HomeMy WebLinkAboutGrant Related - BOCC (004)GRANT COUNTY
BOARD OF COUNTY COMMISSIONERS
Dated this day of
IV
Mud of County Commissioners
Grant County. Was. Kington
Apj� rove Dimprove.
Memo Distfl Dist #1
Dist#')
Dist #3 Dist #3
To: Board of County Commissioners
From: Janice Flynn, Administrative Services Coordinator
Datm December 16, 2021 �r
Dist #I
Dist #2
Dist -0
I
Re: Authorization for Release of BOCC Approved Funds #4, SIP #2021 -01 -
GC Hospital #4 — McKay Healthcare, Phase I Capital Improvement
Plan
20
Nbstai I n
McKay Healthcare has certified the requirements for release of funds in the above -
referenced SIP project, which was approved by the BOCC pursuant to Resolution
No. 21 -013 -CC dated February 16, 2021. The proof of requirements is in the form
of a signed Project Certification form from the Hospital and supporting invoicing of
the project that meets the requested amount.
To that end, I am requesting the release of funds on this SIP project as follows:
(1) 4th installment of the grant award in the amount of Three Thousand
Six Hundred Fifty Three and 62/100 Dollars ($3,653.62) to McKay
Healthcare.
Note: The full grant amount is $350,000. This leaves a balance of $330,086.28.
Thank you.
N
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:.
01
SIP Funding Recipient
41 4�
SIP Project Description
SIP2021 -01
McKay Hospital & Rehab
Phase I Capital Improvement Plan
IV the undersigned, do hereby ceftify 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
just authenticate and certify to this claim. I also certify that this claim of $3,653.oz is 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 pro ect a ac riling to the intent of the proposal,
ec�Crdin
S�ignature_67 rV Title
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Printed Name
Date Signed
Printed Title
@. diA *
Completed, signed original certification and invoice are to be mailed to:
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 4 M* the amount of $3,653.62
ATTACHMENT
Pennell Consulting Inc.
PAO* Elachtcal mdElectronIcs
SyStem DesIgn
400 South Jefferson, Suite 301
Spokane, WA 99204
RECEIVED Ki
0 3 2021
invoice
11/30/2021 2.989
Pennell Consultima Inc.
Efcctricof and Electronics
System Design
Revised Description of Work
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MCKAY HEALTHCARE
591 PCI 12/0912021 936
Invoice Number Invoice Date Description Gross Amount Discount Taken Net —Amount Paid
2989 1113012021 Admin - PS - Other (SIP Grant) $3,653.62 $0,00: $3,653.62
$3,663,62,1 $0.00 $3,653.62