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HomeMy WebLinkAboutGrant Related - BOCC (002)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: BOCC REQUEST SUBMITTED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: DYES ONO DATE -4/3/2024 PHONE:eXt. 2937 OMNIA ❑Agreement /Contract ❑AP Vouchers ❑Appointment / Reappointment ❑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 ® Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances ❑ Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution El Recommendation ❑Professional Sery/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB FA ------------ Reimbursement request from Hopesource on the Emergency Housing Fund (EHF)grant # 24-4619D-106 in the amount of $24,577.96 for October 2023 expenses. DATE OF ACTION: APPROVE: DENIED ABSTAIN D1. { D2: D3: DEFERRED OR CONTINUED TO: f ti Form 19-1A VOUCHER DISTRIBUTION AGENCY Short Code Commerce Contract Number NUMBER CMS Invoice ID: DEPARMENT OF 1030 24-4619D-106 390194 COMMERCE VENDOR OR CLAIMANT (Warrant payable to:) INSTRUCTION TO VENDOR OR CLAIMANT: Grant County Board of Commission Submit this form to claim payment for materials, merchandise or PO BOX 37 services. Show complete detail for each item. EPHRATA, WA98823-0037 Vendor's Certificate: The individual signing this voucher below warrants they have the authority to do so as authorized and on behalf Kerrie Stockton of the entity identified in the Vendor/Claimant section. The individual (Vendor Contact Person) signing below certifies under penalty of perjury that the items and totals listed herein are proper charges for materials, merchandise or (509) 754-2011 ext 2937 (Vendor Contact Phone) services furnished 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, <kstocktonC@,grantcountywa.gov> (Vendor Contact Email) national origin, handicap, religion or Vietnam era or disabled veterans status. 07/01/23 - 06/30/24 (Contract Period) Karrie Stockton Kstockton2 4/3/2024 1:34:46 PM 10/01/23 - 10/31/23 (REPORT PERIOD) (SUBMITTED BY) (SUBMIT DATE) DESCRIPTION BUDGET REQUESTED EXPENDED TO AMOUNT THIS.AWARD AMOUNT DATE INVOICE REMAINING Admin - Unassigned $120,383.00 $2,580.68 $52,874.51 $.00 $67,508.49 Operations - Unassigned $681,156.00 $19,489.99 $214,396.48 $.00 $466,759.52 Rent - Unassigned $27,153.00 $.00 $4,829.71 $.00 $22,323.29 Facility Support - Unassigned $325,646.00 $21507.29 $163,296.06 $.00 $162,349.94 Non - Match Total: $1,154,338.00 $24,577.96 $435,396.76 $.00, $718,941.24 PROGRAM APPROVAL Date (The individual signing this voucher warrants they have the authority to sign this voucher.) DOC DATE CURRENT REFERENCE DOC NO. VENDOR NUMBER and SUFFIX DOC. NO. SWV0002426 03, ACCOUNT NO. ASD NUMBER VENDOR MESSAGE 45761 TRANS REV MASTER SUB SUB., MG MS GL ACCT SUB AMOUNT PROGRAM CODE CODE INDEX OBJ SUB SID INDEX OBJ 46ECO220 NZ 4620C READY to BATCH PREPARER DATE WARRANT TOTAL CREATED BY Karrie Stockton (Kstockton2) DATE 4/3/2024 1:31:04 PM Form 19-1A VOUCHER DISTRIBUTION AGENCY Short Code Commerce Contract Number NUMBER CMS Invoice ID: DEPARMENT OF 1030 24-4619D-106 390194 COMMERCE Fx-1 All Expenses under $1,000 Paid by U131 Paid b Y Organization Name Paid to Contractor Type Paid to ]BI Paid to Organization Name Paid to Org Type Expense Type Amount Subcontractor Total Sub Subcontractor Total 0 11108 WA4 Ow I f As the lead grantee for this contract, / certify that the sub grantee expenses listed above have been reviewed and are accurate. Lead grantee staff name: Karrie Stockton Date: 4/1/2024 Lead Grantee Name: Grant County Totals Invoice Period (Month/Year): Oct -23 Organization Name: Hopesource Date : 4/1/2024 -27" a- 068 "Y"S 1111z� gSn era tiolh ;51, -A 'A M -9 9 FO i ity, t: C S V13 139 91": 507.2 9 .Ren t. 000 Totals $241577.96 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Invoice Total: $24,577.96 0 11108 WA4 Ow I f As the lead grantee for this contract, / certify that the sub grantee expenses listed above have been reviewed and are accurate. Lead grantee staff name: Karrie Stockton Date: 4/1/2024