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Home My WebLink AboutGrant Related - BOCC (005)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: Kat'I"I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 1 /2 1 /2025 PHONE:2g37 IN ❑Agreement / Contract DAP Vouchers ❑Appointment / Reappointment ❑ARPA 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 Serv/Consultant ❑ Support Letter ❑ Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB Matey i/- - Reimbursement request from McKay Healthcare on the Strategic Infrastructure UA W W -_ - ---Project (SIP) #2023-01 in the amount of $1345.50. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO 0 N/A DATE OF ACTION: — APPROVE: DENIED ABSTAIN D1: 4� D2: �. D3: 4/23/24 DEFERRED OR CONTINUED TO: WITHDRAWN: GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding, before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: SIP2023-01 SIP Funding Recipient McKay Hospital & Rehab SIP Project Description Phase 1 Architecture and Engineering Site Plan 15 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 $1,345.50, 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 any 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. Signaturdo/', Victor Odiakosa "00 Printed Name o� —Date S igned Administrator/Superintendent Title ,Adm,*im*strator/Sut)e.n*ntendent Printed Title Completed, signed original certification and invoice are to be mailed to: Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823 ffn Reimbursement # 23 in the amount of $1,345.au ATTACHMENT 4 McKAY HEALTHCARE 606 Western Pacific Engineering & Survey, Inc 01 /09/2025 94725 Invoice Number Invoice Date Description Cross Amount Discount Taken Net Amount Paid 14975 15010 12/01 /2 024 12/17/2024 Admin - PS -SIP 2023-01 Admin - PS - SIP 2023-01 $500.00 $845.50 $0.00 $0.00 $50900 $845.50 $1, 345.50 $0.00 $1,35.50 PAY TO THE ORDER OF MEMO McKAY HEALTHCARE us BAND 6041 094725 127 SECOND AVE SIN - PO BOX 819 96-651/1232 SOAP LAKE, WA 98851 (509) 246-1111 1 !Q9/2025 Western Pacific Engineering & Survey,lnc 1224 S Pioneer Way Moses Lake, WA 98837 $ $1,345.50 One Thousand Three Hundred Foq Five Dollars and 50 Cents DOLLARS n' V�'wvw � ft— ip 90 4 L0 9 4? 2 51; 1 2 3 2 0 1� 5 L C3 L 5 3 2 L00 20 L 3 4� Western Pacific Engineering & Survey, Inc. Moses Lake, WA 98837 (509) 765-1023 E-Mail accounting@wpeine.net McKay Healthcare & Rehab ATTN: Cliff Sears P.O. Box 819 Soap Lake, WA 98861 Description Professional Surveying Services in support of die existing project located on Parcel Nos. 08-0383,000 & 08-0655-006 within a portion of Section 24, Township 22 North, Range 26 East, W.M. Grant County, WA TASK ORDER #3 - LEGAL DESCRIPTION W/EXHIBIT (5) 1 500-00 500.00 Vendor #AC� (r'- 0 r 1, Arni qA 4 Sam codo- Name L01 -AA*- -4 Total: Dept. He"a'd AppVC."Val. Invoice Invoice #: 14975 Invoice Date: 12/1/2024 Due Date: 12/1/2024 Project: 23170 P.O. Number: � i P aoi,;s *Licensed in Washington and Idaho Payment shall be due within 30 days of billing unless prior arrangements have been made. This service shall bear interest at the rate of 1.5% per month on the unpaid balance, commencing 30 days from date of initial billing. A minimum charge of $1.00 per month shall be to all past -due accounts. Should the account be referred to an attorney or collection agency for collection, the undersigned shall pay reasonable attorney's fees and collection expenses. WPES reserves the right to lien your property for any unpaid balances until the time your balance is paid in full. Total $500.00 Payments/Credits 0 -- - - - ---------- QTY Balance Due $500.00 changed Rate Amount Serviced Western Pacific Engineering & Survey, Inc. Moses Lake, WA 98837 (509) 765-1023 E-Mail accounting@wpeinc.net McKay Healthcare & Rehab ATTN: Cliff Sears P.O. Box 819 Soap Lake, WA 98861 Description Professional Surveying Services to complete an ALTA Survey for project located on Parcel No. 08-0380-000 within aportion ofSection 24, Township 22 North, Range 26 East, W.M. Grant County, Washington. BOUNDARY LINE ADJUSTMENT RECORDING FEE Code (A -3-5- f .50 Totai- 'c Dept. 1-1,ea'd Aprphrc-,�izj�, 0, Invoice Invoice#: 15o10 Invoice Date: 12/17/2024 Due Date: 12/17/2024 Project: 23170 P.O. Number: SIP 2023-01 QTY Rate Amount Serviced *Licensed in Washington and Idaho Payment shall be due within 30 days of billing unless prior arrangements have been made. This service shall bear interest at the rate of 1.5% per month on the unpaid balance, conunencing 30 days from date of initial billing. A minimurn charge of S 1,00 per month shall be charged to all past -due accounts. Should the account be referred to an attorney or collection agency for collection, the undersigned shall pay reasonable attorney's fees and collection expenses. WES reserves the right to lien your property for any unpaid balances until the time your balance is paid in full. Total $845.50 .11. 1.44eO 4 Payments/Credits $0.00 Balance Due $845.50