The URL can be used to link to this page

Home My WebLink AboutGrant Related - BOCC (003)GRANT COUNTY BOARD OF COUNTY COMMISSIONERS 1' I l �_I_I_.�J JUN 2 0 2023 CONSE To: Board of County Commissioners From: Janice Flynn, Administrative Services Coordinator Dabx June 8, 2023 Re: Authorization for Release of BOCC Approved Funds, Request #12, SIP #2021-01- GC Hospital #4 — McKay Healthcare, Phase I Capital Improvement Plan McKay Healthcare has certified the requirements for release of funds in the above - referenced SIP project, which was approved by the BOCC pursuant to Resolution No. 21 -013 -CC dated February 16, 2021. The proof of requirements is in the form of a signed Project Certification form from the Hospital and supporting invoicing of the project that meets the requested amount. To that end, I am requesting the release of funds on this SIP project as follows: (1) 12th installment of the grant award in the amount of One Hundred Forty Three Thousand, Four Hundred Twenty Eight and 34/100 Dollars ($143,428.34) to McKay Healthcare. Note: The full grant amount is $350,000. This leaves a balance of $170,616.87. Thank you. RECEIVED G 0, L I N T Y 0% e Cg's R"I 1" 0 N E R S GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM P'ROJECT 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. SIP Funding Recipient SIP Project Description IP 2i -o1. McKay Hospital & Rehab Phase 1 Capital Improvement Plan 1, the -undersigned, do hereby certify under penalty of perjury, that the materials have been famished, 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 of $143,428.34 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 I entity, this project shall be called to the attention of the Washington State Auditor's Office and gn emphasis audit will be requested to assure that these funds were expended 41 toward the project and according to the intent of the -proposal, Signature Randi Saeter Printed Name C) Date Signed Administrator Title Administrator Printed Title C I? ompleted, signed ori gm*al certification and invoice arto be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 12 in the amount of $141,428,34 ATTACHMENT 4 Pennell CortsuLtinglyw. Elechlcal and Electronics ..AF: System Design 400 South Jefferson,, Suite 301 Spokane, WA 99204 aeceiveo Invoice 11/30/2022 3179 SWR=4 600� I =I 10.1 LEW. LFO D 501 pC|. 12807/2022 T-nvoice Number- Invoice Date Description Gross Amount Discount Taken Net Amount Paid 3179 111/30/2022 fAdmin - PS - Other � $1,135,721 $O,OQL__ $1 135.7 21 Ref Klo-. G70-18022 Electrical and Electronics System DesIgn rant Count t H : = J -lame::- ..-.Mc a F egithcare G'nerator .ROplaoe ent .. Billing Cutoff: 15th Rab Job:NUmber: .2021113 Revised Description of Work : Aecum Priot Mos Current Mohth Total Billed F7_ Prev'lous Total % Balance to Item # Description Of Work Budget % Previous Billed Current % Current to Bili Billed Total Bitted complete 1 Design Development $ 51503.89 1.00% 51503,89 100% $ - 100% $51503.89 $ 2 65% Construction Documents 81255.83 100% 81255.83 100% $ - 100% $8,255.+83 $ - 3 100% Construction Documents $ 91478.93 100% 9,478-93 100% $ - 100% $9,478.93 $ - 4 Bid Phase $ 611.54 100% 61.1..54 1001 $ - 100% $611.54 $ - 5 Construction Administration $ 61115.43 25% 1.,500.00 25% $ - 25% $1,500.00 $ 4,615.43 6 Project Close Out $ 611.54 0.00 � - Ole 54 _ :-:....: •.....::..... ' ., ;i:i.. :.•::. Vii: ..:. .. .. ... ... •_ ....... .. s ....... ...... a .. •... •.... .... .. ., - .. •_...... .,. 'it :til . : ,. !. a .e .. .: >• .... s. x. ...x . , ....x . s .r :. ... ......x... .. ......: ...-t ;ice°•:i. .a..-:..... .._......::. ....:..lx-.....,< 1.......:.__......Y.s..•./..,..........„.....5...: <.. <. ._>.... •....>. .. [.. ._:,.. .f. >_i. ia. ..i_:_.::.•.,w:w.,••f-••...•.:::>•.1rov-..a,.>II. ....•...<..<•.. w.r«.Y......,•.... ... I.•... •.. •. ..... Reimbursabtes Design Trip #1 (4/28121) $ 653-62 100% 053.62 100% $ - 100% $653.62 $ - - Design Trip #2 (6/14121) $ 653.62 100% 653.62 100% $ - 100% $653.62 $ Design Trip #3 (10112121) $ 653.62 100% 653,62 1600 $ � 100�1e $653.62 $ - Design Trip #4 (1119122) $ 653-62 100% 653.62 1004/ $ - 100% $653.62 $ - Pre -Bid Walk Through ##1 � ' �1 t Z. $ 893.62 1001 893.62 100% $ - 100% $893.62 $ .. CA Trip #1 ` 893.62 0.00 -}4a $E.OE $ 893.62 --- ------- ---- ------- - UtilityCoordination $ 1,101,.12 0.00 $ � 0%$0.00 $ 1,10112 L&I Permit Pees $ 920.00 100% 920.00 100% $ - 100% $920.00 $ - Total Reirnbursables $ 6,422.84 $ 4,428.10 $ - $ 4,428.10 $ 1,994.74 CONTRACT TOTAL $ 37 000.00 . $ 29,778.29 $ - $ 291778.29 $ 7,221,71 Change Orders: - Dept. of Health Fees DCC}##'( pt $ 6,17'6.50 10014 6,176.50 100% $ - 100% $6,176.50 $ .. DCO#2 - Second Pre -Bid Walkthru $ 1,135.7'2 0.00 � 100% $ 1,1 72 100% $O.QO $ - PCC JeGt Totals ' .... . . .. . ....... $ 44:312.22 $ 35,954.79 $ 17135.72 $ 35,954.79 $ 7,221.7'1 A Use Only: invoice # : • 31.79 Date: 11/30/2022 1 /E: a -.. I ar Please remit payment to: Colvico, Inc. PO Box 2682 Spokane, WA 99220 (509) 536-1875 BILL TO: Public Hospital Dist, 4 of Grant Co. PO Box 819 Soap Lake, WA 98851 MA INVOICE #: 163995 INVOICE DATE: 5110/2023 PERIOD TO: 413012023 APPLICATION #-., 1 RECEIVED MAY012023 PO#: DUE DATE: 61912023 JOB: 10206 McKay Health Care Generator Replacement Contract 2022-2 Totals $767,734.00 $0.00 $130,805.00 $0.00 $130,805.00 PREVIOUS RETAINAGE CURRENT BILLING $1300805.00 NEW RETAINAGE 0-1 rjYW1114 ven wr P: L-.). t a, --) Bars Code Warne Arnount Toital: Dept. Head Approval: ORIGINAL CONTRACT SUM $ CHANGE BY CHANGE ORDER CONTRACT SUM TO DATE TOTAL COMPLETED AND STORED $ TOTAL RETAINAGE TOTAL EARNED LESS RETAINAGE $ LESS PREV CERTIMCATES FOR PAY $ 8.41)% SALES TAX: $ CURRENT PAYMENT DUE $ $636,929.00 $0.00 767,734.00 767,734.00 130,805.00 $0.00 130t805,00 1304805.00 10,987,62 10p987.62 SCHEDULED PREVIOUS CURRENT STORED TOTAL % ITEM DESCRIPTION VALUE APPLICATION COMPLETED MATERIALS COMPLETED COMPLETE BALANCE RETAINAGE i Submittals $2,000.00 $0.00 $2,000.00 $0.00 $2,400,00 100% $0.00 $0.00 2 Roads $6,300.00 $0-00 $6;300,00 $0.00 $6,300.00, 1001 $0.00 $0.00 3 Perrnb & Fees $5,600.00 $0.00 $5,600.00 $0.00 $5.600,00 100% $0.00 $0.00 4 Mobilization $18,300.00 $0.00 $18,300.00 $0,00 $18,300.00 100% $0.00 $0.00 5 Cartage, Rentals, Shack $11,200.00 $0.00 $11,200.00 $0.00 $11,200.00 100% $0.00 $O.OD 6 Supervision $7,000.00 $0.00 $700.00 $0.00 $700.00 10% $6,300.00 $0,00 7 Electdcal Warranty $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 $0,01) 8 Demolition $36,000.00 $0.00 $31300.00 $0.00 $3,300.00 9% $32,700.00 $0.00 9 Conduit $73,300.00 $0.00 $3,690.00 $0.00 $31690.00 5% $69,610.00 $0,00 10 Manholes & Ductbanks $25,000,00 $0.00 $25,000,00 $0.00 $25,000,00 100% $0.00 $0.00 11 Bldg. Wiry & Cable $139,890.00 $D.00 $0.00 $0.00 $0.00 0% $139'850'00 $0.00 12 Boxes $8,450.00 $0.00 $0.00 $0.00 $0,00 0% $B1450.00 $0,00 13 Wiring Devises $3,200.00 $0.00 $0.00 $0.00 $0.00 0% $3,200.00 $0.00 14 Cabinets & Enclosures $8,000.00 $0,00 $0,00 $0,00 $0.00 0% $8,000.00 $0.00 Is Grounding & Bonding $5,430.00 $0.00 $0.00 $0.00 $0.00 0% $5,430.01) $0.00 16 Supporting Devices $14,180.00 $0.00 $0.00 $0.00 $0,00 0% $14,180,00 $0,00 17 Electrical Identification $5,200.00 $0,00 $0.00 $0,00 $0,00 0% $5,200.00 $0.00 18 $Wtchboards $61,500.0in $0.00 $0.00 $0.00 $0.00 0% $61,500.00 $0.00 19 Panelboards $86,700.00 $0.00 $0.00 $0.00 $0.00 0% $86,7610.00 $0.00 20 Circuit Breakers $11,700,00 $0.60 $0.00 $0.00 $0,00 0% $11,700.00 $0.00 21 Fuses & Fuse Accessories $1D,900.00 $0.00 $0.00 $0.00 $0.00 0% $10,900.00 $0.00 22 Enclosed Transfer Switch $14,950.00 $0.00 $0.00 $0.00 $0.00 0% $14,950.00 $0,00 23 Emergency Power Generation $49,040.00 $0.00 $47,155.00 $0.00 $47,155.00 96% $1,885.00 $0.00 24 Interior Lighting $1,560,00 $0.00 $1,560,00 $0.00 $1,660,00 100% $0.00 $0.00 25 Power Systems Study $6,000.00 $0.00 $5,000.00 $0.00 $5,000.00 100% $0.00 $0.00 ALT 1-1 Supervision $6,000.00 $0.00 $0.00 $0.00 $0.00 0% $6,000.00 $0.00 ALT 1-2 Electrical Warranty $734.00 $0.00 $0.00 $0.00 $0.00 0% $734.00 $0.00 ALT 1-3 Demolition $21,400.00 $0.00 $0.00 $0.00 $0.00 0% $21,400.00 $10.00 ALT 1-4 Conduit $24,900.00 $0,00 $0,00 $0.00 $0.00 04% $24,900.00 $0.00 ALT 1-5 Bldg. Wire & Cable $84,300.00 $0.00 $0,00 $0.00 $0.00 0% $84,300-00 $0,00 ALT 1-6 Circuit Breakers $12,000.00 $0.00 $0.00 $0,00 $0,00 0% $12,000.00 $0.00 ALT 1-7 Power Systems Study $1,000.00 $0.00 $1,000,00 $0.00 $1,000.00 100% $0.00 $0.00 Totals $767,734.00 $0.00 $130,805.00 $0.00 $130,805.00 PREVIOUS RETAINAGE CURRENT BILLING $1300805.00 NEW RETAINAGE 0-1 rjYW1114 ven wr P: L-.). t a, --) Bars Code Warne Arnount Toital: Dept. Head Approval: ORIGINAL CONTRACT SUM $ CHANGE BY CHANGE ORDER CONTRACT SUM TO DATE TOTAL COMPLETED AND STORED $ TOTAL RETAINAGE TOTAL EARNED LESS RETAINAGE $ LESS PREV CERTIMCATES FOR PAY $ 8.41)% SALES TAX: $ CURRENT PAYMENT DUE $ $636,929.00 $0.00 767,734.00 767,734.00 130,805.00 $0.00 130t805,00 1304805.00 10,987,62 10p987.62 MCKAY,HEALTHCARE 563 Golvic'o Inc 05/18/2023 92888 Invoice Number Invoice Date --t�6scrlp tion Gross Amount Discount Taken Net Amount -Paid7 163995 05/10/2023 Maint - PS $10,987.62 $0.00 $101987.62 $103987.62 $0.00ffF - $10,987.62 McKAYHEALTHCARE bank,. 96-671 415 127 SECOND AVE SW - PO BOX 819 1232 SOAP LAKE, WA 98851 (509) 246-1111 6041t.092888 92888 05/18/2023 $10,987.62 Ten Thousand Nine Hundred Eighty Seven Dollars and 62 Cents PAY TOTHE Colvico Inc ORDEROF PO Box 2682 Spokane, WA 99220 L j BY AUTHORIZED SIGNATURE NP Wk 1116014 09 28138118 1:1232067LOi: LS3607`3139530u, Pgn=lf congutting Znc. Ele9—..tr1cq1 and Elechlonics System Design 400 South Jefferson, Suite 301 Spokane, WA 99204 Public Hospital District #4 of Grant County WA PO Box 819 Soap Lake, WA 98851 Attn: Erica Gaertner Invoice 3/23/2023 3225 ClIent Account job Number Project 2-021.13 McKay Healthcare Generator Rpicmt DescOption Quantity Rate Amount C . onstruction Administration @ 32% 500.00 Vendor #:25-� Bars Code Namd Amount Total. Dept. Head Approval: . ...... ... Please contact Cindy Merrick with questions at (509) 747-1888,, or Total $500.00 cindV.merrick@penneliconsulting.,cc)m MCKAY HEALTHCARE 501 PCI 05104/2023 92855 InvoicNumber Invoice Date Description Gross Amount Discount Taken Net Amount Paid -- - I e 3225 03/23/2023 Admin - PS - Other SIP Grant $500.00 $0.00 $500.00 $500.001 $0. $500.000 McKAY-II[EALTHCARE bank.. 96-671 415 127 SECOND AVE SW - PO BOX 819 1232 SOAP LAKE, WA 98851 (509) 2-46-1111 60411.092855 i 92865 05/04/2023 $500.00 Five Hundred Dollars and 00 Cents PAY TO ^ME PCI ORDER OF 400 S Jefferson, Ste 301 Spokane, WA 99204 IL. 111160109285SWI ".'h2320&?L01: IS360738953011" Job eatcae.Genatr6place.mentGrant-County Vi billing Cutoff:. I 5th --Rob Job Number: 2021.13 Revised Description of Work Accum Prior Mas Current Motith Total Blued Flikerrs Previous, Total % Balance tv # tion of -Work $ +udget :. previous Billed Current' Current to Bill Billed �'otat Btiie+� � Complete. rnescri 1 Design Development $ .._ _.. 5,.503.89 1001 5f503.89 100% $ - 100% $5,503.89 $ .. 2:65% Construction Documents 8125.5.83 100% 8125.5.83 100% $ - 100% $8,255,$3 $ - 3 100% Construction Documents 9..47$.93 100% 91478.93 100% 100% $9,478.93 4 Bid Phase $ 611.54 100% 611..54 100% $ 10G% $611..54 $ - 5 GonstrurAion Administration $ 6,115.43 25% 1,,500.00 33% < 500.00 33% $2x000.00 $ 4011.5.43 0 Project Cruse Out 611.54 0.00 - 0°f° $0.(l0 611.54 - X. a . F. . <i. L .. ... J. •t!•f •. -•s :. .. .. <. a. /Eye � - .. .... ... - iic2yy'' .... > -.. .. - •_ • �`-:::.• •''•..:•`::':•. '. 1 47 S > . ..x •. .•�tvs> iw=y :.:....•.:-:icz>,... .,_.ev <,_ •bL>.••,. _ 3e>:•, •,.-x . ._m>.-, :wnk>.. e»iwsne. ,.:.T -->.:-4..• - - Reim 'iursaables design Trip #1 (4128/21) $ 663.62 100% 653.62 100% $ 100% $653.62 $ - L1esign Trip #2 (6114/2'1) $ 653.62 100% 663.62 100% $ 100% $663.62 $ Design Trip #3 (10112121) $ 653.62 100% 653.62 100% $ - 100% $553.62 $ - Design Trap #4 (1/19122) $ 663.62 100% 653.62 100% $ - 100% $653.62 $ - Pre -Sid Walk Through #1 $ 893 62 100°/0 893.62 100% $ - 100% $893.62 $ CA Trip #1 $ 893.62 0.00 $ - 0%$£�.QO 893.62 Utility Coordination$ 1,101,'/ 2 Q.00 - 0Q4 $0.x}0 1.101.12 L&I Permit Fees $ 920.00 100% 920.00 10001 $ - 100%.- $920.00 $ - Total Relrnhursables $ 5.422.84 $ 4t428-10 $ - $ 41426.'10 $ 194.74 _ CONT�4OT TOTAL, _ M ► • �7 .2�7 .$ 50\:/;00. - _ $ • 30,2Js 6;: ? $ - 6,721.7'1 Change Orders: DC0#1 - Dept. of Health Fees $ 6F176-50 100% 61176.50 100% $ 160%10 $6�'I76.50 $ - DG0#2 - Second Pre -Bid Ufa lkthru $ 1,'135.72 100% 11135.72 100% $ - ` 100% $1,135.72 $ - rosct 'otals .. _ $ " 44, 12.22 $ 371!.90.9 .. 2 600:00 _ $ 37}690.5'! $ 6�72�I.7'1 R Use. OrirYf Invoice # 3225 M i . ,3f 23/2023 M/E: E AIA Type Document CONTRACT FOR: ,McKay Healthcare & Rehabiliation VIAARCHITECT: y The Undersigned Contractor certifies that to the best of the Contractor's knowledge, information and CONTRACTORS APPLICATION FOR PAYMENT belief the work covered by this application for Payment has been completed in accordance with the Application is made for payment, as shown below, in connection with the Contract. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous AIA Document G703, Continuation Sheet, is attached. Certificates for Payment were issued and payments received from the owner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM ............. . ...... Application and Certification for Payment 767,734.00 Page 1 of 3 TO (OWNER): Public Hosp Dist 4 Grant Cty PROJECT: McKay Healthcare {& Rehab Gener APPLICATION NO: 'I DISTRIBUTION 127 2nd Ave SUS 127 2nd Ave SW � �� 1,St� .�.- TO: Soap Latta, WA 98851 Soap Lake, WA 98851 — OWNER 8.00 b_ 0-00 % of Stored Material $ CONSTRUCTION Total retainage (Line 5a + 5b) . ..... . ............. Tt :3i3112t 23 ^ MANAGER FROM Colvico, Inc. $ CONTRACT DATE_ 412012022 —ARCHITECT CONTRACTOR: PO Box 2682 PROJECT NOS: —CONTRACTOR Spokane, WA 99220 (Line 6 from prior Certificate) ..... _ ... _ .. _ ........ $ — FIELD 8. CURRENT PAYMENT DDE .... - • ............... VIA CONSTRUCTION 130,805.90 —OTHER MANAGER., (Line 3 minus Line 6) $ 6364929.00 CONTRACT FOR: ,McKay Healthcare & Rehabiliation VIAARCHITECT: y The Undersigned Contractor certifies that to the best of the Contractor's knowledge, information and CONTRACTORS APPLICATION FOR PAYMENT belief the work covered by this application for Payment has been completed in accordance with the Application is made for payment, as shown below, in connection with the Contract. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous AIA Document G703, Continuation Sheet, is attached. Certificates for Payment were issued and payments received from the owner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM ............. . ...... $ 767,734.00 2. NET CHANGES IN THE WORK ........... $ 0.00 3. CONTRACT SUM TO DATE (Line 1 + 2):.......... $ 767,734.€ 0 4. TOTAL COMPLETED AND STORED TO DATE ...... $ 1381805.00 5. RETAINAGE: 0.60 a. 0.00 % of Completed Work $ 8.00 b_ 0-00 % of Stored Material $ 0.00 Total retainage (Line 5a + 5b) . ..... . ............. $ 0.00 S. TOTAL_ EARNED LESS RETAINAGE ... . .... . ..... $ 130,885.00 (Line 4 minus Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) ..... _ ... _ .. _ ........ $ 0.00 8. CURRENT PAYMENT DDE .... - • ............... $ 130,805.90 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 minus Line 6) $ 6364929.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0.00 0.00 Total approved this month, including Construction Change Directives 0_t}0 0.00 TOTALS 0.00 0.00 NET CHANGES IN THE WORK 0.60 CONTRACTOR: Cvlvico, Inc. PO Box 2882 Spokane, VITA 99220 By: Date-, State of: County of: Subscribed and Sworn to before me this Notary Public_ My Commission: Expires: CERTIFICATE FOR PAYMENT Day of 20 In accordance with the Contract Documents, based on evaluations of the Work and the data comprising this application, the Construction Manager and Architect certify to the Owner that to the hest of their knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED ............................... $ (Attach explanation if amount certified differs from the amount applied initial all figures on this Application and on the Continuation Sheet that ,are changed to conform to the amount certified.) CONSTRUCTION MANAGER: By: Date= (l� O TE: If Multiple Prime Contractors are responsible for performing portions of the ARCHITECT`. Project, the Architect's Certification is not required.) By: date : This Certificate is not negotlable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, Payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA T lie Document Application and Certification for Payment Page 2 of 3 TO (OWNER): Public Hosp list 4 Grant Cty PROJECT: McKay Healthcare & Rehab Gener APPLICATION NO; 1 DISTRIBUTION 127 2nd Ave SVV 127 2nd Ave SW TO: Soap Lake, WA 98851 Soap Lake, WA 98851 PERIt�D TC?. 3131 �2CI23 _ OWNER -ARCHITECT -CONTRACTOR FROM (CONTRACTOR): Colvico, Inc. VIA (ARCHITECT): ARCHITECT'S PO Box 2682 PROJECT NO: Spokaner WA 99220 CONTRACT FOR: McKay Healthcare & Rehabiliation CONTRACT DATE; 412012022 SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 1 Submittals 2,000.00 0.00 21000.00 0.00 21000.00 100.00 0.00 0.00 2 Bonds 6,300.00 0.00 6,300.00 0.00 51300.00 100.00 0.00 0.00 3 Permits & Fees 57600-00 0.00 51600.00 0.00 5,600-00 100.00 0.00 0.00 4 Mobilization 181300.00 0.00 181300.00 0.00 18,300,00 100.00 0.00 0.00 5 Cartage, Dentals, Shack 11,200.00 0.00 11,.200.00 0.00 11,200.00 100.00 0.00 0.00 6 Supervision 71000.00 0.00 700.00 0.00 700.00 10.00 61300.00 0.00 7 Electrical Warranty 7,000.00 0.00 0.00 0.00 0.00 0.04 71000.00 0-00 8 Demolition 36,000-00 0.00 31300.00 0.00 8,300.00 9.17 321700.00 0.00 9 Conduit 731300.00 0.00 31600.00 0.00 33690.00 5.03 60,610.00 0.00 10 Manholes & Ducthanks 25,000.00 0.00 25,000.00 0.00 25,000.00 100.00 0.00 0.00 11 Bldg. Wire & Cable 139,890.00 0.00 0.00 0.00 0.00 0.00 139,890.00 0.00 12 Boxes 87450.00 0.00 0.00 0.00 0.00 0.00 8,450.00 0.00 13 Wiring Devices 3,200.00 0.00 0.00 0.00 0.00 0.00 3,200.00 0.00 14 Cabinets & Enclosures 8,000.00 0.00 0.00 0.00 0.00 0.00 8T000.00 0.00 15 Grounding & Bonding 5,430.00 0.00 0.00 0.00 0-00 0.00 51430.00 0-00 16 Supporting Devices 14,180.00 0.00 0.00 0.00 0.00 0.00 14,180.€ 0 0.00 17 Electrical Identification 5,200.00 0.00 0.00 0.00 0.00 0.00 51200.00 0.00 18 Switchboards 61,500,00 0.00 0.00 0.00 0.00 0.00 61,500.00 0.00 19 Panelboards 86,700.00 0.00 0.00 0.30 0.00 0.00 86,700.00 0.00 20 Circuit Breakers 11 P700-00 00-00 0.00 0.00 0.00 0.00 0.00 11 r700.00 0.00 21 Fuses & Fuse Accessories 10,900.00 0.00 0.00 0.00 0.04 0.00 101900.00 0.00 AIA Type Document Application and Certification for Payment Page 3 of 3 TO (OWNER): Public Hasp Dist 4 Grant Cty PROJECT: McKay Healthcare & Rehab Gener APPLICATION NO; 1 DISTRIBUTION 127 2nd Ave SW 127 2nd Ave SW TO, - Soap Lake, WA 98851 Soap Lake, WA 98851 PERIOD TO: 313112023 - OWNER ARCHITECT - CONTRACTOR FROM (CONTRACTOR): Colvico, Inc_ VIAARCHITECT: ARCHITECT'S PO Box 2682 PROJECT NO: Spokane, WA 99220 CONTRACT FOR: McKay Healthcare & Rehabiliaticn CONTRACT DATE: 412012022 SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED o BALANCE RETAINAGE 22 Enclosed Transfer Switch 14,950.00 0.00 0.00 0.00 0.00 0.00 14,950.00 0.00 23 Emergency Dower Generation 49,040.00 0.00 47,155.00 0.00 47,155.00 96.16 1,885.00 0.00 24 Interior Lighting 1,500.00 0.00 1,560.00 0.00 1,560.00 100.00 0.00 0.00 25 Power Systems Study 5,000.00 0.00 51000.00 0.00 5,000.00 100.00 0.00 0.00 ALT 1-1 Supervision 61000-00 0.00 0.00 0.00 0.00 0.00 63000.00 0.00 ALT 1-2 Electrical Warranty 734.00 0.00 0.00 0.00 0.00 0.00 734.00 0.00 ALT 1..3 Demolition 21,400.00 0.00 0.00 0.00 0.00 0.00 211400.00 0.00 ALT 1-4 Conduit 24,900.00 0.00 0.00 0.00 0.00 0.00 247900.00 0.00 ALT 1-5 Bldg. Wire & Cable 84,300.00 0.00 0.00 0.00 0.00 0.00 84,300.00 0.00 ALT 1-6 Circuit Breakers 12, 000.00 0.00 0.00 0.00 0.00 0.00 12, 000.00 0.00 ALT 1-7 Dower Systems Study 1"000.00 0.00 1,000.00 0.00 17000.00 100.00 0.00 0.00 RI PORT TOTALS $767,734.00 0.00 '130x805.00 $0.x}0 $00�130,805.00 17.04 $636,929.00 $0.00 Ven dcar Bars -Code ame Amount 13 JL T - Total: Dept. Hasa Approval_ MCKAY HEALTHCARE 563Colvic*o Inc 05/0412023 92840 Invoice Number Invoice Date Description Gross Amount Discount Taken Net Amount Paid APP NO 1 .04/2012023 Maint - PS - SIP Grant $130,805,00 $0.001 $130,805-001 $130,805.,001 $0.00 1_ $1306805.001 bank. McKAY HEALTHCARE 96-671 415 127 SECOND AVE SW - PO BOX 819 1232 SOAP LAKE, WA 98851 6041092840 (509) 246-1111 92840 05/04/2023 $130 805.00, One HundredThirty Thousand Eight HundredFive Dollars and 00 Cents u PAY TO ME Colvico IncBY V �, ' , � ORDER Of: PO Box 2682 Spokane, WA 99220 k. IWP dl1THC RG -0150 SIGNATURE 111604 109 2attO in 41232 67 101"m IS 360 73139530115