HomeMy WebLinkAboutGrant Related - BOCC (002)GRANT COUNTY
BOARD OF COUNTY COMMISSIONERS
JUNVO 21 U [y[�
"1 11, iT AM a a a
To: Board of County Commissioners
From: Janice Flynn, Administrative Services Coordinator
Data June 8, 2023
Re: Authorization for Release of BOCC Approved Funds, Request #1, SIP
#2022-05- 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. 22 -128 -CC dated December 6, 2022. 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) 1st and final installment of the grant award in the amount of Twenty
Thousand Nine Hundred Seventy Four and 00/100 Dollars
($20,974.00) to McKay Healthcare.
Note: The full grant amount is $21,000. This leaves a balance of $26.00, which
will be returned to SIP available funds.
Thank you.
RECEIVED
GRANT COUNTY
STRATEGIC INFRASTRUCTURE PROG
PROJECT CERTIFICATION
This Foran must be signed and returned, with afunding,n.invoice, for the approved
before reimbursement can be approved by Grant County.
SIP Project Proposal Numbet, SI 202
SIS' Funding Recipient GC. Hospital, #4 — McKay Healthcarc,&, Rehab
SIP Project Description Phase I Feasibility Study aid ,Capltal Needs
Assessment, Architecture nng &'En ine fi Plan
91 e� .
1, the Ursod, do here -by ceftif-y under penalty of 1)e-flury, that th , matefials have
services ren ere as e -*b the
been furnished, the d d, an the labor rrja6d d :
Perfo scrix in
project proposal for the. above -referenced SIP Project- and that J am authorized to
authenticate certify to thisclaim. I also cert" that this 61aim of,$20 974.00 *s "ust
SO Cy
and due and is, an. unpaid. obligation against Grant If ounty.
accordin to the SIP P ect Fundiniz Policies., I attest that At the next audit off`. ,My
Further, r0i
enti this ect sh
all be called to the attention of the Washington State Auditor" s
ty" proi Ito .
Office and,an emphasis -audit will. be requested to. - assure -that these funds were expended
toward the pro, ect acc
and ording to the intent of thepropos aL
Signature
Randi Sauter
Printed Xie
Date Signed
Admi 0 mstrator
Title
#' 10
Adrm-nistrator
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Adm inistrative. Services Coordinator, PO Box 37, E��r at IWA98823
a,
Reimbursement In the amount of0 4,00
aw"W"ANOMPM �L
ATTACHMENT 4
y .
569 Architecture, P.S. 0412` 12023 92835
I.nvoic-e Number Invoice Cate Desai tion Gross Amount DiscountTaken Net mount Paid
4595 0411412023 Admin - PS - Outer SII " $20,974.00 $0.00 $20y974.00
--------------------------
$20x974.00 $� $20) 74,00.
A R C H I T E C T U R E
1111111 11 7
McKay Health Care
Cliff Sears
127 2nd Ave SW
Soap Lake, WA 98861
Please return top portion with remittance.
Invoice number
"Date
T E 8}j
S-POAANEF, WA Si9101
7.1AARCHITECTURE.CON4
i. 509,4,56,8236
4595
0411412023
Project 2241 McKay Health - CNA &
Modernization Feasibility Study - Soap
Lake,
Contract Percent
Description Amount, Complete Nor Billed Total Billed Current, Billed
CNAr -and Feasibility Sttidy 201974.00 100.000.00 20�074-00 20,974.00
. ............. I. ....
Total 201974-00 100.00 0.00 .20,974.00 203974-00
Invold c t 20 9740
Aging Summary
Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120
110, WOW
4596 04/1412023 20,974-00 20,974.00
Total 20,974.00 20,974.00 0.00 0.00 0.00 0.00
Approved by:
Sarah E-. Breda
Associate
Vroandor
Bars Code Me �Or a U- te--, Oft
De,;I Had Appric-smak
0-.-
ZBA Architecture, P.S. Invoice number 4695 Invoice date 04/1412023
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