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Home My WebLink AboutGrant Related - BOCC (002)9 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 suBnnirrED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 1/3/2024 PHONE:eXt. 2937 / T N .. .ice ,. .i._..... ..... - ..,. Reimbursement Request from Grant County Hospital #4, McKay Healthcare in the amount of $31,588.41 for expenses incurred regarding SIP Project #2022-02, Capital Improvement Plan Generator Expansion. DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: r-,, 4, D2: D3: DEFERRED OR CONTINUED TO: ❑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 El Invoices / Purchase Orders ®Grants — Fed/State/County ❑Leases ❑MOA / MOU ❑Minutes ❑Ordinances ❑Out of State Travel El Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution El Recommendation ❑Professional Sery/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's []Tax Title Property ❑WSLCB / T N .. .ice ,. .i._..... ..... - ..,. Reimbursement Request from Grant County Hospital #4, McKay Healthcare in the amount of $31,588.41 for expenses incurred regarding SIP Project #2022-02, Capital Improvement Plan Generator Expansion. DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: r-,, 4, D2: D3: DEFERRED OR CONTINUED TO: GRANT COUNTY BOARD OF COUNTY COMMISSIONERS T �lJ_rm r. ".Pei To: Board of County Commissioners From: Karrie Stockton, Grants Administrative Specialist Data January 3, 2024 Re: Authorization for Release of BOCC Approved Funds, Request #3, 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) 3rd installment of the grant award in the amount of $31,588.41 to McKay Healthcare. Note: The full grant amount is $500,000, which leaves a balance of $31,588.41. 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 fumished, 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 $1,941.01 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 expende d toward the project and according to the intent of the proposal. Victor Odiakosa Printed Name Z Date Signed Administrator/Spperintendent Title Admin i strator/Suverintendent Printed Title 9 Completed, signed original certification and invoice are to be mailed to. Administrative Services Coordinator, PO Box 37, E, phrata, WA 98823 Reimbursement # 04 in the amount of $1,1941,01 ATTACHMENT 4 tis c'� 6,8 S'31J�5_ Al MCKAY HEALTHCARE 563 Colvico Inc 12107/2023 ',9,3417 Invoice Number Invoice Date Description GrossAmount DiscountTaken Net. Amount Paid 165322 11/1412023 Maint - PS - SIP 2022-02 $1,941.01 $0.00 $1,941.01 $1,941.011 $0.o $13941.011 6-671 IM Air y 41V THC b" k� mcK. ARE "PO -BOX: '1232 SE a 19 WNPAVE 8W. 1509) 246- .111 MT -7 -SOAP. LA.KEj.WA.9PQ51: 6 Eft 934 '12/07/202 lls941.01 3 One Thousand Nine Hundred Forty One Dollars and 01 Cents PoYColvico Inc HE ORDER OF PO Box 2682 Spokane, WA 99220 L. .4 E31 fl@ 604 L0934 17,10 as 123 2067 L040 15360? 3139 5 301,11 Plea.,se remit payment to: colvico, Inc. PO Bo -.X-. 2682 Spokane, WA 99220 (609) 53,6-1-875 BILL TO: Publia Hos PAW Dist. 4 of Graft Co, PO Box 819 Soap Lake, WA 98851 AIA INVOICE #: 165322 INVOICE DATE: 11/14/2023 PERIOD TO: 10131120.23 APPLICA. TION 7 PO#: DUE DATE: 12/1312023 JOB: 10206 McKay Health Care Generator Replacement Contradt 2022-2 CURRENT PAYMENT DUE $ . 11941-01 SCHEDULED ULED PR EVIOUS CURRENT STORED TOTAL ITEM IjESGRIPTION VALUE, APPLICATION COMPLETED MATERIALS COMPLETED COMPLETE BALANCE RETAINAGE I Submittals $2,000.00 $400.00 $0.00 $0.00 $2,000.00 100% 10,00 $0.00 2 Bonds $P1300.00 $6800,00 $0,00 $0.00 $6,300.00 100% $0.00 0.00 3 Permits Fees S5,600.04 $5,600.00 $0,00 $0.00 $5.600,00 10011/0 $0.00 $0.00 Mobilization $1813,00100 $18,3000 Koo, $0.0.0 $1813.00.90 `100% 5 Cartage -Rentals, Shack $11,200.00 $11.1200.00 $6.00 $0.0 1 0 $11,200.00 1 0011/0 $0.00 $0.00 6 Sti porvislon $7,600.00 $5,600.00 $0.00 $50600.00 _80% .$1,400400 $0.00, 7 Eledtdcafflarr.anty 7,000,00 $0.00 10- $0.00 $0.00 0%, �'$7,00009 $9.00 a Demolition $36,000,00 $17,400.00�1 $0.00 $17,400.00 48/6 $10.00.00 $Q.00. 9 Cbridult $73,30D.00 $73,300.00 $0.00 $73,300.00 `1010% $0.00 $0,00 10 Ma'niio1es,&' Duclh4nks $26,000-00 $25,000.00 $0.00 $0.00 $215 00UQ 1.00% _$0110 0 $0.06 11 141do.Wire & Ca* $139,890.00 $1 . 30,795.50 $0.00 $0,00 $130,796,50 93% $9,094.50 $O.00 12 Boxes $8,450.00 .$8,450-00 $0.00 $0.00 $8,460.00 100% $0.00 -$0,0.0 13 Widng Devices $3,200.00 $3,200*00 $0.00 $0.00 $3,200.00 100% $0.00 14 Cabinets & Enclosures .000.00 $0.000 $0 00 ;Q1000.00 10011/0 $0.00 6,00 16 Grounding Bonding $5,430.00 .$6,430.00 $0.00 $0.00 $5,430.00 100% $0.00 $0.00 16 Suppor 1. H ng- Devices $14,180.0,0, $1.4,18G.00 $0.00 $0.00 $14,180.00'I00% .$6.00 $0,00 17 Electrical Ideh.tification $ 1. 611-00,00 40.06 $0.0.a $0.00 W00 0% $61200-00 0.00 18 zwItchboards $61,00.00 $55j600.0D $0.00 $0,00 $660600.00 .90% $60000.00 $0..00 19 Panelboards $4.6,700.00 6.700.00 $85,'630.00 $0.00 $0.00 $85,630-00 .09% $10170.00 A Circuit Breakers'. $11#700.00 .$111700100 $0.00 $0.00. .$11700.0100/0 '0 $0.00 21 Fuses a Fuse Accessories $10,900.00 $101000.00 $0,00 $t3.0D $10,9010*00 100% $0.00 10.00 22 Enclosed Transfer Sm"tch. $,14,95 1 0.00 .$14,950.90 $0.00 $6.00 $14,950-00 1000/0 $0.00 10.00 23 Emergency Power Generation $49.940.00 $49.04 0.00 $0.00 $0.00 $40,040.00 10 00% $0.0 .0 WOO: 24 Interior Lighting $1.,56t}.00 $0.00 $0.00 $1,560.00 1000/0 $0.00 $0.00 26 Power Systems Study $0.00 ;OX0 $51000,00 -100% $0.00 $0.00 ALT 1-1 Supervision $6000.00 $4,200.00 $0.00 $0.00 $4,200.00 700/0 $1,800.06 $0.00 ALT 1.2 Electrical Wairrianty $734.00 $0100 $0,00 $0.00 $0.00 .0% $734.00 ALT 1- Demolilion $21,400.00 040.00 $0.00 $0.00 $2,140.00 10% $19,260.00 $Q.00 ALT 1-4 Con.dult $244900,00. $2410,00 $0,00 $0.00 $2'900,100 .4 00 1000/0 MOO 0.00 ALT 1-5 Bldg, Wire Cable $84,300.00 $57�600,,00 $0.00 $0.00 $57.600.00 68% $26,700.00 $0.00 ALT 1-6 Circuit Breakers $ 1 0,00 $Q-00 IV 1,806.001 98% $260.00 ALT 1-7 Powor Systems Stuidy $1,000.00 $1,00,0,00 $0.00 $0.00 $11000.06 100% $00 $0.00 CO1 Disconnect for Water Heater $1,61449 $1,410.77 $00 $0,06 '$10410.77 8710 $203.72 $0,00 CO2 Breakers $1,786.76 $1$785.76 $0100 $0.00 $V85.76 100% $0.00 $0.00 003 "romp Generator $0.00 $0.00 $0.00 .$0.00 $0.00 #DIV10I $0,00. $0.00 C04 troubleshoot Gen & ATS .$1,790.60 $0.00 $0.00. $11790,60 400% $0.00 $0.00 Totals $772,0.24.8$ $673,772,03 $1,790,60 $0.00 $675,562.63 $97,362.22 40.00 PREVIOUS RETAINAGE ORIGINAL CONTRACT, SUM $ 767,734.00 CURRENT BILLING $1,790.60 CHANGE BY CHANGE ORDER $ 0,194.85 NEW RETAINAGE CONTRACT SUM TO DATE $ 172?924.86 TOTAL COMPLETED AND STORED $ 675,562.63 TOTAL RETAINAGE $0.00 TOTAL EARNED LESS RETAINAGE $ 675,562,63 LESS PREY CERTIFICATES FOR PAY 673,772.03 880% SALES TAX: $ 160.41 CURRENT PAYMENT DUE $ . 11941-01 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 dais claim. I also certify that this claim of _$29,647.40 is just and due and is an unpaid obligation against Grant County. Further according to the SIP P Ject Funding Policies, I attest that at the next audit of my ro] 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, Signature Victor Odiakosa Printed Name Date Signed Administrator/ Superintendent Title Administrator/Sqperintendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 05 in the amount of $29.647.40 W ATTACHMENT 4 MCKAY HEALTHCARE Colvico Inc Invoice Number Invoice Date Description 167401 11/28/2023 malirpt - PS - SIP 12/14/2023 94 Gross Amount Discount Taken Net Amount Pay $29,647.40 $0.001 $29,647.40 ---------------- -- Please remit 'aymen to: P A 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 98861 AWINVOICE #: 167401 INVOICE DATE: 11/28/2023 PERIOD TO: 11/21./2023 APPLICATION 8 POM DUE DATE: 12/27/2023 JOB: 10206 McKay Health Care Generator Replacement Contract 2022-2 SCHEDULED PREVIOUS CURRENT STORED TOTAL % ITEM DESCRIPTION VALUE APPLICATION COMPLETED MATERIALS COMPLETED COMPLETE BALANCE RETAINAGE I Submittals $2,000.00 000.00 V'0001001 $0,00 $0.00 $2,010000 100% $o..00. $0.00 2 Bonds $6,300.00 $VOO�.00 $0.00 $0,00 $61300,00 100% :$0.00 $01.00 3 Permits Fees $5,606.06 $5,600.00 $040 $0.00 $516001001 lob% $0.400 $0.00 4 Mobilization :$1000-06 $18,300,00 $0.00 $0.00 $18,300.00 100% $6,00 $4..00. 5 Cartage; Rentals,. Shack $11,200.00 $11,2014.00 $0.00 $0.00 4110200,00 1000/0 $0"00 $0.00 6 Supervision $7,000,00 $5,600,00 $711,400 $01,00 $6,300.00 900 $700.00 $0.00 7 Electrical Warranty :$0.00 $0100 40.00 $0.00 60/0 $7,000,00 $0.00 8 Demolition $36,000,00 $17,400.00 $0.0 0 $0.0010.00 $17,400.00 48% $18,000.00 9 Conduit $0.00 $0.00 $73,300.00 1 a $0'o'00% 10 Manholes Dvotbanks $25,00000 . $25,00100 $0,00 $0.00 $25,000.00 100% $0.00 $0100 11 Bldg. Wire & Cable $139,69000 $130$795"60 $0,00 $0,00 $1$00795.50 93% $96094.60 -$0.00 12 Boxes $8,45 1 0.00 $8,40,00 %00 $0,00 $8,450.00 1100% $0.00 $01.00 13 `!!tiring Devices $3,200.00 $39200.00 $0.00 $0,00 $,3,200.90 100% $0,00 $0.00 14 Cabinets & Enclosures 0,000.00 $80000.00 $01100 $01.00 $8,000,00 100% $0.00 $0.00 15 Grounding & Bonding $50430,00 :$5,430.140 $0.00 $0,00 $5+430.00 100% $01.00 $0.00 16 ul PortigDevices $14t160-00 $140180.0 0,00. $14,180000 100x% $000 $0.00 17 trical Identil'icalio ,�.E ec n $5,200.00 0.00 09 $0,00 $000.00 7 V4, -$11300,00 $0.00 $6.1 500100 $560500.00 040 $0.00 $61,500.00 $0.00 $0 00 1 10 Panelboards $86,700.00 $85'530.00 $0.00 $0,00 $85,630.100 09% $1o1,70,00 $0'00� 20 Circuit BreaRer's $1111.700.00 $11,7030.00 $0.00 $0.00 $1-1,700-00 100% $0.00 -' $ 4,00 21. Fuses & Fuse Accessories $104900.00 $10,1900.00 $0,00 $0,001 $101900,00 100% $0,00 $6.00 22 Enclosed Transfer Switch $14,950.60 $440P50.00 $0.00 $0.00 $14,95.0.00 100% $0.00 P"00 23 Emergency Power Generation $490040*00 $49o040.00 $0.00 $0.00 $49,040.00 1*000/0 $0.00 -$0.00 24 Interior Lighting $1,560.00 $1,660.1311 $0.00 $0.00 $11560-00 100% $0.00 26 Power Sys . terns Study $5,000-00 $5,000.00 $9,00 $9.00 $5100003 100% $0.00 $0100 ,ALT 1-1 Supervision $61000.00 $4,200.00 $0.00 $0.100 $4,200013 70% $1,1800.00 $0.00 ALT 1 -2 Electrical I . Warranty $7$4.00 $0.160 $0!'013 $0,00 0% $734.00 $0.00 ALT 1,,$ Demolition $2'1,440.00 $2,140.00 $03.00 $0.00 $2,140.00 10% $19t260-00 $910 ALT 1-4 Conduit $24,900.00 $24,0001,00 $0,00 $0.00 $24,900.00 100% $0.00 $0.00 ALT l[05 '�p $60160.00 $57,600,00 014OU0 $0.00 $74,160.00 $10,760,.010 $0.00 ALT 1.6 circuit area- kors $12,000.00 $11,60000 $2003.001$0.00 $120000,00 $0.00 $0,00 ALT 1-7 Power Systems Study $1,000.00 $11000,00 $0.00 $0,00 $1,000,00 100% $0.00 $0.00 CQ'I Disconnect for Water Heater $1,614A9 $1j410.77 $0,00 $0.00 $11,41037 87% $203.72 $0.00 CO2 Breakers $1$78516 $1,785.76 $0.00 $0,00 $1,785.76 10004 $0.00 $0,00 C63 Do not use $0.00 $0,00 $0.00 $0.00 0% $01-00 $000 C04 Troubleshoot Gen SATS $7,7901.80 $1,790.60 -$0.00 $0.00 $1,"790.60 100% $0,00 $0.00 Totals $712,924.85 $675t562.63 !$Vj'3' 60.00 $0.00 $702;912.63 $70,012,22 $0.00 PREVIOUS RETAINAGE ORIGINAL CONTRACT SUM $ 767.0734,00 CURRENT BILLING $27,350,00 CHANGE BY CHANGE ORDER $ 61190-85 NEW RETAINAGE CONTRACT SUM TO DATE $ 772.924.85 TOTAL COMPLETED AND STORED $ 702,912,63 TOTAL RETAINAGE $0.00 TOTAL EARNED LESS RETAINAGE $ 702t912.63 LESS PREY CERTIFICATES FOR PAY $ 675,562.63 SAO% SALES TAX: $ 2o297A0 CURRENT PAYMENT QUE $ 290647.40