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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: gOCC REQUEST SUBMITTED BY: Karrl@ Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal'I"I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 06/02/2025 PHONE:2937 SUBMITTED:----------------------------------------------------------------------------------------- ALL THAT APPLY)_ ❑Agreement / Contract - - ----------------- -- ❑AP Vouchers ___.__(qHECK ❑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 El Professional Serv/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB :1 !XV19j jj !j I j [C-11 IS] ;TAje _j:4Zln= I IMMU11MMUMM I 1, 0 flum Reimbursement request from Renew on the American Rescue Plan Act (ARPA) Suicide Prevention category in the amount of $11,999.16 for April 2025 services. If necessary, was this document reviewed by accounting? ❑ YES LEGAL REVIEW: Is If this ..review,legal If necessary, was this document reviewed by legal? ❑ YES ❑ NO DATE OF ACTION: APPROVE: DENIED D1: D2: D3: ABSTAI N 4/23/24 ❑NO ON/A DEFERRED OR CONTINUED TO- WITHDRAWN - 0 N/A 9 Grenew is PO Box 1057 Moses Lake, WA 98837 Phone (509) 764-2643 Fax (509) 764-4124 BILL TO: Grant County Attention: Karrie S. Stockton PO Box 37 Ephrata, WA 98823 DATE: May 27, 2025 INVOICE # 4/30/2025 FOR: Apr-25 DESCRIPTION Amount units Total Amount ARPA FUNDS - SUICIDE PREVENTION $ 11,999.16 1 $ 11,999.16 Total $ 11,999.16 Thank you! ! ACCOUNT TRANSACTIONS- GJ Open Year Journal Entry TRX Date Account Number Account Description Credit Amount Debit Amount Reference 2025 1014338 4/30/2025 108.150.00.9000.566511100 MH... ARPA.REG SALARIES & WAGES 0.00000 5,870.92000 ALLOC SALARIES 04/2025 2025 1014341 4/30/2025 108.150.00.9000.566512100 MH... ARPA.RETIREMENT 0.00000 534.84000 ALLOC RETIREMENT 04/2025 2025 1014342 4/30/2025 108.150.00.9000.566512200 MH... ARPA.SOCIAL SECURITY 0.00000 411.95000 ALLOC SOCIAL SECURITY 04/2025 2025 1014343 4/30/2025 108.150.00.9000.566512300 MH... ARPA.MEDICAL & LIFE INSURANCE 0.00000 1,422.20000 ALLOC MED & LIFE INS 04/2025 2025 1014344 4/30/2025 108.150.00.9000.566512301 MH... ARPA.STATEWIDE FMLA INSURANCE 0,00000 15.38000 ALLOC FMLA 04/2025 2025 1014345 4/30/2025 108.150.00.9000.566512400 MH... ARPA.INDUSTRIAL INSURANCE 0.00000 21.67000 ALLOC INDUST INS 04/2025 2025 1009919 4/14/2025 108.150.00.9000.566513100 MH... ARPA.SUPPLIES - OPERATING 0.00000 -- 37.96 7348 - PREVENTION - MAR 2025 2025 1011652 4/29/2025 108.150.00.9000.566513200 MENTAL HEALTH ... ARPA.FUEL 0.00000 3.80 510-130323 2025 1007309 4/1/2025 108.150.00.9000.566514100 MENTAL HEALTH... ARPA.PROFESSIONAL SERVICES 0.00000 w 190.96 Renew Mar-25 2025 1011662 4/29/2025 108.150.00.9000.566514100 MENTAL HEALTH... ARPA.PROFESSIONAL SERVICES 0.00000 .,®,.190.96 Renew Apr-25 2025 1007309 4/1/2025 108.150.00.9000.566514200 MH...ARPA.COMMUNICATIONS 0.00000 1122.07 Renew Mar-25 2025 1011662 4/29/2025 108.150.00.9000.566514200 MH... ARPA.COMMUNICATIONS 0.00000 4°�,22.08 Renew Apr-25 2025 1008635 4/8/2025 108.150.00.9000.566514202 MH...ARPA.COMMUNICATIONS-CELLULAR 0.00000 *-..41.32 287333762696 Apr-25 2025 1009918 4/14/2025 108.150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 "-262.75 6886 - GRIS ML - MAR 2025 2025 1009918 4/14/2025 108,150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 "*-262.75 6886 - GRIS ML - MAR 2025 2025 1009918 4/14/2025 108.150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 .,%62.75 6886 - GRIS ML - MAR 2025 2025 1011686 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 1%0 411.00 REIM - FLIGHT & BAGGAGE 4qi 2025 1011686 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 *,,.40.00 REIM - FLIGHT & BAGGAGE 2025 1011686 4/29/2025 108.150.00.9000.566514304 MH...ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 ...% 40.00 REIM - FLIGHT & BAGGAGE 2025 1011687 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 .411.00 REIM - FLIGH & PARKING 45030 2025 1011687 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 `' 119.00 REIM - FLIGH & PARKING 2025 1011691 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 .`,40.00 REIM - FLIGHT & BAGGAGE 2025 1011691 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 "")40.00 REIM - FLIGHT & BAGGAGE 56-2, 2025 1011691 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 .,35.00 REIM - FLIGHT & BAGGAGE 1 2025 1011691 4/29/2025 108.150.00.9000.566514304 MH... ARPA.TRAVEL-OTHER TRANSPORTATION 0.00000 411.00 REIM - FLIGHT & BAGGAGE Total for April 2025 11,121.36..! March 2025 Expenses 213.03 -00` Total for April 2025 10,908.33 **' ADMIN FEE 10% 1,090.83 ''op, TOTAL INVOICE FOR APRIL 2025 11,999.16 , "' Contract #_ARPA SUICIDE PREVENTION Submitted to GC by: Reyna Gonzales Request for Reimbursement No. $11,999.16 Grant County's Subrecipient Checklist: State Auditor's Office Audit Procedures for Testing Activities Allowed And Not Allowed, As Published In 2007 Questions to ask before submitting a payment request Was the expenditure or cost: X Made for an allowable activity under the grant guidelines? X Authorized (or not prohibited) under state or local laws or regulations? X Approved by the federal awarding agency, if required? X Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43? For payroll transactions: _X_ Does the employee's time and effort documentation meet the requirements of Circular A-122? Allocable to the program? (i.e., was the dollar amount charged to the program relative to the benefits received by the program? Is the federal grantor being charged its fair share of the cost?) X_ Based on actual costs, not budgeted or projected amounts? Applied uniformly to federal and non-federal activities (i.e., is the federal government being charged the same amount as if non-federal funds were being used to pay the cost)? _X_ Given consistent accounting treatment within and between accounting periods? (Consistency in accounting requires that costs incurred for the same purpose, in like circumstances, be treated as either direct costs only or indirect costs only with respect to final cost objectives). X_ Calculated in conformity with generally accepted accounting principles, or another comprehensive basis of accounting, when required under the applicable cost principles? Not included as a cost (or used to meet cost sharing requirements) of other federally -supported activities of the current or a prior period? Net of all applicable credits? (e.g., volume or cash discounts, insurance recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and scrap sales). Not included as both a direct billing and as a component of indirect costs? Properly classified (e.g., some costs may be incorrectly claimed as a direct cost instead of being incorporated as part of the indirect cost rate). _X_ Supported by appropriate documentation? (e.g., approved purchase orders, receiving reports, vendor invoices, canceled checks, and time and attendance records.) Documentation may be in an electronic form. _X_ Correctly charged to the proper account code and grant period? Page 1 !U, ZEZN''� Mail Y Pri €ate d Name: Bethany EsC m-'Ma Pay Period;_ _ _ _. March 1, 2025�...�._._... __ Employee ID #: 5630 Staff Signature: IT _. Supervisor Signature: ,x Sips (A.,1L, ........... ...._.__ F a,____jSuPervisor initials rxar t.4..on-S. t ndard o*week Pay Pe rti od 116120 ( nVdd1y1yyy) pay 0w JV4026 CLINICAL Mar 16 Sun Mar 17 1, Mar 18 Mar 19 Mar 20 r Mar Mar Mar Mar 26 Mar 7 Mar Mat 29 ,.� Mod Tue Wed Thu Fri Sat Sun Mon Tue Wets Thu Fri Sat TOTAL RPA 9000 6,00 ` 9,00 9.00 8,00 6.00 9,00 ,00 6,00 800 10..E ,BURY DUTY Total cir�s�'�9 pia _ �,.�i� �;�3�3�._ +�;�� #x. T - 9. � 3 6.00 8.00 10.00 - � 81.00 1.00 ANNUAL SItt CK HOLIDAY ... P e M OTHER (Bereavement f Military) __.___. FLE COMP TAKES LWOP t i € ROTAL HOURS 9,00 1 9-001 =6,00 LV taken 13.00 QP ENTERED LEAVE longne annlne sickne sne£t holes civil milpaylbervne salyne + a 1.00 0.00 4100 i_.WOP »r Cl_ M *p S Fli0 `aH L P u„ R P 0w, a,,;; a.•` 0,* 0 0 ► renew, NON-EXEMPT ~Le V Printed Name: Bethany Ewr-af*0! paf;u J Pay Period: March 30, 2025 Employee ID #: 6630 . ....... S�T'"� �-tials fof Non-Stancid- rd Wcg*,yvee4k Staff Signature: A Supervisor Signature: Pay Period: 3/3012025 (mm1dd/yyyy) �1- -1/ T- Pay Date 40812025 AprOl Apr02 Apr03 Apr04 AprO5 Apr06 AprO7 AprO8 Apr09 Aprl0 April Apr 12 Mar30 Mar3l CLINICAL Sun Mon 8,00 Tuo S. Wed Thu Fri Sat Sun Mon Tus Wed Thu Fri Sat TOTAL 9DO 9,00 17,00 9,00 9.00 . . ...... . . . ... . ...... ARPA 9000 800 78.00 4 00 � OTHER HOURS WORKED � � -4 JURY DUTY Total Worked Hrs 8,00 •8.00 9,00 COO 17.00 9.00 9.00 78.00 1.00 ANNUAL SICK T HOLIDAY - --- — --- OTHER (Bereavement i Military) . ..... FLEXICOMP TAKEN LWOP TOTAL HOURS 8-.0-0- 8.,00 9.00 9.00 0 17.00 8.00-t Is.00 6,00 9,00 9.00 100.100 Total Worked Hrs 41.00 -9.0 60,00 - --- ----- 40 M00 longne annIne sickne snect holne m"Payl civil salyne LV taken - 2(X) 2 bervne 40 OU GP ENTERED LEAVE 80.00 0,00 22140 0.00 0.00 0.00 0.00 581!P00 LWOP PAYROLL SPREAD SHEET L>L P/ L '**PAYROLL PURPOSES 00 NOS" WRITE W THIS $EC TION American Rescue Plan (Cares Act — ARPA) Today's Date: 3/3/25 Vendor: Amazon Business ❑ Received Supervisor Approval ❑ Scanned supporting documents ❑ File into binder ❑ Item(s) received Receipt Date: 3/3/25 Detailed Description: Logitech M705 Marathon Wireless Mouse `Charge to Aig' Month: ❑ July 2024 ❑ January 2025 ❑ August 2024 ❑ February 2025 ❑ September 2024 2 March 2025 ❑ October 2024 ❑ April 2025 ❑ November 2024 ❑ May 2025 ❑ December 2024 ❑ June 2025 Deliverables: 0 General Taskforce supplies ❑ Goal 1: MH Literacy & BH Promotion ❑ Goal 2: Postvention ❑ Goal 3: Perception/attitudes ❑ Staff Travel / Professional Development Requested by: a966"^L Supervisor Signature: Prevention Requisition Form Revised 07.2024 Form of Payment 2 VISA **** QQQ_ ❑ Invoice (paid) ❑ Invoice (needs paid) ❑ Other: Charge Account: 0 ARPA (g000) ❑ Other: $ 37.96 Date: 3/3/25 Date: 3/3/25 ❑ Food renewGiss GRAIN COUNTY PUBLTC WORKS 1 42' 4 ENTERPRISE STREET S6i.;' EPHRATA, WA 98821 (509) 754-6082 APR ANEW Date: 04/16/2025 840 E. PLUM ST MOSES LAKE, WA 98823 Customer No: 510-1310323 Invoice No: Z25045 Total Due: $2,490.12 Page # 1 of January Fuel - Ment's=1 I th/ Develop Disabilities'/RENEW Description Quantity Unit Cost Unit of Haas Total Cost Mental Health 100.8i Z-22 r6D 7 2,69.35 . ................. 100.88 RENEW 725-57 2.67 1 9 3 '17 2 725 . r,7 _3 Devellop D44.sabl11tie s 56.57 2.67 151.04 i e s Fee 6.57 0.15 70 44 12 �fL C z� ZQQ. �i got tit _AP q 14 4 �4 - 711:51XII-0 I w ('9 (14 4 (f '3 -Z (C 0 zd 9 0 1 q �' 3 ZtCA' � 7 bt II On Receipt GRANT COUNTY PUBLIC WORKS -124 ENTERPRISE STREET SE EPHRATA, WA 98823 (509) 7054-6082 w F, 5(#91L4q3rVd1'*' S 4 4 14 a (C q C; RENEW Total $2 t 4 90 . 12`_ Customer No: 510-130323 Invoice No: Z25045 TOTAL DUE $2,490.12 Amount of Remittance Renew -April 2025 TS Network & Security Services System Administration Services General Hetpdesk & Asset Management System Administration Services Accounting.Apptication- GP Software as a Service VOIP-PHONE ACCOUNT 4152 $ 1.186-19 $ 822.45 $ 14,548.80 $ 1,26562 $ 663.84 $ 6,146.77 Ednefics V01P Services (Phones) ACCOUNT ,taq nn A '9 A n A, _R .92-08 4200 MHBG 168-00 564 3,708.67 -SUD 12 566 264.90 MHBG recovery coach CV-2 DCR- Rick G. - ARPASUICIDE PREY -Bethany ARPA-Psychol- Lanny A. Moses Lake 4,260,55 $ 24,633,67 $ 28,894.22 $0.00 I -1-W-As DCL- 108.150.00.00W564.12.4152 108.150,00.0000-566.00.4152 564 566 109 11 20,766.75 2,100.55 MHBG- 8063 2 381.92 Recovery Coach - Crisis - 8079 2 381.92 CV-2 DCR- Rick G. - 76W564,41 1 190.9 ARPA SUICIDE PREV BETHANY- 9000 1 190�96 ARPA-Psychol- Lanny A. 9000.564.41 1 Housing- 50%- CBRA 8078 0.25 47.74 Prevention -lit, SUPTRS 9097 1 19o.96. Prevention- City of Quincy 9064 1 190.96 20,25 24,633.67 2 8053 44.15 2 8079 44.15 17609-41 22.08 .22,08 1 9000.566.51 19000.564.41 22.08 1 9097 22.08 4,150.17 $ 4t 150.17 3 8003 66-23 1 8002 22.08 :1 8001 22.08 110.38 25 $ 4,260.55 $ 4,260.55 $ 28,894,22 $28,894.22 $0.00 FIRS ■ NET. Built with AT&T _Wfreless continued Page: 4 of 249 Issue Date: Apr 19,2025 Account Number: 287333762696 Foundation Account: 62317818 Invoice: 287333762696XO4272025 Activity Monthly charges Company Government since fees & fees Number User Page last bill Plan Equipment surcharges & taxes Total 509370.5000 MADISON GONZALEZ 163 $32.22 $218 $4.42 $1,90 $41.32 509,770,5442 MELODY 0XVIS 165 $3222 $2.78 $4.42 $1.90 $41.32 509370.5.458 ROBERT WEST 167 $32.22 $2.78 $4.42 $1,90 $41,32 509.770,5675 WISE ENGLISH 169 $32,22 $2.78 $4.42 $1.90 $41.32 509,770.5969 MEGAN CLOYD 171 - $3222 $2.78 $4.42 $1.90 $41.32 509,770.6546 JUAN PADILLA 173 - $32,22 $2.78 K42 $1,90 $41.32 509.770.9154 TANNER LONG 175 - $32,22 $2.78 $4.42 $1.90 $4132 509.771 A324 BETHANY ESCAMILLA 177 - $32,22 $2,78 $4.42 $1,90 $41.32.' ' 509.771.5032 THOMAS MIT HELL 179 - $32.22 $2.78 $4.42 $1,90 $4132 509,771.5037 VERONICA GONZALEZ 181 - $32,22 M78 $4,42 $1.90 $41.32 509.771.5038 ELEISER PAID O 183 - $32.22 $2.78 $4.42 $1.90 $41.32 509J71,5043 KIMBERLY BAILEY 185 M $32.22 $2.78 $4A2 $1.90. $41.32 509,771 ,6055 SARAH NELSON 167 - $3222 $2.78 $4A2 $1.90 $4132 509,771,5062 AI LENE BELTRAN 189 - $32,22 $2.78 $4,42 $1.90 $41 Y32 509,771,5207 TANYA NUNEZ 191 - $35.00 $22.23 $4.42 $1.90 $63.55 509371.5334 C [NTH [A LLAMAS 193 - $3222 $2.78 $4A2 $1.90 $4132 509.771.5530 ONIA FERNANDEZ 195 $32.22 $2,78 $4.42 $1,90 $41.32 509.771.7001 VELMA DE LA ROSA 197 M $32.22 $2.78 $4.42 $1.90 $41,32 509,771.7105 INDELISA SALINAS 199 $32,22 $2.78 $442 $1.90 $41.32 509371.7263 LISA STOBER 201 - $32,22 $2.78 $4.42 $1.90 $41.32 509371.7374 LISA HAMILTON 203 - $32.22 $2.78 $4.42 $1,90 $41.32 509.771.7633 JASON NVILA 205 - $32,22 $2.78 $4A2 $1.90 $41.32 509.771 Y634 MEG AN WATSON 207 - $32.22 $2.78 $4A2 $1.90 $41.32 509.771 Y661 COTT DERTING 209 - $32.22 $2.78 $4.42 $1.90 $41.32 509393.0005 JAMIE MULLET IX 211 - $32,22 $2.78 $4.42 $1,90 $41.32 509.793.0016 KILAH KING 213 - $32.22 $2.78 $4.42 $1.90 $4132 509.793.0640 RYAN HARDY 215 - $32.22 $2.78 $4.42 $1.90 $4132 509.793,5794 JASMINE ARROY, 0 217 $44Y99 - $4,56 $1,96 $51.51 509.793.6001 ANGELA CLAY 219 $44.99 M $4.56 $1.96 $51.51 509.793.8959 ZULEMA GUTIERREZ-CO... 221 - $44.99 - $4.56 $1.96 $-51'51 509.797x5242 CRYSTAL CRUZ 223 - $3222 $2.78 $4,42 $1.90 $41.32 509,855.0347 TINA STEINMETZ 225 - $35.00 $238 $4,42 $1.90 $44,10 509.855.8358 JENNICA ROCHA 227 - $35.00 $2.78 $4.42 $1.90 $44,10 509.855M55 BROOKE DECUBBER 229 - $35M $2.78 $4,42 $1,90 $44.10 509.855,0383 ZACHERY NYGREN 231 - $44.99 - $4.56 $1.96 $51,51 509.855,1236 CECILLIA GODINEZ 233 - $44.99 $4.56 $1.96 $51,51 509.855-3215 ARASELI VERDUZCO 235 - $44.99 $4.56 $1.96 $51.51 509.855.3276 MALEENA LOPEZ 237 - $44.99 $4.56 $1.96 $51.51 509.855.3281 IZABELLA VALDEZ 239 - $44,99 w $4.56 $1.96 $51.51 509.989.1048 FERNANDO GALARZA 241 - $36.80 $3.24 - $40.04 509.989.3150 SAMUEL SCHEELKE 243 - $44.99 $4.56 $1.96 $51.51 Wireless continues.. N 0 R T H Er R N, EST t RESORT & CASINO u Guest Name: Maria Flallatt Page jk'o, 1 Po Box .37 Room 502 Epluata, WA 98823 USA Folio #: R I I E C _3`5 Group 9: Guests: I Clerk: 115122 CL 4: Arrive- 03/28,125 Depart 03/29/25 Status: HIST Date Description Reference Comment Charges Payments 03/281270255 ROOM CHARGE 502 S 2 33 9. 0 0 $0.00 0 -1X1 28/2025 TOURISM PROMOTION ARE 502t KALISPEL TOURISM FEE $2.00 $0.00 03/2812025 LODGING FEE 5 0 2- t LODGING FEE $21.75 $0.00 03 )/29/2025 PAY VISA Ck Out 12:21 ************6886 028091, $0.00 ($262.75) 0.0000 Balance Due: $0.00 0 WLIPL, 100 NORTH HA FORD RD, AIRWAY HE'iGHTS, INA 9900-1 FOR RESERVATIONS: 877.871.6772 NORTH ERNQU ESTCOM SHARE YOUR EXPERIENCE WITH US AT TRIPADVISOR.COM NORTHERR E ST t RESORT & CASINO u GLIeSt Name: Bethany Avey Po'ge 1VO. Po Box 37 Ephrata Room Ephrata, WA 9882.) USA Folio #: R1 I EC30 Group #: Guests: I Clerk: 115122 CL 124: Arrive: 03 )/28/25 Depart: 03/29/25 Status: HIST Date Description Reference Comment Charges Pavments 0.3/2812025 ROOM CHARGE 519 S 239.00 $0.00 033/28/2025 TOURISM PROMOTION ARE 519t KALISPEL TOURISM FEE $100 $0.00 03/28/2025 LODGING FEE 519t LODGING FEE S21.7-5 $0.00 03/29/2025 PAY VISA Ck Out 12:23 ************6886 028713 $0.00 (S262.75) Balance Due: S0.00 -4 4 1 " KZ' 0 IS PIE- L 100 NORTH HAYFORD RD. AIRWAY HEIGHTS, 'VVA 9q001 F(DR RESERVAT'tONS-, 877871,6772 NORTHER NQU EST.COM SHARE YOUR EXPEPIENCE WITH US AT TRIPADVISOR.COM RENEW EXPENSE REIMBURSEMENT CLAIM COUNTY AUDITOR GRANT COUNTY, WASHINGTON c of C1 Claimant: Conne Guerrero Claimant's Dept.: -Qu,ina --------- - ---- Purposeof Claim: AAS 20 2 5 Con fernce Added Expense, Destination: Spokane, WA - Columbus, Ohio MEALS DATE BF - - - ------- L J) --- 1E ....... . TOTA L. -- --------- ------------- - - - ------- ---------- - ''0, 20 3,0 i 00 S 0, 0 0 50,00 TOTAL S0.00 MOTELS ceq-,ts requi red) ;NECK -lei [) A TE C, 11-1 EC K - 0 U T D A 11', MILEA(YE DAT'E -- ----- FRONI (ci-mvi-) TO (LITY, STJ 1, 1,- S ------ --- RATE TOTAL S0.670 S0,00 $0.670 S5 0. 0 0 $0,670 SOW $0.670 S0,00 $0.670 $06 ZO TOTAL 5 0, 0 0 I H 0 T 9"', L N A IM E 0-TAIL A � ,.. _1 0T1lER;-t-,cz ,e' w, O D DATE I DESCRIPTION REASON FOR EXPENSE LOCATION OTAL 4/4/2025 Return Flight f Alaskaa Ai fl irie-41 flifaht was deb yed/wasp't going to back connect Columbus, Ohio - Spokane, WA $411.0(0 4 4 2 042:S ;Checked Bag fee (United Airlin, to check a bag for conference days Colurn hw;, Ohio $40M 73/29/2025 C-1 _c-kcd' Bar, Fee (united Airlines) de d to check- a bag for conference day s- pokane, WA IS 1 S40.00 *-Amount maybe different due to rounding TOTAL 1 $491-00 TOTAL REIMBURSEMENT CLAIM =491.00 CERTIFICATION ;gut horizatit-in required for Emplo, 1, the undersioned, do hereby certif� under penalty of perjury that the r1p I ELECTED OFFICI.AL, DEPARTMENT HEAD, OR DESIGNEE claim is a just, due and unpaid o.bligation against the County. and that I are authorized tf.),certitV to said claim. Nan e (printed),- . . . ..� � � ...... .. At_ Sianavure: Claimnant Signature. cc D AN� a t e Date: 4-t IL ---- 1- ----- - --------- - - - - — -- ----------- --- -- �'Counn' Commissioners or Elc� AuthorMition requwIL"C"A IM COUNTY AUDITOR Name (printed): Si.anature: y Date: Authorization required for the County Auditor-, Department Heads, meals expenses ()utside of travel status, and out of state travel. COUNTY COMMISSIONERS Commissioner Commissioner: Chairman 14OCC-. Date: RENEW EXPENSE REIMBURSEMENT CLAIM COUNTY AUDITOR GRANT COUNTY, WASHINGTON Claimant H91aft, Maria CWmant's Dept.: R eff'nE t—a ..:Ihra Purpose of Mid= JAAS25 Destinations Columbus, OH MEALS MILEAGE �maao� $0.00 HOTELS (mcwpmmpdred) DATE FROM (cm. m TO (cm. sn M MUM RATE TOTAL $0,670 so -Go $0.670 $0.0O $0.670 $0.00 $0.670 $0.00 $0.670 $0.00 $0,670 M1 $0.00 TOTAL 1. S0_00 I TOTAL J_ $0.00 1 CHECK -IN DATE CHECK-OUT DATE HOTEL NAME LOCATION (couNw, sT) TOTAL OTHER f rwatm mwAntdi PV� � 0 000 - C A (4 ULA" -, h 1A DATE DESCRIPTION REASON FOR EXPENSE LOCATION (coum, s-0 TOTAL 4/4/2025 Alaska Airlines Flight Flight home 11- l1 CburnbusOH 411 . 4/4/2025 Airport Parking Agency Vehicle ParMng Spokane, Wa $119-00 *Amount may be different due to rounding TOTAL $530.00 CERTIFICATION 1, the undersigned, do hereby claim is a just, due and unpah am authorized to certify to sa Claimant Signature - Date: I ty of perjury that the the County, and that I TOTAL REIMBURS04ENT CLAIMI Authorization required for Employees: ELECTED OFFICIAL, DEPARTMENT READ, OR DESIGNEE IName (printed): IA Signature: L. Date: 4 / I / C IV Authorization A uth`or`iz� uthorization required for County Commissioners or Elected Officials: COUNTYAUDITOR OUMI Name (printed): m Sjiz tul Sienature- I IDam- uthodwdon required for the County Audltw, Department Heads, meals expenses outside of travel status, and out of state travel: COUNTY COMMISSIONERS Commissioner %ONO 1w&&Z"&4%91 %fflbalwa 0 Chairman BOCC: Date: 01-10 00-10 RENEW EXPENSE REIMBURSEMENT CLAIM COUNTY AUDITOR GRANT COUNTY, WASHINGTON C laimant: c an Avq Claimant's Dept.: Community Relations Reimburse travel fees Purpose of Claim: Destination-, t.-Olurnbus, OH --------- ------ - - - ----- ---- ----- - -------- ---------- MEALS MII.FAC.F DAT E BF D JFF E TOT; A L S000 $0,00 sotoo - -- - -------- S00 SO-00 $0.00 TO T AL $0.00 D A R 0 M (CITY, STI TO fcl-Y. gr) MiLES RATE TOTAL $0:67(1 $0-00 $0.670 $0M $0.670 $0.00 S0_670 $0.00 $06'70 0 S0.670 $0,00 "I"OTAL $0.0 CHECK -IN DATE CCHFECK-OUT DATE 0 T ET, N A ME LO CAT I ON (couNry, sT) TOTAI -1 OTHER I (A' DATE DESCRIPTION RZEASON FOR EXPENSE LMCATION (COUNtry, s-r) Tri ) T A L 3/29/2025 United Airlines Fee for checked baggage Spokane, VVA $40-00 4/4/2025 United Airlines Fee for checked baggage Columbus, 0 H $40,00 4/4/202.5, Alaska Airlines Fee for checked baggage Columbus 01-1 $35,00 4/4/201.5 Alaska Airlines One way ticket to Spokane, WA due to original 11 lo ht cancellation (U rn itwd Airlines) - Approved by Crenny Huberdeau Columbus, OR 1,00 000 *Am(-)unt rna be different due to rounding TOTAL $526.00 CERTIFICATION 1, the undersigned. do ury hereby certify under penalty of perj I , that the claim is a just, due and unpaid obligation against the County- and that 1 am authorized to certify to said claim. Claimant Signature' Date: 4/11/25 TOTAL REINIBURSEM ENT CLAIM[ $526.0-0 _j Authorization required for Ernpl,c'�Yet_--S ELECTED OFFICIAL, DEPARTMENT HEAD, OR DESIGNEE Nain-e (printed): A SuynatureN COUNTY Authorization required for County Cc�,mmissioners or Elected Officials: COUNTY AUDITOR 'u 0 th U 0 N r 10 Name (printed): Signature: Date: I Authorisation reqaired for the County Auditor, Department Heads, meals expenses outside of travel status, and out of state travel: COUNTY COMMISSIONERS ('0mmissioner Commissioner: Chairinan BOCC: Date: