HomeMy WebLinkAboutGrant Related - BOCCGRANT COUNTY
BOARD OF COUNTY COMMISSIONERS
LlJ1=�_I_L.�J
To: Board of County Commissioners
From: Janice Flynn, Administrative Services Coordinato
Data November 30, 2021
Re: Authorization for Release of BOCC Approved Funds, SIP #2019 -12 -
Port of Coulee City, Coulee City Medical Center
The Port of Coulee City has met the requirements for release of funds in the above -
referenced SIP project, which was approved by the BOCC pursuant to Resolution
No. 19 -093 -CC dated November 18, 2019. The proof of requirements is in the
form of a signed Project Certification form (Attachment 4 to original award letter)
from the Port and supporting invoicing of the project that meets the SIPg rant award
amount.
To that end, I am requesting the release of funds on this SIPproject as follows:
(1) The grant award amount of One Hundred, Sixty -Eight Thousand,
Nine Hundred Ninety Seven and 66/100 Dollars ($168,997.66) to the
Port of Coulee City.
Thank you.
Dated this day of 2
Board of CotInty Colnlnissio
ners,
Grant County. Washington
kr—o ve LYINS'al R Prove C-Abigain
Dist# I Dist #I
Dist #2'' Dist #2 ------ Dist #1
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Dist #2
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Dist #3
--1 . . .... Dist #3
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mc - 1 2021
r, f� A kA �,,,ITCOUNTY COMMISSIONERS
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STRATEGIC INFRASTRUCTURE*teOiRlEARUN��IONERS
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:
SIP Funding; Recipient:
4:)
SIP Project Description:
2019-12
Port of Coulee City
Coulee City Medical Center
1, the undersigned, do hereby certify under penalty of perjury, that the materials have been
famished, the services rendered, and/or the laborperformed 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 isjust 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 theproposal.
§Figna re
Printed Name
*2 --1 � - 7-1
Date Signed
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
ATTACHMENT 4
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Invoice
Grant Gounty Port District No. 4 M July 27, 2G2".10
P.O. Box 537 Project No- 20840,00
Invoice, No:
Coulee City, W -A 99115
Project 20 40-00 Cowlee City Medical Clinic
Rrofessional Sent iceLfmom Ju ne 21,20-2q-.
y 202no
Profess"ional -Personnef
i` Al t.,7
S
Hours
Rate
Amount
Technician
Covolf, Allan
.50
111.86
Totals.
50
M913
Totak, Labor
55.93
Consultants
Architectural Con sultant
7/8/2020 Loofburrow Wetch
Coulee City
484333,34
Arch.1-tects, P.S,
Other on tont
7/8/2'020 Plateau Archaeological
CCPD 4
11 125.25
investigabons
Total Cons-uftant%.,
1.1 times
4-%458.59 64,404.46
Bitting Limits
Current
prior
To -Date
Total Billings
541,4060-38
0.00
54,460.38
Limit
Remaining
1-26539.62
t
Toaltbl M: MFi
IK460.38
i` Al t.,7
S
Invoice
Grant County Port District No. 4 August 2.0,20,2.0
P f 0 - 8 Oxx -'g'j 3 Pr jecft No;.
Invoice, No'
COUIE-3=%e City, VV Ak .III5-1
pr` ojeIrCIAIII., 20840.00 (,'-'OUIee CVty Medical Cline
ftofg�sional Services from JU
Pre'fe-ssitonal Pers-onne-I &Uaust 111.5.41.20-20
Principal
Julius, Lakvrr,-.ncc-
Totals
Total Labor
Consultants
Architectural Consultan'T
8/13/2020 Loo: bur roklv Wetch
Architects, P.S.
Geotechni-coal Consultant
-817/202.0 Pan -GE Inc,
Total Consuftants
Billing LIWIts
Total Billings
Limit
Remaining
flours
I Rate
20840M
2
Amount
"1. 0 4175,36 175.36
1.00 175�36
176-36
Coulee City
48,333.33
Gratit Co.PD 4
4,3022
P nor To -Date
,074-44
5414-60-3.8 112,634. 8,2
181,000.00
681465.18
'Total this Involli,ce
63 f }
it
D. Box 6-53P
Gcmul ele. Obv,
FO 4 0 0 m4dIGNEM. - LANI-IC,
ua,
-Servicostremn A
prows -i-, oxnal Posm. "I
Pw� - I
.01U.-ful'u's-i IL-awfVR, CZ
TOW Lobor
Coo, -v uitaru
AmMectu
9A 020
Uut Consultants
*fie h
-8-Illi-n-gg Lffvnift-tsi- Curl' Int
21 B!'-
Urr {dam
Rair alfil-itif
"jq
3
17-6-36
.1, titrias
"'3"<'i p�g� may: �.
24-il
Pilot
53
-4131-11. ul 7b DO
4,10 IFW.48
Truta"Ithis Inv,
Jr 1%
Ur4ay 4Nr "shol-,T-Ine,
W , f
EInvoice----
,.- ---- ---- I
projea 20"0.00 Coulee City Medical CLINIC
Et KO.W LonJ.O.. fte E CI Cft � ftmw., 8 9 aft m b e r 13 2020 t o 0 c t o b e r..I 0
Profestional Palsonnef
Houm Rate Amount
Principal
Julius, Lawrence 1.00 V5.36 175.36
Totals 1.00 176.36
Total Labor
11,903.34
V5*36
1130 Rainier Avenue S.. Suite 300 Seattle, Washington 98,1 .4-4 Y206) 284.0660 Fax (206) 283-3206
Invoice
Goramt County Port, OlisviEflict No., 4
P-0, eim-4, 537
09,1 115",
tlf
At
P
Invoice No4-
ProOd. -ical cf-
e e ca I t�, frilc
k- 2.0-840.00
Long 0
.,at's-ervices from., I.
-Noje.mb.e,, S. 2 20 to Dece n --b 5, .2020
Pmfts,sfonal Personnref,
Hours IR at4 pe
Julicts. La-ve-ert-ce 31 00
E:nv.. Spec.
Powem Russell
T6tals 13-50
Total Labor
Consultants
Architectural Consultant
1119/2-02:0 Looftiurrow Wetch Coulee e City.
Total -Consultantt
40"Ni-
811-11ing, L'imitf-r. ,*Urrent
-161.49-07,59.
A
K
I f
M
R;I,z. m a. in i n c.
7 It.1w
S4 V-16
'i
1 its
Amount
-1
117110,94
1 tt71 7494
12,263.32
1 A ti -mi -as 42-1263,32 13 74 -18 -9.6 -
Per To -Date.
167
00,
Total Uhis Inv
ek
reo
Invoice
V
2
-�O
4 rant (,;"wntw Peri District No� -4- P,-qf4-- ect No, 2 WE 0 10
y
RO, f3o-A--.. 637 Invoice No,,, fB
Coule
Me i"Ity, 'IAM
H
99. .0 1,
Clinic
Calry
to
proiessional Pe monnel
Mom
R ft to
Arnount
P i P. - - tf a t
I
ORAN& Lsto, ence
4-50
176t-36�i
-0,789.112
8 11 L ts-
curr nt
Prior
T o 1- 1 B 'R Hlb Vi Sit
78912 t 8, 18; 0 6-
. 18
1 OrO 0. 0
���:�' '.'_•�'', a
sf �'� . WY's `�+� i• �-` 3 � i •,t
In
M=nn
Al
n -voice
. . . . . . ....
April 26., 2021
Grant County Port DilkstriGt N. 4 Proolect No: 208.4 UO
P.O. Box. 637 Invoice No-, 10
Coulee City, WA 99115
Project 2(' ) 8 4 DO, 0 0
17-iodlee Gltv Ake,,,dital Clinic
Prg-- s i p A.- gai I S o ry, 1,4-*- e. -s f � c-..) rv�i M
4 i.
Profs"km Iona! poemosinel
H0m
Rs te.
A-mo-unt
Princ�lpal
J UOy r w ! f��+a�US2
.50
175,38.
43SAO
Totals
2,, .6 o
438.40
Total Labow
4*3' R. 4 0
6 11 I'l 2 Cl I ts-,-
Current
pefor
:1,0"Mri to
t I I* ngv-j
f al Ul 1
4 .40 7 0 60 7 '118
i741.1 4143,55.1
4:0 0
81- 0001,00
"Totall this
Invoic 3 40
43.