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Home My WebLink AboutGrant Related - BOCC (002)GRANT COUNTY FIRE DIST. NO.3 1201 CENTRAL AVE. S. PHONE (509) 787-2713 Keven Gardner, Commissioner PO BOX 565 Alan Williamson, Commissioner Carl E. Yeates, Commissioner QUINCY, WA. 98848 Carmen Weber, Secretary w .acfd3met November 25, 2019 Grant County Board of Commissioners Attn: Jill Hammond PO Boa 37 Ephrata, WA 98823 Re: SIP 2019-01 Request #1— Grant Payment Trinidad/Crescent Bar Fire & Life Safety Facility" Grant County Fire District #3 requests payment on the SIP Project #2019-01. Grant County Fire District #3 has paid Knutson General Contracting LLC $103,327.61. The district is requesting payment of $62,500.00 from the grant portion of SIP Project #2019-01. Grant County Fire District #3 has paid Knutson General Contracting LLC $71,716.09. The district is requesting payment of $62,500.00 from the loan portion of SIP Project #2019-01. Thank you for consideration of the payment. If there is any additional information that is desired, please feel free to contact me. Respectfully submitted, Carmen Weber Executive Assistant Board of Commissioners Grant County Fire District #3 Dated this day of Board of Counly Commission Grant Cou:uy. lt'as ' on Aoprov -,,1@5=019 AbItah Dist#I Dist4 Dist#1 Dist #2 Dist #2 Dist #2 Uist Disl #3 _ __ i)is! #i r-Cr..tt NOV 2 6 2019 St37 Conts/2019 �;R,\. r r• ��i`VT`(�� r90 cid pc' Reimbursement Request #1 Full Payment/Grant/Loan GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding, before reimbursement can be approved by Grant County. SIP Project Proposal Number: 2019-01 SIP Funding Recipient: Grant County Fire District No. 3 SIP Project Description: New Fire Station — Trinidad/Crescent Bar I, the undersigned, do hereby certify under penalty of perjury, that the materials have been furnished, the services rendered, and/or the labor performed as described in the project proposal for the above -referenced SIP Project and that I am authorized to authenticate and certify to this claim. I also certify that this claim is just and due, and is an unpaid obligation against Grant County. Further, according to the SIP Project Funding Policies, I attest that at the next audit of my entity, this project shall be called to the attention of the Washington State Auditor's Office and an emphasis audit will be requested to assure that these funds were expended toward the project and according to the intent of the proposal. 01� �;� Signature Don Fortier Printed Name Date Si ed Title District Fire Chief Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 ATTACHMENT 4 REORDER 9018 • U.S. PATENT N0. 5538290. 5575508, 3641183. 5785353, 5984364. 6030000 Vendor ID Name I Account jPaymentNumber ICheckDate Document Number KNGNC KNUTSON, MICHAEL 9401482395 11/14/2019 000000083486 Invoice Number Description Date Amount Amount Paid Net Paid Amoun FD3.2019.11.01 11/13/2019 $71,716.09 errant �.q.y F;re [)15trict #3 !Q1 r;Dtltr� AVS. South WA $71,716.09 $71,716.09 A COL RED BORDER AND BACKGROUND PLUS A KNIGHT & FINGERPRINT YifATERMARK ON THE BACK - BOLD AT kNOLE TO VIEW GRANT COUNTY, STATE OF WASHINGTON PAYABLE THROUGH U.S BANK 1-888-800-8626 TO THE TREASURER OF GRANT COUNTY 96-671 Warrant Number EPHRATA, WASHINGTON 1232 9401482395 Seventy One Thousand Seven Hundred Sixteen Dollars and 09 Cents KNUTSON, MICHAEL DBA: KNUTSON GENERAL CONTRA PO BOX 774 QUINCY, WA 98848 111940 L48 239 SO I: L 2 3 206 7 101: L S 3 GO 7 313 9 S 30,10 PAY THIS AMOUNT $71,716.09 CHECK DATE 11/14/2019 Irltiroiee; - 11/4/2019__--- Customer Don Fortier I Grant County Fire District #3 1201 Central Ave S Quincy WA 98848 509-787-2713 Steel building Erection- Equipment - For: Fire and Life Safety Building Trinidad $64.963.50 $5,000.00 Subtotal, $69.963.50 Tax Rate 7.90% Total CoSt $75.490.62 -rirran_n1, If you have any questions concerning this Proposal, use the following contact inform Mike Knutson, 509-398-7312 or email mikeknutson88@hotmail.com �fOV Thank you for your business! REORDER 9019 • J.S. ?A7ENT NO. 5538250, 5515508, 5641.133, 5785353, 5984364, 3030000 Vendor ID Name jAccount jPaymentNumber ICheekDate Document Number KNGNC KNUTSON, MICHAEL 9401481699 10/10/2019 000000082790 Invoice Number Description Date jAmount I Amount Paid I Net Paid Amoun PUJ. 19.1U.U1 10/09/2019 $103,327.61 $103,327.61 $103,327.61 , STATE OF WASHINGTON PAYABLE THROUGH GRANT COUNTYU.S BANK 1-888-800-8626 TO THE TREASURER OF GRANT COUNTY 96-671 Warrant Number EPHRATA, WASHINGTON One Hundred Three Thousand Three Hundred Twenty Seven Dollars and 61 Cents KNUTSON, MICHAEL DBA: KNUTSON GENERAL CONTRA PO BOX 774 QUINCY, WA 98848 1119401L,816990 i:123206710i:1S3607389S30n5 1232 9401481699 PAY THIS AMOUNT $103,327.61 CHECK DATE 10/10/2019 ,G 2 9390 ge Order #1 Customer: Don Fortier I Grant County Fire District #3 1201 Central Ave S Quincy WA 98848 509-787-2713 A? ' 10/7/2019 '77 _. b For: OCT 0 1 ` ' Fire and Life Safety Building Trinidad r M and S excavation- did water/power line as discussed with Don Fortier on location etc. I $2,338.00 I Due upon reciept Subtotal Tax Rate Tota I Cost Please make check payable to: Knutson General Contracting, If you have any questions concerning this Proposal, use the following contact information: Mike Knutson, 509-398-7312 or email mikeknutson88@hotmail.com Thank you for your business! Nx 2 61 "too )9::3j .j i,. Customer: Don Fortier I Grant County Fire District #3 1201 Central Ave S Quincy WA 98848 509-787-2713 10/7/2019 Si�tur For: Fire and Life Safety Building Trinidad M and S excavation $29,694.50 771, $8,447.00 slab rebar and material- $2,500.00 slab concrete OCT 0 -7 - I For: Fire and Life Safety Building Trinidad M and S excavation $29,694.50 slab prep labor $8,447.00 slab rebar and material- $2,500.00 slab concrete $ 7,123.00 slab pour and finish- $5,700.00 steel building erection - $45,000.00 Due upon reciept Subtotal Tax Rate Tota I Cost Please make check payable to: Knutson General Contracting, If you have any questions concerning this Proposal, use the following contact information: Mike Knutson, 509-398-7312 or email mikeknutson88@hotmail.com Thank you for your business! tic 2009-t t erenmuin connxt State of Washington Invoice Voucher 2. Agreement ID or Contrxt Number —=.0 070 I K3919 Vendors Ceddoale Ihereb f y ceni y —er penairy ory>•,aX1:+uat he n ms ora r olxr cMrge. f« matehals, mercnaneise «semioes mrnisnea tome dale of Washington. and tha; an goods furnished arWw seivic der dee without min uon bemuse of age. sex, mono) status. race. creed. col«, halon.) orgm. nandiwo. rNigion «viemam ora or di.abled �e;erah: ` d .AGIiS�I' S:\1V Health Care Authority PO Box 42691 Olympia, WA 98504-2691 OR Grant County .. 840 E Plub Street Moses Lake, WA 98837 _.. - �� n nk, Tom TaYlor, B�CC Chair - -----------------'_' (title) (date) TAS IDENTIFICATION NUMBER 91-6001319 iMONTHIYEAR OF SERVICE Aw-tS IRECEIVED BY IDATE RECEIVED BARS YRCGR/a. ACnVRT W1ME CSAv 5TRATEGv iont SABG GFS PFS NCE PFS 2019 DMA slNCE SOR SOR PP General Supp T-1EBP co _- 21 Com unity -Basad Ccorc,earor = Com unity -Based Procass sal-Indlreat 22.5 Community Coalmon C -- i Community -Based Process UniversakDiren 225 Community Coalmon Community -Based Process Universal -Direct 2251 Community Coalition Community -Based Process Universal -Direct 421693 4.21693 000 22 5.1 General Coalmon Supphes CommunM-based Process universabDirect 8627 86.27 222 1 PAX Good Behavior Gama -Program Supplies Education Universal-Daect 1,17753 1 177.53 222 1 PAX Good Behavior Game -Mileage Education UnwersakDu- 13920 139.20 000 000 0.00 000 000 000 000 coo 000 000 000 2251 Community Coalition Coordinator -Oumcy Community -Based Process - - �u-ea 2.897.51 4.79212 768963 2251 Community Coalition - Omncy- Supplies Community -Based Process ,a�'rcr '940 11940 __000 000 2211 Public Awareness Campaint-MaONana Vdpe W-sho, Information Dissemination _- __ - _- 30311 303 11 0 000 000 000 000 000 00 000 000 000 000 000 000 000 000 000 000 000 000 000 000 " = 000 3.129.31 1.17753 0.00 9420 000 5,631.80 0.00 1505682 PREPARED BY/DATE - Reyna G.—le, 1112012019 TELEPHONE 509 1154-2150A19 Effective 711/19 through 6/30/21 REVISED 7118119 CURR DOC NO DOC DATE VENDOR NO. AGENCY APPROVAL: Sarah Mariani 360-725-9401 Sarah. Mariani@hca.wa.gov ACCOUNTING APPROVAL FOR PAYMENT! DATE 2009-t t erenmuin connxt I I Fenn State of Washingt- ts-u Invoice Voucher liaakh Gre Authoril r -- _ PO Box 42697 Olympia,WA 985042691 - ---- �- � EPIbStreet - Moses Lake, WA 98837 - -- -' _ -- ---} - -} Agreement I or C-1- mo K3919 - Ventl Cerl fxale htteby certify uMer penally of pervfy tytthe er-,s �nE I�pIWAT'FTFerern a pry charges for materials merchand se or servKes turn shetl warn gt ntl met all goods f.-hoarM/orswiteI rerWl- n ' � viRh.. d sc n because of age 11.1status race, creetl color, n...(origin had e p ligwn, or Uetnam era or d�.sabletl veterans slaw Tom Taylor, BOCC Chair (wgninink) (tit's) - -_ --T .. --- to the State of TAX IDENTIFICATION NUMBERMONTHIYEAR 91-6001319 OF SERVICE Seo-t9 RECEIVED BY !DATE RECEIVED BARS ePOGRAM Acimiy tu.ME - cs ioM SABG GFS PFS NCE PFS i01a EBP DMA STR NCE PP General .BOR BOR Supp Total 11.1 Admar '61 58 0 DO 339 48 48620 1 5-2 49 21 Community-Based Coordination-P, Com unity-Based Process Umveisal-Indueci 22.5 Community Coasbon Coordinator Community-Based Process UniversaFDaect 225 Community CosiMon Community-Based Process sal-Detect 2251 Community Coalition Coordinator-ML Community-Based Process Universal-Drect 3,98E 5,255.90 22 51 Community Coaliton-ML Community-Based Process Universal-Direct 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2251 Communay Coabton Coordinator- Ouincy Community-Based Process Jmversal-Direct 1,743.45 - 5,167 43 225.1Community-Based Process Universal-Deect 2.50000 18-'.91 41373-81 0.00 000 0.00 0.00 2231 Healthy Alternahve Activities-Sm On Teen C-Quincy AXernewes Universal-Direct 68.25 68.25 0.00 0.00 2271 Celebratnnof Cuarres2019-Digft Graphics-Quincy Other J-ersal-Direct 71160 71180 0.00 0.00 0.00 0.00 0.00 0-00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3,980 59 581.58 0 DO 4 582 93 1.315-3t 0.00 105.22 0 00 6,563.84 0.00 77,129.47 PREPARED BYl DATE Reyna Gonreres 11/26/2019 ---- TELEPHONE --- -- -- - --- 509 781.2880 A19 Effective 711119 through 6130121 REVISED 7118/19 CURR DOC NO DOC DATE VENDOR NO, AGENCY APPROVAL: Sarah Mariani 360-725-9401 Sarah.Mariani@hca.wa.gov ACCOUNTING APPROVAL FOR PAYMENT/ DATE Peat