HomeMy WebLinkAboutGrant Related - BOCC (007)GRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:OOpm on Thursday)
REQUESTING DEPARTMENT: gOCC
REQUEST SUBMITTED BY: Karrie Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Kal"I"I@ Stockton
CONFIDENTIAL INFORMATION: []YES 8 NO
DATE: 11/6/2025
PHONE:2937
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SUBMITTED:
(CHECK ALL
THAT APPLYP
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Ulm# l�
Reimbursement request from McKay Healthcare &Rehab Center on the
Strategic Infrastructure Program No. 2024-07, Phase 1 Master Planning Project
in the amount of $16,309.00.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 7 N/A
If necessary, was this document reviewed by legal? ❑ YES ❑ NO 0 N/A
DATE OF ACTION: I�' IG'o�.TDEFERRED OR CONTINUED TO:
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
WITHDRAWN:
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: 2024-07
SIP Funding Recipient: McKay Healthcare and Rehabilitation Center
SIP Project Description: Phase I Master Planning
1, the undersigned, do hereby certify under penalty of perjury, that the materials have
been furnished, the services rendered, and/or the labor perfonned as described in the
project proposal for the above -referenced SIP Project and that I am authorize to
1% th :xfio an 1?
authenticate and certify to this clahn. I also certify that this claim of -ol6,309.00 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.
(2 9-:4A-121 -------
Signature
Audra Gutierrez
Printed Name
Date Jignled�_ -
Administrator/SLiperi-ni[endent
Title
Administrator/Su-nerintendent
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823
Reimbursement# 4 . in the amount of $16,3 9.00
ATTACHMENT 4
MACC Estimating Group., LLC
PO Box 935
Liberty Lake, WA 99019 US
RECEIVED b�y u 4 Lu"
------
(509) 981-9393
MAICC
jim@maccestimating-corn
ESTIMATING GROUP
Vendor #: (PW
INVOICE
Bars, Code Name AMO*Vht
M 3,35L
1300
McKay Healthcare
..........
09/02/2025
127 2nd Ave SW
1.3opt. Head Approval:
Due on receipt
Soap Lake, Washington
98851
09/02/2025
US
DATE
ACTIVITY DESCRIPTION
QTY RATE AMOUNT
04/25/2025
Cost Estimating Design Development
I 22s000-00 22,000.00
08/29/2025
Cost Estimating Construction Documents
0 221000.00 0.00
22,000.00
0.00
22,000-00
$22,000.00
Estimate Summary
Estimate BS2025-11
58,000.00
Invoice 1242
14,000.00
This invoice 1300
$22,000.00
Total. invoiced
36,000.00
C
Pay invoice oZ3--bi
...'One ZIP
0-cl.
McKAY HEALTHCARE
656 MACC ESTIMATING GROUP LLC 10/23/2025 95519
Invoice Number Invoice Bate Description Gross Amount Discount Taken Net Amount Paid
1300 09102/2025 Admin - PS - SIP $22,000.00 $0.00 $221000O 00
$22,000.00 $0.00 $22,000.00
Y
M cKAY HEALTHCAFM USBANK 60- 41 095519
127 SECOND AVE SW - PO BOX 819 96-65111=
SOAP LAKE, VITA 98851
(509) 246-1111 10123/2025
PAY TO THE
ORDER OF $22,00+D.00
Twenty Two Thousand Dollars and 00 Cents DOUARS
MACC ESTIMATING GROUP LLC 4 3
PG Box 935
Liberty Lake, VGA 99019 s
`Jy ALP
ji!
MEMO , H4HOAMW *tea M
wIC01,109 5 5 1911" 1. 1 2 3 206 5 LE,'. L 5 3 2 i00 20 1 34""
656 MACC ESTIMATING GROUP LLC 10/23/2025 95519
Invoice Number In---- -voice Date Description Gross Amount Discount Taken Net Amount Paid'
1300 09/02/2025 Admin - PS - SIP $22,000,00 $0.00 $2 ,000.00
i
$22,000.00 $0.001 $22,000.00