HomeMy WebLinkAboutGrant Related - BOCCGRANT COUNTY
BOARD OF COUNTY COMMISSIONERS
Memo
To: Board of County Commissioners
Frorre Janice Flynn, Administrative Services Coordinator
DafiP, January 7, 2021
Re: Authorization for Release of Funds, Dept of Commerce, CDBG PSG #20-
62210-005, Reimbursement #1, Subrecipient OIC Request #1
OIC has requested reimbursement regarding the above -referenced grant in the amount
of $1,328.77 for Sept expenses only. Their documentation is attached for review.
I am requesting the release of funds for payment to OIC in the amount of $1,328.77.
Thank you.
111
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BON 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY SUBRECIPIENT:
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902
CONTRACT NO:
20-62210-005
REPORT PERIOD:
Jul -20
REPORT NUMBER:
I
TOTAL AMOUNT REQUESTED THIS PERIOD: $0.00
(11 6� p IV1_
2020 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
CERTIFICATION: I certify that the information on this form is a
true and accurate report of the cash status and that all reported
expenditures are properly chargeable to the referenced grant.
Signature:
Printed Name: Dereie Mekuria
Title: Chief Financial Officer
Date: 12/21/2020
1. Name of Service Program: Asset Development 62 CDBG amount requested for these program activities thisperiod:
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing
counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school
classes. Free tax -prep.
2. Name of Service Program: Energy Assistance 196 JCDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy
assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -Indirect Admin IFCDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: General
administration expenses associated with managing energy assistance and asset development activities oversight and
assessments. Indirect admin.
i
`lp
WASHINGTON STATE
DEPARTMENT OF COMMERCE
VOUCHER DISTRIBUTION
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
46
Commerce Contract Number
20-62210-005
AGENCY NAME
DEPARTMENT OF COMMERCE
ATTN: CDBG
PO BOX 42525
OLYMPIA, WA 98504-2525
INSTRUCTION TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise or services furnished to the State of Washington,
and that a furnished and/or services rendered have been provided without
discrim' a ec s f age,marit tatus, race, creed, color, national origin,
handic , r i on or tnam e r isab veterans status.
VENDOR OR CLAIMANT (Warrant is to be payable to)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: JULY 2020
By:
_ UE INK)
Cindy Carter, BOCC Chair a
(TITLE) (DATE)
Description
QUANTITY AMOUNT
IDIS
Activity ID
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
8189
05 Public Services
$117,184.001 0.00 0.00 $117,184.00
$0.00
$0.00
8190
2 1 A General Admin
3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST
$120,684.00 $0.001 0.00 $120,684.00
Everything below this line is for Dept of Commerce
FED TAX ID K
PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)
PRINTED NAME: Jeff Hinckle SIGNATURE:
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV # 0002426-03
ACCOUNT NO.
ASD NUMBER
38243
VENDOR MESSAGE
CDBG #
M
TRANS 0
CODE D
SUB
MASTER SUB SUB
INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
620F0320 NZ
20-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
Contract 20-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 1
JULY 2020
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the Cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X_ Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X_ Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
1:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 266 2020-2 1 \Subrecipient Checklist 2020-21.docPage
1
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY SUBRECIPIENT:
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902''ss
CONTRACT NO:
20-62210-005
REPORT PERIOD:
Aug -20
REPORT NUMBER:
2
TOTAL AMOUNT REQUESTED THIS PERIOD: $000
2020 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
CERTIFICATION: I certify that the information on this form is a
true and accurate report of the cash status and that all reported
expenditures are properly chargeable to the referenced grant.
Signature:
Printed Name: Dereje ekuria
Title: Chief Financial Officer
Date: 12/21/2020
I. Name of Service Program: Asset Development 62 CDBG amount requested for these program activities thisperiod:
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing
counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school
classes. Free tax -prep.
2. Name of Service Program: Ene Assistance 163 CDBG amount requested for these program activities this period: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy
assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -Indirect Admin jjCDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: General
administration expenses associated with managing energy assistance and asset development activities oversight and
assessments. Indirect admin.
WASHINGTON STATE
^' DEPARTMENT OF COMMERCE
" Y VOUCHER DISTRIBUTION1030
AGENCY NUMBER
IDIS PROJECT NUMBER
46
Commerce Contract Number
20-62210-005
AGENCY NAME
DEPARTMENT OF COMMERCE
ATTN: CDBG
PO BOX 42525
OLYMPIA, WA 98504-2525
INSTRUCTION TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise or services fumished to the State of Washington,
and It a ds fu ' an r servi s rendered have been provided without
disc* inat b u�Shecl
of age, s marit I s tus, race, creed, color, national origin,
han cap, r I i oin a r isa led terans status.
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: AUGUST 2020
BY:
A USIGN I LUE INK)
Cinder Carter, BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
IDIS
Activity ID
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
8189
05 Public Services $117,184.00 0.00 0.00 $117,184.00
$0.00
$0.00
8190
21A General Admin 3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $120,684.00 $0.001 0.00 $120,684.00
Everything below this line is for Dept of Commerce
FED TAX ID k
PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)
PRINTED NAME: Jeff Hlnckle SIGNATURE:
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV # 0002426-03
ACCOUNT NO.
ASD NUMBER
38243
VENDOR MESSAGE
CDBG #
MSUB
0 MASTER SUB SUB
D INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
620F0320 NZ
rS
20-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANTTOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
Contract 20-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 2
AUGUST 2020
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
1:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 266 2020-2I\Subrecipient Checklist 2020-2LdocPage
I
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY SUBRECIPIENT:
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902
TOTAL AMOUNT REQUESTED THIS PERIOD:
CONTRACT NO:
20-62210-005
REPORT PERIOD:
Sep -20
REPORT NUMBER:
3
2020 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
CERTIFICATION: I certify that the information on this form is a
true and accurate report of the cash status and that all reported
expenditures are properly chargeable to the referenced grant.
Signature: 4,;
Printed Name: Dereie Mekuria
Title: Chief Financial Officer
Date: 12/21/2020
1. Name of Service Program: Asset Development 62 DBG amount reguested for these program activities thisperiod:
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing
counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school
classes. Free tax -prep.
2. Name of Service Program: Ene Assistance 92 CDBG amount requested for these program activities this period: $1,078.06
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy
assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -Indirect Admin jCDBG amount requested for these program activities thisperiod: $250.71
Description of service program how low- and moderate -income (LMI) persons were served this period: General
administration expenses associated with managing energy assistance and asset development activities oversight and
assessments. Indirect admin.
WASHINGTON STATE
DEPARTMENT OF COMMERCE
'r.
v, VOUCHER DISTRIBUTION
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
46
Commerce Contrail Number
20-62210-005
AGENCY NAME
DEPARTMENT OF COMMERCE
ATTN: CDBG
PO BOX 42525
OLYMPIA, WA 98504-252.5
INSTRUCTION TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise ors ices furnished to the State of Washington,
and that EE
furnished and/ors ices ren e d have been provided without
discrimin of at, sex, a tal stat , r e, creed, color, national origin,
handicap etna era or is bl d v ran status.
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: SEPTEMBER 2020
By:
(ISIGNIN BLU INK)
(Ji cl_y Carter, BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
IDIS
Activity ID
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
8189
05 Public Services $117,184.001 0.00 $115,842.03
$0.00
$0.00
8190
21A General Admin 3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $120,684.0011 $0.00 1 $119,342.03
Everything below this line is for Dept of Commerce
FED TAX ID 9
PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)
PRINTED NAME: Jeff Hinckle SIGNATURE:
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV # 0002426-03
ACCOUNTNO.
ASD NUMBER
38243
VENDOR MESSAGE
CDBG #
M SUB
TRANS O MASTER SUB SUB
CODE D INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
620F0320 NZ
20-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
Contract 20-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 3
SEPEMBER 2020
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X_ Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X_ Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
I:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 266 2020-21\Subrecipient Checklist 2020-21.docPage
1
Page:
Page 1 of 1
General Ledger System
12/23/2020
Time:
OIC OF WASHINGTON
Annualbudget
Unexpended
$23,436.80
$23,186.09
$72,872.70
For User: INGRID FRANK
$16,874.50
$15,796.44
$4,000.00
$4,000.00
RW Expenditure report for: 266 - 266 CDBG
Report year: 7/1/2020 thru 6/30/2021
Period ending:
September 2020
--------------Monthly-------------
-----------------To Date ---------------
Account
Budget
Expenditures Pct
Budget
Expenditures
Pct
Admn Admin - Asset Dev/Energy Asst
$1,951.00
$250.71 12.85%
$5,853.00
$250.71
4.28%
Asst Asset Development
$6,068.00
$0.00 0.00%
$18,204.00
$0.00
0.00%
Ener Energy Assistance
$1,402.00
$1,078.06 76.89%
$4,206.00
$1,078.06
25.63%
Othe Other Asset Development
$331.00
$0.00 0.00%
$993.00
$0.00
0.00%
Report Totals
$9,752.00
$1,328.77 I 13.63%
$29,256.00
$1,328.77
4.54%
Page:
Page 1 of 1
Date:
12/23/2020
Time:
10:18:14 AM
Annualbudget
Unexpended
$23,436.80
$23,186.09
$72,872.70
$72,872.70
$16,874.50
$15,796.44
$4,000.00
$4,000.00
$117,184.00 $115,855.23
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK Page: Page 1 of 2
Fund Expenditure report for: 266 - CDBG PS 7/1/20-6/30/21 (Fund status: Active) Date: 12/23/2020
Report year: 7/1/2020 thru 6/30/2021 Period ending: September 2020 Time: 10:18:58 AM
Total for sub program ----->
Total for program 02 ----->
Total for department 009 ---->
$1,951.00 $250.71 12.85% $5,853.00
$1,951.00
$1,951.00
$250.71
_-
---------------Monthly -------------
--------- -- -----To Date-------- -- -----
Cf&7
Account
SALARIES,WAGES EXPENSE
Budget Expenditures Pct
Budget Expenditures
Pct
Annual budget
Department: 009 INDIRECT ADMIN
CL O, X74 &q
-'�, I a �%1'
5353
STATE UCI(ES),OIC EXP
Program:
02 ADMIN. POOL -BASE
PAID FAMILY MEDICAL LEAVE
$15.00
5360
5312
SALARY ADM. ALLOCATION
$1,210.00 $156.07 12.90%
$3,630.00 $156.07
4.30%
$14,531.80
5354
P/R TAX & BEN. ADM ALLOC.
$507.00 $69.77 13.76%
$1,521.00 $69.77
4.59%
$6,093.00
5999
NON PERSONNEL ADM. ALLOC.
$234.00 $24.87 10.63%
$702.00 $24.87
3.54%
$2,812.00
Total for sub program ----->
Total for program 02 ----->
Total for department 009 ---->
$1,951.00 $250.71 12.85% $5,853.00
$1,951.00
$1,951.00
$250.71
12.85%
$250.7
12.85%
Department: 010 PROGRAM
Program:
25 PROGRAM SUPPORT GC,3.4p�4
Cf&7
5311
SALARIES,WAGES EXPENSE
$3,837.00
5351
FICA,OIC EXP
$278.00
5352
LAND I,OIC SHARE
$36.00
5353
STATE UCI(ES),OIC EXP
$85.00
5355
PAID FAMILY MEDICAL LEAVE
$15.00
5360
DISABILITY OIC EXPENSE
$53.00
5361
MEDICAL INSURANCE,OIC EXP
$1,113.00
5362
LIFE INSURANCE,OIC EXP
$21.00
5363
PENSION,OIC EXP
$277.00
5364
ACCRUED PTO EXP
$353.00
5500
TRAVEL
$83.00
5700
CONSUMABLES
$83.00
5949
STAFF TRAINING
$83.00
5950
TESTING CHARGES
$41.00
5970
POSTAGE
$41.00
Total for sub program -----> $6,399.00
Sub program: 54 ENERGY ASSISTANCE
$5,853.00
$5,853.00
$250.71 4.28% $23,436.80
$250.71 4.28% $23,436.80
Unexpended
$14,375.73
$6,023.23
$2,787.13
$23,186.09
$23,186.09
$250.71 4.28% $23,436.80 $23,186.09
$0.00 0.00%
$11,511.00
$0.00
0.00%
$46,053.00
$46,053.00
$0.00 0.00%
$834.00
$0.00
0.00%
$3,341.00
$3,341.00
$0.00 0.00%
$108.00
$0.00
0.00%
$440.00
$440.00
$0.00 0.00%
$255.00
$0.00
0.00%
$1,027.00
$1,027.00
$0.00 0.00%
$45.00
$0.00
0.00%
$187.00
$187.00
$0.00 0.00%
$159.00
$0.00
0.00%
$639.00
$639.00
$0.00 0.00%
$3,339.00
$0.00
0.00%
$13,361.00
$13,361.00
$0.00 0.00%
$63.00
$0.00
0.00%
$254.00
$254.00
$0.00 0.00%
$831.00
$0.00
0.00%
$3,328.00
$3,328.00
$0.00 0.00%
$1,059.00
$0.00
0.00%
$4,242.70
$4,242.70
$0.00 0.00%
$249.00
$0.00
0.00%
$1,000.00
$1,000.00
$0.00 0.00%
$249.00
$0.00
0.00%
$1,000.00
$1,000.00
$0.00 0.00%
$249.00
$0.00
0.00%
$1,000.00
$1,000.00
$0.00 0.00%
$123.00
$0.00
0.00%
$500.00
$500.00
$0.00 0.00%
$123.00
$0.00
0.00%
$500.00
$500.00
$0.00 0.00%
$19,197.00
$0.00
0.00%
$76,872.70
$76,872.70
Page: Page 2 of 2
Date: 12/23/2020
Time: 10:18:59 AM
Annualbudget
Unexpended
General Ledger System
$11,453.38
OIC OF WASHINGTON
$863.85
$120.00
$116.27
For User: INGRID FRANK
$255.78
$48.00
$45.63
Fund Expenditure report for: 266 - CDBG PS
7/1/20-6/30/21
(Fund status: Active)
$1,378.00
$1,005.07
Report year: 7/1/2020 thru 6/30/2021
$54.00
Period ending: September 2020
$848.00
$806.52
- ---- Monthly----------
------------To Date------------
AccountjY �p� �- �,
Bud et
9
Expenditures Pct
Budget
Expenditures
Pct
_ _
5311 SALARIES,WAGES EXPENSE
$1,003.00
$592.62 59.08%
$3,009.00
$592.62
19.69%
5351 FICA,OIC EXP
$75.00
$41.15 54.87%
$225.00
$41.15
18.29%
5352 LAND I,OIC SHARE
$10.00
$3.73 37.30%
$30.00
$3.73
12.43%
5353 STATE UCI(ES),OIC EXP
$22.00
$13.22 60.09%
$66.00
$13.22
20.03%
5355 PAID FAMILY MEDICAL LEAVE
$4.00
$2.37 59.25%
$12.00
$2.37
19.75%
5360 DISABILITY OIC EXPENSE
$12.00
$7.56 63.00%
$36.00
$7.56
21.00%
5361 MEDICAL INSURANCE,OIC EXP
$114.00
$372.93 327.13%
$342.00
$372.93
109.04%
5362 LIFE INSURANCE,OIC EXP
$4.00
$3.00 75.00%
$12.00
$3.00
25.00%
5363 PENSION,OIC EXP
$70.00
$41.48 59.26%
$210.00
$41.48
19.75%
5364 ACCRUED PTO EXP
$88.00
$0.00 0.00%
$264.00
$0.00
0.00%
Total for sub program 54 ----->
$1,402.001,078.0
it 76.89%
$4,206.00
$1,078.06
25.63%
Total for program 25 ----->
$7,801.00
$1,078.06 13.82%
$23,403.00
$1,078.06
4.61%
Total for department 010 -- >
$7,801.00
$1,078.06 13.82%
$23,403.00
$1,078.06
4.61%
Fund Totals
$9,752.00
$1,328.77 13.63%
$29,256.00
$1,328.77
4.54%
Page: Page 2 of 2
Date: 12/23/2020
Time: 10:18:59 AM
Annualbudget
Unexpended
$12,046.00
$11,453.38
$905.00
$863.85
$120.00
$116.27
$269.00
$255.78
$48.00
$45.63
$144.00
$136.44
$1,378.00
$1,005.07
$57.00
$54.00
$848.00
$806.52
$1,059.50
$1,059.50
$16,874.50 $15,796.44
$93,747.20 $92,669.14
$93,747.20 $92,669.14
$117,184.00 $115,855.23
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY SUBRECIPIENT:
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902,
TOTAL AMOUNT REQUESTED THIS PERIOD:
CONTRACT NO:
20-62210-005
REPORT PERIOD:
Oct -20
REPORT NUMBER:
2020 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
CERTIFICATION: I certify that the information on this form is a
true and accurate report of the cash status and that all reported
expenditures are properly chargeable to the referenced grant.
Signature:
Printed Name: Derele Mekuria
Title: Chief Financial Officer
Date: 12/21/2020
1. Name of Service Program: Asset Development 62 JJCDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing
counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school
classes. Free tax -prep.
2. Name of Service Program: Energy Assistance 469 1CDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy
assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -Indirect Admin jjCDBG amount requested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: General
administration expenses associated with managing energy assistance and asset development activities oversight and
assessments. Indirect admin.
WASHINGTON STATE
'{? r DEPARTMENT OF COMMERCE
r
VOUCHER DISTRIBUTION
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
46
Commerce Contract Number
20-62210-005
AGENCY NAME
DEPARTMENT OF COMMERCE
ATTN: CDBG
PO BOX 42525
OLYMPIA, WA 98504-2525
INSTRUCTION TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise or services furnished to the State of Washington,
and that a mished and/ors ices re d have been provided without
discrimi ation b aces f ge, sex, a ' al stat s, ce, creed, color, national origin,
handic p, reli i r Viet era or is 1 v era s status.
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: OCTOBER 2020
By: &L
� ldl/j
\QSIGN IN BLUEINK)
�i!dyCarter, BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
IDIS
Activity ID
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
8189
05 Public Services $117,184.00 13 ,_� 0.00 $115,842.03
$0.00
$0.00
8190
21 A General Admin 3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $120,684.00 { .'. "j i 0.00 $119,342.03
Everything below this line is for Dept of Commerce
FED TAX ID N
PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)
PRINTED NAME: Jeff Hlnckle SIGNATURE:
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV # 0002426-03
ACCOUNTNO.
ASD NUMBER
38243
VENDOR MESSAGE
CDBG #
M SUB
0 MASTER SUB SUB
D INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
620F0320 NZ
r
20-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
Contract 20-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 4
OCTOBER 2020
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X_ Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
1:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 266 2020-21\Subrecipient Checklist 2020-21.docPage
1
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY SUBRECIPIENT:
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902
TOTAL AMOUNT REQUESTED THIS PERIOD:
CONTRACT NO:
20-62210-005
REPORT PERIOD:
Nov -20
REPORT NUMBER:
5
2020 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
CERTIFICATION: 1 certify that the information on this form is a
true and accurate report of the cash status and that all reported
expenditures are properly c argeable to the referenced grant.
Signature:
Printed Name: Dereje Mekuria
Title: Chief Financial Officer
Date: 12/21/2020
1. Name of Service Program: Asset Development 85 CDBG amount requested for these program activities thisperiod:
Description of service program how low- and moderate -income (LMI) persons were served this period: Housing
counseling, credit coaching, foreclosure services, business start-up, financial education workshops and high school
classes. Free tax -prep.
2. Name of Service Program: Ene Assistance 210 CDBG amount requested for these program activities this period: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: Energy
assistance and conservation education.
3.Name of Service Activity: Asset Develop/Energy Develop/EnergyAssist Admin -Indirect Admin JFDBG amount reguested for these program activities thisperiod: $0.00
Description of service program how low- and moderate -income (LMI) persons were served this period: General
administration expenses associated with managing energy assistance and asset development activities oversight and
assessments. Indirect admin.
WASHINGTON STATE
DEPARTMENT OF COMMERCE
VOUCHER DISTRIBUTION
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
46
Commerce Contract Number
20-62210-005
AGENCY NAME
DEPARTMENT OF COMMERCE
ATTN: CDBG
PO BOX 42525
OLYMPIA, WA 98504-2525
INSTRUCTION TO VENDOR OR CLAIMANT:
Submit this form to claim payment for materials, merchandise or services.
Show complete detail for each item.
Vendor's Certificate: I hereby certify under perjury that the items and totals listed herein are
proper charges for materials, merchandise or services furnished to the State of Washington,
and that all go u ed andlor, se-' s rendered have been provided without
discriminatio betas of e, x, maria tatu ace, creed, color, national origin,
handicap, reli ion o V tam or dis bl d et a s status.
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
EPHRATA, WA 98823-0037
REPORTING PERIOD: NOVEMBER 2020
By:
� V 1A Ax � IIVIA�
— I NK)
Cindy_ Carter, BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
IDIS
Activity ID
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
8189
05 Public Services $117,184.00 j• 7 0.00 $115,842.03
$0.00
$0.00
8190
21 A General Admin 3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $120,684.00 0.00 $119,342.03
Everything below this line is for Dept of Commerce
FED TAX 10 a
PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)
PRINTED NAME: Jeff Hinckle SIGNATURE:
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV # 0002426-03
ACCOUNT NO.
ASO NUMBER
38243
VENDOR MESSAGE
CDBG #
M SUB
0 MASTER SUB SUB
D INDEX OBJ OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
620F0320 NZ
r
20-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
Contract 20-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 5
NOVEMBER 2020
Grant County's Subrecipient Checklist:
State Auditor's Office Audit Procedures for Testing Activities Allowed
And Not Allowed, As Published In 2007
Questions to ask before submitting a payment request
Was the expenditure or cost:
X Made for an allowable activity under the grant guidelines?
X Authorized (or not prohibited) under state or local laws or regulations?
X Approved by the federal awarding agency, if required?
N/A Allowable per Circular A-87 (June 2004 version), Attachment B, items 1-43?
For payroll transactions:
X_ Does the employee's time and effort documentation meet the requirements of
Circular A-122?
X Allocable to the program? (i.e., was the dollar amount charged to the program
relative to the benefits received by the program? Is the federal grantor being
charged its fair share of the cost?)
X Based on actual costs, not budgeted or projected amounts?
X Applied uniformly to federal and non-federal activities (i.e., is the federal
government being charged the same amount as if non-federal funds were being
used to pay the cost)?
X Given consistent accounting treatment within and between accounting periods?
(Consistency in accounting requires that costs incurred for the same purpose, in
like circumstances, be treated as either direct costs only or indirect costs only
with respect to final cost objectives).
X Calculated in conformity with generally accepted accounting principles, or
another comprehensive basis of accounting, when required under the applicable
cost principles?
X Not included as a cost (or used to meet cost sharing requirements) of other
federally -supported activities of the current or a prior period?
X_ Net of all applicable credits? (e.g., volume or cash discounts, insurance
recoveries, refunds, rebates, trade-ins, adjustments for checks not cashed, and
scrap sales).
N/A Not included as both a direct billing and as a component of indirect costs?
N/A Properly classified (e.g., some costs may be incorrectly claimed as a direct cost
instead of being incorporated as part of the indirect cost rate).
X Supported by appropriate documentation? (e.g., approved purchase orders,
receiving reports, vendor invoices, canceled checks, and time and attendance
records.) Documentation may be in an electronic form.
X Correctly charged to the proper account code and grant period?
1:\DATANONSHARED\ACCOUNTING\ingrid's stuff\CDBG\CDBG ML 266 2020-21\Subrecipient Checklist 2020-21.docPage
1