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Home My WebLink AboutGrant Related - BOCC (004)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: BOCC REQUEST SUBMITTED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: DYES ®NO DATE: 12/13/2023 PHONE:eXt. 2937 MR WA A A, ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ❑ABPA Related [-]Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget ❑ Computer Related ❑ County Code ❑ Emergency Purchase ❑ Employee Rel. ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders ® Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑Minutes ❑Ordinances ❑Out of State Travel ❑Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑Recommendation ❑Professional Sery/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB tAXew- . ... i... _... ....: 1. ::%... _;� ..... i. _. _. r, .. i Reimbursement Request from Grant County Hospital #4 McKay Healthcare in the amount of $329,696.71 for expenses incurred regarding SIP Project #2022-02, Phase 1 Capital Improvement Plan Generator Expansion. DATE OF ACTION:Ia� r�JJ 5 APPROVE: DENIED ABSTAIN D1: D3: DEFERRED OR CONTINUED TO: G-4"RANT COUNTY BOARD OF COUNTY COMMISSIONERS LlJ1=i1_I_.�J To: Board of County Commissioners From: Karrie Stockton, Grants Administrative Specialist Date: December 13, 2023 Re: Authorization for Release of BOCC Approved Funds, Request #2, SIP #2022-02- GC Hospital #4 — McKay Healthcare, Phase I Capital Improvement Plan — Emergency Generator Expansion 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. 22 -077 -CC dated August 2, 2022. 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) 2nd installment of the grant award in the amount of $329,696.71 to McKay Healthcare. Note: The full grant amount is $500,000, which leaves a balance of $81,040.62. Thank you. 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: SIP2022-02 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Phase I Capital Improvement Plan — Emergency Generator Expansion 1, 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 of $185,827.95 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. V 111.11'r".. Signa e Victor Odiakosa Printed Name 2. Date Signed 0 Admimstrator/Superintendent Title Administrator/ S 14 ntendent Printed Title 40 Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 e amount of $185,827.9.5 ATTACHMENT4 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 AJA INVOICE 164005 INVOICE DATE., 6/8/2023 PERIOD TO: 5/31/2023 APPLICATION #: 2 Pot DUE DATE: 71712023 JOB: 10206 McKay Health Care Generator Replacement Contract 2022-2 CURRENT PAYMENT DUE $ 185,e27.96 SCHEDULED PREVIOUS CURRENT STORED TOTAL % ITEM DESCRIPTION VALUE APPLICATION COMPLETED MATERIALS COMPLETED COMPLETE BALANCE RETAINAGE i Submittals $2,000.00 $2,000.00 $0.00 $0.00 $2,000.00 100% $0.00 $0.00 2 Bonds $6.300.00 $6,300,00 $0.00 $0,00 $6,300.00 100% $0.00 $0.00 3 Permits & Fees $5,600.00 $5.600.00 $0.00 $0.00 $5,600.00 100% $0.00 $0.00 4 Mobilization $18,300.00 $18,300.00 $0.00 $0.00 $18,300.0D 100% $0.00 $0.00 5 Cartage, Rentals, Shack $11,200.00 $11.200,00 $0.00 $0.00 $11,200.00 100% $0,00 $0.00 6 Supervision $7,000,00 $700.00 $1.,750.00 $0,00 $2,450.00 35% $41550.00 $0.00 7 Electdcal Warranty $7.000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 $0.00 8 Demolition $36,000.00 $34300.00 $3,600.00 $0.00 $6,900.00 119% $29,100.00 $0.00 9 Conduit $73,300.00 $3,690.00 $40,140,00 $0,00 $43,830,00 60% $29,470.00 $0.00 10 Manholes & Ductbanks $25,000.00 $25,000.00 $O.OD $0.00 $25,000.00 100% $0,00 $0.00 11 Bldg. Wire & Cable $139,890.00 $0.00 $0.00 $0.00 $0.00 0% $139,890.00 $0.00 12 Boxes $8,450,00 $0.00 $1,300.00 $0.00 $14300.00 15% $7,150.00 $0.00 .3 Widng Devices $3,200.00 $0.00 $0.00 $0.00 $0.00 0% $3,200.00 $0.00 (4 Cabinets & Enclosures $8,000,00 $0.00 $0.00 $0.00 $0.00 0% $81000.00 $0.00 15 Grounding & Bonding $5,430.00 WOO $ij629.010 $0.00 $1,629X0 30% $3.801.00 $0.00 16 Supporting Devices $14,160-00 $0,00 $8,154.00 $0.00 $81164.00 58% $6,026.00 $0.00 17 Electrical Identification $5.200,00 $0.00 $0,00 $0.00 $0,00 0% $5,200.00 $0.00 18 SvAtchboaTds $61,500.00 $0.00 $0.00 $0.00 $0.00 0% $61,600.00 $0.00 19 Panelboards $86,700,00 $0.00 $80.850.00 $0.00 $80,850.00 93% $5,860.00 $0.00 20 Circuit Breakers $11,700,00 $0.00 $0X0 $0.00 $0.00 014 $11,700,00 $0.00 21 Fuses & Fuse Accessories $10,900,00 $0.00 $5,200.00 $0.00 $5,200.00 48% $5,700.00 $0,00 22 Enclosed Transfer Switch $14,950.00 $0.00 $10,855.00 $0,00 $101855.00 73% $4,095,01) $0.00 23 Emergency Power Generation $49,040.00 $47,155.00 $0.00 $0.Q0 $47,155.00 96% $1,885,01) $0.00 24 Interior Lighting $1,560.00 $1,560.00 $0,00 $0.00 $1.560,00 100% $0.00 $0.00 25 Power Systems Study $5,000.00 $5,00.00 $0.00 $0.00 $51000.00 100% $0.00 $0.00 ALT 1A Supervision $6,000.00 $0.00 $1,200.00 $0,00 $1,200.00 20% $4,800.00 $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 $2,140.00 $0.00 $2,140.00 10% $19.260.00 $0.00 ALT 1-4 Conduit $24,900.00 $0.00 $14,610.00 $0.00 $14.610.00 59% $10,290.00 $0.00 ALT 1-5 Bldg. Wire & Cable $134.30100 $0.00 $0,00 $0.00 $0,00 0% $84,300,00 $0.00 ALT I-0 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 $1,000.00 $0.00 $0.00 $1,000.00 100% $0.00 $0.00 Totals $767,734.00 $130,805.00 $1711428.00 $4.4D $302,233.00 $465,501.00 $0.00 PREVIOUS RETAINAGE ORIGINAL CONTRACT SUM 1 767,734.00 CURRENT BILLING $171,428.00 CHANGE BY CHANGE ORDER NEW RETAINAGE CONTRACT SUM TO DATE $ 767,734.00 TOTAL COMPLETED AND STORED $ 302,233.00 TOTAL R ETA I NAGE $0.00 TOTAL EARNED LESS RETAINAGE $ 302,233.00 LESS PREV CERTIFICATES FOR PAY $ 130,805.00 8.40% SALES TAX, $ 14,399.95 CURRENT PAYMENT DUE $ 185,e27.96 Iv CKAY HEALTHCARE 563 Colvico Inc 11/16/2023 93374 — - -------- --- - Invoice Number Invoice Date Description Gross Amount Discodnt Taken Net Amount Paid 164001 05/20/2023 Maint - PS - SIP 2022-2 $185,827.95 $0.00 $185,827-95 $185,827.951 $0.001 $185,827.951 A 'McKAYHEALTHC RE 415 127 SECOND AVE SW PO -BO X. 819 1232 .6-0.41 .'93-374 .(509) 2.46.-!.1111 R 933.74 11/16/2023 $185,827.9%r-11 ,20 One Hundred Eighty Five Thousand Eight Hundred Twenty Seven Dollars and 95 Cents U 0 r PAY Colvico. Inc TO THr: �� ORDER OF PO Box 2682 BY Spokane, WA 99220 A AUTHORIZOD MN URE AP ife Pao 4 10 9 3 3 ? 1,111 1801 12 3 20 rn ? 101mm I S 3 60 ? 38 9 S 30110 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: SIP2022-02 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Phase 1 Capital Improvement Plan — Emergency Generator Expansion 1, the undersigned, do hereby certify under penalty of perjury, that the materials have been furnished, the services rendered, and/or the labor perfonned as desefibed 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 $143,,868.76 is just and due and is an unpaid obligation against Grant County, Further, according to the SIP Project Funding Policies, I attest that at the next audit of my entity, this project shall be called to the attention of the Washington State Auditor's Office and an emphasis audit will be requested to assure that these funds were expended toward the project and according to the intent of the proposal. Victor Odiakosa Printed Name Date Signed - Administrator/$Werintendent Title Administrator/Spperintendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 03 . i4 the amount of $1, 68.76 ATTACHMENT 4 AIA INVOICE #: 165241 Please remit payment to,. INVOICE DATE: 10/30/2023 co co coly1co, Inc. 'PO Box. 2682 PERIOD TO: 1.0/31/2023 Spokane, WA 99220 APPLICATION M 6 (509) 536.1875 Po#: DUE DATE. 11 /29/2023 .13ILL TO": JOB: .10206 PublliG, Hopbl Dist. 4 of Grant Co. McKay Health Care PQ Box 819 Gederator'Rep'laceme nt Soap Lake, VVA 0.8851 coritraO. 422-2 SCHEDULED PREvious CURRENT' STORED TQTAL. ITEM DESCRIPTION VALUE APPLICATION COMPLETED MATERIALS COMPLETED. COMPLETE, BALANCE RETAINAGE 7 I -Subm'fflats $2,000.00 $2.000-00 40.00 $0.66 $.2,000,00: .00 $01,00. 2 Bonds $5,300.00 $6,%0,00 $0.-00 $0 .00 $0,300.00 100% $0.00 3 Permits- & Fees $5,600xo $0.00 $9100 $5,600.00. 106010 $0.00 $0,00 4IRlloelii do $18,300.CIC $18,300.00 $0.00 $0 0 $18.,300.06 166% 10-00 $0.00 5 C4dage'Rpritals, Shack .$11,200000 411.200.00 $0.00 $00, $11;200:00 100% $o.aC $0.00 6 Supervision $74'000.00 $5,000.00 %00 $0.00 '$5,600,00. �$0 000.00 $0.00 $0.0 06/0 -.0- Electriwl Warranty '0 10.90 $ 000,00 36,000-00 $17,400.00, $000 $0.00 $17400.00 48% $18,6001,.0 0 $0,00 0 nduit- $ 73,300.00 $73j3'011}.00 $0,00 100% 40.00 $0.00 $ 10 Manholes & Du6tba'nks $25 000.00 $25. 000.00 $0.00 $0.00 $25,000.00 100% Bid-o'. Wlrowazgtil, 0, $13%890,00 $130,795.50 $0.06 $0.00 -'$130,796,60 $0100 19 $804-56,00 $080.00 $O.OD $0,00 $8,450.0.0 100% $0.00 W.00 13 NVIring De.vices $34200.00 $3,200.00 $01.010 $0.0.0 $3,200.00 1000/0 $040 CabineisA Enclosures $6,00D.00 $81000.00 $0.00 $8. 4 000�00: $0.00 100%, Grounding in, $0,00 unding & Bond' .$54,30,00 $4v447.00 $543.00 $0,00 $6,430.00 100%� .00 $0,00 1000/0. 16 Supporting Devices t14,180,00 �1411.80.00 $0-00 $14,180.00 17 Eldotri odl Iden0fication $5,200.01- $0.00 $01.00 $O,pq $6.601 0% �$0.00 1$ SvdIc . h6oards $61t-600,00 $0.00 $55 00,00 0100 90% $6,000.00 $0.06 19 P.:" $0 00 and dards $86,100.00 $061630�00 $0.00 $0-00 $451,5400 99111ra. $1070.00 Circuit llr6akefs , $11,700.00 $11,700.00 . . . $0,00 6 40.00 20Q $11,700X 10011/0 $0.00 21 FuOs & Fuse Accessories $1000.00 4917900 $101110-p0 $0.60 '001,900.00 10.0% 40.00 $0.00 22 Enclosed Ttansfer,Swlt6h 1$1419,50,00: S93,812.50 $1.137.50 40,00 $141950.00100% $0.00 ;0,0D 23 Emergenq Power GeneraUon $49*040.00 $48 286.00 $76400 $0.00 $49$040.G0 10()Oto $0.00 $Cf,gOi 24 16t $it,660.00 40,00 e or Lighting "p.w $1,586,00 106% 0*00 $0.00 25 PoWer Systems Study $5,000,00 450000100 $0.00" .00 $$,0,00,0,0 106% $0.00 $0,00 ALT-1-1 Supervision $6,000.00 $4,20.0.00 $0,40 $6.0-6 $4,2=0 -70% $1,400.00., $0.00 ALT 1-2 Electrical Warranty $714.100 $4.00. $0,00 -$0.00 $01.001 Q% 1-734.00 $0.00 - 10400.00 -jr .00 10% ALT 13 Demolition $2 $2,140,00 $0.00 $0.00 $2 .4. 401 $19426000 $0.00 ALT 1.4. Conduit $241900.00 $22t4i0-00 $2,490.00$0.00 $24goo.00. 1006/0 $0.00 $9.00 ALT 1,�5 MO. Wire & Cable $84,300.08 $0.00 $57,600.00 $0,00 :'$57;600':00 681/14 $26,'700,00 $0.00 ALT 1.6 Circuit Bre I akers .$12,000.00 $0.00 $110800..00 $11.011 $11,80101.00 98% $200.00 $0,00 ALT 17 Power Systems Study $101000406 $1,000.00 $0.04 $0.00 $1,000.00 100% $0.100 $0,00 co.1 D1sdbnn0ct for Water.Heater s1m4-40 $1,410.77 $0.00 $0.00 $1,4037 676/0 $203.72 $0.00 Breakers $1,785.76 $0.0D $1,785.76 $0.00 $'1,785.76 100% $0.00 $0,00 CO3. Temp Generator $9.00 $0.00 $0,00 $0.00 41DIV101 ;0.00 :$0.00 Total's $771,134.25 $641,051.77 $132,720.26 $0,00 $673j772.03 $97,362.22 $0.00 PREVIOUS RETAINAGE ORIGINAL CONTRACT SUM $ 767,734-'00 CURRENT BILLING $1320720.26 CHANGE BY CHANGE ORDER NEW RETAINAGE CONT131ACT SUM. TO DATE $ 767,734.00 TOTAL COMPLETED AND STORED $ 673,772,103 TOTAL RETAINAGE $0.00 1 TOTAL EARNED LESS RETAINAGE $ 673,772.03 LESS PREY CERTIFICATES FOR PAY $ 541,051.77 8.40% SALES TAX: $ 11,14840 CURRENT PAYMENT DUE $ 143,869.76 E XWBI T "B" PREVAILING WAGE AFFIDAVIT FORM PREVAILING WAGE AFFIDAVIT FORM STATE OF WASEUNIGTON ss. COUNTY OF SPOKANE: I the, ndersigned., liaving been duly sworn, depose. m al ccrt y that in 1 0 on N%rith the y id if I at com e ti performance of tho work, pad nient for which this voucher is submitted,, I have paid PTOValling MragC IZACS in accordance wiAi the Staternent of Intent to PZLY Prevailing Wages prQviously W filed ith the District- and no labar err-�d lcss than the prevailing rate of Imorkman or mecbruic so erwiptoyed upon such work bas been p wage or less thmi the minimum rate of wages as specified in t1jo prilicipat contract; that I hve read the. cabove and foregoing statement and certifi cate., 1(n mm the contents thereof and die substance as set forth thereffi is 11-ue C;F to my lcnowtedgrc and belief. < Signature of Contractor's Authorized Representative: Nmiio: fesse Kure. Tito: Proiect Manner SUBSCRIBED AND SWORN to before me this 27th day of October, 2023 el Signature of NotaV1,ublic (Sud or Stamp) Title: Residhig at: My Appointment Dxpires Nx% Zz N V so wag Gob- 0 dew PAMLIG wx 0 W-4 P IV 0-00 0, CIO: WIX 'e'sk�%twV% erli 1111011110 LocALS 3O2 SND 612 OF THS INTERNATIONAL UNION OF OPERATING ENGINEERs TRUST FUNDS 7525 SB 24'h St, suite 200, Mercer Island, WA 48040 • P. O, Box 34203'- Seattle, Washington 98124 Phone (206) 491-7574 - Fax (206) 505-9727 Administered by Welfare and Pension Administration Service, Inc. October 30, 2023 COIF I o INC 12C AFFEDA IT 2812 N PITTSBURG ST Account No. 10399:, 10402,10404> SPOICANE, WA 99207 21056,21057,21059,210% 210623 21 o66y 10403 The Locals 302 and 612 of the Intematxonal Union of Operating Engineers Trust Funds hereby certifies that in accordance with the Trusts' records, and to the best of their knowledge, the above-named subcontractor has paid all benefits due on hours worked by its employee's for the ,period. of October 1 - 21, 2023. This certification shall in no way relieve the subcontractor of responsibility for employee benefits not reported. or *.correctly reported and. clue. Ploychanok Kepner Data Control .trol Departent 'PA., Inc. 206 441-7574 K