11 Community Prevention Education -ML Information Dissemination Universal-Dnect - - - 0.00 000 222.1 Positive Acton Program Curriculum -ML Education Universal -Direct 7430.00 1,430.00 0 00 2221 Strenghening Families Program - ML Education Universal -Direct - 000 000 2221 IPAX Good Behavior Game- Supphee- ML Education Universal -Direct 7,250.83 7,250.83 222 1 IPAX Good Behavior Game -Summit Plain Tickets- ML Education Universal -Direct 1,551.35 1,691.21 3.242.56 2261 Environmental Policy - ML Environmental Universal -Direct 0.00 coo 2271 Traming -Summer Inst Meals 8 Hotel- ML Omer Umversal-Direct 451.70 451 70 000 0 00 0.00 0 00 0 00 0.00 0 00 0 00 000 coo 2251 Community Coalron Coordinator Quincy Community -Based Process Universa[ -Direct 1.607.57 5,11572 1 6,723.29 2251 lCommunfty Coalncch- Camara -Quincy Community -Based Process Universal -Direct 648.36 648.36 2211 Youth Development - Quincy Information Dissemination Universal -Direct 0.00 0 00 2211 Public Awareness -Quincy Information Dissemination Universa] -Direct - 0.00 000 2221 Middle School LikfeSulls -Quincy Education Universal -Direct 0.00 o_00 22 2 1 Strengthening Families Program - Quincy Educabon Universal -Direct - 0.00 0.00 2231Healthy Attain vies Graduating Sar- Nighte Pliea"mitry Alternatives Universal -Direct 862.12 862.12 2231 '" • � °' Alternatives Universal -Direct 11566 115.66 22.6 Environmental Policy - Quincy Environmental Universal -Direct - 000 2271 Training- Summer Inst Meals B Hotel -Quincy Other Universal -Direct 1 661.05 1 1 1 661.05 227, Trainirg-A Mid -Year Re,-- A'r'na Tickets -0 Ily Other Universal -Direct 7,71060 7.71060 0.00 0.00 - - -. 18,280.10 51087- 1,69�212 0� ,. '-000 t4,939.94 .-0� .::9787223 PREPARED BY/DATE ___ ._.. _. - Reyna Gonzales 11/2112019 TELEPHONE ---.- 509 764-2660 A19 Effective 711119 through 6130121 REVISED 7118119 CURR DOC NO BH DOC DATE VENDOR NO. SVVV0002426-19 AGENCY APPROVAL: Sarah Mariani 360-725-3774 mariase@dshs.wa.gov ACCOUNTING APPROVAL FOR PAYMENT/ DATE 2009-11 Biannium conuacr