Laserfiche WebLink
EL., EVERETT <br /> MIMI WASHINGTON <br /> City of Everett Human Needs Grant <br /> January 1, 2019 through December 31, 2019 <br /> Exhibit C <br /> Request for Reimbursement <br /> Organization&Program: Interfaith Association of Northwest Washington <br /> Mailing Address: P.O. Box 12824,Everett,WA 98206 <br /> Report Month and Year: Click or tap here to eirter text. <br /> The expenditures made during the report month were for the specific purpose of: <br /> Click or tap here to enter <br /> Define one unit of service: Clic,or tap here to enter text. <br /> During this billing period a total of click or t^.e here to enter text. units of service were provided to Click or tap here to enter <br /> text. residents of the City of Everett using these grant funds. <br /> Contact name/phone for questions on invoice: enter text <br /> Expenditures <br /> Category Total Budget Current Report Total Expenses Balance Remaining <br /> Period Billed to Date <br /> Salaries/Wages $ $ $ $ <br /> Benefits $ $ $ $ <br /> Office and Operating $ $ $ $ <br /> Supplies <br /> Professional Services $ $ $ $ <br /> Other:C5ckGr tap nere to enter $ $ $ $ <br /> Other:Click or Trio here tr._;ter+. $ $ $ $ <br /> Total $ $ $ $ <br /> Request for Payment: The undersigned Program Manager certifies that the information submitted in support of this Request for <br /> Reimbursement is true,accurate and complete to the best of their knowledge. <br /> Program Manager Signature Date <br /> Approved for Payment <br /> Rebecca A. McCrary Date <br /> Housing and Community Development Programs Manager <br /> GL Code: 009-5000199410 <br /> Vendor No: American Red Cross: Local Disaster Relief (City use only) <br /> 16 <br />