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 suennir-rED BY: Karrie Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton
CONFIDENTIAL INFORMATION: DYES 0 NO
DATE. 6/24/2024
PHONE; 2937
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UCG
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,.... , .-- Reimbursement request from New Hope on the Emergency Housing Fund (EHF)
grant # 24-4619D-1 06 in the amount of $28,299.09 for May expenses.
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: l' '21--
APPROVE:
/
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
4/23/24
DEFERRED OR CONTINUED TO:
VTTATE Or W.A.5HIN( .410H
EPARIMENT'OF COMMERCE
1-011 Plum Beset SE -, P-0, BOX 42525 0- 0�ympiar Mshi-b(gw? 98,504-2525 - (360) 72.54470,0
www-awimercemwa,gov
Form 19-1A
VOUCHER. DISTRIBUTION
AGENCY
Short Code
`Commerce Number
NUMBER
CMS Invoice ID:
DEPARMENT OF
1030
24-4619D-106
396393
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
<kstockton@-qrantcountvwa.gov>discrimination
because of age, sex, marital status, race, creed, color,
(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) 6/24/2024 8:50:36 AM
05/01/24 - 05/31/24
(REPORT PERIOD)
(SUBMITTED BY) (SUBMIT DATE)
DESCRIPTION BUDGET REQUESTED EXPENDED TO
AMOUNT THIS AWARD
AMOUNT DATE
INVOICE". . REMAINING
Admin - Unassigned $139,618.00
$1,233.41 $73,968.36
$.00 $65,649.64
Operations - Unassigned $649,156.00
$201271.08 $383,830.16
$.00 $265,325.84
Rent - Unassigned $27,153.00
$6,794.60 $15,476.26
$.00 $11,676.74
Facility Support - Unassigned $338,411.00
$.00 $2520880.83
$-00 $85,530.17
--Non - Match Total: $1,154,338.00
$28,299.09 $7265155.61
$-001 $428,182.39
PROGRAM APPROVAL
Date
(The individual signin'g this voucher warrants they have the authority to sign this voucher.)
DOC DATE
CURRENT
REFERENCE DOC
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
46207
READY to BATCH PREPARER
DATE
WARRANT TOTAL
CREATED BY I
Karrie Stockton (Kstockton2)
DATE
6/21/2024 3:39:40 PM
Form 19-1A
VOUCHER DISTRIBUTION
AGENCY
Short Code
Commerce Contract Number
NUMBER
CMS Invoice ID:
DEPARMENT OF
1030
24-4619D-106
396393
COMMERCE
0 All Expenses under $1,000
Paid by UBI
Pard b
Organization Name
Paid to,
Contractor
Type
Paid to UBl
Paid to
Organization Name.
Paid to
Org Type
Expense
Type
Amount
Subcontractor Total
Sub Subcontractor Total