HomeMy WebLinkAboutGrant Related - BOCC (009)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@ StOCI(tOCI
CONFIDENTIAL INFORMATION: ❑YES ®NO
DATE: 5/20/2025
PHONE:2g37
❑Agreement / Contract
❑AP Vouchers
❑Appointment / Reappointment
DARPA 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 Reg.
❑Tax Levies
❑Thank You's
❑Tax Title Property
❑WSLCB
��.���
Z�--Izr
Reimbursement request
from McKay Healthcare on the Strategic Infrastructure Program
(SIP) 2023-01 Phase 1 Architecture and Engineering Site Plan Project, in the
amount of $13,916.60.
E
If necessary, was this document reviewed by accounting? ❑ YES
arior to submission_
If necessary, was this document reviewed by legal? ❑ YES ❑ NO
DATE OF ACTION: ,� DEFERRED OR CONTINUED TO:
APPROVE: DENIED ABSTAIN
D2:
D3:
WITHDRAWN:
* N/A
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 1 Architecture and Engineering Site Plan
1, the undersigned, do hereby certify under penalty of perjury, that the materials have
been ftu-nished, 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 ,$13,916.60 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
AudraGutierrez
Printed Name
(�51 icy `a�
Dat�e §ig d
Admini§trot or
/ �Su ermt ndcnt
Title
Adm i'n*i,'stra"tot,./Supenntendent
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 27 'in the amount of $13,916.tou.
.A.._.._
ATTACHMENT 4
275 Fifth Street, Suite 100
Bremerton, WA 98337
(360)377-8773
J J
Public Hospital District No. 4 of Grant County, Washington
P.O. Box 819
Soap Lake, WA 98851
Professional services through 04/3012025
Invoice Summary
4.-
!:
L69 L
9 2 1 t, 5 30
r o v al:
tr-
Invoice number 2023052.00-020
Date 05/09/2025
Project 2023052.00 McKay Healthcare SNP Pre.
Design - Master Planning'
Contract
Total
Prior
Contract
Current
Description
Amount
_0 Billed
Billed
Remaining
Billed
Scope 1A - Conceptual Design
100l184.00
100o184-00
1001,184.00
0.00
0.00
Scope 1A - Schematic Design (Reduced by C07)
66o840-00
66o840.00
66,840.00
0.00
0.00
Scope I B.1 - Site Plan Design (Reduced by
77s200.00
67o162.00
629200.40
100038.00
41961.60 SIP2023-01 oOo*
Change Order 04)
Change Order 02 - Scope 113.2 - Zoning Approval
13,728.00
13,727.90
13g727.90
0.10
0.00
(Reduced by C07)
Change Order 03 - Phase I Schematic Design
1749500.00
174,500.00
174t500.00
0.00
0.00
Change Order 03 - Phase I Design Development
213,000.00
53s685.55
10,916.25
159,314.45
42,769.30 SIP2024-05
Change Order 04 - Phase 2 Master Planning
513940.00
12,658.75
31703.75
39,281.25
8,955.00siP2023-01
Change Order 05 - Phase I CD
Change Order 05 - Phase 1 CD - RFM
166,790.00
0.00
0.00
166,790.00
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 I CD - Landscape
281560.00
0.00
0.00
28,560.00
0.00
Change Order 05 - Phase I CD - Structural
34,160,00
0.00
0.00
340160.00
0.00
Change Order 05 - Phase I CD - MEP
729240.00
0.00
0.00
72,240.00
0.00
Change Order 05 - Phase I CD - Specs
6,750.00
0.00
0.00
-61750.00
0.00
Subtotal
353,300.00
0.00
0.00
353,1300.00
0.00
Change Order 06 - Phase I Food Service DD - CD
34.1496-00
0.00
0.00
34o496-00
0.00
Reimbursable Expenses
4,925.79
4,925.79
41925.79
.0.00
0.00
Total
130901113.79
4931.683.99
436,998-09
596,1429.80
56,685.90
Invoice total 562685.90
Aging Summary
Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120
2023052.00-020 0510912025 56,685.90 56,685.90
Total 56,685.90 56*685.90 0.00 0.00 0.00 0.00
For any questions regarding this invoice please contact Jill Wollard at (360) 377-8773 orjwolfard@rftnarch.com
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-020 Invoice date 05109/2025
Washington
McKAY HEALTHCARE
586 RiceFerq-usMiller
05/1512025 95126
Invoice Number
Invoice Date..
Descr! ptw ion
Gross Amount
Discount Taken
Net Amount Paid
2023052-00-020
05/09/2025
Admin - PS - SIP
$56l685-90
$0.00
$56,685.90
$56l685.901
$0-001
$56,685.90
*0 NOSOOONMOM ROM ..............
McKAY HEALTHCARE us BANK 6041 095126
127 SECOND AVE SW - PO BOX 819 9"5111232
SOAP LAKE* WA 9W51 05116/2025
(509)246-1111
PAY TO THE
ORDER OF
$56,685.90
Fifty Six Thousand Six Hundrec.tl Five Dollars. and 90 Cents DoLLARs
RiceFergusKi.lier
275 Fifth Street, Suite 100 . ....
.:4
Bremerton, WA 98337
IL X ax�
MEMO ��j OWN t4
Stja4ATUFS
111.1604109SI26111 '0w&232065L6l: IS3210020L341l!