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Home My WebLink AboutGrant Related - BOCC (002)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: Karrl@ Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal"1'I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 1 /6/2025 PHONE:2937 tCH5CK L A AP PL n ❑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 El 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 Serv/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP) 2024-05 in the amount of $30,900.70. mete a rinanuiai menuesr_ corm n If necessary, was this document reviewed by accounting? ❑ YES ❑ NO R N/A If necessary, was this document reviewed by legal? El YES F-1 N 0 7m N /A ..�+� J DATE OF ACTION: ^% ''Z� DEFERRED OR CONTINUED TO: APPROVE: DENIED ABSTAIN D2: r— D3: 4/23/24 WITHDRAWN: GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding, before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: SIP Funding Recipient: SIP Project Description: 2024-.05 McKay Healthcare & Rehabilitation Phase 1 Master Planning 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 $30,90-0.10 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 funds were expended toward the project and according to the intent of the proposal. mature Victor Odiakosa Printed Name Date Signed ,* ,Aaministrator/Su6nte d n:t Title Administkato/8'g'r ' de . enn � en At. Printed Title Completed, signed original certification and invoice are to be mailed to: Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823 0 D t.-I Q � Reimbursement # 2 in the amount of-S-34MS`- ATTACHMENT 4 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 perfort-ned 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 $38 +1„'92.91 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 funds were expended toward the project and according to the intent of the proposal. Signature Victor Odlakosa ------ W, Printed Name L Date Signed Ad,ministrator,,f'Superintenden:t Title AdministratoLiSuperintendent Printed Title Completed., signed original certification and invoice are to be mailed to: <ZY Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 21 in the amount of $38,192.91. 5110 3011100&-JO J024-05 PwM 6Na. L ATTACHMENT 4 -1;Z92*2.1 20L3-0( McKAY HEALTHCARE 586 Rice FergusM iller 12/015/2024 94624 Invoice Number 'Invoice Date Description ..... Gross Amount Discount Taken Net Amount Paid 2023052.00-014 11/18/2024 Admin - 1. PS - SIP2023-01 $38t19 VI $0.00 $38,192.91 ------- - _rj 7 $38,192.911 $0.001---- $3692 McKAY HEALTHCARE US BANK 6041 094624 127 SECOND AVE SW - PO BOX 819 96-65111232 SOAP LAKE, WA 98851 12/05/2024 (509) 246-1111 PAY TO THE ORDER OF MEMO $38J92.91 Thirty Eight Thousand One Hundred Ninety Two Dollars and 91 CF&t4LARS Rice Fergus Miller 275 Fifth Street, Suite 100 Bremerton, WA 98337 110 F30t, L094 1� 2 L, 1" 1: 12 3 20C3 5 11; 15 3 2 100 20 13 40 RIC -blit-MMLUM 275 Fifth Street. Suite 100 Bremerton, WA 98337 (360) 377-87711 Public Hospital District No. 4 of Grant County, Washington P.O. Box 819 Soap Lake, WA 98851 Victor Odiakosa Professional services through 10/31/2024 s BY Invoice number 2023052.00-014 Date 11/18/2024 Project 2023052-00 McKay Healthcare SNIF Pre - Design - Master Planning Invoice Summary Contract Total Prior Contract Current Description Amount Billed Billed Remaining Billed Scope I A - Conceptual Design 100,184.00 94,360.00 94,360-00 5,824.00 0.00 Scope 1A - Schematic Design 78,936.00 59,975.52 54,870.56 18,960.48 5,104-96 Scope 113.11 - Site Plan Design 879280-00 54,800.00 541800-00 32,480.00 0.00 Change Order 02 - Scope 1 B.2 - Zoning Approval 40,000.00 110565.10 9,522.60 28,434.90 21042.50 Change Order 03 - Phase I Schematic Design 174,500.00 60,905.70 30,005-00 113,594.30 < JmaL�-�)5 Change Order 03 - Phase 1 Design Development 213,000.00 0.00 0.00 213,000-00 0.00 Reimbursable Expenses 0. - 0 - 0 3,190.62 3,045.87 -3,190.62 144.75 Total 693i"900.00 284f796.94 246,604.03 409,103.06 38,192.91 Change Order 02 - Scope 113.2 - Zoning Approval Labor Billed Units Rate Amount Dean Kelly Loreta L. Cook Change Order 02 - Scope 1 B.2 - Zoning Approval subtotal Reimbursable Expenses Reirribursables IRS 2024 Mileage Reirnbursables 0.25 250.00 62.50 9.00 220-00 1,980.00 2,042.50 Billed Units Rate Amount 193-00 0.75 144.75 Invoice total 38,192.91 Aging Summary Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 2023052.00-012 09/13/2024 6,352.60 6,352.60 2023052.00-014 11/1812024 38,192-91 38,192.91 Total 44,545.51 38,192.91 0.00 6,352.60 0.00 0.00 Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-014 Invoice date 11 /1812024 Washington Public Hospital District No. 4 of Grant County, Washington Invoice number 2023052.00-014 Project 2023052.00 McKay Healthcare SNIF Pro -Design - Master Planning Date e 11/18/2024 WPM" - For any questions regarding this invoice please contact Jill Wolfard at (360) 377-8773 orjwolfard@rFmarch.com Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-014 Invoice date 11118/2024 Washington