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'I'12 Stockton
CONFIDENTIAL INFORMATION: ❑YES ® NO
DATE: 1 /26/2026
PHONE: 2937
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IRE,/%/��iy��/i��"�%��/��i/��'�,
Reimbursement request from McKay Healthcare and Rehab Center on the
Strategic Infrastructure Program, Project No. 2025-03 Kitchen Expansion in the
amount of $1,500.
If necessary, was this document reviewed by accounting? ❑ YES
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D2:
D3:
❑NO ON/A
DEFERRED OR CONTINUED TO-
WITHDRAWN -
0 N/A
4/23/24
GRANT COUNTY
�,TRATEGIC INFRASTRUCTURE PROGRAJ
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: 2025-03
SIP Funding Recipient: McKay Healthcare and Rehabilitation Center
SIP Project Description-, Phase I Kitchen Expansion
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 Project and that I am authorized to
01
authenticate and certify to this claim. I also certify that this claim of $�.�.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 ensure that these funds were expended
toward the project and according to the intent of the proposal.
Signature
Audra Gutierrez-Ritari
Printed Name
Date * D Si*gn e"d
te
Administrator
Title
Administrator
Printed Title
Completed, signed original certification and invoice can be mailed to:
Grant Administrative Specialist, PO Box 37, Ephrata, WA 98823 or emailed to the
Grants Administrative Specialist, Kstockton*grantcountywa.gov
4.
Reimbursement # 2 in the amount of $1,500.00
ATTACHMENT 4
MACC Estimating Group, LLC
PO Box 935
Liberty Lake, WA 99019 US
(509) 981-9393
jim @maccestimating cam
T
McKay Healthcare
127 2nd Ave SW
Soap Lake, Washington 98851
us
DATE ACTIVITY
12/23/2025 Cost Estimating
DESCRIPTION
Schematic Design
Estimate Summary
Estimate BS2025-67
This invoice 1339
Total invoiced
Pay invoice.
QTY
1
1339
1212612025
Due on receipt
12/26/2025
RATE AMOUNT
1,500.00 15500.00
1,500.00
0.00
1;500-00
$1$500.00/
1,500.00
$10500.00
1,500.00
McK" HEALTHCARE
ARA MArr. PSTIMATING, GROUP LLC 01/2012026 95736
PAY TO THE
ORDER OF
----------------- ----- . . ......
--------------- - - - - - - - - - - - - - ..... t
----- ------
US BANK
McKAY HEALTHCARE 6041 095736
127 SECOND AVE SW - PO BOX 819 96-65111232
SOAP LAKE, WA 98851
(509) 246-1 111 - 01/20/2026
$1,500.00
One Thousand Five Hundred Dollars and 00 Cents DOLLARS
MACC ESTIMATING GROUP LLC
PO Box 935
Liberty Lake, WA 99019
MEMO AUTHORIZED SIGNATURE
11*604.Loq S? 3611m 1: 123 20[6S 161: IS 3 2 100 20 13to"11
656 MACC ESTIMATING GROUP LLC 01120/2026 95736
i Gross Amount Discount Taken Net Amount Paid
Invoice Number Invoice Date Description 12/23/2025 $1,500.00 $0.00 $1,500.00
1,339
$ 1 500.00 $0.00 $1950Q.00j