HomeMy WebLinkAboutGrant Related - BOCC (005)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.. Karo@ Stockton
CONFIDENTIAL INFORMATION: EIYES W N 0
DATE: 4/1 /2024
PHONE:ext. 2937
Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP)
Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of
$241253.32.
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
DEFERRED OR CONTINUED TO:
ElAgreement / Contract
EIAP Vouchers
ElAppointment / Reappointment
FIARPA Related
El Bids / RFPs / Quotes Award
ElBid Opening Scheduled
El Boards / Committees
0 Budget
El Computer Related
OCounty Code
El Emergency Purchase.
El Employee Rel.
F-1 Facilities Related
ElFinancial
1:1 Funds
01-learing
F-1 Invoices / Purchase Orders
iRGrants — Fed/State/County
01 -eases
DMOA / MOU
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0 Out of State Travel
7 Petty Cash
El Policies
❑ Proclamations
El Request for Purchase
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E]Tax Title Property
EIWSLCB
Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP)
Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of
$241253.32.
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: SIP2023-01
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 furnished, the services rendered, and/or the labor perfonned 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 $24,253.32 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 finds were expended
toward the project and according to the intent of the proposal,
Si stare
Victor Odiakosa
Printed Name
Date Signed
#
Admimstrator/Supefi.tendert
Title
V 9
Admnustrator/SupLnntendent
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement 6 in the amount of $24,253.32
46F*1400~�
ATTACHMENT 4
0gU 1LLER
275 Fifth Street, Suite 100
Bre'merton, WA 98337
(360) 377-8773.
Public Hospital District No. 4 of Grant County,, Washington
P.O. Box 819
Soap Lake, WA 98851
Victor Odiakosa
Professional services through 01/31/2024
SIP 2023-01
Invoice number 202-3052.00-005
Date 02/0812024
Project 2023052.00 McKay Hevil ftire "SNF Prow.
Design - Master Planning
Contract Total Remain ' ing Current
Desodptiton Amount Billed contract 13111ed
Scope I A - Conceptual Design 10%184.00 75s672.80 2415111.20 81699.60
l .- C M1
ScopelA She itt-c sign
78t9.36.00 35,200.00 431736.00 15,1232-50
Scope' 18.1 - Site Plan Design, 871280.00 39J20.00 48$160.00 0.00
Total 266,400,00 149,992.80 11 6t4O7.2O 493210
Reimbursable Expenses
Reimbursables
Printing and Reproduction's
Billed
Units Rate Amount
321.22
Invoice total 24,253.32
Aging Summary
Invoice Number Invoice Date. Obtstandin Current Over 30 Over 60 Over go Over 120
2023052.00-005 02/0812024 24,253.32 24-1253.32
Total 241253.32 24,253.32 0,00 0.00 0.00 0.00
For any questions rogardln g- this invoice please contact Jill Wolfard at (360) 377-8773 ori'wolfard@rthnarchco M -
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-005 Invoice date 02/08/2024
Washington
MCKAY HEALTHCARE
586 RiceFergusMiller .03/21/2024 93804
Invoice Number Invoice Date Description Gross Amount Discount Taken: Net Amount Paid
2023052,00-005 02/08/2024 Admin - PS - SIP2023-01 $243253.32 $0.00 $24,253.32
$24,253.32I[ $0. -0 -O -F— $24,253.321