HomeMy WebLinkAboutGrant Related - BOCC (004)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: ❑YES R NO
DATE:5/22/2024
PHONE:2937
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Reimbursement request from City of Moses Lake on the Emergency Housing
Fund Grant #24-4619-D-1 06 in the amount of $46,278.03 for April 2024.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A
If necessary, was this document reviewed by legal? ❑ YES ❑ NO 0 N/A
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1:
D2:
4/23/24
DEFERRED OR CONTINUED TO:
STATF OF WASHIW,T`IN
DEPARTMENT OF COMMERCE
1011 P16171 Stretal SE -, PC) Box 42525 & 0100,1, Was hinalon 98504-2525 * (3 60) 7254000
Form 19-1A
VOUCHER DISTRIBUTION
AGENCY
Short Code
Commerce Contract Number
NUMBER
CMS Invoice ID:
DEPARMENT OF
1030
24-4619D-106
394067
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
I :--,—.-,-",----",-----.-1-���e--",-"---l-
(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,
<kstockton(q)grantcounL)ma.gov>
(Vendor Contact Email)
national origin, handicap, religion or Vietnam era or disabled veterans
status.
07/01/23 - 06/30/24-11
(Contract Period)
Karrie Stockton (Kstockton2) 5/22/2024 11:14:43 AM
04/01 /24 - 04/30/24
(REPORT PERIOD)
(SUBMITTED BY) (SUBMIT DATE)
DESCRIPTIONBUDGET
REQUESTED EXPENDED TO
AMOUNT THIS
AWARD
AMOUNT DATE
INVOICE
REMAINING
Admin - Unassigned $139,618.00
$2,383.54 $67,746.28
$.00
$717871.72
Operations - Unassigned $649,156.00
$23,835.39 $317,894.88
$-00
$331,261.12
Rent - Unassigned $27,153.00
$.00 $5,584.38
$.00
$21,568.62
Facility Support - Unassigned $338,411.00
$20,059.10 $2181333.85
$.001
$120,077.15
Non - Match Total: $1,154,338.00
$46,278.03 $60%559.39
$.00
$544J78.61
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
TRANSN�l
REV
MASTER
SUB
SUB
MG
MS
GL ACCT
SUB
'AMOUNT
PROGRAM
OD
CODE
CODE
INDEX
�OBJ
SUB
SID
INDEX
OBJ
46ECO220
NZ
4620C
I
I
I
I
V
READY to BATCH PREPARER
DATE
WARRANT TOTAL
CREATED BY
Karrie Stockton (Kstockton2)
DATE
5/22/2024 11:12:41 AM
Form 19-1A
VOUCHER DISTRIBUTION
AGENCY
Short Code
Commerce Contract Number
NUMBER
CMS Invoice ID:
DEPARMENT OF
1030
24-461913-106
394067
COMMERCE
0 All Expenses under $1,000
Paid b
Paid by U131 Paid
Organization Name
Paid to
Contractor
Paid to U131
Paid to
Organization Name
Paid to
Org Type
Expense
Type
Amount
Type
Subcontractor Total
Sub Subcontractor Total