HomeMy WebLinkAboutGrant 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 aY: Karrie Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: K81'1'I@ Stockton
CONFIDENTIAL INFORMATION:. DYES ANO
DATE. 4/1/2024
PHONE:ext. 2937
Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of
$16,291.10.
DATE OF ACTION: � e
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
DEFERRED OR CONTINUED TO:
❑Agreement /Contract
❑AP Vouchers
❑Appointment /Reappointment
❑ARPA Related
❑ Bids / RFPs / Quotes Award
❑ Bid Opening Scheduled
❑ Boards / Committees
❑ Budget
❑Computer Related
❑County Code
El 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
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
Reimbursement request from McKay Healthcare on the Strate is Infrastructure Pro ramg g (SIP),
Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of
$16,291.10.
DATE OF ACTION: � e
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: SIP2023-01
SIP Funding Recipient McKay Hospital & Rehab
IF Project Description Phase I Architecture and Engineering Site Plan
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
0
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,§,z91.10 is gust
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.
Signature
Victor Odiakosa
Printed Name
Date Signed
0
Admimstrator/ au erintendent
Title
Administrator/Suvqn*ntendent
Printed Title
Completed, signed original certification and *invoice are to be mailed to.
Administrative Se-rvices Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 4%WROMMSCOMMEM in the amount of $16,291.10
ATTACHMENT4
RIC er tMMILLER
275 FifthRreet',.Suite 100
Bremerton, WA 98337
(360) 377-8773
Public Hospital District No. 4 of Grant County, Washington
P.O. Box 819
Soap take, el WA 98851
Vi.qto'r Odlakosa
Professional -services through 12/31/2.023
S.I.P. Grant 2023-01
Invoice- number 2023052.00 -0'04 -
Date
Project 20230.52.00 McKay Healthcare SNF Pro -
Design, - Master Planning
Invoice total I . 6,291.10
Aging Summary
),Invoice Number Invoice. }ate Outstanding Current Over 30 over 60 over 90 over 120
2023.052.00-004 01.1/08/2.0124 16,291.10 16,291.10
Total 16,291.10 16,291.10 0.
00 0.00 0.00 0.00
For a hy qu- 9 s* tion s'. regardng this In v dk' please contact Jill Wolfard at (360) 377-5773 or-
jwo1ferd@rAmarch.Via m
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-004 Invoice date 01/08/2024
Washington
Contract
TOWR
. emaln'Ing
Current
Description
Amount
Billed
contract
Billed
'$col* p - e 1A -Concep . tual bosIgn
100 ,1841.00
66,97311'20
33,2101080.
103.60
Scope -1 A - Schematic Design
78.1936600
1%967,60
58f.968150
6f'_517.50
Scope 113.1 *Site Plan Design,
87,280.00
:391120.00
480160.00
812700100
Total 266,400.00
.126,060.70
1111*1401330.30
18,291,10
Invoice total I . 6,291.10
Aging Summary
),Invoice Number Invoice. }ate Outstanding Current Over 30 over 60 over 90 over 120
2023.052.00-004 01.1/08/2.0124 16,291.10 16,291.10
Total 16,291.10 16,291.10 0.
00 0.00 0.00 0.00
For a hy qu- 9 s* tion s'. regardng this In v dk' please contact Jill Wolfard at (360) 377-5773 or-
jwo1ferd@rAmarch.Via m
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-004 Invoice date 01/08/2024
Washington
MCKAY HEALTHCARE
586 RiceFergusMifler 02/0112024 93628
Invoice Number--' Invoice Date--- Description Gross Amount Discount Taken Net Amount Paid'
202305 404`004 01/08/2024 Admin - PS - SIP 2023-01 $16,291.10 $0.00 $%291.10
$16,29,110 0.W.-O$16j29 1
Moffoum None Mal I 111glumill
walk
ARE
..96-671
.'�1�.�.T'
�C�.,-A
.,.127-SECOND'AVE.SW '.T.0-BOX 819: 1232
415.
..-SOAF WA 98851
2
36.28.
).-LAKt
-.4509) 246:-
0
93628, "02/01/2024
$16,29 1. 10
Sixteen Thousand Two Hundred Ninety One Dollars and 10 Cents
PAY Rice Ferg usMiller
TO THE
ORDER OF 275 Fifth Street, Suite 100
Bremerton, WA 98337
7
BY
9
NP
BY
AUTHORVt64IGNATURE h.p
110 60 4 10936 28,18 "a' 123 206? 10100 L5360?38953011