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Home My WebLink AboutGrant Related - BOCC (006)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., KarC'12 Stockton CONFIDENTIAL INFORMATION: DYES ®NO DATE: 12/13/2023 PHONE:ext. 2937 DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO: 1111110 ElAgreement / Contract ❑AP Vouchers ---- ----- E]Appointment / Reappointment EIARPA Related ❑ Bids / RFPs / Quotes Award 013id Opening Scheduled El Boards / Committees 0 Budget OComputer Related DCounty Code ❑El Emergency Purchase 0 Employee Rel. E]Facilities Related 1:1 Financial [I Funds El Hearing 7 Invoices / Purchase Orders FmJGrants — Fed/State/County 7 1 -eases ❑ EIMOA / MOU E]Minutes ElOrdinances [:]Out of State Travel 7 Petty Cash 7 Policies 7 Proclamations El Request for Purchase 1:1 Resolution 1:1 Recommendation 7Professional Serv/Consultant DSupport Letter OSurplus Req. E]Tax Levies ElThank You's E]Tax Title Property OWSLCB ----------- Reimbursement. Request for Grant County Hospital #4, McKay Healthcare, Strategic Infrastructure Program (SIP) Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of $367401.35 DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO: 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: IP 023-0 #. SIP Funding Recipient McKay Hospital & Rehab SIP Project Description 0 10 r0i Phase I Architecture and Engineering Site Plan 1, the undersigned, do hereby certify under penalty of pe�ury, that the materials have been fumished, the services rendered, and/or the labor Perfonned as described in the 4k project 0. proposal for the above -referenced SIP Project and that I am I authorized to authenticate and certify to this claim. I also certify that this claim of $16,401.35 is just and due and is an unpaid obligation against Cn-ant County. Further, according to the SIP Pr 4 ect Funding Policies, I attest that at the next audit of my 01 1 1 entity, this Protect 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, Signature Victor Odiakosa Printed Name / Date Signed Administrgtor/Spperiontendent Title Administrator/Superintendent Printed Title Completed, signed original certifleation and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement ft 2 in the amount of $1 ATTACHMENT 4 R1Cqb--(!'�YU,W1LLER 275 Fifth Street, Suite 100 Bremerton. WA 98337 (360) 377-8773 Public Hospital District No. 4 of Grant County, Washington Victor Odlakosa P.O. Box 819 Soap Lake, WA 98851 Professional services through 09130/2023 Invoice number 2023052.00-001 Date 10/0412023 Project 2023052.00 McKay Healthcare SNF Pre. Design - Master Planning Reimbursable Sxpenses Reirnbursables Travel Billed Units Rate Amount 393.67 .. . .......... . Invoice total 169401.35 Aging Summary Invoice Number Invoice Date Outstanding Current Over 30-- Over 60 Over 90 Over 120 2023052A00-001 10/0412023 16,401,35 16,401-35 . ......... - Total 16,401.35 16,401.35 0,00 0.00 0.00 0.00 For any questions regarding this invoice please contact Jill Wolford at (360) 377-8773 orjwolfard@rfmarch.com �36CO�Ood. no l coiyo 1 . 3Y �2 3(p,4oi Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-001 Invoice date 1010412023 Washington Contract Total Remaining Current Description, Amount Billed Contract billed Scope 1A - Conceptual Design 100$184.00 16,007.68 84, 176.32 161007.68 Scope 1A - Schematic Design 78;936-00 0.00 78,938.00 0.00 Scope IB -1 - Site Plan Design 87;280.00 0.00 87,280.00 0.00 Total 266,400.00 16,007.68 250,392.32 16tOO7.68 Reimbursable Sxpenses Reirnbursables Travel Billed Units Rate Amount 393.67 .. . .......... . Invoice total 169401.35 Aging Summary Invoice Number Invoice Date Outstanding Current Over 30-- Over 60 Over 90 Over 120 2023052A00-001 10/0412023 16,401,35 16,401-35 . ......... - Total 16,401.35 16,401.35 0,00 0.00 0.00 0.00 For any questions regarding this invoice please contact Jill Wolford at (360) 377-8773 orjwolfard@rfmarch.com �36CO�Ood. no l coiyo 1 . 3Y �2 3(p,4oi Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-001 Invoice date 1010412023 Washington MCKAY HEALTHCARE 686 RiceFergusMiller 11/0812023 93366 Invoice Number Invoice Date Description Gross Amount Discount Taken Net Amount F 2023052.00-001 10/04/2023 Admin - PS - SIP $10,401.05 $0.00 $16,401 1 �1(jj401-351$0.001 $10,401 AY ggga�--------- lam= -67 96 -AY RE na 1 2k BOX81 . ON -sw.-- -SOAR 933LAK WA 9> ,. ,:..; :..:.:':.'...r ..::.::;;.'t...; :; ; ;(5Q9)24fi-.1;111.:.:, :`..:-.;. ::..:.. ;. -`.. ':: .: .......::: . 604, .1.56. 93356. -11/0..8/2.023 S.Ixteen Thousand Four Hu*ndred One Doilars and 35 Cents PAY RiceFergusMiller T0'Mc_ 41 ORDER OF 275 Fifth Street, Suite 100 BY Bremerton, WA 98337 L BY .16111 40'0 AUT96FIl'i-EDS' JNq E 06041 9335gull g'o 12 3 20 6 7 10109 1 S 3 60 ? 313 q 5 30111 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 Numbev IP2023-01 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Phase I Architecture and Engineering Site Plan 1, the undersigned, do hereby certify under penalty of perjury, that the materials have been finnished, 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 q,000.00 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 Wasbington State Auditor's Office and an emphasi's audit Will be requested to assure that these funds were expended toward the project and according to the intent of the proposal. dig i Q tur_e_ Victor Odiakosa Printed Name l G- / Date'§igne'd Administrator/Superintendent Title Administrator/ uperi.ntendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement #3 In the amount of $20,4000,00 ATTACHMENT 4 GSI Transforming Age Ventures dba GS1 Invoice WA 9 r 1k r A R�- 1i INVOICE NUMBER., INV767 INVOICE DATE: 10/18/2023 Bill To McKay Healthcare 127 2nd Ave SW Soap Lake WA 98851 united States Terms Due Date Balance Forward $0.00 TOTAL ''UM00-00, Do Descrip�lon ...Rate Amount Consulting Services $20r00O.00 $20j000.00 Completion of Assessment Phase October 2023 1111111111111111111111111111 INV767 Subtotal $20,000.00 Tax (01/16) $0.00 :r�nv oice T a �20'0000 ot .0 60" -Total Balance .$20,000.00 1 of 1 MCKAY HEALTHCARE 592 G Research WA 11116/2023 93376 Gross Amount Discount Invoice Number Invoice Date Description Taken Net Amount Paid$ INV767 :10/1 --8/2023 Admin -PS SIP 2023-01 $20,000..00 $0.00 20,000.00 L $20�000-00 $0.001 $20,000.00 AM 96-671 415 MEAL. .:-McKAY T JWAM P-POBOX819.'. :A27:,SEG0NDAVE SW ..,933 6 :6 04.1 7 SOAP LAKE, WA 98851 (509) 246.1 191, 93376 11/1612023 $20t000-00 Twenty Thousand Dollars and 00 Cents PAY GSI Research WA EaTO OROF 1980 112th Ave NE SuiteM Bellevue, WA 98004 119r.04 109337r=1111 1*. h 23 2067 L010, L5360?38953ID111