HomeMy WebLinkAboutGrant Related - BOCCWASHINGTON STATE
DEPARTMENT OF COMMERCE
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
0021
Comma roe Contract Number
118-62210-005
A19 VOUCHER DISTRIBUTION
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
that all goods furnished and/or services rendered have been provided without discrimination
because age, sex, rital tatus, race, creed, color, national origin, handicap, religion or
VIstna ra sabl vet status
VENDOR OR CLAIMANT (Warrant is to be payable to:)
GRANT COUNTY
PO BOX 37
���HRATA WA 98R230037,
r�� PQ��a,
REPORTING PERIOD: JANUARY 2019
By:
-
kSIGN IN BLUE K)
Tom Taylor BOCC Chair
(TITLE) (DATE)
Description QUANTITY AMOUNT
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
7714
05 Public Services 117,597.00 183.31 10,956.38 $106,457.31
$0.00
$0.00
7717
21A General Admin 3,500.00 $3,500.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $121,097.00 $183.31 10,956.38 $109,957.31
Everything below this line is for Dept of Commerce
FED TAX ID#
PROGRAM APPROVAL
DATE
DOC DATE
CURRENT DOC. NO.
REFERENCE DOC NO.
VENDOR NUMBER
SWV0002426-03
ACCOUNTNO.
ASDNUMBER
34112
VENDOR MESSAGE
CDBG P mt #
M
TRANS 0 MASTER
CODE D INDEX
SUB
OBJ
SUB
SUB
OBJ
GL ACCT
SUBSID
INVOICE
AMOUNT NUMBER
62280320
NZ
18-62210-005
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
DATE
STATE OF WASHINGTON
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525
OLYMPIA, WA 98504-2525
COMMUNITY ACTION AGENCY
OIC OF WASHINGTON
815 FRUITVALE BLVD
YAKIMA WA 98902
CONTRACT NO:
18-62210-005
REPORT PERIOD:
Jan -19
REPORT NUMBER:
6 am+ 6mi�
TOTAL AMOUNT REQUESTED THIS $10,956.38
2018 COMMUNITY DEVELOPNIENT 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 chargeable to the referenced grant.
Signature:
Printed Name: RITA DEBORD
Title: CFO
Date: 2/20/2019
1. Name of Service Activitv: Asset Development 36 CDBG amount requested for these program activities this period: $8,787.09
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 Activity: Energy Assistance 273 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 Assist Admin -Indirect Admin CDBG amount requested for these program activities this period: $2,169.29
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.
Contract 18-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 07
JANUARY2019
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 stuft\CDBG\CDBG ML 264 2018-19\Subrecipient Checklist 2018-19.docPage�
1
OIC OF WASHINGTON
For User: INGRID FRANK
RW Expenditure report for: 264 - 264 CDBG
Report year: 7/1/2018 thru 6/30/2019
Account
Admn Admin - Asset Dev/Energy Asst
Asst Asset Development
Ener Energy Assistance
Report Totals
General Ledger System
Period ending: January 2019
--------------- Mo1rtlrly--------------
---------
Budget
Expenditures Pct
Budget
$1,958.00
$2,169.29 110.79%
$13,706.00
$6,503.00
$8,787.09 135.12%
$45,521.00
$1,328.00
$0.00 0.00%
$9,296.00
$9,789.00
$10,956.38 111.93%
$68,523.00
Page: Page 1 of 1
Date:
2/20/2019
Tlme:
3:17:54 PM
--To Date ---------------
Expenditures
Pct
Annual budget
Unexpended
$2,206.90
16.10%
$23,519.00
$21,312.10
$8,787.09
19.30%
$78,085.00
$69,297.91
$145.70
1.57%
$15,993.00
$15,847.30
$11,139.69
16.26%
$117,597.00
$106,457.31
General Ledger System
OIC OF WASHINGTON
$1,958.0_j0,_ $2,169.229
110.79%
$13,706.00
Program: 03 ADMIN POOL -OTHER
For User: INGRID FRANK
oU%) -
E_, f
5312 SALARY ADM. ALLOCATION
$0.00 $269.25
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active)
$0.00
5354 P/R TAX & BEN. ADM ALLOC.
$0.00 $121.06
Report year: 7/1/2018 thru 6/30/2019 Period ending: January
2019
5999 NON PERSONNEL ADM. ALLOC.
$0.00 $54.00
0.00%
---------------Monthly--------------
----------------To Date---------------
$0.00 $444.31
Account
Budget Expenditures Pct
Budget
Expenditures
Pct
Department: 009 INDIRECT ADMIN
LAND I,OIC SHARE
$30.00
$38.06
Program: 02 ADMIN. POOL- BASE�//�/
5353
STATE UCI(ES),OIC EXP
$88.00
$114.40
5312 SALARY ADM. ALLOCATION
$1,234.00 $1,314.58 106.53%
$8,638.00
$1,337.84
15.49%
5354 P/R TAX & BEN. ADM ALLOC.
$509.00 $591.07 116.12%
$3,563.00
$601.20
16.87%
5999 NON PERSONNEL ADM. ALLOC.
$215.00 $263.64 122.62%
$1,505.00
$267.86
17.80%
Total for sub program ----->
$1,958.00 $2,169.29 110.79%
$13,706.00
$2,206.90
16.10%
Total for program 02 --->
$1,958.0_j0,_ $2,169.229
110.79%
$13,706.00
Program: 03 ADMIN POOL -OTHER
t L- VY,
oU%) -
E_, f
5312 SALARY ADM. ALLOCATION
$0.00 $269.25
0.00%
$0.00
5354 P/R TAX & BEN. ADM ALLOC.
$0.00 $121.06
0.00%
$0.00
5999 NON PERSONNEL ADM. ALLOC.
$0.00 $54.00
0.00%
$0.00
Total for sub program ----->
$0.00 $444.31
0.00%
$0.00
Total for program 03 ---->
$0.00
$444.31
0.00%
Total for
department 009 ----->
$1,958.00
$2,613.60
133.48%
Department: 010 PROGRAM
$14,817.00
$13,479.16
$6,115.00
Program:
25 PROGRAM SUPPORT-
CL.�'I
Y �� '7��:�
5311
SALARIESNAGES EXPENSE
$4,249.00
$5,500.00
129.44%
5351
FICA,OIC EXP
$313.00
$403.36
128.87%
5352
LAND I,OIC SHARE
$30.00
$38.06
126.87%
5353
STATE UCI(ES),OIC EXP
$88.00
$114.40
130.00%
5355
PAID FAMILY MEDICAL LEAVE
$0.00
$22.00
0.00%
5360
DISABILITY OIC EXPENSE
$74.00
$96.70
130.68%
5361
MEDICAL INSURANCE,OIC EXP
$1,022.00
$1,507.97
147.55%
5362
LIFE INSURANCE,OIC EXP
$16.00
$28.12
175.75%
5363
PENSION,OIC EXP
$221.00
$385.00
174.21%
5399
FRINGE
$490.00
$691.48
141.12%
$0.00
$13,706.00
Page:
Page 1 of 2
Date:
2/20/2019
Time:
3:17:07 PM
Annualln budget
Unexpended
$0.00
$403.36
$14,817.00
$13,479.16
$6,115.00
$5,513.80
$2,587.00
$2,319.14
$23,519.00
$21,312.10
$2,206.90 16.10% $23,519.00
$269.25
0.00%
$0.00
18.49%
$121.06
$45,488.00
0.00%
$0.00
$403.36
$54.00
18.41%
0.00%
$0.00
$3,353.64
$444.31
0.00%
$0.00
18.12%
$444.31
0.00%
$0.00
$2,651.21
19.34%
$23,519.00
$21,312.10
($269.25)
($121.06)
($54.00)
($444.31)
($444.31)
$20,867.79
$29,743.00
$5,500.00
18.49%
$50,988.00
$45,488.00
$2,191.00
$403.36
18.41%
$3,757.00
$3,353.64
$210.00
$38.06
18.12%
$370.00
$331.94
$616.00
$114.40
18.57%
$1,061.00
$946.60
$0.00
$22.00
0.00%
$0.00
($22.00)
$518.00
$96.70
18.67%
$897.00
$800.30
$7,154.00
$1,507.97
21.08%
$12,269.00
$10,761.03
$112.00
$28.12
25.11%
$203.00
$174.88
$1,547.00
$385.00
24.89%
$2,656.00
$2,271.00
$3,430.00
$691.48
20.16%
$5,884.00
$5,192.52
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active)
Report year: 7/1/2018 thru 6/30/2019 Period ending: January 2019
Page: Page 2 of 2
Date: 2/20/2019
Time: 3:17:08 PM
----------------To Date ---------------
---------------Moir t/r /y --------------
Account
Budget
Expenditures
Pct
Total for sub program ----->
$6,503.00
$8,787.09
135.12%
Sub program:54 ENERGY ASSISTANCE
$78,085.00
$69,297.91
$6,573.00
5311 SA 6 -,WI
$939.00
$0.00
0.00%
5351 FICA,OIC EXP
$70.00
$0.00
0.00%
5352 L AND I,OIC SHARE
$8.00
$0.00
0.00%
5353 STATE UCI(ES),OIC EXP
$19.00
$0.00
0.00%
5360 DISABILITY OIC EXPENSE
$9.00
$0.00
0.00%
5361 MEDICAL INSURANCE,OIC EXP
$131.00
$0.00
0.00%
5362 LIFE INSURANCE,OIC EXP
$2.00
$0.00
0.00%
5363 PENSION,OIC EXP
$54.00
$0.00
0.00%
5399 FRINGE
$96.00
$0.00
0.00%
Total for sub program 54 ----->
$1,328.00
$0.00
0.00%
Total for program 25 ----->
$7,831.00
$8,787.09
112.21%
Total for department 010 ---->
$7,831.00
$8,787.09
112.21%
Fund Totals
$9,789.00
$11,400.69
116.46%
$94,078.00
$85,145.21
$54,817.00
$8,932.79
16.30%
$94,078.00
$85,145.21
Page: Page 2 of 2
Date: 2/20/2019
Time: 3:17:08 PM
----------------To Date ---------------
Budget
Expenditures
Pct
Annual budget
Unexpended
$45,521.00
$8,787.09
19.30%
$78,085.00
$69,297.91
$6,573.00
$114.00
1.73%
$11,270.00
$11,156.00
$490.00
$8.72
1.78%
$846.00
$837.28
$56.00
$1.20
2.14%
$107.00
$105.80
$133.00
$2.37
1.78%
$233.00
$230.63
$63.00
$1.88
2.98%
$119.00
$117.12
$917.00
$0.14
0.02%
$1,577.00
$1,576.86
$14.00
$0.56
4.00%
$35.00
$34.44
$378.00
$7.98
2.11%
$652.00
$644.02
$672.00
$8.85
1.32%
$1,154.00
$1,145.15
$9,296.00
$145.70
1.57%
$15,993.00
$15,847.30
$54,817.00
$8,932.79
16.30%
$94,078.00
$85,145.21
$54,817.00
$8,932.79
16.30%
$94,078.00
$85,145.21
$68,523.00
$11,584.00
16.91%
$117,597.00
$106,013.00
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