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HomeMy WebLinkAboutGrant Related - BOCC (002)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: gOCC REQUEST SUBMITTED BY: K Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Kal"fl@ Stockton CONFIDENTIAL INFORMATION: ❑YES 8 NO oarE:5/15/2026 PHONE:2937 ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ❑ARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget ❑Computer Related ❑County Code El Emergency Purchase El 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 McKay Healthcare on the Strategic Infrastructure Program (SIP) No. 2026-03 Continuation of Assisted Living, Memory Care Wing, and Community Center Expansion in the amount of $8,350.00 If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO 7 N/A DATE OF ACTION:5 7124, ZAP APPROVE: DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO - WITHDRAWN: 4/23/24 GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding,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-, 2026-03 SIP Funding Recipient: Hospital District 4, dba McKay Healthcare & Rehabilitation SIP Project Description: Phase 1 Continuation of Assisted Living, Memory Care Wing, Community Center 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 projectproposal 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,8,350.00 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. Audra Gutierrez-Ritari Printed Name Signed 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 A►.dministrative Specialist, Kstockton@grantcountywa.gov Reimbursement # 3 in the amount of.$8,350-00 ATTACHMENT 4 710 2nd Avenue Suite 925 Seattle, WA 98104 Tel: 206-621-8626 ar@obrien360.com TO: Cliff Sears ' McKay Healthcare and Rehabilitation 2505 2nd Ave Ste 200 Seattle, WA 98121 csears@nwi.net S I P2026-03 INVOICE TAX ID: 65-1313009 INVOICE DATE: 4/30/2026 INVOICE NUM: 9023.26 BILLING THROUGH: 4/30/2026 ProjectAcKay Healthcare !Managed By: Katrina Morgan CONTRACT PREVIOUSLY CURRENT REMAINING INVOICED % INVOICED PHASE TYPE AMOUNT ; INVOICED INVOICED CONTRACT TO DATE TO DATE Design Phase Fixed $7,000.00 $0.00 $7,000.00 $0.00 $7,000.00 100% Construction Phase Fixed $15,000.00 $0.00 $0.00 $15,000.00 $0.00 0% Performance Period Fixed $20,000.00 $0.00 $0.00 $20,000.00 $0.00 0% Reimbursable Expense Fixed $2,000.00 $0.00 $1,350.00 $650.00 $1,350.00 68% TOTALS $"9000.00 $0.00 $35,650.00 $8,350.00 19% TOTAL CURRENT INVOICE $8,350.00 SUBTOTAL $8,350.00 AMOUNT DUE THIS INVOICE $8,350.00 This invoice is due on 5/30/2026 Page 1 of 1