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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: BOCC REQUEST SUBMITTED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal"CI@ Stockton CONFIDENTIAL INFORMATION: ❑YES ®NO DATE: 1 /6/2025 PHONE:2937 WIT - ❑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 &-ilm*11111 2AIDU11119 lojjm�glm= ju � tMilluT Tj ITTIXTITI Gxmj� Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP) 2023-01 in the amount of $7,292.21. 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: /-/y —2j— DEFERRED OR CONTINUED T0: APPROVE: DENIED ABSTAIN D1. r D2: D3: WITHDRAWN: 4/23/24 GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding,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: 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 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 $7,292.21 is just and due and is an unpaid obligation against Grant County. C� 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 Odiakosa Printed Name / fz� Date 54igned Admini'strator/Supefintendent Title Administrator/Superintendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 21 - REVISED in the amount of $7,292.2.t 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 11 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 1$38,192.91 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 Odiakosa Printed Name Date Signed Administrator/Su ve nntendent Title, Administrator/Superintendent Printed Title Completed. signed original certification and invoice are to be mailed to-,. .r C;7 Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 Reimbursement # 21 in the amount of $38,192.91 :S —11 2�z 10Z �p�gpp.�o ATTACHMENT 4 McKAY HEALTHCARE 586 RiceFergusMiller Invoice Number Invoice Date Description 2023052-00-014 111/18/2024 Admin PS - SIP2023-01 12105/2024 94624 Gross Amount l Discount Taken Net Amount Paid - $38,192-911 $0.001 $38,192.91 - -- ------- - ...... '1 1 $38 -- $381192.9li $0.00, 92-91 McKAY HEALTHCARE US BANK 6041 094624 127 SECOND AVE SW - PO BOX 819 96-65111232 SOAP LAKE, WA 98851 12/05/2024 (509) 246-1 Ili PAY TO THE $38,192.91 ORDER OF MEMO Thirty Eight Thousand One Hundred Ninety Two Dollars and 91 GARS RiceFergusMiller .01 275 Fifth Street, Suite 100 Bremerton, WA 98337 W' 6 D t, 10 9 t, F3 240 '"M 12 3 2 0 Ca S 1;,: 15 3 2 100 20 13 411" Ric erwAmiLLeR 275 Fifth Street, Suite 100 Bremerton, 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 10/3112024 Invoice number 2023052.00-014 Date 11 /1812024 Project 2023052.00 McKay Healthcare SNF Pre - Design - Master Planning Invoice Summary Contract Total Prior Contract Current Description Amount Billed Billed -- -- ------ Remaining Billed Scope 1A - Conceptual Design 1001184.00 94,360.00 94,360.00 5,824.00 0.00 Scope 11A - Schematic Design 78.936.00 59,975.52 54,870.56 18,960.48 5,1104.96 Scope I B.1 - Site Plan Design 87,280.00 541800.00 54,800.00 32,480.00 0.00 Change Order 02 - Scope I B.2 - Zoning Approval 40,000.00 11,565.10 9,522.60 28,434.90 2,042.50 Change Order 03 - Phase I Schematic Design 174,500-00 60,905.70 30,005.00 113,594.30 (3- 0,9 0 0.7 Change Order 03 - Phase I Design Development 213,000-00 0.00 0.00 213,000,00 0.00 Reimbursable Expenses 0.00 3,190.62 3,045.87 -3,190.62 144.75 Total 693,900-00 284,796.94 246,604-03 4091, 103.06 38,192,91 Change Order 02 - Scope I B.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 0.25 250.00 62.50 9.00 220.00---- 11980.00 2,042.50 Reirnbursables Billed Units Rate Amount IRS 2024 Mileage Re imbursables 193.00 0.75 144.75 Invoice total 38,1192.91 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 11118/2024 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 SNF Pre -Design - Master Planning Date 11/1812024 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 1111812024 Washington