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HomeMy WebLinkAboutPW13-204 - Change Order - #4 - SCI Infrastructure, LLC - Hawley Rd Levee Improvements Phase II - 05/16/2014 KENT I CHANGE ORDER NO. #4 NAME OF CONTRACTOR: SCI Infrastructure. LLC ("Contractor") CONTRACT NAME & PROJECT NUMBER: Hawley Rd Levee Improvements Phase II ORIGINAL CONTRACT DATE: 8/28/2013 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, Contractor shall provide all labor, materials, and equipment necessary to: Emergency repair on a 12 inch watermain on the UPRR tress}. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $442,679.76 (including applicable alternates and WSST) Net Change by Previous Change Orders $11,015.80 (incl. applicable WSST) Current Contract Amount $453,695.56 (incl. Previous Change Orders) Current Change Order $22,296.62 Applicable WSST Tax on this Change $2118.18 Order Revised Contract Sum $478,110.36 CHANGE ORDER - 1 OF 3 Original Time for Completion 60 working days (insert date) Revised Time for Completion under 0 prior Change Orders (insert date) Days Required (f) for this Change 0 calendar days Order Revised Time for Completion 60 working days (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, the Contractor accepts all requirements of this Change Order by signing below. Also, pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this contract modification, which is binding on the parties of this contract. i 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written be w. CONTRACTOR: CITY OF KENT: 1 By By l a� ( nature) (signature) Print v Q - ' LLB Print Name: Tim LaPorte, P.E. Its C o a/gc-t Its Public Works, Director (title) ( Yle) DATE: —i b ,-1 DATE: 5 Z CHANGE ORDER - 2 OF 3 KENT FLUE No: 200.2 w.. ,.o.o CHANGE ORDER WORKSHEET NO. 4 Construction Management Division — Public Works Project: Hawley Road Levee Project No.: 10-3010.5 Improvements Phase 2 Project Engineer: Kelly Casteel Fed-Aid No.: Owners Rep: Alan Chau Contractor: SCI Infrastructure LLC Date: 4/10/2014 i I. PROPOSED CHANGE Emergency repair on 12 inch watermain on th UPRR tressel. i II. REASON AND BACKGROUND FOR CHANGE Emergency repair. III. METHOD OF PAYMENT NEW PAY ITEM(S) ❑ Not Applicable Change Order No. i I _ I i IFOR ACCOUNTING USE ONLY Sch. No. Item Description I Total Qty this Unit Unit Price Total Estimated Cost of — — I Est. Qty PE — ( Item Re—Pa ir.o—n iZ_inch watermain _I ?_— I _1_-I_Sum_J__22,296.62 22 Z96.62 _ ❑ Independent Estimate Attached I ❑ I CREATE PAY ITEM ONLY- Payment to be made ® PAY THIS PAY ESTIMATE _RE UIRED at a later date u on com letion of work 4— ---- p-'--P---- ❑ Material Submittals Required - CC: Construction Coordinator New Sub Reqrd? I No DELETE EXISTING PAY ITEM(S) per 1-09.5 ❑ Not Applicable Change Order No. I _ FOR ACCOUNTING USE ONLY Sch. No. B.I. No. Item Description Unit,-- -- Unit Price Cost of Item ❑ Independent Estimate Attached -REQUIRED ❑ i INCREASE/DECREASE TO EXISTING PAY ITEM(S) ❑ Not Applicable Change Order No. J _ FOR ACCOUNTING USE ONLY Sch. No. B.I. No. Item Descry p n . Ql� Unit Unit Price Cost of Item Li I Independent Estimate Attached - REQUIRED I ❑ 1 REV. DATE: 4/01/10 IT FILE NO: 200.2 KEN TOTAL ESTIMATED COST OF CHANGE ORDER * $22,296.62 *Total of the Cost of Item Columns THIS PAY ESTIMATE $22,296.62 IV. WORKING DAYS Original Contract 60 Due This Change Order* 0 Previous Total j 60 =� : -- __DXTEx la nation Justification Re wired• -------) ATE: 12/20/13i_________ I TOTAL WORKING DAYS* 60 *This Change Order + Previous Total All work, materials and measurements to be in accordance with the Standard Specifications and Contract Special Provisions for the type of work described. Prepared By: %/i'/f Date: 15 1z1 1+ -Al Ch � , � \Construction Supervisor: Date: Pa Kue n Construction Manager: Date: Z it 2 REV. DATE: 4/01/10 I FA Sheet No.: DAILY REPORT OF FORCE C OU T ORK Z �„- Project Name: sy Repair roject No: Item No.: 2000 Water Date: 4/10/and 4/11/2014 Description of Work: Emergency repair on 12 inch waterm ' on the UP RR tr ssel Z01 at d Workty Subc actor?: NO Prime Contractor: SCI Sub-Contractor: LABOR STRAIGHTTWE OVERTIME DOLLAR NAME CODE OCCUPATION Hrs I Hourly Rate Hrs OT Rate AMOUNT Chris Bullard foreman 17 63.4 2 85.76 $ 1,249.32 Casey Dale operator 16 60,56 2 49,48 $ 1,067.92 Eric Haulet pipelayer 16 49.48 2 49.48 $ 690.64 Marty Adams Teamster 8 55.27 $ 442.16 SUBTOTAL-LABOR: $ 3,650.04 LABOR OVERHEAD&PROFIT @ 29% $ 1,058.51 LABOR TOTAL $ 4,708.65 EQUIPMENT EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT F350 service truck 18 26.56 S 478.08 truck and lowboy trailer 8 95,84 $ 766.72 United Rentals 18 23.42 $ 421.56 United Rentals 18 38.08 $ 685.44 SUBTOTAL-EQUIPMENT $ 2,351.80 EQUIPMENT OVERHEAD&PROFIT @ 21% $ 493.88 EQUIPMENT TOTAL $ 2,846.68 MATERIALS/SERVICES/RENTALS MATERIALS SERVICES Quantity Units Unit Price DOLLARAMOUNT railroad Liability Innsurance 1 LS $ 1.800.00 $ 1,800.00 Union Pacific Adminstlrative Fee 1 LS $ 1,000.00 $ 1,000.00 Tacoma Screw 1 LS $ 33.80 $ 30.87 AABCO Barricade Company 1 LS $ 150.56 $ 137.50 HD Fowler(Inv*13601712-$3512.14+inv#13607468-$348.57) 1 LS $ 2,535.09 $ 3,860.71 HD Fowler(Inv#13601705$1573.52+inv#13616189$156.51) 11 LS $ 1,730.03 $ 1,730.03 HD Fowler(Inv#13601011$2535.09) 11 LS $ 2,535.09 $ 2,535.09 Cutting torch reference Inv for filling bottles 1 LS $ 289.59 $ 289.59 Emergency Malerail Procument 1 LS $ 650.00 $ 650.00 ecology block from SCI yard 21 EA 1 $ 75.00 1 $ 150.00 $ 75.00 $ 12,183.79 OVERHEAD&PROFIT @ 21% $ 2,558.60 TOTAL $ 14,742.39 Verification of Hours Worked: TOTAL: $ 22,296.62 12% MARKUP (for prime when subcontract work) $ - Contractors Representative Dale SHEET TOTAL: $ 22,296.62 Owners Representative Dale Comments ;SV afF[OCr�SL of ��cl�n�/c3�✓1 A10 1-Uv � LLO�tr7 e 5-2-2bI`( Invoice SCI Infrastructure, LLC 2825 South 154th Street SeaTac, WA 98188 City of Kent 400 West Gowe 400 West Gowe Kent, WA 98032 US Kent, WA 98032 US hhhhlh����Ih„LILd 261 Folder No.829.68 1406`01 04/24/14 05/24/14 Net 30 Days 14,M 21 1 City of ISent'lV c6l1ne Repair 1405- i Q':JOA 22,585.30 Notes: Total'22,585.3 Work performed 0411 011 4-04111114, Sales"Tax 2,145.60 L Les`sRdtafria a r, ■ 24,730.90 Page 1 of 1 SCI Infrastructure, L L C Daily Cost Record 21429, 21430 Union Pacific Project: Emergency Waterline Repair Job# 1406 Date: 04110/14.04/11/14 Description: See individual DCR for detailed description. i HOURS DETAIL COST RECORD CODE S.T. O.T. D.T. I Total RATE EXTENSION Chris Bullard FM 17 17 63.40 1,077.80 Chris Bullard FM OT 2 2 85.76 171.52 Eric Haulet PL 16 16 49.48 791,68 Eric Haulet PL OT 2 2 68.21 136.42 Casey Dale OP 16 16 60.56 968.96 Casey Dale OF OT 2 2 81 AS 162.96 0 0.00 cc Marty Adams TM 8 8 55.27 442.16 O Marty Adams TM OT 0 73.51 0.00 m 0 0.00 0 0.00 J Sub-Total 3,751.50 Travel Time 0.00 Labor Markup1 087.94 Total Labor Costs 4li 44 rn 1-Ton Truck 1B 18 26.56 478.08 Lowboy mobilization 8 8 95.84 766.72 O Case Backhoe R 18 18 23,42 421.56 O JD 135 Excavator R 18 18 38.08 685.44 0 0.00 Sub-Total 2,351,80 Equipment Markup 493.88 Total Equipment&Tools Costs $2 845.68 Railroad Protective Liability Insurance 1.00 11 1,800.00 1 800.00 Union PacificAdministrative Fee 1.00 1 1,000.00 1,000.00 Tacoma Screw Projects #16221886 1,00 1 33.80 =:r - - _33,80 AABCO Barricade Company, #96018 1,00 1 150.56 , 150,56- HD Fowler, #13601011 1.00 1 2.535.09 2,535.09 HA --aWIeF-, k'-%9662 0 0.00 Kentox Invoice#48494791 1.00 1 262.69 262.69 Kentox Invoice#48439035 1.00 1 54.41 54.41 Material Procurement Fee 1 1.00 -1 650.00 650.00 ECO Blocks SCI Stock 2.00 -2 75.00 150.00 HD Fowler#13601712 1,00 1 3,512.14 3 512.14 HD Fowler#13607468 1.00 11 348.57 348.57 HD Fowler#13601705 1.00 1 1,573.52 1,573.52 v> HD Fowler#13616169 1.00 1 156.51 156.51 cc: 0 0.00 u 0 a00 x - Sub-Total 12227,29 O Sale Tax If applicable) 0.00 Markup2 567.73 Other Costs 14 795.02 Contractor's Representative Sub-Total 22,480A3 Sales Tax on Rented Equipment 105,17 Sub-Total 22,585,30 Subcontractor's Reipresentative' OwnePs Representative No, Sheet 1 of 1 TOTAL 22 585.30 i I 0 O M fp y N O O O m n C N '„Oj m eM- N m p W fvR� lD O y 0 n Y' VI N H C U o O O U O1 N N v a o K 'uj3 ' a @ � m 9 U U t' O a Q 0 U IpUpL 0� E2 Q Q O U Q`i 12 IaL ! 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C > V 0) O aa mN N N W (DN M V' (O a r r N N M V N r uaiiy vuZA r.UL;ui u 1508 VALENTINE AVE SE • PACIFIC,WA 98047• (253)218.0444 • FAX;(253)218-0454 21429 f ` � o prtiectI LY{''eI^-{� - V do d R cx Date L -L / /LJ , Weather 5'" hl/ Descrl liol2 mu 1 bo om Isle r .moo < v 14i1—+•t{.11;•�tv�� i~~~,U///'J c,c, —'vn c v�, {v :rc ;ice t S I —� Ytc '% 41tC.S DETAIL COST RECORD HOURS CODE RATE EXTENSION S.T. O.T. D.T. TOTAL O co Sub-Total — ----- Labor Taxes& Fringe Benefits --- ---- — Labor Markup -- Total Labor Costs — n --------------- J w IL Sub Total — — w Equipment Markup Total Equipment Costs _'S�/1AA� __ nCly' J— �S{1S •C� IGCb'l+tic, SLht l..l _ w — Sub-Total Sales Tax(if applicable) ' Material Markup Total Material Costs "- LU _. w Total Other Costs j Sub-Tole, Bond Insurance Taxes 7 / Miscellaneous Costs Conif=tor's Representative Sub-Total Overhead 5ubconlractor's Representative v wner's Representative Sub-Total Sales Tax No. Sheet of TOTAL 1508 VALENTINE AVE SE PACIFIC,WA 98047 (250)218-0444 FAX:(253))218-0454 ' t / / 2 1 4 3 0 Projectf-IY U lr..vn r. �.�t✓� dobk ! L��4.� _ Dato ---I )f/ �/ Woalher .sl.krI I / �=' Y Desorl (ion must bo cool lots � �_ �a�pr ) ,.J I ._�=! ''..b, <�-`r i - I �wp.{� ,e.. 'Via--4�h1/�inrN,<� f��a.Ytr=---r?✓!�-"-c�.lr �i .. ��%nc�c�- �v �- oc :c . DETAIL COST RECORD CODE --- HOURS RATE EXTENSION S.T. O.T. D.T. TOTAL —L_.Y1�= ._q _ I1 m Sub-Total --�-- ----- - ---- Labor Taxes& Fringe Benefits -- Travel Tlme -- — Labor Markup Total Labor Costs 7_ S c -- F- Z w n. Sub Total 0 Equipment Markup Total Equipment Costs votCR S J Q _ rr LLJ Sub-Total Sales Tax(If applicable) Material Markup Total Material Costs W F Lo Total Other Costs _ 'I r .r Sub-Total j Band Insurance Taxes �/ Z-� ' •-� Miscellaneous Costs Contrpctor's Representative Sub-Total _ Overhead �� � Su onlraclor's Representative Owner's Representative Sub-Total Sales Tax No. Sheet of TOTAL kOU1PM@NT WATCH m www.equipmentwatch.com Rental Rate Blue Book@ May 1,2014 On-Highway Truck Tractors Miscellaneous Models Size Class: 60.001 GVW&Over 60,001 GVW&Over Configuration for On-Highway Truck Tractors Power Mode Diesel Axle Configuration 6X6 Maximum Gross Vehicle Weight 70,000 Ibs Horsepower 450.0 Equipment Notes: Non-Sleeper Cab !, Blue Book Rates `*FHWA Rate Is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated FHWA Rate** Operating Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates $4,085.00 $1,145.00 $285.00 $43.00 $62.30 $85.51 Adjustments Region(100%) - - - Model Year(100%) Ownership(100%) - - - - Operating(100%) Total; $4,085.00 $1,145.00 $285.00 $43.00 $62.30 $85.51 Rate Element Allocation Element Percentage Value Depreciatlon(ownership) 44% $1,797.401 mo Overhaul(ownership) 43% $1,756.55/mo + CFC(ownership) 4% ( 1 -� Indirect(ownership) 9% $367.651 mo Fuel(operating)@$3.98 70% $43.88/hr Revised Date: 2nd Half 2013 L-- cs��a�— All material herein©2003-2014 Penton,Inc.All rights reserved. Page 1 of 1 HUIE"IVIEINT WATCH . e .equipmenswatch,com Rental Rate Blue Book® May 1,2014 Hydraulic Removable Gooseneck Equipment Trailers Miscellaneous Models Size Class: All All Configuration for Hydraulic Removable Gooseneck Equipment Trailers Number of Axles 3 Number of Tires 12 Capacity 85 t Equipment Notes: Costs do not include self-contained power pack. Blue Book Rates "FHWA Rate Is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated FHWA Rate** i Operating Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates $2,810.00 $785.00 $195.00 $29.00 $10.30 $26.27 Adjustments Region(100%) - - - - Model Year(100%) - - - - Ownership(100%) - - - - Operating(100%) Total: $2,810.00 $785.00 $195.00 $29.00 $10,30 $26.27 Rate Element Allocation Element Percentage Value Depreciation(ownership) 45% $1,264.501 mo Overhaul(ownership) 33% $927.301 mo CFC(ownership) 4% $112.401 mo Indirect(ownership) 18% $505.801 mo Fuel(operating) Fuel cost data Is not available for these rates. Revised Date: 2nd Half 2013 All material herein©2003-2014 Penton, Inc.All rights reserved. Page 1 of 1 - -WATGH www.equlpmentwatch.com Rental Rate Blue Book@ May 1,2014 On-Highway Flatbed Trucks Miscellaneous Models Size Class: 19,501 -26,000 GVW 19,501 -26,000 GVW Configuration for On-Highway Flatbed Trucks Power Mode Diesel Axle Configuration 4X2 Maximum Gross Vehicle Weight 20,000 lbs Horsepower 200.0 Blue Book Rates **FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated FHWA Rate" Operating Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates $1,340.00 $375.00 $94.00 $14.00 $21.70 $29.31 Adjustments Region (100%) Model Year(100%) Ownership(100%) Operating(100%) Total: $1,340.00 $375.00 $94.00 $14.00 $21.70 $29.31 Rate Element Allocation Element Percentage Value Depreciation(ownership) 52% $696.80/mo Overhaul(ownership) 31% $415.40/mo CFC(ownership) 5% $67.00/mo Indirect(ownership) 12% $160.80/mo Fuel(operating)@$3.98 72% $15.60/hry�f Revised Date: 2nd Half 2013 All material herein @ 2003-2014 Penton,Inc.All rights reserved. Page 1 of 1 T'rQIR;V1l1'L'1,ill nr lu'rxLa 1�:��-s-e.ta-v 4�4 rr InsgHlo.Lo rC.u.1 UY/1n/4V14 UVIbO rage ! of United Rentals, RENTAL AGREEMENT BRANCH N61 2302 BAST IQ- STREET TACONA wA 9a121 253-383 a 4 118768622 253 253-572.5192 PAY Customer # 226192 Agreement Date 04/09/14 4103 HORSESHOE BEND Rental Out 04/D9/14 12:00 PM �H E VALLEY HWY &. S 259TH SIT URh Cob 1Loa ed n : ESVALLEY HWY &/07/14 0SP259 x: HORSESHOE@BEND UR sob # : 156 Q ILENT WA 98032 Customer Job ID: 156 P.O. # ! INTERURBAN TRAIL fJ Office: 253- 218 - 0444 M#): 206-255 -9257 Ordered By : TYSON /SX/DH Written By : JESSE ENGLISH Salesperson : AUSTIN NICHOLSON SCI INFRASTRUCTURE LLC 2825 S 154TH SIT j SEATAC WA 98188 -2034 This is not an invoice i Please do not pay from this document !j N :1•n:l l::::,1:::'.v:a le sal::::.lu:::all lal::,-.::c:IIC::::_T.:'S:a::lgll y:ru:::V 141prrl,::l:::v ll lr c::r r:r,v<n uc:r -r::vr cl R L ITEMS: City Prnuioment Deacrintion Minimum Day Week 4 Week EStinatild APPI 1 998314 BACKHDB/LOADER 60-90HP 4WD 295.00 835.00 1025.00 Make: CASE Model: 580M SERIES II Serial: Fl7C424715 Meter out: 2464.70 1 902/5024 BACKH08 BUCKET 241, 1 984941 BACKHOS VIBRATORY PLATE COMPACTOR 154.00 482.00 1236.00 Make! KE14T Model! RHP 65 FT Serial: 650640 Meter out: 2.00 SAL88/MI BCELLAN80D8 ITEMS: Rental Subtotal; I Item Priae ITnit of Mea SIIrP Extended Ant. 1 DELIVERY CHARGE 95.000 EACH 95.00 1 PICKUP CHARGE 95.000 EACH 55.00 gales/Mien Subtotal; 190..00 COMMENTS/NOTES: CONTACT; CHRIS CF,T:L#: 2 06-60 4-4622 .�-------"-- a 259th to interurban trail �1 �In ���a//� 7 A CLEANING CHARGE WILL APPLY TO EQUIPMENT RETURNED WITH EXCESSIVE �Vl ✓1 J 1 6 DIRT, CONCRETE, AND/OR PAINT. CUSTOMER 11; RESPONSIBLE FOR ALL 31 DAMAGE MMISSSINGINCLUDING KEYS. A FUELTIRES. CHARGETHERE WILLWILL BEE AN APPLIED TO ALLADDITIONAL UNITS NOT CHARGE FOR NOT RETURNED FULL OF FUEL 4 f t le t . ♦ t In f in TO SCHEDULE EQDIPMENT FOR PICKUP, CALL 800-DR-RENTS (800-877.3687) WE ARE AVAILABLE 24/7 TO SUPPLY YOU WITH A CONFIRMATION # IN ORDER TO CLOSE THIS CONTRACT f, Ili 'ENVIRONMENTAL CHAROE;The ton-,Ilu4ealetl above ale ion tot to an emw onmeMrl[hall'ath"ll 11"I'll"ll W leso t UnNetlS llPut aM11no1wrt IY.peol to,pre lon"PI ITanarih,anti ripening oh%asle yNOcu,Ra irilOUs" real LUlalnialre We coats This is net pnelnm enhlnalllaled dial He FUEL,Fuel EINIfe,deal l ritime P aew"w1a..,lout alike MI -• rI OPTIONAL RENTAL PROTECTION PLAN Tfo.56 ENTIL PROTECTION PLAN IS NOT INSURAAICL Upoo kcemnSllla pooehafftenlel P,aeoHo PIe,{ IACaxI G 9 x�Neeero p;ya cfl6y0 CnP61lo Of the jell,ehanfes MIR,,,RCnt GL'ulnfnfl Man l9[PrtI e11 by11C RPIIIir Plo v`f loll Plan o naho a0letfolth el ARllentoln I[one Ren44Ag McMent,Unted.vil eeto wa1 CeRav oo4n5tMaccitientl I TIPS,lO oriHAt of 1 vo,hcnrcmU Larygnnont I(monq JminU rani I'll"'I'll Loa Cookanbl leln mO511abb fbl allellef HaninfUl assato InthecoolUdinsfiendu AUOendon I to0e RentI Agreement NOTICF FOP.RENTAL LW A MOTOR I. IIAE:THIS CDNt RACT OFFERS.FOR AN ADOn IOTIAL CHARCF.A DAMAGE WAIVER TO LIMIT YOUR FINANCIAL RESPONSIBILITY FOR DAMAGE TO OR THEFT OF THE MOTOR VEHICLE BFFOPE OEr.101I YIHTiiER TO PURCHASE THE OftLASE IWIVER,YOU MAY WISH 10 DETERMINE WHETHER YWR OWN INSURANCE AFFORDS YO'J CENERAGE THE PURCHASE OF THIS DAMAGE'NNVBR IS NOT MANDA.TORV MI)LIAY BE WMYLO SO DECLINED READ RE FORE 61014II10. Oy sill nlnl)oeltl:v(.l,Nuln el{v)AlV des l01111!Selma Yn:Icry µrXl Ulle[a nla lluU llI In"tt(rt al l9rV`ele erH,1.)AI29a oil on eGlnlllaenl l511,.1i,ono,to o, I an Minolta,Rpo R(s CPAIn:eaW the 111.1 ano Innl9mns of the r:ry:p5nal Ralllal PIOYaRUn Plan,J Ip1 Ac6ulx,Soil R)AUthalm5 Vued le Fhar,CRslomel 54e11i1 fall IIIIII abOl2.1 an pie.Ir anpt[aUla Colwael dbo a<MnJHIWpea hall la�Wly lalnlRar WlUl Ne cp¢I of en and u:n of(Fe Wvlpmenl nn,Ile,lalaa ll III the elpupmenl In p WU u,vWng a tlel,fb)aE<a,Hy OUllellna;(f I au nperamr manuAs,vll ftU dl montYaflol er a labulaell Rota for We for the p otetlrve AFe n egmpmept listed In ryp X CUSTOMER SIGNATURE DATE CUSTOMER NAME PRINTED UNITED RENTALS REPRESENTATIVE/DELIVERED BY DATE A LARGER FONT COPY OF THE TERMS AND CONDITIONS IS AVAILABLE UPON REQUEST. page: Y so eO �o o'�•`.\o s o�t��;�� pa��� 4 WEEK BILLING .SQ , „ 12 INVOICE �TUTO LIIl IIA ON WAY 360:7TER 4,0 assD1.623" # 112349147-007 16o-3s7-zeds Pnx Customer # : 226192 Invoice Date 12/11/13 G1 Date Out 07/08/13 08:00 AM 4.7 Billed Through 12/23/13 0 0:0 0 -'d UR Job Loa co OR Job # Customer Job ID: D.O. # F3 Office: 253-218-0444 Cell : 206-255-9257 ordered By : TYSON /SK Written By : JOSEPH MESSING Salesperson SCOTT KUKLINSKI SCI INFRASTRUCTURE LLC 2825 S 154TH ST Invoice Amount: $6,092,80 SETAC WA 98188 Te=ma: Dee NPe" Receipt PaY,0en0 options: Contact our credit office 704-916-4125 RENT TO, UNITED RENTALS(NORTH AMERICA),INC. FILE 61122 LOS ANGELES CA 90074-1122 '.. RENTAL ITEMS: - QtY Ramipmen6 Descti]2tion Minimum Day Week 4 17cC1: Amoun[ '. 1 1115315 EXCAVATOR 30000-34999# ZERO TAIL SWING 450.00 1700.00 3950.00 3,950.00 Make: JOHN DEERS Model: 135D Serial: FF135DX302101 Meter out: 3443.40 Meter in: .00 1 1217512 EXCAVATOR PLATE COMPACTOR 200.00 626.00 1625.00 1,625,00 Make: WENT Model: K-HP135IIFT Serial: 1356643 1 905/5030 EXCAVATOR BUCKET 30" N/C Rental Subtotal: 5,575.00 SALES/MISCELLANEOUS ITEMS Qty , Item Price Unit of Measure Extended Amt. 1 ENVIRONMENTAL CHARGE [ENV/MCI] 25,000 (EA) EACH 25.00 Sales/Miso Subtotal: 25,00 Agreement Subtotal: 5,600,00 Tax: 492.80 Total: 6,092,00 COMMENTS/NOTES: BILLED FOR FOUR WEEKS 11/25/13 P4RV V 23/13 08 00 All f TO SCHEDULE EQUIPMENT FOR PICKUP 80 LRrrrr PS (13 WE ARE AVAILABLE 24/7 TO SUPPLY Y 17ITF7 P C 11 T t J IN ORDER TO CLOSE , i s � If } yl )0 THIS 4 WEEK BILLING INVOICE 15 ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE RENTAL AGREEMENT,WHICH ARE INCORPORATED HEREIN BY REFERENCE. A COPY OF THE RENTAL AGREEMENT IS AVAILABLE UPON REQUEST. Page: V❑/VL/ LULY Cltl 11 pY C'HA IgJVU�/VV❑ CCLVMUTASTAT4 UFIlr,, e,.arlL ,wwuoio • 9f.URA�Zf, p,I2025 st+Ia.M sgtli rJ" .•. /rig pn'! cl llic tnu, i '. ROE;Smt6/Sgp SL '. 11 )I•'-�°,'r —•0312' 5,000. U '� 1200)2i2.005y fix ^�A4,0)02' , ^':rOnefhousoo Arid xxl'9,RodoNArs""` '� „ �• • . Woo paolfic Rallro?d 6 p901' 4 , .i n' ,i rnoa.09ObYSoNliv h.�rwvu� pq'? ' 1d000oLNiasElioal�. •' v6loac�rynwnnv❑Feor;,dyc❑n�mck 1❑vle ` Omalia Na 66170 ..,�f,.., , m[1).osioo 1: 125ioa27d47onOr,m146 , 40, IV -1 v Lu -qo at M k 6 A.- mz 1.1 j, . it.k it V•JI V.1 Lv is 1'n1 l: Jd CMn IgAVV dI VVJ OO.92t%lp$JMAx , ., 040508., . , '.31.e2}nG61 OATH _ Nap:w x,ilmU..ueAAvur CH'CB NO, . 2E9E€annf9amRl. gA1077�ge dOK6� ' S9upp}}9o,WA 9818E _ •(2E9j PdP�OE FAR 12Wj P,1M10%98 I .�11^��i'.•t_—� •. ' 1110na•t0azond alflht hundrud and xx($60 DoIlars�^' Msmb USA 10. I•,• PO Doi TX76214-0Oti. EaaUAL OPPOPTUM RUPWYEq RAY ABI e TX T5 YOIO/ dR.60 PAYS FROM GATE OF HECK ORDER i 1 OF L .�I• �tr aJ NOIVt6 YASUF4 11104g50Au' rig& i0827a].700D5601 Ex I ............ ............. ra In ;j It 3'0 %6�' C6 IM li L;j '4 o 00 w Lij I; W F' O;v J: rn --t 6 '71 Lh I j, tr 'I II APPLICATION FORM $2M / $6M RAILROAD PROTECTIVE LIABILITY INSURANCE DO NOT submit unless all mandatory (*) fields are complete. 1. *Name of Union Pacific Representative Connie Alvlg Emall Address cralvlS@up.com 2, *UPRR Contract Folder Number#####-## 829,68 Note: separate applications must be completed for each folder assigned 3. *Description of Project (example! horizontal bare/pipe,,,,) Underground Parallel Installation 4. *Please Complete Either Section A OR Section B QR Section C Below; Section A. Traverse Installation - Wire and Pipe 7 14 If Project is Traverse Installation Overhead or Underground, use the drop down arrow to select the linear feet. - Overhead — � Underground 0-250 = $1,800.00 • - t tta atr '',, Please Describe Project (Include Project Location, County,and Zip Code) Project Cast Within $ 25,001 - $ 75,000 = $ 900 Total Project value TBD 50'RR Property S. *Job Location (Nearest City, State) Kent,WA *Estimated Start and End Date of Work Within RR Right- B. of-Way Begin 04/09/2014 End 04/30/2014 7, *Name on Certificate of Insurance SCI Infrastructure, LLC (contractor completing the prgjgco Malling Address 2825 S 154th Street City,State, ZIP Seattle, WA 98188 Phone #206.242-0633 Fax# 206-242-0792 E-Mai( mark@sclinfrastructure,com 8. Name of Involved Governmental Authority or General Contractor SC[Infrastructure, LLC g, Cost of Railroad Protective Liability Coverage for this Project: 1800.00 ONLY enter amount from A QR 8 QR C above. THIS IS YOUR TOTAL PREMIUM Premium Includes 17.5%commission for Marsh USA Inc. Your payment will acknowledge acceptance of this transaction. A Check Payable 1n the amount quoted In Item*9 abover Payable to; MARSH USA Inc. 'I PO Box 846015 Dallas,TX 75204,0015 NOTICE: nyEHnox.,axeadlwAHr kao f10.TICE:Any preen wfio MoMnpIY,or knowlnply w•hb mplhrt,file.m appllctllvn for Immrunc•ar cbim<andlnln0 any fllw,Incmnpl.e prmldntllne infvrm*tlon ' Irsa.pwpa•s araeh•uding p1 aU•mplNO tp d•Inud en Imunnu Company m•y M aulHy of a cdrrw mtl mry b••ubpat b admina7 and oNll P•n•lun wtl bw at Applicant Signature I(I/f/`,", Applicant Phone 206-242-0633 Date 04/07/2014 Please PrintAppllcant's Name Mark Scoccolo UPPRPLI.v.02232011 Linda Anderson From: Jennifer Scoccolo Sent; Monday,April 07,2014 12:26 PM To: Linda Anderson Cc; Skip Jinneman Subject: FW:Folder No.829,68 Wireline Crossing Please prepare a$1000 as noted below. Our Folder No.is in the subject line of this email. From:Connie R.Alvis rmallto:CRALVISCaUP COM] Sent:Monday,April 07,2014 12:23 PM To;Jennifer Scoccolo Subject:Re; Folder No.829.68 Wireline Crossing Union Pacific Railroad Company to the address below,marked with the folder no, on your permit.. Connie Alvis Contract Manager for: Ar,Az,La,Ok,Or,Tn,Wy UPRR Railroad Company RE Dept.MS•1690 '. 1400 Douglas St, Omaha,NE 68179 Phone:(402)544-8553 Fax: (402)601-0340 Email: cralvisOuo.com UP Website: htto7/w uorr conVreus/pipeline/instail shtml From: Jennher Scoccolo gennlferrdsdlnrrastructcre.com> To: "cralvlsrduo.com'ttrablealw..bma Dalet 041077201412:40 PM Sublacl: Folder No.629.58 WIrallne Grossing We are performing the emergency work on the project for the City of Kent,Wireline Crossing Maintenance. I need to know what entity the$1000 administrative fee needs to be made out to. Will you please provide this information? Thanks, Jennifer Scoccolo via 9 SCIINL'99LA 'i 2923 S 1541h Suvet j Scaalc,WA 90188 P206-242.0633 F206-242-0792 1 i� Tacoma Screw Products, Inc. Invoice INVOICE # 15221886 J lncomasermf.com LOCATION KENT slnn•iar, REcEIVED DATE 04/11/14 REMIT TO 2001 CENTER STREET qq p p �7 TACOMA WA 98408J885 USA NT'7 U 791Y PAGE 1 OF 1 800-562-8192 t9 IIIIIIIIIIlIIIIIIIIIIIIillllllllllllilll IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllll BILL TO SHIP TO F-486703 f—S C I INFRASTRUCTURE LLC S C I INFRASTRUCTURE LLC ATTN RECEIVING ATTN SUPERVISOR ACCTS PAYABLE 2825 SOUTH 154TH ST 2825 SOUTH 154TH ST SEATTLE, WA 98188 SEATTLE, WA 98188-2034 I ORDER NUMBER ORDER DATE ORIGINAL QUOTE CUSTOMER P/O NUMBER PAYMENT TERMS KE97664- 04/11/14 1406 1% 20 DAYS, NET 30 D WRITTEN BY SALES REP CUST RELEASE# JOB NUMBER SHIP VIA LLH WLO 1406 WILL CALL - KENT s '� Pl� ti3U6r/p5r;,)atPTitl�Y ,Qt1AN7l'kYp4lA1yY(TX p4Ct97'7Y r PAID tail Tex ES4YENSI�N 057-011-1 14 14 0 74.7905 C F 10,47 STEEL HEX FULL NUT 1-1/8"-7 PLAIN 060-011.1 14 14 0 109.6683 C F 15.35 STEEL'HEX FULL NUT GRB 1-1/8"-7 PLAIN 058.007-1 4 4 0 126.2211 C F 5,05 STEEL HEAVY HEX FULL NUT 1-1/8"-7 PLAIN l; IOU Thank you for your order. Please note that all sales are subject to Tacoma Screw Products, Inc.'s Terms of Sale and Conditions of Sale. If there should I, be any questions, or if we can be of further service, please call (253) 572-3444 or 1800) 552.8192. We appreciate and value your continued business. MERCHANDISE DEPOSIT DEPOSIT TOTAL HANDLING MISC CHARGE TAX FREIGHT AMOUNT APPLIEb INVOICE TOTAL 30.87 0.00 0.00 2.93 0.00 0.00 0.00 PICK-UP SIGNATURE: CASEY INVOICE 96018 SIGN SHOP • ROAD SAFETY PRODUCTS • RENTAL&SALES AABCO BARRICADE COMPANY INC. SINCE 1978 4025 80th St. S,W. • Mukilteo, WA 98275 Seattle(206)363.6212 •Everett(425)353-5619 Toll-Free(800) 550-6212 E-mail: info(a).aabcoslon.com Web: www.aabcoslgn.com RECEIVED Sold To: Ship To., SCI I NFRASTRUCTURE,LLC SCI INFRASTRUCTURE,LLC 2825 SOUTH 154TH STREET YARD SEATTLE, WA98188 SEATAC Invoice Date: 04/04/14 P.O. Number: Customer ID: 1060 Ship Date: 04/04/14 Job Number: 1406 Del. Order Number: 122672 i Order Ship Qty BO Qty Description Unit Unit Amount Qty Price 1 1 0 48"CUSTOM WOOD ENG, SIGN Each 122.50 122.50 1 1 0 Delivery Fee Each 15.00 15,00 Subtotal 137.50 Sales Tax 13.06 Shipping `-0.00 TOTAL INVOICE 150.56 AABCO'S NEW EMAIL AABCOSALES@AOL.COM ' i THANK YOU rOR YOUR BUSINESS s"4UJ�13 I�jV���r. � a II ME t 1 We Invoice on the 15th and at End of Job (E.O.J.) - Terms Net 30 INTEREST AT THE RATE OF 1.5 PERCENT PER MONTH APPLIES TO ALL PAST DUE ACCOUNTS ALL ACCOUNTS SUBJECT TO MASTER CREDIT TERMS AND CONDITIONS Not responsible for placement of rental equipment 13440 SE 30th St., Bellevue, WA 98005 El- �m�o ® � � PO Box 160, Bellevue, WA 98009-0160 �25 1 R E C E I V E D Phone 425-746-8400 • Fax 425-641-8885 ® COMPANY PO Box 160, Bellevue, WA 98009-0160 APR 2 9 1014 Pacific Branch ® 1417 Thornton Avenue SW 'I Invoice Number 13607468 PABI Pacific, 98047 (253)863-8600 Fax(253)863-8681 # 192970 To: Ship to: WILLIS ST 111 0 SCI INFRASTRUCTURE LLC KENT WA 98188 2825 S 154th St Order# Inv Date: Order Writer: SEATTLE WA 98188 04476086 04/18/14 Fred Carlson Terms: 10P+30 Due: 06/10/14 PO/JOB: KENT JOB FOB: H. D. FOWLER COMPANY Ship Via: OUR TRUCK Qty Qty Part# Unit Extended T Line Ship'd BO'd UoM Description Price Price X 1 1 0 EA 12" 316 STAINLESS STEEL#250 DRILLING 1/4" 348,570 348.57 THICK BLIND FLANGE (FABU PO/REQ#: 14903) III i � 'E 4 �4�_u��_ ,: s,i _ Utz Sub total 348.57 Freight 0.00 Tax 0.00 Grand Total 348,57 TYSON Serving the Pacific Northwest since 1911 wvvw,hdfawler.com i I � N.D. FOWLER Pacific Branch COMPANY 1417 Thornton Avenue SW PO Box 160*Bellevue,WA*98009-0160 Pacific, WA 98047 - �. IVED APR 2 9 2014 425-746-8400 (253)863-8600 Fax(253)86 Invoice Number 13601712 PAWH # 192970 To: SCI INFRASTRUCTURE LLC Ship to: WILLIS ST 2825 S 154th St KENT WA 98188 SEATTLE WA 98188 Order# Inv Date: Order Writer: 04476467 04/11/14 Fred Carlson Terms: 1OP+30 Due: 06/10/14 POIJOB: KENT JOB FOB: H. D. FOWLER COMPANY I Ship Via: OUR TRUCK Qty Qty Part# Unit Extended ' Line Ship'd BO'd UoM Description Price Price 1 1 EA 12"X 2' FL X FL DI SPOOL CEMENT LINED & 757.14 757.14 STANDARD COATING 2 1 EA 12' X 18' FL X FL DI SPOOL CEMENT LINED & 2230.00 2,230,00 STANDARD COAT 3 1 EA INBOUND FRT/BILLABLE 450.00 450.00 Sub total 3,437.14 Freight 75.00 Tax tyson Grand Total 3,51214 Serving the Pacific Northwest since 1911 www.hdfowler.cam H.D. FOWLER Pacific Branch COMPANY 1417 Thornton Avenue SW PO Box 160*Bellevue,WA*98009-0160 Pacific,WA 98047 425-746-8400 (253)863.8600 Fax(253)863.8681 Invoce Number 13601705 PAWH # 192970 To: SCI INFRASTRUCTURE LLC Ship to: WILLIS ST 2825 S 154th St KENT WA 98188 SEATTLE WA 98188 Order# Inv Date: Order Writer: 04475751 04/11/14 Fred Carlson i Terms: 10P+30 Due: 06/10/14 PO/JOB: CITY OF KENT FOB: H. D. FOWLER COMPANY Ship Via: OUR TRUCK Qty Qty Part# Unit Extended T Line Ship'd BO'd UoM Description Price Price X 8 36.5 FT 12" CL 52 DI PIPE TJ,C1511A21.51,C104,C/L,18.25- 43.11 1,573.52 NOM. LGTH,SBR GASKET(47.5 LBS/FT) �uE`�EO ppR 2g �p1� R Sub total 1,573.52 Freight Tax TYSON LASHBROOK Grand Total 1,573.52 Serving the Pacific Northwest since 1971 , www,hdfowler.com FOH.D. FOWLER Pacific Branch ' COMPANY 1417 Thornton Avenue SW PO Box 160'Bellevue, WA'98009-0160 Pacific,WA 98047 Invoice 425.746.8400 (253)863-8600 Fax(253)863-8681 Number 13616189 PAWH # 192970 To: SCI INFRASTRUCTURE LLC ship to: WILLIS ST 2825 S 154th St KENT WA 98188 SEATTLE WA 98188 Order# Inv Date: Order Writer: 04475751 04/29/14 Fred Carlson Terms: 10P+30 Due: 06/10/14 PO/JOB: CITY OF KENT FOB: H. D. FOWLER COMPANY Ship via: OUR TRUCK Qty Qty Part# Unit Extended T Line Ship'd BO'd UoM Description Price Price X 23 1 EA 12"S89 PIPE SUPPORT WITH 6" BASE PLATE 156.51 156.51 ELCTRO GALV. FINISH i REC�NED ppR 2 g 2014 i Sub total 156.51 Freight Tax TYSON LASHBROOK Grand Total 156.51 Serving the Pacific Northwest since 1911 www,hdfowleccom Corporate Offices 13440 SE 30th St., Bellevue, WA 98005 H.D. 0gip i PO Box 160, Bellevue, WA 98009-0160 H FOWLER Phone425-746-8400 • Fax425-641-8385 -- COMPANY PO Box 160, Bellevue, WA 98009-0160 Pacific Branch r� Sy j lrr Invoice 1417 Thornton Avenue SW [1 Number 13601011 PAWH Pacific,WA 98047 APR y # 192970 (253)863-8600 Fax(253)863.8681 To: Ship to: WILLIS ST 3/4 rhnlu�llll'�IIIh16n�rllllihllllhnll�lhllllillllh'41h 2 SCI INFRASTRUCTURE LLC KENT WA 98188 2825 S 154th St Order# Inv Date., Order Writer: Seatac WA 98188-2034 04475751 04/10/14 Fred Carlson Terms: 10P+30 Due: 06/10/14 POIJOB: CITY OF KENT FOB: H. D. FOWLER COMPANY Ship Via: SALESPERSON DELI ERY Qty Qty Part# Unit Extended T Line Ship'd BO'd UoM Description Price Price X 1 1 0 EA 12" FL 90 DEGREE ELL,DI,AWWA C110,C/L(275 416.850 416.85 LBS) 2 , 0 EA 12" FL 45 DEGREE ELL,DI,AWWA C110,ClL(195 352.020 04:04` LBS) - 3 1 0 EA 12" MJ X FL ADAPTER DI,AWWA C153, C/L LESS 189.040 189,04 ACC(80 LBS) 4 Z T 0 EA 12"2501.138 FLANGE BOLT SET 16EA,A307 GRADE A 96.500 r289;50 1-118"X 5-1/2" LONG - 5 -�r 0 EA 12"250LBS FLANGE RED RUBBER RING GASKET 25.000 75-00 6 C �6 0 EA 12"PLATED BOLT&NUT KIT,A307 GRADE A, (12EA 35.000 r"c,--2.1.0:00` 7/8"X 3-3/4" BOLT WITH NUT)IMPORT 7 6 0 EA 12" 1/8" RING GASKET RED RUBBER, 150# 12,000 72.00 9 1 0 EA 12" FIELD LOCK TYTON JOINT GASKET SS RUBBER 162.710 162.71 10 0 EA 12"WEDGE ACTION MJ KIT FOR DI PIPE W/BOLTS, 97.070 -157 WEDGE ACTION GLAND &GASKET -1 95 , 3 '- 11 1 0 EA 12" MJ SLEEVE LNG PATTERN DI, AWWA C153 166.010 166.01 LESS ACCESSORIES (82 LBS) /7�9�,q9 C' 12 /2 0 EA 12"MJ 45 ELL,DI,AWWA C153,C/L,LESS ACCESS 179.950 '§59 (109 LBS) 18 1 0 EA 12" MJ CAP DI,SSB,AWWA C153,LESS ACCESS (44 87.250 87.25 LBS) 19 1 0 EA 12"COMPACT BODY MJ ACCESSORIES KIT 30.910 30.91 COMPLETE WITH GLAND, GASKET AND(8)3/4"X 4" T-BOLTS TYSON Serving the Pacific Northwest since 1911 www.hdfowler.com AMPRAMIR INVOICE DATE... CDODN:,v IA4CICE: uuRR. PRAXAIR DISTRIBUTION INC 1 02/05/14 EW583 48494791� 12714 VALLEY AVE E *PAYMENT DUE BY: 03/07/2014 SUMNER WA 98390 (253) 863-1844 RECEIVED M 163-PRAXAIR DISTRIBUTION INC 2211-1/1:2276 T PO BOX 120812 DEPT 0812 SCI INFRASTUCTURE LLC �FO 13 2014 DALLAS TX 75312-0812 N 2825 S 154TH ST (800) 266-4369 f SEATAC WA 98188-2034 SCI INFRASTUCTURE LLC 2825 S 154TH ST d PSEATTLE WA 98188 ° 200 SHOP b0968-00 °2F/05 163 155 142 I OUST PICKUP DF TNET 30 v,{s+xrcV i'rn�751iV C411N0E115�. m��tiNutaa�R ��o .:tll° Ir�M u�schlrtiQn )Irjrr iirirr pASek AMOUNT" ... QIP O.TRS:U: . .. :: if: .. F. r �i:, lu: +* LOCATION: 163 ** AT 5 0 ACETYLENE 5 L 229.95 229.95 VOLUME 32bUl' /U.54j100 F - ZZZHM5 `9.9 Su total / 239. 0 70TAL CY IN ER SHIPPED: 1 RETURNEE : 0 i 11 ` 7- if - 1 , Pay your bills by credit card! Call 1-800-266-436S to start. Tax 22.79 rax,.me AMOVNI INUb1.C.E MCOUII fS PAST OUR H CC CNAPAAA A CEPVICC CIIH W.T.F$1.A.%°N A FINANCC CHAPOC OF 1 6Y. PCA MU A B AAW PATE]AT TIIC 239.90 AMOUIU'C. 262.69 °UISTAeRIIAV BALANCE,WHICHEVFfl IS OPEATFA PLEASE`DETACH AND RETURN BOTTOM PORTION WITH PAYMENT KWN FOR CREDIT CARD PAYMENT AKN iH0 SEE REVERSE SIDE ixt B TC, CCQUNT i, aNRD,if,rL,NUlABER,.J e 1?-we P,Y'%k1I§, I INVOICE ,.. 02/05/14 EW583 48494791 1 262.69 ❑CHECK HERE FOR CHANGE OF ADDRESS. SEE REVERSE 513E AMOUNT ENCLOSED . _..__.. PLEASE MARE CHECKS PAYABLE TO AND MAIL TO: „ P e SCI INFRASTUCTURE LLC " 163-PRAXAIR DISTRIBUTION INC L 2825 S 154TH ST T PO BOX 120812 DEPT 0812 SEATTLE WA 98188 T DALLAS TX 75312-0812 EW583 48494791100000262693 i INVOICE :OR'TE ACC©UNS:tl '' INVOICF, rJl1MBFR 01/31/14 EW583 48439035 PRAXAIR DISTRIBUTION INC 1402 20TH St. N.W. Bay 1 *PAYMENT DUE BY: 03/02/2014 AUBURN WA 98001 E(253) 854-6600 H 161-PRAXAIR DISTRIBUTION INC 30213-2/2:30549 T PO BOX 120812 DEPT 0812 III d DALLAS TX 75312-0812 (300) 266-4369 P SCI INFRASTUCTURE LLC SCI INFRASTUCTURE LLC 2825 S 154TH ST d 2825 S 154TH ST PSEATTLE WA 98188 SEATTLE WA 98188 PO a CIpEp. ORaee 31 enaxcn w nIP nA rums PA E 110-144 6329496-00 1/EA 161 155 142 CUST PICKUP BT NET 30 1 IFc61 171IhL9fR 0➢nNTl1 Uni;ri+Y CY�.INOEC+$' 1TGh1 OE§CHIRTIB2: :UNIT UNYc PRISE" AMOUNT; ... nrceen Henn".. ...:.. :.. ** LOCATION: 110 ** �. .:... _.._.. . ....: ZZZDEMANDCHGCYL 0 DEMAND CHARGE CYLINDERS IEL A .44000 1.44 ** LOCATION: 161 ** OX K 3 0 OXYGEN K 49.69 149.07 3 AR STAR14-T 0 STARGOL➢ C25 ARG-0O2 25% L 75.12 75.12 VOL: 381 HE B-M 0 HELIUM BALLOON M L 327.00 .00 ** Sale price ** VOL: 0 HYP220675 5 PLAS SHIELD PMX45 GOUGIN EA 16.96 .00 PRS66212 0 GLASSES VORTEX IR 5.0 FR PR 7.99 7.99I JAC20529 GOGGLES WILDCAT SH5 IRUV R 18.950 18.95 ZZZHM HAZARDOUS MATERIAL CHARS EA 9.95 9.95 Su tot 1 262.52 TA CYLINDER SHIPPED: 4 RETURNEE : 5 i TLI,A. Pay your bills by red't card! Call 1-800-266-436- tc sta_t. t 24.94 ACCOVNO PRST ORE WILL 6E CH MNEO p EEI ICE (�CER MO Ci$1;% OP A FINANCE CF TOE Oi 15'I. �1{N�/yO'I.I✓E /PER MONTHIIBY.ANNUAL P TE)IEFE ER THE `I62C2 AMOUNT pOIli5TAN01NE YALANEE,µHICHEVFA IS OPEATL A. Ll1G J : 2U7.46 PLEASE DETACH AND RETURN BOTTOM PORTION WITH PAYMENTCAR PAVMENY Wxx x?t SEE REVERS SIDE xk tlNCk,_, AC60QIJT�H .:INVOICE'WUMBEfi, INVOICE N\VOI/ /'. .Nye..}yg piY Ti AkpVNT Ol/31/14 EW583 4843903-9 CE 267 46 ❑CHECK HERE FOR CHANGE OF ACORESS. SEE REVERSE SIDE AMOUNT ENCLOSED PLEASE MAKE CHECKS PAYABLE TO AND MAIL TOo fl u e SCI INFRASTUCTURE LLC " 161-PRAXAIR DISTRIBUTION INC t 2825 S 154TH ST T PO BOX 120812 DEPT 0812 T SEATTLE WA 98188 T DALLAS TX 75312-0812 o EW583 48439035100000287469