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HomeMy WebLinkAboutReimbursable Work Request - RenewForm A141A Inw=V.wh., '-4rNI0r11AM Health Can Auth"Ity 1121 8th Avenue BE Olympia. WA 98504 - VODOa¢a7AIMAIM :oE%� Moses Lab, WA 98837 - Agency Nw1070 K3919 vendn-s ca rr e. r nareoy iy unea- w that fttrey u and totals listed ho -in are props, charges for rnals gals, me�cnenmse n woke.+ ivnis e a wani o,, arw rn Ianeo ewa services.enderd neve been provided rwrrreur dsarmnaiai hecause Drage, sex. maHr stew, aloha gin en apron, a vanarn ra a dsalXd valla slaw. I Cindy Carter, WCC Chair - Z (btle) (da-) TAX IDENTIFICATION NUMBER MONTHIVEM OF SERVICE = "1319 10/12020 Supiplarrentad W RECEIVED BY DATE RECErVED :?.fit Kee"5, ,•^�r,.>K 45._«^;'r "'nrt '>'.E� tl .z9`.�`?�`' 'R°'. #iN0 9t" i`,"y.Ma: .�;. .Ggawi w,�4i ft4#►A. xf9Y 11.1 Admit 0.00 -- r% !%Y+,`.. 95.00 48.00 21 con.-AyBasd Coonimbo-P. Corr-ity-Based Process UM-&lndk t :: „S: e3`%¢6-:".: ,':-- .a.? 4� r i'^!'%!!k'�,>7vY+�'i° y"'-`Q•tm+-,•,i 1i`8 '�'° -w�4.{ s 0.00 22.5 CavvAay Coalition C -din s)r Cvmxrvy-Based Process uni-l-Oirect`r? S ?:"0+«: ... • . :.'. ` 0.00 22.5 CorrcvAdY Coalition C-iry-Based Process UnNeretl-Direct i '.? ;IWT ,r q$x' 0.00 rni ,rn't,.i1 * 4ry>,:y3., .i u4, --777F7 a"�ti':..: 77 `` 4 '+- 22.5.1 CavnuMly Cadition Caadratcr-ML Prncess UMversaFDrect 0.00 22.5.1 jCorrrr l Cod4on-IAL Process UMverstl-tiniest 0.00 22.1.2 PAX -Good Behavior Garro -ML Irdornnation pssemitetion Universa-laliact 0.00 22. .1 Positlte Acibn - ML Education Unhwsal-Dwwt .:.-:* 'A`at 0.00 22.2.1 Youth EmPavrmenl-IAL Education UMtersi-Dkect ;i'iu:.;; 0.00 22.1.2 Outreach S EducNm- ML Information Dissemination Universsl4ndirect '>'Tic ,-" 0,00 22.1.2 Talk. Hear Vou-ML They Irdortnation Dlsanination Universa-Idiecl 3.,. 0.00 22.1.2 Under The Influence IX You- ML IMarrnalion psaMnaBon Universal -Indirect �.777: 0.00 22.1.2 Character Strang - ML In formiticn DissdMnal on Uniwrsai4diract 0.00 22.1.2 You Can - ML Inlonna&xn D-naton Universal-indrecl ..,.-; .;_`.'- 0.00 22.5.2 Restorative Justice -ML Environ-ud Universal -Indirect 0.00 22.8.2 T-va-Infarnd ScMxds - ML Environmental Universal -Infract 0.00 22.7.1 Coal tionfCommunily Trair" - ML Other Universal -Dred - 0.00 22.7.1 Caardraor Prdessional Development - ML 0Ms Unhersal-Dirael °-- 'r�`-�". 000 0.00 22.5.1 Cv^r^'a'Ry Caaition Covdnaor-O Can Praess UnlversaFDiecl 0.00 22.5.1 Car -nay C eon -0 MISC for vi mmbge Com Process Unive---Deed 0.00 22.2.1 Strengthening Fa rk- Program - O Education 0.00 22.2.1 SPORT PPW-O- Education Wecl ";;:-.Y:'<. 800.00 500.00 22.3.1 Healthy Alternatives- 0 Alt -111 s -Direct 0.00 22.1.1 Youth De''eoPmrs" 0- Infinnotion psaninatlon -prod - - 0.00 22.1.2 YouCan-O Information Ddssamiation RUnfr-W-DmtDirect nowt 0.00 22.1.2 Under The lydkrones IXVou-O Information psankation -Indvxl ,k3.«"*s 000 22.1.2 as.arw�a.oeo.e..apv.aazruerewxIrVarrotion Disaninaan ndrecl000 000 22.1.2 Suns W9h One,0 Infomvwtbn Disanination Indracl - 000 22.111 Drug Free Parks -0 EnWorm W Umvrsa-Indaect 000 22.8.2 OHS pscptinarY-0 Environ -tel Universa -Indirect :'+i'+'+.-,. 0.00 22.7.1 CoafOaNCvnmunay Training - 0 Other Universa-Dvecl 0.00 22.7.1 Coordinator Professional Da'.eloprnent-O OIMr Universal-Dirxl 0.00 22.8.2 Px Sustainability Policy- 0 Enwonmrea Unbars. -Indirect - .-:''s" 0.00 22.7.2 CannanSy Education Workshops- 0 Othar Universal -Indirect 0.00 0.00 . .:.Tr..: 0.00 0.00 0.00 0.00 0.00 0.00 -i:5.ti':':.- 0.00 0.00 :'� :,t .. 0.00 .:king >.�?'ftw tfia,;x`�`6.9t1 :i1b.00 :tai- �"£xMQ06 �� � r;::: saw PREPARED BY/DATE aTELEPHONE wn Go -les sae 751-2ee0 A19 Effeettw 711119 through 6150/21 REVISED 1012020 CURR DOC NO DOC DATE VENDOR NO. SWV0002426-00 AGENCY APPROVAL: Sarah Marianl 360-7259401 Sarah.Marlanl hoa.wa. ov ACCOUNnNG APPROVAL FOR PAYMENTr DATE Pp 1 FavII-