HomeMy WebLinkAboutReimbursable Work Request - GRIS (002)2pa11 BbWum Conbacl P� 1 Reu 7.1-08
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state ofWashngmn
Invalc. V lchol
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'Mr4 r Agreement lO w Comel Number
1070 K3919
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vandorticemlicate, herebycertfyunder PanairyaParl 1-�rw'-IIID items and to ISlsI. herelna ParcMrges for mammals merchandise or-ces
Washin9l.n and Nat all goods furnished endlor sernces arae naw been Dre etl without discd anon because ora sec, mantel staNs rata tread
. on or Vietnam era or disabled veterans s /\
handicap nlq
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furnished to We State of
color national onOn,
AOECPY kN1 rj
HeaNh Can Authority _ _.
PO BOX 42691
OI m a, WA 986042691
VENDORORCIA
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Grant County
WNT
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Cindy Carter, BOCC Chair -
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840 E Flub Street
Moses Lake, WA 98637
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7- _ full.)
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TAX IDENTIFICATION NUMBER
91-6001319
MONTHIYEAR OF SERVICE
Jan -20
RECEIVED BY DATE RECEIVED
BARSpROG--11-'.-E
CSAP eTRATEOY
IOM
9AB0 GFS pvs WE PF9 to 16 DMA STR NCE SOR
EAP pp Gen.nl
SOR Supp Tdal
11,1 Admin
581 58 000 141.90 379.7a 1?5.23
1,238.53
27 Communit Based Coordination-Px
Community -Based Process
Universal -Indirect
22.5 Community Coalition Coordinator
Community -Based Process
Universal -Direct
0.00
22.5 Community Coalition
Community -Based Process
Universal -Direct
0.00
2251 Community Coalition Coordinator -ML
Community -Based Process
Universal -Direct
2,121.73
2.121.73
2251 Community Coalilion-ML
Community -Based Process
Universal -Direct
0.00
0.00
22.2,1 A%GBG N.. sr. Tninlna Sup-, s. u�,..arw- S- MI. Education
Universal -Direct
198.86
198.88
22 2,1 PAX Game 8 Tod Kits- ML
Education
Universal -Direct
4.748.78
4,746.79
0.00
0.00
0.00
0.00
0.00
0.00
0,00
0.00
0.00
0.00
0.00
22.5.1 Community Coalition Coordinator - Quincy
Community -Based Process
Uni-iul-Direcl
1 77480
1,774.60
Commmily Coalition- Member Window CW19-Quincy Community -Based Process
Universal -Direct
0.00
0.00
0.00
0.00
V2221
0.00
StrenBNa^ilq pamaies-balniyrenackvnlarluv costs -0vlzr
'Education
Universal -Direct
1690.11
1,690.41
MOO
O.OD
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
2,318.59 581.58 0.00 1,916.78 4,748.78 0.00 379.74 0.00 1 1,825.641
0.00 11,769.11
PREPARED BYI DATE
Reyna Oonnke 312812020
TELEPHONE
609764.4690
A19 Effective 711119 through 6130121 REVISED 7118119
CURR DOC NO
DOC DATE
VENDOR NO.
AGENCY APPROVAL:
Sarah Marland 360-725-9401 Sarah.Mariani@hca.wa.gov
ACCOUNTING APPROVAL FOR PAYMENTI DATE
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2pa11 BbWum Conbacl P� 1 Reu 7.1-08