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Grant Related - BOCC (005)
I 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 suBnnirrED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: KBPfIe Stockton CONFIDENTIAL INFORMATION: ❑YES 8 NO DATE: 7/1 7/2025 PHONE:2937 kwj:j IMENTS SUBMI EO.CH ALL THAT.. ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ©ARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget El Computer Related El County Code El Emergency Purchase El 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 ❑ Professional Serv/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB P �� FOR AGE�A - .�� Reimbursement request from Renew on the American Rescue Plan Act (ARPA) Suicide Prevention category in the amount of $20,037-34 for May 2025 services. 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 ❑ YES ❑ NO 0 N/A .�...,,,,�s..._ DATE OF ACTION: DEFERRED OR CONTINUED TO: APPROVE: DENIED ABSTAIN D 1: �J D2: D3: WITHDRAWN: 4/23/24 Grenew iss PO Box 1057 Moses Lake, WA 98837 Phone (509) 764-2643 Fax (509) 764-4124 BILL TO: Grant County Attention: Karrie S. Stockton PO Box 37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: July 9, 2025 INVOICE # 5/31 /2025 FOR: May-25 DESCRIPTION Amount units Total Amount ARPA FUNDS - SUICIDE PREVENTION $ 205037.34 1 $ 20,037.34 Total Is 207037.34 Thank you! ! ACCOUNT TRANSACTIONS - GL MAY 2025 Ooen Year Journal Entry TRX Date Account Number Account Description Credit Amount Debit Amount Reference 2025 1018376 5/31/2025 108.150.00.9000.566511100 MH... ARPA.REG SALARIES & WAGES 0,00000 8,806.38 ALLOCATE SALARIES MAY 2025 2025 1018379 5/31/2025 108.150.00.9000.566512100 MH... ARPA.RETIREMENT 0.00000 802.26 ALLOCATE RETIREMENT MAY 2025 2025 1018380 5/31/2025 108.150.00.9000.566512200 MH... ARPA.SOCIAL SECURITY 0.00000 636.51 ALLOCATE SOC SEC MAY 2025 2025 1018381 5/31/2025 108.150.00.9000.566512300 MH...ARPA.MEDICAL & LIFE INSURANCE 0.00000 1,422.20 ALLOCATE MED/LIFE INS MAY 2025 2025 1018382 5/31/2025 108.150.00.9000.566512301 MH... ARPA.STATEWIDE FMLA INSURANCE 0.00000 23.07 ALLOCATE FMLA MAY 2025 2025 1018383 5/31/2025 108.150.00.9000.566512400 MH... ARPA.INDUSTRIAL INSURANCE 0.00000 37.68 ALLOCATE IND INS MAY 2025 11,728.10000 2025 1012972 5/6/2025 108.150.00.9000.566513100 MH...ARPA.SUPPLIES - OPERATING 0.00000 14.04 Renew. �~ 2025 1013785 5/13/2025 108.150.00.9000.566513100 MH... ARPA.SUPPLIES - OPERATING 0.00000 14.04 Renew 2025 1014411 5/13/2025 108.150.00.9000.566513100 MH... ARPA.SUPPLIES - OPERATING 0.00000 72.65 7348 - PREENTIONV APR 2025 '- 2025 1014411 5/13/2025 108.150.00.9000.566513100 MH. ,ARPA.SUPPLIES - OPERATING 0.00000 109.00 7348 - PREENTIONV APR 2025 2025 1013775 5/13/2025 108.150.00.9000.566513500 MH...ARPA.MINOR EQUIP <$550 0.00000 158.94 7005042839 2025 1016147 5/27/2025 108.150.00.9000.566514100 MENTAL HEALTH ... ARPA.PROFESS 10NAL SERVICES 0.00000 190.96 Renew moo 2025 1016147 5/27/2025 108.150.00.9000.566514200 MH... ARPA.COMMUNICATIONS 0.00000 22.08 Renew 010 2025 1012958 5/6/2025 108.150.00.9000.566514202 MH... ARPA.COMMUNICATIONS-CELLULAR 0.00000 41.32 287333762696 2025 1014408 5/13/2025 108.150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 1,653.21 6613 - GRIS APR 2025 2025 1014408 5/13/2025 108.150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 1,653.21 6613 - GRIS APR 2025 2025 1014408 5/13/2025 108.150.00.9000.566514301 MENTAL HEALTH ... ARPA.TRAVEL-LODGING 0.00000 1,653.21 6613 - GRIS APR 2025 2025 1015487 5/20/2025 108.150.00.9000.566514400 MH... ARPA.ADVERTISING 0.00000 500.00 ARPA- 2025 1015488 5/20/2025 108.150.00.9000.566514400 MH... ARPA.ADVERTISING 0.00000 500.00 Payables Trx Entry 2025 1018373 5/31/2025 108.150.00.9000.566514902 MENTAL HEALTH ... ARPA MISC DUES & SUBSCRIPTIONS 95.00000 - Treasurer GL Import: 05/31/25 TOTAL Refund 18,310.76 TOTAL FOR MAY 2025 MINUS REFUND 18,215.76 ADMIN 0.10000 1,821.58 TOTAL FOR MAY 2025 ARPA SUICIDE PREVENTION 20,037.34 NON-EXEMPT **"Leave Printed Name: Bethany Avey Slips iAfLf Pay Period: April 27, 2025 Employee ID #: 5630 Staff Signature: a4ld Supervisor Initials for Non -Standard Workweek 0 � iW ` Pay Period: 4/2712025 (mm/dd/yyyy) Supervisor Signature: 4.41 Pay DaW 5/1612025 Apr 27 Apr 28 Apr 29 Apr 30 May 01 May 02 May 03 May 04 May 05 May 06 _May 07 May 08 May 09 May 10 CLINICAL Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat TOTAL pq ARPA 9000 8,00 $,0c. 8,00 9,00 5.60 3.00 9,00 11,00 8,00 9M 1 3M 81 50 1.00 OTHER HOURS WORKED i JURY DUTY Total Worked Hrs 8.00 8.00 &,00 %00 5.60 9.00 11.00 8.00 9.00 3.00 Mtn 1.001 ANNUAL SICK HOLIDAY . . . . .................. OTHER (Bereavement f Military) FLEXICOMP TAKEN LWOP t TOTAL HOURS 8�00 800 A 8.00 9�00 6.50 3.00 1 - 9.00 8.00 9.00 1 3.00 , Total Worked Hr5 40,00 41.50 - - ------ 40.00 40.00 Iongne annIne sickno snect holne - -F milpayl bervne Civil salyne LVtaken 0.00 40.00 GP ENTERED LEAVE 80.00 0.00 0.00 0.00 0.00 0.00 0.00 8 .00 LWOP PAYROLL SPREADSHEET "*PAYROLL PURPOSES - DO NOT WRITE IN THIS SECTIION "' i renew K1nfj.1=Y1=MPT Printed Name: Bethany Avey Pay Period: April 13, 2025 Employee ID #: 5630 Staff Signature: 4 _D Rl *_4 I.V ;.* Supervisor Signature: I ",*Leave Slips (AIL. Supervisor Initials for Non -Standard Workweek Pay Period: 4/13/2025 (mm/dd/yyyy) Pay Date, 5/212025 Apr 14 Mon Apr 18 Fri Apr 19 Sat Apr 20 Sun Apr 21 Mon Apr 22 Tue Apr 23 Wed Apr 24 Thu Apr 25 Fri Apr 26 Apr 13 CLINICAL Sun Apr 15 Tue j Apr 16 Wed Apr 17 Thu Sat TOTAL 750 8000 .1001 ARPA 90®0 9,00 800 900 900 500 6.50 8,00 9.00 9.00 OTHER HOURS WORKED JURY DUTY Total Worked Here 9.00 8.00 9.00 9.00 5.00 A 6,50 8.00 9.00 9.00 7.50 80.00 1.00 ANNUAL SICK HOLIDAY OTHER (Bereavement I Military) FLEX/COMP TAKEN LWOP ITOTAL HOURS 9,00 8.00 9.00 9.00 6.00 6.60 8.00 1 9.00 9.00 1 , 7.50 80.00 I Total Worked Hrs LVtaken GP ENTERED' LEAVE PAYROLLSPREADSHEEt % 18.00 " 22.00 40.00 ,/ --' LWOP 40.OQ / _0ooe 14U.UV OM 40M -*PAYROLL PURPOSES - 00 NOT WRITE IN THIS SECTION *** renew Bersawkwal ~1th 6 WON""* NON-EXEMPT *"Leave Printed Name: Bethany Avey Slips (AIL, Pay Period: May 11, 2025 �_. ., .w .. Employee ID #: 6630 .. . Supervisor Initials for Non-Standardr6rkMvir—_ Staff Signature: r . . ..... (mm/dd/yyyy) Pay Period: 5/11/2025 Supervisor Signature: Pay Date: 5rIM025 CLINICAL -May 11 F Sun __�iay_12 Mon -May 13 Tue May 14 Wed May 15 Thu May 16 Fri May 17 Sat May 18 Sun May 19 Mon May 20 May 21 May 22 May 23 May 24 M TOTAL Tue Wed Thu Fri Sat ARPA 9000 9.00 600 9.00 8.00 8.00 8.00 8.00-- 5600 OTHER HOURS WORKED JURY DUTY Total Worked Hrs 9.00 6.00 9.00 8.00 8.00 8.00 8.00 56.00 1.09 1 ANNUAL - SICK HOLIDAY OTHER (Bereavement Military) FLEX/COMP TAKEN 8,00 &00 8.00 24M LWOP TOTAL HOURS 9.00 COO 1 9.00 8.00 8.00 8.00 1 8.00 8.00 1 8.00 8.0 0 80.00 Total Worked Hrs 40,00 LV taken GP ENTERED LEAVE [PAYROLL SPREADAET LWOP 40.o/ IbAju 24,00 40M &*PAYROLL PURPOSES - DO NOT WRtTE IN THIS -SECTION *46 American Rescue Plan (Cares Act — ARPA) Today's Date: 4/29/25 Vendor: Signs Now Detailed Description: Name Plate for new office `Charge to Aig' Month: ❑ July 2024 ❑ January 2025 ❑ August 2024 ❑ February 2025 ❑ September 2024 ❑ March 2025 ❑ October 2024 2 April 2025 ❑ November 2024 ❑ May 2025 ❑ December 2024 Deliverables: ❑ June 2025 0 General Taskforce supplies ❑ Goal 1: MH Literacy & BH Promotion ❑ Goal 2: Postvention ❑ Goal 3: Perception/attitudes ❑ Staff Travel / Professional Development Requested by: 6f Supervisor Signature: ❑ Received Supervisor Approval ❑ Scanned supporting documents ❑ File into binder ❑ Item(s) received Receipt Date: 4/22/25 Prevention Requisition Form Revised 07.2024 Form of Payment ❑ VISA ****— _ — — ❑ Invoice (paid) 2 Invoice (needs paid) ❑ Other: IITI Charge Account: 0 ARPA (g000) ❑ Other: $ 28.09/ ` Date: 4/29/25 Date: 4/29/25 *00 s renewGiss 710 E. Broadway Moses Lake, WA 98837 (509) 765-8955 http://www.signsnowmoseslake.com Created Date: 4/22/2025 d Payment Terms: Net 30 DESCRIPTION: x9 6"x2.625" Styrene Name Plates Bill To: Renew Pickup At: Signs Now - Moses Lake, WA PO Box 1057 710 E. Broadway Moses Lake, WA 98837 Moses Lake, WA 98837 us us Requested By: Sarah Nelson Salesperson: House Signs Now - Moses Lake, WA Email: snelson@grantcountywa.gov Entered By: Ali Gome,-7- Work Phone: (509) 765-9239 N ; Product Summary QTY UNIT PRICE AMOUNT 1 x9 6 if x2.625" Styrene Name Plates 9 $23.6644 $212.98 1.1 .030" Polystyrene Clone - Part Qty: 1 Width: 6.0011 Height: 2.625t Sides: 1 1.2 Standard Callendared Digital print for substrate mount - Part Qty: 1 Lamination Width: 6,0011 'Lamination Type: Premium Calendered Height: 2.625" Text:yJ Bethany Avey 1� tv ;7 (7) Dayana Ruiz Fernando Galarza Marisol Gonzalez Megan Watson Catalina Guzman .5 4 3 1W 14, Wendy Garza -Jonathan Muck MAAM q st tio Base Subtotal: $212.98 Thank you for considering Signs Now of Moses Lake for your signage needs. The quote we discussed is attached below, If you have any questions, please ---- - -------- Shipping: $20.00 don't hesitate to call us at 509-765-8955 or email signsnow364@gmail,com. Subtotal: $232.98 Please visit our website www.SignsNow.com/moseslake for more ideas and Taxes: $19.80 options. Grand Total: $252.78 Deposit Required: $126.39 PLEASE NOTE: to proceed with this project we do require a 50% deposit before I preparing art files & proofing. PROOFING POLICY: Upon receipt of the required deposit I proof will be Generated On: 4/23/2025 9:488 AM 7 10 E. Broadway Moses Lake, WA 98837 (509") 765-89:)-D 11 V P 6. /11,,,,,(-�tvA-.-.5icnsnowmoseslake.com �7 Created Date: 4/123/1.2025 'DESCRIPTION: x9 6`x2.625" styrene Name Plates INVOIC 1,,68021 Completed Date.- 4/23/2025 Payment Terms: Net 30 Payment Due Date: 5/23/2025 81111 To: P'C-new Pickup At: Signs Now - Moses Lake, WA PO Box 1057 710 F. Broadway Moses Lake, WA 9883 Moses Lake, WA 98837 us us Ordered By: Sarah Nelson Salesperson: House Signs Now - Moses Lake, WA Emalil: snel�-.on@grantcoun-tLywa.gov Entered By: Al{ Gorne-7 Wo.-k Phone- (1-09) 765-9239 N (D Product Surnmary - --------- - - -------------- -- ------- QTY UNIT PRICE AMOUNT 1 x9 6"x2.625" Styrene Name Plates -- - -------- 9 S 23 66 S212,98 -030" Polystyrene Gone - Part Qty,,. I Width: 6.00'* Height: 2.6,2, 53 A Sides, 1 2 Standard Cslandered Digital print for substrate mount - Part Oty: 1 Lamination Width: 6.00" amination pePrern,wq-i Calendere sy'M Text: - Bethary t;4 - Dayana RUj7 - Fernando Galarza - Marlsol Gonzale z - Meaan Watson - Catalina -man - Wendy Jonathan Mur- ,,K r -4a_JR44j z �4 Base Subtotal: S � 12 9 ss Shipping: S 2 0, f% 10 Subtotal: $ 2 3 2, 9 It-3 Taxes: $19.80 Grand Total: $252-78 Amount Paid: S0,00 BALANCE DUE: 2_5 2 � 78 J wy 2 bo, 1 3 _11' MH -44 t 5097709154 ----- - --------- -------- TANNED LONG 5097709154 $41.32 MH - 44 - - ---------- :5097715043 -- -------- ------ ----------- ------------------- .................... KI M BERLY BAI LEY ............... --------------------------------------------- - -------- - ------------------------------------------------- 15097715043 ......... .raw.. ............ $41.32 MH - 44 '5097715207 . .. . . ..... )TANYA NUNEZ -- - --------------- ------- - - --- ----- -------------- 15097715207 4 ...... __ ---------- - --------- -------------- ....... - $63-55 MH - 44 �5097715530 'SOMA FERNANDEZ ....... 15097715530 $41.32 MH -44 .5097717105 ----- -------- .......... -- - ------- INDELISA SALINAS ............. ............... ------ --------------- ........... '5097717105 41- $32 MH -44 15097717374 .......... -------- .............. .... - ....... ......... f LISA HAM I LTON ....................... - - -- - -- ...... .................... 5097717374 . $41-32 MH - 44 .........................................................-------- ....... SCOT DENTIN G5097717661 : ....... ...... ...... ......... . . ..... $41.32 MH- 4 �5097930640 RAN HARDY 1 ............ - 5097930640 ------- $41-32 MH - 44 ........... - .. . ....... ..... . . ....... ....................... .............. ---------- .................... .... ..... ........... ------- JASMINE ARROYO $51.51 ....... ......... MH - 44 . .... .......... .5097938959 ....... 1ULEMA GUTIERREZ-CONTRERAS .5097938959 $51.51 MH - 44 15098550383 ........ ----- - - ........ .......... .......................... ........ ZACHE` NYGREN .. ................. .... ...... - --------- .5098550383 $51-51 MH -44 15099893186 . . . ....... ........... ------------ ......... .......... .............. - PATRICK DI APEAU ..... . ... ....... ........ ........... ---------- - - ............... ...... . ..... .5099893186 ...... ....................... ....... ................ . . ... . ...... . ..... $51.51 -- ---------- ............... .. . ....... . ....... ........... ........ .......................... ---------------- MH 44 ....... ....... ............. ........ . $1737.49 MOT - 8053 -__ . ...... 5097079264 - ----- . ..... ------- ----- MARISOL GONZALEZ --- - -------- . ............ . .......... ........ - -------------- -----_---- .5097079264(8053) ......... ...... $41-32 MOT -053 1509707926 - - --------- . ..................... . ... -------- FERNANDO ALA ZA ----............. ...... ............. ......... ............ . .... ........... ...... ...... .......... 150970792(8053) - --------------------------------------...... $41.32 MOT - 9053 5099891048 .. . ....... ........................... . ........... .... . ... ............... ................ ............ .................. FERNANDO GALA ........................ - - - - - ................ ....... .......... . 15099891048 ....... $40�04 MOT - 8053 .5099893764 ------------ . .............. MARISOLONZALES ......... .......................... ... ................. ..... . .......... . . ........... - .......... ...... - ..... ............ .......... .. . ............. .5099893764 -------- ....... ........ ...... . . ............. $40.04 ............. ....... . . .......... ---------- - .................... ------ - ----- - ........... ........ ...... ------ ...... Total MOT ...... - - -- ----- ...... .... .... ........... ................................. .......................... . ............ . . .......... - - ----- $162.72 ...................... Prevention - 9000 .5097714324 . ... ............... BETHANY ESCAMILLA .......... ....................... ............ ------ ---------- $41.32. Prevention - 9097 .5097717634 . .... ..... ............ ..... ....... ...... ...... ... ............. ......... ........................... .......... . ....... MEGAN WATSON .. �5097717634 $41,32 ........... .......... ------ ....... .................. Prevention - 9064 .................................... . ..................................................................................... ...................... ............................................ ...... ................... :5097975242 ............ ....... .... - ...... - - --- - - - ......... . . .... .......... - ............ ...... - ----_- CRYSTAL CRUZ - -- ...... ...... ------ - .... ------------------------- ........... ....... ...... ................................... - -------- .5097975242 - - - ---- - - --------- ........... ...... ----- ... . .... ... ....... ... . .......... $41.32 . .................. . .......... . ............ . . . Rec Coach - 8079 ----- - .. . .... .......... ................ . . . . . . . ................ ... .... . . . .......... ............ ...... ... . ..... ------------ ----------- -------- ---------,- ..... . ..... . .... - - - - - ------ - - - ------- . ELEISER PND AO - ---------------- ...... - ... ------- ------------ ........... ........ .............. - .... --- - . . ...... $41,32 ..................... . ........................................ ...... .............................. Rec Coach - 8079 ......................... ........... . ............. ................. ......... .......... ........ ---------- - - -------- ....... .............. ............ JAM MULLENIX ----------- ...... ...... . . .30 50979005 --------- W --------- - - ............. . ......... . ...... . . ............ .................... $41-32 ................... ......................... ....... ................................................... ......... .............. ..................... .............................................................................................. ...................... ....... . ............................................................ ................................... ---------- ------ - ....... ........... --------------- ------- - ... ........ .......... . ........ ...................... .. .................. ----------- ...... ......... ---------- - ... ..................... --------------- ..,... .; .:... ;.:r Total 8079 - ---- ...... . -------- - - ----- ...... .v...viii..i..........r..... .......... ................................. ....................... ... . .................. ........ . . - - -- .... . ......... $ 2. -.... WISe - 8059 ................................................. WISe - 8059 .2 509431057 :HEIDI PINCKRD A �5094310572 $41-32 .................................................... ................. ............................... ................ ............... ............. ....... - .... ........... EDDY DEHERRERA ............. - - -------- - ...... .......... 5 097079095 (SUD Professfol. $4132 ---------- - .. .............. ....... ....... ................... . t5097079162 . . ........ ........... ......... .............. NOEMI GARCIA . ...... �5097079162(SUD) ........ $41-32 .......... ........ ........... ....... . .... ....... 15097502545 ... ............... ........... - - ------ - -------- ...... ...... ELAINA SANTACRU ..... ....... ........... ....... ....... ............. 5097502545 $51.51 . i5097503006 ...... ......... ......... ............ ...... --------- ..... DALE WEAVER ......... ...... . ... .... .5097503006 $51-51 .5097509926 --------- _- - ---- - ------ ------- ...... . ... KATHY VERTREES ............................... ........... . .... ....... ........................................... ......... $ 51.51 5 097703387 DARCI ALAMOS ....... ........ ................... - ........ 5097703387 (SU D) .. . ...... . ........ .... $41.32 .......... ..... ------- �5097705969 - - ----- - - .............................. i MEGAN CLOYD ........ ................... . ..... ........... ....... _-F ................. Z5097705969 $41.32 .......... __,_ _---_-------- - ... . ..... 15098553215 .......... .. ..... . ........ . . ......... ..... ... . ...... 'ARASELI VERDU`ZC0 ....... ... ................. ...... .......... ............................... 15098553215 ......... $51.51 5098553276 ... ............ . . .......... ___ ....... .. .. ......................... ............... MALEENA LOPEZ .......... ...... . . .......... ....... ....... $51-51 -- -------- ................... .. . . ............................. .............. �5098553281 .................. .......... 1 IZABELLA VALDEZ -------- ...... ......... ----- - -- ............ ..... ..... .......................... 15098553281 $51.51 ........ ..... ...... ....... .............. ............. ........... .................................... ....... ...... . . . . . . . . . . . . . . . . . . . . . ............................... . . . . . . . . . . . . . . . . ...... . ... . .......... ........... ........ . . . . . . . 'TotalSUD . . . ...... . ........... ---------- ---------- - -----_--_----- ............ .. ..... ........... ................. ...... . ... . ...... ......... ..... ... ...... - ............ .......................... ........................................ ................................... ........... ......................... ... .... ............ 5094317240 DEEANNA SANDOVAL 5094317240(8059) .......... ............................ ...... . . ........... . ......................................................................... -- --- --- --- - 4 ............. ......... .. ......... ............. _ ........... - ------ ---------- - --- ------- --- ---------------------- ---------- -------- -------------- ----- ------------ - .... _ ---___- 5097073475 TATIANA HERNANDEZ .5097073475 $515.661 $41-32 $41.32 American Rescue Plan (Cares Act - ARPA) Today 's' Date: 4/2 Vendor: Amazon Business 11 Received Supers isor Approval El Scanned supporting documents 0 File into binder 0- Itern(s) received Receipt Date: 4122125 ....... Detailed escript. TP-Unk USB Hub, Mental Health Awareness Flags (Qty of 60), Dion. "End the Stigma" keychains ,..(Qty of .30) "Charge to Aig'Month: C July 2024 0 January! 2025 0 ugust 2024 0_3 Febniat-y7 2025 0 September 2024 171 March 202- 11 October 2024 2 April 202-) 1:1 Nove-tuber 2024 11 May 202- 171 I)ecember 2024 D June 202- Z) Deliverables: * General Tasl<force supplies * Goal i: MH Literacy, & Btu Promotion * Goal 2: Postvention * Goal 3'. Perception/ attitudes C1 Staff Tra-vel / Professional Development Requested by: e Supervisor Signature: Prewntion Requisition Form Revised 07 2024 Form of Payment 2 VISA **** 7348 El invoice (paid) 171 Invoice (needs paid) 0 other: Charge Account,0 0 ARPA (g000) 0 Other: s 72,65 i I Date- 4/22/25 4/221125 Date: *10renew W,w* Aeaft'l- & am,axonwm' Detail,,s for Order #112-8620840-90,35444 LEI thii Q2,,,9t!QL-V-0—Ur-r=Q-r0,54 Order Placed: April 22, 2025 Amazon.com order number: 112-8620840-9035444 Order Total: $72.65 Not Yet Shipped Items Ordered Price 2 of Outus Ment"I Health Stick Flags Decorations 30 Pcs Small M-ini Handheld Rag,-, for Easf�-er Religious International Festival $11.99 Celelbration Party Holiday Favors Supplies Spring Outdoor Indoor I Sold by: Tenjage (se4ler profile) Stipple d by: Other Condition, New, I of: Yinkin 30 Pcs End the Stigma Mental Health Awareness Key Chaefns Inspirational Gifts G.,-e,-:,n Ribbon Jewelry, for Me-'n $15,99 Worrien Suppowlt S I old by-, Bkado (se4Wr profiley Supplied by- Other Condlftion� New 1 of -. TP-Link Powered USB Hub 3. 0 with 7 USB 3.0 Data Ports and 2 Smart Charging US6 Ports, Compatible with Windows, Mac, $26.99 I Chrome & Linux OS, with Powe,r 0rV0,,,T Button, 12V14A Power Ada pter(UH720) Sold by, Arrnazon.corr Services, Inc Supplied byher Cor?dAjon- New Shipping Address: Shipping Speed: Delivery in fewer trips to your address -- ---- - - ---- - ----- Payment information Payment Method: Itern(s) Subtotal: Visa ending In 7348 Shipping & Handling: Billing address Total before tax: GR1S PREVENTION GRA1JNT COUNTY Estimated tax to be collected: PO BOX 37 Grand Total: EPHRATA, WA 948823-003-7 U n i r- e ,: I it a t" e s To view [he status of your order, return to Order Summary. -'e Conditions of U!ie I Privacy Nouc 1996-2015, Amiazon.cc m.. Irf,-. or jr_ s affihates Have an idea to help us improve.? Send feedback > Get to Know Us Let Us Help You Work with Amazon Careers Customer Service Sell on Amazon Business Blog Futfillment By Amazon Business Solutions Amazon Business app S 6 6. 9ED $66.96 $5.69 $72.65 Buy For Your Business Buy wholesale Today's Deals American Rescue Plan Care,---.-. Act — ARPA Toda-Ws Date, -4/15/zz) Vendor, Amazon Business E! Received Supe"--isor Approval 17 Scanned supporting. documents Ell File into binder 11 Item(s) received a I Wee* t Date* 4 -,115/25 1P D etaile. Office supplies to accomdate smaller space.� Book shelf. under d Description. desk storage, large calendar, over -the -door coat hanger, 'Charge to A19'Mont1i. E] July 2024 El JanuarV 2025 Ell AlIgU.St 2024 71❑ Februaly 202 71 September 2024 1] March 2025 7-1 October 2024 2 April 2025 El November 2024 El MaV 2025 December 2024 1 June 2025 Deliverables: * General Taskforce supplies * Goal 1: MH Literacy &- BH Promotion * Goa12'. Postvention * Goal 3: Perception/attitudes * Staff Travel / Professional Development Requested by: Super-% sor Si( gy Forni of Pavment 2'WSA 01 Invoice (palid) • Invoice (needs paid) • Other: 0 Food charge ,keeount: L3 ARP A (0000) 0 Other: $ 149.00 Date: 4/15/25 f 4/15/2025 Date.- -' Vre�-entton Requisition Form 40*9 Revised 07.2024 renew-4 . I:- -- 4-41� i uworwft amazon.com Details for Order # 112-4548638-3011422 Order Placed-, April 14, 2025 Amazon.com order number: 112-4548638-3011422 Order Total: $109.00 Not Yet Shipped Items Ordered Price I ganiz Of- Under Desk Drawer Or er Clamp -On, Mesh Moral Desk Drawer Attatchment, 2 Dravever Slide Orb, Oo Desk Or Under Desk S201?1r99 I '0rgar' t I zer For Office Supplies & Home Essentials (2 Drawers) Sold by- FRESH FINEST It girg-fiLM Conaftion- New 1 Of. Optish Over The Doo-Hooks. Doorpar ger Hook3 for Hang Ing, Over The Door Towel Racks for Bathroom, Coat Rack Door Towel Hanger Towel Hooks (lPack, Whitej Sold by: 0ptish Business Price Condibon: New 1 Of: SUPVEE 2025 Wall Calendar Large 22.75W5,Y with Lines, 21 Month Cat endalr from Now to June 2026, Vertical Extr $18,99 a Large Monthly Catendar 2025 for Wall, Seasons Color Sold by: Sunee N-lerl-harts (3gUeLpmfile) Business Price Con6tion: New 1 Of: Fufinno, Luder Bookcase / Bookshelf / Storage ShehveS, 5- Tier Blackwood $41.99 Scial by: Amazon Buvness Prce Cori dition: New Shipping Address: Bethany Avey (Escamill1a) 840 E PLUM ST MOSES LAKE. WA 98837-1874 United StateS*. Shipping Speed: Delliveri in fewer trips to your address ---------- --- Payment information Payment Method: Visa I Last digits- 7348 Billing address GRI S PREVENTION GRANT COUNTY PO BOX 37 EPHRATA, WA 98823-0037 United States Itern(s) Subtotal.- $100.46 Shipping & Handling.- $0.00 Total before tax: $100,46 Estimated Tax-, $8,54 Grand Total: $109.0 To view the status of your order, return to Qr ,UMjj), 3' _ry Ow IL Staples taples ATTN-,FSSC 500 Staples Dr Framingham, MA 01702 Federal ID: 04-3390816 I Summary Number 7005042839 GRANT MENTAL HEALTHCARE Attention: PAYABLE Invoice Number Invoice Amount 840 E PLUM ST 6030139611 $317.88 MOSES LAKE, WA 98837 Invoice Date Due Date 04/25/2025 05/25/2025 Order Number Terms 7655681144-000-001 Net 30 Days Bill T 11 b Customer Account @961298 LA 1579471 Detail Invoice Ordered By Order Date Budget Center BC Description ANNASERRAND 04/14/2025 DAYANA PUIZ Deliver To Approved By PO Number PO Description AID NA Ship -to ID PO Release PO Release Description GCMH Ship -to Name Shipping Address RENEW 840 E PLUM STMOSES LAKE,WA,98837-1874 Line Item Description/LIBC cusl u0m Qty Unit Extended Tax Total Number SKU Price Price Amount I 24549SI4 HP OFFICEJEET 8015E AI Q PRINTER 24549514 EA 2 $146A9 $292.98 $24,90 $317.88 Subtotal: $292.98 Freight/Other: $0.00 Tax ($8.50%): $24.90 Total: $317.88 J011" or ---. Please Remit All Payments To: ACH Check Wells Fargo Staples Account. 4654634682 Routing., 121000248 PO Box 660409 ARRernittance@Staples,com Dallas, TX 75266-0409 For invoice and payment related inquiries please call 888-753-4103 Page: 1 on w Greet BeAmOoml He-althf'y Uleflness Name: Date,, L,�_ Reason for Requesta. ------- =3 iAT xate Please have your supervisor sign the form and I - then suomit Wit to finance, Renew -May 2025 TS Network & Security Services $ 1, 186, 19 System Administration Services $ 822.45 Generat He(pdeSk & Asset Management $ 14,548.60 System Administration Services $ 1,265,62 Accounting Application- GP $ 663-84 Sottware as a Service $ 6p 146.77 VOIP-PHONE 4,,260.55_ $ 24,633.67 $ 28,894-22 ACCOUNT 4152 $0,00 129 $ 190,96 108-150,00-0000.564.12.41-52 108.1%000000.568.W4152 564 566 109 11 20,766.75 2,100.55 MHBG- 8053 2 381-92 Recovery Coach - Crisis - 8079 2 381.92 CV-2 DCA- Rick G. - 7609.564.41 1 190-96 ARPA SUICIDE PREV BETHANY- 9000 1 190.96. ARPA-Psychot- Lanny A. 90W564.41 1 190.96 Housing- SO%- CBRA 8078. 0.25 47,74 Prevention - ML SUPTRS 9097 1 190.96 Prevention -City of Quincy 9064 1 190.96 20.25 24,633.67 Ednetics V01P Services fftones) 193.00 4,260,55 ACCOUNT 22.08 4200 MHBG, 168.00 564 3,708.67 SUCH 12 566 264.90 MHBG 2 8053 44.15 recovery coach 2 8079 44-15 CV-2 DCR- Rick G. - 17609-41 22,08 #000 ARPASUICI DE PREV -Bethany 1 9000.566.51 22.08 ARPA-Psychol- Lanny A, 1 9000.564.41 22,08 dosesLake1 9097 22.08 4,150.17 Y $ 4,1W17 DCL- 3 8003 66,23 1 8002 22,08 i 8001 22.08 110.38 25 $ 4,260.55 $ 4,260r55 $0.00 Renew without DCL 05.2025 . ........ (2025-Estimated Support Coveragei Ban MW 129 A 't i7jot 03% Renew S(RVLH5 7 125 5.6000000% ,Renew_NETWORK DEVI"AS. 5ti 771 7.5226978% Renew GP Users. 5 18 6 4102564* Renew servers: 71 1257 5,6000000%1 Network & Security Services HiSVI"ar" Hourly Rate Total Yearly Quarter[ 3.7474 3.5Wb7 wrin Martin $ 90,47 189,217,60 14 2134 � 2 7 $ - V 1 5 S $ 14,234.27 $ 3" I - tem Admini3tration Servim Sys!!�s -- Hre'F Hourly Rate Total Yearly Quarterly Monthly Keith Contey 080.001 $ 84.73,1_$ 176.2.38.40 $ 9,869.35 $ 2.467,34 $ 822.45 9.869.35 $ 2,467.34 $ 822.45 Phone Services Number Of Lines Rate Total Yearly Quarterly Monthly_ Ednelics VOIP Services (Phones) 22,0_/539 $4.260�5",) $51,126.60 $1 '11, 781.65 $ 4.260.55 gkjar Memeni Vanessa Brown Hi", #r Hourly Rate Yearly Qu:_ 2080,.(,)U 56,23 $ 116,958,40 $ 20,810.53 $ 5,202-63 $ 1.734.21 Ricky Gutierrez 2080.00 $ 76.81 $ 159,764.80 $ 28,42-1.12 $ 7,106�18 $ 2.368,93 Jeremy Hall 2080.00 $ 67,79 $ 141,003,20 $ 25,088.85 $ 6,272.21, $ 2,090.74 Evan Little 2U$0,00 77 .94 $ 162.115,20 $ 28,845.33 $ 7.211.33 $ 2,403.78 Seth Sampson 2080.00 $ 69.25 $ 144,040.00 $ 25,629,19 $ 6,407.30 $ 2,135.77 Alex Sukhovetskiy 2080,00 $ 66.73 $ 138,798.40 $ 24,696.54 $ 6,174.14 , $ 2,058.05 Luke Lankhaar 20t30mi $ w98 $ 118,518.40 1 $ 21,088.10 $ 5.272.03 $ 1,767.34 Systems Admin isUal ion Services Total Cost Years TotNt Yearly Quarterly Monthly TeJaiviewer (Ye,,jr I of 3 Year Contracti $ 34,773.61 3.00 $ 11,591.20 $ f>49.11 $ 162.28 $ �4,09 E tine t tcs/SM.ARTne t Maintenance $ 22.000,00 1.00 $ 22,000,00 $ 1,232M $ 308-00 $ IO2.67 Netapp Storage Hardware Service $ 33,158.00 LOO $ 33.1,58,00 $ 1,856.85 $ 464.21 $ 1,54,74 Edneticti One $ 24,978.38 too $ 24,978.38 $ 1,398.79 $ 349-70 $ 116,57 Rubrik (Reptaced Veeaoi,! $ 538,428-91 3,00 $ 179.476.30 $ 10.050.67 $ 2,512.67 $ 837,56 Accounting Application Total Cost Years I TaTfYr Yearly Quarterly Monthly Dynamics GP 124,270.00 1,001 $ 124,27&00 $ 7,966,03 $ 1,991-51 $ 60-84 $ 7.966.03 1.991,51 S 60.84 Quarterly Morrilu ExaShangp Online Plan IG $ 5,01 /19 5,00 $ 41,81 $ 209-05 $ 52-', $ -17,421 Uffics 365 G3 $ 169,819.44 123,00 $ 280.03 $ 34,443,69 $ 8,610.92 $ 2,870,31 Azure Active Directory Premium Plan I $ 45,205,40 161,00 $ 62.79 $ 9,481.29 $ 2,370.301 $ '190.11 Adobe.Acrobat Pro $ 18,328.21 MOO $ 113.14 $ 3,167.92 $ 791.98 $ '263.99 Adobefilustrator $ 1,785.39 LOO $ 446,35 $ 6.35 " $ 111.59 $ 37.20 Adobe Creative Cloud Ail App�, $ 14.9:30.,93 TOO $ 931 IS $ 1,866,36 $ 466.59 $ 155, 53 Ba(racudd Ernail Atchaiver and Anti-SPWTI $ 38,33133 150.00 $ 159.72 $ 23,958.00 $ 5,989.50 $ 1,9%,50 Blue Bearn $ 3,113.00 1.00 $ 188.62 $ 188.62 $ 47.16 15.72 ILasertiche DMS Mainlanance(]OSI $ 3,70145 1 35.00, $ 10,8,1 $ 3,70345 $ 925-86 308.62 $ 18.4 40.32 , S 6,14677 28894,22 *includes 3% COLA and Annual Raises 11 GRANT COUNTY CO MERE AGENDA MEETING RETEST FORM (Vust be submIted to ft CfeA of ttv Boat by 12700prn on Thursday) REQUESTING DEPARTMENT: Rene. REQUESTSUBMITTED BY- Anna Serrano DATE- 1/9/25 PHONE: (509) 765-9239 ext, 5a53 Dell Anderson CONTACT PERSON ATTENDING ROUNDTABLE;. CON9138MAL INFORMATION,- OYES WN0 a Kelm mial ClAgreement I Contract OAP Vounhem rya irtnent, I Reaxbrrent OARPA Related 0 Bids I RFPs I Qtotes Awwd 0 Bid Open t 'ng S&eduled 0 Boar d s I Co rn rrdein, OBudget OCorrputer data OCourvtj Code Cucy Pury ohase OlEmPfoyeo Ro! UFacilifies Related 0 Financral OFunds 0Heading I Olnvo*/ Orders ces- Purchase s OGrant - Fed /State fCounty OLase s OMOAIMOU DMinutes 00rdinances @Out of State Trave. OPetty Ca&) OpoliCISS CIPmetamatiom OReWest for Purchase OResoluUon CIRecommeridation C]Pr&esslonal Serv/Consuttant 0 Support Letter ClSurplus- Req- OTax Levies OTbank Yoj's OTax Title Pro"rty 0'WSLCB W!W1qWUt:*aW* I I W L-MffflWtTjaj=tyA Asti Out,-of,state travel request for Bethany Escamilla, Maria Hallett & Corms Guerrero AAS25 58th Annual Conference - Columbus, OH, March 29th - April 4th, 2025 Estimated Cost: $4,240.20 each / $12,720.60 Total Fund'Ing: 108.150.00.9000.566.51.xxxx (ARPA - Suicide Pre venbon) If necessary, was this document reviewed by accounting? El YES 13 NO W N/A if necessary, was this document reviewed by legal? 0 YES L] N 0 N/A DATE OF AGTI01*4�- 700) DEFERRED OR CONTINUED TO: VA T H D RAY44: APT BP- YL QL D2� 03 4!23/24 American Rescue Plan (Cares Act -, ARA) Tads Date., 4/11/25 j,rendor: Hilton Columbus Downtown L1 Received Supervisor Approval 0 Scanned supporting documents Fire into binder 01 0 Item(s) received Receipt Date: 4/4/25 Detailed Descrz*ption: Hotel rooms for Bethany Ave y (Escamilla), Conne Guerrero, and Maria Hallatt - AAS25 Conference in Columbus, OH `Charge to A:19'Month. 0 July 2024 CJanualy 2025 13 AUgUSt 2024 0 FebruarV 2025 El September2024 2 March202- C October 2024 0 Apri12025 November2024 0 May 2025 December2024 13June2020 Delihrerables-. 0 General Tas1dorce supplies 13 Goal i: MH Literacy & B14 Promotion 0 Goal2' Post-vention 0 Goal 3: Perception/ attitudes E.� Staff Travel / Professional Development Requested by: &7 Supenisor Signature* Form of Payment 2 VISA 1:1 C3 Invoice (paid) 0 Invoice (needs paid) 0 Other: I Food 0 Charge Account. 0 ARPA (goon) 0 Other.-.-,. $4,969.63 Date: 4/11/25 Date: 4/11/25 Prevention Requisition Form Revised 07 202114 renew 1AN 2 2025 RENEW 00haooro Heotb 6 W10*15 + Must attach training information linctudingagenda, start and end times and meat information. 4'+ Forms missing any of the required Information wilt be returned for completion. + All fields must befilled in completety. 0 1 n -State Tra i n *1 ng eflbutwof -State Training 0 Web inar (Must be received 30-days in advance) (Must be received 90-days In advance) Employee Name.-. t 4S Today's Date Trall ning Name: k to cl Location: 1 6 Dates of training: Departing Date-, Returning Date-, Departing Time: ReturningTime: Registration Cost: Hotel: vye s 0 No Are there any room blocks for this training at a specific hotel? Transportation: 0 Personal Car Ad'Company Car If requestingto take personal car, direcAt supervisor signature is required below) Airfare: 2 f'OYO'*e s 0 No Flight / airport preferences?,. ..... How it this training add value to the organization*.) 7 TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY Estimated Cost.- Funding Source: Training Approved: es 11 No. Direct Supervisor Signature-, Personal Car Approval.,, El Yes 0 No Direct Supervisor Signature: Executive Staff Approval: des 0 No Executive taft Signature: D . .............. • HILTON COLUMBUS DOWNTOWN Hil.ton 402 North High Street Columbus, 01-1 j 43215 T. 614 384 8600 F. 614 4.84 51219 C04UMBUS DOWNTOWN W: hilton.com NAME AND ADDRESS: HALLATT, MARIA Room 814IKi Arrival Date: 312912026 3:29:OQ PM 2309 PLUM ST Departure Date*. 414/2025 EPHRATA WA 98823 Adult/Child- , 1/0 UNITED STATES OF AMERICA Room Ratel10 2:34.100 Rate Plan. AAS25 HH # 1619528324 SILVER AL: Car. Confirmation Number: 3203751367 414/2025 DATE DESCRIPTION ID REF. NO CHARGES CREDITS BALANCE 413/2025 RM - SALES TAX HTHOMPSON 5083638 $18.72 29 4/312025 RM - OCCUPANCY TAX HTHOMPSON 5083638 $23.40 e "BALANCE" EXPENSE REPORT SUMMARY 3/2912024 3/30/2025 3/3112025 4/1/2025, ROOM AND TAX $2 74.96 $274.95 $274.95 $276,12 DAILY TOTAL $27,4,95 $274.95 $274.95 $276.12 EXPENSE REPORT SUMMARY 4/2/2020 4/312025 STAY TOTAL ROOM AND TAX 076A2 $276.12 $1,653.21 DAILY TOTAL' $276,12' $276.12 $1,653.21 Hilton Honots(R) stays Ore posted wjt�ljq 72 hours of checkout. To check your eamings or book yDur next stay at more tlan ,�,5001- hotels and resorts in I 19 countries, plisse visit Honors.com Thank you for choosing Hilton. You'll get more when you book directly with. us - more destinations, more points, and morq valp-P. Book your next stay at hilton.com. �P�l � g400. Ly Jft ACCOUNT NM DATE OF WAGE FOUQ N0,JCHR(X NO, 11349804 A CAM MCM MR NMIE --iiTABLISHIMEN-T NO, & LOCATION IV wNwo to CrWWxjWAfM VAYMNT ............................ CARO MEMDER'S SJ�ATWE MERCHANDISE AMIC SEWICES PL9CMSE3 ON THIS CARD SHALL NOT BE RESOLD OR RETURNED FOR ACTH MFUND, AUTH0RJZA710t4 INITIAL PURC"ES & SERVICES TAXES TIPS & MISC. 1MTALJkMCCU W H i l iton PAYMENT DUE UPDX RECEIPT FOR THE STW HILTON COLUMBUS DOWNTOWN Hilton 402 North High Street I Columbus, OH 43215 T: 614 384 8600 Ft- 614 484 5219 COLD BUS DOWNTOWN W.- hilton.com NAME AND ADDRESS:u. HALLATT, MARIA Room: 814/Kl Arrival Date., 3/29/2025 3:29:00 PM 2309 PLUM ST I Departure Date: 414/2025 EPHRATA W4 98823 Adult/Child- 110 UNITED STATES OF AMERICA Room Rate:. 2X00 Rate Plan: AA525 HH1 4 1619628324 $ILVER AL: Car: Confirmation, Number: 3203751367 41412025 DATE .. ... ... .. DESCRIMON ID REF, NO CWGES CREDITS OAI.ANCf 312,912025 GUEST ROOM JRING4 5075050 W4,00 3/29/2025 RM - DES TAX JRING4 5075050 $17.55 312912025 RM - OCCUPANQY TAX JRING4 6075050 $23.40. 3130/2025 GUEST ROOM, HTHOMPSON 5076986 $2�4,Op 219 3130/2025 RM - SALES TAX HTHOWSON 5076980 29 3/30/2025 RM - OCCUPANCY TAX HTHOMP50N 6076986 U-3,40 29 3/31/2025 GUEST ROOM HTHOMP$ON 5078729 $234,00 29 �31/2025, RM - SALES TAX HTHOMPSON 6078729 $17,55 29 313112025 RM -. QCCQPANCY TAX HTHOMPSON 5078729 $2140 29 4/112025 GUEST ROOM JRING4 6080182 $234,00 4/112.025 RM - SALES TAX, JRING4 5080182 $18.72 4/1/2025 RM - OCCUPANCY TA J1 ING4 5080182 $23.40 4/2/2025 GUEST ROOM HTHOMPSON 5081646 $234,00 29 4/212025- RM - SALES TAX HTHOMPSON 5081646 $18,72 29 4W2025 PM - OCCUPANCY TA4 HTHONIPSON 5081646 $23,40 S ; 29 4/312025 GUEST ROOM, HTHOMPSON 5083638 $234.00 29 'AccoUtif <ARD MWWR NAME ESTABLISHIM ENT NO & LOCATICA CARD )AEM SEWS UGNATU RE --r- IVIFRCHANDISE AN0,1011 SPRVICES PURCHASED ON THIS CARD SqAk . NOT BE RESOM 00 RETURNED FDR A CASH BERM: DATE OF CRAM E FOLIO NO/CAECK K1, 1349804 A AU'MRLZATION INITIAL PURCHASES & SERVICES 'rAXEs TOTAL AMOLWT [Hilton PAYIMENT DUE UPON RECEIPT FOR THE STAY" OUT OF STATE TRAVEL REQUEST APPLICATION Traveler"s Name* DeptfCommilttee* Date of Request* Travel Type* - - ------------- Maria Hallatt case manager 1/912025 Out of State Travel Departure Date* Return Date* Grant* Fund/Dept* -------------------- - E ------ 3/29/2025 j 4/412025 Ye's Nwo ARPA 05. . 00 AM 11 -4.5 A.. Destination (City, County, State)* Purpose of Travel* Columbus, Franklin, OH American Association of Suiddology 58th Annual Conference- X Hotel - GSA Rate* Hotel - Nightly Rate* Cost ApplriCatilon* Rental Car Required $131.00 $234.0ro Conference Rate No x? Hotel Total* Conference Fee* $1,649Y0 $1,249.00 Daily MWE at Rental Car Cost per Destination* day* $8U0 $0,00 1 1 XI Explanation for Rate (required if hotel cost is greater than per diem, or government rate)* No GSA rate rooms available. Air Carrier* Cost of Flight* Total trip cost (include all cost totals)* United $767 $4,240.20 X X- Preparer's Name* Preapproved by EO/DH?* yes. im Preparer"s Title* Accounting Technician Use of travel card to fill a rental vehicle gas tank prior to its return is recommended. GRANT COUNTY COW-MRSMNERS AGENDA MEETING REQUEST FORM (VI.LA! � SJDf-ited, t to D rk ofW oat ty 1200pni ar Thirsda`j DATE. 1 5 CONTACT PERSON ATTENDING OUr0ABLE: Dell Anderson [718ids I RFPs 1 Quotes } t OBE iN S:-��ulieeBoards C m dees d u g 0omuter Related OCcrmIty Code L-Eee�cy Purchase oy_. UFact-i i s Related OFIn nt [I Hey r g gin 4�:-. l rwo'c nd s Orders L.s ant$ :.'.. Fed:,'State/�'+ ounty sO :.,ea �.�1 M�"*OU $'' � 0mnut 0z� ROW of St3te Traver! 7. PttCash op licles 13lama 5 rlRequest for Pur&ase OResolubort ORemrnm nda63 n O r 'a'E n Sem' 'onsuft s t CIS-uWrl Let DSur Max Levies OR=k Youos n axTitlePro c� j%_B U=441 9 WaIRWINIC21#1 = N1 I __ - Mimi Out-of-state travel request for Betho y Escarmlla, Mn'a Hlat & Corms Guerrefo AS25 5 th Annual Conference Columbus, OH, March 29th - April 4th, 2025 Estimated Cost. S4,240.20 each $12,720.60 Total IBM necessary, was this document reMiewed by accounting? 0 YES LEGAL.. REVIEW: EW If IS document reguires Lepal review, route to r review � color 1 necessary,_qalif DATE OF C ` N- ,1_ . t ��y.��{�3y3j �YS - 4,17 DEFERRED OR CONTINJE10 TO: American Rescue Plan (Cares Act -- ARPA) Today's Date: 4/11/25 Vandor: Hilton Columbus Downtown ID Received Supervisor Approval D Scanned supporting documents El File into binder L-3 Item(s) received Rece*t Date: 4/4/25 Ip Detailed Descri*ption: Hotel rooms for Bethany Avey iEscamilla), Conne Guerrero, and Maria Hallatt - AAS25 Conference in Columbus, OH 'Charge to AiLq'Month: JUIV 2024 0 January 202- AUgUSt 2024 0— Februaty 202r- 0 September 2024 2 March 2025 0 October 2024 LI April 202- C1 Noxrember 2024 10 May 2025 0 December 9.02.4 F-I June 2025 Deliverables: • General Task-force supplies • Goal i: MH Literac-v- & BH Promotion • Goal 2'. Postvention f • Goal 3: Perception I 'attitudes E� Staff Travel / Professional Development Requested bv-. /V Supen-isor Signature: Form of Payment 2 VISA ****-6513 El invoice (paid) E Invoice (neelcis pal*d) 7 Other: 0 Food Charge Account: 0 ARPA (g000) E3 Vhler: S 4,969.63 Date.- 4/11/25 4/11/25 Date. Prevention Requisition Forin Rey ised 07,2024 • renew*-Wl* 69howhar1w 40001 11 UWArab" OUT OF STATE TRAVEL REQUEST APPLICATION Traveler's Name* Dept/Cornrnittee* Date of Request* Travel Type* I--------- 1-1 [Beth -any Escam4la Suicide Prevention 1/9/2025 Out of State Travel se Xe X Departure Date* Return Date* Grant* Fund/Dept* 3/2912025 4/412025 Yes ARPA 05:00 AM 11 :45 PM Destination (City, County, State)* Purpose of Travel* Columbus., Franklin, OH Anierican Association of Suicidology 58th Annual Cgriference- Hotel - GSA Rate* Hotel - Nightly Rate* Cost Application* Rental Car Required $131.00 $234.00 Conference Rate No IV le I Hotel Total* Conference Fee* Dally M&IE at Rental Car Cost per $1,649.70 $1 t249.00 Destination* day* $80"00 $0.00 41 Explanation for Rate (required if hotel cost 'is greater than per diem,, or government rate)* No GSA rate morns available. Air Carrier* Cost of Flight* Total trip cost (include all cost totals)* United- 'F$767 $4,240.20 1 0Z Preparer's Name* Preapproved by EO/DH'171* Yes *to Pre parer's Title* Accounting Technidan Use of travel card to fill a rental vehicle gas tank prior to its return is recommended RECEIVED 0 "renew Must attar h training information including agenda, start and end times and ryneal information. Forms missing any cat the required information will be returned for completion. Al.tfietds must befitled in comptetety. El In -State Training 0 Out -of -State Training F-11 We bin a r 'Must be received 30-days itadvance-K 5st be received 90-days in ad-vance) E BaTod12/13/24 m p toye e N a . rn.. e: ethany Escamillay's Date: AAS 25 Annual Conference Training Name: LocatlonColumbus, OH Dates of training:, March 30 - A n" 4, 2025 Pvlar& �w 2025 Depa.rting Date: -' ' ' ____%9 — Returning Date. April 5, 2025 Departm- ingTi e- NIA ReturningTime: N!A ,Registration Cost- 1$1 r249 Hotel- Yes 01 N o I HiltoColumbus Downtown Are there any room bLocks for this trim aig at a specific hotel?,n , r, Transportation 01 Personal Car XCornpanyCal (if requesting to take personal car, direct supervisor signature is required below) Airfare: P-1 Ye s 0 No Ftight/ airport prefere--mces? SP0*1,XT, Tri Ciiies, orWenat&ee, Fight departureno earl ier than 8 am if possVe due to travel Wme, Howe i this training add vatue to the organization? By attending this conference I will have the opportunity to learn about recent advancements ire in the study of suicidology. I will bring what I learn back to the Grant County Suicide Prevention Taskforce to help in the planning and 'Implementation of suicide prevention goals. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY 0 - Estimated Cost:_---_- F u n d 1 ng S o u rc e: 9004AYypt Training Approved: 8 Yes A IJJ N o D - I Suprire: evsor SignatuDate: 12/12 ire .... ... .. F-1 Via -z Personal Car Approval. 5.d nt W 0 No Direct Supervisor Signature. te: Da Executive Staff Approval: W Yes 0 No 12/ 1, 3/24 Executive Staff Signature: ------- ............... Date'. - 3 20.74 HILTON COLUMBUS DOWNTOWN Hi l 402 North High Street Columbus, OH 43215 n 1 614 384 8600 1 Fv. 614,484 �219 T. CoLumaus 0OWNITOWN W: hilton"corn NAME AND ADDRESS; ESQAKI-LA, BETHANY 8251K1 Arrival Date: 3/29/2025 3:33:00 PM xxxx Departure Date: 4/4/2025 COLUMBUS ON 00000 Adult/Child- 110 UNITED ES STATOF AMERICA Room Ratc** 234.00 Rate Plan: AAS25 HH # AL: Ciar. Confirmation Numbw, 3198437125 t 414/2025 DATE DESCRIP MON ID IREF. NO CW-GES CREDITS UALANC� 4,1312025 RM - SALES TAX HTHOMPSON 5083650 $18.72 29 41312024 Rai - OCCUPANCY T" $23.40 HTHOMPSON 5083650 "BALANCE" EXPENSE REPORT SUMMARY 312912025 3/3Ot2O25 3/31/2025 4/1/2025 ROOM AND TAX $274.95 $274.95 $274.95 $276,12 QAJLY TOTAL $274.95 $274.95 $274,95 $276.12 EXPENSe REPORT SUMMARY 412/2026 413/2026 STAY TOTAL ROOM AND TAX $276,12 $276,12 $1,653.21 1?AILY TOTAL $276.12 $276.12 $1,653.21 CAA0 MEM3ER NAME ES"'ABLISHNICENT O. & LOCATION an4 pt��q Awtnvoimoww rocAw.-vwx w-txo&wt ri . . . . . . . . . . . . . . . . . . . . . CARD N181+1 UR'S SIGNATURE MEA"NDISEAKWORSERVICE5 PURCRASED UN _1_VtSCAft[)SN4C*,T8ERML0 OR RUURKO FOR A CASH VAIND. DV E OF 04ARGE m.10 N0jc14E0c No 1344803 A Al-9140 RIZATM4 PUR041ASES & SAXES TAWS nps &wsc. . .... . .... ........ TOM AMOU NT H ifluon PAYMENT DUE UPON KaIVI HILTON COLUMBUS DOWNTOWN Hilton 'h High Street 402 North I Columbus, OH 43215 T. 614 384 8600 1 F: 614 484 5219 COLUMBUS DOWNTOWN W*. hilton,com NAMEANDADDRESS, ESCAMILLA, BETHANY Room: 82511<1 Arrival Date: 3129/2025 3:33:00 PM xxxx Departure Date., 414/2025 COLUMBUS OH 00000 Adult/Ch1110-1: 110 UNITED STATES OF AMEBIC Room Rate., 234.00 Rate Plan: AAS25 HH AL: Car. Confirmation Number: 3198437125 4/412026 DATE DESCRIPTION ID REF, NO CMaG M 3/2912025 GUEST ROOM JRING4 5075061 $234,00 3/29/2025 RM - SALFS TAX JRING4 5075061 $1785 3129/2.025 RM - OCCUPANCY T� JRING4 5075061 $23.40 W3012025 GUEST ROOM HITHOMPSON 5V76990 $234.00 29 3130/2025 RM - SALES TAX NTH OMPSON 5076990 $17,66 29 130/2025 RM - OCCUPANCY TAX HTHOMPSON 5076990 $23.40 29 313112025 GUEST ROOM HTHOMPSON 5078739 $234.00 29 3/31/2025 RM - SAES TAX I-ITHOMPSON 5078739 $17,55 29 3/31/2025 RM - OCCUPANCY T4 HTHOMPSON 5078739 $23,40 29 4/112025 GUEST ROOM JRING4 15080192 $234,00 411/2026 RM - SALES TAX jRING4 6080192 $18,72 411/2025 RM - OCCUPANCY TAX JRING4 5080192 $23.40 4/2/2025 QUEST ROOM HTHONIPSON 5081658 $234.00 29 40202 RM - SALES TAX HTHOMPSON 5081658 $18,72 29 412/2025 RM - OCCUPANCY TAX I-ITHOMPSON 5081658 $23.40 29 4i3/2025 GUEST ROOM HTHOMPSON 5083650 $234.00 29 — -- - -- - - --- - - --------- - ACCOUNT NO. DATE Of 04ARGE FOLIO N0,1CHe" NO, 1349803 A CARD MEMMY, NAME ESTABUSIH-WEV 40, & LGOVION CARD MEMaER'S SR3NA TURE MR04ANDISt. A!`NDIVt SERVICESPURCHAMED ON THIS COD S34,q% 1 OT BE RMLD OR MURNED FOR A CASH KUM. AUTHOPUZATION PUR0-ASES & SFERVIC�ES TAXES I P's &- M; 5c. PAYNiEW DUE UPON RECEIPT INMAL Hilfianl FOR THE STAY' GRANT COUNTY COMMISSMERS AGENDA MEETING REQUEST FORM (Wmt be subrVhed to 4ie Clerk of d-* ekoand by 12,00pm on TWrV,;ay';1 Renew REQUESTING DE-PARTMENT: DATE--, 119!25 Anna S&Y-rano (55W'765-923 �5_1 �, REQUEST SUBMITIFED BY: PHONE:— , 9 ext, 5353 CONTACT PERSON ATTENDING ROUNOTA3LE. Dell Anderson COWDENTIAL INFORMATION,- CJYES KNO TYPqS) OF DOCUMENTS SUBMITTED: (CHECK ALL THAT App�Y, i Contrad — - - ------------ n-AP VoteC'"Irtnerft I Re poi- DARPA Refated 08ids I RFPs I Ouctes A--wan-l# OW Oponlng S&,ed,-ted C58camas / Commftm- D&jdot OComputer ReWal *0unt ty Code C]Elrerrgentc� pjn:t'ase DErnp4tee Re; OFacilities Retated OF!nanc.41 OFunds 7D Hear, ng Ice ElInvio' s I Purchase Orders L-lGrants - Fed./SWelCouity OLeases 7_1 IM OA I M OU i 0%mAes 00rdkiamm Out of State Trayet D p ett, C a Sh CPoliJes (21pmdamaoms C-73Reque-st foiv, Purchase L]Resolution 0Remnrne,ndatbn CMrofessional Serv!Consultant ElSuppert LettIter 11-DSurplus Req -*Tax Levies C n 0, Th a k You' s 0_jTax I-te Prop" r]ws,^ f LA-.".,� [SUGGESTED WORDING FOR AGENDA, (Whci, What, When, y. Term,. Cost, etc.) ----- --- - ---- Out-of-state travel request for Bethany Escamilla, Maria Hallatt & Conne Guerrero AAS25 58th Annual Conference - Columbus, OH, March 29th - April 4th, 2025 Estimated Cost: $4,240.20 each 1 $12,720.60 Total Funding: 108.150.00.9000.566.51.xxxx (ARPA - Suict"de Prevention) 'if necessary, was this document reviewed by accounting? 0 YES LEGAL REVIEW-. If this document rp ,, route to lepal fot teview p qVires lepal rev* jew, riot I If necessary, was this docurnent reviewed by legat? C1 YES 11 N 0"', M R APPF, _*D'ENNEQ A -laTAIN D2: D3 Ito 4t? W4 C3 NO 19 NIA 19 N/A DEFEERREED OR CONTINLJED TO: WTHDRAW American Rescue Plan (Cares Act .- ARPA) Today Date- 41111/25 -V,?rendor: Hilton Columbus Downtown 0- Receixved Supervisor Approval 0 Scanned supporting documents El File into binder 0 Item(s) received Rece* f Date,- 1P Detailed Descrip6ort: —Hotel rooms for Bethany Avg y (Escam illa), Corms Guerrero, and M-arla Hallatt .S25 Conference in Columbus. OH 0 'Charge to Aig'Month. Janual-V 2025 JUIV 2024 AuguSt 2024 FebruafY 2025 2 March202,5 September '.,-)024 - October 2O24 pril 202 NoN-ernber2024- MaV 2025 DJune 20 2ecember2024 D Defiverables: 0 General Ta4force supplies 0 Goal i: MH Literacy & B1-1 Promotion 0 Goal2: Postvention 0 Goal 3 Perception/attitudes Et Staff Travel / Professional Development Requested by: Supenisor Signature: Form of Pa-*mient 01 Invoice (paid) * Invoice (needs paid) * Other: 7-1 F o o d Charge Account: 13 ,,kRPA (goon) C1 Other: 4,969.63 Date: 4/11/25 Date: 4/111/25 Prevention Requisition Form Rev is-ed 07 2024 ren - e-w R E C" F I V F, D 0 n Oewwforw "01Ah 0 -- ---------- - ------------- ------ - - -- - ------- - ------------------------------- 1______'_ Must attach training information inctudingagenda., start and end times and meat information. • Forms missing any of the required information will be returned for completion. 4�, At( fields must befitted in completely. 0 In -State Training 9 Out.%of"State Training 13 We (Must be received 30-days in advance) (Must be received 90-days in advance) ErnptoyeeName: 6LIe-freco 12/18/24 Today's*Date: AAS Annual Conference 4 Training Name: Location. March 30- nil 4, 2025 Dates of training-, Departing Date:.-M—arch 29,2025 — Returning Date. April' 4th* 2025 DepartingTime-, Returning Time: ...... . Registration Cost: Hotel* 9 Yes 0 No Are there any room blocks for this training at a specific hotel? Hilton Columbus Downtown Trans po rtation - 0 Personat Car 11 Company Car (It requesting to take personal car, direct supervisor signature is required below) Alits re.- Yes 0 No Flight / airport preferences? How will this training add value to the organ4ation? Assist Outreach team and supporting in suicide prevention work in the branch locations. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY Estimated Cost: .......... FundingSource- . M I *-A000._41A , Training Approved: 0 No z Date:—! Direct Supervisor Signature: 0/ Personal Car Approval: 11 Yes 0 No Direct Supervisor Signature: Executive Staff Approval: 2110Y�es 0 N p� Executive Staff Signature: Date:—_--,--___ .___ HILTON COWMBUS DOWWOWN * 402 North High Street I Columbus, OH 43215 ton T4 614 384 $600 1 F: 61.4 484 5219 COLUMBUS DOWNTOWN W: hifton,com NAME AND ADDRESS: GUERRERO.CONNE Room: 8151K1 Ardval Date, 3/2912025 3:32:00 PM xx)(x Departure ]Date: 4/412025 COLUMBUS OH 00000 AdultlChlld: 110 UNITED STATES OF AMERICA Room Rated: 234,00 Rate Plan: AA826 HH# 1069067989 BLUE AL* Car: Confirmation Number: 3204702059 4/412025 DATE DESCRJPTION ID RF'. NO 'CHARGES CREDITS SALANC�, 4/312025 RM - SALES TAX HTHOMPSON 5083639 $18,72 29 4/3,12025 RM - OCCUPANCY TAX HTHOMPSON 5063639 $23,40 *13ALANCE' 29 EXPENSE REPORT SUMMARY 312912025 ROOM AND TAX $274.95 DAILY TOTAL $274-95 EXPENSE REPORT SUMMARY 402025 ROOM AND TAX $276.12- DAILY TOTAL $276,12 3/30/2025 3,13112026 411/2025 $274.95 $274,95 276.12 $274.95 $274.95 $276.12 4/312025 STAY TOTAL $276.12 $1,663.21 $276.12 $1,653,21 t. r ACCOUNT NO DATE Of CHARGE FOL.0 N0,101ECX NO 1349807 A CARDMEMBERNMAE ES TIABU rH IM ENT N 0, & LOCATION CARD M EM BE R'S SIGNATURE WkCHAN.')a AN010OR �KV,C!S POUI-ASEV ON THIS 0M S44A tiOT RF 911-UN-D DftiFTUMED FOR A 'rAS14 Off UNO• AUTHORIZATION INITIAL PURCHASES & SERVICE S -TAxts TIPS & misr- TOTAL AMOUNT ------------------- ---- -- ... ---. - RAY Tv1E?%17'EKJE I. RECEIPT .__�__. ___ _1 60 Hilton1 FOIR THE STAY' HILTON COWMBUS DOWNTOWN H1*1ton 402 No Hiah Street Columbus,, OH 43215 T: 614 384 96W F: 614 484 5219 COLUMBUS DOWNTOWN . . ......... . .. W: hifton.com NAME AND ADDRESS: GUERRERO, CONNE Room: $151K1 Arrival Date: 3129/2D25 3:32:00 PM xxxx De-parttire Date: 4412025 COLUMBUS OH 00000 AdulVChIld, 1/0 UNITED STATES OF AMERICA Room ftate;' 234,00 Rate Pfan, AA825 HH # 1069067989 BLUE AL: Car: Conflrmation Numnr: 3204702059 4/412025 DDT e DESCRIPTION ID ............ RE-F. NO CHARGiES CREDITS BALANCE 3/29/2025 GUEST R-OOM JRING4 6076051 $234,00 3129/2425 RM - SALES TAX JRING4 5075051 $17.55 V29/2025 RM - OCCUPANCY TAX JRING4 5076051 $2$,40 313012025 GUEST ROOM HTHOMPSON 5076987 $234.00 3/3012026 RM - SALES TAX HTHOMPSON 5076987 $17.55 29 $/30/2025 RM - OCCUPANCY TAX HTHOMPSON 5076987 $23,40 29 3/31/2025 GUEST ROOM HTHOMPSON 5078730 $234.00 29 3/31/2025 RM - SALES TAX HTHOMPSON 5078730 $17m 29 3131/2025 RM - OCCUPANCY TAX HTHOMPSON 6OT8730 $23.40 29 411/2025 GUEST ROOM JRING4 $080183 $234.00 4/V2025 RM - SALES TAX JRING4 5080183 $18.72 411/2025 RM - OCCUPANCY TAX, JRING4 5080183 $23.40 41212025 GUEST ROOM HTHOMPSON 5081 6>47 $234.00 412/2025 RM - SALES TAX HTHOMPSON 5081647 $18,72 29 412/2025 RM - OQPUPANCY TAX HTHOMPSON 5081647 $23,40 29 41312O25 GUEST ROOM I-ITHOMPSON 6063639 $234.00 29 ACa)UHT Imo, DATE OF CHARGE FOLIO N0.1cs2cyt N'1'0. 1349807 A E S`MBL IS H W. EN T NO. & LXAT110N ...... . ... CARO MCWRER'S SIGNATURE MEACIIANDUANO/OKSEWMPUKT-WED ON T1f5CARDS 14LN0f BE 40=011RIEMRNED FOR A CASI I REFUNR J AUTHOR17AXIM4 INMAL PURC4ASES & SERWaS TAXES TIPS & VISC TOTAL AMOUNT H 101ton PAYMENT DUP UMN RECEIPT FOR THE STAY"' OUT OF STATE TRAVEL REQUEST APPLICATION Traveler's Name* Dept/Committee* Date of Request* Travel Type* Corms Guerro Therapy 1/912025 Out of State Travel e rtur Date* Return Date* Grant* Fund/Dept* 3/29/2025 4 /4 1 2025 Yes ARRA 1------------- imm - 1-1-1-11 05:00 AM 11 :45 PM 190,10, Xr, Destination (City, County, State)* Purpose of Travel* ColUmbus, Franklin, OH American Association of Sulcildology 58th Annual Conference Hotel - GSA Rate* Hotel - Nightly Rate* Cost Application* Rental Car Required $234.00 Conferemce Rate No Hotel Total* Conference Fee* Daily MWE at Rental Car Cost per $1,64970 $1,249N00 Destination* day* $80.00 S0}00 Explanation for Rate (required if hotel cost is greater than per diem, or government rate)* No GSA rate rooms available. Air Carriers Cost of Flight* Total trip cost (include all cost totals)* United $767 $4,24010 Preparer's Name* Preapproved by EO/DH"*)* Yes M Preparer's Title* Accounting Technician Use of travel card to fill a rental vehicle gas tank prior to its return is recommended. X American Rescue Plan (Cares Act — ARPA) Today's Date: 4/25/25 V'endor.,* Coeur d'Alene Press 01 Received Supervisor Approval 0 Scanned supporting documents 0 File into binder 0 Item(s) received Receipt Date: 4/24/2%1.3 Dcri ,detailed Desption** Mental Health Aw. nareness Ad for Chamber Magazines , Ephrata, Grand Coulee, & QUiLcy - Full page advertisement 'Charge to A:tg'Month..,0 El JUlY 2024 L 0 Jane. arV 2025 ID AuguSt 2024 0 FebrualT� 2025 El September 2024 0 March 202.5 - 2 April 2025 0 October 2024 El November 2024 0 May2025 Ell December 2024 0 June 202,5 Deliverables: * General Taskforce supplies * Goal 1: NIII Literacy & BI-I Promotion 11 G'oal 2: Postvention 0 Goal 3'. Perception attitude 0 Staff Travel. / Professional Development Form of Payment El VISA ****— E, Invlee (Paid) .2, Invoice (needs paid) 0 Othen El Food 0 Charge Account. 12 ARPA (g000) IJ Other: 11500.00 Requested by: Datet -4/-2-5/25 ------------- - Supenq'sor Signature: Date: Prevention Requisition Form Revised 07.2024 4/28/2025 renew Columbia Basin Herald PO BOX 910 M SES LAKE, WA 98837 765-4561 ADVERTISING ST TEMENT{INVOICE SILLIING PERIOD ADVERTISER NAME < 1_ 05, to 04130.12025 At-JERI IAN RESCUE PL "4SUICIDE PREVENTION TOTAL AMOUNT DUE *UNAP I`ED AMOUNT TERMS OF PAYMENT It CURRENT NET AMOUNT 30 DAYS 60 CLAYS OVER 90 DAYS' --------------- M R C N RESCUE PLAN SUICIDE PREVEN BETHANY AEY 840 E PLUM ST MOSES LAKE, WA 98837 BILUNIG DATE 04/30/2025 OWLED ACCOUNT NUMBER 56008 ADVERTISER NUMBER 56008 MITT{ NCF ADDRESS Columbia Basin Herald PO BOX 700 COE R D AL ENE, ID 83816 MAKE CHECKS PAYABLE TO: Columbia Basin Herald PLEASE DETACH AND RETURN UPPED' PORTION WI I H YOUR REMITTANCE Columbia Basin Herald Start Date End Date Newspaper Reference Deschption Days Billed Amount ..l -s. �.< r2 04t 3 =2025 41 0 202 0 1 1 -043 202 I�PN�i �13�. �� rF ��i���R �;��u ff ff 0� f�.6 , 'Al s 5� z_�.;. 4 Previous Amount Owed. $0, New Charges This Period-, V..000,00 Cash This Period- 5O0 Det)it Adjustments This Period. E 0 0 I Credit Adjustments This Period. $0,00 e Appreciate your bus_- es . STATEIIET OF ACCOUNT URR NT 30 DAYS 60 DAYS 90 DAYS* TOTAL AMOUNT € U ' NAPPUED AMOUNT so 00 Saw'$ R*P Advertiser information f ui [ Velma 69-114og Period Billed Account Numb*r Advertiser Number Advertiser Na( t tr/.iCff to d":1'+iJ 13- 0�z. i4. �tPl PN SUICIDE PREVENTION 05/01 i20 5 11.34:5 ADVERTISING STATEMENT/INVOICE ICOLUMBIA BASIN HERALD PO BOX 7000 COEUR D[ALENE, ID 83816 (208) 664-8176 ADVERTISING ACCOUNT 56008 AMERICAN RESCUE PLAN BILLING DATE 4/24/2025 ---- ------ ------- --- - ---------------- ------------ B-11 LING PERIOD ADVERTISER NAME AMERICAN RESCUE PLAN SUICIDE PREVENTION ------------------- -- ------------------- --------- I'll, TOTALAMOUNTDUE TERMS OF PAYMENT $ 1t500-00 NET+ 15 ....... . . . . TREMITTANCE ADDRESS SUICIDE PREVENTION COLUMBIA BASIN HERALD 840 E PLUM ST PO BOX 7000 MOSES LAKE, WA 98837 ICOEUR DALENE, ID 83816 ------ - ----- MAKE CHECKS PAYABLE TO: COEUR DALENE PRESS PLEASE DETACH AND RE -TURN UPPER PORTION WITH YOUR REMITTANCE DATE AD NUMBER DESCRIPTION AMOUNT 04/18/25 13815 Quincy Chamber Magazine $ 500-00 W01-00 04/30/25 13816 Ephrata Chamber Magazine $ 500.00 06/30125 TBD Grand Coulee Magazine $ 500-00 TOTAL AMOUNT DUE 1,500.00 We appreciate your business.