HomeMy WebLinkAboutGrant 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: gOCC
REQUEST SUBMITTED aY: Karrie Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Kal'1"le Stockton
CONFIDENTIAL INFORMATION: ❑YES ® NO
DATE: 5/8/2025
PHONE: 2937
TYPE(S) OF DOCUMENTS
SUBMITTED:
ICHECK ALL
THAT APPLY)
❑Agreement / Contract
❑AP 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
Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program
(SIP) No. 2024-05 Master Planning Project, in the amount of $6,756.25.
Remaining balance is $198,265.89.
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:
D2:
D3:
DEFERRED OR CONTINUED TO-
WITHDRAWN -
4/23/24
GRANT COUNTY
STRATEGIC INFRASTRUCTURE PROGRAM
FROJIECT 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 PI n1i I -a
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 $6,756.25 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 WasMngton 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.
�� Y %.
Signature
Lisa Tellefson .......... ..................... mom
Printed Name
Date Signed
Aft. ft u-strator Desig- ge- e/DN'S
Title
Administrator Desi t*[DNS
Printed. Title
Completed, signed original certification and invoice are to be mailed to:
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823
AW
Reimbursement # 6 in the amount of $6,756,21,z)
ATTACHMENT 4
R cVIALLER
275 Fifth Street, Suite 100 l
Bremerton. VITA 98337
{360} 377-8773 - - ----- -- - - - - -- - - - - `�-'� --
�SCEjVFD
Public Hospital District No. 4 of Grant County, Washington
Invoice number
2023052.00-019
P.O. Box 819
-
Date
04/15/2025
Soap Lake, WA 98851�
h
Project
2023052.00 McKay Healthcare
SNF Pre-
::
Design - Master Planning
Professional services through 03/31/2025
Invoice Summary
Contract
Total
Prior
Contract
Current
Description
Amount
Billed
Billed
Remaining
Billed
Scope 1A - Conceptual Design
100,184.00
100,184.00
100,184.00
0.00
0.00
Scope 1A - Schematic Design (Reduced by C07)
66,840.00
66,840.00
66,840.00
0.00
0.00
Scope 113.1 - Site Plan Design (Reduced by
77,200.00
62,200.40
62,200.40
14,999.60
0.00
Change Order 04)
Change Circler 02 - Scope 113.2 - Zoning Approval
139728.00
131727.90
13,727.90
0.10
0.00
(Reduced by C07)
Change Order 03 - Phase 1 Schematic Design
1740500.00
174,500.00
174,500.00
0.00
0.0O
Change Order 03 - Phase 1 Design Development
213,000.00
10,916.25
4,160.00
202,083.75
6,756.2�-�
Change Order 04 - Phase 2 Master Planning
51,940.00
31703.75
0.00
48,236.25
3,703.75 SIP 2023-1
Change Order 05 - Phase 1 CD
Change Order 05 - Phase 1 CO - RFM
173,540.00
0.00
0.00
173,540.00
0.00
Change Order 05 - Phase 1 CD - Civil
44,800-00
0.00
0.00
44,800.00
0.00
Change Order 05 - Phase 1 CD - Landscape
28,560.00
0.00
0.00
28,560.00
0.00
Change Order 05 - Phase 1 CD - Structural
34,160.00
0.00
0.00
34,160.00
0.00
Change Order 05 - Phase 1 CD - MEP
72,240.00
0.00
0.00
72,240.00
0.00
Subtotal
353.300.00
0.00
0.00
353,300.00
0.00
Change Girder 06 - Phase 1 Food Service DD - CD
349496.00
0.00
0.00
34,496.00
0.00
Reimbursable Expenses
41925.79
4,925.79
41925.79
0.00
0.00
Total
1,090,113.79
436,998.09
426,538.09
653,115.70
10,460.00
Invoice total
105460.00
Aging Summary
Invoice Number Invoice Date Outstanding
Current
Over 30
Over 60
Over 90
Over 120
2023052.00-018 03/1212025 4,160.00
40160.00
2023052.00-019 04/15/2025 10,460.00
10,460.+00
Total 14,620.00
10,460.00
4,160.00
0.00
0.00
0.00
For any questions regarding this invoice please contact Jill VWolfard at (360) 377-8773 orjwolfard@rfmarch.com
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-019
Invoice date 04/15/2025
Washington
McKAY HEALTHCARE
586 RiceFerguslVl-iller
1--- n ----- v- o-ice Number Invoice Date Description
2023052.00-019 104/15/2025 lAdm-PS-SIP2023-01/2024-1
PAY TO THE
ORDER OF
04/24/2025 95055
— - -------- ----- ------- Gross Amount Di' -----
i
------ scount Taken Net Amount Pai
$10v460.00 $0.00 $10,460-00
$ $10,460.00
Dollars and 00 Cents 00U-ARS
W40�
MEM®
iiv60� L09 SOS SO L 23 206S LGi: L S 3 2 LOO 20 L34ii*
RiceFergusMiller
275 Fifth Street, Suite 100
Bremerton, WA 98337
Ten Thousand Four Hundred