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Home My WebLink AboutGrant 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: K81"1"I@ Stockton CONFIDENTIAL INFORMATION: ❑YES ®NO DATE: 4/24/2026 PHONE:2937 ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ®ARPA 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 Req. [--]Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB Reimbursement request from Coulee City Fire Department on the American Rescue Plan Act (ARPA) in the amount of $52,770.44 which is the total grant award. 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 ❑ YES ❑ NO 0 N/A DATE OF ACTION: ,, DEFERRED OR CONTINUED TO- APPROVE: DENIED ABSTAIN DZ D3: WITHDRAWN - 4/23/24 ZO) 21012AR"O, A R PA, v e r e ("-I, 1i e r aa i ril D U I't m ra n t TUnds for the �ofl ow i n g V , 'Items. yii DefibridaLors with acce, sories TWo Preven"LaLIVe M- Pi-kains To a I I r% - z. 3 Z, 21, 0'' 9 0 4 1 o�a-1 gva� a,)aoc� Don W. Ru! s hton, Ch lic.,� Coulee CiIre€ EyMS 2!OLLO World Wide Headquarters 269 Mill Road Chelmsford, MA 01824 Attn: Accounts Payable Coulee City Fire Department PO Box 398 Coulee City, WA 99115 Remit To: ZOLL Medical Corporation PO Box 27028 New York, NY 10087 Phone: (800) 348-9011 -- -------- Invoice Invoice Seq PO Number 4347490 DON RUSHTON Coulee City Fire Department 317 W Main St Coulee City, WA 99115 Payrnent Terms Inv Date Due Date -1.-c3ales Order Num'ber Customer Number NET 30 DAYS 15-OCT-25 14-NOV-25 5010409 18053 Ship Date Ship Via Shipping Reference Sales Person 15-OCT-25 UPS -Parcel- 1Z038EO70394636956 Ground Item Description Oty Unit Price Amount 1 601-2231011-01-662 X SERIES, MONITOR DEFIBRILLATOR, 12 LD W/ 2 21.800,00 43,600.00 INTERP, ECG, PACING, NIBP, SP02, SPCO, CPR EXPANSION PACK. ETCO2, D 1-MSD T REFURB (TIER 2_) TRADE-IN ALLOWANCE 400.00 2 8900-0400 CPR STAT-PADZ ELECTRODE (P/N 8900-0402'), 811CASE 1 561.75 561 3 8300-000208 MiCROSTREAM ADVANCE ADULT -PEDIATRIC 1 25920 .75 259.20 INTUBATED CO2 FILTER LINE, SHORT TERM USE, BOX OF 25 4 8300-000200 MICROSTREAM ADVANCE ADULT ORAL -NASAL CO2 1 343-80 343-80 FILTER LINE WITH 02 TUBING, SHORT TERM USE. BOX OF25 REUSE-1 2L-2MQ LARGE ADULT LONG CUFF, 32-43CM, DOUBLE TUBE 1 43.20 43.20 V41TWIST-LOCK CONNECTOR 6 REUSE-10-2MO SMALL ADULT CUFF.20-26CM,DOUBLE TUBE W.J_P�IIIST- 1 32.40 32.40 LOCK CONNECTOR 7 REUSE-09-2MQ CHILD CUFF, 15-21 CM.DOUBLE TUBE W/TWI,'-'_3T-L_ O_CK 1 31-50 31.50 CONNECTOR 8 8900-0006 6 ECG RECTANGULAR ELECTRODES. 10 S H-E-L'F'-- 1 132,02 132.02 CARTONS I CASE (600) 9 8900-0810-01 PEDI-PADZ 11 ELECTRODES - ONE PAIR 3 112-50 - 337.50 10 8000-002005-01 CABLE SLEEVE, PROPAQ / X SERIES, ZOLL BLUE 2 51-66 103.32 11 REUSE-1 1 L-2MQ ADULT LONG CUFF, 25-34CM. DOUBLE'ruBE WiTWIST- 2 38.70 77.40 LOCK CONNECTOR 12 n 8012-0206 12-LEAD ECG SIMULATOR 1 19168.50 11168.50 1 0 8900-0190 TRAINING CPR STAT-PADZ ELECT RODE Wj"CABLE 1 98.40 98.40 14 8000-001392 RAINBOW RC-4,4FT REUSABLE EMS PATIENT CABLE 1 256-66 ------ 256.66 (REF: 4 481) 15 8000-000371 RAINBOW DCI ADULT REUSABLE'' -SENSOR, 2 882.32 1,764.64 SP0211SPCO/'SPMET 3 FT M-15 CONNECTOR (REF: 9355-000371, 2696) Remit to: ZOLL Medical Corporation Sub -Total: 48,810.29 PO Box 27028 Tax Total: 4,002.44 New York, NY 10087 Invoice Total: 52,812.73 Currency: USD Page 1 of 2 ZOLLO World Wide Headquarters 269 Mill Road Chelmsford, MA 01824 Attn: Accounts Payable Coulee City Fire Department PO Box 398 Coulee City,, WA 99115 Remit To; ZOLL Medical Corporation PO Box 27028 New York, NY 10087 Phone: (800) 348-9011 II'i;;l OCT 272025 �Vj Invoice Invoice Seq PO Number 4343510 DON RUSHTON MW Coulee City Fire Department 317 W Main St Coulee City, WA 99115 PaWment Terms Inv D ew D u c r,'* a t ce Sees Order Nurtiber Customer Number NET 30 DAYS 09-OCT-25 08-INOV-25 5010409 18053 Ship Date Ship Via Shipping Reference Sales Person 09-OCT-25 UPS -Air -Next 1Z038EO70194826370 Amy Turley day air Itern Description aty Unit Price Amount 1 8900-0004 4 ECG RECTANC]IULAR EELECTRODES, 10 SHELF 2 105.78 211-56 CARTONS / CASE: (480) Remit to-, ZOLL Medical Corporation Sub -Total: 211.56 PO Box 27028 Tax Total: 17.35 New York, NY 10087 Invoice Total: 228.91 EFT or A information: Acct# 323284051 ABA # 021000021 CUrrency: USD Please email EFTIACH remittance to EFT-ACHremit@zoll.com Online Payments - Register or pay as guest at https://zol.l.bilipay.r diusone.com/ TAX REGISTRATION NUMBER: 04-2711626 All discounts of list price are contingent upon payment within agreed upon terms. A f-Anyinvoice discrepancies rnust be repo led to ZOLL in writing within / business days of receipt. Otherwise, the customer deems all charges, terms and conditions valid. For invoice terms and conditions go to - htt,P:Ewww..zoll-com/about-zoll/c,ompliance ZOLL Medical has gone Green. If you wish to receive your invoices via email instead of mail, please contact us at CHILI -Collection Team@zoll.com. We will be happy to make this change for you. Page 1 of 1 TOWN OF COULEE CITY, WA 991155-0398 16236 Town Of Coulee City Z01-1 Medical Corporation WmTant: 0.16')36 Amount. '*_)j)041,64 PO Box 270'.28 Date: 12 /10 1".) 02 5 Account: NewN"ork, New 10087 For: -EMS - DEFIBRILLATOR.- Purchase; EMS - Defibrilkator PLtrchase Invoices'. 4347490 5 8 12,73 4 3) 4 '3510 T-1 "1, 9 1 PAY TO THE TREASURER OF THE CLAIMS FUND NO, 16236 TOWN OF COULEE CITY NORTH CASCADES BANK P,0- BOX 398 1.800.603,9342 98-799/1251 COULEE CITY, WA 99115-0398 (509) 632-5331 Fifty'l`hree Thousand. Forty One and 64/100 IATE 12 11 / 10 / 2 0 - -2 5 AMOUNT;;:;.- * _5 3 � G 4 1.6 4 r r I I _1 - I World Wide Headquarter-0 269 IN/till Road Chelmo-ford, NIA 01824 M 116�1 Attn: Accounts Payable Coulee City Fire Department PO Box 398 Coulee City, V/A 99115 Remit To: ZOLL M-edical Corporation PO Box 27028 N-91N York, NY 10087 Phone, (800) 34B;901 1 lyr nvoice 1 Invoice Seq PO Number 9100-1053 - - - ---------------- Coulee City Fire Department 317 W Main St Coulee City, WA 9911 -0 Payment Terms. Inv Date Due Date Sales Order N'umber Gqstomer Number' _ - NET 30 DAYS 16 OCT-25 15-NOV-2b US-9320979 18053 S _ShipYla' *iRefernce Sales Person Amy'Turley em Description _P_ .. ..... it Price Un) Amount 8778-.890 -PIM NI SERVICE PLAN, 3 YEARS, POINT OF SALE: 2 325.00 6050.00 Te.rm, 2026-10-15-2027-10-14 Serial Nlo: AR2310'78302AR24P084933 2 8778-89003-PIM PNI SERVICE PLAINI, 3 YEAS,'�O'INT OF SALE'- 2 325,00 610-0,00 Term., 2027--10-10"-2028-10-14 Serial No: AR231078302,AR24FO84933 3 8778-8d693- PiM PM SLERVICEH PLAN, 3 YEARS, POINT OF SALE; 2 325,00 6-00.00 Term- 2028-10-15-2029.10-14 Serial No: AR231078302AR2= F084933 Remit to: ZOLL Medical Corporation PO Box 27028 Ne,v York, NY 10087 EFT or A information.oct# 323284051 ABA# 021000021 Please em.all 'EFT/AC H remittance to EFT-ACHr�mit81zollcom Online Payments - Regis -ter or pay as guest at hit P83:/!zoU,bj 1,1pa,y rad i Usone.. goml Sub -Total: 11950,00 Tax Total: 159.90 Invoice Total: 21109.90 Currency: USCG TAX REGISTRATION NUMBER: 04-2711626 All discounts off list price are continigent upon payment vdthin agreed upon terms. Any invoice discrepancies must be reported to ZOLL in writing within 7 business days of receipt. OtherliMse, the customer deems all charges, terms and conditions valid. For invoice terms and conditions go to - . . . ...... .. Z r* - _. 11 . %W -ivle your invoices via email instead of mail, please OLL Medical has time. G. If you wish to receive contact u s a t C H. , #{ZiD.H.con-i. We will be happy to make this change fOr YOLL P-Iniz-1 i r)f 1 TOWN OF COULEE CITY, WA 99115R0398 Town Of Coulee City C U11, I N10' FUND NO, 16332 1) 111) ) : ZOLL Medical Corporatton Warrant: 016-)-)." Amount: 21109.90 PO Box 27028 New 2- 2 '? 0 -) 6 Yo I rk-, NY 10087 Date-, 04/ #/' Za Service Plans For Defibbillators I 13 ) - 5 94 22 64 000 - Equiprnent 9,109.90 SF1 3 1 0350T-1SA 0-tt'Safeguard tREORDER FROM YOUR LOCAL SAFEGUARD ADVISOR, &IF UNKNOWN. cALL 800-51IM-2422 CTJJ4X0010000 Y13,SF000328 TOWN OF COULEE CITY, WA 99115-0398 16332 Town Of Coulee Cfty ZOLLMedical Corporation arrant: 01633)� Amount: 2)109.90 PO Box 217028 Date: 04/221/20-426 Account: New York, NY 10087 For-, Service Plans For Defibbill .tors Invoices, 910015-53 '),109,90 70 J_ TO THE TREASURER OF THE TOWN OF COULEE CITY NORTH CASCADES BANK CLAIMS FUND NO, 16332 P.0, BOX 398 1,800,603.9342 9,9-799/1251 COULEE CITY, WA 99115-0398 (509) 632-5331 PAY Two Thousand One Hundred Nine and 9011100 DATE 0 4 /12 2 2 02 6 AMOUN Tri: 109. C;;�9 0 TO THE IVIL�Ul 0i PULULion PO Box 2702.8 "I've ORDER New York, NY t 0087 BY OF MAYOR B FOR- Service Plans FofibbiYr'Deltators CITY CLERK 11"0 1 Ei 3 3 2 b 2 S 107991310 1505 27 L Slig