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HomeMy WebLinkAboutGrant Related - BOCC (003)IfopeSource 700 E. Mountain View Ave Suite 501 Ellensburg, WA 98926 Phone: 509-925-1448 Fax: 509-925-1204 HopeSource 700 E. Mountain View Ave. Suite 501 Ellensburg, WA 98926 0 Phone (509) 925-1448 • Fax (509) 925-1204 110 Pennsylvania Ave, Cle Elum, WA 98922 • Phone (509) 674-2375 • Fax (509) 674-5187 m INVOICE Invoice # 2022-01 ERAP-G Date 2/16/2022 eference # Reference 21-4619C-108 Contact ontact Person JAriam Mehtsentu 700 E. Mountain View Ave. Suite 501 Ellensburg, WA 98926 0 Phone (509) 925-1448 • Fax (509) 925-1204 110 Pennsylvania Ave, Cle Elum, WA 98922 • Phone (509) 674-2375 • Fax (509) 674-5187 m d' ori i'rTAVW f 4'^{' Form 19 -IA VOUCHER DISTRIBUTION AGENCY. Short Code Commerce Contract Number NUMBER CMS Invoice ID: DEPARMENT OF 1030 21-46,19C.108 344536 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, WA 98823-0037 Vendor's Certificate: The individual signing this voucher below Janice Flynn warrants they have the authority to do so as authorized and on behalf (Vendor Contact Person) of the entity identified in the Vendor/Claimant section. The individual signing below certifies underpenalty of perjury that the items and (509) 754-2011 ext 9937 totals listed herein are proper charges for materials, merchandise or (Vendor Contact Phone) services furnished to the State of Washington, and that all goods furnished and/or services rendered have been provided without iflynnograntcountywal -GOV discrimination because of age, sex, marital status, (Vendor Contact Email) race, creed, color, national origin, handicap, religion or Vietnam era or disabled veterans 10/01/21 - 06/30/23 status. (Contract Period) 01/01/22 - 01/31/22 Brittany Lutz (belutz) 3/8/2022 3:41:58 PM (REPORT PERIOD) (SUBMITTED BY) (SUBMIT DATE) DESCRIPTION BUDGET, REQUESTED EXPENDED TO AMOUNT THIS AWARD -AMOUNT DATE, INVOICE . REMAINING Admin - Unassigned $543,575.00 $5,940.14 $20, 682.48 $ - .00 $522,892.52 Program Operations - $780j435.00 Unassigned $37889.36 $78,695.98 $.00 $701,739-02 Rent/Utilities - Unassigned $13,083,796.00 $42,340.06 $3,779,228.16 $-00 $9,304,567.84 By and For - Unassigned $926,866.00 $.00 $.00 $.00 $926,866.001 Rent/Utilities Advance - Unassigned $.00 $.00 $.00 $.00 $.00 d By and For Advance - - - Unassigned $.00 $.00 $.00 $.00 $.00 Non - Match Total: $153334,672.00 $523169.56 $3,878,606.62 $.00 1 $11,456,065.38 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 190-001.00.7610.3332210000 40877 TRANS REV MASTER SUB SUB CODE CODE INDEX OBJ SUB MG MS GL ACCT SUB AMOUNT PROGRAM OBJ SID INDEX 469VAA20 NZ 4619C 469WAA20 NZ 4619C 469WO220 NZ 4619C 469VO220 NZ 4619C 469VO320 NZ 4619C READY to BATCH PREPARER I DATE I -- WARRANT TOTAL CREATED BY (Brittany Lutz (belutz) DATE i3/8/2022 3:39:57 PM Lead Grantee Name: Report Week or Month/Year: I Jan -22 List Sub Grantee Names Below ITotal GL Code 7000 7000 7100 7101 7105 7106 7107 7108 7110 8010 8100 8200 8300 8350 8400 8405 8420 8500 8510 8650 8660 8700 8710 8711 8712 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Title Session ID Transaction Description Salaries & Wages 100 Salaries & Wages JVA1481 FICA & Medicare JVA1481 Expense 100 Employee Tax JVA1481 Health Benefits JVA1481 Unemployment JVA1481 Insurance Exp Allocated line for Admin Allocation L & I tax expense JVA1481 Other Benefits JVA1481 Employee Incentive JVA1481 Professional Fees JVA1481 Office Supplies JVA1481 Communication JVA1481 Expense Postage & Shipping JVA1481 Dues& JVA1481 Subscriptions Rent - Space Lower JVA1481 County Utilities - Ellensburg JVA1481 Repairs & JVA1481 Maintenance - General Asset/Equipment JVA1481 Purchase Program supplies JVA1481 and tools Photocopy Expense JVA1481 Printing & JVA1481 Publications Travel Expense JVA1481 Meeting Exp JVA1481 Training & Technical JVA1481 Assistance Representation JVA1481 expense Opening Balance Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Allocated line for Admin Allocation Divi... Code Division Title 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration Allocated line for Admin Allocation 100 Administration 0.00 2,798.21 257.06 584.34 700.79 23.86 39.08 17.81 19.12 714.51 10.01 21.09 3.17 130.14 158.95 19.16 48.51 80.30 17.45 34.51 19.41 15.25 230.85 11.19 Date: 2/15/22 11:49:27 AM Page: 1 0.79 15.23 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title Debit Credit 8800 Vehicle JVA1481 Allocated line for Admin Allocation 100 Administration Maintenance & 0.68 related 8992 Bank Fee JVA1481 Allocated line for Admin Allocation 100 Administration 0.71 Transaction Total 5,956.16 16.02 Bala... Administration 5,940.14 100 8940 Rent Assistance Opening Balance 611 Direct Client 0.00 Services 8940 Rent Assistance AP1038249 ERAP 2.0 - Maria Vega Garcia - Rent Assistance - July thru 611 Direct Client 990.00 Nov 2021 Services 8940 Rent Assistance AP1038309 ERAP 2.0 - Rent - Luis Mejia - Dec 21 thru Feb 22 611 Direct Client 2,379.00 Services 8940 Rent Assistance AP1038341 ERAP 2.0 - Rent Assist - Winter Cloyd - Sept 2021 thru Feb 611 Direct Client 4,680.00 2022 Services 8940 Rent Assistance AP1038342 ERAP 2.0 - Rent Assist - Maira Castro - Nov 2021 thru Feb 611 Direct Client 3,100.00 2022 Services 8940 Rent Assistance AP1038352 ERAP 2.0 - Rent Assist - Bethanee Stockman - Dec 2021 & 611 Direct Client 1,800.00 January 2022 Services 8940 Rent Assistance AP1038394 ERAP 2.0 - Rent Assist - James Tronson - Dec 2021 thru Fek 611 Direct Client 2,550.00 2022 Services 8940 Rent Assistance AP1038400 ERAP 2.0 - Rent Assist - LuDene Groves - Jan thru Feb 2022 611 Direct Client 890.00 Services 8940 Rent Assistance AP1038410 ERAP 2.0 - Rent Assist - Nicole Martinez - Dec 2021 thru Fek 611 Direct Client 2,607.00 2022 Services 8940 Rent Assistance AP1038414 ERAP 2.0 - Rent Assist - Kaitlyn Moore - Jan & Feb 2022 611 Direct Client 2,004.00 Services 8940 Rent Assistance AP1038515 ERAP 2.0 (Grant Co) - Rent Assist - Ashley Dotson - Oct 202 611 Direct Client 4,200.00 thru Feb 2022 Services 8940 Rent Assistance AP1038517 ERAP 2.0 (Grant Co) - Rent Assist - Jason Smith - Aug 2021 611 Direct Client 6,223.92 thru Feb 2022 Services 8940 Rent Assistance AP1038520 ERAP 2.0 - Rent Assist - Gracie Harris - Oct 2021 - Feb 2022 611 Direct Client 2,650.00 Services 8940 Rent Assistance AP1038523 ERAP 2.0- Rent Assist - Kailet Cortez -Jan thru March 2022 611 Direct Client 4,485.00 Services 8940 Rent Assistance AP1038537 ERAP 2.0 - Rent Assist - Brenda Albarran - Oct 2021 - Feb 611 Direct Client 3,580.43 2022 Services Date: 2/15/22 11:49:27 AM Page: 2 GL Code GL Title 8950 Utility Assistance 8950 Utility Assistance AP1038515 AP1038517 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 Divi... Transaction Description Code Division Title ERAP 2.0 (Grant Co) - Utilities Assist - Ashley Dotson - Dec 611 Direct Client 2021 Services ERAP 2.0 (Grant Co) - Utililities Assist - Jason Smith - Sept 611 Direct Client thru Dec 2021 Services Transaction Total 7000 Salaries & Wages 42,340.06 Opening Balance 7000 Salaries & Wages CDSPRO1227 Payroll Jan 1-15, 2022 7000 Salaries & Wages CDSPRO1232 Payroll Jan 16-31, 2022 7000 Salaries & Wages CDSPRO1236 Accrued Vacation Jan 2022 7100 FICA & Medicare CDSPRO1227 Payroll Jan 1-15, 2022 34.51 Expense Program Operations 56.02 7100 FICA & Medicare CDSPRO1232 Payroll Jan 16-31, 2022 Program Operations Expense 613 Program Operations 7101 Employee Tax CDSPRO1227 Payroll Jan 1-15, 2022 7101 Employee Tax CDSPRO1232 Payroll Jan 16-31, 2022 7105 Health Benefits CDSPRO1227 Payroll Jan 1-15, 2022 7105 Health Benefits CDSPRO1232 Payroll Jan 16-31, 2022 7106 Unemployment CDSPRO1227 Payroll Jan 1-15, 2022 Program Operations Insurance Exp 613 Program Operations 7106 Unemployment CDSPRO1232 Payroll Jan 16-31, 2022 Bala., Insurance Exp 1,561.03 613 7107 L & I tax expense CDSPRO1227 Payroll Jan 1-15, 2022 7107 L & I tax expense CDSPRO1232 Payroll Jan 16-31, 2022 7108 Other Benefits CDSPRO1227 Payroll Jan 1-15, 2022 7108 Other Benefits CDSPRO1232 Payroll Jan 16-31, 2022 8675 Advertising Expense AP1038431 ERAP ad - Grant - Jan 2022 Transaction Total 8010 Professional Fees Opening Balance 44.76 155.95 42.340.06 Date: 2/15/22 11:49:27 AM Page: 3 0.00 29.13 124.11 3.80 157.04 Direct Client 42,340.06 CBala... 611 Services 613 Program Operations 0.00 613 Program Operations 400.61 613 Program Operations 701.06 613 Program Operations 64.00 613 Program Operations 34.51 613 Program Operations 56.02 613 Program Operations 69.96 613 Program Operations 124.11 613 Program Operations 85.75 613 Program Operations 116.89 613 Program Operations 4.25 613 Program Operations 5.15 613 Program Operations 5.76 613 Program Operations 6.38 613 Program Operations 0.40 613 Program Operations 0.95 613 Program Operations 42.27 1,718.07 Bala., Program Operations 1,561.03 613 613... Program Support - 0.00 Pool Date: 2/15/22 11:49:27 AM Page: 3 0.00 29.13 124.11 3.80 157.04 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title 8010 Professional Fees AP1037692 IT Support for January 2022 Backup Service & Email Securitj 613... Program Support - - Pool 8010 Professional Fees AP1038367 Microsoft Office 365 - Business Premium - Nonprofit (Inv 613... Program Support - 732-393193) - Dec 2021 Pool 8010 Professional Fees AP1038542 IT Support for January 2022 Backup Service & Email Security 613... Program Support - Pool 8010 Professional Fees AP1038542 Microsoft Office 365 - Business Premium - Nonprofit (Inv 613... Program Support - 732-393193) - Dec 2021 Pool 8100 Office Supplies AP1038549 B.I.E - Moses Lake office Supplies, INV#10278 - Dec 2021 613... Program Support - Pool 8100 Office Supplies AP1038549 Bargain Town Christmas decorations/ office supplies Moses 613... Program Support - Lake -Dec 2021 Pool 8100 Office Supplies AP1038549 BIE Mooses Lake office Supplies, INV#10499-0 - Jan 2022 613... Program Support - Pool 8100 Office Supplies AP1038549 ML Office Supplies - Dec 2021 613... Program Support - Pool 8200 Communication AP1038228 Main Office Internet Svc 12/1-12/31/21 613... Program Support - Expense Pool 8200 Communication AP1038228 Main Office Telephone Svc 12/1-12/31/21 613... Program Support - Expense Pool 8200 Communication AP1038379 Upper County Office Internet - Svcs 2/1-2/28/22 613... Program Support - Expense Pool 8200 Communication AP1038542 Main Office Internet Svc 12/1-12/31/21 613... Program Support - Expense Pool 8200 Communication AP1038542 Main Office Telephone Svc 12/1-12/31/21 613... Program Support - Expense Pool 8200 Communication AP1038543 Upper County Office Internet - Svcs 2/1-2/28/22 613... Program Support - Expense Pool 8200 Communication AP1038549 Internet & Telephone Services for ML Office - Svcs from 613... Program Support - Expense 1/1-1/31/22 Pool 8350 Dues & AP1038431 Monthly Digital Fax Subscription - Feb 2022 - UC 613... Program Support - Subscriptions Pool 8350 Dues & AP1038542 Monthly Digital Fax Subscription - Feb 2022 - UC 613... Program Support - Subscriptions Pool 8400 Rent - Space Lower AP1037807 Main Office Rent - January 2022 613... Program Support - County Pool 8400 Rent - Space Lower AP1038542 Main Office Rent - January 2022 613... Program Support - County Pool Date: 2/15/22 11:49:27 AM 219.84 7.80 409.50 14.54 176.59 23.17 188.48 313.64 3.86 5.32 2.26 7.19 12.28 115.68 0.17 0.29 234.89 333.84 Page: 4 219.84 7.80 3.86 5.32 2.26 0.17 234.89 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title 8401 Rent - Space Upper AP1037815 Upper County Office Rent for January 2022 613... Program Support - County Pool 8401 Rent - Space Upper AP1038542 Upper County Office Rent for January 2022 613... Program Support - County Pool 8405 Utilities - Ellensburg AP1038276 Main Office Utilities - Solar Allocation for acct#306089, 613... Program Support - 306090- Svcs from 12/2/21-1/4/22 Pool 8405 Utilities - Ellensburg AP1038276 Main Office Utilities - Svcs from 12/2/21-1/4/22 613... Program Support - Pool 8405 Utilities - Ellensburg AP1038542 Main Office Utilities - Solar Allocation for acct#306089, 613... Program Support - 306090- Svcs from 12/2/21-1/4/22 Pool 8405 Utilities - Ellensburg AP1038542 Main Office Utilities - Svcs from 12/2/21-1/4/22 613... Program Support - Pool 8406 Utilities - Upper AP1038277 Upper County Office Utilities - Svc Period 12/8/21-1/7/22 613... Program Support - County/Offsite offices Pool 8406 Utilities - Upper AP1038542 Upper County Office Utilities - Svc Period 12/8/21-1/7/22 613... Program Support - County/Offsite offices Pool 8406 Utilities - Upper AP1038549 ML Office Utilities- 1000 W Ivy - Svcs 12/15/21-1/14/22 613... Program Support - County/Offsite offices Pool 8420 Repairs & AP1038156 Reimbursement - Main Office Maintenance Amazon charged 613... Program Support - Maintenance - Personal Card- Jan 2022 Pool General 8420 Repairs & AP1038188 Snow Plowing and De -Icing - Main Office - INV 29656 - Nov 613... Program Support - Maintenance - 20221 Pool General 8420 Repairs & AP1038189 Cleaning Service - Main Office - INV 11341 - 10.8.21 613... Program Support - Maintenance - General Pool 8420 Repairs & AP1038191 Property Restoration - Carpet Stretching - Main Office - INV 613... Program Support - Maintenance - 385740203086 - 11.9.21 Pool General 8420 Repairs & AP1038221 Main Office Property Maintenance- 1943085- December 202' 613... Program Support - Maintenance - General Pool 8420 Repairs & AP1038221 Main Office Property Maintenance- Parking Lot - 1942603- 613... Program Support - Maintenance - December 2021 Pool General Date: 2/15/22 11:49:27 AM 9.29 15.90 9.29 8.14 21.90 42.69 8.14 21.90 4.52 7.73 4.52 69.60 8.52 10.80 10.18 28.81 0.46 0.17 Page: 5 Debit U.1U 11.32 1.43 12.92 2.02 16.08 0.89 12.11 0.29 18.36 27.55 Credit Page: 6 1.43 11.32 0.46 0.17 8.52 0.20 12.92 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title 8420 Repairs & AP1038325 Taylor- Main Office Maintenance R&H Statement pmt- Dec 613... Program Support - Maintenance - 2021 Pool General 8420 Repairs & AP1038334 Main Office Building Maintenance- Invoice#207- January 202 613... Program Support - Maintenance - Pool General 8420 Repairs & AP1038498 Add'I Bathrooms - SSVF Training Rm - Dec 2021, January 613... Program Support - Maintenance - 2022 Pool General 8420 Repairs & AP1038498 Weekly Cleaning Main Office - January 2022 613... Program Support - Maintenance - Pool General 8420 Repairs & AP1038542 Add'I Bathrooms - SSVF Training Rm - Dec 2021, January 613... Program Support - Maintenance - 2022 Pool General 8420 Repairs & AP1038542 Main Office Building Maintenance- Invoice#207- January 202 613... Program Support - Maintenance - Pool General 8420 Repairs & AP1038542 Main Office Property Maintenance- 1943085 & Parking lot 613... Program Support - Maintenance - 1942603 -December 2021 Pool General 8420 Repairs & AP1038542 Main Office Property Maintenance -1943085- December 202' 613... Program Support - Maintenance - Pool General 8420 Repairs & AP1038542 Main Office Property Maintenance- Parking Lot - 1942603- 613... Program Support - Maintenance - December 2021 Pool General 8420 Repairs & AP1038542 Reimbursement - Main Office Maintenance Amazon charged 613... Program Support - Maintenance - Personal Card- Jan 2022 Pool General 8420 Repairs & AP1038542 Taylor- Main Office Maintenance R&H Statement pmt- Dec 613... Program Support - Maintenance - 2021 Pool General 8420 Repairs & AP1038542 Weekly Cleaning Main Office - January 2022 613... Program Support - Maintenance - Pool General 8420 Repairs & AP1038549 Iron Mountain: (12/22/21-1/25/22) - ML Office Shredding 613... Program Support - Maintenance - Pool General Date: 2/15/22 11:49:27 AM Debit U.1U 11.32 1.43 12.92 2.02 16.08 0.89 12.11 0.29 18.36 27.55 Credit Page: 6 1.43 11.32 0.46 0.17 8.52 0.20 12.92 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title Debit Credit 8420 Repairs & AP1038549 ML Office Cleaning - Inv #2021-1636- Svcs in January 2022 613... Program Support - 136.80 Maintenance - General Pool 8421 Repairs & AP1038549 Moses Lake Office Pest Control - 11/5 and 9/17/2021 613... Program Support - 67.86 Maintenance - Pool Program 8510 Program supplies AP1038165 Uline invoice 142469460, floor mats, pouch 613... Program Support - 3.74 and tools Pool 8510 Program supplies AP1038165 Uline invoice 143265158, grocery carts 613... Program Support - 3.47 and tools Pool 8510 Program supplies AP1038306 Shirtworks: UC Uniforms (Inv #1031231) - Jan 2022 613... Program Support - 1.78 and tools Pool 8510 Program supplies AP1038542 Shirtworks: UC Uniforms (Inv #1031231) - Jan 2022 613... Program Support - 3.04 1.78 and tools Pool 8510 Program supplies AP1038542 Uline invoice 142469460, floor mats, pouch 613... Program Support - and tools Pool 3.74 8510 Program supplies AP1038542 Uline invoice 142469460, floor mats, pouch & Uline invoice 613... Program Support - 12.34 and tools 143265158, grocery carts Pool 8510 Program supplies AP1038542 Uline invoice 143265158, grocery carts 613... Program Support - and tools Pool 3.47 8650 Photocopy Expense AP1038329 UC Office Copier/Printer Usage & Maint-12/19/21-1/18/22 613... Program Support - 0.16 Pool 8650 Photocopy Expense AP1038542 UC Office Copier/Printer Usage & Maint-12/19/21-1/18/22 613... Program Support - 0.27 Pool 0.16 8650 Photocopy Expense AP1038549 ML Office Copier/Printer Usage & Maintenance- 613... Program Support - 25.22 12/16/21-1/15/22 Pool 8660 Printing & Publications AP1038549 Vistaprint: ML Thank You Cards - Dec 2021 613... Program Support - 8.25 Pool 8800 Vehicle AP1038377 Main Office Pool Vehicle Maintenance -Inv# 537767- Jan 202; 613... Program Support - 1.07 Maintenance & Pool related 8800 Vehicle AP1038542 Main Office Pool Vehicle Maintenance -Inv# 537767- Jan 202; 613... Program Support - 1.52 1.07 Maintenance & Pool related 8990 Interest Expenses AP1038549 Loan Payment for ML Office - January 2022 613... Program Support - 214.82 Pool Transaction Total 2,891.56 563.23 Date: 2/15/22 11:49:27 AM Page: 7 Hope Source Expanded General Ledger - BL- ERAP - Unposted Transactions Included In Report 625202110 - Eviction Rent Assistance- Grant- ERAP 2.0 From 1/1/2022 Through 1/31/2022 GL Code GL Title Session ID Transaction Description Divi... Code Division Title nahi+ Bala... Program Support - 2,328.33 613... ool Balance 625202110 - 52,169.56 Eviction Rent Assistance- Grant- ERAP 2.0 Report Opening/Current Balance 0.00 0.00 Report Transaction Totals 52,905.85 736.29 Report Current Balance; 52,905.85 736.29 Report Difference 52,169.56 Date: 2/15/22 11:49:27 AM ¢ a,3af(.33 i Sml,o3 3, 8 8� 9.3 -raD 0 ma+ Page: 8 Washington State Department of pis Coxa ree Eviction Rent Assistance Program 2.0 (ERAP 2.0) - Report, Form VERSION 2 Report Period: Enter corresponding week or month that matches the invoice reimbursement request. Match all of the information below to the information collected on the ERAP2.0 Instructions. payment Forms and Household Information and Eligibility Form. Grantee: Hopesource - Grant County Report period: 1.1.22 -1.31.22 Total No. of 14 Applications Household Payment Information -a&of Information{select from?droptlown)�: Household !D EXAMPLE: 080120200945 8181 8209 8394 8487 8634 8960 8980 8891 7622 8037 8217 8994 72932 9008 Total no. of months of Total Financial financial assistance Assistance Povided 12 100 2 1800 2 2004 3 2550 3 2607 5 990 3 2379 6 4680 4 3100 2 890 5 4244.76 3 4485 7 6379.87 5 2650 5 3580.43 Head of Household is 18- 24 or Unaccompanied Youth 16-17 Gender No Man es Cisgender Woman yes Cisgender Woman yes Cisgender Man yes Cisgender Woman yes Cisgender Woman yes Cisgender Man yes Cisgender Woman yes Cisgender Woman yes Cisgender Woman yes Cisgender Woman yes Cisgender Woman yes Cisgender Man yes Cisgender Woman yes Cisgender Woman Race American Indian/Alaska Native/indigenous White White White White White White White White White White White White White White Ethnicity Rental Type Non-Hispanic/Non- leased lot space/mooring fee Latin a) o x Non-Hispanic/Non-Latin(a)(o)(zleased rental unit Non -His anic/Non-Latin(a)(o)(x; leased rental unit Non-Hispanic/Non-Latin(a)(aE leased rental unit Hispanic/Latin(a)(o)(x) leased rental unit Hispanic/Latin(a)(o)(x) leased rental unit Hispanic/Latin(a)(o)(x) leased rental unit Non-Hispanic/Non-Latina (o)(x, leased rental unit Hispanic/Latin(a)(o)(x) leased rental unit Non-Hispanic/Non-Latin(a)(o)x; leased rental unit Non-H!spa nic/Non-Latin(a)(o)(x, leased rental unit Non-Hispanic/Non-Latin(a)(o)(x. leased rental unit Non-Hispanic/Non-Latin(a)(o)(x, leased rental unit Non-Hispanic/Non-Latin(a)(o)(x; leased rental unit Hispanic/Latin(a)(o)(x) leased rental unit Percent Area Median Income (AMI) 30% or less 30% or less 31-50% 30% or less 30% or less 30% or less 30% or less 30% or less 51-80% 31-50% 30% or less 30% or less 51-80% 31-50% 31-50%