HomeMy WebLinkAboutGrant Related - BOCC (003)GRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:00pm on Thursday)
REQUESTING DEPARTMENT:130CC
REQUEST SUBMITTED BY:Karrie Stockton
CONTACT PERSON ATTENDING ROUNDTABLE.. Kai"C'I@ Stockton
CONFIDENTIAL INFORMATION: DYES ONO
DATE. 5/29/2024
PHONE:2937
� ... .moi,.,,_, � ., ,,_..... _ :. _ s �. �;
two
Reimbursement request from Port District #4 Coulee City on the Strategic
Infrastructure Program (SIP) Project #2023-05, Coulee City Medical Center
in the amount of $114,868.37.
If necessary, was this document reviewed by accounting? 0 YES W NO 0 N/A
If necessary, was this document reviewed by legal? ❑ YES ® NO It N/A
DATE OF ACTION: �(" q, 7
APPROVE: DENIED ABSTAIN
A I
D1:
D2:
D3:
4/23/24
DEFERRED OR CONTINUED TO:
ElAgreement / Contract
EIAP Vouchers
ElAppointment / Reappointment
FlARPA Related
[-]Bids / RFPs / Quotes Award
E]Bid Opening Scheduled
F1 Boards / Committees
0 Budget
ElComputer Related
El County Code
El Emergency Purchase
El Employee Rel.
ElFacilities Related
ElFinancial
1:1 Funds
ElHearing
F-1 Invoices / Purchase Orders
® Grants - Fed/State/County
E]Leases
11MOA / MOU
❑Minutes
ElOrdinances
7 Out of State Travel
El Petty Cash
El Policies
F Proclamations
0 Request for Purchase
El Resolution
El Recommendation
0 Professional Serv/Consultant
E]Support Letter
E]Surplus Req.
❑Tax Levies
E]Thank You's
E]Tax Title Property
E1WSLCB
� ... .moi,.,,_, � ., ,,_..... _ :. _ s �. �;
two
Reimbursement request from Port District #4 Coulee City on the Strategic
Infrastructure Program (SIP) Project #2023-05, Coulee City Medical Center
in the amount of $114,868.37.
If necessary, was this document reviewed by accounting? 0 YES W NO 0 N/A
If necessary, was this document reviewed by legal? ❑ YES ® NO It N/A
DATE OF ACTION: �(" q, 7
APPROVE: DENIED ABSTAIN
A I
D1:
D2:
D3:
4/23/24
DEFERRED OR CONTINUED TO:
GRANT COUNTY
STRATEGIC INFRASTRUCTURE PROGRAM
PROJECT CERTIFICATION
a
This form must be signed and returned, with an invoice, ce, for the approved funding,
before reimbursement can be approved by Grant County,
SIP Project Proposal Number.* 2023-05
SIP Funding Recipient: Grant County Port District #4, Coulee City
SIP Project Description: New Coulee City Medical Cli '
mil c_
1, the undersigned, do hereby certify under penalty of pe�ury, •that the materials have
been fin-nished, 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 � 4(0,Z'IS
�;1 '
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 fends were expended
toward the project and according to the intent of theproposal.
Signature
�VGI-���� �F1tfl
Printed Name
Date Signed
ff-�OL n
Title
C)An
Printed Title
Completed, signed original certification and invoice are to be mailed to;
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823
ATTACHMENt
11i1r.14100409G,11' m"L2320G?L0,mm LS360?38qS30W'
... .. .. ... . .....
Grant County Port District 04 61410040"
E(Q
Leone & Keeble, Inc.
Cash Account
Grant County Port District 04
Leone & Keeble, Inc.
5/16/2024
1 14,868.37
114,868.37
61410040Q05/16/2024
114,868.37
Cash Account
114,868.37
PRODUCT SSLTI 04 USE WITH 91663 ENVELOPE Deluxe Corporation 1-800-328-0304 or www.deluxe.com/shop
24 1388E
D7WKCL SLKDKO3 12/15/2022 07:32 -36-
r'f
10.26 AM Grant County Port District
05/17/24 Check Detail
May I - 17, 2024
Type Num Daae Name Account Paid Amount
Check 4061 05116/2024 Boss Public Affairs... Cash Account
514.40 - Professions,.. -1,000.00
TOTAL -11000.00
Check 4062 05/1612024 Grant County Econ... Cash Account
514.40 - Dues/Mem... 15000.00
TOTAL -11000.00
Check 4063 0511612024 Coulee City Roden ... Cash Account
514.40 - Advertising/... -800.00
TOTAL -800.00
LIAQk
Check ,4-- 05116/2024 Leone & Keeble, Inc. Cash Account
Capital Projects 1141$58.37
TOTAL -114,868.37
Check 4067 0511612024 Travis Liening Cash Account
513.10 - Cammissio... -349.00
TOTAL -349.00
Check 4068 0511612024 Joy Beardsley Cash Account
513.10 - Commissio... -349.00
TOTAL -349.00
Check 4069 05/1712024 McDonald, Howard Cash Account
513.10 - Commissio... -349.00
TOTAL -349.00
Check 40'70 05117/2024 Travis Liening Cash Account
Page 2
4
10.26 Ali
05117/24
uraznt County Porgy District #4
Check Detail
May I - 17, 2024
Type
Num
Date
Name
Account
Paid Amount
Check
4054
05/1612024
WA State Auditor's ...
Gash Account
514.40 - Professiona...
-21225.60
TOTAL
-2,225.60
Check
4055
0511612024
Centurylink
Cash Account
536.40 - Utilities
-85.46
TOTAL
-85.46
Check
4056
05116/2024
Chris Erickson
Cash Account
514,30 - Office Supp...
-333.16
514.10 - Part Secret...
-200.00
TOTAL
-533.16
Check
4057
051/6/2024
Enduris
Cash Account
514.40 - Insurance
-41205.00
TOTAL
-41205.00
Check
4058
0511612024
Gray & Osborne, Inc.
Cash Account
514.40 - Professiona...
-31737.66
TOTAL
-3,737.66
Check
4059
0511612024
ShirleyRae Maes
Cash Account
514.40 -Advertising/...
-279.17
TO"T"AL
-279.17
Check
4060
06116/2024
Town of Coulee City
Cash Account
�
538.40 - Utilities
-138.66
TOTAL
-138.66
Page 1
10:26 AM Grant County Port District
05/17124 Check Detail
May 1 -17, 2024
Type Num Date Name Account Paid Amount
545.40 - Boat Slip R... -31474.54
TOTAL -3,474.54
GENERAL FUND
GRANT COUNlY PORT DISTRICT #4
P. 0. BOX 537 DATE;
COULEE CITY, WA 99115 WARRANTS.
1, THE UNDERSIGNED k f —
,DQ HEREBY CERTIFY UNDER PENALTY OF PERJURY, THAT THE MATERIALS HAVE BEEN FUR.NisHED, THE SERVICES RENDERED OR THE
LABOR PERFORMED ASDESCRIBED HEREIN,, AND THAT THE CLAIM IS A JUSTNST GRANT iCOUNTY PORT DISTRICT #4 AND
DUE AND UNPAID OBLIGATION AGAI
-4
THAT I AM AUTHORIZED TO AUTHENTICATE AND. CERTIFY SAID CLAIM,
SIGNED BY
WARRANT NO.
APPROVED.,
ALM ITOR
PORT DISTRICT COMMISSIONERS
GENERAL FUND
GRANT COU 7Y PORT DISTRICT #4
P. 0. BOX 537
COULEE CITY, WA 99115
VOUCHER L15.
DATE: ,�;�tt(
WARRANTS:
It -1 HEUNDERSI,GNED., DO HEREBY CERTIFY UNDERKNAL TY OF PERJURY� THAT THE MATERIALS HAVE BEEN FURNISHEDV THE SERVICES RENDES , I ES RENDE
OR THE
LABOR PERFORMED AS DESCRIBED HEREIN, AND THAT THE CLAIKIS A JUST, DUE AND'UNPAID OBLIGATION AGAINST GRANT COUNTY PORT DISTRICT #4 AND
THAT I AM AUTHORIZED TO AUTHENTICATE AN D. CERTIFY 'SAID CLAIM.
SIGNE:D BY:
WARRANT NO.
APPROVED:
11
It
PORT DISTRICT COMMISSIONERS
A �� IRTIF .COM _LORMMENT
'#VJ'R�arzun#ctt1r�tnit. 4?' : t3u1P, City lnxc.:srPIIaC{1 sibiti�r c:
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7:',WXSHlNQT Q* STAT-Ft:SAM TAX.
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A!A DOCUMENT 7 �•. •AfPLl0A�.rcit t tr ,
use May t: omppVt A40to
APPLICATION AND CERTIFICATE FOR PA` NIENT
Co-Lilee City Medical Clinic & Library
Coulee City, WA 99115
Job # 23-1154
Period 4/30/2024
Architect: Loofburrow Wetch A
Estimate No. 1
SUBTOTAL
C
D
E
F
H
SCHEDULED
VALUE
PREVIOUS
APPLICATIONS
CURRENT
APPLICATION
TOTAL
TO DATE
BALANCE
TO FINISH
$ 1,986.,576.00
$
$ 106,163.00
$ 106,163.00
$ 1,880,407.00
CO TOTAL
$
$
$
-
$
$
SUBTOTAL
$
1)986p57O.00
$
$
106,163.00
$
106,163.00
$ 1,880,407.00
SALES TAX 8.2%
$
162,898.74
$
8,705-37
$
8,705.37
$ 154,193.37
TOTALCONTRACT
$
2,1149,468.74.
$
$
114,868.37
$
114.,868.37
$ 2,034,600.37
RETAINAGE 0%
$
$
-
114,868.37
$
$
1$
114,868.37
-
114,868.37
TOTAL LESS RETAINAGE
PREVIOUS PAYMENTS
DUE THIS ESTIMATE
UNPAID BALANCE
1.$ 21034,600.37
The undersigned Contractor certifies that to the best of his knowledge, information and belief the work
covered by this Application for Payment has been completed in accordance with the Contract
Documents, that all amounts have been paid by him for Work for which previous Certificate of Payments
were issued and payments received from the Owner, and that current payment shown herein is now due.
A-DLICt�TION-FOK T`AYN ENT
Coulee CitY- . Medical Cl*nic & Liber
Period
4130fIfl2-4
Coi?Ie .City, WA -99145,
Architect
Loofbwow Wemh Architects - P;S:
,Tote
TOTAL
TC�'�`At P9KC�i`
NAL, T� VALUE
VALUE
CONTRACTCONTRACTCOWLETE
COMPLM
EVIOUS CLTIRENT
'CONTRACT
TUE
TO DATE
EMMATES - F TMATE
BALANCE
;
Awl
-<i
101,
_
s..'•.
r . t
s;
.�.'}� //^^1�. _ "- . ' -' ' '. `: "': .. -
-TOTAL
�. 'Y +�f #��F.a Y'�e'r:
k.�•�.�LIDO_•
.5
APPLICATTO FOR t''AYIL+IEW
C;ouit:c,Qi1YMdicai: Clinic & Librw Period 0/2024
Coulee:Cil, WA. 99115 Architect:. Loofburrow.Wetch=Architects, RS,
"1154'MINIMUM
r ry.�+.y._ �:,. �_.7,.r_..
::_. .. '.; .-. •:: +l.' � '?�i #3 t 3 YA 0i1 F 4+LilY 1 x411 x117:.' VE: V Ver : .
# 7 .. .... ._ }}^•+yy}. p. _
A YL d✓A#PT :;. :_.
;0n-RhC1-
n iTL T . COMPLETE ke.- x.S
x �C ON-
.-. .-: .. .'.:-: ....•.: .'. _._.... ,.-_. ..: ,... _...:.:..
Ai4
i�..l. DATE iyft-IMA �i'IM-A
BALF- Lit i1.JVY
10
f 11 u#�m��a�s ! �b�ta r�t�or►
1,720-00
,720M .
'72 d.-rtF j i+ l yiL T a:
V
23,qwoo
_.v! • :": '.
23,900,90
' Procure Packapzed RTU!s
24,400.00
_ ., ..
24,400,00
74 Procure: EXhaust Pans
1,£3moo
i;00OM
75 Procure Duct Heaters
7,900-00
:-w= _
2,900,0
76 Procure Split System
2,450M.
-*_
2,450..
1 77 Procure.il.00f Hoods •
120X0
78 Procure O'5,25{}�it3
3;25t{3t�
1 73 PabriGateti c Procured Ductwork'
21, 0000
21,500,OQ
Ductwork- ork �c Equipment
0 In�st.ayIisptio{nl�ui
:{}t{�
:.
63.1 600
�3]
Refry eratton. l _ping
�3j� �+60
.4,500' lO
_ •s . •_a : +�t
�00
2,50Q.;00
2 Duct nSuiatun
7000�
,
7,0
L FW1KI fWLr3n/Controls
3}+00,0(:
.���
.
3y0P0 00,
. 84 VAC .t13ment StaztuP
4,€100.00
4j000�00
15 Test, -Adjus(ing-& -Adjusting-&3afanc ng
2,440 f3t3
2,490.00
$6 - Final -Documentation
1,720.00
I=720M
87- Punch Lisp.Cem- letibn
3,440,00
5,440:00
-88 coinntisslortf g
x,440,-00
.. at
3;440>00.
-i8'j0 DIVISION -26- - ?A�tiRI4#L
✓lA I1 t44il�.il�-L' ri:11 JJTylb4ifiz tion
7-1275,0
.T
1 .
��1.n
9.1 Prim yService$ Mateiial
4.260,00
4';260,.4m. �0
92 primary Services - Labor
6,650 00
93 Branch Conddit & -Wire -1 aterial
8158+q{3Q
-
8,580.OF1
_94 Bs ch-Cdnduit,& -Witt..abvr
23,400.00
_ •' _-
23,400,00
95 Feeder. Cohdr t * :1 -ire .. Wt660).:
i"800,00
9f' Feeder Conduits :Wire - Labor
2,850.00
97 Exteddr Lighting - laterial
5;334;00
5,330,013:
98 Exterior Liitin8-'Laboic
5,6240Q
- =
5;6z0.t30
99 F$iiels 13tsconnecN � h tenal
5517€3D : Q
: w ,«•
55,300.00 ;
100- Panels &.Dicnnects -Labor
11y510;00
12'1,,8S01�0
}4 �0+ '
101 Tmm`Atwi
«!.
1.02 - Tdm - Lab&
-11, 500,00
:: y . w
-11,500.00
103 Light i;'airtures.- l4tatenat
32,900.00
1.04 Light Vixtures. - Labor
25,1.10, 0.
251110,-00', :.
W-
105 Comm/Data - MaLteri
5.9004;00
106 Ci'?9 mffiiiti! - Labor
7,500=00-
1,500.0
107M Pinar Documentation-
2,249"00.=
2;248,00 '
108: Punch:Lit.Completion
4;496:00
4,49.6.00
109 CQmrnWioning
4,496 00
41 ' :� �
4,496.00
10'- DIVISION 31
I'll Bring Site io Sub de
10,347bQ(1
+=
1,1,307,00
t 12 Foundatiaa: xca''anori: Backfill
2:5j709i,00
12r954t.50 50 12,85-4,50
I2w 4 0
113 Buildngiab rte
18,413.110
9:206.54 50 9;206,51}
9;2%6:5{3
1.14 S de v lc l cep.
94595.04
00
1.15- Trenching for Flearkal
5,670A
5,6-70,00-
116- Prep forConcrete &Asphalt Silt walks [PAving
45.951!00,
45,962;00
117- Pine Grade Continuous: P60tings
578,00
11.8: Fine. tide S{7
11239�00
119 DIV ISIOX 32 - SITE- -WORI
120 Vapor- ;ar r Under SOG
2:;212-011
�,� !2 {117
121 A 'haltPaving
-36,0y�2i014t/ 0
�, �:.
3�6,0+2�0tr
22. Pkvf'In#`it+ial�tr8s
f',.77ilrCtYl
y: '�
y�01
ls�IkJtl1! _
123 DIVISION 33 ]UTILI IES
1.24: 'Utilities (Trenching)
125 Site 1,3tflitics. Water systems - Material
3,64'
3,641,00 100 - • 3,04.1.00
-..
126 Site Viijiffes, Water Systems - Labor
8=22bROf1
.8 ,22600 -100 �__ 8,226.00
127 bite. U#ilitics_ ati Se �►er - Materials
1,_112.€30
1,� �:?hOQ 100 1,11.2.Q
128: Site UtilLties ajaitary -Sewer - Labor
x,406,00
5*406--00 MO 5,406.00
129 bite Utilities Storm Drairtap r Swale -.Materials
3,172,50
3,172XtH1
130 Site Utilities Storm-Dminii& I Swale - Labor
14,405M
,4i3 .OQ
'T6TA"ril`1.I:I`I"1'P' :.• =
:.: :1F 7i1.:.._
106 1610 ..:..: _ ....: :.. ....
,0
APPLICATION FOR PAYS
Coui+ee. Cid Medical Clinic-& Library
Period-
�t �2424
C uie CtiA 911
Archiket
cu e► 11 ciiitects, : _
- MT -PERCENT
VALUE _ '�l AL1 TE
'��L . '
ITEM . _ DESCRIPTION
C3 'R .CCT
CIM1FUTECOWLS'
PREV101US CURFXW
CONTRACT
TO DATE
MENT
339;122;00
16,95kiO 5_
X35 "I
3221165,.�O :.
3 13&O and Insurance
19,054.€0
90Z70 5
902,70
4 Bonu1
27,298.00
27,29&-00
2'7,298 -.0th
5 Final Docamentation
14;349.00
4,349;.QO -
.6 Punch L.is€. Completion
28496.00
i CQM'm)SS10q 3
Da696;{t0
• -
w..
25,696 X
5 Permit A lgAm'v'ancemay
66,5001000Q
• 6;500-00 100
. 6,500A
:...
�
9. DI 'I� ISIa l � - $1+�+ WORK
YY ORK
10 mective Site Demolition*
3,:��7:�f�
3;55700 100
-3587.04,
1.1 DIVISION 3 -, CONCRETE.
I2: C n rete Anchors
-
4,5 5:.-10
I'360,50 30
=_ 1T36Q-50
3,174.5Q
13 C'slIP conCii6te 8ujlidll� g{+�
I+,i2?s
9J 11110 1_ Q
-: 9;:1 12.70
8`2,{11�'.3�(yl ' ';
14_ l I �CongiSvl - S11i7.1_ al ik -
J 3 tV11
's
w
JZ63 ll
15: ClP Coricref - Trans oimerP d
1, 892001,68
.11
16 post � pa�iel. i nage. Concrete
658A555
00 -.
IT Grout StW Wutnii Base
746,00
19 DIVISION 5-a :i TALE
19 ftuetural Steel Framing
1,416 :4Q
20 Metal Lad&era
6,882
6,88?Y (l
21- DIVISIONN'6. - CARPENTRY.
22 Rough Carpentry
1W 3444..4
'
163,34,00
23: Casework $lockYri & Backing
13x522.0()
110
2:4 kbuO Hardware
2;44: §00
25 Hoisting I Craning
2,000100
-
AQ00,00
26 In'teripr Finis Carpentry
48,217,..041
49y2 Y AQP
��r�IVI�.��t�({yl��`M*'�Y-� TIKERMAL AND MOISTURE I"1 OTEC'TIi}��iyy`�
,2�/']y7�
i.LJ .1�-il.:L i1� insulation
/�/y
27.�.i7.Y5,00
: �
it , Y00,
29 Below: Grade Rigid insulation
714*041
.. -
774}00
30: Thermopfastic-Single Ply Membrane Roating:
56r455�00
31- gift&
35 000:00:
32 RoPf Accessanes
500,00
33 10tC1t Sealants
1,122,00
3 DIVISION 8 -DOORS AND GLAZE,
3.$ W L3por$ & Frames
43,359100
47z359;99
36 Wood Doors
2,710200
37 Vinyl Winda-Yvs
6,583.0{}6,583a00;
38 Harli ar+e:
12,3°*7�3fr/(i0
22 379.00
yDoor
V /3i ii 7 ..
_ y Y7 :f: zi.
i:_ a%..
•'i!
5,037C00`
411 DIVISION 9 FINISH S
41 Gypsum Powd .
58,970-00
5� 9'703
42. Acom call of ini g
*9A80-00
"'- ai-"
T -J .r-...
1.9,48(3.00 ,•
43 Flooring
-31',06Z,fl(i
31,6.02.
44 Painting
27,665:00
tt�� shy /yam ryy .±ay1(i��ey+y=}��y
4.5. .D4 7. SIO IQ - L7► �.rE�. SORMS
46 Panel. Signage :.
8,499.00
.
8,49 .4143
47 Wall*. Dour'Protection
190,00
1943.00:
48 Toilet: Bath & .Laundry .accessories
796.00
796.43€3
49 fire' rote pecialfies
779,..0.0
779 00
50 Knox*Boxes,
823.00
823,041 >.
51 took Return
11,44600
11446.A'.
52 DIVISION t2 -FURNISHING
53 Window Treatments
5,000.00
5y043Q.0
54 .Casework
65,496,1141
,
65,486:00-
5.5 DIVISION 22 PLUMBING
56 Jndersta PiutLab'
o
24,fl04:flUr
200U4z4€
57 Underslab,P14 mbingMa:tedal.5
16,00G,00
44 .
16 i3 043 .
� �f4?T
58 Rough In Plumbing Labor
20,0471 ,00
,.: , .
;� ;.
�
M,000,00
2M,000,00 -
59
59 .Rough In Plumbing Materials
4,000..00
45,,00.00.
61 Trim 0ut.P1urbing_Labor-
9,75300
,3 �00:
61 T?4C Out-l;sM{Lela4ss
15,000400N.
K
t so:!0V1:.V:
62 PjOe Instflation
8y0D4)�[34}
63 Admio 3ubsito Labor
7,1000,i3f3
- � .
:. ;�:.
:7.0Q43. _.
64 Commissioning
3,099,00
i'. 'a..
"5 '.
3,099µO 0 . �. .
65 Punch. List Completion
3,(199:0
� ..
�. �
3,4399�43t3 :
df Final Documentation
1 549.06
_
i-,
1,549�00:
67 Office Ov rhead-
3
3. 4)
d :Equipment Rental :.
2300.00
2v700_00
77%00 ..
-
4w'J�'I'I�
`L#+t'fila:At�'I`
..
= • :
,:I-04 =
-1.3241