HomeMy WebLinkAboutGrant Related - BOCC (002)*—I
WASHINGTON STATE
DEPARTMENT OF COMMERCE
AGENCY NUMBER
1030
IDIS PROJECT NUMBER
0021
Commerce Contract Number
A19 VOUCHER DISTRIBUTION
18-62210-005
AGENCY NAME INSTRUCTION TO VENDOR OR CLAIMANT:
DEPARTMENT OF COMMERCE Submit this form to claim payment for materials, merchandise or services.
ATTN: (I)BG Show complete detail for each item.
PO BON 42525
OLYMPIA, NVA 98504-2525 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 goods furnished and/or services rendered have been provided without discrimination
VENDOR OR CLAIMANT (Warrant is to be to:)
payable because of age, sex, marital status, race, creed, color, national origin, handicap, religion or
Vietnam era or disabled veterans statys.
GRANT COUNTY By:
PO BOX 37 ( IGN IN BLUE INK)
EPHRATA, WA 98823-0037 -
BOCC Chair �i Z
�11� (TITLE) (DAT )
REPORTING PERIOD: MAY 2019
Description .k— / QUANTITY AMOUNT
f(J
PREVIOUSLY AMOUNT REMAINING
BUDGET REQUESTED THIS INVOICE BALANCE
7714
05 Public Services 117,597.00 54,852.98 28,961.95 $33,782.07
$0.00
$0.00
7717
21 A General Admin 3,500.00 3,500.00 $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT REQUEST $121,097.00 $58,352.98 28,961.95 $33,782.07
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
ACCOUNT NO.
ASDNUMBER
VENDOR MESSAGE
34112
CDBG P mt #
M SUB
TRANS 0 MASTER SUB SUB
GL ACCT
SUBSID
INVOICE
CODE D INDEX OBJ OBJ
AMOUNT
NUMBER
62280320 NZ
18-62210-005
F14
SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT
DATE
WARRANT TOTAL
ACCOUNTING APPROVAL FOR PAYMENT
STATE OF WASHINGTON 2018 COMMUNITY DEVELOPMENT BLOCK GRANT - PUBLIC SERVICES GRANTS
DEPT OF COMMERCE
ATTN: CDBG PROGRAM
PO BOX 42525 CERTIFICATION: 1 certify that the information on this form is a
OL-t'61PIA, WA 98504-2525 true and accurate report of the cash status and that all reported
expenditures are nronerly cbareeable to the referenced Brant.
COMMUNITY ACTION AGENCY
CONTRACT NO: Signatu�E`c%�.
OIC OF WASHINGTON 18-62210-005
815 FRUITVALE BLVD REPORT PERIOD: Printed Name: RITA DEBORD
YAKIMA WA 98902 May -19
REPORT NUMBER: Title: CFO
11
Date: 6/20/2019
TOTAL AMOUNT REQUESTED THIS $28,961.95
1. Name of Service Activity: Asset Development 45
CDBG amount requested for these program activities this period: $14,765.40
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: Ener Assistance 68
CDBG amount requested for these program activities this period: $14,196.55
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: $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.
Contract 18-62210-005
Submitted to GC by: OIC OF WASHINGTON
Request for Reimbursement No. 11
MAY 2019
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 264 2018-19\Subrecipient Checklist 2018-19.docPage
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK
RW Expenditure report for: 264 - 264 CDBG
Report year: 7/1/2018 thru 6/30/2019
Period ending:
May 2019
---------------N/onfhl y --------------
---------
Account
Budget
Expenditures Pct
Budget
Admn Admin - Asset Dev/Energy Asst
$1,958.00
$0.00 0.00%
$21,538.00
Asst Asset Development
$6,503.00
$14,765.40 227.06%
$71,533.00
Ener Energy Assistance
$1,328.00
$14,196.55 1069.02%
$14,608.00
Report Totals
$9,789.00 / $28,961.95 295.86% $107,679.00
1� 33. 7�?kD�
Page:
Page 1 of 1
Date:
6/20/2019
Time:
11:58:21 AM
--To Date ---------------
Expenditures
Pct
Annual budget
Unexpended
$7,806.05
36.24%
$23,519.00
$15,712.95
$60,901.55
85.14%
$78,085.00
$17,183.45
$15,178.87
103.91%
$15,993.00
$814.13
$83,886.47
77.90%
$117,597.00
$33�,,710.53t'
1
1� 33. 7�?kD�
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK
Page:
Page 1 of 2
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active)
Date:
6/18/2019
Report year: 7/1/2018 thru 6/30/2019 Period ending: May 2019
Time:
8:12:13 AM
---------------Monthly--------------
-----------------To Date ---------------
Account
Budget Expenditures Pct
Budget
Expenditures
Pct
A,nnnual/fbudget
Unexpended
Department: 008 DIRECT ADMIN r r,
�" `��
_ ,r�J�,r f(�QI l� �2�
C?� r �✓Y� C��/�
�i
I.LCJ/1'� iii
Program: 83 COO/ I.T.
/ J
5500 TRAVEL
$0.00 $0.00 0.00%
$0.00
$122.41
0.00%
$0.00
($122.41)
Total for sub program ----->
$0.00 $0.00 0.00%
$0.00
$122.41
0.00%
$0.00
($122.41)
Total for program 83 ----->
$0.00 $0.00 0.00%
$0.00
$122.41
0.00%
$0.00
($122.41)
Total for department 008 ----->
$0.00 $0.00 0.00%
$0.00
$122.41
0.00%
$0.00
($122.41)
Department: 009 INDIRECT ADMIN -
Y
Program: 02 ADMIN. POOL -BASE
5312 SALARY ADM. ALLOCATION
$1,234.00 $0.00 0.00%
$13,574.00
$4,705.02
34.66%
$14,817.00
$10,111.98
5354 P/R TAX & BEN. ADM ALLOC.
$509.00 $0.00 0.00%
$5,599.00
$2,145.13
38.31%
$6,115.00
$3,969.87
5999 NON PERSONNEL ADM. ALLOC.
$215.00 $0.00 0.00%
$2,365.00
$833.49
35.24%
$2,587.00
$1,753.51
Total for sub program ----->
$1,958.00 $0.00 0.00%
$21,538.00
$7,683.64
35.67%
$23,519.00
$15,835.36
Total for program 02 ----->
$1,958.00 $0.00 0.00%
$21,538.00
$7,683.64
35.67%
$23,519.00
$15,835.36
Program: 03 ADMIN POOL - OTHER
U I Q_ - jj,�j - b,
) j Or, �.
5312 SALARY ADM. ALLOCATION
$0.00 $0.00 0.00%
$0.00
$1,865.30
0.00%
$0.00
($1,865.30)
5354 P/R TAX & BEN. ADM ALLOC.
$0.00 $0.00 0.00%
$0.00
$850.99
0.00%
$0.00
($850.99)
5999 NON PERSONNEL ADM. ALLOC.
$0.00 $0.00 0.00%
$0.00
$357.32
0.00%
$0.00
($357.32)
Total for sub program ----->
$0.00 $0.00 0.00%
$0.00
$3,073.61
0.00%
$0.00
($3,073.61)
Total for program 03 ----->
$0.00 $0.00 0.00%
$0.00
$3,073.61
0.00%
$0.00
($3,073.61)
Total for department 009 ----->
$1,958.00 $0.00 0.00%
$21,538.00
$10,757.25
49.95%
$23,519.00
$12,761.75
Department: 010 PROGRAM
Program: 25 PROGRAM SUPPORT
LCfk7t-01�T_
5311 SALARIES,WAGES EXPENSE
$4,249.00 $9,180.00 216.05%
$46,739.00
$38,757.98
82.92%
$50,988.00
$12,230.02
5351 FICA,OIC EXP
$313.00 $670.09 214.09%
$3,443.00
$2,828.95
82.17%
$3,757.00
$928.05
5352 LAND I,OIC SHARE
$30.00 $79.74 265.80%
$330.00
$320.56
97.14%
$370.00
$49.44
5353 STATE UCI(ES),OIC EXP
$88.00 $190.94 216.98%
$968.00
$806.16
83.28%
$1,061.00
$254.84
/
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK Page: Page 2 of 2
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active) Date: 6/18/2019
Report year: 7/1/2018 thru 6/30/2019 Period ending: May 2019 Time: 8:12:14 AM
---------------- Moirtklv-------------- -----------------To Dale---------------
Account Budget Expenditures Pct Budget Expenditures Pct Annual budget Unexpended
5355 PAID FAMILY MEDICAL LEAVE $0.00 $36.72 0.00% $0.00 $155.03 0.00% $0.00 ($155.03)
5360 DISABILITY OIC EXPENSE $74.00 $157.67 213.07% $814.00 $676.80 83.14% $897.00 $220.20
5361 MEDICAL INSURANCE,OIC EXP $1,022.00 $2,257.54 220.89% $11,242.00 $9,665.72 85.98% $12,269.00 $2,603.28
5362 LIFE INSURANCE,OIC EXP $16.00 $46.01 287.56% $176.00 $197.49 112.21% $203.00 $5.51
5363 PENSION,01C EXP $221.00 $642.60 290.77% $2,431.00 $2,713.06 111.60% $2,656.00 ($57.06)
5399 FRINGE $490.00 $1,504.09 306.96% $5,390.00 $4,779.80 88.68% $5,884.00 $1,104.20
Total for sub program ---- $6,503.00 $14,765.40 227.06% $71,533.00 $60,901.55 85.14% $78,085.00 $17,183.45
Sub program: 5 ENERGY ASSISTANCE
5311 SALARIES, EXPEL � - - $939.00 $9,803.65 1044.05% $10,329.00 $10,480.32 101.47% $11,270.00 $789.68
5351 FICA,01C EXP $70.00 $733.52 1047.89% $770.00 $784.14 101.84% $846.00 $61.86
5352 LAND I,OIC SHARE $8.00 $99.72 1246.50% $88.00 $106.52 121.05% $107.00 $0.48
5353 STATE UCI(ES),OIC EXP $19.00 $203.90 1073.16% $209.00 $217.98 104.30% $233.00 $15.02
5355 PAID FAMILY MEDICAL LEAVE $0.00 $39.22 0.00% $0.00 $41.47 0.00% $0.00 ($41.47)
5360 DISABILITY OIC EXPENSE $9.00 $165.41 1837.89% $99.00 $176.81 178.60% $119.00 ($57.81)
5361 MEDICAL INSURANCE,OIC EXP $131.00 $1,339.23 1022.31% $1,441.00 $1,424.75 98.87% $1,577.00 $152.25
5362 LIFE INSURANCE,OIC EXP $2.00 $48.61 2430.50% $22.00 $51.97 236.23% $35.00 ($16.97)
5363 PENSION,01C EXP $54.00 $686.23 1270.80% $594.00 $733.59 123.50% $652.00 ($81.59)
5399 FRINGE $96.00 $1,077.06 1121.94% $1,056.00 $1,161.32 109.97% $1,154.00 ($7.32)
Total for sub program 54 -----> $1,328.00 $14,196.55 1069.02% $14,608.00 $15,178.87 103.91% $15,993.00 $814.13
Total for program 25 -----> $7,831.00 $28,961.95 369.84% $86,141.00 $76,080.42 88.32% $94,078.00 $17,997.58
Total for department 010 -----> $7,831.00 $28,961.95 369.84% $86,141.00 $76,080.42 88.32% $94,078.00 $17,997.58
Fund Totals $9,789.00 $28,961.95 295.86% $107,679.00 $86,960.08 80.76% $117,597.00 $3Q,63Ca92�
General Ledger System
OIC OF WASHINGTON
,.
Page: Page 1 of 2
For User:
INGRID FRANK
Date: 6/20/2019
Transaction work file listing,_,,
/I
Tlme: 12:18:54 PM
Number Period
Date
Description
Journa
ccount
-_
-
Debit Amt Credit Amt
-- —-- -'-
20864'
1
31 -Jan -19
Payroll cost allocatio
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
71.54
(VAC FRINGE) for
period ending 1/31/2019
20427
1
31 -Jan -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
179.11
(VAC FRINGE) for
period ending 1/31/2019
20427
1
31 -Jan -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
36.41
(VAC FICA) for period
ending 1/31/2019
20427
1
31 -Jan -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
475.96
(VACATION) for period
ending 1/31/2019
20513
2
28 -Feb -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
29.13
(VAC FICA) for period
ending 2/28/2019
20513
2
28 -Feb -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
143.29
(VAC FRINGE) for
period ending 2/28/2019
20513
2
28 -Feb -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
380.77
(VACATION) for period
ending 2/28/2019
20595
3
31 -Mar -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
317.31
(VACATION) for period
ending 3/31/2019
20595
3
31 -Mar -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
119.41
(VAC FRINGE) for
period ending 3/31/2019
20595
3
31 -Mar -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
24.27
(VAC FICA) for period
ending 3/31/2019
20748
4
30 -Apr -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
80.34
(VAC FICA) for period
ending 4/30/2019
20748
4
30 -Apr -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
367.93
(VAC FRINGE) for
period ending 4/30/2019
20748
4
30 -Apr -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25 -
- 5399
FRING
1050.24
(VACATION) for period
ending 4/30/2019
20845
5
31 -May -19
Payroll cost allocation
Payroll
2019- 264 - 010 - 25-
- 5399
FRING
80.32
(VAC FICA) for period
ending 5/31/2019
General Ledger System
OIC OF WASHINGTON
For User: INGRID FRANK Page: Page 2 of 2
Fund Expenditure report for: 264 - CDBG PS 7/1/18-6/30/19 (Fund status: Active) Date: 6/20/2019
Report year: 7/1/2018 thru 6/30/2019 Period ending: April 2019
Time: 12:12:30 PM
---------------Monthly-------------------------------To Date ---------------
Account Budget Expenditures Pct Budget Expenditures Pct Annual budget Unexpended
5355 PAID FAMILY MEDICAL LEAVE $0.00 $37.80 0.00% $0.00 $118.31 0.00% $0.00 ($118.31)
5360 DISABILITY OIC EXPENSE $74.00 $158.66 214.41% $740.00 $519.13 70.15% $897.00 $377.87
5361 MEDICAL INSURANCE,OIC EXP $1,022.00 $2,189.38 214.23% $10,220.00 $7,408.18 72.49% $12,269.00 $4,860.82
5362 LIFE INSURANCE,OIC EXP $16.00 $46.33 289.56% $160.00 $151.48 94.68% $203.00 $51.52 '
5363 PENSION,OIC EXP $221.00 $661.59 299.36% $2,210.00 $2,070.46 93.69% $2,656.00 $585.54 V)
5399 FRINGE $490.00 $1,498.51 305.82% $4,900.00 $3,275.7 66.85% $5,884.00 $2,608.29
Total for sub program -----> $6,503.00 $15,017.66 230.93% $65,030.00 $46,136.1570.95%
$78,085.00
Sub program: 54 ENERGY ASSISTANCE o �� �\� o n\
5311 SALARIES,WAGES EXPENSE $939.00 $562.67 59.92/0 $9,390.00 $676.67 7.21 /o $11,270.00 $10,593.33
5351 FICA,OIC EXP $70.00 $41.90 59.86% $700.00 $50.62 7.23% $846.00 $795.38 _
5352 LAND I,OIC SHARE $8.00 $5.60 70.00% $80.00 $6.80 8.50% $107.00 $100.20
5353 STATE UCI(ES),OIC EXP $19.00 $11.71 61.63% $190.00 $14.08 7.41% $233.00 $218.92
5355 PAID FAMILY MEDICAL LEAVE $0.00 $2.25 0.00% $0.00 $2.25 0.00% $0.00 ($2.25)
5360 DISABILITY OIC EXPENSE $9.00 $9.52 105.78% $90.00 $11.40 12.67% $119.00 $107.60
5361 MEDICAL INSURANCE,OIC EXP $131.00 $85.38 65.18% $1,310.00 $85.52 6.53% $1,577.00 $1,491.48
5362 LIFE INSURANCE,OIC EXP $2.00 $2.80 140.00% $20.00 $3.36 16.80% $35.00 $31.64
5363 PENSION,OIC EXP $54.00 $39.38 72.93% $540.00 $47.36 8.77% $652.00 $604.64
5399 FRINGE $96.00 $75.41 78.55% $960.00 $84.26 8.78% $1,154.00 $1,069.74
Total for sub program 54 -----> $1,328.00 $836.62 63.00% $13,280.00 $982.32 7.40% $15,993.00 $15,010.68
Total for program 25 -----> $7,831.00 $15,854.28 202.46% $78,310.00 $47,118.47 60.17% $94,078.00 $46,959.53
Total for department 010 -----> $7,831.00 $15,854.28 202.46% $78,310.00 $47,118.47 60.17% $94,078.00 $46,959.53
Fund Totals $9,789.00 $20,443.06 208.84% $97,890.00 $57,998.13 59.25% $117,597.00 $59,598.87