HomeMy WebLinkAboutReimbursable Work Request - GRISFarm 5tateofwashnglon
A19-1A Invoice Voucher
�� A91.... ID or Coraract Number
070 K3919
AGIDICY X-0-NE
Health Can Authority- --------
PO Box 42691_
___ - __ _ _ _ - _-_
Olympia, WA 98504-2691
OR CLILNA.\7
Grant County
840 E Flub Street
Moses Lake, WA98837 _
__.
venaars cemn�ale 1 neren nal alar
y ce y un penalty of Palply that the terns and totals h.t. neren are prof charges I« mater alts. merchandrse «sernces furnished to the Stale of
Washington. arM mat all goods'mnisned anal« serves tendered have been p-dad -tho diatnm nat- because of age, se,. marital status, race creed. color,, national origin.
hand��ap gi0n reit , w V�emam d-bl
eta or ed �etetans state:
1{
(sign in mk)
Tom Taylor, BOCC Chair - - - - -
_10°el... - _ IdateI
TAX IDENTIFICATION NUMBER MONTH/YEAR OF SERVICE
91-6001319 September 2019 Supplemental
RECEIVED BY DATE RECEIVED
BARS PRCCRIda ACTNRY NAME -1
mM
SABG GFS PFS NCE PFS 2019 DMA
STR NCE
EBP PP General
SGR sOR Supp Total
11 1 Admin -co-_
- -
-
0 oc
21 Community-Based Coordmabon-Pe Community-Based Process
Unive,sal-Indrect
22.5 Community Coalition Coordinator COmmumly-Based Process
Univesal-Dnect
0 GC
22.5 Community Coalition Community-Based Process
Universal-Direct
C OC
22.51 Communay, Coalition Coordinator-ML CommunM-Based Process
Universal-Direct
0.00
22.5.1 Community Coalition -Refreshments, Supplies-ML Community-Based Process
Universal-Direct
61 88
61.88
000
000
000
000
0.00
0.00
000
000
0.00
0.00
0.00
0.00
0.00
0.00
2251 Community Coalition Coordinator -Quincy COmmunby-Based Process
Universal-Dhect
0.00
22.5.1 c'"""cO"e"-`Ni°'•R'0^e"s`OpiyiP1v4A1't""` c- Community-Based Process
Universal-Direct
0.00
000
000
0.00
0.00
22.3.1 Healthy AftemaW Activities - 5m Ort Tam Oamea-Ouncy Alternatives
Universal-Direct
000
000
0.00
2271 Celebration of Cultures 2019-Digital Graphics -Quincy Other
Universal-Direct
0.00
0.00
0.00
000
0.00
0.00
0.00
0.00
000
0.00
0.00
0.00
0.00
0.D0
0.00
0.00
61 88 coo 000 O.00 000 0G 03- 0 00
0 00 000 61 88
PREPARED BYI DATE
.--.--.--- -
Reyna Gonzales 12/512019
TELEPHONE
--------- --
309 764-2660
A19 Effective 711/19 through 6130/21 REVISED 7118119
CURR DOC NO
DOC DATE
VENDORNO.
AGENCY APPROVAL:
Sarah Mariani 360-725-9401 Sarah.Mariani@hca.wa.gov
ACCOUNTING APPROVAL FOR PAYMENTI DATE
_ _