HomeMy WebLinkAboutGrant Related - BOCCGRANT 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: KaCI'I@ Stockton
CONFIDENTIAL INFORMATION: ❑YES LINO
DATE: 1 /26/2026
PHONE:2937
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Reimbursement request
from McKay Healthcare and Rehab Center on the
Strategic Infrastructure Program (SIP), Project 2024-07 Phase 1 Master Planning
Continued in the amount of $108,517.35.
If necessary, was this document reviewed by accounting? ❑ YES
APPROVE: DENIED ABSTAIN
D 1: !2 �
D2:
D3:
F
❑NO 7N/A
a N/A
4/23/24
% GRANT COUNTY
Q,TRATEGIC 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 1 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 authorized to
authenticate and certify to this claim. I also certify that this claim of $1,08,517.35 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.
140%
AAV
Siature
Audra Gutierrez
Printed Name
Date-, ign.ed.
d m *1 n Ls gr _atom /.S. u v e r. i n t nd ht
Title
A .,t * - - - . '0 .. A -
ACmintgrator/Suverintennent
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823
Reimbursement,# 6 in the amount of 1108,517.35
ATTACHMENT 4
Rq (e
275 Fifth Street, Suite 100
Bremerton, W.A 98337
(360) 377-8773
Public Hospital District No. 4 of Grant County, Washington
P.O. Box 819
Soap Lake, WA 98851
Professional services through 10/31/2025
--------------
Invoice Summary
t 11� � 7,4 0- ()1
Invoice number 2023052.00-025
Date 11121/2025
Project 2023062.00 McKay Healthcare SNF Pre -
Design - Master Planning
Contract
Total
Prior
Contract
Current
Description
Amount
Billed
Billed
Remaining
Billed
Scope 1A - I Conceptual Design
1001184.00
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 I B.1 - Site Plan Design (Reduced by
77,200-00
77,,200.00
77t200.00
0.00
0.00
Change Order 04)
Change Order 02 - Scope 113.2 - 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 1 Design Development
2130000.00
213s000.00
213,000-00
0.00
0.00
Change Order 04 - Phase 2 Master Planning
51,940.00
28,750.40
28,750.40
23,189.60
0.00
Change Order 05 - Phase I CD
3530300-00
193,604.35
850087-00
159,695.65
1089517.35
Change Order 06 - Phase I Food Service DD - CD
34,496.00
6,921.60
61921.60
270574.40
0.00
Expenses
4192539
4,925.79
4,925.79
1 . 0.00
0.00
'Reimbursable
--- - ------Total
11090,113.79
879,654.04
771,136.69
210,459.75
108,517.35
Invoice total 108,617.35/
Aging Summary
Invoice Number Invoice Date Outstanding_ Cu rre nt Over 30.. Over 60 Over 90 Over 120
2023052-00-024 10/13/2025 10,875.00 10,875-00
2023052.00-025 11121/2026 108,517.35. 108,517.35
- - - - --- ------------- '111-1.1"..
Total 119,392.35 108,517.35 10,875.00 0.00 0.00 0.00
For any questions regarding this invoice please contact Lori Hoggard at (360) 362-1433 or lhoggard@tfmarch.com.
Public- Hospital District No. 4 of Grant County, Invoice number 2023052.00-025 Invoice date 11/21/2025
Washington
McKAY HEALTHCARE
RiceFergusMiller
01/20/2026 95747
- ---------------
--------------------
-- -- --- ---
----------------------- - ---- -------
. ............
-------------
McKAY HEALTHCARE US BANK 6041 095747
127 SECOND AVE SW - PO BOX 819 96-65111232
SOAP LAKE, WA 98861
(509) 246-1111 01/20/2026
PAY TO THE
$
ORDER OF $218,665.35
Two Hundred and Eighteen Thousand Six Hundred Sixty Five Dollars%RM-W
Cents
RiceFergusMiller
275 Fifth Street, Suite 100
Bremerton, WA 98337
MEMO
AUTHORMED SIONAWA
Ole-,
260L, L09 S 74 WN L 23 201�S LP=11"M L S 3 2 LOO 20 13 Lt H"
586 RiceFergusMillor 01/2012026 957471,
- — ----------
Invoice Number Invoice Date Description ------ Gross Amount Discount Taken Net Amount P is
2023052000-025 11/2112025 SIP 2024-07 $108,517.35 $0.00 $108t617.35
2023052.00-026 12/1812025 SIP 2024-07 $1102148.00 $0.00: $110,148.00
$218,665.351 $0.00 $218,665.35