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Home My WebLink AboutGrant 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 SUBMITTED BY: Karrl@ Stockton CONTACT PERSON ATTENDING ROUNDTABLE: K81"fl@ Stockton CONFIDENTIAL INFORMATION: ❑YES 8 NO DATE: 7/02I2025 PHONE: 2937 11"a Awksli-A =N L 1:4 � I :juhli I K Lei a I RMANIII I som ❑Agreement / Contract DAP Vouchers ❑Appointment / Reappointment DARPA 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 8 Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances ❑ Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑ Recommendation ❑ Professional Serv/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB &-il=:m 1:4!"* il I] I g Imm jm:4 j 16 molm Reimbursement request from Community Services of Moses Lake (Moses Lake Food Bank) on the United States Department of Agriculture (USDA) Grant No.K5556 in the amount of $17,789.22 for June 2025. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO R N/A DATE OF ACTION: -- APPROVE: DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO: WITHDRAWN: 4/23/24 xJ, Fad F WASHINGTON STATE AGENCY USE ONLY yf nDEPARTMENT OF AGRICULTURE AGENCY NUMBER AGREEMENT NUMBER 4950 K5556 FORM A19-IA CSFRF COUNTY INVOICE VOUCHER Instruction to Vendor or Claimant: Submit this form to claim payment for materials, AGENCY NAME: DEPARTMENT OF AGRICULTURE I I I I WASHINGTON ST SE, 2nd FLOOR merchandise or services. Show complete detail for each item. P.O. BOX 42560 OLYMPIA, WA 98504-2560 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. VENDOR OR CLAIMANT (Warrant is to be payable to:) Subrecipient Name and Address: Grant County 35 C Street NW/PO Box 37 By: Karrie Stockton Ephrata Wa 98823 (SIGN IN INK - ANY COLOR EXCEPT BLACK) 0 Grant Administrative Specialist 7/2/2025 Statewide Vendor Number: SWV0002426-59 (Title) (Date) SUBRECIPIENT INVOICE VOUCHER REIMBURSEMENT REQUEST EXPENDITURE DETAIL Total Budget Expenditure Period: 06; 0l, 2025 to %;'0i2025 $ 759054.29 Remaining Funds for June Expended this Billing Net Amount $ 179849.22 Period Salaries & Benefits Adjustment Requested $ - Pass -through Awards $ - Food Purchases $ 17,789.22 $ 17,789.22 Distribution & Transportation $ - Indirect Costs $ - Other $ _ Total This Period $ 17,789.22 $ - $ 17,789.22 BELO1 ' - FOR AGRICULTURE USE ONLY FED TAX ID # PROGRAM APPROVAL DATE DOC INPUT DATE CURRENT DOC. NO. REFERENCE DOC NO. VENDOR NUMBER SUFFIX ACCOUNT NO. ECMS CONTRACT # VENDOR MESSAGE TRANS FUND FUND APPN PROGRAM SUB SUB INVOICE CODE SOURCE (ACCT) INDEX INDEX OBJ SUB OBJ AMOUNT NUMBER ACCT APPROVAL FOR PAYMENT DATE is AGR-XXXX (N/10/21) 'Now -$Momw- CN community services of moses lake, CSIVIL Invoice #3 Farm to Food Contract # K5556 Attn-. Karrie Stockton Fr: Nan Gardener, CSIVIL Please see attached invoices and check stubs for request for reimbursement, Palouse Pastured Poultry #3 Bird Dog Cherries 06/26/25 Total Submitted $793120 $6787.55 $3068AT-- $17,789.22 Makin(ey a diff rence In the li%ves of those in need,, 4.1 P.O. Box 68319299 Beacon Road NE I Moses Lake, WA 98837 -�mltoo -kv. ml food org Ph ('509)765-810 11 Fax (509)7654.2.77 1 CSML(a CSMU'il mlfood.org Community Service3 of Momw Lake, Inc. Palouse Pastured Poultry Date Type Reference 5113/2025 Bill WA Trust - CHKG 5/13/2025 Original Amt. Balance Due Discount 7t933-20 7,33.E0 Invoice #8003 Farm to Food.- Country Contract Check Amount 1 0'tt 0 Payment 71933.{��..yyt 20 71933.20 71933.20 -- 13272 www.�her.kstortess.com 800-245-5775 Order 9 3534550-1 D ate. 5 / 13' /215*1 Sold To: Community Services of Moses Lake .0 9299 Beacon. Rd NE Moses Lake, WA 98837 509-43 1 -_3473 Palouse Pastured Poultry Invoice: 8003 4 W. Babb Rd. Resells, WA 99170 509-523-4933 emmy(l�,,,palousepasturedpoultry.coiii Corn -Free- Sov.-Frpp- CAVICI-Froo Pactivri--t2aierhil Size Price/size Quantitv Total classification Free —Rancre Pastured 263.51 chickens -a - — -------- Chicken 50 ,S5./lb total weight of S -1) 1442.40 lb .q_,:� iLo — - -- ------------------ cases) Pastured Extra Large Eggs — (Minimum '2_ 7 o z,ld S.6.75/dozen Pastured Large Eggs (MInInWin 24 oz/"doz) S6.50/dozen - - ----------------- Pastured Medium S5 01/dozen (M inimuni .2 1 ozidoz) .5 Pastured Small Ems — (rn'n*murn 5 /doz oz' ,S3.00/dozen I Free-Range Pastured S,7.00/lb Turkeys Total Thanks so much'. I S 7, 3.20 Community SdWia"269es LakePMOUSe Pastured Poultry Date Type Reference Original Amount Balance Due 06/30/2025 Bill 4 6,787.55 6,787.55 Check. Amount WA Trust - CHKG 16739 Payment 6,787.55 6,787.55 6,787,55/ 13272 wwwchockstorless,com SW-245-5775 Order 0 3S34650-1 Date-, 6/27/2).�' Sold To: ("onimunity Sei-vices of Moses Lake 9*'" 299 Beacon RdNE Moses Lake, WA 98837 :509-43 1 -'1347-3 Palouse Pastured Poultry Itivoice: 8004 4 W. Babb Rd. Rosalia, WA 99170 5 0 9 - 52.03- 4 8 3 3 emi-nyi.," palousepasturedpOLlitry.coni Corn -Free, Sov-Free, G.M.0-Free, Pasture -Raised Chicken, Turkeysandi E s* Ize Price/stze Quantity To ta I c l assi,,fir r on Free - Range PaSt-ured 169 chickens Qj total Chicken $5.50/lb weallit of 1234.1 lb S6.78T.55 Z� (45 cases) ---------- ----------- ------ ......... Pastur,t'.-d Extra Large Eg(..,Is — t$6.75/dozen (Minimuni 27 o7,/d.oz) Pastured Large Eggs, Wini.nium 42 N oz/doz) $6.5 )O/do7en Pastured Medi= Eggs — $5.50/dozen Winitiium 21 oz/doz) pastured Smal I Egg. s — $3.00/dozen (minimut'n 15 oz/doz) ... ... . ....... --------- -- I`ive-Range Pastured $7.00/lb TUrkeys Total Tbanks so much' Sionature C_ Community s&6IaW2*2&sez LakiepW Dog Orchards, LLC 16738 Date Type Reference Original Amount Balance Due Payment 06/30/2025 Bill 062625 31500.00 3,500.00 3,500.00 Check Amount 3,500.00 c3 0 agqor Y 7 --'� WA Trust - CHKG 13272 *",,chw*sfod#ss,com OW-245-5775 Ordw 0 353"WI Date: 06/26/25 Bill To: Moses Lake Food Bank Moses Lake, WA From: Bird Dog Orchairds LLC P.O. Box 445 Othello, WA 99344 Description 20 lb Cherry Box INVOICE Quantity 350 Unit Price Total $3500.00 Total Due Thank you for supporting your local farmers! '�� / , � 3 �"'S rr� �.,,