HomeMy WebLinkAboutGrant Related - BOCC (004)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: Karrle Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Kal"t"I@ Stockton
CONFIDENTIAL INFORMATION: ❑YES BNO
DATE: 11/6/2025
PHONE:2g37
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[4`111= *3 9:4 a U116i �!j 19 a IN M I
"I"Mansum luilliffam"M
Reimbursement request from McKay Healthcare & Rehab Center on the
Strategic Infrastructure Program (SIP) No. 2023-01 Phase 1 Architecture & Engineering
Site Plan, in the amount of $4,614.40.
If necessary, was this document reviewed by accounting? ❑ YES
•
If necessary, was this document reviewed by legal? ❑ YES ❑ NO
DATE OF ACTION: I k • 10' as -
APPROVE: DENIED ABSTAIN
D1:
D2:
D3.
4/23/24
❑NO ON/A
DEFERRED OR CONTINUED TO:
WITHDRAWN:
0 N/A
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 PTcj ect and that I ain authorized to
110
authenticate and certify to this claim. I also certify that this claim of $4,614.4 *s 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.
ki A 'OVA
-N IdA
Signature
Audra Gutierrez
Printed Name
Date Signed
Administrator/Superintendent
Title
Adnn*m*strator/SUVen*ntendent
Printed Title
Completed, signed original certification and invoke are to be mailed to:
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 31 in the amount of $4,614.40.
ATTACHMENT 4
Rq(erguARm
275 Fifth Street, Suite 100
Bremerton, WA 98337
t360) 3.77-8773
Public Hospital District No. 4 of Grant County, Washington
P.O. Box 819
Soap Lake, WA 98851
Professional services through 08/31/2025
Invoice Summary
Invoice number 2023052.00-023
Date 09115/2025
Project 2023062.00 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
100,184.00
0.00
0.00
Scope 1 A - Schematic Design (Reduced by C07)
66,840-00
66,840-00
66,840-00
0.00
0.00
Scope 1 B.1 - Site Plan Design (Reduced by
77,200.00
77,200.00
77,200.00
0.00
0.00
Change Order 04)
Change Order 02 - Scope 113.2 - Zoning Approval
13,728.00
13,727.90
13l727.90
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
213;000.00
213,000-00
0.00
0.00
Change Order 04 - Phase 2 Master Planning
51,940.00
28,750.40
289750.40
23,189.60
0.00
Change Order 05 - Phase 1 CD
353g300.00
74,212.00
20,065.00
279,088.00
RAIJ
Change Order 06 - Phase I Food Service DD - CD
34,496.00
6,921.60
2,307.20
27,574.40
4,614A0 U13
Reimbursable-, Expenses
4,925.79
4,925.79
41925.79
0.00
0.00
Total 1,1090,113.79 760,1261.69 701,500.29 329,852.10 58,1761.40
Invoice total 58,761.40
Aging Summary
Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over9O Over 120
2023052.00-023 09/15/2025 58,761.40 58,761.40
Total 58,761.40 58,761.40 0.00 0.00 0.00 0.00
For any questions regarding this invoice please contact Jill Wolfard at (360) 3778773 orjwoffard@rfmarch.com
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-023 Invoice date 09/15/2025
Washington
McKAY' HEALTHCARE
586 RiceFergusMiller 10/23/2025 95525
Invoice Number ------------- Invoice Date Description Gross Amount Discount Taken I Net Amount Paid
202305200-023 09/15/2025 Admin - PS - SIP $58,761.40 $0.00 $58l761.40
$589761.401 $0.00 $58,761.40
McKAY HEALTHCARE US BANK 6041 095525
127 SECOND AVE SW - PO BOX 819 9"5111232
SOAP LAKE, WA 98851
(509)246-1111 10/23/2025
PAY TO THE ORDER OF $58t761.40
Fifty Eight Thousand Seven Hundred Sixty One Dollars and 40 CentROLLARs
RiceFergusMilter rk
275 Fifth Street, Suite 100
Bremerton, -----------
WA 98337
MEMO Ai irkn000n cin-mwn i=
iie P304 109SS 2S'l* 1: 123 20P3 S I C31: IS 3 2 LOO 20 13 till*
586 RiceFergusMil-ler 10/23/2025 95525
Invoice Number -- Invoice Date Description Gross Amount Discount Taken Net Amount Paid
2023052.00-023 09/15/2025 Admin - PS - SIP $58,761.40 $0.00 $58,761.40
$58,761.40 $0.001 $58,761.40