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'1"I@ Stockton
CONFIDENTIAL INFORMATION: ❑YES 8 NO
DATE: 5/8/2025
PHONE: 2937
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Reimbursement request from McKay Healthcare on the Strategic Infrastucture Program
(SIP) No. 2023-01 Architecture/Engineering Site Plan Project in the amount of $3,703.75.
Remaining balance is $42,991.1010.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A
If necessary, was this document reviewed by legal? ❑ YES ❑ NO R N/A
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D 1: �.
D2:
D3.
DEFERRED OR CONTINUED TO:
WITHDRAWN:
4/23/24
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
prof ect 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.$3,70175 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.
Lisa Tellefson -0
Printed Name
Date Sianed
Administrator Doi nee1DNS
Title
Administrator Designee/DNS
Printed Title
Completed, signed original certification and invoice are to be mailed to,
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 26 in the amount of $32703.7311
ATTACHMENT 4
Rot-12114MIER
275 Fifth Street, Suite 100
Bremerton. WA 98337
(360)377-8773
RECEIVED ,1Pa 211U25
Public Hospital District No. 4 of Grant County, Washington
P.O. Box 819
Soap Lake, WA 98851
Professional services through 03/3112025
Invoice Summary
i)o
Invoice number 2023052.00-019
Date 04/1512025
Project 2023052.00 McKay Healthcare SNF Pre -
Design - Master Planning
Contract
Total
Prior
Contract
Current
Description
Amount
Billed
Billed
Remaining
Billed
Scope 1A - Conceptual Design
100,184-00
100,184.00
1003184-00
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 I BA - Site Plan Design (Reduced by
77,200.00
62,200.40
621200.40
141999.60
0.00
Change Order 04)
Change Order 02 - Scope I B.2 - Zoning Approval
13,728.00
13,727.90
13,727.90
0.10
0.00
(Reduced by C07)
Change Order 03 - Phase I Schematic Design
174,500.00
174,500.00
174,500.00
0.00
0.00
Change Order 03 - Phase I Design Development
213,000-00
10,916.25
4,160-00
2021083.75
6,756.25
Change Order 04 - Phase 2 Master Planning
51 T940.00
3,703.75 vl---�
0.00
48,236.25
31703.75"S"i'-
Change Order 05 - Phase I CD
Change Order 05 - Phase I CD - RFM
173,540.00
0.00
0.00
173,540-00
0.00
Change Order 05 - Phase I 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 I 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 Order 06 - Phase I Food Service DD - CD
34,496-00
0.00
0.00
34,496-00
0.00
Reimbursable Expenses
4,925-79
4,925-79
4,925.79
0.00
0.00
Total
1,090,113.79
436.998.09
426,538-09
653,115.70
10,460.00
Invoice tht-al 10,460-00
Aging Summary
Invoice Number
Invoice Date
Outstanding Current Over 30 Over 60 Over 90 Over 120
2023052.00-018
03/12/2025
4$160.00 4,160.00
2023052.00-019
04/15/2025
10,460-00 101-460-00
Total
14,620-00 10,460.00 4,160.00 0.00 0.00 0.00
For any questions regarding this invoice please contact A Wolfard at (360) 377-8773 orjwolfard@rfmarch.com
--------------- I - - --------- -
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-019 Invoice date 04115/2025
Washington
McKAY HEALTHCARE
586 Rice FergusMi Iler
Invoice Number Invoice Date Description
2023052-00-019 104/15/2025 Adm -PS-SI P2023-01 /2024-05
McKAY HEALTHCARE
127 SECOND AVE SW - PO BOX 819
SOAP LAKE, WA 98851
(509)246-1111
04/24/2025 95055
Gross Amount Qiscount Taken Net Amount Paid
$10*460.00, $0.001 $10,460.00
10J46-0,0001 $0_.POJ $10,460.00
US HANK 6041 095055
96-651/1232
04/2412025
PAY TO THE $10,460.00
ORDER OF
Ten Thousand Four Hundred S' Dollars and 00 Cents DOLLARS
RiceFergusMilter
275 Fifth Street, Suite 100
Bremerton, WA_ 98337
MEMO AUTHOFUZED StCa"rJFAZ_
jit60Lt 109 SOS SV 1: 1 23 2065 161: IS 3 2 100 20 L3 Lill*