HomeMy WebLinkAboutGrant Related - BOCCGRANT 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: Karrl@ Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton
CONFIDENTIAL INFORMATION: OYES BNO
DATE: 8/21/2024
PHONE:2937
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rem
Reimbursement request from Port of Royal Slope on the Strategic Infrastructure Plan
(SIP)#2024-01 in the amount of $85,000.00, this will leave a zero balance.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
0 N/A
4/23/24
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:
r0i
SIP Funding Recipient:
SIP Project.Des t'
crip ion:
2024-01
Port of Royal, Slope
Rd, E SW Waterline E"xtension
L. the undersigned, do hereby certify under penalty of perjury, that the materials have
begin furnished, the, services rendered e
and/or the !Abor Performed as d * scribed 'in the
progect proposal for. the above -referenced SIP Project and that I am authorized to
authenticate and certify to this claim. I also ceitify that this claim of $ &Z obo - W is
just and. duo and is an unpaid obligation against Grant County.
Further, according to the SIP Project Funding Policies, I attest that at the next audit d* of my
entity., this - -'J "
project -shall be called to the attenflon of the Washington State. Aud itol
Office and an emphasis audit will be requested to assure that these funds were expen, . �� d
toward the prof J ect and a cordi to the intent of the proposu.L.
c, cording
Signature
Printed Name
I /
Date Signed --
Title
Printed Title
Completed, signed original certification and ,invoice are to be mailed to:
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823
ATTACHMENT 4
Hilmes Construction Inc.
1716 S. Broadway Ave.
Othello., WA 99344
(509) 488-5295
Bill To
Port of Royal Slope
PO Box 147
Royal City, WA 99357
Less 5% Re
Sales Tax
Page 2
Invoice
Cate I nvo*ic—e#�
8/11/2024 120291
'� Total $135.1229.06
C�tcz� tS �e cgs ago.
K%1
Hilmes Construction Inc.
1716 S. Broadway Ave.
Othello, WA 99344
(509) 488-5295
41
Descr'ipfion
Port of Royal. Slope Road, E SW Water Line Extension
1. Mobilization
2. Connect to Existing
I Traffic Control Plan
4. 12 " Water Line
5,*. 8,11 Water Line
6. Trench -Safety- Systems
7. Imported Backfill Material
8. 12" Gate 'Valve
9-0 1.211 12" x. 172" Tee
0. 1,211 x 12" x,8" Tee
1. 8" x 6" reducer
12.. Fire,Hydrant Assembly
13. 1211 Cap
14. 2" Water Service
15. 12" Mechanical Joint Restraints
.0PT10NB1D
i 1. Mobilization
,2. 12" C900 PVC Water line
13. Imported Backfill Material
14. Trench Safety Systems
1: Chat e::::T InvoiceV
8/11/2024 120291
P.O. No. I Terms
Due on receipt
Quantity Rate Amount
0.9 101000.00 9X0.00T I
0i,9
-3,500000
3J50-00T
0.9
500.00
450.9 11
144*44
65J218.00T
36.19 1
1, 15 075',
471.1 8T
487.8
-2.001
975.60T
90 i
45.00
4�050.00T
0.9
7570.00
61813.00T
0.9
2, 0.00
23070.00T
0.9 1
11000.00
900.00T
0.9 -
650.00
585.00T
0.9 1
71550.00
9795.00T
1*8 i
400.00
720.00T
0.9
4500.00
41050,00T
4.5
350.00
1 1575.00T
0.9
1,000-00
900-00T
131.4
145.00
19,053.00T
18
45.00
, 81 O.00T
I � 1.4
'02 .00
262.80T
----------
Total
Page 1
io;.' I ij 4, Q '.J4
Aft ZAK
Mbaink. 13782
PORT OF ROYAL SLOPE
DISTRICT NO. 2 OF GRANT COUNTY
1800 US BANKS
www.usbank.corn
P.O. BOX 147
ROYAL CITY, WA 99357
96-671/1232
GENERALFUND
8/14/2-024.,
PAY TO THE ORDEROF $ **135,229.06 Ems
One Hundred Thirty -Five Thousand Two Hundred Twenty7N,ine and 06/1
DOLLARS
HILMES CONSTRUCTION INC
1716 S BROADWAY AVE
OTHELLO, WA 99344
en__ - _�x
MEMO ALJTH0R1ZW SIGNATURE
291 _RD ,W e,Extension
__,aterlin,
�1 a ua;
Ill, Pm It 2 10 L A 713 21111 V'No 12 3 20 G 7 h 0 1 S 3 LO 7 38 9 5 3011"
PORT OF ROYAL SLOPE DISTRICT NO, 2 OF GRANT COUNTY
HILMES CONSTRUCTION INC
Date Type Reference Original Amt. Balance Due
8/1412024 Bill II V# 120291 135,22,9.06 135,229.06
General Fund Account INV# 120291 FAD E SW Waterline Extension
PORT OF ROYAL SLOPE DISTRICT NO. 2 OF GRANT COUNTY
HILMES CONSTRUCTION INC
Date Type Reference Original Amt. Balance Due
8/14/2024 Bill INV# 120291 135,229.06 135,229.06
13782
8114/2024
DiSCOUnt. Payment
135)229.06
Check Amount 135,229,06
1351229.06
13782
8/14/2024
Discount Payment
135,229-06
Check Amount 135,229.06
General Fund Account INV# 120291 RD E SW Waterline Extension
135,229.06
SF5001-1 (njZ� SFjfegLjard' REORDER FROM YOUR LOCAL SAFEGUARD DISTRIBUTOR, IF UNKNOWN, CALL 800,523-2422 CDG4VNT0010OL43 V06Sr-0120-116