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["WASHINGTON STATE"]
["DEPARTMENT OF COMMERCE"]
[null,null,null,null,null,null,null,null,null,null,"AGENCY NUMBER",null,"Short Code","Commerce Contract Number"]
["Form 19-1A","       VOUCHER DISTRIBUTION",null,null,null,null,null,null,null,null,1030]
["DEPARTMENT OF COMMERCE",null,null,null,null,null,null,null,null,null,"INSTRUCTION TO VENDOR OR CLAIMANT:"]
["PO BOX 42525",null,null,null,null,null,null,null,null,null,"Submit this form to claim payment for materials, merchandise or services.  "]
["OLYMPIA, WA  98504-2525",null,null,null,null,null,null,null,null,null,"Show complete detail for each item."]
["VENDOR OR CLAIMANT (Warrant is to be payable to:)",null,null,null,null,null,null,null,null,null,"Vendor's Certificate:  The individual signing this voucher below warrants they have the authority to do so as authorized and on behalf of the entity identified in the Vendor/Claimant section.  The individual signing below certifies under penalty of 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 because of age, sex, marital status, race, creed, color, national origin, handicap, religion or Vietnam era or disabled veterans status.  "]
[]
[]
[]
[]
[]
[]
["Contact Person:",null,null,null,null,null,null,null,null,null,"By:"]
["Phone:",null,null,null,null,null,null,null,null,null,"(SIGN IN BLUE INK)"]
["Email:"]
["Project Name"]
["PERIOD BILLED FOR",null,null,null,null,null,null,null,null,null,"                               (TITLE)                                                                  (DATE)"]
["Operating and Maintenace",null,null,null,null,null,null,null,null,null,"AWARDED",null,"Previously Reported Expended",null,"Expended This Request",null,"Grant Balance"]
["Utilities"]
["Maintenance"]
["Project Administration"]
["Nonprofit Admin of Grant"]
["Operating Reserves "]
["Replacement Reserves"]
[null,null,null,null,"Totals:",null,null,null,null,null,{"$f":"SUM(K21:L24)","v":0},null,{"$f":"SUM(M21:N24)","v":0},null,{"$f":"SUM(O21:P24)","v":0},null,{"$f":"SUM(Q21:R24)","v":0}]
[]
[]
[]
["New Grant Balance for current Fiscal Year",null,null,0,null,null,null,null,null,null,"Reimbursement Request this Reporting Period",null,null,null,0]
[]
[]
["Match:   Year / Dollars / Coding",null,null,null,null,"PROGRAM APPROVAL (The individual signing this voucher warrants they have the authority to sign this voucher.)",null,null,null,null,null,null,null,null,null,null,"DATE "]
[]
["DOC DATE",null,null,null,"CURRENT DOC. NO.",null,null,"REFERENCE DOC NO.",null,null,null,"VENDOR NUMBER and SUFFIX"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
["ACCOUNT NO.",null,null,null,null,null,null,"ASD NUMBER",null,null,null,"VENDOR MESSAGE"]
[]
[null,null,null,"SUB OBJ",null,"SUB",null,null,null,null,null,"AMOUNT",null,null,null,"INVOICE"]
["TRANS","MASTER",null,null,null,"SUB","GL",null,"SUBSID"]
["CODE","INDEX",null,null,null,"OBJ","ACCT","ACCT",null,"ACCOUNT"]
[]
[]
[]
[]
[]
["SIGNATURE OF ACCOUNTING PREPARER FOR PAYMENT",null,null,null,null,null,null,null,null,null,"DATE",null,null,"WARRANT TOTAL"]
[]
["ACCOUNTING APPROVAL FOR PAYMENT",null,null,null,null,null,null,null,null,null,"DATE"]