HomeMy WebLinkAboutPW15-152 - Change Order - Change Order #1 - Pacific Civil & Infrastructure, Inc. - 640 Zone Pressure Reducing Valve Station - 09/16/2015 ® Records Mana .
KEI�T
......„ Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: Pacific Civil & Infrastructure, Inc.
Vendor Number:
JD Edwards Number
Contract Number: PW 15-152 -• OC �-
This is assigned by City Clerk's Office
Project Name: 640 Zone Pressure Reducing Valve Stations
Description: ❑ Interlocal Agreement ® Change Order ❑ Amendment ❑ Contract
❑ Other:
Contract Effective Date: 4/22/2015 Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Ken Langholz Department: PW Engineering
i
Contract Amount: $401,194.31 ; , `-4 4)
a
Approval Authority: (CIRCLE ONE) Department Director Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Change Order#1
As of. 08/27/14
CHANGE
yqpA,g GYwn ORDER NO 1
NAME OF CONTRACTOR: Pacific Civil & Infrastructure, Inc. ("Contractor")
CONTRACT NAME & PROJECT NUMBER: 640 Zone Pressure Reducing Valve Stations #10-3025
ORIGINAL CONTRACT DATE: April 22, 2015
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:
Equitable adjustment for extra materials and labor--both inside and
outside the vaults to field fit due to incorrect pothole data, various
conflicts, and adjustment to the plans.
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, $401,194.31
(including applicable alternates and
WSST)
Net Change by Previous Change Orders $0.00
(incl. applicable. WSST)
Current Contract Amount $401, 194.31
(incl. Previous Change Orders)
Current Change Order $11,954.76
Applicable WSST Tax on this Change $1,135.70
Order
Revised Contract Sum $414,284.77
CHANGE ORDER - 1 OF 3
Original Time for Completion 120 working (lays
(insert date)
Revised Time for Completion under 120 working days
prior Change Orders
(insert date)
Days Required (t) for this Change 14 calendar days
Order
Revised Time for Completion 134 working days
(insert date)
I
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.
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 below.
CONTRACTOR: CITY OF KENT:
By � i By
signature) r-' a ,�' ) signature)
Print Name " -' �4 Print Name
Its , Its AHjl1G '�AllyyS 0I(uA-Dr
r _ / (title) , xtle)
DATE: /%ds' DATE:
CHANGE ORDER 2 OF 3
APPROVED AS TO FORM'
(applicable if Mayor's signature required)
Kent Law Department
pn this field,ycu may enter the electronic hk,th where the.o tr.d has been sa d]
CHANGE ORDER - 3 OF 3
e T FILE NO: 200.2
Ci�iA1
CHANGE ORDER WORKSHEET NO. I
Construction Management Division - Public Works
Project: 640 Zone Pressure Reducing Project No.: 10-3025
Valve Stations
Project Engineer: Mark Howlett Fed-Aid No.: N/A
Owners Rep: Phil McConnell Contractor:
Date: 8/12/2015
I. PROPOSED CHANGE
Equitable Adjusment: extra materials and labor, both inside and outside the vaults to field fit
PRV's
II. REASON AND BACKGROUND FOR CHANGE
incorrect pothole data, various conflicts and adjustment to the plans
III. METHOD OF PAYMENT
NRY PAY ITEM(S) Not Applicable
Change Order No. _ FOR ACCOUNTING USE ONLY
Sch. No. Item Description Total Est. Qty this i Unit Unit Price Total Estimated Cost of
city PE Item
2 equitable ad)ustment C 1 1 LS y $11 954 76__ 11,954 76
- — -
- -_-------- -- -- - ! --
!_ Independent Estimate Attached CREATE PAY IT ONLY- Payment to be made 0 PAY THIS PAY ESTIMATE ',..
-_REQUIRED I— !. at a later date upon completion of work '.
_-.-__._ .-.-.-_ _.-.-.-. .-.-_--- --_- _� -.--__ ...-.-.___..-
Material Submittals Required - CC. Construction Coordinator l New Sub Regrd� No
DELETE EXISTING PAY ITEM(S) per 1-09.5 ® Not Applicable
Change Order No. _ ! FOR ACCOUNTING USE ONLY
Sch. No. 13.1. No. Item Description Qty Unit Unit Price Cost of Item
I Independent Estimate Attached - REQUIRED
fNCREASE/DECREASE 1.0 EXISTING FLAY ITENI(S) ® Not Applicable
Change Order No. FOR ACCOUNTING USE ONLY
--
Sch No. B I No. Item Description city unit Unit Price Cost of Item
..---- -_ -._.,_ --_-_-- -----__-_ __.__-. ------- r
Independent Estimate Attached - REQUIRED
1 REV, DATE: 4/01/10
T
FILE NO: 200.2
TOTAL ESTIMATED COST OF CHANGE ORDER_ $11,954.76�
*Total of the Cost of Item columns
THIS PAY ESTIMATE 11,954.76
IV. WORKING DAYS
Original Contract j 120 Due This Change Order* 14 Previous Total !. 134
..DATE IDAM
._._.____ _____...____
'- ---. -_I_ - --- ..._.— .._...... : DATE
Explanation Justification Re wired: Work impacted critical path
TOTAL WORKING DAYS* 134
*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: 1�.\ ' f ��'.;c.,. L LI' Date: ry••�I `rY' J'—c=`i�_ '�
Phi Mc Co n II ¢J.? _
Construction Supervisor: € v _ Date: —
P ul, uehne
Construction Manager: - Date
Eric Connor
2 REV. DATE: 4/01/10
i
Unforseen Water Conflict Breakdown
FA 1 side sewer conflict $400.12 '`
FA 2 3 inch relief replumb at Park Orchard $4,783.11
FA 3 3 inch relief replumb at Millennium $1,253.37
FA 4 additional tie in parts required $997.31t-'
FA 6 18 inch vault riser and ladder $2,908.90,
FA 7 water tie in OT $608.02
FA 8 steel plates for pipe supports $1,003,93
$11,954,76
II
I
i
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED xEraT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 4000 Date: 2/27/2015
Description of Work: conflict between new storm and existing side sewer
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHT TIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT
Mark Heintz Supt 1 73.78 $ 73.78
Scott Lehman Foreman 1 60.59 $ 60.59
Brian Rinkel operator 1 60.59 $ 60,J9
Broc Rinkel pipelayer 1 57.33 $ 57.33
SUBTOTAL-LABOR: $ 252.29
LABOR OVERHEAD&PROFIT @ 29%7 73.16
LABORTOTAL $ 326.45
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT
Komatsu WA270 Loader(rental) 1 26,251 S 26.25
JD 85D Mini Excavator 1 20.00 $ 20.00
F650 Sinlge Axel Dumptruck(rental) 1 11.88 $ 11,88
F550 Flatbed Diesel Truck 1 3.58 $ 3.68 '.
SUBTOTAL-EQUIPMENT $ 61.71
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 12.96
EQUIPMENT TOTAL $ 74.67
MATERIALS/S ERVI CESIRE NTALS
MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT
SUBTOTAL $ _
OVERHEAD&PROFIT @ 21%
TOTAL $ -
Verification of Hours Worked: TOTAL: $ 400.12
i
12%MARKUP (for
prime when subcontract work) $ -
Contractors Representetive:�Z�l��...a',•''� SHEET TOTAL $ 400.12
-
OwnersReprasenabve r- i' .�Ir ,( ' Oete w,. �� 'r �jrr
1.
Comments
i
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED KENT
Project Name: 640 Zone PRV Stations Project No: 10-3026
Item No.: 2000A Date: 6-2 &6-3-2015
Description of Work: Park Orchard redesign and replumb 3 inch relief
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHT TIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate Hrs TOT Rate AMOUNT
Mark Hientz Supt 3 74.13 5 222.39
Scott Lehman Foreman 8 62.8 5 502.40
Brian Rinkel Foreman 8 62.8 5 502.40
Broc Rinkel pipelayer 8 57.52 $ 460.16
SUBTOTAL-LABOR: $ 1,687.35
LABOR OVERHEAD&PROFIT @ 29% $ 489.33
LABORTOTAL $ 2,176.68
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT
Komatsu WA270 Loader(rental) 8 Z6,25 $ 210.00
JD 85D Mini Excavator 4 33.10 4 20.00 $ 212.40
F650 Sinlge Axel Dumptruck(rental) 6 60.18 2 11.88 $ 384.84
F550 Flatbed Diesel Truck 8 47.29 $ 378.32
SUBTOTAL-EQUIPMENT $ 1,185.56
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 248.97
EQUIPMENT TOTAL $ 1,434.53
MATERIALS/SERVICES/RENTALS
MATERIALS!SERVICES Quantity Units Unit Price DOLLAR AMOUNT
Line 1 3"FLxFL 90 3 EA $ 45.78 $ 137.34
Line 2 3"FLxFL spool 2 EA $ 158.79 $ 317.58
Line 3 5'x 3"FLxPE spool 1 EA $ 195.06 $ 195.06
Line 4 3"MJxMJ 90 1 EA $ 35.37 $ 35.37
Line 5 3"FL bolts 6 EA $ 2,39 $ 14.34
Line 6 3"FL gaskets 6 EA $ 2.04 $ 12.24
Line 7 3"megalug kit; 2 EFl $ 24.19 $ 4&38
Line 8 6"care 1 EA $ 125.00 $ 125.00
Line 4"screw cap 1 EA $ 4.96 $ 4,96
Line 10 Sx15 steel sheet 6 Hrs $ 7.28 $ 43.68
Line 11 8x10 steel sheet 6 1-Irs $ 5.76 $ 34.56
SUBTOTAL $ 968.51
OVERHEAD&PROFIT @ 21% $ 203.39
TOTAL $ 1,171.90
Verification of Hours Worked:
TOTAL: $ 4,783,11
12% MARKUP (for
prime when subcontract work) $ -
Contrsclore Repreeenf�pre �-(ram �i �r, Datci _ � C SHEET TOTAL: $ 4,783.11
Owners Represent.fi e '�- ��� ('� ._ �� Dale
Comments
i
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED KENT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 2000B Date: 6/12/2015
Description of Work: redesign and replumb 3 inch relief
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHT TIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate HisOT Rate AMOUNT
Scott Lehman Foreman 5 62.8 $ 314.00
Brian Rinkel Foreman 3 62.8 $ 18840
Broc Finkel pipelayer 3 57.52 S 172.56
$
$
SUBTOTAL-LABOR: $ 674.96
LABOR OVERHEAD&PROFIT @ 29% $ 195.74
LABOR TOTAL $ 870.70
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description 1-7Hourly Rate Hrs Standby Rate AMOUNT
Komatsu 1NA270 Loader(rental) 3 26.25 $ 78.75
JD 85D Mini Excavator 33.10 3 2000 $ 60.00
F650 Slnlge Axel Dumptruck(rental) 60.18 3 11.88 $ 35.64
F550 Flatbed Diesel Truck 3 47.29 $ 141.87
SUBTOTAL-EQUIPMENT S 316.26
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 66.41
EQUIPMENT TOTAL $ 382.67
MATERIALS/SERVICES/RENTALS
MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT
$
$ - l
$
SUBTOTAL $ -
OVERHEAD&PROFIT @ 21% $
TOTAL $ -
Verification of Hours Worked: TOTAL: $ 1,253,37
12%MARKUP (for
prime when subcontract work) $ -
i
i 714� �/.
Conlractofs RepresentativeF:,-�.,;�w� n� ,�r Dela/�/� ill SHEET TOTAL: $ 1,2$3.37
j r 99
owners RePresenlatwa ��-t�r�� {r��k >,1.� Date
Comments ( "
pamuc MPoP Ph: (253) 874-3965 EXTRA WORK ORDER
Fax: (253) 874-3950 Sheet1' of
Customer Date Job No. EWO No.
Employees on Project lass Hours Rate Description of Worl,
-:a.•.r �_ S �-rr� /� � i 1� ni L'FC-� 'an �-'S � Yet- i7� :�,
Pacific Civil Equipment Eq.No. Hours Rate
,/Z+ r
Comments
fi- ;-.
I
Rental Equipment No. Hours Rate Materials
(, Qty U
/ � nit Cost
--
I
Owner Representative's Signature Date Foreman's Sinnature Date
White = Customer ++ Yellow= Projecf Manager ++ Pink= Foreman
& Ph: (253) 874-3965 EXTRA WORK ORDER
Fla >
M("v a"mtuDtOPC O Fax: (253) 874-3950 Sheet 7 of
Customer Date Job No. E A 0 No.
Project
Employees on Project Class Hours Rate Description of Work
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Pacific Civil Equipment Eq.No. Hours Rate
� C fr l) tiZ- Comments
h Zrj- S rc,
J 7
Rental Equipment No. Hours Rate Ilmaterials
Qty Unit Cost
12
Ovvner Representatives Signature Date Fore an s Signature Date
White = Customer ++ Yellow= Project Manager ++ Pink= Foreman
Ph: (253) 874-3965 EXTRA WORK ORDER
0[tulmipuctfifr Fa>;: (253) 874-3950 Sheet/of
Customer _ Date , Job No. / EWO No.
Project
c/ , 1 ("P'(.ii,
Employees on Project Class Hours Rate Description of Work
,R/% "�i�- %�i`' %.+°�j;�Y"� _ =.�..
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Pacific Civil Equipment Eq.No, I Hours Rate
- S7
Comments
�
Rental Equipment No. Hours Rate Materials
Qty Unit Cost
f
I
O\ R resent tive's Si nat are Date Forema s Si F nat re Date
White = Customer ++ Yellow = Pir) ct Manager ++ Pinl< = Foreman
i •i, DUPLICATE INVOICE# E015680
INVOICEINVOICE DATE 6118115
ACCOUNT# 220750
Local Service, Nationwide erancn Address:
SALESPERSON TYLER WASHBURN
P.O. Box 1419 SEATTLE WA
Thomasville, Ga 31799-1419 Branch - 301 BRANCH# 30110013 MLr, dR Way South
Seattle WA 98176-207B
' 2B2 .73
206/722-9800
Remit To:
HE SUPPLY WATERWORKS, LTD.
FILE #56214
LOS ANGELES, CA
90074 6214
Shipped to:
PACIFIC CIVIL & INFRASTRUCTURE 10920 SE 248TH ST
ACCOUNTS PAYABLE (AND OTHER LOCATIONS)
3450 S 344TH WAY STE 115 MARK HEINTZ #253-606-6284
FEDERAL WAY WA 98001 9540 KENT, WA I.
......................................................_..................................................._........._.............._......_CUSTnMF R...JOB.c..._1_A_$.........._.._.64Q...ZONE....PRY..............E01568D.........
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Data Ordered Date Shipped Customer PO No. Job Name Job No. _Bill of Lading Shipped Via I Order Number
6/03/15 6/03/15 108 640 ZONE PRV 108 o:1R TRUCK
Product Code Description o d tl Shipp d Back-
-d Price Per Amount
Line
2503FF0100 2 FLGXFLG DI PIPE 2, 1011 1 1 156.7900 EA 15B.79
24I039F 3 FLG 90 BEND(I) C/L DI C110 2 2 51,8300C EA 103.a6
24AFGFR03A 3Xl/8 FLG FF RR GASKET 4 4 2,0400 EA B.16
24AFBNKZ03 3 ZINC PLTD HEX BOLT & NUT KIT 4 4 3.0300o EA 12.12
This transaction is governed by and subject to HD Supply Waterworks standard terms Terms Subtotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to
http:/Iaterworks,hdsupply.comlTandCl. NET 30 282.73
Freight Delivery Handling Restock Misc Tax '
282 .73 '.
SEATTLE WA E015680
Branch - 301 I
10013 MLK SR Way South
Seattle WA 98178-207B Page: 1
00000
p q .o DUPLICATE E011722
INVOICE INVOICE DATE 6/04/15
ACCOUNT# 220750
Branch Address:
Local Service, Nationwide SALESPERSON TYLER WASHBURN
P.O. Box 1419 SEATTLE WA
Branch - 301 BRANCH# 301
Thomasville, Ga 31799-1419
10013 MLK JR Way South
Seattle WA 98178-2078
1,537.35 j
206/722-4e00 Room
Remit To:
HD SUPPLY WATERWORKS, LTD.
FILE #56214
LOS ANGELES, CA
90074 6214
Shipped to:
PACIFIC CIVIL & INFRASTRUCTURE CUSTOMER PICK-UP
ACCOUNTS PAYABLE
3450 S 344TH WAY STE 115
FEDERAL WAY WA 98001 9540
...................._................_................._........._..........................................................................._CUSTOMER..-JOD.-...._14_$..............._6°_9_..ZONE E....I?RV..............._E 01172 2..........
Return Top Portion With Payment For Faster Credit Thank You For Tire Opportunity To Serve You,
We appreciate your prompt payment.
.Date Ordered Date Shipped Customer PO No. Job Name Job No. Bill of Lading Shipped Via Order Number
6/03/15 6/03/15 SEE BELOW 640 ZONE PRV 108 WILL CALL
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
CUSTOMER PO#-640 ZONE $"_OB j
74ROMACRFCA396 RF'CA 3 RESTR FLG CPLG ADPT 396 3 _ 89.8000, EA 269.40
BI➢ SEQd( 770
Line
24I039F 3 FLG 90 BEND(1 C/L DI C110 3 3 45.78000 EA 137.34
BID SEQ# 830
24AFBNKZ03 3 ZINC PLTD HEX BOLT & NUT KIT 12 12 2.39000 EA 28.68
5 BID SEQ# 860
24AFCFR03A 3X1/8 FLG FF RR GASKET 12 12 2.04000 EA 24,48
BID SEQ# 870
2503FPOSOO 3 FLGXPE DI PIPE 510" C/L 3 3 195.0600C EA 585.1a
21I039M 4. 3 MJ 90 BEND (I) CP DI C153 1 1 35,37000 EA 35.37
2].TAMF703JMPM MJ DI LUGGED RESTR PACK (I) 2 2 24.19000 EA 48.38
96IREDLINE20X50 50 LB 20 MIN REDLINE 12 12 33.14000 EA 397.68
27O4PCP 9 4 SWR PVC COMPR PLUG 1 1 4.99000 EA 4.96
2804CCI 1056-44 4 CPLG Cl/PVCXCl/PVC 1 1 5.88000 EA 5.89
This transaction is governed b and subject to He Supply Waterworks standard terms
9 Y 1 PPY Terms Subfofal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to
http:Ilwaterworks.hdsupply.com7TandCl. NET 30 1,537 .35
Freight Delivery Handling Resfock Misc Tax °
°
1,537 ,35
SEATTLE WA ® E011722
Branch - 301
10013 ELK OR Way South
Seattle WA 96178-2078 Page: 1.
o ua u0
y, RECEWED I
Puget Construction Services Inc I JUN 0 8 2015 � Invoice
1609 Central Avo S. Unit 20
Kent, WA 99032 I�_$PACIFIC CIVIL Date nvoice it
253.856.2572 Phone 5/2
"�^ - �
7/2015 39670
253.859.5087 Fax
Bill To Job Name
Pacific Civil [nfiastrucuire,Inc Job 1l106
3450 S 344th Wary,Suite 115 640 Zone PRV
Federal Way,WA 99001 10920 SE 248th St
Kent,WA
i
P.O. Number Terms Due Date Rep Date Complete I�
Net 30 6/261 015 Note 5/27/2015
Quantity Description Rate Amount
2 12"Concrete Coro 225.00 450.00
2 6"Kor-N-Seal Boot 79.00 158.00
1 6" Concrete Core 125.00 125.00
3 4" Concrete Core 75.00 225.00
1 3" Concrete Core 75.00 75.00
�Yr 11033 ; OL
�U
1
Total �1,033.00
'afance Due $1,038.00
rite Rentals° RENTAL AGREEMENT
aRANCH 652
713E SET AVE. SOUTH
SEATTLE VIA 98106 ,4.128562506
206-767-3121 _ _ f# I.
206-767-0265 FAX Customer # 1371278
Agreement Date OS/21/15
Rental Out OS/21./15 03:00 PM
PACIFIC CIVIL Scheduled In 05/28/15 03 :00 PM
dA SE 232ND PLACE & 108TH AVE SE TOR Job Loc SE 232ND PLACE & JOB
%; UR Job # 12
Customer Job ID:
p KENT WA 98030 P.O. # : MARK VERBAL
h Office : 253-874-3965 Cell : 253-606-6284 Ordered By : MARK HEINTZ
Written By VICKI DOLAN
Salesperson NA.TE BROST
PACIFIC CIVIL & INFRASTRUCTURE
3450 S 344TH WAY STE 115
FEDERAL WAY WA 98001-9540 This IS not an Invoice
Please do not pay from this document
RENTAL ITEMS:
Qty Equipment Description _ Minimum DO. Week 4 Week _ Eetinlated Amt.
1 944/9942 ROAD PLA^E S' X 10' 38.22 38,22 98. 10 230.30 99.70
1 944/9840 ROAD PLATE 8' X 15' 45.43 45.43 13�` 291.20 138.60
$230.30/40hrs=$5.76h�enw�L,ntgtal: 237.30
Agreement Subtotal: 237,30
$291.20/40hre=$7.281-W.timeued Total: 2s9.8F
COh7MENT5/ISOTE S: I
A CLEANING CHARGE WILL APPLY TO EQUIPMENT RETURNED WITH EXCESSIVE
DIRT, CONCRETE, AND/OR PAINT. CUSTOMER IS RESPONSIBLE FOR ALL
DAMAGE INCLUDING TIRES. THERE WILL RE AN ADDITIONAL CHARGE FOR
MISSING KEYS. A FURL CHARGE WILL BE APPLIED TO ALI, UNITS NOT
RETURNED FULL OF FUEL
CUSTOMER HAS RECEIVED THE MANUFACTURER'S TABULATED DATA
FOR SHORING EQUIPMENT RECEIVED
/ - t . f ;L
t r E
I F t I
'ENNRONMENTAL OHARGE iM1:Aems Intllcalod above ere subfed to an znvfranmenlal cM1arge v,blcA is tleslgnetl to remwr UnlleJ'e dbeal end IMiretl ezpenaes for IM1e M1antlling,mznag�ng enJ Jlaposng olvnsle prcdVels,haxmboue
related admin¢velNa coals.This is ncla go,comartmandered charge FUEL Hal charges do no;htlutle lademI dada,or Ideal axes.to,.
CPTIONM.RFNTAI PROTFcTI0N PLAN
LIE HEAIALPH0 TE6110M1 PVIN IS NO IINSURANCEUpor adwpllnn iM1 r IRascal Pr II PI. Guslomer ogre¢,Is c,o she,,egml Is I
l IIM1 II M1a,grs q' IC lumen and=wvered trl lb R I IP II PLlangran - II Ihl Pdtl d I 4 R 1 Ag LU'Id 1 cepa:r Gx ns br aceltlenlal tlar she In or Rolla'
such covered isqUarmenin g I nomaland oare(ul Use.Customer remn noll role to all Wo,damages as set loddln the mndAbneSari in AJJe,cu.v Ito the ft IAgreement
COT OF FOR RENTAL OF 07VE'CLE THIS CONTRACT OFFER FOR AN ADDITIONAL CHARGE A DAMAGE WAIVER TO LIMIT YOUR FNANCIA—RES.OSIBIL'Y FOR DAMAGE TO CR THEFT OF THE MOTOR VEHICLE.
9EFORE DECIDING AHETHER O PURCHASE THE DAMAGE NMV_R.YOU MAY VMSH TO DETERMINE NHETIIei YOUR OWN INSURANCE AFFORDS YOU COVERAGE FILE PURCHASE OF THIS DAMAGE WAIVER IS NOT ,
MANDATORY A'!D MAY 6ENAME)OR DECLINED, i
READ BEFORE SeNING A,."H,line ir,cc Ubmar(x)Agrees to Lee heral chd ei chi lainedia th c cnl,l of,CcalI(a)Areas that the q'p I a I,ta 1-d: so fill a,the CrifillpNh )Acres,to
He In E dA f in OPl one:Rental W 1 U pl II ,load' J jr)A,I U 1 d C xt tlT d l'I d L R,'. prl.wbl Customer M -og 11 1'I' file f with the
oporol! ng u,e of the glIcer em and his rc,ecud Ial Lie eoulp-nenl in Chad vlari irg ref tl all safely bullet'ns(I all operator man,al;and ltl all manulac'urel,mbuldod dale for the s,the pi Aati-equlp ra Misled
have.
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: I
United Rentals PARTIAL RETURN
BRANCH B52 INVOICE
7135 STE AVE SOUTH
SEA- 67LE-3121 WA 90108 # 128562506-001
SEATT7
206-767-0265 FAX Customer # 1371278
Invoice Date 05/28/1.5
PACIFIC CIVIL Rental out 05/21/15 03 :00 PM
a.3 Rental In Q5/26/15 09:48 AM
"s SE 232ND PLACE & 108TH AVE SE UR Job Lee . SE 232ND PLACE s 108
IUR Job # : 12
X- �' Customer Job In:
'
a KENT WA 98030 P.o. # MARK VERBAL
1-7 Offlce: 253-874-3965 Cell : 253-606-6284 ordered Ey : MARK HEINTZ
Written By VICKI DOLAN
Salesperson NATE HROST
PACIFIC CIVIL & INFRASTRUCTURE Invoice Amount: $1 ,283.86
3450 S 344TH WAY STE 115
FEDERAL WAY WA 98001-9540 Due Upon
?a,aixe option.: Cnn1ac1 our oeojit office 212-333-6600
REMIT To: UNITED RENTALS(NORTH AMERICA),INC.
FILE 51122
LOS ANGELES CA 90074-1122
RENTAL ITEMS:
Qty Equipment Description .. ... Minimum Day Week 4 Week_ Amount
967006 TRENCH BOX ALUMINUM 8' X 16' 232,40 706.30 2C39.90 706.30
Make: SPEEDSHORE Model; APS-0816
Serial: 7-1015AS $706.30/4O hrs=$17.66/h r
4 940/9725 ADJUSTABLE SPREADER 60"-96" 1.05 2.01 4.04 12,20 16.16
SFT AT 8' SPREADER NIDTH
SALES/MISCELLANEDUS ITEMS: Rental Subtotal: 722.46
Q1 Item _ Price Unit of MCasure Extended Amt.
1 DELIVERY CHARGE 225,000 EACH 225.00 '.
I
1 PICKUP CHARGE 225.000 EACH 225.00
Sales/Misc Subtotal: 45D.00
Agreement Subtotal: 1,172.46
Tax: 111.40
Total: 1,283.86
COMIAENTS/NOTES:
ARE YOU OR YOUR EMPLOYEES IN NEED OF OP^RATOR CERTIFICATION TRAINING?
CONTACT UNITED ACADEMY TODAY 544-222-2345 OR WWT1.UNITEDACADEMY.UR.COM
TRAINING IS NOT AVAILABLE ON CERTAIN EQUIPMENT IN CANADA.
I �
� 5
THIS INVOICE IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE RENTAL AGREEMENT,WHICH ARE INCORPORATED HEREIN BY REFERENCE.
A COPY OF THE RENTAL AGREEMENT'S AVATAEL%UPON REQUEST.
You Can Nmv Access Invoice Himlory and Update apeAese Orders Online Page: 1
To Sign Up,cantaN DRCon(ro(SVppon&o cden
DAILY REPORT OF FA Sheet No.:
FORCE ACCOUNT WORKED KE - T
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 2000 Date: 6-16 & 18-2015
Description of Work: Pick uo and delivery of additional parts for tie ins at Park Orchard and
Millennium
Work by Subcontractor?. NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHT TIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate His OT Rate AMOUNT
Scott Lehman 4 60.59 $ 242.36
S
SUBTOTAL-LABOR: $ 242.36
LABOR OVERHEAD&PROFIT @ 29 A $ 70.28
LABOR TOTAL $ 312.64
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT
Komatsu WA270 Loader(rental) § _
JD 85D Mini Excavator $ _
F650 Sinlge Axel Dumptruck(rental) $ -
F550 Flatbed Diesel Truck 4 47.29 $ 189.16
SUBTOTAL-EQUIPMENT $ 189.16
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 39.72
EQUIPMENT TOTAL $ 228.88
MATE RIALSISERVICESIRENTALS
MATERIALS I SERVICES Quantity Units Unit Price DOLLAR AMOUNT
HD Invoice E0851Ill 1 LS $ 98.49 $ 98.49
HD Invoice E0732233 1 LS $ 278,20 $ 'L78.20
SUBTOTAL $ 376.69
OVERHEAD&PROFIT @ 21% $ 79.10
TOTAL $ 465.79
Verification of Hours Worked: TOTAL: $ 997.31
12%MARKUP (for
prime when subcontract work) $ -
Contractor's Rapreaenlali Date ,/�' , SHEETTOTAL; $ 997.31
Q I r �[ �'
Owners Representafrva7 f (kr� �•(L Dalel �r '�w,..;-.�
Comments
it
I
i
Ph: (253) 874-3965 EXTRA WORK ORDER
f
-p �6�C€ �ti���tUufN� Fax: (253) 874-3950 Sheet t ofz�
Customer Date Job No. EWO No.
Projec _
Employees on Project Class Hours Rate Description of Work
F"_
Pacific Civil Equipment I Eq.No, I Hours Rate
Comments
Rental Equipment No. Hours Rate Materials Rental Unit Cost
•ram �-,>
i
Otimer P,e resentative's S Forem n's Si natu DateiT
a--
��T bVhite = Customer ++ Yellow= Project Manager'++ Pink = Foreman
Pac[ItifcGNU Ph: (253) 874-3965 EXTRA WORK ORDER
Fax: (253) 874-3950 Sheet—�of
Customer IJob No. EN10 No.
Project.
Employees on Project I Class Hours Rate Description of Work
All
II
Pacific Civil Equipment Eq.No. Hours Rate
6.:
Comments
Rental Equipment No. Hours Rate 11materials
Qty Unit Cost
i
Owner Representative's Signature Date Fore a Si na ure• Date
l hite = Customer ++ Yellowy = Pl'oject IVlanager ++ Pink = Foreman
_ •p per• es DUPLICATE INVOICES E073223
INVOICEINVOICE DATE 6/17/15
ACCOUNTS 220750
Local Service, Nationwide Branch Address:
SALESPERSON c•xLEx wssxsvEx
P.O. Box 1419 PUYALLUP WA BRANC HS
Thomasville, Ga 31799-1419 Branch - 302 302
602 Valley Ave NE ,
Puyallup WA 98372 r
278.20
283/890-5505
Remit To:
HD SUPPLY WATERWORKS, LTD.
FILE 456214 '..
LOS ANGELES, CA
�Iiliijnlil�uilLuiullL�uiii�niiil��nnlnlilniilii l 90074 6214
Shipped to: '.
PACIFIC CIVIL L INFRASTRUCTURE CUSTOMER PICK-UP
ACCOUNTS PAYABLE
3450 S 344TH WAY STE 115
FEDERAL WAY WA 98001 9540
._._..._..__._........._.-.................-......................................_.._.._....._.__.._.................._........_CUSTOt ,1 3„JO)3::.........98................64.�...ZONE.._�RV...............E..73.....3..........
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Date ordered Date Shipped Customer PO No. _ Job Name Job No. Bill of Lading Shloned Via Order Number
6/16/15 6/16/15 SEE BELOW 640 ZONE PRV 1D8 WILL CALL
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
CUSTOMER PO#-64o zoNE Alos
Ord by:MARK HEINTZ
21IAMF708JMPM 8 MJ DI LUGGED RESTR PACK (I) 2 2 44.33e0o EA 88.66
21D SEQ,Ij 1260
24AFBNKZOB 8 ZINC PLTD HEX BOLT & NUT KIT 2 2 7.7200 FA 15.44
BID SEQ4 127D
24AFGFR08A 8X1/8 FLG FF RR GASKET 2 2 4.44000 EA 8.88
BID SEQ# 1280
21I08AF 8 MJXFLG ADPT (I) CP DI C153 2 2 82,6100( EA 165.22
278,20
This transaction is governed by and subject to He Supply Waterworks standard terms Terms Subtotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to
http:fiwaten orks.hdsupply.comlTandCl. NET 30 278.20
Freight Delivery Handling Restock Misc Tax
on
278.20
PUYALLUP WA B073223
Branch - 302
602 Valley Ave NE
Puyallup WA 98372 Pape: I
oaoae
i
DUPLICATE INVOICE# E085111
_ ® INVOICE INVOICE DATE 6/19/15
ACCOUNT# 220750
Address:
Local Service, Nationwide BranchSALESPERSON zYLEa wxsxsvxN
P.O. Box 1419 PUYALLUP WA
Thomasville, Ga 31799-1419 xzaneh - 302 BRANCH# 302
602 Valley Ave NE
Puyallup WA 98372
98.49
253/840-5505
Remit To:
HD SUPPLY WATERWORKS, LTD.
FILE #56214
LOS ANGELES, CA
Shipped to: 90074 6214
PACIFIC CIVIL & INFRASTRUCTURE 10920 SE 248TH ST
ACCOUNTS PAYABLE (AND OTHER LOCATIONS)
3450 S 344TH WAY STE 115 MARK HEINTZ #253-606-6284
FEDERAL WAY WA 98001 9540 KENT, WA
CUSTOMER JOB- 108 640 ZONE PRY, E085111
Return Top Portion With Payment For Faster Credit Tlrank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Date Ordered Date shipped Customer PO No. Job Name Job No. Bill of Lading Shilitaed Via Order Number
6/18/15 6/7.8/15 SEE BELOW 640 ZONE PRV 1,08 OUR TRUCK
Product Code Description Quantity Quantity Back- Price Per Amount
Ordered Shipped Ordered
CUSTOMER PO#-640 ZONE #108
Ord by: SCOTT - TIE IN MATL
21106AF 6 MJXFLG ADPT (I) CP DI C153 1 1 54.51000 EA 54.51
24AFGFR06A 6X1/8 FLG FF RR ,GASKET 1 1 3.64000 EA 3.64
24AFBNKZ06 6 ZINC PLTD HEX BOLT & NUT KIT 1 1 7,67000 EA 7.67
21IAMF706JMPM 6 MIT DI LUGGED RESTR PACK (I) 1 1 32.67000 EA 32.67
MATT, ORDERED PER SCOTT 6/18 98.49
650DTAPE OD TAPE 4 4 9.7000 EA .00
3710811444WNI; 1311-444WNL 1 BALL CURB FIPT 1 1 74.2700 EA .00
NO LEAD
This transaction Is governed by and subject to No Supply Waterworks standard terms Terms Subtotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terns and conditions,please point your web browser to
http:llwaterworks.hdsupply.comlTandC/. NET 30 98.49
Frei ht Delive Handlina Restock Misc Tax ' p
98.49
PUYALLUP WA EOBS111
Er.eb - 302
602 Valley Ave NE
Puyallup WA 98372 Page: 1
00000
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED KENT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 2000 Date: 7/17/2015
Description of Work: Cost to supply and install additional 18 inch
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHTTIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT
Mark Heintz Supt 73.78 $
Scott Lehman Foreman 2 60.59 $ 121.18
Brian Rinkel operator 2 60.59 $ 121A8
Broc Finkel pipelayer 2 57.33 S 114.66
SUBI"OTAL-LABOR: $ 357.02
LABOR OVERHEAD&PROFIT @ 29% $ 103.54
LABOR TOTAL $ 460.66
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Houdy Rate Hrs Standby Rate AMOUNT
Komatsu WA270 Loader(rental) 2 26.25 $ 52,50
JD 85D Mini Excavator 2 20.00 $ 40.00
F650 SmIge Axel Dumptruck(rental) 2 11.88 $ 23.76
F550 Ftalbed Diesel Truck 2 3.58 $ 7.16
SUBTOTAL-EQUIPMENT $ 123.42
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 25.92
EQUIPMENT TOTAL $ 149.34
MATERIALS/SERVICES/RENTALS
MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT
Old Castle 18 inch riser 1 LS $ 1,650.00 S 1,650.00
Old Castel 24 wide ladder 1 LS $ 250.00 $ 250.00 '
$
SUBTOTAL $ 1,900.00
OVERHEAD&PROFIT @ 21% $ 399.00
TOTAL $ 2,299.00
Verification of Hours Worked: TOTAL: $ 2,908,90
12% MARKUP (for
i prime when subcontract work) $ -
Contractor's RepresenfahvC/!l)'iDate SHEET TOTAL: $ 2,908.90
t /
Owners Representative (, l'�f`�.,.� Data
Comments
i
� ��to��o�j� Ph: (253) 874 3965 EXTRA WORK ORDER
�� � �(t$6��J fNQ➢�CECfi9 Fax: (253) 874-3950 Sheet / of f
Customer Date _ Job No EWO No.
e
Project � ,_
Employees on Project Class Hours Rate Description of Work
j/' ,/" Jr�
/' 1
1% V-r
Pacific Civil Equipment Eq.No. Hours Rate
5 i/�. .•O� �( Comments
Rental Equipment No. Hours Rate Materials Qty Unit Cost
l
i
Owner Re'r`eseQ ative's Sa nature Date Forema 3 Signature Date
r
} L White =Customer ++ Yellow = PI oject Manager ++ Pink= Foreman
f IvV01GE Page t of 1
(Ndc--u;stti1-`-;Precast
Oldcaslle Precast Inc. '.
PO Box 588 Telephone: 253-839-3500 P.O.Box 742387
Auburn,WA 98071 Fax..........: 253-735-4201 Los Angeles,CA 90074-2387 ! !
Tax exempt number: A31898116
SOLD TO: SHIP TO:
Pacific Civil Infrastructure Inc. Pau Civil
3450 S 344TH WAY Millenium
STE 115 11919 SE 270th ST
FEDERAL WAY,WA 98001 9540 Kent,WA 98064
Invoice No. Date Customer No. Order No. Customer PO 1 Delivery Terms Mode of Delivery
010198893 7/17/2015 O1 D004532 S126488 y F_O_B_Job Site Oldcasirt Truck_
Packing slip(s)...: SP147677,SPi47956
City Unit Item Description Mark Unit Price Amount I
------------------------ __._.__.-_..._-__ _ _._---- _ _..._.__.____ _---.--__-----I
1.00 Ea 0000003 Additional DeliveryInfo:Name:Mark H 0.00 0.00
Contact#.253 606 6284 Mlsc:.
1,00 Ea 0110400 612 18"Riser 1,650.00 1,650.00
1.00 Ea 2291070 6'4"9a1y ladder WIDE 250.00 250.00
i
TOTAL AMOUNT DUE BY: 08/16/15 US 1,900.00
mmunum te:i nandung charge on all wlumsJ goods. No ggoods to be relumed w,mom consent. Give as reference our Invoice number and date. Clamrs for damages,back charges for labor,offer expenses,bill not he
allo.ved aness as a of,ed in wAgeg oy the Asper.TI10 oritt oa anNor services covereo by this Invo!ce w..eh dviced In compliance mn Iha Federal Labor slanCaNs I.d of 1636,os emended.
The Cuslotner Agroos
1 THAT'N IE ABOVE TOTAL IS PAST DUE IF NOT PAID WITHIN 30 DAYS OF DATE OF THIS INVOICE
2.TO PAY A FINANCE CHARGE OF L5%PER MONTH(';Ps PER ANNUMI ON ANY PAST DUE AMOUNT,
3. TO PAY COLLECTION COSTS,INCLUDING REASONABLE ATTORNEY FEES,AFTER DEFAULT BY THE CUSTOMER
II
FA Sheet No.:
DAILY REPORT OF
CCOTFORCC ACCOUNT
RKED
KENT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 2000 Date: 7/1 512 0 1 5
Description of Work: Mandated OT water tie by the water department
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHTTIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT
Mark Heintz Supt 73.78 $ -
Scott Lehman Foreman 60.59 4 22.21 $ 88.84
Brian Rinkel operator 60.59 4 22.21 S 88.84
Broc Rickel pipelayer 57.33 4 20.33 5 81.32
$
SUBTOTAL-LABOR: $ 259.00
LABOR OVERHEAD&PROFIT @ 29% $ 75.11
LABOR TOTAL $ 334,11
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rale AMOUNT !
Komatsu WA270 Loader(rental) 26.25 $
JD 85D Mini Excavator 20.00 5 -
F650 Slnlge Axel Dumptruck(rental) 11.88 $ -
F550 Flatbed Diesel Truck 3.58 $ -
SUBTOTAL-EQUIPMENT $ -
EQUIPMENT OVERHEAD&PROFIT @ 21% $EQUIPMENT TOTAL $
MATERIALS/S E RVIC ESIRENTALS
MATERIALS/SERVICES Quantity Units I Unit Price DOLLAR AMOUNT
Light lower invoice 1 LS S 226.37 S 226.37
S -
S
$
SUBTOTAL $ 226,37
OVERHEAD&PROFIT @ 21% $ 47,54
TOTAL $ 273.91
Verification of Hours Worked: TOTAL: $ 608.02
!i 12%MARKUP (for
�^ prime when subcontract work) $ -
Contractors RepreseNatl /',`_r�Nj'����/� Date��/ f SHEET TOTAL $ 6�$.02
r
Ownefs Represenlalrve•akI � ( ,j., ,�- � ( � Date'
V I(�, a 11�
lr
Comments
Rate in the OT coloumn is the premium portion of the
OT rate
1 � , Vi CMG WUM 8L
Ph: (253) 874-3965 EXTRA WORK ORDER
OCtGngumarNm Fax: (253) 874-3950 Sheet of
Customer , �, Date Job No EVVO No.
Project C �� �,_y� i-// —Ii,)s O�Z1 r" a I.
Employees on Project Class Hours Rate // Description of Work
;c G
l�n!^ t�•�/1 f7 c7 r'�r! /� "l�i� f!�% -77) cl' / r i
7
9 � p 'I
r f
S l 1� S l-C rrl "//��-F L
:•'r/ `�1� � �� ;s5 ..1/'I ."err �- ,' I -II �i- —
Pacific Civil Equipment Eq.No. Hours Rate
Comments
(Rental Equipment No. Hours Rate Materials Qty Unit Cost
i
OGmer tativelrs Si nature Date nature _ Date
White = Customer ++ Yellow= Project Manager +a- Pink= Foreman
Page 1
CUSTOMER COPY
e� t�tr}Hertz,
® ORIGINAL INVOICE IIIIIIIIIIIIIIIIIIIIIIlIIIIIIIIIiilll
Equipment R801 7/17/15 Invoice Number: 2 81 3 045 7-001
Res/Quote Number: 50024239
AMOUNT DUE: $ 247.89
PAYMENT TERMS ARE NET 10 DAYS '..
LATE CHARGES MAY APPLY AMOUNT ENCLOSED: S _
Customer is responsible for FUEL, FLATS, -
DAMAGE and CLEANUP FEES. CUSTOMER NUMBER: 2907713
PACIFIC CIVIL & INFRASTRUCIURE MAILPAYMENTTO:
3450 S 344TH WAY SUITE 115 HERTZ EQUIPMENT RENTAL CORPORATION
FEDERAL WAY,WA 98001 P.O. BOX 650280
DALLAS,TX 75265-02B0
_ _To insure accurate and timelyposting,detach and send top portion with your payment_- _ _ _ _ _ _ _ _ _ _ _ _
RENTED FROM: SHIPPING ADDRESS: RENTAL HOURS: 12.00
HERTZ EQUIPMENT RENTAL (722) 640 ZONE PRESSURE REDUCING INVOICE FROM DATE', 7/15/15 19:01
4403 20TH STREET EAST 11010 SE 248TH ST INVOICE THRU DATE; 7/16/15 8:00
FIFE, WA 98424 KENP, WA 98030
Ph: 253-922-3652
Ori.ai.nal Adl ustments Total '
Fax:253-922-7736
RENTAL CHARGES 100.00 100.00
PO$: OTHER CHARGES 16.37 16.37
SOB NUMBER: 3 - 640 ZONE PRESSUR DELIVERY/PICK UP 110.00 110.00
RENTAL, START DATE: '7/15/15 19:00 TAXABLE CHARGES 226.37 226.37
DELIVERED BY:
TAX —2-1 5
TOTAL CHARGES 7-r8-9-�� i -g-'}-g-9-
ORDERED BY; MARK HEINTZ INTZ
SIGNED BY: CNAS
SALES REP: CHRIS JOHNSTON Sales tax added to the end of the Change order
CLOSED BY: TODD L. HOPE
4'ti
NET DUE z47;"
QTY EQUIPMENT A HRS/ MIN HOUR DAY WEEX 4 WEEK AMOUNT
1 LIGHT TOWER/4000 WATT 536-45 B/ 100,00 16.67 100.00 250.00 450,00 100.00
80D042126 Make: MAGNUM Model: MLT3060K Ser H: 1413484
S360400 ]tours Free: 8 40 160
HR OUT: 369.100 HR IN: 370.200 TOTAL: 1.100
FREE: 8.000 EXCESS: 0 HRS CHG: 6.250
EMISSIONS & ENV SURCHARGE EMISSIONS 1.37
DELIVERY FUEL CHARGE 3712000O01 15.00
it
Customer Number 2907713 Res/Quote Number: 50024239 Invoice Number: 28130457-001 Invoice Date: 7/17/15I,
For GREAT DEALS on USED EQUIPMENT-Visit us at www.herUequip.com
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED KENT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: 2000 Date: 8/1/2015
Description of Work: Steel Plates to attach pipe supports above the vault sub grating
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor.
LABOR
STRAIGHTTIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate I Irs OT Rate AMOUNT
Mark Hientz 73.78 $ _
Scott Lehman 60.59 4 $ 242.36
Brian Finkel 60.59 $ _
Broc Finkel 67.33 $ _
SUBTOTAL-LABOR: $ 242.36
LABOR OVERHEAD&PROFIT @ 29% $ 70.28
LABOR TOTAL $ 312.64
EQUIPMENT
EQUIPMENT OR ATTACIFIMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT
Komatsu WA270 Loader(rental) $ _
JD 85D Mini Excavator $ _
F650 SiN9e Axel Dumptruck(rental) $ _
F550 Flathed Diesel Truck 4 47.29 $ 189.16
SUBTOTAL-EQUIPMENT $ 189.16
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 39.72
EQUIPMENT TOTAL $ 228.88 '..
MATERIALS/SERVICES/RENTALS
MATERIALS!SERVICES Quantity Units Unit Price DOLLAR AMOUNT
Steel Plates for Pipe Supports 1 LS $ 382.16 $ 382.16
5
S -
SUBTOTAL 5 382.16
OVERHEAD&PROFIT @ 21% $ 80.25
TOTAL $ 462.41
Verification of Hours Worked: TOTAL: $ 1,003.93
12% MARKUP (for
prime when subcontract work) $ -
Contractor's Representative-�-- te SHEET TOTAL: $ 1,003.93
� I
Owner's Representative �� � � r �;�_� /� Cete
t
Comments
I
/ Ph: (253) 874-3965 EXTRA WORK ORDER
t {p 1 i.l
� Fax: (253) 874-3950 Sheet_Lof
i
Customer Date _ 06 No. EVVO No. j
Project.
Employees on Project Class H —Description of Work
----
1.
1
Pacific Civil Equipment Eq.No. I Hours Rate
Comments
I
Rental Equipment No, Hours Rate Materials Qty unit Cost
Owner Reuresentative's Si[;nat'L]le Date Fode Mali's SiRnature Date
White=Customer i+ Yellow= rroject Manager ++ Pink= Foreman
i
THE FAB SHOP
10315 16th Street East �;: y
Edgmvood,WA 98372 �. �"\ t , s ' 4 ("'C-^—
Phone:253-568-9124 �
Fes:253-568-9173 1
ri
5
Quote PACIFIC CIVIL &INFRASTRUCTURE
To: 3450 S. 344 TH WAY SUITE 115
FEDRAL WAY,WA 98001
United States
Quotation
Quote Number: 31527 contact: MARK HINES
Quote Date: 07/29/15 Expires: 01/25/16 Terms: DUE ON RECEIPT, 1.5% MONTHLY
Customer: PACIFIC CURL&INFRASTRUCTURE Phone: (253)606-6284
Quoted by: ERIC R Fax: (253) 874-3950
Ship Via: BESTWAY
PLATES 218 PL SE SE 20TH
Part Number
Item Description Quardi Price li
1 ST-P124896 16 $12.01 /SQF
STEEL, PLATE, SMOOTH, 1/2", 48"X 96",A35, HOT ROLLED, 32 SOFT SHEET
2 LABOR 1 $190.00 /HR
BUILD 2 PLATES 21" BY 6"WITH 2 X 2 SQR TUBING ON EACH END 6" LONG
Total: $382J6
Tax as Applicable
Printed Name Signature Purchase Order Number Date
Signed authorization S, PO are required to process order.