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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: BOCC REQUEST suBnnirTED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrle Stockton CONFIDENTIAL INFORMATION: ❑YES ®NO DATE: 7/1/2024 PHONE:2937 -- -- - ----- ❑Agreement /Contract ❑AP Vouchers ------ ❑Appointment /Reappointment ❑ARPA Related El Bids /RFPs /Quotes Award ❑Bid Opening Scheduled El Boards /Committees ❑Budget ❑Computer Related ❑County Code El Emergency Purchase ❑Employee Rel. El Facilities Related El Financial ❑Funds ❑Hearing F-1 Invoices /Purchase Orders ii Grants —Fed/State/County ❑Leases ❑MOA / MOU El Minutes El Ordinances ❑Out of State Travel El Petty Cash 1:1 Policies El Proclamations E] Request for Purchase E] Resolution ❑Recommendation El Professional Sery/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB ---------- -------- RM "I'll" I • ----------- - ------ Reimbursement request from OIC on the Community Development Block Grant (CDBG) Public Service Grant (PSG) in the amount of $12,444.69 for services in the months of March 2024 -June 2024. ��,� � �� l� �. �6 5 If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 7 N/ A If necessary, was this document reviewed by legal? ❑ YES ❑ NO CJ N/A DATE OF ACTION: --7/9 /42 1 1 / I - APPROVE: DENIED D1: ABSTAIN 4/23/24 DEFERRED OR CONTINUED TO: y; STATE. OF WASONGTON DEPARTMENT OF O NIME:R .E 1011 P iUARi mYPt'Zr,. e :i:. - F O A.O'4LF 'T19:.525 - 01 3,510a 98504-2525 -.J51 6V) 3 .00 Form 19-1A VOUCHER DISTRIBUTION AGENCY Short Code Commerce�Contract Number NUMBER CMS Invoice ID: DEPARMENT OF 1030 22-62210-005 397123 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 Janice Flynn warrants they have the authority to do so as authorized and on behalf 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 (509) 754-2011 ext 2937totals listed herein are proper charges for materials, merchandise or �/�///y//�.��.///.�///�///�,l/�/,/,/// seo e State of Washington, and that a (Vendor Contact services furnished tthe II goods furnished and/or services rendered have been provided without ifivnngrantcountywa.gov / /5Y / discrimination because of age, sex, marital status, race, creed, color, (Vendor Contact Email) y national origin, handicap, religion or Vietnam era or disabled veterans 07/01/22 - 06/30/24 status. (Contract Period) 03/01/24 - 06/30/24 Karrie Stockton Kstockton2 7/1/2024 3:04:02 PM (REPORT PERIOD) (SUBMITTED BY) (SUBMIT DATE DESCRIPTION BUDGET REQUESTED - EXPENDED TO AMOUNT THIS AWARD AMOUNT DATE INVOICE REMAINING Contract Total $.00 $.00 $.00 .00 $ $.00 8622 — 05Z Public Services $243,000.00 $12,444.69 $213,742.65 $.00 $297257.35 8623— 21A General Admin $7,000.00 $.00 $3,500.00 $.00 $3,500.00 Non - Match Total: $250,000.00 $12,444.69 $217,242.65 $.00 $32,757.35 PROGRAM APPROVAL.: Date (The individual signing this voucher warrants they have the authori y to sign this voucher.) DOC DATE CURRENT REFERENCE DOC NQ. VENDOR NUMBER and SUFFIX DOC. NO. SWV0002426 03 ACCOUNT NO. ASD NUMBER VENDORMESSAGE 43260 TRANS REV MASTER SUB SUB CODE CODE INDEX OBJ SUB MG MS GL ACCT SUB AMOUNT PROGRAM OBJ SI® INDEX 622FO320 NZ 62210 623FO320 NZ 62210 WARRANT TOTAL 7/1/2024 3:03:23 PM READY to BATCH PREPARER DATE CREATED BY Karrie Stockton (Kstockton2) DATE r} WASHINGTON STATE DEPARTMENT OF COMMERCE _ _.. AGENCY NUMBER IDIS PROJECT NUMBER Commerce ontraet Number --- 1030 2021-0019 2 -62210-005 A19v uCHER DISTRIBUTION AGENCY NAME _ �NSiRUCTtOi�'F� 111:MDOR OR CLA1rrIANT � � � 9J �- '� x K , DEPARTMENT Of COMMERCE ',< i� � ,r.�.y ➢ FJ � TG 5T >� �,£ 7 i:� 4 � i "t°� __ ; �` �N� �� ` ,�a � > ' Sut+ss�init Is.form to claim payment for matenats merctsndse or services ¢ .� z �j,' ATTN: CDDG f (w "±SJk, �•. 1 "!r ,,�.v �,-> '�' }:.y, 13 { w,. d-2,. f'�a'�'S:"': ,�✓ ` yr f Y.Zt,7` PO SOX 42525 ,r - r x ,z jf �^� J�9 �;t'ed �>z> ,•.- `'� s.,r «,.. S.='ca, i '�!' �'•}� � � rSs,'.. 7.1 � J..r % - 5.v 5 - .,u �� Y✓ f%" S g�� ��� F'fis�i`k\ a'.F �"�a' --. t '45.v. rt 4., G�a y--. A .Ff: OLYMPIA, WA 98504-2525 �- �- .rt!-�'.'�•faf� i32 G I'-. •,}',c, S f F,, f 1..� H �- re3' 'S T � 't,yF L'h .Y�_� t J .7-ir. -k �, 3' l'a-t`Z'•}y, i7 { t 35 'i L" .- ..J}j ; (,"Jy 14 «fW J I i'�<<� '�.s at�.J���iS.'.✓�3s'�+ 5�➢3Z.�✓. Fi �Z3'.� ���bw ,i��- J,�" 5 } JF i1 �..�•t�-t •£k. fi. ��+�' 1. ii, fi, ,W+ ,^n"r'ibiici#.h-> Veriaors, • � :4�_ ��`�t�- P ,F 1F -_.�Jl",U�/Mrl�.Q�y certify -uncle► -.perjury thatahe items andtotals-listed herein __" _ . - + r:^ }.�.,.area?fit% w er na es. ^ p . p'inaberial 'mer�hannnnnnnnise o�: - v }, r9-for:�w � ssnricesxfuMlshetlto� e th _ r., a�w �, Stafe of 1Nashinon� a :, ��.r� ���5 - 9t rttl ; that a ALL, It vola-fwrnfshed and/or.aenrfcas rendered have'been ``" �""� ! _ Y � - � t r> � 9r ed withoutdiscriminati VENDOR OR (Warrant i CGAIMAtiT(Wa r s to be payable to:)-�.�,>v: �;- �>�;-:U-, I of age, s�ex,5 marital status; race, creed color. national ori in handicap, reiigion or j r`3.�, s'r i I J veterans status wiry yi •t,WE G°rz ti a r 4t: >�,•..� .�s.+si'saa °r?,:�5..ex y't �s.�3U .r: r✓r t ".>'f�u+-,r-A� � ^` � rs?` Grant County �t■{/�■■ (�v 7j� L.�/fl 3 qtr` r �Et;y�� ;�r�^ vh. t,cY pK`'Jz2VZ-rc..rrv�S^'V.,; k A. - � '�ira�f`� Y. 2: i M1:.iL 3•>^cs -.aY 's �'Arsy,,>-„`�1L' b �l'�"i�_,ii7 � �*3 •s-v't�s'Yit'„� F.�^�},rtav�✓Y'St'y'+ yd s2'7= '.F'�s'�'✓1-�s-,'S`kI •t r„3�• F,t-..x�t,;,,t- ., 8 SX.iiC i q G is �3F y J y": r%"`.s,#£'{�,>^t'ef»:aYr=�G�4i/ f Ephrata, W A 98823 �?`' Yr't ,b ?� - � 4N Fd`� +�n � v�".'^k1.Yy: %�_vlwY sjr'{$ �,�%. 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''-.. -,za .} _Y..,"�Li• .. .. a'�`. -,,- Description QUANTITY AMOUNT cDis PREVIOUSLY AMOUNT REMAINING ` Activity ID BUDGET REQUESTED THIS INVOICE BALANCE 8622 05Z - Other Public Services not in 03T 05A-05 _ 24300.00-. 0.00 2.1.3,742.65 - 1211444.6,9 $163812.66 $0 00 . _ -- 8623','2]A-6 - General Program Administration _ _ $ 71000.00 $3,500.00 $0.001 $3,500.00 $0.00 --- ....... _$0.00' ... _ . $0.00 $0.00 , _ _ $0.00 $a 00 TOTAL PAYME4 NT REQUEST _ . 250,UD0.00 $ 1 ? 242 65 12 4449 _$20,31 x.66 - Everything below this line is for Depti of _orrmerce _ _�Y ■ I TAX W ':ivF ''V- b i-Y,.y, 1 3a jd',,.-. '�� �' r5 L -i 'WC4 d. >yjjW,.y ... -- < , OGRAM'APPR `�' slh...11-a-. - PR AL The irtd >✓ , �. , 4 ... _. is. ocher 11� v - - ivi�lual i �� .✓ Y . � �. r .. , , � n .Ito - .J ._Rhl .. ._..., _. .t ,. _ ��. � �.- „ .. � � _ A , _- . _ ha thea Y ;fes .. . x. > .. t, SJ Y- th cher. •:�: _.�.,�- .� �..: .. ".. ... .., , .,rc-,.. l r - , a .t,. ,��». r. .- -J, .,. „ .y •V� - =.4#! .. 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". .. ,.. ... ... .. ... t . ... .., f. .. . -,. ... _ .. ,..- i... . , r 1'L_s. - .. . 4. ....... ... •„ Via;::. 1.--. , v 1rM, FO320111R`VT •�//•��� _ _ _ $ 128,000,-00 12=' 1a-005 SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT-- _ PATE WARRANT TOTAL ACCOUNTING APPROVAL FOR PAYMENT DATE STATE OF WASHINGTON COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS DEPT OF COMMERCE ATTN: CDBG PROGRAM PO BOX 42525 �,'1•.'!�'1"1�1�.t+i��: 11�� .I ��t�T tl�tat'i[�� i"ni'c�Rnr��Ic�ri ��;�i��� ��r�rra' i�'rr OLYMPIA, WA 98504-2525 s rid rr< i i #e l , t `t t"iii +jar d: 6; Oitirir r i�r It r% + it�t �rl�►i qtr Eire ert _ _ COMMUNITY ACTION AGENCY SUBRECIPIENT: CONTRACT NO: Z2-622 10-005 Signature..-___ OIC F WASHINGTON_ _ _ 815 FRUITVALE BLED REPORT PERIOD: Printed Name Dereje Mekuria YAKIMA WA 98902 May 24 REPORT NUMBER Tine: CFC)_...... 20 Date: 6/26/2024 TOTAL AMOUNT REQUESTED THIS PERIOD: S129444.64„ Iw Name of Service.. Program: Asset Develo ment & Other AssetDevelo Development— CDDG amount re uested.for these. ro rum activities this eriod _ __ - _.. + 3 Description of service program how low- and moderate-income(LMI)ersons were served this eriod: Housi ` p p in counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school classes. Free tax -prep. 2. Name of Service Program: Ener v.Assistance _ _ CDBG amount- requested for these -program activities this perio& SO.00 Description of service program how low- and moderate-incomeLMI persons were served this � � p s period. energy assistance and conservation education. 3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -indirect Admin jjCDBG amount requested for these program activities this riod: Description of service program how low- and moderate -income (LMI) persons were served this eriod; general administration expenses associated with managing energy assistance and asset development activities oversight and assessments. Indirect admin. 4. Name of Service Activity: Contract Recipient General ProLram Admi iistration C'�i�["� �.r..�...�t ro�...a�tna �'r... f�.,��.....,...,....... , ..�__.s�t ,.. a�� � _ �e _ a _ 7 _ ,M