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Home My WebLink AboutGrant Related - BOCC (002)GRANT COUNTY BOARD OF COUNTY COMMISSIONERS To: Board of County Commissioners From: Janice Flynn, Administrative Services Coordinator Date: February 23, 2023 Rw. Authorization for Release of BOCC Approved Funds, Dept of Commerce, CHG Grant #22-46108-10, Hotel Leasing Amendment, Reimbursement #16, Renew, Request #6 Renew has requested reimbursement for the above -referenced grant, per the contracted guidelines in the amount of $403.73 for January 2023 expenses. The invoice and supporting documentation are attached for review. I am requesting the release of funds for payment to Renew in the amount of $403.73. Thank you. Grantee Name: Grant County Report Month/Year 2023 TOTAL USED IN 2022 TOTAL GRANT Lead Grantee Grant County Renew $29.91 $0.00 $373.82 $0.00 List Sub Grantee Names Below BUDGET $1,434.88 $2,261.14 $8,301.93 $0.00 $11,997.95 2002.05 $14,000.00 Jan -23 TOTAL OF BALANCE REMAINING $0.00 ti 'ti Lead Grantee Grant County Renew $29.91 $0.00 $373.82 $0.00 List Sub Grantee Names Below BUDGET $1,434.88 $2,261.14 $8,301.93 $0.00 $11,997.95 2002.05 $14,000.00 Jan -23 TOTAL OF BALANCE REMAINING $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 W"R $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ..................... $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0-00 $0.00 $29.91 $29.91 $1,404.97 $0.00 $0.00 $2,261.14 $373.82 $373.82 $7,1928.11 $0.00 $0.00 $0.00 Invoice Tota $403.73 $403.73 $11,594.22 Grantee Name: Grant County Lead Grantee List Sub Grantee Names Below Report Month/Year: 01/23 Grant County I I I I I Renew Total Admim. I $0,00 a c Supp -ease sin 0 CHG-Other,kent/k p L &:;.HO6 Costs. $0,00 tHG-RiehV& f-' se.- ts'. "Cos U PO 7.0G $000 Ps. cW0,61, Pi XM �$0 00 $0.00 pt� $ 0.00 ,P$H/CA.Hl -1A S 4t $G QO Nil: 1, 1 mi Ogg 111[)� 1 All Z, �H "Im' $0600 ftmll� Av NICE 0 bl, 11, $0, 100 $0*00 $0.00 $0.00 $29.91 $0.00 2, & 373 82 E . $373 .82 $0.00 Invoice Total $403-73 Lwe 1 230202 0 PAGE I OF 2 1 0 4030 om cX118 01ACM6 Cardholder Name Account Number page I -of 2 -G-RIS CRISIS XXXX-XXXX-XXXX-1473VISA GRAW c0uNTy rfi#; WashingtonTrupt-Bank Njolibl, POW All" ,0, Ipwi m) 4koompif Informa(lon GO tarfibnt CidsIng Date =212M WORLImit s2o,bo0ter. _6 E r, 4 0 S Pp C i~I odft 061t AT AA Avall&.6 0�sh 6 All" ,0, Ipwi m) TO _6 E r, 4 0 S Pp C i~I QUAITY INNS M08M LAK.E -w AT AA 01119, 6 vlow ja ggo yhlbtita and D- redIts $0.00 oi/2-2 246021W501140M 4A0K IN THE 6dX,8aq,,i MOJ�$ LAR ` E WA .8 04t2s 017-24 VE �Pq INN ON, SRO A Moqg�s W�r= WA 0 24592160-' TiXGAVr8V .4, 01h, 0. h" X 13alaTI(le $ 6 $0to"o y lit worffiati, on Payment NO OMtO: OkV2023 MIMMUm P-0jiliMf Due. $0,00 New 13alance: $6,00 flora. Annud Parcentap Ratti (APR) Is tho,4001 tnterest fq�p 6n ypt)e owuhl. ApR y purc 10780�, 17. 4 .9 oya .a0 ------ A e 1h payllient ko., u Mall InquIdes"rw WMHINOTON TUT BANK PA 00.X21270PQK---. 7EIXA�99214-21 A _21 Call Cug,fdiner Sarvfm: PO 8V 21 �7"$OdKAW, W'A,Oal 0-2127 udt,0 801011 z We apptboj,4(.g yqur bv*iossf WASHINGTON TRUST SANK PO bOX Z 2-7 S1 OKANC-1 WA OD210027 P%se,indluda Your r,9,606t WASH(NOTON TRUSST BANK PO BOX MY SPOKANE, WA 992,10-2127 *XWN POthOnL O.Qd Date F . bp Adcount Numbar XXX -XX -)=X-1+ 8 , M 'T 2 3 4 .00 13. 4 10 J7 j_A Mininium PayMellt f)ue Zf -R.Z4.2� NONE Arflount P-nofosod GRITS CRISIS GRANT COUNW ATTN MIC--Hr--Lr-, JAP�RLUND PO TIOX R EPHRATA WA 98829;-607 000000060000000041295700310914737' - -------- -------- ---- -f4. —ku _6 E r, 4 0 S Pp C i~I QUAITY INNS M08M LAK.E -w 01/20 01119, 24440,60003Ly2r-, K AC.. RM -t48 1'102B47 VOSES L-AKr-- WA 01/24 oi/2-2 246021W501140M 4A0K IN THE 6dX,8aq,,i MOJ�$ LAR ` E WA .8 04t2s 017-24 VE �Pq INN ON, SRO A Moqg�s W�r= WA 0 24592160-' TiXGAVr8V -SQ *INN ON S"RD AVE M 08 a a, 9 WA, 02ro-i10.0,7-MukWOD 80'. *WN ON.3 P-0 AVE: tAOSE'S L'A115 VVA 0000.049WOOMPO TOTAL, OU R.'OH, AdV.t $04.67 'r6TAL Pf 44.�, �7 TOTAL PEES FQR Tp p p�-Rjd() TOTAL INTEW-,9'14 riOR. -rH18 P.,MqD TOTAL *rINANCE CHARGI-�* BILL.1t) IN'202p, $ flora. Annud Parcentap Ratti (APR) Is tho,4001 tnterest fq�p 6n ypt)e owuhl. ApR y purc 10780�, 17. 4 .9 oya .a0 ------ A e 1h payllient ko., u Mall InquIdes"rw WMHINOTON TUT BANK PA 00.X21270PQK---. 7EIXA�99214-21 A _21 Call Cug,fdiner Sarvfm: PO 8V 21 �7"$OdKAW, W'A,Oal 0-2127 udt,0 801011 z We apptboj,4(.g yqur bv*iossf WASHINGTON TRUST SANK PO bOX Z 2-7 S1 OKANC-1 WA OD210027 P%se,indluda Your r,9,606t WASH(NOTON TRUSST BANK PO BOX MY SPOKANE, WA 992,10-2127 *XWN POthOnL O.Qd Date F . bp Adcount Numbar XXX -XX -)=X-1+ 8 , M 'T 2 3 4 .00 13. 4 10 J7 j_A Mininium PayMellt f)ue Zf -R.Z4.2� NONE Arflount P-nofosod GRITS CRISIS GRANT COUNW ATTN MIC--Hr--Lr-, JAP�RLUND PO TIOX R EPHRATA WA 98829;-607 000000060000000041295700310914737' o renew 03rant Sebovioral Healths UMInUSS Project # RGCHB1277 Hotel Leasing Grant CONTRACT # 22-46108-10 Date: Account Staff Jan -23 108.150.00,0000,564.00.1100 108.150-00-0000-564.00.2100 108.150.00.0000.564.00.2200 108.150.00.0000-564-00.2300 108,150,00.0000.564.00.2301 108.150.00,0000.564.00.2400 108.150.00.0000.564.00,2599 Salary & Benefits MMOMMUMMUM moll 108.150.00.0000,,564.00.4502 143.50 108.150,00,0000.564,00.4502 86-82 108,150-00-0000-564.00.4502 71.75 108.150.00,0000.564.00.4502 71.75 ----------------- 1 Operating Exp 373-82 1 -Feb 2 NIGHT 1-Ja n 1 NIGHTS 24 -Jan 1 NIGHTS 25 -Jan 1 NIGHTS ***01/17/2023 Employees did not enter their time on Time sheets, so I can not enter salaries and benefits. Rg Departing renew 108.150.00.0000.564.00.4502 nuTEL LEASING GRANT Jan -23 '' iBV. ARA'c"' IrA uTAL EA "PENSES GP LEDGER 108.150.00. 000.564.0 .110 SALARY- Employees did not enter their time onT/"Z 108.150.00.0000-564.00-2100 Retirement 108..150.00.0000.564.00.2200 SSI 108.150. 0.0000.564.00.23 0 Medical 108.150.00.0000.564.00.2301 FM LA 108.150.00.0000.564.00.2400 L 108.150.00.0000.564.00.2599 Employment $ 1 -Feb 2 NIGHT 1-Ja n 1 NIGHTS 24 -Jan 1 NIGHTS 25 -Jan 1 NIGHTS ***01/17/2023 Employees did not enter their time on Time sheets, so I can not enter salaries and benefits. Rg Departing 108.150.00.0000.564.00.4502 12533955 01/31/2023- 02-01/2023; HMIS # 1595+. 1435. 108-150.00.0000.564.00.4502 12537459 1/13-01/14/2023 HMS # B2138C43D 108.150.00.0000.564.00.4502 125406141/24/23-01/25/23 HMIS #1 9F $ 71.75- 108.150.00.0000.564.00.4502 125406141/24/23--01/25/23 HM I5 # $ 71.75 $ 373.82 J,ili) -3 - P 7-3 'T1 DONE 1 -Feb 2 NIGHT 1-Ja n 1 NIGHTS 24 -Jan 1 NIGHTS 25 -Jan 1 NIGHTS ***01/17/2023 Employees did not enter their time on Time sheets, so I can not enter salaries and benefits. Rg Departing Wa,e.-hington State NPartmentof C OJIMe r October 2022 Consolidated Homeless Grant Self -Declaration Form Complete this form to document housing status or income., when applicable. Homelessness — In the narrative include information about household's primary nighttime residence (where they sleep the majority of the time) and if exiting a system of care narrative must also include information on homelessness prior to system of care entry, If fleeing violence, indicate in the narrative "fleeing violence," No additional information is required, At Risk of Homelessness — Refer to Verification of Household ElIgIbility and Income Recertification Form for Information that needs to be included in narrative used on housing situation, Chronic Homelessness — Client must attest to chronic homelessness. *in addition., the case manager must provide written documentatlon of the living situation and duration1frequency, and the steps taken to obtain the standard evidence I allowable for chronic homelessness. This additional documentation must be in the client file. Income — in the narrative include details on source of income, income amount, and frequency of income. in addition, case manager must document attempts to obtain written and verbal ver1ficadon. This add t al documentation must be in the 1 fon c1len tfile, [] No Income — Indicate in the narrative "no income," Client Name HMIS Client Identifier W5 Pate I 9f 123 Narrative � � �., ��G1�i��,�►t �(lC�Y1�i,,�SS C\j1r11`�V1�Il�, Y\(W\1�114C�11� huu�1`v� TU WAG U'UtVurawuM) � YO 0 R WI7Y1 I�OY�1� I�L�I� G4�10WS Ali alleVv�ul� �n0u�1'vtc� So�Uhov� Client Signature* fir *if intake Is conducted remotely and client signature cannot be lmmedl37e'ly obtained, case mana ers ou d notate ellen "narrative above and obtain signature atfirst in-person meeting with client. Ch runic Homelessness* (see additional documentation required from case manager abovel Client Attestation III --. have experienced being homeless for the last 12 months In which I lived in a place not meant for human habit tion or in an eme(gency shelter, or on at least four separate occasions in the last three years, I was homeless for a t tal of at least 12 months, Client Signature -J Case Manager Signature An efino Serrano _-- / From-,/nrOn�rdAvev1e�ouor �! Sent:Tuesday, January �1, � 34-08 PM ' - ~''=-`----'---' � 'rm Serrano / Subject: Receipt from km On 3rd Ave Now when you shop atsellers who use Square, your reoalobn w4U be delivered eutonlatioc-,111y. Inn ve El Let Inn On3rd Ave know how your expedence was � � � �_�~ ~�� °- ~ � -_0��-~� � ^� 0 '-'- .-.'-----'.-... ----'_-_'_--_-.-' -'.-.-_- fBed Omeen Nightly Weekday x 2 $129.B0 -. --'-.'-'--'-'-__-----.--''.-------'''--- ' Purchase Subtotal $129,88 Sales Tax (1U'4%) $13.52 Tota) $143,50 Inn On 3rd Ave 1 &40*.& Washington Stete MW qM repmmerlt Of *40koC W (Mmerce July 2022 Consolidated Home -less Grant Third Party Verbal Verification Form Complete this form to document housing status or income,when applicable. Homelessness — In the narrative include details of the phone call to the temporary housing provider verifying applicant's temporary housing or system of care representative verifying applicant is exiting and was previously homeless, At Risk of Homelessness — In the narrative include details of the phone call to the relevant party. Refer to Vierificoation of Household Eligibility and Income Recertification Form for specific Information to include and who to contact. Chronic Homelessness — In the narrative include details I of where they were living and spocific months, q Earned Income — In the narrative include name of employer, pay amount and frequency, average hours worked pLir week, amount of any additional compensation. Other income — in the narrative Include name of income source, income amount, and freque.ncy of income. ane t•,17'•'' womb., 'A H M'I S",.dik! n"t , IVI i U SS 10 l:;., ;:J = t,Y:�y :" :'k •wilvi Itmol OU) of boo(:�Ofv) �'+V"V(k4 .. U Y) ?1� UAI(A%C VIOT�)fAll AhVI) 1,. 'P av A a m Tfir fty" on yj Z(AUS :-."P-'0Aj6'n/Tine or. u r re n t - 0 K s -t 4a" 'ncl 'njrijr : n, 00/F.I16' Ta 1 Vve On Q b 9449 k6 j� .I. t :, ,1� •tilt �_`•, i."�' '.; ?•f�i: '" -'a plicable `3 1�' Oil •6r :Wd Managefesigha'Ur A -AAAIV-. I ��a[FL I N N Y* W, 1. _Mcli 1WELS .300 E 9TFl AVE APT-DI03 Ploses Lake, WA 98837 U/ Qualfty Inn (WA.255) 449 Melva Lane Moses Lake, WA 98837 (509) 765-8886 GM.VVA255@cho1ce.hote1s.c*fln Account: 850927892 Date: 1/13123 Room: III LCONST Arrival Date; 1/13123 Departure Datb: 1/14/23 Check In'Time: 1/13123 2:01 PM Check Out Time-, - Rewards Program ID, You were checked out by: You were checked in by; CMONTM Total Balance Due: (86.82) Post Date cif"ScOption Amooht III =03 Visa Payment (86,82) XXXXXXXXXXXX1473 F(410 Swimary 1113/23 o, 11U/23 Tisa Payment ((8 B.,81 Balance Due. - With this rate you ave able to earn valuable Choice Priv"lleges points! x 4.�CHOJCE privileges., .ftq'Vt1.F*% You could be earning, free nights at Choice hotels and other great rewards. Join Choice Privileges today by stopping by the front desk, or logging on to 12 3��-1�`1 d901 State lvlla�hhgt�on State P Ci el€ C onunerce October 2022 Coin s C1,11 d a te d H orneless Gllran 'I*. Se-H-Declarapion Fonai Complete this form to document housing status or income, when applicable, RHomelessness — In the narrative include information about household's primary nighttime residence (where they sleep the majority of the time) and if exiting a system of care narrative must also include information on homelessness prior to system of care entry. If fleeing violence, indicate in the narrative "fleeing violence." No additional Information is required. At Risk of Homelessness — Refer to Verification of Household Eligibility and Income Recertification Form for information that needs to be included in narrative based on housing situation. Chronic Homelessness —Client must attest to chronic homelessness.* *In addition, the case manager mustprovide written documentation of the living situation and duration1frequency, and the steps taken to obtain the standord evidence allowable for chronic homelessness. This additional documentation must be in the client file. Income — In the narrative 'Include details on source of income., income amount, and frequency of income. In addition, case manager must document attempts to obtain wn'tten and verbal verification. This additional documentation must be in the Is Clientfile. E] No Income --Indicate in the narrative "no income," obtain signature at first in-person meeting with client. Chronic Homelessness* (see additional documentation required from case manager above) Client Attestation - f r ; kv-W have experienced being homeless for the last 12 months in which I lived in L .a p f ace not meant for human habitation or in an emergency shelter, or on at leastfour separate occasions in the last three years, I was homeless for a total of at least 12 months. Client Signature Case Manager Signature Tra d' H u n t Fi-ornf Kayleen E. Simpson Sent: Wednesday, January 25, 2023 9:16 AM To: Traci Hunt Subject, FW: Receipt from Inn On 3rd Ave is. i .l lot Firom. Inn On 3rd Ave via Square <rece[pts@messaging.squareup.com> Sent: Tuesday, January 24..2023 4:34 PIVI To: Kayleen E. Simpson <ks!mpsonL@gr@ntcountywa.90V> Subject: Receipt from Inn On 3rd Ave Sends neceipxs to.) tl-te "--.111.1a:1i ad -Ch alki J.c)7 o Lot Inn On 3rd Ave know how your experienm was I V V h (P prate Ct Oix 3rd Ave Lot Inn On 3rd Ave know how your experienm was I Thomas E. M.1tchell From: Sent: Inn On 3rd Ave via Square <rece'lpts@messag-ing.squareup.com> To: Wednesday, January 25, 2023 1020 AM Thomas E. Mitchell Subject, Receipt from Inn On 3rd Ave Now when you shop at sellers who use Square, your receipts will be deliveritt-2,xcl autornatt'i0ally. Not Inn On 3rd Ave Let Inn On 3rd Ave know how your experience was I $71.75 I Bed Queen Nightly Weekday x 1 $64.99 Purchase Subtotal $64.99 Sales Tax (10.4%) $6.76 I Total I Inn On 3rd Ave 509-765-1170 Visa 1473 (Swipe) GRIS CRISIS $71.76 2023 at 1010 AM #ImGc Ruth code: 025347 Return Policy: No refunds By signing this you acknowledge you are financially responsible for all damage to your room WI FI redsparrow447 Policies., -Check out is at I I am -jNO VISITORS after 10 Pm, you will be charged for extra occupants if you have unregistered guest staying longer than 15 minutes. -Damage of or rearranging of room fixtures and or furnishings will not be tolerated and Will result in removal from the property. -Threatening behavior towards employees or other guest will result in removal from the property without refu nd. -Illegal activity Of any kind will result of removal from property with no refund, -This property is privately owned and the management has the right to refuse service to anyone. -The owners of this property will not be held responsIble for accidents or injury to guest or guest 2