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Home My WebLink AboutGrant 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 SUBMITTED Bv: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: KafTl2 Stockton CONFIDENTIAL INFORMATION: DYES 8 NO DATE: 11 /13/2024 PHONE:2937 log IMUM119111k-JUNUM111111114M LVIMIEN ) i i ❑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 ❑Recommendation El Professional Serv/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB 1114 NK Iasi rj!j 19 a&] im:4 g I a= Reimbursement request on the Community Development Block Grant CDBG CV1 No. 20-6221 C-111, from Opportunities Industrialization Center in the amount of $38,079-57. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO Fm-1 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO 0 N/A DATE OF ACTION-_I,(4-74 APPROVE: DENIED ABSTAIN D1: D2: D3: 4/23/24 DEFERRED OR CONTINUED TO- WITHDRAWN - 111 195 1 MR Voucher #8 WASHINGTON STATE DEPARTMENT OF COMMERCE AGENCY NUMBER IDIS PROJECT NUMBER COMMERCE CONTRACT NUMBER 1030 107 20-6221 C-1 11 INSTRUCTION TO VENDOR OR CLAIMANT: Submit this form to claim payment for materials, merchandise or services. A19 VOUCHER DISTRIBUTION AGENCY NAME DEPARTMENT OF COMMERCE ATTN: COB(; -CV PO BOX 4252_5 OLYMPIA, WA 98504-2525 Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are proper charges for materials, merchandise or 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, national origin, handicap, religion or VietnaT era or disabled veterans status, ti I ----------- VENDOR OR CLAIMANT (Warrant is to be payable to:) GkANT COUNTY PO BOX 37 EPHRATA, WA 98823-0037 X, (SIGN IN BLIUE INK t JAe REPORTING PERIOD: Mar-23 (T/'r1Fi ----- ----- ----- ORIGINAL PRIOR ANIOUNT AMOUNT THIS REMAINING BUDGET REQUESTED INVOICE BALANCE IDIS Activity ID Add or DESCRIPTION -------------- delete budget line items as needed, Includes CV1 and Cr, as applicable. 8_310 21A General Adinin (Grant CounNr Expenses Only) $ 190.00 $ 190.00 8311 81 311 8' ) 12 05Q Public Services Admin. Budget (01C) a 05Q PS -Subsistence Payments (r%.nt. mortageutilltv) (01C) 05X PS- Housing Counseling and.Admin. Budge, (01C) Z= S 96367.84 175,0MOO Ilk),715,59 $ 66,453-96 $ 100,2 -90.99 — $ 22,756.19 S 982.30 $ 18,931.58 - S 1,400.00 S 2.7366 $ 7.3,309.01 S 223.74 8313 8313 1 8C - Microenterprise Assistance- Admin. (01C) 18C - Microenterprise Financial Assistance. (Ofc) 1 "26,034-57 50,000.00 $ $ 25,697,92 32,961.61 J -S 70,084,10 S - 24,302,98 8313 18C - M icroenterprise Training (OTC) 12,000.00 $ - S 12,000.00 8706 ----- 050 - Uruent Need- Mental Healtli, -General Public (Grant Co.' ----- — -------- 304,900,00 $ 199,954.- 17 104,947,83 ) S 8706 050 - Urgent Need- Mental Health Jele-l-lealth (Grant C Z� o.) $ 32), 15 7. 0 0 $ 32, 157.00 8706 050 - Urgent Need -Mental Health -Coum Jail (Grant Co.) --------- --1--- Balances , S 92. 9,3 6 5 - () 70 S 470,296-193&079 Z) 420,989.24 BELOW THIS LINE IS FOR IDEPTARTMENT OF COMMERCE ------ --------------- 0 - --- --------- --- ------ ---- -- ---------_----- ---- --- ----- -- - ----- ------------- - - --- --------- - ----- ---- - ---- ------ — --- ------- — - -- - - --------- -- - --------------------- ---- - --- ---- - --- ------- TRANS CODE - MD 0 --------------- MASTED INDEX SUB OBJ SUB -- SUB OBJ -------- GL ACCT SUBSID ----------- AMOUNT INVOICE NUMBER C1 622- C 0 32) 0 NZ --- - -- ----- - - -- - - -- -------- --- - - ------------ JA SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT Jennifer LevAs, Program Manager DATE ----------- 1V;7JARRANT TOTAL CMS Invoice ID: DATE -_ ACCOUNTING APPROVAL FOR PAYMENT STAI"E OF WASHINGTON DEPTOF COMMERCE ATTN. CDBG PROGRAM PO BOX 42525 0I.A.MPIA, WA 98504-2525 SUBRECIPIENT; 01C OF WASI]INGTO'N 815 FRUITVALE Bt..,,VD YAKIMA WA 98902 TOTAL,, AMOUNT REQUESTED THIS PERIOD: CDBG Public Services Expenditure Report CDBG CONTRACT NO*- �- 1 20-6221 C- I I I REPORT MONTH: .far-23 REPORT NUMBER*- F 30 $51117.96 COMMUNITY DEVELOPMENT BLOCK GRANT - CV GRANTS HOUSING & SUBSISTENCE CER'rIFICATION: I certify that the information on this form is a true and accurate report of the cash status and that all reported expenditures are properly chargeable to the referenced grant. Signature: Printed Naine.- DereJe Mek.uria "Title: CFO Date: 8/26/2024 CDBCj amount teguested for these prograill activities th.is.,_g riod: 5.66 1. Name of Service 11'ro, ranl:_ 1-10US ING CDBG CV and Description of service program and how low- and moderate -income (LMI) persons were served this period: Assistance was advertised by radio, print and social media to targeted areas qualifying households throughout the service area. General administration expenses associated with managing Housing activities oversight and assessments. Indirect admin. Ln S 1,400.0() 11G amount crested for these program activities this.12criod: 2., Name of Service Ilrogram-, SUBSISTENCE CDBG CV -11-1 1... erate-incorne (LM0 persons were served this period.* Assistance was advertised by radio, print and social media to targeted areas and qualifying Description ofservice program how low- and mod households throughout the service area. . ..... S981.30 3. Name of Service Vrograill: SUBSISTENCE & 01"EIZATIONS activities oversight General administration expenses associated with tnanaging Subsistence a Description of service program how low- and moderate -income (LMI) persons were served this period. and assessments. Indirect admin. CDBG Public Services Expenditure Report ("MMUNITY DVELOPMENT BLOCK. GRANT - CV GRANTS STATE OF WASHINGTON "'OE DEPTOF COMMERCE . MICRO -ENTERPRISE ,,k'F'I'N: CDBG PROGRAM CERTIFICA'I'ION: I certify that the information on this form is a PO BOX 42525 true and accurate report of the cash status and that all reported OLYMPIA, WA 98504-2525 expenditures are properly chargeable to the refemiced grant. SUBRECIPIENT: CDBG CONTRACT NO: Signature: OIC OF WASHINGTON 20-622 1 C-11 _� 815 FRUITVALE BLVD REPORT MONTH: PrInte(I Name: Dereje Mckuria YAKIMA. WA 98902 IN _1W 1 00 Mar-3 2 F . . . . ....... - . — ---- NUMBER: REPORT Title*- CFO 30 Date: 8/1112024 TOTAL AMOUNT REQUESTED THIS PERIOD*- $32, ,1961.61 ted, 1`61. these pr0r oam activities this perio , (1: S0.00 1. Name of Service Proor(anl: MICRO -ENTERPRISE CDBG arnount ro, - Description of service program and how low- and moderate -income (LMI) ace -to - persons were served this period: Assistace was advertised to Micro -Businesses by radio, print, social media f fAce and assisted to financially qualifying businesses within the service areas. $371, 1.61 FC[D—)B G ra ni 0 Ll tl t I for these prog in activities this perim, .2., Name of Serviceranio, ADMINISTRATION MICRO-ENTER.PRISE requeste( Description of service program how low- and moderate -income {EMI) persons were served this period: General administration expenses associated with managing Micro -Enterprise activities oversight and assesments. Indirect Admin. 01C Billing Period: Mar-23 Billing Indirect Admin Variance H Requested Indirect Admin Per Indirect Admin Category Amount (a) GL(b) Per NICRA (c) indicates Unbilled Amt. (d) 1-- A -1 Arjrn; I;4 r-trnt County) 4.1 1-, 1 Direct Payments on upper section of Expenditure Report. All 05Q PS Admin Admin and Operations in lower section Admin - Indirect 163,72,/ 227.09 163.72 Admin - Direct Salary Taxes & Benefits Operations Costs 818.58 05Q PS Admin Budget (OIC) OSQ Admin & Opp -rations Total 982.30 (jSQ PS Subsistence Pyrrits 1,400.00 05Q PS TOTAL 2,382.30' Direct Payments and technical assistance for beneficiary 18C Microenterprise Admin workshops on upper section of Expenditure Report. All Admin 7Admin0.12 and Operations in lower section. Direct Micro Assistance -Indirect $ 5,493.60 V/ 5,,493.60 V 1 -0.00) Admin - Direct Salary 17,689.S3v/ Taxes & Benefits 8,029.29 Operations Costs $ 1,749.19 18C MICRO TOTAL $ 32,961.61 Salary, benefits, payroll expenses for direct beneficiary work 05X PS Housing Counseling in upper section of Expenditure Report. All other admin and Admin - Indirect 455.94 632.43 45S.94 (0.00) operations in lower setion. Admin - Direct 1,442.07 Salary Taxes & Benefits 649.68 Operations Costs 187.97 05X PS Total 2,73S.66 CV I T01- A 1- 38,079-57 8,479.64 6J13.26 (0-00�) FUND STATEMENT I otal Expenses (a) 38,079.57 Reimbursement Received 30,120.1.8 Amount Due Grantee (if Actual Costs are higher than Total Funds Received) $ 7195939 lExcess Funds Received (if Total funds Received is higher than Actual Costs) $