HomeMy WebLinkAboutGrant Related - BOCC (007)GRANT COUNTY
BOARD OF COUNTY COMMISSIONERS
1Ll=ilJ_�J
To: Board of County Commissioners
From: Janice Flynn, Administrative Services Coordinator
Data September 23, 2022 ,
Re: Authorization for Release of BOCC Approved Funds, Request #10, SIP
#2021-01- GC Hospital #4 ® McKay Healthcare, Phase I Capital
Improvement Plan
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) 10th installment of the grant award in the amount of Seven Hundred
Fifty and 00/100 Dollars ($750.00) to McKay Healthcare.
Note: The full grant amount is $350,000. This leaves a balance of $314,795.21.
Thank you.
OCT - 4 2022
mmm YA
GRANT COUNTY
STRATEGIC INFRASTRUCTURE PROGRAM
This form must be sl* d nd;-returned, with an invoice, for the ap
gne a proved haing
before reimbursement can be approved by Cr An't Couhtyf,
.81 . P.PtojQct Propos,al'Nambet,
SIP Funding Reci ielit
QIP rQjet Dese-11 on
S.IP 0 1- 1
McKay Hospital & Rehab
''ent Plan
Phase 4 C4�._itdtoVem
l
-have
g do h " b t* Un alt y of perjury, that the materi s
L the undersi ne ere _y cet._J:!� ..der pen
been furnish.ed,, the sptwieorende,red, and/or the labor- performed as described in we
pT 'cot proposal orhe aboye-reif-prenced SIP Pr*cct and that I ate. authorized to
oj
e if t
authenticate -and ceitlfv to this olaint i als*o, c rd that tris ".01n of d
, Y Ia. I .
Ae -.01.1s.j US': 4,11
isan.uqpai*dob1i aafiagat
due and on in8t Graht,*Cou*n:,y-,
Erica Gaertner
Printed Name
Date Signed
J4w�
Printed Title
Com toted, signed original certnication. and invoice are to be mailed to:
p
Administrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 10 in the amount of $750.00
ATTACHMENT 4
MC AY HEALTHCARE
Pennell ConsultinqInc.
ElectrIcal O'nd Electronics
System Design
400 South J-efferson, Suite 301
S . pokane, WA 99204
Pubt , 1'C Hospital Distdct #4.
of Grant County WA
POBox 819
Soap Lake, WA 98851
Attn-, EricaGaertner
V
n We
5/26/2022
RECEIVED
MAY 1 8 '2022
1"WO
MPK,ay Health are Generator plant
Mt
---------- -
Pescription Quantity Rate Amount
Construction Administration . istration @ 12% 750.00
750,00
Vendor
Bars Code Ntittle Amount
go a q A5�nv, bi ko
ro! 0- T 1 A, B
Total;
-75:04 DO_
Dept, Head Approval:
Please contact, Cindy Merrick With questions at (509) 747-1888, or Total $750.00
cindy,merrick@penneliconsult'in-g.com.
'IRe Pennell CaTLSUI IT.
El cfcati and l ctronf
System DesI r
�\::' '.a M.,,\ xn \...;.: � ?\i$\\",)a ..\i aa\\ �. '. \:\G�\ �\' � , .. \ \ \\4 �\\. a.,. �.d,#P ti .,.,h\. \1,x,\da\,\� N \\a�.�x\\\C :.\h ' ;.,.�,\, ,,. \ ,,, \�J �\ .,, ,. �\\\ . , • \
;y{\',(('�!1�� V Vr.
,;.,.. „ ,`. \ ::.. , � .' .., \ .. . :.., ..,. ,\',\ - \� „ is \ \ r., •. :� •\ \ iyfi�F \s
IV
\\\\ >���Z ��\ \u„\ ,m\av\�\\ \a\x\-�\\ \a`\iY�\ \\'\\ \\\\ ?\a�.\\ \ Yt :\\a l �ia\\ 4�\ ,. �,;, \y2,�i'i\�p�\\ \\\.• \ \.' i• i\�\\� \ \\\,�� \ �\\
\
... .... r ... .. ..:.... .. .... \, lat.. \...i ',�\.F,. �•... at,. \. \.� '1. \ ,.' �„. .. .. at. ..,.a, a. '.a\.
777
Schedule of,ValuesP"i1fing fdr the,Mo,,,,,
rogress gi ja` of M,t 2022
'eVf.sed DeSCdt,PV6n of Work
. .. ...J� �!► \.\..
gn
MIN -
ad
z.
.. . .
':, •.. :: ,.turn
_.. A'.Ililh,,,,i'-;
.,, \. .., .. .. ... .... ..\ :,\..., ,.,, ..: ,.: . \ :, ..•. \ ., ,,,
M
.. \. .. ....,. ... ,.. .. . \ ,. \,,, ., � \ ,.\ , \ .. w� 1. \ •, ,:..: .. ,... \
MN
>..
Tai$ .,
acry tior�. 'I�'+�rlc y , v ,. , .... ,• .v, , .y& ��, „ v , a e���., � � �
k
1 Design Development 5$50.89 100 ' S�50 w8 100 100Y $57503.89 . 2,:65% Construction Documents 81255.83 100 8,255-83 100 - 100%8*255.53
3 1Ot�� Construction Dactrnents
91478:93 x.'00 1478 . a 00 8.93
4 Bid Phase 511.54 X 00 611.54 IO 100
5 Construction Administration 6115.43 0.�0 12l� � A50.'00 12
5t3s5A
P'c+eCt Close Out 1 'i <4 0, Ol Ow00 x'11 X54
Mill
�,.
IM
l a m ursa es
Design Tri 1 4#28/21 001/0 $653.62 $.
{ 0582 ' 00532 ' 00 X6 ,w
i
Design Trip 2 (0114121 ) 053.52 100° 653* 02 'i 00% $` .. 1 �0��� $053 52 $.
Design Trip �#3 (10!12121) $ 053.62 100% •058.52 100% .$ _ 100% $553.62 $
Design Tr p (1[19/22) $ 658. 00° 053:02 :100% $ 100% $6,53Y02 $ �.
Pre -Bid Wal Through 1 ' $ 808152 .100% 89162 00��a $ � 100% $803.02 $
CA Trip 1 $ 803.62 :-0i;00 $ 0�1� $0.00 $ 8g8 �2
Utility Coordina on $ 1,101.12 0.00 , $ 00 1,10 :'12
L8d Permit. Peen $ 920M 100% �920 00 100% $ 10.0% $920.00 $ -
` dta R bursa les. � c 4*428�
�E i,�y�� /[�jme
\,
75
'.,.:.A.
Chan a +Orders°::
Dept.
,. ...., ro � To LIG$ 1xi?..., .\ c,. '. .. .... .. :,.. ... \\ . .,, o,-»..,�' „\ , \....., .r:\•-\ ..,., :\o,,,, .a,,. ,,,xe,... \� ,, ,\ , a,u.. u, a,:.:.. r \a,:.a. ..\. ;...,,, h. „.,,. \,.,..\. , .. ..\..,. a, ,\, a, a,, .,,a ., U,A\, \,.a., „\. \,a. :..,\,aa
,\
.\, o.\
.
04 U �9
\� P\
a
r
% x
�r'� ".�' r T,• -.v tr” :y.rt' .w `3"F. crw �w.' x ,ew..R C
:� 4,• h t� � C � t 2 a \"{\ 2 � � ��;� � �� a . A � ,��#
wv .•+ .,. .. _,kms ...r z 'y,,, .`•".�, c r. qt ww. # a ,• ,.,,t .N.\.x \.. \. uw+ '� .iw,- > \,...\• a