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Home My WebLink AboutGrant Related - BOCC (004)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 sY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE. 6/28/2024 PHONE:2g37 j*-ugg TWO 91jz2EM= Reimbursement requests #1&2 from McKay Healthcare on the Strategic Infrastructure Program (SIP) #2023-06 for the Engineering & Outdoor Facilities Projects in the amount of $45,899.81. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO ❑ N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO ❑ N/A DATE OF ACTION: PP DENIED ABSTAIN D1: D2: t1A D3: lA-�' 4/23/24 DEFERRED OR CONTINUED TO: [a ❑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 ❑ Invoices / Purchase Orders *Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances ❑ Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑ Recommendation ❑ Professional Sery/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB j*-ugg TWO 91jz2EM= Reimbursement requests #1&2 from McKay Healthcare on the Strategic Infrastructure Program (SIP) #2023-06 for the Engineering & Outdoor Facilities Projects in the amount of $45,899.81. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO ❑ N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO ❑ N/A DATE OF ACTION: PP DENIED ABSTAIN D1: D2: t1A D3: lA-�' 4/23/24 DEFERRED OR CONTINUED TO: [a 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: SIP2023-06 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Engineering and Outdoor Facilities Projects 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 this claim. I also certify that this claim of $8,447.61 is just and 16 NOON" 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. Sig afore Victor Odiakosa Printed Name Date Signed Administrator/Superintendent Title Administrator/Su perintendent Printed Title C (Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # I in the amount of L8,447.61 ATTACHMENT 4 ASBESTOS CENTRAL LLC 1764 WENATCHEE, WA 98807 Bill To McKay Healthcare PO Box 819 Soap lake, WA 98851 Date Invoice # 2/13/2024 1165 I P.O. No. I Terms I Project I Quantity Description Rate Amount Completed an ABIERA survey for suspect AGMs, Removal and disposal of identified 7,793.00 7,793.0OT ACM's (vermiculite insulation), Demo and disposal of incinerator structure and concrete slab @ McKay Healthcare -127 2nd Ave SW, Soap Lake., WA 1312 Soap Lake 8.40% 654.61 Total $8,447.61 608 Asbestos Central LLC 03/07/2024 93732 Invoice Number Invoice Date Description Gross Amount Discount Taken Net Amount Paid 1165: 1172 02/1312024 02/20/2024 Admin - PS - SIP2023-06 Admin - PS - S+P2&A IA $8,1447.61 $250.00 $0.00 $0.00 $8,447.61 $250.00 $81697.611 $0-00I $8,697.61' Ref No, GirLW501-. 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: SIP2023-06 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Engineering and Outdoor Facilities Projects 1, the undersigned, do hereby certify under penalty of perjury, that the materials have been furnished, the services rendered, and/or the laborperformed 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 L372 452-20 is dust 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. Sir -Pure Victor Odiakosa Printed Name -J� Date Signed Administrator/Superintendent Title Administrator/Superintendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37,E phrata, WA 98823 Reimbursement # 2. in the amount of L37,452.20 — ATTACHMENT 4 RE EIVED Fn c JUN 17 2024 GRANT MUM COMIPOiSSIO��t Soorplon Conprote: Ponsty t* Me Ion L 'e' WA -.,9883.7' jlh.voto.e.. 41etalls l ,:, ld".014. Neiq OW'02/ Inv .1ce E). u. 07/ .. oeqpm scl�a�stu�ci°�r�'� o,rpion. LL C MC K ReALTH.CARE. 8." 7. 337 U. Ite. tkiN' lWiS4LCJ.fj4.", M I rl MckaySidewalkProject 2024-3 Estimate #1 Work through June 4th, 2024 To Date Prior To Date Prior Due Wit- 0 UO itV MnA Amo -um t Quantitv Qmantft-y- Amount Amaunt Amunt Sid ewaLk Project 1 LS $ 69.,100.00 0.5 0 $ 34,550.00 $ $ 34;550-00 p TotaLAmount Due- $ 34,550.00 Wa. StateSaLes Tax- $ 21902-20 Less 5% Retainage Bonded Total Amount this Invoice $ 37,452.20 Mcl��y He�tcr� Si:diaiwlk Project Project No. 20.24- Work.throughlu 11e 4p 2-10".2-A.. wner*j��'e'1�� ii f�[�4j .�(1iy {/q] cy{ {q=, ■yam], shy jy�� it ��t�y! f�q{ 4 ..d'. 1 Hea;� 1 W .� .: Y. 4. '�P'� int rCl eI �Ao7 11 7M. i' `�/;1� 8 .' fe' d' d 0 :/bM m"O.K.'a, . an.,.:.: : 1. a :� Lpez BOX'81-9 Total �m�ui�� C�u�'�hi� Es�`rm to i �3-7,�52 ,2 622 Scorpion Concrete Construction LLC OP 10r, /)0'-) A n A A A -7 Invoice Number Invoice Date Description Admin - PS - SIP2023-06 Gross Amount $37,452.20$0.00 A- %-/ A_ --r Discount Taken Net Amount Paid $37,452.20 1.014 06/02/2024 $37,452.20 $0.00 $37,452.20—