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Number <br /> INVOICE—Cost Reimbursement Contracts <br /> Snohomish County Human Services Department-3000 Rockefeller, M/S 305, Everett, WA 98201 <br /> Estimated: Actual: Amount of Payment: $ <br /> Agency Name and Address: Contract#: HCS-18-70-1803-198 <br /> City of Everett Project Title: First Responders Flex Funds <br /> 2930 Wetmore Ave Contract Manager: Tyler Verda <br /> Everett, WA 98201 ` Reporting Period: To: <br /> AUTHORIZING SIGNATURE: DATE: <br /> (sign in ink) <br /> SUB Account Title Current Contract To Date Contract Budget <br /> OBJ Expenditures Expenditures Budget Balance <br /> 10 Salaries/Wages <br /> 20 Personal Benefits <br /> 30 Supplies <br /> 40 Prof. Services <br /> 42 Postage <br /> 42 Telephone <br /> 43 Mileage <br /> 43 Meals <br /> 43 Lodging <br /> 44 Advertising <br /> 45 Op. Rentals/Leasing <br /> 46 Insurance <br /> 47 Utilities <br /> 48 Repair/Maintenance <br /> 49 Printing/Copying <br /> 50 Dues/Subscriptions <br /> 51 Regis./Tuition <br /> 52 Flex Funds $12,481 $12,481 <br /> TOTALS $12,481 $12,481 <br /> CONTRACTING AGENCY MATCHING FUNDS: REVIEWED FOR PAYMENT: <br /> CURRENT PERIOD: $ <br /> AUTHORIZED FUND: <br /> CONTRACT TO DATE: $ <br /> ATTACH: AGENCY CERTIFICATION FORM <br /> Exhibit D <br /> HCS-18-70-1803-198 <br /> City of Everett <br /> Page 1 of 2 <br />