The URL can be used to link to this page

Home My WebLink AboutGrant Related - BOCCDated this _j1r__ day of _�-5 20z' Board of'County Comm issit-)ners Grant County, W"ashington 9fopeSource Aw—rove Di��jj()ve Abstain 700 E. Mountain V e0iw/41 Dist # I Dist # I Suite 501 Dist #2 Dist # 2 Dist # 2 Ellensburg, WA 98 hist #3 Dist # 3 Dist # 3 Phone: 509-925-1 48 Fax: 509-925-1204 HopeSource Program Information Program - Grant :lShelter Grant # Program Period: 8/1/2020 - 6/30/2023 Award : $523,375 Remaining Bal: $168,306.82 For the Period Nov 2021 HopeSource # of Days I Description Current Expense Post -Occupancy Rate $56.00 7= 30 # of Days/ Month in Nov 21 25 Beds funded by Shelter Program $4,r200.00 362 # of Bed nights from HMIS - Nov 21 $20,272.00 JR—equest for Payment $24,472.00 Name: Ariam Mehtsentu Signature: Date: 7 -Dec -21 Grant County Courthouse Attn:lune Strickler, Grant Admin. Specialist P.O. Box 37 [Ephrata, WA 98823-0037 1 700 E. Mountain View Ave, Suite 501 Ellensburg, WA 98926 0 Phone (509) 925-1448 * Fax (509) 110 Pennsylvania Ave, Cie Plum, WA 98922 Phone (509) 6742375 • Fax (509) 674-5187 IJ D �� 2021 INVOICE n oice # 2021-11 ESHAP-G t te 12/7/2021 eterence # 21-461OC-104 Contact Person:Ari �J a n m Mehtsentu # of Days I Description Current Expense Post -Occupancy Rate $56.00 7= 30 # of Days/ Month in Nov 21 25 Beds funded by Shelter Program $4,r200.00 362 # of Bed nights from HMIS - Nov 21 $20,272.00 JR—equest for Payment $24,472.00 Name: Ariam Mehtsentu Signature: Date: 7 -Dec -21 Grant County Courthouse Attn:lune Strickler, Grant Admin. Specialist P.O. Box 37 [Ephrata, WA 98823-0037 1 700 E. Mountain View Ave, Suite 501 Ellensburg, WA 98926 0 Phone (509) 925-1448 * Fax (509) 110 Pennsylvania Ave, Cie Plum, WA 98922 Phone (509) 6742375 • Fax (509) 674-5187 IJ D �� 2021 4i 4- P-.,' E A Form- 19-1A VOUCHER DISTRIBUTION AGENCY Short Code Commerce Contract Number NUMBER CIVIS Invoice ID: DEPARMENT OF 1030 21-4610C-104 339752 COMMERCE VENDOR OR CLAIMANT (Warrant payable to:) INSTRUCTION TO VENDOR OR CLAIMANT: Grant County Board of Commission Submit this form to claim payment for materials, merchandise or PO BOX 37 services. Show complete detail for each item. EPHRATA, WA98823-0037 Vendor's Certificate: The individual signing this voucher below warrants they have the authority to do so as authorized and on behalf Brittany Rang of the entity identified in the Vendor/Claimant section. The individual (Vendor Contact Person) signing below certifies under penalty of perjury that the items and totals listed herein are proper charges for materials, merchandise or N (509) 754-2011 ext 2937 (Vendor Contact Phone) 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, brang@grantcounL)ma.gov (Vendor Contact Email) national origin, handicap, religion or Vietnam era or disabled veterans status. 08/01/20 - 06/30/23 (Contract Period) Brittany Lutz (belutz) 12/15/2021 1:46:05 PM 11/01/21 - 11/30/21 (SUBMITTED BY) (SUBMIT DATE) (REPORT PERIOD) DESCRIPTION BUDGET REQUESTED EXPENDED TO AMOUNT THIS AWARD AMOUNT DATE INVOICE REMAINING Shelter Program A Pre- Occupancy - Unassigned $435,461.00 $.00 $250,000.00 $.00 $185,461.00 I Shelter Program A Post- I Occupancy Operations - $273,375.00 $24)472.00 $60,312.00 $.00 $2137063.00 Unassigned I I I Non - Match Total:1 $708,836.00--1 $24,472.00 1 $310,312.00 $.00 $398,524.00 PROGRAM APPROVAL Date (The individual signing this voucher warrants they have the authority to sign this voucher.) DOC DATE CURRENT REFERENCE DOC NO. VENDOR NUMBER and SUFFIX DOC. NO. SWV0002426 03 ACCOUNT NO. ASD NUMBER VENDOR MESSAGE 190.001.00.7605.334042000 38753 TRANS REV MASTER SUB SUB MG MS GL ACCT SUB AMOUNT PROGRAM CODE CODE INDEX OBJ SUB SID INDEX OBJ 465TO350 NZ 4610C 465TO450 NZ 4610C 465TO250 NZ 4610C READY to BATCH PREPARER DATE WARRANT TOTAL CREATED BY I Brittany Lutz (belutz) DATE 12/15/2021 1:45:14 PM Form 194A VOUCHER DISTRIBUTION AGENCY NUMBER Short Code Commerce Contract Number CIISIIS Invoice ID: 339752 DEPARMENT OF COMMERCE 1 030 21-4610C-104 L7 All Expenses under $1,000 Paid by U131 Paid Paid b Organization Name Paid to Contractor Type Paid to U131 Paid to Organization Name Paid to Org Type Expense Type Amount Subcontractor Total Sub Subcontractor Total COMPLETE GREEN CELLS Number of beds in shelter HMIS project prior to bed Number of beds funded by inventory added by Shelter Count of bed nights Shelter Program Grant Program Grant Days in Month from HMIS report Vacancy Rate Project A Grant County Enhanced Shelter 25 Program-,. p Maximum operating amount that can be billed to Shelter Program Grant (bed nights of new beds funded by grant plus up to 10% vacancy rate) 52%1$ 24..472 TOTAL 1 3621 $ 24,472 Agencies Ci Agencies A, Clients Uni+ Programs P Enrollment Enrollments I Enrollments I Programs F Enrollment Reimbursable Amount Grant Cour HopeSourc 66BB016BE HPGMLES 926970 2021-11-09 4576 22 1232 Grant Cour HopeSourc 2AO5383F4 HPGMLES 926970 2021-11-09 4576 22 1232 Grant Cour HopeSourc 3001FAM HPGMLES 918461 2021-10-12 4576 30 1680 Grant Cour HopeSourc E89020136E HPGMLES 918461 2021-10-12 4576 30 1680 Grant Cour HopeSourc 9816EF98F HPGMLES 918328 2021-10-08 4576 30 1680 Grant Cour HopeSourc F2E3945FB HPGMLES 916715 2021-10-07 2021-11-19 4576 18 1008 Grant Cour HopeSourc 2D596C79(HPGMLES 915351 2021-09-22 4576 30 1680 Grant Cour HopeSourc C8AC471EC HPGMLES 915351 2021-09-22 4576 30 1680 Grant Cour HopeSourc 356131AOC HPGMLES 915351 2021-09-22 4576 30 1680 Grant Cour HopeSourc 13720373A� HPGMLES 911796 2021-09-10 4576 30 1680 Grant Cour HopeSourc AC20E871S HPGMLES 906938 2021-08-23 4576 30 1680 Grant Cour HopeSourc D1E143135( HPGMLES 906154 2021-08-16 4576 30 1680 Grant Cour HopeSourc 533 E47CO4 HPGMLES 905882 2021-08-13 4576 30 .-----..- 1680 362