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HomeMy WebLinkAboutGrant Related - BOCCGRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: gOCC REQUEST suBnnrr-rED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: ❑YES 0 N DATE. 1/19/2023 PHONE:ext. 2937 11111W.UR :1�11111:4 ism ❑Agreement / Contract ❑AP Vouchers --- ❑Appointment / Reappointment -W ®ARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget ❑ Computer Related ❑County Code ❑ Emergency Purchase ❑ Employee Rel. ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders 0 Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑Minutes ❑Ordinances ❑Out of State Travel El Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution F] Recommendation F] Professional Sery/Consultant ❑Support Letter ❑Sur lus Req. P q ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB 0 ----------- I=, 11 Reimbursement request -------- - --------- from New Hope in the amount of $25,859.05 from the American Rescue Plan (ARPA) fund award previously approved. DATE OF ACTION: �10, APPROVE: DENIED ABSTAIN D1: D2: Jd�Of D3: DEFERRED OR CONTINUED TO: New Hope ARPA Nov-23 128-170-00-8021-565501100 $11,.851.34 Salaries 128-170-00-8021-565502*** $5,586.38 Benefits 128-170-00-8021-565503100 $476.88 Goods &Services✓ 128-170-00-8021-565504100 $4,,322.78 Professional Service 128-170-00-8021-565504107 $226.79 Janitorial 128-170-00-8021-565504201 $10.93 Office Phonq/' 128-170-00-8021-565504202 On Call Phone 128-170-00-8021-565504700 $90.69 Office Utilities, 128-170-00-8021-565504580 $1,825.00 Client EFA -Rent/ 128-170-00-8021-565501124 $242.13 HR Service Fee\/ 128-170-00-8021-591657000 $134.40 Copier Lease 128-170-00-8021-591657001$1,091.73 Office Leasee Total $25,859.05 Signature Invoice Documentation Form: Goods & Services Worksheet Agency Name: Grant County New Hope Invoicing Period: Nov -23 Purchases by Vendor and items Vendor Items Expense code Total amount of bill Total amount billed to ABPA AT&T Office Phone 565504201 $ 49.05 $ 10.93 Kelley Connect Copier Lease 591657000/56550410 $ 630.68 134.40 Kelley Connect Copier Supplies 565503100 $ 268.18 47.93 Devries Record Mngmt Office Depot Document Shredding Office Supplies 565503100 $ 6.9G $ 1.23 565503100 $ 540.80 $ 96.6 Mario Padilla Office Utilities 565504700 $ 425.57 $ 90.69 Mario Padilla Office Lease 591657001 $ 7,726.21 11091.73 r PB Janitorial Janitorial 565504107 $ 950.0 $ 187.19 US Linen Janitorial 565504107 $ 180.06 $ 35.48 GC Human Resources HR Service Fee 565501124$ 11354.67: 242.1 Ruth Esparza Client EFA - Attorney Fee 565504100 $ 2,000.00 2,000.00 German Santiago Client EFA -Rent 565504580 $ 1,825.00 11825.0 Les Schwab Tire Client EFA -Vehicle Maint 565504100 $ 11625.46 $ 11625.46 Grant County PUD (Visa) Client EFA - Utilities 565504100 $ 424.17 $ 424.17 CDW Govt (Visa) Office Supplies 565503100 $ 374.71 $ 66.97 Oreilly`s (Visa) Client EFA - Vehicle Maint 565504100 $ 36.85 36.85 Les Schwab Tire (Visa) Client EFA - Vehicle Maint 565504100 $ 236.30 $ 236.30 Amazon (Visa) Janitorial Supplies 565504107 $ 20.9 $ 4.12 Amazon (Visa) Office Supplies 565503100 $ 1,520.78 ' $ 264.09 Total Charges $ 20,196.31 $ 8,421.33 ARPA = County (8021) Agency Name: Invoicing Period: Invoice Documentatiod: Salari Grant County New Hope Nov -23 Fode, Suzi $10,273.73 12.00% - - _.__ _,_ H� s ��, $1,232.85 Garcia, Becky $5,208.40 34.00% $1, 770.86 Sanchez, Rusila $4,477.55 47.00% $2,,104.45 Glenn, Patricia $5,502.94 57.00% $3,,136.68 Adolphsen, Elisa $6,969.68 25.00% $1, 742.42 Barrientoz, Alyce $47940.51 24.00% $1,185.72 Garcia, Celina $969.10 70.00% $678.37 $0.00 Invoice Documentati(n::.Be7neffits Total Salaries: $0.00 $11,851.34 V Fode, Suzi $273769 , . _-_ . 1200% ....,, ___.___, _., w,_���� �t�d� $328.52 Garcia, Becky $1,936.93 34.00% $658.56 Sanchez, Rusila $1,793.78 47.00% $843.08 Glenn, Patricia $2,561.71 57.00% $1,460.17 Adolphsen, Elisa $2,178.51 25.00% $544.63 Barrientoz, Alyce $2,986.30 24.00% $716.71 Garcia, Celina $1,478.16 70.00% $1, 034.71 $0.00 $0.00 $0.00 Total Benefits: $5,586.381/ Page I /I Invoice 0401079 Date 11/7/2023 County of Grant 35 CST NW P.O. Box 37 Ep.hrata.,WA 98823 Vendor: WASHINGTON TRUST BANK.. PO BOX 2127 SPOKANE WA 99210-2127 --------------- 0 M-ument Number Purchase'Order Number -1p Method Payment Terms. ID Vendor 10 Sh p�n X493- 10/2023 - -- WTBCC� Descri ton; --- I NET 30 p on; Amount Visa Statement 10/2023 M075.91 Subtotal $5,075.91 MISC $0.00 Tax $0.00 Freight $0,0 0 Trade Discount $0.00 Payment $,0.00 Total Due $5,075.91 1 � EMIERGENCY FINANCIAL ASSISTANCE REQUEST FORM y Staff: ,"k 4V --- - --- ------ Date Submitted: finevv beginnings. beliet tomorinaws- Amount requested T chant: V OSA bD CVS 0 Y P — ----------------- - - ■ # of C b 4 AF A Client IDA, ;. ..0 Client's Home City, a,' cla SsIst 'What is... --the Emergency Finan- I A '(EFA)_:.request fo 1 a nce- r Explain: ------------ i a Background check for housingMortgage # Children's needs * # Debt assistance #,service DVPO # Driver's license # Utilities bills on C6kr 9 f-0 # Education training 9 �c�rtt Assist Bus fare to return home # Car payments # Cell phone to seek work/housing Food/Necessities Family well being 00 LUL T�4 Z.) ' > 4 s mj Lt t9a ct rL+ w 1_�)e Car • Indicate what other support o resourceslwere..usec ----------- --------- E Housing Authority Salvation Array Serve Explain� xd-4s-s MUQuincy DSHS 0 CPS i Family contribution Friend contribution Supervisor 1, 'PIP pproved Date: OV .PROGRAM.- SHS ODVPA OSA OOVSC { O HD x METHOD OF PAYMENT* OCheck OPetty Cash Meblft CardrCr co Include back up documentation -------- .......... . Receipt Copy of chemo W9, tiff if Gippli4.tG[L,ile r s' j t Updated: Alce K. Bardentoz - ---------- -7 From: Carmen F. Aguila Sent: Thursday, November 2, 2023 3-58 PM To: Alyce K. Barrientoz Subject: Fw: Guardianship of Attachments, LASTEST INVOICE.pdf I Nvill get you the EFA for this. Su zi agreed to pay- $2,000 on7. CaormewvA g vua Legal and Community Advocate From: Jessica Blanco <jessica@esparzaIaw.net> Sent: Thursday, November 2, 2023 2:03 PM To: Carmen F. Aguila <cfaguila@grantcount ywagov> Subject: Fwd,* Guardianship of Jessica Blanco Ixgal Assistant Esparza Law, PLIC 113 Second. St. #400 Vb!"e-natchee, WA 98801 (5-09) 881-51-53) 1 otice: The information contained in this e-mail (including any attachments) message may be privileged, confidential and .L -4 protected from disclosure. If you are not the intended recipient, any dissemination, distribution or copying of the contents of this message is strictly prohibited. If you think you received this message in error, please delete the message and e-mail the sender at O jessicar rzalaw.net. I ,,espq ---------- Forwarded message --------- From: Jessica Blanco <jess1ca@esparza1aw.net> Date'. Wed, Oct 11, 2023 at 1:35 PM Subject: Guardianship of To: Carmen F. Aguila <cfagu*1la@g[antcountywa.gov> I . Good afternoon, Thank your for your call this afternoon, per our conversation see the attached latest invoice. Jessica Blanco Legal Assistant Es arta Law,13L 113 Secotid St. #400 W"enatchee, WA 98801 (509) 881-515 )3 Notice: The information contained in this e-rnail (including any attachments) message may be privileged, confidential and protected from disclosure. If you are not the intended recipient, any dissemination, distribuu-ion or copying of the contents of this message is strictly prohibited. If you think you received this message in error, please delete the message and e-mail the sender at M*sicaaesparz alaw. net. County of Grant. 35 C ST NW P.P. Box 37 Ephrata WA 98823 Vendor: WASHINGTON TRUST BANK.. PO BOX 2127 .SPOKANE WA 99210-2127 Document Number Purchase OrdOr Number 96--63- 101-20 2­3- WTBCC Description: Visa Statement 10/2023 Page 1 /1 Invoice 0401084 Date 11/7/2023 VenderD Shipping Methdd Payment Terms ID NET 30 Amount $3,126.25 Subtotal $3; 126.25 Misc $0.00 Tax $0.00 Freight $0.00 Trade Discount $0100 Payment $0.00 . Total Due $3 126.25 EMERGENCY FINANCIAL ASSISTANCE REQUEST FORM Staff. . Date Submitted, 2�� k - Amount **^qu6e te d r�Lu Cl ^.,, 5. 0 . q001.00 Type. of client. DV EISA VSC 'HDP # of Children: en: {#i �y •� * mss'' �01 Client Rai .�3L4 :')435 Client's Home City: ,w• X 1✓-- 4: 'Y w F•= a . dl.b t.r rL- - F s l e ;c 7 :r:, :t. t t V.P�n. >f ,^.;<.' S^ i T' ,z ��f : � r- :fr• !> ;� f�' -.E 3 �J',r• r��. .1% ff s5+r� ..se �, . X. 2 • - - ,;t ?>. -..S'.. �-.ti•-'��' �:s:.? :vl �t Lo ���3c,w:. - b'• '� Rat r •%+^a+' ! ' � .�:'✓ _ er✓'t' > T F.j > ^ as A i l x. f L�. .✓"'�--ic`t>«l ,`,t .'C` d": �' <.• � }� w''4,. fj•',-u 4 #• S Z' ✓ is 'i Y 1. f L aa'w • Background Check for housing E fain XP ot � • Children's needs ae Mortgage * �eC1f lc�' l� P � i N+4M I A0 r • Debt assistance • Driver s license Utilities bills n(" ul6 � . f t. • Education training, pp(,�,�J, • :11#Ius fare to return. home b/ Security ,assist � �y»a�t, ,y�>y� Assist (.yy�jF, �+IJn�'1nM1�R {��,M.j ly%I�. +� Car payments �, � �� �A 6 4 Y t � �� � �y\.d On Cell phone to welt work/housing . • Family well beim Food/Necessities P C4. 161 - a , i. :Ir _ , L _ F . '% i'. . - :... a --i.. ... � ., - t >f _ n w. .. i.. f ,. _.... -moo d'.�tr'. UP '� Housing Authority---- valuation Armor Serve MUQuincy # E t l� wy� � � --- � o- 1S, 0 CPQkC C bi 0 Family contribution Friend contribution �; xaQg_6 ay_� Act ` S Si nat g ure U Aupeivisor. Ped .0 -De 'ied P rov n Date. PROGRAM: OD H VP CASA D V C OY HDP JA_ METHOD OF PAYMENT: ♦ heck OPe ty dash ODebit CardWD reit Card 0 , Include back up documentation: Receipt Copy of check tt'419, if applicable Updated: 2/11/2020 1146 LWG 3 7 1 231102 0 PAGE 2 OF 2 1 0 4833 0030 CX48 OIAC1146 Cardholder Name and Account Number 'age 2 of 2 NEW HOPE SHELTER ADVOCATE VISA GRANT COUNTY XXXX-C-8493 i ........... ..' may/! +��iyYy�.y�j�y' �/�+�■�)+y■���Ms�. y�e���y}y��y■ ,y(y�� y■� RV�i irT+3�l ANV •#M/'An`#R1if�r►AN4 Post Da Tans Date Reference Descd tion. Amount 10/25 10124 24226389ABLGZAHTX WAL-MART #2007 MOSES LADE WA $2431 10/27 10/26 24137469QO120NQZQ USPS PO 5456420837 MOSES LAKE WA $66.00 ' 1.0127 10/26 24692,169B2ZQF756N SCS *1.49 DESIGNS Ephrata VSA $1,607.53 10/20 10127 24445009Q5SB 6145 WALMART.COM 8009666546 800-966-8546 ARR X44.31 11101 10/30 24154079G31T8Y88N STAPLES 00113019 MOSES LASE WA. 11101 10/31 24431069G2DYYTAVVX GRAFT PEED 509-758-2508 WA $2C>4.02--- 11/01 10/31 .24431069G2DZDXHW4 GRANTPUD 500-758-2508 WA $160A51-1-;, 11/01 10/31 24455019G447Y5N45 WAL-DART #2007 MASE LAKE A $5,2�a ° 11/01 10/31 24733349GOF'�11M9'�fZQ MI CASA MARKET MOSES LAKE WA_` $13.99 11102 11102 00000000000000MPC TOTAL PURCHASES $5,075.91 TOTAL $5,075.91 TOTAL FEES FOR THIS PERIOD TOTAL INTEREST FOR THIS PERIOD FOR REBATE PROGRAM QUESTIONS, CALL 800.788-4578. Due back to �31 County of Grant 35 C ST NW P.O. Box, 37 Ephrata WA 98823 Vendor.- WASHINGTON TRUST BANK.. PO BOX, 2127 SPOKANEWA 992110-2127 Document: Number 7139 - 10/2023 CRED Description: Visa Statement Credit 1012023 Purchase. Order Number Vendor ltd i WTBCC Page 1 /1 Credit Memo 0401078 Date 11/7/2023 Subtotal$47.67 Misc $0. 00 Tax $0,00 Freight $0.00 Trade Discount $0.00 Payment $0.00 Total $47.67 1146 LWG 3 7 1 231102 0 PAGE 2 OF 2 Cardholder Marne and Account Number AL.YCE SARRIENTOZ GRANT COUNTY X, -XXX-.LXX-713 1 0 4833 0030 CX48 OIA 01146 VISA Page 2of2 FOR REBATE PROGRAM QUESTIONS, CALL 800~788-4578. Tra sal ons (6ont need Pest. Date Trans Dae Reference Description Amount 10/27 10127 24692l69Q2-ZKMDH4W EXPEDIA 72684783798431 EPEDIA.COM WA $601.32, 10/29 10/27 244 1059DRQEEN6GS O'REILLY 3732 EPH BATA WA $36.86 10/29 10/27 24445009DHE11F:WHGX LES SCHWAB TIRES #0342 EPHRATA WA $236.30 11/01 10131 24226369HBLH5RPAT VIAL -MART ##2007 11 OSES LAKE WA $47.77 11/02 11/02 0O000000000000MPC TOTAL PURCHASES $2,012;63 TOTAL RETURNS $47.67 TOTAL. $1,964.96 TOTAL FEES FOR THIS PERIOD TOTAL INTEREST FOR THIS PERIOD FOR REBATE PROGRAM QUESTIONS, CALL 800~788-4578. EMERGENCY FIINANCIAL ASSISTANCE RE QUEST FORM Staff. Rusila Sanchez y Date Submitted. 10125/2023 new beginnirqs. befter Amount requested 1 Z tomorrows Type of client, xDV SA EICS i # of Children: 3 Client D GE 11 /6775 'Client's Home Citi., Ephrata, w .;Y t � �. ;a •vf:. G � t.. d i '1s Explain: Client is seeking assistance with a car hatters and some • .Background check for housings switches for his vehicle'. The client does. not have other means of * Mortgage transportation and has three young children who have medical • Children's .needs Service DPO •Dassistances assistance • Utilities bills appointments. A vehicle is essential for this client because he lives in a. • Dnv r s license 0 Security Assist rural area. The client will be going into surgery soon and needs his • Education training • Rental Assist vehicle to run to be able to take his children to -school during winter. • Bus fare to return home Car payments • Cell phone to seely work/housing This assistance would help client. tremendously because he is ai single � � Food/Necessities • Family Well being fathe.i wit zer support+ c vv " ' s rt b i� '.. „ _ _. :. %«'ri 'R�.��%24.,� 1C.�". .. .. .,,v� _. �,".->< .. .. .> '� r. _.. ,.... � ,�- anL�tfiit�;s� iC• _ Housin g Authon Explain. • Salvation army 0e�rve l uincy H DSHS • CP • Family contribution • Friend contribution ! 4. t. T i. yY. f '4 5. 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'f S. aiM:.: Include back up documentation; Receipt Copy of check y W% if applicable Updated, 2/11/2020 10/4/23, 4:23 PIVI CHECKOUT: KOUT., CONFIRMATION CHECKOUT: CONFIRMATION Account Cart 10 Thank you for your order. Order Number-, 1CCGRXW Order by: Alyce Barrientoz Date: 10/4/2023 6:23:25 PM Confirmation Emait Sent to: abarrientoz@grantcountywa,gov Billed from; CDD Government, 75 Rem itta nce Dr., Suite 1515, Chicago, IL - 60675 (800) 594-4239 Want to Ship This Order to Another Address? Reorder Now. Reorder and ship the exact same items, add new items or change quantities. 0 Shipping Address Alyce Barrientoz New Hope Narne/Attention.- Alyce Bardentoz 311 W 1rd, Ave Moses Lake, WA 98837-1905 Shipping method UPS 2nd Day Air Monday, October 9, 2023 (Air) $14.11 Ship all items together Billing & Payment Billing'Address Payment Method Grant County, Alyce Sarrientoz visa Expires-, 12/2024 PO* Box 37 Ephrata, WA 98823 P.O. Number/Description Office supply Order Details ITEM QUAN-1717Y PRICE EXTENDED PRICE Lenovo ThinkPad Universal Thunderbolt 4 1 $331.54 $331-54 Smart Dock - docking station - Thun MFG #:40BI0135US CDW Part.6846233 UNSIPSC:43211602 OrderSummary subtotal $331.54 *ATTENTION NEW FEDERAL CUSTOMERS: Shipping $14.13 If tax appears on your order, it will be deleted when the order is processed, No tax will Sales Tax $29.04 be charged. Order Total $374,71 https.,//www.cdwg.com/Cheekout/confirmat'lon'.?orderkey=AFCBCA55-5515-450E-A59D-OBE6CBFC41 DB 1/2 19-23 02:63 PM $476-N"i , ASSIGNMENT OF WARRANTIES - LIMITATION OF REMEDIES, SELLER ASSIGNS TO PURCHASER ALL RIGHTS AND REMEDIES UNDER MANUFACTURER EXPRESS AND IMPLIED WARRANTIES BUT OTHERWISE EXCLUDES ALL LIABILITY FOR WARRANTY DAMAGES. INCIDENTAL AND CONSEQUENTIAL DAMAGES OF ANY TYPE WHATSOEVER, EXCLUDED TO EXTENT LAW ALLOWS. ALL CLA.IMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS INVOICE. Customer Signature X 4, 411. indicates promotional price For moreinformation on our products and seMces, Nn"sft www.LesSchwab.com. All parts now unless specified. Invoice Date[Time: 10-19-2023 04:23 PM Page 2 of 2 i M N Y FIN NkC"AAL AS` 5 W RE"`0`T F"'I'M UEb UK 3 Oh Al .. y 0 1 staff: it ' �/ 1/P - x� jy Date Submitted. 3 3Wr�, qct (@ yyr �sj sq� §{ };9¢ ows. new 3 i Amount requested Tyne of IL-Ap%� ---ft, clie V OSA OCVSC 0 DP # of Children: t� Client ID: E 0 Wnrim�lµ Client's Home City: lk, I - 0 -�)C" .. .... . ------------------------- is - Wh � h -E-- e r enc... . �. nand a l .' � � EFA) � �oques forla. { Explain: • Background check for housing Mortgage • Children's needs Ince * Service INFO • Debt a'h/'.1.� i�Y *Yew � k { • Driver's licene * t�l�t�es bill* ' fif on ;, f <) • Education training Security Assist • Bus fare to return home Rental ;Assist ic> * Car arnent Cell phone to seek workhousin ki/ Pat, Family well being 51 Lt Y9 Indicate'j? Housing Authority Saltation Army pan: L) kd.,�P -S Serve MUQuincy DSHS3 CPS Family contribution Friend contribution Supervisor Signature., ---------- I A proved 11 Denied \1 Ap. Date: IRLIOGRAW, O SHS DVP OSA CVSC YHP METHOD OF PAYMENT: OCheck OPetty Cash ElDebit Card %�redit Card Include back up documentation. Receipt Copy of check W9, if applicable e E ff� Updated, 2/11/2020 F*mW**9 qu for Taxpayer Q:WV.00totWM'S) dnttn Number and Cifatn 110 Irk= ; V W, IM" *S I '_" o- Go to *wwJmgov/FbrmWV for Instmeflons srW the Wast InfoffmaWn. WOM 5q- -1 1 - r r � F e _�r I . � I I I I 1 W Na" Is mquWl on tMe the; do not leave this D" blank. t4" (as Shown W yow kuxwm rehim) CL Germn Sandagq "emandlez 2 Misiewmas nan-WdW*gwded entity MMO, 3 ChjK* OpWop"s box fbr W" tax da"ftatkm of the Win whom 0" Is entered on One i. Chw* on w* of the kMowkV w." box#& Indiv*Jual/9010 pvprwor or El c corporawn D s corptnoon El Pwtnmhip 11 Twsveeats LLC Give Form to the raquesWr. Do not send to the IRS. 4 F_xwVtkw* * o* to Owwrl Orl%", ro kovwuafs; S" kwhewm on PVI 3); E"Mpt M" cods Of awy) 0 Lh*ed Nabft, M.nP-WW- EAtW 916 NIX Cia"Meawn (0---c- Corptom ss MPMftn' P=PX1W4* * Noto: Ct*ck ft appropdate box In ft rm above ftw the tax ckwification of the single -member owrw. Do rx)t dw,..k Exempti from F ATC .A repoMr LLC 4 the LLC i�s cWmTed as a ftk��ftr LLO ftt is tiLvogwded Imm the ow' w*u the OwrierOf 010 = is OXM rd SM*h W w*#w LLC ftt is root dimoparded ftm the owner for U.S. W tax WMM9. Oftrwho, a skVk�-merrkff LtC #v# is ftmgwded **m tM ovww shmAd check 0* apprWlate box for the tax ctwowation of ft owrw. I 0OW 0" k4VU06") * &0% (nurfgW, Stmt, and aPt. Or sufte no) See instrwOons. Qu'L'rnLr, WA M48 7 is act mmiMos) twe Opft* Enter your TIN mi the appropiate bm The TIN Provided must match the name given on One 1 to avoid bacl(V wffftking. FOr Oxf�� Ws is generWly your social security number M. However, for a rftident aliem sole pqxkftr,, or dwWarded entity, see the instructions for Part 1, Ww. For Wim'" entt*S, it is your identifimfion number (EIN). If you do not have a nwtw,, see How to got a TW, WM Noten If the account is in more ffm one name, sw the instructions for line 1. Also see What Nam and Nwrbw To G� ge Reqjsstar for guidelines on w4we number to enter. Ox" ft 0010* ft U $-I woi~o _ L rw,*- a.W. ad&sa (ooftn4 - — — ------ ----- ---------- 'Dun I'D once L moo Under woMw of pe*sy, I cerW ftt 1. The ralrber 4wmn on #is form IS M correcA i WMer identiftation number (or I am wWWq. for a rimber to be !=md to, nv); and 2. 1 am rot stbiect to badaip wMx**V because: (a) I am w,,empt from badq�p wftMx**V., or (b) I tom flot been noffled by ffm hyternual Revenue Swice WP #ud I am Mi4ect to badoip WffiftOng as a resuft of a failure to report au Interest or OWerm1% or (c) the IRS h no kxW wbjed to bacl%p wftK"1ng;, -and as notified me that I am 3. 1 arn a U.S. cifim or other U.S. person (defined below); and 4. The FATCA wdeW entered on ft form Of any) ind` from FATCA reMtrig - =Tect is CerWk*5w kwbucftm You must cross obt item 2 above if you have been WOW by the IRS that you are currently subiect to backup mfithhoOng because you have WW to report all kdw-W aW dMdends on your tax return. For real estate km 2 does riot apply. For mottago intemt - acqWAM orabW4MwrWd of se=sd pmpeft cancellation of debt., contributl'ons to an kdviduW re&wxmt amwgemmt pRA), WW paidt. 9ener*,, payme(ft Ww tm kftag and d*wWends,, you are not requited to sin the ceMcaffon, but you must pmvide your CWeCt 11N. See the om f11, e . or Pad tat`. SOctiOn tefOWXx* am to the Interim Revenue C*de unless otherwise row. FuWrO . FOr the Westk4mmlion *W developments related to F W-9 ar)d b lrwUwWm, such as legislation enacted WW #*Y WOM WWWW, go to WWW.,1r5.gov1FbtmV*. Purpose of Form An individual or wW (Form W-9 reques* Wto is required to Me an infOrmadOn nAum with thO IRS must obtain your car%t taxpayer Identification number (r" wiroch MY bO YW $WW SOCUrity number (SSN), i"divid" to mer' k"ficadon number ([TIM, adwdon WMer kkw"Ca� MWMW MM, Or WrPIQYer idOntification number ON, to refit On an inf0mulfim return the amount PaW to you, or Other amount reportable on an Inforrnation retum, ExampWs of informa#on returns Include, but are not limited to, the following, # Form 1099 -INT (interest owned or pao NAFWAM Fban 1099, -DIV (&vJd*n&.:1,, Wudrmj ffXW fi-OM stocks orm. utual Form 1039 -MC (amu s types of kxxxne, prizes, awards, or gross proceeft) * Form 1099-8 (stock or mutual kind uW and cerWn raw tametions by brokom) • Form 11 W (p=oeds from real $state tn"1saCb=) • Foffn 1099-K (merctwt card and third party netwo* ftwetions) • Form 1098 Rxxm mort~ intemt), I OWE (stent ken interest), I OWT btu ion * Form 1 OWC (Covelod debt) * Form I 099-A (acquisition or abwxWnwt of secured property) Use Form W-9 o* if you am a U.S. person Qnclucft a resident alien), to provide your correct "M If you do not tuturn Form W-9 to ft tequester wfth a 77NO you ni4ght be subject to backup withho"V. 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M K yyr� a\ ` `\'att�, Ric t `' 3 vc i 1 Tt'� 3. �\ g`CzS C1 �, a ah aV \"J`A {+t \ a) ", +k Y ° �Ow 0 \,SMt`Mh Z \`i Okv \ \ < {' ,3k. t! .Y� ryv saat J " �� \7y0�,Sop, g 1��ia\ \\\��\�\\ "a � n + � t• ? t a° �7 _ �c kr\d 4 �w a t 'h t'P\�\\ ��4 e3`' V,;ag �a r „Yx aF{ 'Y\ ��,iY k #1 ?^' L '%G„ �' ' ik t i1n �i\\'\•m^'ik'�i,7Q� �?,`}�Y.,' ��kkuuu �'it��`��,�{'Fr�''a,Za\' 4v`v+ �\ ,�e��{ftlrw}d s,>k aS r}.^c'al��«� :'� + @ e a` .}, ....n, , t6uk :, i4,,,,t, 'V\$ ,',th<\\ W. \ ,k�^ \ ' \+ { ,, a F h 4 u y.. ; a" s ru\ rob`�•`\,�. �\ �a P \, , �, t �ic! >.�\C , a i ,, ,,- b m,. . mS4 at \? i r,�J�, . . EMERGENCY FINANCIAL ASSISTANCE REQUEST FORM "'.. 00 r1ew eg, 1) ningrter , tomortrows js� be, Type of client: OV OSA *VSC 0 YHW Staff: Date Submitted: [ �� �` , Amount que ted ci e.- ojt te r ri C C) 06). ry # of Children: -- -------- Client ID. A 4Zt f k Client's Home City, L) ............. What.i.s.1ne gencyiftinCan ssisa c a td n t quo$ ­ Explain` • Background check for housing mortgage U61 • Children's needs to S C. • Debt assistance # Service DVPo �(4 0 • Drev er.ts license * Utilities bills • Education trainingy * Securit Assist # Bus fare to return home 9 Rental Assist Ptc 61 * Cell phone to seek work/housing o Car payments Col .50 5kz 13 o Food /Necessities- # Family well being Indicate what other suPport. 0 r. resources were -,,used? # Housing Authority plai 0 SalvatioExn: n Army Lot 6 Serve MUQuincy DSHS C) C,70 16111 CPS I cat�l CA C Family contributi ton Friend contribution It p Approved 0 Denied Dates PROGRAM, DDS 11DVPA 13SA OS C Ei YHDP METHOD OF PAYMENT, *heck OPetty Cash Mi t Card KCredit Card 13 Include back up documentation: Receipt Copy of check W9, if applicable Updated: 2/11/2020 Prior Balances Date Invoice Number 08/11/2023 177 Total Due Date Amount Payments/Credits 08/18/2023 $3,042.50 $1t185.00 $3,042.50 $1,185.00 Payment Summary Date Note. Paid By 08/11/2023 Account Summary Account Name Trust Transaction History Trust Balance Date Description 05/05/2023 Check deposit 05/12/2023 Transfer to Operating for payment of Invoice $0.00 #93 05/22/2023 Transfer to Operating for payment of invoice $0.00 # 100 05/23/2023 Cash deposit 06/06/2023 Transfer to Operating for payment of *Invoice $2x935M #100 06/08/2023 Transfer to Operating for payment of invoice $3tociacio #111 07/05/2023 Cash deposit 07/10/2023 Transfer to Operating for payment of invoice $1380.00 #132 07/10/2023 Transfer to Operating for payment of invoice $0.00 #111 07/19/2023 Transfer to Operating for payment of invoice #147 08/11/2023 Transfer to Operating for payment of invoice # 177 Due $lt857.50 $1,857.50 Source Amount Trust $1185.00 Balance $0DO Credit Debit Balance $5.000.00 $0,00 $5tOOO.00 $0.00 $3,095.00 $1,905.00 $0.00 $1,905.00 $0.00 $5,00 0.00 $0.00 $5s000.00 $0.00 $2,065-00 $2,935.00 $0.00 $2x935M $0.00 $3,000.00 $0.00 $3tociacio $0.00 $552.50 $2447.50 $0.00 $1,067.50 $1380.00 $0.00 $195m $1,185.00 $0.00 $1,185.00 $0.00 Invoice No.: 192 Page 2/3 Total Invoice No.: 192 Page 3/3 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor: GRANT CO HUMAN RES Document Number rM Purchase Order Number WU12U/43-NH = HR5 Description-, HR Service Fee Vendor[D Page 1 / 1 Invoice 0401499 Date 11/15/2023 __ - -__ - . ....... I . ......... . ..... . . . ........ . ....... Shipping Method Payment Terms ID - — ---------- NET 30 Amount 511354,671 Subtotat M12sc Tax Freight Trade Discount Payment Total Due $1,3541.67 $0,00 $0.00 $0.00 $0,100 $0.00 $11%354.67 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor., RUTH ESPARZA ESPARZA LAW PLLC 113 SECOND ST SUITE 400 WE ATH WA 98801 Document Number Purchase Order Number - — --------- I --------- - - - ------ — - ----- .......... ...... . ..... Description: Client EFA - Attorney. 'Vendor ID ESPAR Page 1 / 1 Invoice 0401098 Date 11/7/2023 Shipping Method Payment Terms ID Amount $27000.00 Subtotal $2,000.00 misc $0.00 Tax, $0,00 Freight $0, 00 Trade Discount $0.00 Payment $0.00 Total Due $2)000100 'nen U.S. Li ind Uniform Delive..ru, Invoice U.S. LINEN & UNIFORM 1106 HARDING ST RICHLAND, WA 99352 (888)875-46361 NEW HOPE 311 W THIRD AVE MOSES LAKE, WA 98837 T 0 11/09/2023 3225833 Thu 110350 5 4180 CHG 110350-00000 311 OFFICE ROUTE .. ...... . . 'D Cn 08 btl :es M Lin 1 11" 1 6265 3X5 SLATE MAT 3 6 $0.00 $17.35' 2 6269 3X10 SLATE MAT 4 8 $0.00 $44.92 FUELSURCHARGEMOO $7.50 S ERV/DEL CHG V 5-7- TEXTILE MAINTENANCE ���1 � ��. Total Due Cur. Bus. Cur. Bal. 30 60 90 120 $88.02 $0.00 $88.02 $ 0.00 $0.00 $0.00 $0,00 Comment: Received By: Office Adj.: $0.00 Subtotal: Tax Adj,: $0.00 Sales Tax: Net Adj.: $0.00 Prebill: Total Adj,: Tax Adj.: $84.91 Route Adj.: $7.13 Tax Adj.: $92.04 Net Adj.: US. n A, and U ri , f o rMo� — ., \V U.S. LINEN & UNIFORM 1106 HARDING ST RICHLAND, WA 99352 (888)875-4636 "Mmaj NEW HOPE 311 WT IRD AVE MOSES LAKE, WA 98837 Date invoice Day Garment Mark Freq.] Se q Term Account Route 10,12612023 3218607 1 Thu 110350 5 4180 .1 j CHG 110350-00000 311 Comment: Total Due Cur. Bus. Cur, Bal. 30 60 90 120 $88.02 $0,00 $88.02 SO.00 $0,00 $0.00 $0.00 KeGeivea by: N I U/Zb/ZUZ3 1:59WIPM I ......... ....... -- Office Adj,, $0.00 Subtotaf OFFICE Tax Adj,: $0.00 Sales Tax: OUT Net Adj. $0-00 Prebilk Line iter Empf Name I Description Sizes Qty. Inv. Min. Ad EAdj. Arnt' jQty. Ext. Price Adf� Q ty. Adj, Amt. Totai 6265 3X5 SLATE MAT 3 6 0 $0.00 $1&52 0 $0,00 $16.52 2 6269 3XIO SLATE MAT 4 8 0 $0.00 $42,78 0 $0�00 $42,78 FUEL SURCHARGE $0.00 $7.50 $0;00 $T50 SERV/DEL CHG $0.00 $7,20 $0.00 $7.20 TEXTILE MAINTENANCE .. ......... $0.00$7 ,20 $0,00 $7.20 Comment: Total Due Cur. Bus. Cur, Bal. 30 60 90 120 $88.02 $0,00 $88.02 SO.00 $0,00 $0.00 $0.00 KeGeivea by: N I U/Zb/ZUZ3 1:59WIPM I ......... ....... -- Office Adj,, $0.00 Subtotaf 8120 Rte. Adj.: $0,00 Tax Adj,: $0.00 Sales Tax: $6.82 Tax Adj_: $0.00 Net Adj. $0-00 Prebilk $88.02 NetAdj.: $0.00 Total Adj,, WOO Tax Adj.: $0.00 Net Charge: $88.02 Page 1 /1 Invoice 0401518 Date 11/15/2023 County of Grant, 35 C ST NW P.O. Box 37 Ephrata WAS 98823 Vendor: U,S.Linen Uniform 1106 Harding St. Richland WA 99352 .......... -------- Document Number Purchase Order Number I Vendor lD Shipping Method Payment Terms ID ------------------ ------ ..... ....... . . ..... ........ ........... . .............. ------ 3225833 USLUF NET 30 - - -­- . ........ ......... Description. Amount Janitorial $92.04 ................. ...... . ..... . ...... ... . ... ......... - - -- - __ ........... . ................... ............. ........... ......... _-_ ........... Subtotal $92.04 mise $0.00 Tax $0.00 Freight $0.00 Trade Discount $0.00 Payment $0.00 Total Due $92.04 r B JANITOR 16,22 5 WALL T. 10ES LAKE, VIVA 98837 509-989-42,52 BARRIEENTOZtPA 1GE2112?@GMAIL,COM Description November, JANITORIAL November WINDOW WASHING Date: I 1 /0 1 /2023 INVOICE # 202311 To NEW HOPE 311 W TMD AVE MOSES LAKE, WA 98837 509-764-8402 SFODE@GRANT COUNTYWA -GOV ABA RRIENTOZ@GRA NTCOUNTYWA GO V Harr Line Total 750.00 200.00 Total 950.00 Make all. checks payable to PAIGE BARRIENT OZ Thank you for your bust"ness! Page I / 1 Invoice 0400673 Date 11/1/2023 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor: PAIGE BARRIENTOZ 1622 S WALLACE ST MOSES LAKE WA 98837 Document Number r NumberVendor]D' Ship 'no Method P1 .... . .. . . . ....... --- - - ----- . ..... Purchase Orde '202311 ..... . ...... BARNP .......... ........ . .......... 'Description: Janitorial fi - - -------------- Subtotal MISC Tax Freight Trade Discount Payment Total Due Payment Terms-- -ID--- . . ............... 11-1 ........ . . . ...... . ... .. . . . ............. ..... . ............ Amount $9 50.0 0 $950.00 $0.00 $0.00 $0.00 $0..00 $0.00 $950.00 Rents due, in advance, without receipt of a billing or statement, the first day of each �I -* V month and is to be paia carectly to THE LESSOR. A one and one-half percent (1.5%) service charge will be collected Bor payments received after the tenth of the month for the month in which they are due. If any cheek received by THE LESSOR is - returned for any reason THE LESSOR will make an additional charge of Twenty- Mve Dollars ($25.00). In the event the tenn of this Lease shallbegm' or end other than on the first day of a calendar month, the rental. for any such partial month shall be pro -rated. Rental for months other than partial months shall be paid on the first day of each calendar month, in. advance for the ensuing month. 3. OTHER TAXES,- THE LESSEE shall pay all taxes, licenses and fees, which by law are ImPosed on THE LESSEE, by reason of THE LESSEE'S operations or upon any of THE LESSEE'S personal property situate in or about the leased prerwises. If other taxes, licenses- or fees, which by law are 'imposed on THE LESSEE or assessed upon the premises leased herein during the term of this Lease by any governmental, agency, THE LESSEE shall reasonably pay same. 4. USE: THE LESSEE shall not use said pr-emi"ses for any other puqose other than the use of general executive office space and the uses resulting thereby without the prior written consent of the Lessor, in which said consent shall not be unreasonably Withheld. THE LESSEE agrees that no stock of goods Will be carried or anything :one M' or about the presses which will increase the present rate of insurance. The rental contained herein is predicated on, among other things, THE LESSOR!S existing insurance prenuums, and in the event that THE LESSEE'S Commercial Lease Page 2 10 Year Year Year Year Year Year One Two Three Four Five Year Six Seven 81112022 811123- 811124- 811125- 811126- 811127- 811128- -7131123 7131122 7131125 8131126 7131127 7131128 7131129 Kids Hope Rent $3,992-00 K151. 8 $4.,317-75 $4,490.46 $4,670.08 $4.,856.88 $5,051,15 Landlord Donated Portion $300.00 1 $300.00 1 $300.00 $300.00 $300.00 $300.00 1 $300.00 Net Amount Due from New Hope $31692.00. $3851.68 $42017351 $4J90.46 $4,370.08 $4,556-88 $4751.15 Rents due, in advance, without receipt of a billing or statement, the first day of each �I -* V month and is to be paia carectly to THE LESSOR. A one and one-half percent (1.5%) service charge will be collected Bor payments received after the tenth of the month for the month in which they are due. If any cheek received by THE LESSOR is - returned for any reason THE LESSOR will make an additional charge of Twenty- Mve Dollars ($25.00). In the event the tenn of this Lease shallbegm' or end other than on the first day of a calendar month, the rental. for any such partial month shall be pro -rated. Rental for months other than partial months shall be paid on the first day of each calendar month, in. advance for the ensuing month. 3. OTHER TAXES,- THE LESSEE shall pay all taxes, licenses and fees, which by law are ImPosed on THE LESSEE, by reason of THE LESSEE'S operations or upon any of THE LESSEE'S personal property situate in or about the leased prerwises. If other taxes, licenses- or fees, which by law are 'imposed on THE LESSEE or assessed upon the premises leased herein during the term of this Lease by any governmental, agency, THE LESSEE shall reasonably pay same. 4. USE: THE LESSEE shall not use said pr-emi"ses for any other puqose other than the use of general executive office space and the uses resulting thereby without the prior written consent of the Lessor, in which said consent shall not be unreasonably Withheld. THE LESSEE agrees that no stock of goods Will be carried or anything :one M' or about the presses which will increase the present rate of insurance. The rental contained herein is predicated on, among other things, THE LESSOR!S existing insurance prenuums, and in the event that THE LESSEE'S Commercial Lease Page 2 10 Rent is due, M* advance, without receipt of a billffig or statement the first day of each month and is to be paid directly to THELESSOR. A one and one-half percent (1.50/,a) service charge will be collected for payments received after the tenth of the month for the month * which they are due. If any check received by THE LESSOR is retumed for any reason, THE LESSOR will make an additional charge of Twenty -Five Dollars ($25.00). In the event the term of this Lease shall be9* or end terod hthan on the first ay of a M calendar month, the rental for any such partial month shall be pro -rated. Rental for months other than partial months shall be paid on the first day of each calendar month, M* advance for the ensu*month. Ing 3. OTHER TAXES: THE LESSEE shall pay all taxes, licenses and fees, which by law are imposed on THE LESSEE, by reason of THE LESSEE'S operations or upon any of THE LESSEE'S personal property situate M or about the leased prem*ses. If other taxes, licenses or fees, which by law are. u*nposed on THE LESSEE or assessed upon the premises leased herein during the term of this Lease by any governmental agency, THE LESSEE shall reasonably pay same. 4. USE: THE LESSEE shall not use said premises for any other purpose other than the use of general executive office space and the uses resulting thereby without the prior written consent of the Lessor, M* which said consent shall not be unreasonably withheld. THE LESSEE agrees that no stock of goods Will be carried or anything done in or about the premises which will increase the present rate of insurance. The rental contaffied herein is predicated on, among other things, THE: LESSORS, existing m*surance premiums, and M* the event that THE LESSEE'S Commercial Lease Page 2 0 Year Year Year --- -------- Year Year ------ --- Year - - ------ One Two Three Four Five Year Six Seven 81112022 811123. 811124.. 811125- 8IM6. 811127. 81wx -7131123 7131-122 713IJ25 813 V2 6 713 L12 7 713 L12 8 7131,129 New Hope ......... Rent $4013.97 $4J74.51 $41341.51, 515.17 $4,695.78 $41,883.61 $5,078.95 Landlord Donated Portion $300.00 $300.00 $300.00 $300.00 $300.00 $300.00 $300.00 Net Amount Due from New Hope, $3,713.97 $37874.5 $4,041.51 $4,215.17 $4,395.78 $4,583.61 I $4.1778.9L Rent is due, M* advance, without receipt of a billffig or statement the first day of each month and is to be paid directly to THELESSOR. A one and one-half percent (1.50/,a) service charge will be collected for payments received after the tenth of the month for the month * which they are due. If any check received by THE LESSOR is retumed for any reason, THE LESSOR will make an additional charge of Twenty -Five Dollars ($25.00). In the event the term of this Lease shall be9* or end terod hthan on the first ay of a M calendar month, the rental for any such partial month shall be pro -rated. Rental for months other than partial months shall be paid on the first day of each calendar month, M* advance for the ensu*month. Ing 3. OTHER TAXES: THE LESSEE shall pay all taxes, licenses and fees, which by law are imposed on THE LESSEE, by reason of THE LESSEE'S operations or upon any of THE LESSEE'S personal property situate M or about the leased prem*ses. If other taxes, licenses or fees, which by law are. u*nposed on THE LESSEE or assessed upon the premises leased herein during the term of this Lease by any governmental agency, THE LESSEE shall reasonably pay same. 4. USE: THE LESSEE shall not use said premises for any other purpose other than the use of general executive office space and the uses resulting thereby without the prior written consent of the Lessor, M* which said consent shall not be unreasonably withheld. THE LESSEE agrees that no stock of goods Will be carried or anything done in or about the premises which will increase the present rate of insurance. The rental contaffied herein is predicated on, among other things, THE: LESSORS, existing m*surance premiums, and M* the event that THE LESSEE'S Commercial Lease Page 2 0 Grant County PUBUC UTIUTY DISTRICT Customer Service PO Box 1519 Moses Lake, WA 98837 Address Service Requested 00001039 TGCSTMNT1 03123025530 01100000000 0001026 003 Mn* o Padilla 113 E Marquis Ave Moses Lake WA 98837-2479 St STheater,,,--Moses Lake WA 98837-0000 Page 1 of 6 Power Factor: 100,0000% Billing Demand: 17.344 Us -age Histry (in KWH) 270M 218M 16252 10834 5417 M Od Nov D"- Jan Fob Mar Apt May im JW Aug $op Oct 2M2 2023 Rate 2 - General Service Bill kg Pedod: 09/1412023 - 10/12/2023 Pdor Balance $182.99 Payments Applied THANK YOU 4182,99 Balance�O.OQ Basic Charge 29 Days Q $1.08 $31.32 Energy Charge 1,659.840 kWh @ $0,04389 $68,46 ***SUBTOTAL ENERGY*** W46 City Tax CURRENT CHARGES $105.77 Z-OWRRENT AMOUNT DUE $1105.77 4"001; ---------­--­---- - -- amazon.com F-h-lal DeRtalflsz- for Ordeir #I 1132-86812418-2312262 Order Placed: September 29, 2023 PO number: equip and supplies Amazon.com order number: 112-8681418-2312262 Order Total: $20.92 Shipped on October 2, 2023 Items Ordered 1 Of: BI SELL Woolit&& Advantage Carpet & Upholstery Cleaner, 3325, 12 Ounce (Pack of 4) Sold by: Amazon.com Condition: New Price $19.491 Shipping Address: z. tide Item(s) Subtotal: $19.49 311 W 3RD AVE Shipping & Handling- $0,00 MOS LAKE, WA 98837-1905 Amazon Day discount,* -$0.19 United States Estimated Tax.* $1.62 Grand Total: Total before tax.� $19.30 Shipping Speed: Sales Tax: -$1.62 Amazon Day Delivery Total for 'his Shipment: $20.92 Payment information Payment Method: Item(s) SUbtotal'. $19.49 Visa Last digits: 9663 Shipping & Handling: $0.00. Promotion applied.4 -$0.19 Total before tax: $19.30 Estimated Tax.* $1.62 Grand Total: $20.92 - --------- Credit Card transactions Visa ending in 9663-4 October 2, 2023: $20.92 To view the status of your order, return to Qrder Summary ., Conditions, cif ase j ap _.Notice @ 1996-2020 y Amazon.com, Inc. Final Detail's for Order #113-505,1197347-7341810 Order Placed: October 17, 2023 PO number: Office Supply - PG Othello Amazon.com order number.,- 113-5059347-7341810 Order Total: $21.45 1- Shipped on October 18,, 2023 1 Items Ordered Price 1 Of: Door Chime, e, Daytech Wireless Door Sensor Chime 1000ft Range Door Entry Chime with 55 Chimes 5 Adjustable Volume $19.79 Im Im Mute Mode LED Indicator Door Open Ch' Im Sold by: Daytech co.,Ltd.Dfi ReLDr kag lg) Business Price Condition. New Shipping Address: ALYCE BRI TO 311 W 3RD AVE MOSES LAKE, WA 98837-1905 United States Shipping Speed: FREE Prime Deli ivery Payment Method: Visa I Last digits- 9663 Billing address NEW HOPE AMAZON PO BOX 37 EPHRATA, WA 98823-0037 United States I Credit Card transactions Payment information Item(s) Subtotal: $19.79 Shipping & Handling: $0.00 Total before tax: $19.79 Sales Tax: $1,66 Total for This Shipment: $21.45 Itern(s) Subtotal: $19.79 Shipping & Handling: $0.00 Total before tax: $19.79 Estimated Tax: $1.66 Grand Total: $21.45 Visa ending in 9663: October 18, 21023: $21.45 NNONWNNIN� I To view the status of your order, return to —Ordar-Summa tion ,fit —Use RdYa!� I @ 1996-2020, Amazon.com, Inc. [F i 311 W 3RD AVE MOSES LAKE, WA 98837-1905 United States Shipping Speed: FREE Prune Delivery Payment information Shipping & Handling: $0.00 Total before tax: $269.99 Sales Tax: $22.68 Total for This Shipment: $292.67 Payment Method: Item(s) Subtotal: $809.97 Visa I Last digits.. 9663 Shipping & Handling-. $0.00 Billing address NEW HOPE AMAZON Total before tax: $809.97 PO BOX 37 Estimated Tax: $68.04 EPHRATA, WA 98823-0037 United States Grand Total: $878,01 Credit Card transactions Visa. ending in .9663: October 4, 202:3*0 $878,01 To view the status of your order, return to Qrder-, UMrn=. Conditions of Use I Pdvacv Notice @ 1996-2020, Amazon.com,, Inc. r Ft inia! LF)efeailvc- ft -)r Ordxeu;v.,113.-904676P�-.-1589846 Order Placed: October 4, 2023 PO number: Office Supply - AB Amazon.com order number: 113-9046768-1589846 Seller's order number: 16048020 Order Total: $85.84 Shipped on October 4, 2023 Items Ordered I Of. VIVO Triple 23 to 32 inch LED LCD Computer Monitor Desk Mount VESA Stand, Heavy Duty Fully Adjustable Tilt, Swivel, and Rotadori, Fits 3 Screens, Black, STAND -V103 Sold by,,, V I V 0 (sellerl)rofil I Product question? (Ask Selle Business Price Condition: New IShipping Address-, ALYCE BARRIENTOZ 311 W 3RD AVE MOSES LAKE, WA 98837-1.905 United States Shipping Speed-, Expedited Shipping Payment information Payment Method: ma I Last digits: 9663 Billing address NEW HOPE AMAZON PO BOX 37 EPHRATA, WA 98823-0037 United States herr(() Subtotal: Shipping Handling: Total before tax: Sales Tax: Total for This Shipment: Price $79.191 $79.19 $0.00 $79.19 $6,65- $85.84 Item(s) Subtotal'. $79.19 Shipping & Handling: $0,00 Total before tai; $79-19 Estimated Tax: $6.65 Grand Total: $85.841 Credit Card transactions Visa ending in 9663: October 4, 2023-4 $85,84 To viers the status of your order, return to rd-er Surnmary . Coditions I of -Use Buivam- ti @ 1996-2020, Arriazon.com, Inc. I - - I �V/ oint Packing slip -- Marion Rd Sto 4 Order #,,, 109062 Suz! FodePOequlp and supplies 311 �*/ 3R ID AVE VIOSCS., LAKE, IYVA i)8837.1905 US +1 400-6118-1534-14 ext- 74633 %v I 2jP 1 zJ Sbipping UPSP--, %.j Dole 529120213 Dimonsions "GAC)O x 10,00, x 7,00 (' In) Ship Data 101212tlk.3 W e iq h t 6 1 bs. 8, 58 a2., Item itebC a t1 3 2 01 3 9 fj 6 2 9 3 15,680 ZWarenousL"Oghtacb HD Pro 7 .......... UPS3 2nd DBy Mir tt Cal D e t a,:1111 S x r 0 r de r .30 - 7 0 3 3 12 -eZ6 6 346 2 Order Placed: October 4, 2023 PO number: Office Supply - AB Amazon.com order number: 113-7033812-2663462 Order: Total:, $878.01 Shipped on October 4, 2023 Items Ordered 1 Of ** PHILIPS 276EIA 27n Frameless Monitor, 4K UHD IPS, 109% sRGB, S.peakars, VESA, 4Yr Advance Replacement Warranty Sold by., Amazon.com Condition: New Shipping Address: AL YCE BARRIENTOZ. 311 W 3RD AVE MOSES LAKE, WA 98837-1905 United States Shipping Speed: FREE PrimeDelivery Shipped on October 4, 2023 Price $269.99 Item s) Subtotal: $269.99 Shipping & Handling: $0000 Total before tax., $269.99 Sales Tax: $22..68 Tectal for This Shipment,*, $292.67 Items Ordered I Ofi PHILIPS 278EIA 27" Frameless Monitor, 4K UHD IPS, 109% sRGB, Speakers, VESA 4Yr Advance Replacement Warranty Sold by: Amazon.com Condition: New Shipping Address: ALYCE BARRIENTOZ 311 W 3RD AVE. MOSES LAKE, WA.98837-1905 United States Shipping Speed: FREE Prime Delivery Shipped on October 4, 2023 Price 1 $269.991 Item(s) Subtotal: $269.99 Shipping & Handling.- $0.00, Total before tax: $269.99 Sales Tax: $22.68 Total for This Shipment: $292-67 Items Ordered Price 1 Of'. PHILIPS 278EIA 27" Frameless Monitor, 4K UHD IPS, 109% sRGB, Speakers, VESA 4 Yr Advance Replacement Warranty $269.99 Sold by: Am.azonxom Condition': New Shipping Address: Itern(s) Subtotal. $269.99 ALYCE BARRIENTOZ 1146 LWG 3 7 1 231.102 0 Cardholder dame and Account Number NEW NOPE AMAZON RAPT COUNTY AUDITOR XYM-X XX -)(XXX -9663 PAGE 2 OF 2 1 Q 4833 0030 CX48 O IACI146 VISA Page 2 at 2 Transactibits (co tinu ec Post Date Trans Da -t -e --T Reference Description Amount 11/02 11102 Ot OOOOOt}OOOOCt MPC TOTAL PURCHASES $3,126.25 TOTAL $3,120.25 TOTAL FEES FOR THIS PERIOD TOTAL INTEREST FOR THIS PERIOD FOR REBATE PROGRAM UESTIONS, CALL 800-788-4578. Service Address: 311 3rct Ave w , muses LaKe WA !M53 I 4 KZ0831 33942 09113/23 10/12-123 ---- ----------- 21:313,973 2,335,233 21,2601 ------ 80,W 11700,800 KVM No Billing Demand; 11.648 Power Factor: I 00,P0000% Rate 2 - General Servioe 1 - -1. B111'Ing Period, G9/1412023 - I 0A 2/2023 Usage Hitsbry (in KM) $731 Prior Balance $147 93 Payments Applied THANK YOU -$147.93 4MMS R Basic Charge 29 Days $1.08 $31,3 2 ha ;AlC -,-111 . . . . . . . . . . . . . N 3439 E nergy Charge 1,700.800 kWh $0.04389 $74.65 SUB TOTAL ENERGY" $74,65 sri City Tax 2= R CUR -RENT CHARGES $112.33 . . . . . . . . . . . M W, N; 10 %Vi, P54 `1146 41 - i.-I CURRENT AMOUNT DUE WIAANK IN it - " " P M ON -;R0 0 Oct Nov Dee Jan Fob Mar Apr May Jun Jul Aug Sep Oct 2022 =3 •MNT1 031 2302551Q,91, �,. 00001026 00022T7003-0005TQQ�$ Page I /1 Invoice 0393287 Date 11/19/2023 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor: PADILLA, ARID 10281 BASELINE E RD MOSES LAKE WA 98837 ......... . Document Number Purchase Order Number VendorlD Shipping Metho4 I Payment Terms ID P ........ :8/l/23-7/31/24 A ......... . ---------­ ......... ...... . . ....... Description: Amount LEASE AGREEMENT $3,874-53' . ..... . ...... ....... . ...... ...... --_ - - ------- Subtotal $3t874.53 Misc $0.00 Tax $0.00 Freight 50-00 Trade Discount $0.00 Payment $0.00 Total Due $3,874,53 |office supplies Jj 339.43 — IE AK 2648 REPRINT OF 10000 ORIGINAL INVOICE THANKS FOR YOUR ORDER IF YOU HAVE ANY QUESTIONS VC) OR PROBLEMS, JUST CALL US It V $IN ESSP $0 W IONS, LL _C FOR CUSTOMER SERVICE ORDER: (888) 263-3423 FOR ACCOUNT INQUIRIES ,(800)721-6592 Federal ID # 86-2161688 INVOICE NUMBER AMOUNTDUE PAGE NUMBER 340307053001 339.43 1 OF INVOICE DATE TERMS PAYE NT DUE 01-NOV-23 Net 30 03 -DEC -23 Bill To: ATTN: ACCTS PAYABLE GRANT COUNTY NEW HOPE DV & SAS 604 W 3RD AVE STE B MOSES LAKE WA 98837-2076 Ship To- GRANT COUNTY NEW HOPE DV & SAS 311 W 3RD AVE MOSES LAKE WA 98837-1905 ACCOUNT NUMBER ACCOUNT MANAGER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 73863215 1.0/-U Depot, Office 31IW3RDAVE 173336 340307053001 30 -OCT -23 01-NOV-23 BILLING ID PURCHASE ORDER RELEASE ORDERED SY DESKTOP COST CENTER 31818219 1 0 ALYCE -0.11 C38 -SK 'cAULoG y BARRIENTO . ... .. ... 1, ITEM # I DESCRIPTION I CT Ulm---------------- YD 0 OTY QTY UNIT EXTENDED MANUF CODE CUSTOMER ITEM # TAX 00 T SHIP 810 PRICE PRICE 00�v Lilor- F_1v0U__F\. 1 P%r_f__,U'zr\ 1 %jr-,Q1 mm I I U 1.0/-U C38 -BK 173336 Y 73338 Coupon Discount EA 1 0 -0.110 -0.11 C38 -SK 173336 y 6028288 PAP ER,OD COPY,20LB, 11, 10 CT 2 2 0 39.890 79.78 ODBCP92-CTIA 6028288 Y 592768 TOWELSMULTIFOLD,2-PLY,P CT 4 4 0 38.630 154.52 21000 592768 Y 592768 Coupon Discount CT 4 4 0 -2.258 -9.03 21000 592768 Y 140664 BAGS TRASH, OD, 56GAL, 20CT BX 2 2 0 5.110 10.22 DP00664 140664 Y 140664 Coupon Discount BX 2 2 0 -0300 -0.60 DP00664 140664 y 251368 TISSUE,,BATH,ANGLSFT,450 CT 2 2 0 40.640 8128 16840 251368 Y 251368 Coupon Discount CT 2 2 0 -2375 -4,75 16840 251368 y County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor-, OFFICE DEPOT PO BOX 29248 PHOENIX AZ 85038-9248 Document Nmbe �—Qjd�d�-3001 Description: Office Supplies r Purchase Order Numlw Vendor[D ............... (FDPO Page 1f1 Invoice 0401104 Date 11 /7/2023 Shipping Method HF Subtotal is Tax Freight Trade Discount Payment Total Due - -1-1 ----------- Payment Terms ID -11-- Payment -- Amount $339.43 $339.43 $0,00 $0.00 $0.00 $0,00 $0.00 $339.43 REPRINT OF 10000 ORIGINAL INVOICE THANKS FOR YOUR ORDER IF YOU HAVE ANY QUESTIONS OR PROBLEMS, JUST CALL US BUSINESS PSOLUTIONSLLC FOR CUSTOMER SERVICE ORDER: (888) 263-3423 FOR ACCOUNT INQUIRIES '(800) 721-6592 Federal 1D # 85 -216168831 INVOICE NUMBER ` AMOUNTDUE UE PAGE NUMBER 340327513001 104.84 1 O F 1. INVOICE DATA TERMS PAYMENT DUE -OCT -23 Net 30 - 03 -DEC -23 Bill To: ATTN: ACCTS -PAYABLE GRANT COUNTY NEW HOPE DV & SAS 504 W 3RD AVE STE B MOSES LADE WA 98837-2076 111111111,tl1n11111ItI,IIII111„Ir11111111 Ship TO: GRANT COUNTY NEVA! HOPE DV & SAS 311 VV 3RD AVE MOSES LADE WA 98837-1905 ACCOUNT NUMBER ACCOUNT MANA.+ ER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 738632/5 Depot, Office 311 W3RDAVE ---------------- 340327513001 30 -OCT -23 31 -OCT -23 EIS UNG ID PUR HA E ORDER RELEASE ORDERED BY DESKTOP COST CENTER. 31818219 ALYCE BA.RRIENTO CATALOG 00 ITEM # DESCRIPTION I U#M OTS` OTY EXTENDED DEI MANUIF CODE CUSTOMER ITEM # TAX ORD SNAP 810 PRICE PRICE 3680129 CSX KEYS FOR MAC SPACE GR EA 1 1 0 96.720 96,72 7UQ857 3680129 Y SUB -TOTAL 96.72 TIERED DISCOUNT 0,00. DELIVERY 0.00 MISCELLANEOUS 0,00 SALES TAX 8.12 ALL AMOUNTS ARE BASED ON USD TOTAL 104.84 CURRENCY Uox dnca Insert our pacring list, or copy Minis Invoice. t -tease nate prouiem so we may issue credit or replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage or damage must be reported within 5 days after delivery. --_-_-_,._____-,._,...,.w,...----.---w..—___----__-_-..--_----_------_-_..-,...--..-----......_..________________..-..,.---------_-_---___-..-....,.,....----_---_---_--......_..----__-------_..-,.,.,--------___-_----.----_---_-- n ]E-rA6. rC 1-1 URS IE CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE DATE INVOICE AMOUNT AMOUNT ENCLOSED GRANT COUNTY NEW HOPE DV & SAS 31818.219 340327513001 31 -OCT -23 104.84 FLO 318182193 34032?5130014 00000010484 PLEASE. ODP Business Solutions, LLC PLEASE RETURN THIS STUB WITH YOUR PAYMENT TO SEND YOUR PO BOK 2.9248 ENSURE PROMPT CREDIT TO YOUR ACCOUNT. CHECK TO: PHOENIX AZ 85038-9248 PLEASE DO NOT STAPLE OR FOLD. THANK YOU REPRINT F 10000 0 ri ORIGINAL INVCTHANKS FOR YOUR ORDER IF YOU HAVE ANY QUESTIONS OR PROBLEMS, JUST CALL US FOR CUSTOMER SERVICE ORDER, (888) 283-3423 FOR ACCOUNT INQUIRIES :(800)721-6592 INVOICE NSI BER AMOUNT DUE PAGE NUMBER 340327515001 96.53 1 OF 1 INVOICE DATE Federal ID # 85_2101588 TERMS PAYMENT DUE 1 -OC Tw23 Net 30 03 -DEC -23 Bill To, ATTN.- ACCTS PAYABLE GRANT COUNTY ' NEW HOPE DV & SAS 604 gni 3RD AMIE STE B {MOSES LAKE WA, 98837-2075 it11111IIlif�lfllfflliflfTlrllli!llf�fl�1lli Ship To: GRANT COUNTY NEWHOPE DV & SSS 311 W 3RD AVE MOSES LAKE WA 98837-1905 ----- - C UNT NUMBER 73853215 ACCOUNT MANAGER Depot, Office SHIP TO IDI 311 3RDAVE ORDER NUMBER 340327515091 DEDATE 39 -CBCT -23 SHIPPED DATE 31 -OCT -23 B LLING ID PURCHASE ORDER RELEASE ORDERED BY DESKTOP COST CENTER 3°1818219 ALl`CE BARRIENTO CATALOG TEI DESCRIPTION U1M JOW � OTY UNIT EXTENDED" MANU CGDE -CUSTOMER ITEM# TA I ORD SHIP B/O PRICE PRICE 774744 HAN DWASH A TIBAC,FOAM, 12 EA►. 4 4 0 23.640 94.55 CCJ515.204EA 774744 Y 774744 Coupon Discount EA 4 4 9 -1.378 -5.51 OJ516204EA 774744 Y ALL AMOUNTS ARE BASED ON USD CURRENCY fi return supplies, please repack in original box and insert our pacldn5 ii -S Wcopy SUB -NOTAL TIERED DISCOUNT DELIVERY MISCELLANEOUS US SALES TAX TOTAL P ease nate problem so we may issue credit or replace-------------- ment, whichever you kap vv 11vt 1v%ve1t atattittucid tit ma.c.643.es until you call us first for instrucuonss. zsnortage or carnage must be reported within 5 days afterdelivery, 89,05 0,0 0.00 9.! 7,48 95453 not ship collect 1EIR- 1E CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE DATE INVOICE AMOUNT AMOUNT ENCLOSED GRANT COUNTY NEW S, HOPE. DV & SAS 31818219340327515001 i°[ �jy�J3 3.93 515001 31µCCT-23 95.qtp " FLO 318182193 34032?5150012 00000009653 PLEASE CDP Business Solutions. LLC PLEASE RETURN THIS STUB WITH YOUR PAYMENT TO BEND YOUR PCS BOX 29248 ENSURE PROMPT CREDIT TO YOUR ACCOUNT. CHECK TO: PHOENIX AZ 85038--9248 PLEASE DCS NOT STAPLE OR FOLD. THANK YOU County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor.: OFFICE DEPOT PO BOX 29248 PHOENIX AZ 85038-9248 Document Number Purchase Order Number Vendor 1D . .... . .... . .340327515001 ............ OFDPO Description: Office Depot ---------- Page 1/1 Invoice 0401103 Date 11 /7/2023 Shipping Method Payment Terms ID Subtotal misc Tax Freight Trade Discount Payment Total Due .............. Amount $96.53 $96.53 $0 00 $0,00 $0.00 $0.00 $0.00 $96.53 INIES --Slz SERVICES BUSINE 601 E. PACIFIC SPOK&NE. WA 99202 (509) 838-1044 866-4335-4691 w-ww.dcvriesinc.com GRANT COUNTY NEW HOPE Attn: ALYCE BARRIENTOZ 311 W. 3RD MOSES LAKE, WA 98837 Invoice Deyries Business Services 601 E. PACIFIC SPOKANE, WA 99202 (509)838-1044 (866)433-4691 khopper(Odevriesinc-com Date, 10/31 2023 Invoice #: 0172903 Customer #: GCNEWHOPEI Terms: Net 10 Total Amount Due-, $ 6.90 Total Enclosed NOTE: DeVries also offers professional and trustworthy service in Document Destruction, Business Reoords Storage, Co'urier Services, and Commercial Office Moves! SERVICE DESCRIPTION RATE QUANTITY TAX FEE — --------- No Invoice Category On -Site Record Destruction - Console $6.9000 1.00 N $6,9000 Remit. To: SUB -TOTAL $6,90 601 E. Pacific Spokane, WA 99202 TAX $0.00 MOICE TOTAL $6.90 Page,- 1 Invoat Rev,20230323 D626080 -5.2.1,03A4 . .............. . .... m. aseal jaidoo Keeley connect I Copier Lease �. 4 5 C, & ,, Itcap"t i County of Grant 35 C ST NW P.O.. Box 37 Ephrata WA 98823 Vendor: KELLEY CONNECT CO 22710 72ND AVE S KENT WA 98032 Document Number P Order Number dN1470905 ....... . . ....... . ....... ...... . . ....... . ............. Description: Coder Lease Page 111 Invoice 0401466 Date 11/15/2023 Vendor lD Shipping Method Subtotal Mise Tax Freight Trade Discount Payment Total Due ---- — ------- ---- Payment Terms ID -- — ------ - - .......... --- ......... – Amount $163-17 —J $163,17 $0.00 $0.00 $0.00 $0.00 $0.00 $163-17 Page 1 / 1 Invoice 0400579 Date 11 / 1 /2023 County of Grant 35 C TW P.O. Box 37 Ephrata WA 98823 Vendor-, KELLEY CONNECT CO 22710 72ND AVE S KENT WA 98032 --- -- ----- ------------------------------------------------ . .......... ..... . . . ............. ................ ...... ....... . ... .... ......... . .. . . . . ................... ........... .... ...... . ......... Document Number I Purchase Order Number I VendorlD Ship Ino Method Payment Terms ID P1 .......... ...... — ..........._:r.. --........... .......... . ... . . AN1456754 KECOC - ----- . ....... ..... . .. . ...... -------------- ... ... ... . ........ ............. ............ ....... i Description: Amoun Copier Lease/ Suppties $270,92: - ---- ----- .......... . ...... . . ..... ....... .... Subtotal $270.92 disc $0.00 Tax $0.00 Freight $0.00 Trade Discount $0m Payment $0.00 Totat Due $270.92 Page 1 /1 Invoice 0400577 Date 11/1/2023 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor: KELLEY CONNECT CO 22710 72ND AVE S KENT WA 98032 . .............. -__-_'_____'__'_____T - - - - ­-­­- - - ----- ------- - ....... ....... ..... ................. . . . . . ............ Document Number i Purchase Order Number VendorlD shipping Method Payment Terms ID . . ... . ..... .... .... .... INN145675 KIECOC ........... ....... .......... Descri*ption: Amountl i Copier .ease /Scap pties $312.60 ............ - - ------ Subtotal $312.60 Misc$0. 00 Tax $0. 0 0 Freight $0.00 Trade Discount $0.00 Payment $0.00 Total Due $312.60 Page 1 /1 Invoice 0401465 Date 11115/2023 County of Grant 35 C ST NW P.O. Box 37 Ephrata WA 98823 Vendor: KELLEY CONNECT CO 22710 72ND AVE S KENT WA 98032 r.......«. ------:-- - Document Number Purchase Order NumberVendor1l) Shipping Me -thod Payment Terms ID ..... . .... ..... ............ IN1470904 ECO .....« ..... - - ­­- ---- ... . .... es ion: Amount! Copier Lease $152.17' Ei .......... ...... ....... Subtotal $152.17 Misc $0.00 Tax $0.00 Freight $0.00 Trade Discount $0.00 Payment $0.00 Total Due $152.17 ,. } :i : Page 9 �.. . _ '................. NEW NOPE DVSA '� ; 311 W 5PIS AVE MOSES LAKE WA 98837-1905 030 261 6606 001 NOV 4t 2023 NOV 29, 2023 ccnx r. _ _..._ ... e .. . . . . . . . . . . . . . . .. . ; . - . . I I . � . . _1 » . . . I . �. _._.. . `! :: _ : i _ : ...... . 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C 4 .573-3467 4:003:00 0.28 WED CINCINNATI OH 515 .21 10/11/23 9:48:31P WED BOZEMANM 406 539-6910 4.00 0.28 10 10/11/23 10:30:08P WEDATLANTA 404 1-6469 4:00 0.28 11 10/12/23 � 13 ,• : P T '°Y y f +I ' U L �G i, ■ '"1€ M543-6691 4:00 0.28 12 10/19/23 8:55:06A THU SAPPINGTON MO 514 729-2400 .4-400 0.28 15 11/01/23 4:09:22P WED PORTLAND OR 503 1-4766 2.00 0.14 .. ... ......+.......,..+.,».....,_......+.+ ..:.. ,w.+„ .,. .. Ian.,,,„_....:..:::':'.. - t, i "�i{ 7: :i is _� .s _ ..ytr y[ �f ' :i it •�y++ :......::....a7...__:..u,i_.,u,:_ w,•,<.-.,, ::..,..:....,...., _.. u,:>._,.: •... w,.,.•,t , , ..., ... ..r-. .... .,s.. a♦•_n....,," iii: :u,.. .r_ { .-....... ... ,I ., ♦.r .♦> ..♦+ _,.. ♦,•w,w,., «,.... ,w• ,.♦, .. ...« ...?�V':..__...+-. ,ass ,<., - .,� < t. IN-STATE CALLS 1.,4 10/06/23 : 01��::,�9P FR MOSES LAKE W.50 760-6789 #. a0- 0.08 . 15 10/06/25 8:32-04P e 1 R 2 f SFE E P E F 1, I OMAK W 509 7- aB 8 ' "_It j�1yq 8 4 y0 0.60 0 16 10/07/23 3:52:09P SAT MOSES LAKE WA 509 431-1223 1:00 . 8 17 10/07/23. 7:341-006P SAS" MOSES LAKE WA 509 760-6789 1 00 0.08 18 10/09/23 9-*45**24A MON EPHRATA WA 509 450-7599 7{00 0.53 . 10/09/23 104-324-37A M H W 0 4 -75 1:100 0.08 0 10/09/25 . . ..ice #. 4 8 * 1F>7t N y Q U N WA 509 i r,{�i 6 1 1-600 0.08 21 10/09/25 11-52:09A MON QUINCY WA 509 787'6120 1.00 0,0 22 10/09/25 4:26:23P MON LONG BEACH WA 560 214-8086 !-too 0.08 23 10/10/23 11:39:02A TUE S NNYSI E WA 509 790-8608 1.00 0.0 24 10/10/2 1.2612.SOP TUE MOSES LAKE WA 509 989-4927 1.0th .08 5 10/10/23 3-425:37P TUE QUINCE' A 50 797-1309 : 00 27:00 0.15 26 10/10/25 ir2 ; -Q SOP ++ TUE MOSES LAKE WA 0 451-5771 IF r 00 . 3 27 10/11/23 8:25:42A WED MATTAWA WA 509 952-3535 3:00 0.23 28' 10/11/23 9:58:40A WED W W - ' 5 1 . 0 .0 ,�! D1�.}/ 1 0/ 1 2 i j � 100-22:33A 1 0 0E 2# 3 H U MOSES`T LAKE WA Ys r 6 - w 1:00 0. 0 30 10/12/23 7#49:45P THU QUINCY WA 509 797-3541 3:00 0.23 31 10/13/23 0/ 1 / y�>T '* 3 s 1 8 P [ I C 1MOSES WA 509 5 5 J- 5 3:00 0 r 5 +�w j� j ` i LAKE ' +2y �[y 761-8871 11:0� 0.j(>��j 33 0/ 1y 5/ 18 11,45-59A SUN LAKE 509561-316009 3:00 . 25 54 {. 34912*:38P (� y y SPOKANE WA �M�k y -5572 1:00 #0 # �, 55 10/16/23 11:41-657A ONE EPH ATA W� '450-7599 5 - 9 1.. 0 0.08 3 10/16/23 (�` f "C ** 1 MON MOSES L LAKE Zis w 0 431-1223 1• Y !�'t�� 0! 08 37 10/17/23 6:18:59P TUE MOSES LAKE WA 509 855-2990 41:00 0A 3 0 38 10/19/23 1:17:30P THU MOSES LAKE WA 509 795.7300 15400 1#1 39 10/19/23 3:38:47P THU MOSES LAKE WA 509 750-1416 2100 061 4 10/1.9/23 4:56 : 4 T MOSES LAKE WA 431-1223 1:00 0.08 41. 10/21/2 1.2;5601P SAB' MOSES LAKE A }0 509 98-0836 »00 0.23 42 10/22/23 1:22:03P SUN MOSES LAKE WA 509 350-6274 1:00 ; 4 10/22/2311-51-48P UN MOSES LAKE i t 509350-6197 3:00 0.2 3 44 10/23/23 ir"It : l MON MOSES LAKE W 509 451-1175 1-400 0r0 8 �.. - > xwo a_== _ " t ;­­­!!-!-!!!----- ----------- ______ 'i.-�-.. - , I .... � i-:!--- 7'.. � I ..., .. --.'!:.-77�,-"--­;­�!. .,.-.;. .- ... 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I I-110, ""Ismoom - — ----- — TELEPHONE NUMBER: 509 764 8402 ......... ------ ....... gewi.. ........ . ............ ...... ...... .. ! ..... ....... .... ...... ... .......... .... .. ...... ...... .. . .... ........ ..... ...... . .... . ...... . .. . . .... . ........ :... ­­ ...... ...... .... . ... ......... ........ ...... ......... ........... .... I ...... .................. Ap R ........... ....... ....... 4i P" .4 9. R_ IUNIVEZ- .:­ .: .... ­­ ........ .. . ........ -ii'liff ........... ......... Regulatory News Attention Customers in Rainey North Carolinas Nevada# Utah and California, If you do not Pay your bill by the due date, and the outstanding balance is *25 or mores AT&T may assess a charge of *5.00 or assess an interest charge of up to 1.5y of the outstanding balance.y as permitted by law. In Maine and North Carolina the maximum interest is 1%. In Utah and Nevada the maximum interest is 1.579. Attention Customers with Service in All States, Except AK, IN NYs PA, TXt and VA; AT&T intrastate., interstate, and international services are provided by AT&T Corp. To view service publications, go to www.att.com/servicepublicati.ons and click on Service Guides and/or Tariffs. (B468) DO NOT CALL If your business makes outbound telephone solicitations, you must comply with federal do -not -call laws and regulations (47 C.FoR. 64,1200 and 16 C.F.R. to and any applicable state laws, AT&T Calling Card is a US -based telecommunications service provided by AT&T Corp. Worldwide access is provided on a bilateral basis in cooperation with AT&T's correspondent carriers in non -US jurisdictionss and in accordance with the Regulations of the International Telecommunications Unions as applicable. FEE DESCRIPTIONS The Admi'nistrative Expense Fee recovers a portion of AT&T"s internal costs associated with the Federal Communications Commission's Universal Service Fund and related programs. The Federal Regulatory Fee rec* overs amounts paid to the federal government for reoulatory costs and telecommunications services for the hearing impaireds and costs associated with local number portability administration. These fees are not taxes or charges that the government requires AT&T to collect from its customers. (B419) Bill Period is the monthly period that the customer's bill processing began and ended. Your monthly bill will include some charges that are billed in advance and others that are billed in arrears. Local Line charges Local Monthly Recurring Charges (MRCs)t and usage charges are billed in arrears. Toll Free MRCs are billed one month in advance. (B415) Attention Customers: If you do not pay your bill by the date it is dues AT&T may assess a late payment charge. The rate shall be 1.5% per month (18% annually) unless an applicable law or regulation specifies a lower rate to be charged,, and then that lower rate shall apply. Alternativel. yp a minimum late payment charge of #5.00 may be assessed if permitted by applicable law or regulation. In Maine the monthly rate for 2023 is 0.267%. 0333) . ..... .... ......... . .... ....... ............ .......... . ..... .... ron 0 .... ................... .. ::.­",::%, H, — ..... ......... .. .... .... . . . .............. .............. — - .. - __ . , , ­:.: . ............... .......... ... ... ...... ....... ..... .. . .... ....... ......... .... ...... .............. ............. ...... ............... Wt: . ........ — — ----------- ------- .... ..... .. ....... �:A..... . .......... Ment ......... �� .... ...... . ...... . .......... ... ... ............. 030 261 6606 001 NOV 4, 2023 NOV 29) 2023 — - -------- ................ . . . . . . . . . . . . ..... ...... . . .. . . .. . ... . . . . . ... . ... . .. .. . . .. . . . . .......... ............... ....... ........... ....... ... ..................... .......... ...... . ...... .......... ........... WAIN I I I ....... ...... AT&T All in One Service AT&T LONG DISTANCE TOTAL SERVICE CHARGES SURCHARGES AND TAXES TOTAL. CURRENT CHARGES See Summary of char ges page for details 427.92 *27-92 417.17 000002il3 NEW HOPE DVSA 311 W 3RD AVE MOSES LAKE WA 98837-1905 TELEPHONE NUMBER 509 764 840 . ...... ... ....................... .... . .... ..... .... Will .'; tWt .A :C ACCOUNT STATUS PREVIOUS BALANCE PAYMENT RECEIVED ADJUSTMENTS TOTAL CURRENT CHARGES 448. 11 448. 1 loo *0.00 $45.09 777", *45.09 TOTAL AMOUNT DUE Pay online at www.att-com/paymybill News From AT&T Just For Your Business See next patio for more news! Login now at http://www.att.com/loqinnow to view Your billing call details online. Then, when You're ready, select Your preferred method of payment; PAY ONLINE - Once logged In-# click "Pay Your Bi llsl* to setup one-time or monthly Payments with a credit card or bank account, PAY BY PHONE - Call the toll-free number at the top of this page to setup a one- time Payment with a credit card or bank account. PAY BY MAIL - Submit the lower portion of this Page with a check payable to AT&T.! Whatever' s most convenient for you! You can manage all of Your ordering and billing inquiries With just a click. Visit us at www.*att.com/customercare for details on AT&T on-line customer service. ........ ........7, .......... : ! I ....... . ........ '777 77TT-T.111" WPM .... ......... .. ......... ....... ...... . ........ . ....... . ....... ............. ................ ...... ...... .. ...... ....... ..... nei a Q . . . . . . . . . . . . . . . . . . Y. U:-dh . ... . ......... -Y ur .......... .......... .. U ..... .... ... . 'e S 10: a e 1.0 VaK U. ty 'T. 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See reverse side, Carol Stream, IL 60197-5075 11 11111111 lift 111111111111 1111111111 SC#00-01 AT&T Account Number: 030 261 6606 001 Bill Date: NOV 4, 2025 Payment Due Date-, NOV 29., 2023 Total Amount Due. - Amount Enclosed.: Is 000002122 .............. page 10 ft 0 u ......... .... . ............ . ........ ----------- NEW HOPE DVSA _lot. ........... _0 ........ ... . ... ----------- 311 W 3RD AVE 030 261 6606 001 NOV 4t 2023 NOV 29, 2023 MOSES LAKE WA 98837�1905 Subaccount: 161429-8090------------ . ........... ....... ............. .......... .......... ......... .... .. ........ .......... - - - - -------- -- .... ... ........... .. ...... ...... ...... . .......... ......... ...... ... ..... 0 �--,-S .... ......... . .......... . .................. ........ . .......... ....... ...... 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K:­ K� LONG DISTANCE SERVICE 0.15 3:00 0.23 BILLED NUMBER: 509 765-4346 2:00 0.115 TOLL-FREE NUMBER: 888 560-6027 0.08 1 : 0 0 IN-STATE CALLS i00 0.23 1.}00 0.08 1, -00 110/25/23 12 -*54:38P MON SUNNYSIDE WA 509 5 91 -2011 2 10/24/23 9:48:06A TUE WALLAWALLA WA 509 200-2190 3 10/24/23 5#-16:53P TUE OTHELLO WA 509 488-5256 4 10/24/23 6:55:39P TUE MOSES LAKE WA 509 855-8588 5 10/25/23 202:08P WED ELLENSBURG WA 509 925-9861 6 10/27/23 12 -*36:33P FRI MOSES LAKE WA 509 770-4405 7 10/27/23 3 -*17:29P FRI YAKIMA WA 509 759-2085 8 10/27/23 3:45-48P FRI WENATCHEE WA 509 421-0063 9 10/27 /23 3*56:37P FRI MOSES LAKE WA 509 431-1223 10 10/29/23 7-.52:49A SUN MOSES LAKE WA 509 431-1175 11 10/50/23 5:07-053P MON MOSES LAKE WA 509 431-1223 12 10/$1/23 11-13:05A TUE SEATTLE WA 206 598-2522 13 11/01/23 4:49-47P WED MOSES LAKE WA 509 431-1223 14 11/02/23 12:07:43P THU SEATTLE WA 206 549-4566 15 11/02/23 5:13:32P THU MOSES LAKE WA 509 771-5448 ............ 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