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Home My WebLink AboutGrant 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'I"12 Stockton CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 6/2/2026 PHONE:2937 IJ XA_ AW []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 _: ,. G�DWOR� 0 Ali A ,. ,- -. .�Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP) 2025-03 Kitchen Expansion Project, in the amount of $478.38 If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO R N/A DATE OF ACTION: (� -9`�C� DEFERRED OR CONTINUED TO: APPROVE: DENIED ABSTAIN D1: D2: y D3., WITHDRAWN: 4/23/24 GRANT COUNTY STRATEGIC INFRASTRUCTURE PROGRAM PROJECT CERTIFICATION This form must be signed and returned, with an invoice, for the approved funding,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: 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 per ury, 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 authenticate and certify to this claim. I also certify that this claim of $47 . 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 -a-vo Date Signed AdmiDi strator ink T it'l10- 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 Reimbursement # 11 in the amount of $478.38 ii ATTACHMENT 4 SIP 2025-03 PO Box 94147. Seattle, WA 98124-6447 F, ARALLON Terms: 2% 10.1% 20; Net 30 days I if C U N S U L T I N G Wire/ACH to: First Interstate Bank Routing 092901683 - Account:101352912 Now Accepting Credit Cards - 3% Fee Applies Email: Accounting@farailonconsulting.com Invoice Total $478.38 Audra Gutierrez-Ritari April 28, 2026 Public Hospital District No. 4 of Grant County, WA D/B/A Project No: 03963-O01.001 McKay Healthcare and Rehabilitation Center Invoice No: 0059696 PO Box 819 Project Mgr: Erin Burgess Soap Lake, WA 98851 Project 03963-001.001 Public Hospital District No. 4 of Grant County, WA D/B/A McKay Healthcare and Rehabilitation Center Critical Areas Assessment Ptqlflwnal 1 u rIl24 2 Task 001 Habitat Assessment Professional Personnel Hours Rate Amount Staff` Biologist 11 Burgess, Erin 4/2/2026 1.00 155.00 155.00 Burgess, Erin 4/3/2026 .50 155.00 77.50 Burgess, Erin 4/6/2026 LOG 155.00 1.55.00 Totals 2.50 387.50 Total tabor 387.50 Reimbursable Expenses Mileage 2/25/2026 Burgess, Erin Mileage to/from Soap Lake 90.88 Total Relmbursables 90.88 90.88 Total this Task $478.38 Total this Invoice $478.38 Outstanding Invoices Number Date Balance 00591.46 3/5/2025 2,961.00 005941g 4/1/2026 1,815.00 Total 4,776.00 Please remember to include Invoice number(s) with your payment. A a f A 2h 16m 2 dep 10 IV 0 Home (151 S Worthen SO 0 121 2nd Ave SW, Soap Lake, WA 98851 Home (151 S Worthen St) Add destination Send directions to Whone via WA-28 E 2 hr 17 min without traffic Details Explore nearby 151 S Worthen St W, Q� Search akmg "route... Gas EV charging irhWqs to do On Hotels AL still C options Wen *D Copy link WOnAId** 2 hr 17 min 109 miles 30 away 2 her 17 MIn COUWO Cay SAC"