HomeMy WebLinkAboutPW15-152 - Change Order - Change Order #2 - Pacific Civil & Infrastructure, Inc. - 640 Zone Pressure Reducing Valve Station - 09/16/2015 i
Recordsh
KENT Document
WASHINGiON
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 15-152d (,r(,
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
Contract Amount: $401.194.31 I �i�C7g, t �
Approval Authority: (CIRCLE ONE) Department Director Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Change Order#2
As of: 08/27/14
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CHANGE ORDER NO. #2
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:
Compensation for extra materials and labor due to an unlocated
Centuryl-ink concrete duct bank, which altered watermain work and
construction delays.
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 $13,090.46
(incl. applicable WSST)
Current Contract Amount $414,284.77
(incl. Previous Change Orders)
Current Change Order $4,749.91
Applicable WSST Tax on this Change $451.24
Order
Revised Contract Sum $419,485.92
CHANGE ORDER - 1 OF 3
Original Time for Completion 120 worldng days
(insert date)
Revised Time for Completion under 134 woridng days
prior Change Orders
(insert date)
Days Required (f) for this Change 4 calendar days
Order
Revised Time for Completion 138 worldng 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.
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�,° gnature) F r (ggnature)
Print
N�mey/ = e?: "`d Print Name: wr 1�ae �t
Its ,- -7 Its PuNA c \&x�g� -mectx�r
(title)
DATE: DATE:
oV
CHANGE ORDER - 2 OF 3
I
— ----- APPROVED AS TO FORM:
(applicable if Alayor's signature required)
Kent Law Department
(M th],field,you may enter the ele&roNc fila,th Where the contra&has been saved?
i
CHANGE ORDER - 3 OF 3
FILE NO: 200.2
CHANGE ORDER WORKSHEET NO,
Construction Management Division - Public Works
Project: 640 Zone Pressure Reducing Project No.: 15-3001
Valve Stations
Project Engineer: Mark Howlett Fed-Aid No.: N/A
Owners Rep: Phil McConnell Contractor: Pacific Civil and Infrastructures
Date: 8/12/2015
I
I. PROPOSED CHANGE
Compensation for extra materials and labor
II. REASON AND BACKGROUND FOR CHANGE
Unlocated Centuryl-ink concrete duct bank resulting in conflicts, which altered watermain work
and construction delays
III. METHOD OF PAYMENT
NEW PAY ITENI(S) ❑ Not Applicable
Change Order No. i FOR ACCOUNTING USE ONLY
Sch. No. Item Description Total Est. Qty this Unit j Unit Price l Total Estimated Cost of
Qty I PE Item
2 Compensation due to 1 1 LS $4,749 91 $4,749.91
Century ink conflict
---- - '
i
_ Independent Estimate Attached CREATE PAY ITEM ONLY — Payment to be made PAY THIS PAY ESTIMATE
REQUIRED at a later date upon com2letion.of work
Material Submittals Required CC: Construction Coordinator New Sub Req rd? l No
DELETE EXISTING PAY ITEM(S) per 1-09.5 ® Not Applicable
Change Order No. _ FOR ACCOUNTING USE ONLY
Sch No B I No. Item Description Qty Unrt Unit Price Cost of Item
- - -_I -, -
i
Independent Estimate Attached -REQUIRED 11 ❑
INCREASE/DECREASE TO EXISTING PAY ITEM(S) 0 Not Applicable
Change Order No. _ j FOR ACCOUNTING USE ONLY
Soh. No. B.I. No. Item Description Qty Unit Unit Price Cost of Item
1 REV. DATE: 4/01/10
FILE IVO: 200.2
Independent Estimate Attached - REQUIRED !, � '•
I
TOTAL ESTIMATED COST OF CHANGE ORDER * 4,74M91
*Total of the Cost of Item Columns
THIS PAY ESTIMATE _$4,749.91
IV, WORKING DAYS
Original Contract j 120 Due This Change Order* 4 i_ Previous Total , 134
�,_. DATE: _
* j Explanation Justification Re wired: work was on the critical ath
TOTAL WORKING DAYS* 138
*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 B
P Y� l ;�� f '�� �k.� / Date
nell
Construction Supervisor: - �` �.�_ Date:
Paul Kueh '
Construction Manager: - Date
Eric Connor
2 REV. DATE: 4/01/10
I
Centuryl-ml< duct bank conflict delay and additional costs
Reg hrs OT hrs
conflict discovered 7/8/2015 6 0.75
excavated and begin concrete removal 7/9/2015 24 2.25
back fill and additional part time 7/10/2015 12
42 3
FA 5 $4,749.91
i
i
FA Sheet No.:
DAILY REPORT OF
FORCE ACCOUNT WORKED KENT
Project Name: 640 Zone PRV Stations Project No: 10-3025
Item No.: Date: 7-8 trhu 7-10
Description of Work: Extra work due to conflict with Centuryl-ink nduit bank
Work by Subcontractor?: NO
Prime Contractor: Pacific Civil & InfrastructesSub-Contractor:
LABOR
STRAIGHT TIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs Hourly Rate Hrs UT RateMAMOUNT
Mark Hientz _Scott Lehman Foreman operator 18 60.59 1 28.38119.00Brian Rlnkel Foreman operator 12 60.59 1 28.38755.46Broc Rinkel Operator 12 57.33 1 25.96713.92
SUBTOTAL-LABOR: $ 2,588.38
LABOR OVERHEAD&PROFIT @ 29% $ 750.63
LABOR TOTAL $ 3,339.01
EQUIPMENT
EQUIPMENT OR At FACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rafe AMOUNT
Komatsu WA270 Loader(rental) 6 26.25 6.25 26.25 $ 321.56
JD 85D Mini Excavator 6 20.00 6.25 20.00 $ 245.00
F650 Sinlge Axel Dumptruck(rental) B 11.88 6.25 11.88 $ 145.53
F550 Flatbed Diesel Truck 12.25 6.25 $ -
$
SUBTOTAL-EQUIPMENT $ 712.09
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 149.54
EQUIPMENT TOTAL $ 861.63
MATERIALS/SERVICES/RENTALS
MATERIALS l SERVICES Quantity Units Unit Price DOLLAR AMOUNT
6 inch 45 degree bends 2 ea $ 50.98 $ 101.96
6 inch restraint gland 4 ea $ 32.67 $ 130.68
314 inch all thread 70 If $ 2.75 $ 192.50
314 washers 32 as $ 0.40 $ 12.80
314 nuts 32 ea $ 0.50 $ 16.00
Star bolts 321 ea $ 2.50 $ 80.00
SUBTOTAL $ 453.94
OVERHEAD&PROFIT @ 21% $ 95,33
TOTAL $ 549.27
Verification of Hours Worked: TOTAL: $ 4,749.91
/ 12% MARKUP (for
prime when subcontract work) $ -
Contractors Representapvej/"X-' , SHEET TOTAL $ 4,749.91
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Owner's Representative r� � r( i f,. Del. I jt, tit Uj
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Comments
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Ph: (253) 874-3965 EXTRA WORK ORDER
]� ,I i3 Cf�xCP , Fax: (253) 874-3950 Sheet of
Customer Date Job No. EV-ON o
Project -
Employees on Project Class Hours Rate Description of work
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Pacific Civil Equipment Eq.No. Hours Rate
/U2 _
"=
Comments
7i
Rental Equipment No. Hours Rate Materials Qty Unit Cost
Owner Representative's Si ng ature Date Fore iaWs SiRnatu Date
1
White= Customer ++ Yellow = P ojeci Manager +i- Pink = Foreman
Ph: (253) 874-3965 EXTRA WORK 0RDER
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Fax: (253) 874 3950 Sheet of r
Customer Date Joh No. FEW No.
Project
Employees on Project Class Hours Rate Description of Work
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Pacific Civil Equipment Eq.No. Hours Rate
(-;�- i..
Comments
Rental Equipment I No. I Hours Rate Materials Qty I Unit Cost
Owner Representative's Signature Date Foreman/s Sigoature Date
771,
/---White = Customer ++ Yellow =f roject Man ger ++ Pinl:= Foreman
*� <` PlacoFir MH G
Ph: (253) 874-3965 EXTRA WORK ORDER
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Customer Date :E Job No EW0 INo.
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Project
Employees on Project Class I Hours RateIF— Description of Work
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Pacific Civil Equipment Eq.No. Hours Rate
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if 1, r,4-4 "duff', '
/
Rental Equipment No. Hours LRate Materials
Qty Unit Cost
�I 1
Owner Representative's Signature Date Foremarj's Si ature/ Date A
70
d �GUhite = Customer ++ Y/e IOW = Pr j Manager ++ Pink = Foreman
> + DUPLICATE INVOICE# E215508
19 INVOICE INVOICE DATE 7/21/15
ACCOUNT# 220750
Local Service, Nationwide Branch Address:
SALESPERSON TYLER WAS F:BIIRN
P.O. Box 1419 WOO➢INVILLE WA
Thomasville, Ga 31799-1419 Branch - 304 BRANCH# 304
5823 238th BE
Woodinville WA 98072
10,56
425/483-2724
Remit To:
HD SUPPLY WATERWORKS, LTD.
FILE #56214
LOS ANGELES, CA
II L I11IJI111II11MIMI1111L111111III1111I11IIL11111111 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
......__...................... ._.........__.._......................._CiJS,'PQMER.._J03.-..._1_Q_$_.._........_64.4...ZONE _P;�2V...............S 2155.0-$_.._....
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 Ladin Shi ed Via Order Number
7/16/15 7/20/15 SEE BELOW 640 ZONE PRV 108 OUR TRUCK
Product Code Description Quantity quantity Back- Price Per Amount
Ordered Shipped Ordered
CUSTOMER PO#-640 ZONE 4108
Ord by: SCOTT - 3/4 EYE BOLT j
24AFEB07409 3/4Y.4 90 DEG OFFSET EYEBOLT 4 4 2,64000 EA 10.5e
I
i
I
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:llwatemorks.hdsupply.com/TandC/. NET 30 10 .56
Frei ht Delive Handlin Restock Misc Tax
I=
10.56
WOO❑INVILLE VIA ® E215508
Branch - 304 '..
5823 238th SE
Woodinville WA 98072 pdae: 1
O OCDO
DUPLICATE INVOICE# E182592
INVOICE INVOICE DATE 7/10/15
ACCOUNT# 220750
'
Local Seivice, Nationwide Address:
ORWlde SALESPERSON TYLER WASHBURN
P.O. Box1419 PUYALLUP WA BRANCH#
Thomasville, Ga 31799-1419 Branch - 302 302
602 Va11ey Ave NE
Puyallup WA 98372
_ - 4,476.18
253/840-5505
Remit To:
HD SUPPLY WATERWORKS, LTD.
FILE #56214
LOS ANGELES, CA
90074 6214
Shipped to:
PACIFIC CIVIL & INFRASTRUCTURE CUSTOMER PICK-IIP
ACCOUNTS PAYABLE
3450 S 344TH WAY STE 115
FEDERAL WAY WA 96001 9540
__CUSTOM,ER JOB- 108_,_..,________64.0. ZONE PRV E182592
..................._............_......................................-.....__........................................_.................. .................._.. .. .-.........................._....................................
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity 7o Serve You.
We appreciate your prompt payment.
_Date Ordered Date shipped Customer PO No. Job Name Job No. Bill of Ladin Shi ed Via Order Number
7/09/15 7/09/15 SEE BELOW 640 ZONE PRV 108 WILL CALL
Product Code .Description Quantity quantity, Back- Price Per Amount
Ordered Shipped Ordered
CUSTOMER PO#-640 ZONF 4108
Ord by: DANIELS - CHANGE ORD
24IO8T06OF 8X6 FLG TEE (I) C/L DI C11.0 2 2 265.0500o EA 530.10
5108A236219 8 A2362-19 MJXF'LG RW GV 01, ON 2 2 825.11000 En. 1,650.22
24AFGFR08A 8X1/8 FLG FF RR GASKET 4 4 4.44000 EA 17.76
24AFBNKZ08 8 ZINC PLTD HEX BOLT & NUT KIT 4 4 7.7200 EA 3D.88
5106A236219 6 A2362-19 MJXFL RW GV OL ON 2 2 528.0200 EA 1,056.C4
24AFGFR06A 6X1/8 FIG FF RR GASKET 2 2 3.64000 EA 7.28
2AAFBNKZ06 6 ZINC PLTD HEX BOLT & NUT IIT 2 2 7.6700 EA 15.34
59VT943BIB 18 94013 VALVE BOX TOP - 4 4 26,3300C EA 105.32
59L940W 940 VALVE BOX LID WATER 4 4 9.8300o EA 39.32
59VB24D 24 VALVE BOX BTM DEEP 4 4 23.7800 EA 95.12
21IAMF708JMPM B MJ DI LUGGED RESTR PACK (I) 2 2 44,33ooc mA Be,66
21I064M 6 MJ 45 BEND (I) CP DI C153 2 2 50.98000 EA 101,96
21IAMF706JMPM 6 MJ DI LUGGED RESTR PACK (I) 6 6 32.67000 EA 196.02
010852T 8 TJ CL52 DI PIPE C/L 1s 18 17.2000C FT 309.60
010652T 6 TIT CL52 DI PIPE C/L 18 18 12.92000 FT 232.56
DANIELS PRV - CHANGE ORDER
MATL ORDERED PER MARK 7/9/15
CONTINUED. . . Page: 1.
oaooa
i-
I
-� ` `M � '''. "- , , DUPLICATE INVOICE# E182592
mm
INVOICE INVOICE DATE 7/10/15
ACCOUNT# 220750
Local Service, Nationwide Branch Address:
SALESPERSON TYLER WASH&URN
P.O. Box 1419 PUYALLUP WA
Thomasville, Ga 31799-1419 Branch - 302 BRANCH# 302
602 Valley Ave NE
Puyallup WA 98372
° 4,476.18
253/840-5505
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 980.01 9540
..................................................................................................................................... CUS'PONFR..,JOB.-_._1.4_$....._........_64.o_,.GnNF,•..._PRV......._...._318 2 5_9 2..........
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You,
We appreciate yourprompt payment.
Date Ordered Date shipped Customer PO No. Job Name Job No. Bill of LadingShi ed Via Order Number
7/09/15 7/09/15 SEE BELOW 64D ZONE PRV 108 WILL CALL
Product Code Description Quantity Quantity Back- Price Per Amount
Shipped Ordered
CUSTOMER PO4-640 ZONE #108
This transaction is governed by and subject to HD Supply Waterworks standard terms Terms Subtotal
and conditions,which are incorporated herein by this reference and accepted.
To review these terms and conditions,please point your web browser to
http:llwaterworks.hdsupply.comtTandCL NET 30 4,476.1B
Fre ici ht I Delivery Handlino Restock Misc Tax `" #7
° 4,476.IS
PUYALLUP VIA E182592
0
Branch - 302 BEE
602 Valley Ave NE
Puyallup WA 98372 Page: 2
OULOO
DUPLICATE D605848
® INVOICE#
N'V 1 C INVOICE DATE 2/27/15
ACCOUNT# 220750
Local Service, Nationwide Branch Address:
SALESPERSON xYLeF ViASHBIIFN
P.O. Box 1419 PUYALLUP WA
Thomasville, Ga 31799-1419 Branch - 302 BRANCH# 302
602 Valley Ave NE
Puyallup WA 98372
5,487.87
253/840-5505 _
Remit To: '..
HD SUPPLY WATERWORKS, LTD. '
FILE #56214
LOS ANGELES, CA
Shipped to: 90074 6214
PACIFIC CIVIL & INFRASTRUCTURE MULTIPLE - CALL AHEAD! !
ACCOUNTS PAYABLE 37TH ST NW L B ST NW
3450 S 344TH WAY STE 115 AUBURN, WA
FEDERAL WAY WA 98001 9540
............................................................................................................................_................._CUSTOML'.$._JOB.-....99.�...............
..........
Return Top Portion With Payment For Faster Credit Thank You For The Opportunity To Serve You.
We appreciate your prompt payment.
Date ordered Date shippedL Customer PO No. Job Name Job No. Bill of Ladin Shi ed Via Order Number
2/26/15 2/27/15 SEE DELOW BNSF UTIL X-ING 007. OUR TRUCK
Product Code Description quantity quantity sack- Price Per Amount
Ordered shipped Ordered
CUSTOMER PO#-BNSF U'1'i L11'Y X-ING
Ord by: MARK HEINTZ - WATER
A 1I164M 16 MJ 45 BEND (I) CP DI C153 4 4 393.98000 EA 1,575.92
21TAMF716JMPM 16 DI MJ LUGGED RESTR PACK (I) a 8 194,19000 EA 1,553.52
24AFEB07409 3/4X4 90 DEG OFFSET EYEBOLT 50 50 2.s000 EA 12S.00
24AF'FW07Z 3/4 ZINC PLATED FLAT WASHER 50 50 .40000 EA 20.00
24AFHN07ZH 3/4 ZINC PLATED HEAVY HEX Kn]T so 5c .50000 EA 25.00
24AFTR07GALV 3/4 GALV(ZINC PLT)ALL THRD ROD 250 25C 2.75000 FT 687.30
9607RCBO 3/4 #80 PLATED ROD CPLG 20 20 1.25000 EA 25.00
011652T 16 TJ CL52 DI PIPE C/L 18 18 58.23000 FT 1,048.14
19ATGL16 16 TS FIELD LOK 350 GASKET SBR I 1 427.7900 EA 427,79
IN LIEU OF 19ATSS16
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:ffwaterworks.hdsupply.comlTandCt, NET 30 5,487 ,87
Freight Delivery Handlinci Restock Misc Tax '
e ,
5,487 . 87
PUYALLUP WA D605843
Branch - 302
602 Valley Ave NE
Puyallup WA 98372 Page: 1
Co Ooo
Show R.A.Number On all Correspondence
UPDATE
r;* COPY *N Hertz. R.A. No. 28029841 I,
�QUI�J(fiL'(lk (�6fitd� Page 1of2
HERTZ LOCATION: 722 BILL TO CUSTOMER: 2907713 SHIPPI14G ADDRESS
HERC TACOMA PACIFIC CIVIL&INFRASTRUCTURE 640 ZONE PRESSURE REDUCING
4403 20TH STREET EAST 3450 S 3441 H WAY SUITE 115 SE 232ND PL&108TH AVE SE
FIFE,WA 98424 FEDERAL WAY,WA 98001 (CENT,WA 98030
253.922-3852
253-606-6284
DESCRIPTION/CHARGES
EST START: 5120116 7:00 EST RETURN: 6/18115 7:00 DROP DATE- 5120115
SHIPPED BY: 38677 ORDERED BY: HEINTZ,MARK DROP TIME: 12;00
ORDER DATE: 5,1 9/15 SALESPERSON: 747
SALES COORDINATOR:
POfl IJOB#: /1-640XONF.PRESSUR
Rates Include maintenance service
Qty Equipment # Era/ Min Hour Day Week 4 V7eek Amount f
1 [WHEEL LOADER/3YD/GEM ]3$T/DSL 8/ 550,00 91.67 550.00 1700.00 4200,00
2 613 0 02 41 Make: ICOMA'rSU Model; WA270-7 Ser 11: 80013 ,1
FIR OUT; 681.20 FIR CHG:
Equipment may have telematics technology enabled.
130 NOT RUN EQUIPMENT OUT OF' DIESEL FUEL; ADDED
CHARGE FOR RE-STARTING SYSTEM
Y
This vehicle/equipment may require DEE (Diesel Exhaust Fluid) , The I
renter is responsible for monitoring DEF level and replacement
of fluid consumed. See operator's manual for monitoring
and fill procedure.
EMISSIONS te ENV SURCHARGE EMISSIONS 57 54
Customer has declined the purchase of LDW.
1 WHEEL IOADER/FORK ATTACH/2-1/2-3-1/2 CY 8/ 75.00 12.50 75.00 175.00 300.00
270710003 Maker TAG Model: QC300CF Ser 4: 9229503 t
Equipment may have telematics technology enabled. s
LDW not offered for this item 3
DELIVERY FUEL CHARGE 3712000001 15.00 €[[€
DELIVERY CHARGE
05.00
e
PICKUP CHARGE
05.00
CONTINUED
x I
For GREAT DEALS on USED EQUIPMENT-visit us on-line at www,her(zoqulp.com
CAREFULLY READ THE TERMS AND CONDITIONS THAT APPEAR BELOW AND ON REVERSE SIDE OF THIS PAGE
No N1,1halnndin3 pay me at orIhe LDW Ire,customer is tlable for ell damage to the Fraternal and expeller,of HERO cvuald by Pm Egvlpm.nl being used or Spam Led In vlo!aIha r[Ole terra and mid On the Rem so Sldo 01 gde
pagv or Ia,.,larea SIPS LOSS AIJD DAMAGE WAIVER GUIDE.
PARAGRAPH12,014THE REVERSE SIDE OF THIS PAGE IS IN UsU 0=111 ALLWARRANTIES,limmINS,IMPLIED ON STATMORY,INCLUUNG,EU(IJDT WNIitD TO,THEIIMLIED WARRANTY OF hL=RCMAIJTABILIIY AND n
THE IIdPUEO n'ARRANTYOF FITNESS FORA PARTICULAR PURPOSE;AND 111i)AIL UBUGAlIok50NTHE PART OF HFRCTUCUSTOMER FOR OAVVnIM NCLUDING,B:T NOT LIMITED TO,INDIRECT,INCIDENTAL,
CQNSEQUENTML OR SPECIAL DAMAGES ARISING OUT OF Oft IN CONN=CTI61l WITH THE LEASMG.NAINTE.NANCE USE,OPERATION,START ERECTION,DISMANTLING OR IM43PORTATION OF THE EIXIIPideNH 1[L
CU$TOIkAREPRESENTS THAT HE HAS FULLY INSPECTRO THE EaJ!PM-ar AND THAT PAUL IS IN GOOD CONDITION AND REPAIR.CUST@fEA IS LJAnUo FOR ALL VIOLATIONS OF LAW MUSING OUT CUSTRIMER'S USE, d
POSSESSION OR OPERATIONOFTHE EQUIPMENT.THE EQUIPMENT DESCRIBED HEREIN IS RENTED PURSUANT TO AND IN ACCOaDARCEWITH THETERMS AND CONDITIONSSET FORTH A.OW AND ON THE 333
REVERSESIDE OF THIS PAGE CUSTOMER REPRESENTS HARING READ AND AGREED TO SAh1E
•EMssionn and Enalmnmanlal Sdrehams-PLLAS4 SE AWARE that HERO adds an Eniselons and LOSS AND DyvACE WANERIIUWq IS NOT INSURANCE.The Charge Per LOW B lead%o
Sale trpnmanWlGwalmrpa ellualerWtlaqulpmanE ro sole This Sw:Ls,alzarvmvory by HERE bhewrisel Cuslb n opa erdec:inea LDW.UGOIOmol occo t LOW,Mmns!dorallon ollho sharBa aUmm abovage e.Lessor p 4 ad.,amen,lndudin,.,.,head,0nama,as Ia1Mvfalbn fol'.av/nptypvsvleandvs.Inarte ball agmvs WSelvecedaNdelm+agaMel ws!vmer lor109i afar dep:npo lv Equlpmonl,LlnrcvNanca rnlb lllo tome and ,f vAN fNHeral,elate end.,calenYwnmeM.0lax:,rtgulefers SO Mcs lele n9 to HERC'.e busmen opemgno andl oSlAdrons wl add,In pam9mph S,an the Favor-Side oflh1c pagx and In the LOSS ME DANADU WAIVER GUIDE
s handful,nomagleg,nndlor dlspealn0 of noalo matelots named vAr rental equ[pmanl from march .,filch Customer ahould revl0y before demdm rholhar to 11rah...LOW.
hrome.as anba ,lence I more,.11,9,a......W hn]ESHE EHI;42)the lmplamertallon of Isinlary mnsel.ran g, P
orgresn'Mllbllves at USES.and 13)the pcq'ulGIGm,end tree a� oavee-°In HER elo hmj lW(l,e,,d musing For UL ranlel,Ow dodudTle WaUrtont yeogmaleJal$ INNIS00 Ilyou[Ilnnl,o rho rnnWly mcmonl,Ws u,m�ml.dvanwd aMentla morsel in0melopl.e.Al I,III,Sarohn pecan)a(the lvtal may change.F.rvmmpla,lhia ertnunt may cM1arrgv ll ,J g '
Io112edogidpmonlmntalcha,,o,b fnotoo.Rmsurchay antmayb.henged/mml'voalearmin you extend or<hrRen the mvtbn alyounonlvl arllyru add s HERC'adlsuebm,.THI55URCHARGEISNOTATAXORGQ ERNMENTLANUATEDCHARGE equlpmenl(v lhv rcnlvl.Yue vm mspanelbly Lr any loss or damaOa up to lhls anoupt.
VaM1idr and n.g Cost Rocova h For;a o V sp-tLJmnehgRacbvaS Fee Is GWER,h U a recovery of I
F=Erlsas and crsla oltlllln9,raUlstedng elld Avpadllq the VoMdo.(TWSIS NDTADWEANIAENidtANDATEU CUSIomeT acknUvded.]es In.[the EgUpman will bq raWmed 118 Jootl,Cearl,nnd U0W0temina(etl
I DITIR001),Tree of Sony and 01 hazardous substances.
"I'll Columnar lJ„ore T,„a -- Terms are Net 10 Days Not valid without Uarcode
g
Gunione'st
alume Des.-
n Carefully read the terms and conditions that appear above and on reverse side of this page II I III Ill II I i I(I I I I Il Ill Il II II II
[
a
Show R.A.Number on all Correspondence
UPDATE* R.A. No. 28029841
COPY Equlpmeut Rental Page 2 of 2
- HERTZ LOCATION: 722 BILL1'OCUSTOMER: 2907713 SHIPPING ADDRESS
HERC TACOMA PACIFIC CIVIL&INFRASTRUCTURE 640 ZONE PRESSURE REDUCING
4403 20TIl STREET FAST 3450 S 3441'H WAY SUITE 115 SE 232ND PL&108TH AVESf_ i
FIFE,WA 08424 FEDERAL WAY,WA 98001 KrNT,WA 98030 j
253-922-3852
253-606-6284
DESCRIPTIONICHARGES P
EST START: 5120/15 7;00 EST RETURN: 6/18115 7:00 DROP DATE: 5120/15 _ f
SHIPPED BY: 38677 ORDERED BY: HEINTZ.MARK DROP TIME: 12:00 -
4
ORUER DATE: 5179/15 SALESPERSON: 747 SALES COORDINATOR: JAMEB H.BLISS
PO(t/JOB#: /1-640 ZONE PRESSUR
Rates Include maintenance service
Qty Equipment 4 Hrs/ Min Hour Day week 4 Week Amount
*** Delivery Instructions *#+
PRE-DELIVER ON 5/19 �
SC: 14ARK 253-606-6284 PLEASE MAI(P, CONTAC f
9
T WITH MARK BEFORE DROPPING EQUIPMENT 1.
OFF
4
TRANSPORTATION-DRIVER WAIT TIME is charged if a driver spends more than 20 minutes waiting to
unload/load Equipment after scheduled delivery/pickup time. Fait time is $20 for each 20-minute III
period thereafter. Customer is responsible for dailymaintenance, fuel, damages, and cleaning Sees 9
if Equipment is not cleaned before return, R,,PUELING-For Equipment valued less than $5,000 and holds ,
less than 3 GAL tuhen full, we assume that 0.6 GAL are needed to refuel. TO ENE RENTAL CIIARGLS,
Customer must call the branch to get a release $.
* Give us your £eedbackt Go to www,herespTvey.com or call 1-P00-451-2206 and take our short surve}'I*
e HO Le location: 722 *
d
G
u
A
A
For GREAT DEALS on USED EQUIPMENT-visit us on-line at www.hertzequip.coni
CAREFULLY READ THE TERMS AND CONDITIONS THAT APPEAR BELOW AND ON REVERSE SIDE OF THIS PAGE I
NOM1lhslemnq Paymonlof NOLOWIao,CuAumerlell Ile Wrnlldamduolo the hqR menl our oxpeoso of HERO sarsod by the EQulpmaN belnq used.(.".pled Jrool0000 oHg lemv.DA mndllH,na on Ule Rovorso SlJu of lhls
page or hr alao10n of the LDS$ANO MMAGE WANE0.GUIDE
PARAGRAPH 12.ON THE REVERSE SIDE OF THIS PACE IS IN LIEU OPHDALL WARRANTIES,EXPRESS,IMPLIED OR STATUTORY,INCLUDING,BUTROT UMITEOTO THC IIRLIED WAWIAMYOF AtERCHANTA01lltt0.Vp
THE IMPLED WARRATTYOF FITNESS FOR APARnMI-Ard PURPOSE;ANDap ALL OBLICATIPNS ON THE PART OF HERCTOCUSTOMoR FOR IMNGE51NCUMIAG,BUT NOT UMREDTO,, NDIRECT,IHCIOENTAL, j
CONS=_OUmiTIA2ESEWSTITATHE HAS FULLY G OGr OF OR IN CONNECNTANDTH AT RMAAS9IN GOOD CONDM N ANDPE P IR.CUSTOMER
STOMGa,EREKE FOR
RIALL VIOLATIONS
OP LAW ARISING OU CtrucIUIPMEIn,
CUSTIN.ERNO RESEMBTHATHEHASFULLYIN$TECTEOTHE NT PMCRIBED HEREIN
12 EIS N PURSUANT
CONDITION AND REPAIR.ACCORDANCE
ITHISLIABLEFORALLVIOLATIONSOF LAWARISINGOUI ONfimFR'S 0.SC,
REVERO SIGN O0.0PEMTION,CUSTOMER
MER REPRESENTS
THE ECU ITS9 R DESCRIBED HEREIN IS HEWED PURSUANT TOAND IN Af.COR0AHC6 W'rTfl THE-TERMS ANOCONUI110N55ET FGRTHABOVE RNDO\'T HC
REVERSE SIDE OF THIS PAGE.CVSTOMER HEYRE5EYT51L4VMG READ AND AGREED TO SAME.
selclonc end Enylipnmonlal SUEbar,o-VLEASE BE AWARE IfmI HERO odds so emaslons and LOSS AND DAMAGEIYANER LOVE rye (0rassro lot ulsi Em{mnneM.1 Snroha;ye on MlmheU agnlpmouvorWls.This Surchx,ye Lsa lemyery by HERC lollalp olfsol LOSS Are DAMAGE
WWELD'N.fl [JOT
W$UeNls LOW,InChel.61l'OWIs Vidm%oloo,s ur,Lei?hr Is one oxponses.Ncludug overhead penersR,ae:eclAed lli:h me l.11sW 0typesof adlvllles:(iJwr^gllo•.¢D nm0�e¢s 10 Y,x1'm cerlaPdalln:againitgUlomolfor Asaofordama,.to Eeulynlsal,nnewNanca vAN Nale,ma e;xl k
vMrlptlaraJ,elate and locol elvimnmontal lavn:,mqu'elionsaM rules lelalin,to HERG,Eusuess',isetans suoh 1dDons sot foAhin Poop, he,ou hre Rover. SWo cmis M to the L055AND DAMAGEWAIVERF.UIDE j
as henME,.N Emem9lrs.ondleldlapoalISM wustu me'.11ole...odaled vdhrenlel equlpnont Wal oo,oln vd:nh CnelDnrernlw0ld ravlm bama d.dalnO whNhcrle pumM1eae oLUW.
he.eugs Esp an nco(i.o.,MsOrCtl,,rease. d hyd Alrlia,Wd;(2)the ImpiemenIsIbe of v Lsrnary consonaii.n
w Bmalf MlllaBvaa aI HERC,antl(3}Ne acquhllloneM ufla o�Ve ddos lnl@RC'e CNJnsesvAn..,loss ince, I'of lhkmtlnl,the deductible E moeflu,ealis"UNI at B 0000.00 If ucho,—the rental.edvensc!nrdaelon wnlrol leohnokoolos,At Eu.mot,Ih,S—h.l,esn»untu,equal to I.5]oerc.nl of lh.total rna Len ,For pxap lo,Pi.um nl vs d+s, Yo 0roelnonl,IMsammnl E[
r lodeedoupmenlresIsIchar,o,he fore aus,mo Sulchrues elmWl re becun0ed serrunre to lhrre In y< P P Y .,lly000x` .ehoder, oudsornt. o(yoln,oninlorlf yeu ntlJ
HERersdiNceson.THIS SIJI'mHARGE 15 NETATA$DR GMERNMENT LANDATED CHARGE. equlymen loth.renlnL You ar.r.epon.nbfnrany lessor Nmm�Beup io mk.rrowl. If
-Vebi0D LieEok,Beer Recovery Fee-If a VeNda Deamlu,Cost Ramvery Too bchar,m,it le u mwv.,y r
FPE)sas Modmsls of llllln,,remoter,ondIspocy the V.Mde.(THIS IS NOT A GOVERPodENT MANDATED Customer acknowledges URI the Egtllflmonl Will be cloned in agood,yran,and Unconlaminited
condl0on,free of any end all haardous subslanoes. d
Pdn:aelo—Nam. nee Terms are Net 10 Days Not valid without Barcode
Crrefully rela Dap II Il I II I I(Ill I III I II IIIIll III
Caarefully read the terms and renditions that appear above and on reverse side of this page g
S
RENRAC
TL COTTVc ` ',�'' Show R.A. Number on all Correspondence
** COPY w* :.. .�`. R.A. No. 28033825
EquiplvenPRenfa/ Page 1 of 1
HERTZ LOCATION: 722 RILL TO CUSTOMER: 2907713 SHIPPING ADDRESS
ICERC TACOMA PACIFIC CIVIL ei INFRASTRUCTURE WILL CALL 9722
4-403 20TH STREET EAST 3450 S 344TH WAY SUITE 116 4403 20TH ST E
FIFE, WA 98424 FEDERAL WAY,WA 98001 FIFE,WA 98424 -
253-922-3852 -
253-255-5232
DESCRIPTIONICHARGES
EST START: 5/21/16 7:00 EST RETURN: 6126/15 7:00 DROP DATE:
s
SHIPPED BY: onorri D BY; MARK HEINTZ DROP TIME:
ORDER DATE: 5121/15 SALESPERSON: 727 SALES COORDINATOR: JAMES H. BLISS ,
PO 1"l JOeli: / 1 -WILLCALL
Rates include maintenance service
t
4ty Equipment ff hrs/ Min Hour Day Week a Week Amount
1 'TRUCK/HOXDUMY/5-6YD GAS/NO C➢L B/ 299.00 49.83 299.00 815.00 1900.00 f
80000*7617 Make: LEDWELL Model: 5/6 YD SOXDUMP Ser #: 3FRNFGHP8DV014236
MI OUT: 7862.60 MIL CHG:
Equipment may have telenlati.cs technology enabled. ,!_ �, .tr ill I� I 1
EMISSIONS & ENV SURCHARGE EMISSIONS
LDW not offered for this item �26.03
3
TRANSPORTATION-DRIVER WAIT TIME is charged if a driver spends more than 20 minutes waiting to ' ,I
unload/load Equipment after scheduled delivery/pickup time, wait time is $20 for each 20-minute
period thereafter. Customer is responsible for daily maintenance, fuel, damages, and cleaning fees g
if Equipment is not cleaned before return. REFUELING-For Equipment valued less than $5,000 and holds
less than 3 GAL when full, we assume that 0.6 GAL are needed to refuel. TO END RENTAL CHARGES,
Customer must call the branch to get a release #.
L
* Give us your feedback! Go to www.heresurvey.com or call 1-800-451-2208 and take our short survey!*
* Hertz location: 722
3
3
For GREAT DEALS an USED EQUIPMENT-visit us on-line at www.hertzequi .00m
CAREFULLY READ TERMS AND CONDITIONS ON REVERSE SIDE OF THIS PAGE
Notwithstanding payment 01 am LDW fee,Customei Is liable for all damage to the Equipment and expense of HERC caused by the Equipment being used or optional in violation of the terms and conditlone '
on the novenae Side of this page or in violation of the LOSS AND DAMAGE WAIVER GUIDE,
PARAGRAPH 12.ON THE REVERSE SIDE OF THIS PAGE IS IN LIEU OF III ALL WARRANTIES,EXPRESS,IMPLIED OR STATUTORY,INCLUDING,BUT NOT LIMITED TO,THE IMPLIED WARRANTY OF y
MERCHANTABILITY AND THE IMPLIED WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE;AND Ili)ALL OBLIGATIONS ON THE PART OF HEnC To CUSTOMER FOR QAMAGES,INCLUDING,HVT
NOT LIMITED TO, INDIRECT,INCIDENTAL,CONSEQUENTIAL On SPECIAL DAMAGES ARISING OUT OF OR IN CONNECTION WITH THE LEASING,MAINTENANCE,USE,OPERATION, STORAGE, i
ERECTION,DISMANTLING OR TRANSPORTATION OF THE EQUIPMENT,CUSTOMER REPRESENTS THAT HE HAS FULLY INSPECTED THE EQUIPMENT AND THAT SAME Is IN GOOD CONDITION AND
REPAIR.CUSI DARER IS LIABLE FOR ALL VIOLATIONS OF LAW ARISING Out CUSTOMER'S USE,POSSESSION OR OPERATION OF THE EQUIPMENT,THE ECUIPMENI UESCRmED HEREIN IS HEWED
PURSJANT TO AND IN ACCORDANCE WITH THE TERMS AND CONDITIONS SET FORTH ABOVE AND ON THE REVERSE SIDE OF TI its PAGE.CUSTOMER REPRESENTS IIAVING READ AND AGREED
TO SAME,
Environmental Recovery Fee--If an Environmental Recovery Fee is LOSS AND DAMAGE WAIVER (LOW) IS NOT INSURANCE,The Charge lot LDW is i6_OO°b .1 ))
charged, it is a recovery by HERC of Its expenses and costs for handling, pmss rental charges.Customer accepts or declines LOW.It Custemsr accepts LOW,In consideration
managing, and/or disposing of waste materials associated with the rented of the Alga shaven above,Lasser agrees to waive certain clums...last customer far loss of ar
damage to Flatfooted,In scaurdance with lha letma and condllions am forth In Paragraph B,on[lie
equipment that Contain hazardous Substances,Such as motor oil, grease, Ravame Side of this page and In the Loss AND DAMAGE WAIVER GUIDE which Customer hablay, �1
and/or hydraulic fluid, as well as related administrative cost. THISAS NOT acknowledges receiving.
A GOVERNMENT MANDATED CHARGE, customer acknowledges that the Equipment v41i he revealed In.goad,dean,and uncmlammated [
condition,(ton of any and all hazardous s mebureas. f
Terms are Net 10 Days Not Valid without Barcode
Print Cuslamm Name Title °
rrI f pt
Cuatamer Signature Data
Carefully read the terms and conditions on reverse side of this page I ( II
RENTAL tl Show R.A. Number on all Correspondence
p
a* COPS *R €goipmenPftertta/ R.A. No, 28050025
Page 1 of 3
HERTZ LOCATION: 722 BILL TO CUSTOMER: 2907713 SHIPPING ADDRESS
HERO TACOMA PACIFIC CIVIL of INFRASTRUCTURE 640 ZONE PRESSURE REDUCENG
4403 20T1i STREET EAST 3450 9 344TH WAY SUITE 115 SE 232N0 PL& 108TH AVE SE
FIFE, WA 98424 FEDERAL WAY, WA 98001 KENT, WA 98030
253-922-3852
253-606-6284
DESCRIPTION/CHARGES
EST START: 5/20/16 7:00 EST RETURN; 6/18/15 7:00 DROP DATE: 112005
SHIPPED BY: 38677 ORDERED BY: HEINTZ, MARK DROP TIME: 1 290
ORDER DATE; 5/19/15 SALESPERSON: 747 SALES COORDINATOR: $
Post JOeF': / 1 -640 ZONE PRESSUR
Rates include maintenance service g
Qty Equipment # Hrs/ Min Hour Day Week 4 Week Amount
'1 EXCAVATOR/6-8 METRIC TON/CRRPILER/DSL 8/ 425.00 'I0.83 425.00 1250.00 C3200_00 p
I 6-0"3-(7-U7U l�ket DEEf2 —s01T F1vD85DX016493WB
HR OUT: 1924.70 HR CHG:
Equipment may have telematics technology enabled.DO NOT RUN EQUIPMENT OUT OF DIESEL FUEL; -
ADDED CHARGE FOR RE-STARTING SYSTEM
*** WARNING: CALL BEFORE YOU DIG *** X
***USA (UNDERGROUND SERVICE ALERT)*** ti
EMISSI0.N5 & ENV SURCHARGE EMISSZOIVS 43 84 t '.
Customer has declined the purchase of LDW,
1 BUCKET/3 0 o/TRENCH/BACKHOE 8/ g
248D10075 Make: CP Model: 30030E Ser #: JODD0200871 -
LDW not offered for this item 's
1 TAMPER/HYD/6000-6999# B/ 140.00 23.33 3.40,00 400.00 955,00 Ili
V11065017 Make: STANLEY Model; HS6026 Ser #: 7191 Lj 3
Equipment may have. telematics technology enabled.
FOR USE ON HERTZ EQUIPMENT ONLY - ,) j,/I601-1
Customer has declined the purchase of LOW.
1 BUCKET/24o/TRENCH/BACKHOE 8/ g
80002.5047 Make; TAG Model: 2430Q2 SOX lit 101416-64
CONTINUED a-
I
[p[p[p€I
For GREAT DEALS on USED EQUIPMENT-visit us on-line at www.hertzecuio noel 5
CAREFULLY READ TERMS AND CONDITIONS ON REVERSE SIDE OF THIS PAGE
Nmvvimsmnding payment of the LDW lee,Cuslmmnr is Ilahle for all damage to Ilse Equlpmenl and¢opens-of HeRC caused by the Equipment being used or operated In violation of Has terms and conditions
on the Rwetee Side of gtia papa or In vioialion of the LOSS AND DAMAGE WAIVER GUIDE. '.
PARAGRAPH 12.ON THE REVERSE SIDE OF THIS PAGE 151N LIEU OF III ALL WARRANTIES,EXPRESS,IMPLIED OR STATUTORY,INCLUDING,BUT NOT LIMITED To,THE IMPLIED WARRANTY OF
MERCHANTABILITY AND THE IMPLIED WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE;AND IIII ALL OBLIGATIONS ON THE PART OF FORD TO CUSTOMER FOR DAMAGES,INCLUDING,LOT E NOT LIMITED TO,INDIRECT, INCIDENTAL, CONSEQUENTIAL OR SPECIAL DAMAGES ARISING OUT OF On IN CONNECTION WITH THE LEASING,MAINTENANCE, USE,OPERATION,STORAGE,
ERECTION,DISMANTLING OR TRANSPORTATION OF THE EQUIPMENT,CUSTOMEH REPRESENTS THAT HE HAS FULLY INSPECTED THE EQUIPMENT AND THAT SAME IS IN E000 CONDITION AND
REPAIR.CUSTOMER Is LIABLE FDH ALL VIOLATIONS OF LAW ARISING OUT CUSTOMER'S USE,POSSESSION OR OPERAq ION aF THE EQUIPMENT,THE EQUIPMENT DESCRIBED HEREIN IS RENTED
PURSUANT TO AND IN ACCORDANCE WITH THE TERMS AND CONDITIONS SET FORTH ABOVE AND ON THE REVERSE SIDE OF THIS PAGE,CUSTOMER REPRESENTS HAVING READ AND AGREED 3
TO SAME.
j
e Environmental Recovery Fee-- If an Environmental Recovery Fee is LOSS AND DAMAGE WAIVER (LOW) IS NOT INSURANCE.The Chsrge for LOW is 15_00 96 of g
charged, It is a recovery by HERC of its expenses and costs for handling, gross rental charges.Cuslumer accepts or declines LOW.If Customer accepts LDW,In conslder.Jlon E
managing, anchor disposing of waste materials associated with life rented of the charge shown above,Lessor agrees to waive certain claims agannt customer fur loss of at 1t
equipment that contain hazardous substances,such as motor oil, tease, damage to Equipment,in accordance with me latma and conditions set forth in Pempraph s,on the
g Reverse Side of this page and In the LOSS AND DAMAGE WAIVER GUIDE which Customer hereby
and/or hydraulic fluid, as well as related administrative cost. THIS IS NOT acknowledges ratul op.
A GOVERNMENT MANDATED CHARGE. Customer acknowledges that the Equipment will he rntumed In a goad,clean,and uncontaminated F,
condition,free of any and all hazardous substances. P
I
Terms are Net 10 Days Not valid without Barcode
Print Customer Name Title
Customer Signal.. Data II I II I Il II 111 II II II IIII II II II -
CarefUlfy read the terms and conditions on reverse side of this page
3 I
UCFiTAL CONTRACT � �� % Show R.A. Number on all Correspondence � it
COPY ** R.A. No. 28030M
Equipment6Tenta! Page 2 of 3
HEH IZ LOCATION: 722 BILL TO CUSTOMER: 2407713 SHIPPING ADDRESS
HERC TACOMA PACIFIC CIVIL U INFRASTRUCTURE 640 ZONE PRESSURE REDUCING
4403 20TH STREET EAST 3450 S 344TH WAY SUITE 115 BE 232ND PL & 10RTH AVE SE
FIFE, WA 98424 FEDERAL WAY, VVA 98001 KENT, WA 98030 r
253-922-3852
253-608-6284
DESCRIPTION/CHARGES
EST START; 6/20/16 7:00 EST RETURN; 6/18116 7:00 DROP DATE: 5/20115
SHIPPED BY: 38677 ORDERED BY: HEINTZ, MARK DROP TINE: . 12:00
ORDER BATE: 5/19/16 SALESPERSON: 747 SALES COORDINATOR: f
POP/JOBN: /1 -640 ZONE PRESSUR
Rates include maintenance service '..
4ty Equipment If Hrs/ Min Hour Day Week 4 Week Amount
LDW not offered for this item
DELIVERY FUEL CHARGE 3712000001 15.00 {
DELIVERY CHARGE 85.00
S
PICKUP CHARGE 85.00 x
3
*** Delivery Instructions *** 3
PRE DELIVER ON 5/19
SC: MARK 253-606-6284 DRIVER PLEASE MAKE
CONTACT WITH MARK BEFORE DROPPING UNIT
OFF
TRANSPORTATION-DRIVER WAIT TIME is charged if a driver spends more than. 20 minutes waiting to _
unload/load Equipment after scheduled delivery/pickup time, Wait time is $20 for each 20-miTbute
period thereafter, Customer is responsible for daily maintenance, fuel, damages, and cleaning fees C[
if Equipment is not cleaned before return. REFUELING-For Equipment valued less than $5,000 and holds 4
less than 3 GAL when full, we assume that 0.6 GAL are needed to refuel. TO END RENTAL CHARGES,
Customer must call the branch to get a release #. f
CONTINUED 3
s'
II
For GREAT DEALS on USED EQUIPMENT-visit us on-line at www.hertzeaui❑ con
's
CAREFULLY READ TERMS AND CONDITIONS ON REVERSE SIDE OF THIS PAGE ,
N.miffimending payment of the LOW fee,Custamer is liable for all damage to the Equipment Imd expense of HERC caused by the Euuiree.r t being used or operated In violation of the terms and rchoRions FC
on the Revers"side of this page or in violation of the LOSS AND DAMAGE WAIVER GUIDE.
PARAGRAPH 12.ON THE REVERSE SIDE OF THIS PAGE IS IN LIEU OF(E ALL WARRANTIES,EXPRESS,IMPLIED OR STATUTORY,INCLUDING,BUT NOT LIMITED TO,THE IMPLIED WARRANTY OF rs MEHCHANTANMTY AND THE IMPLIED WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE;AND Rif ALL OBLIGATIONS ON THE PART OF HEHC TO CUSTOMER FOR DAMAGES,INCLUDING,BUT
NOT LIMITED TO,INDIRECT,INCIDENTAL,CONSEQUENTIAL OR SPECIAL DAMAGES ARISING OUT OF OR IN CONNECTION WITH THE LEASING, MAINTENANCE, USE, OPERATION,STORAGE, e
ERECTION,DISMANTLING ON TRANSPORTATION OF TILE EQUIPMENT,CUSTOMER REPRESENTS THAT HE HAS FULLY INSPECTED THE EQUIPMENT AND THAT SAME IS IN GOOD CONDITION AND
REPAIR,CUSTOMER IS LIABLE FOP ALL VIOI ATIONS OF I.AW ARISING OUT CUSTOMER'S USE,POSSESSION OR OPERATION OF THE EQUIPMENT.THE EQUIPMENT DESCRIBED HEREIN IS RENTED
PURSUANT TO AND IN ACCORDANCE WITH THE TERMS AND CONDITIONS SET FORTH ABOVE AND ON THE REVERSE SIDE OF THIS PAGE.CUSTOMER REPRESENTS HAVING READ AND AGREED
TO SAME,
Environmental Recovery Fee—If an Environmental Recovery Fee is LOSS AND DAMAGE WAIVER{LDW)IS NOT INSURANCE.The Charge for LOW is 16.00% cl i
Charged, it is a recovery by HERC of its expenses and costs for handling, arose rental charges.customer aeeepts or deoanes LOW.If Custamer accepts LOW,In considaratim, 'y
managing, and/Of disposing of waste materials associated with the rented of tho charge shown above,Lessur agrees to waive certain clalms against customer for loss or or
equipment that contain hazardous substances,such as motor oil,grease, damogo to Equipment,le accordance with the terms and cundiders set fund In Paragraph 6,on the L
9 Re,arso Side of this Paga and In the LOSS AND DAMAGE,WAIVER GUIDE which Cgmtomer heron, E j
and/or hydraulic fluid, as well as related administrative cost. THIS IS NOT acknowledges racelvirg.
A GOVERNMENT MANDATED CHARGE. Cusmmar acknowledges V18L the Equipment will he mooned IA a good,ciean,end uncontaminated
condition,free of any and all hazartlous subslancus.
' I
Terms are Net 10 Days Not valid without Barcode A- i
Print customer Name TIVe i
t:stomel S19moure Date II I II I II II l ll II [ II l II I IIII II
Carefully read the terms and conditions on reverse side of this page
RENTAL CONTRACT "� Show R.A. Number On all Correspondence
f€L ='^ H.A.No. 28030025
*' COPY * Equ7pmenPRenfa7 Page 3 of 3
HERTZ LOCATION: 722 BILL TO CUSTOMER: 2907713 SHIPPING ADDRESS
HERC TACOMA PACIFIC CIVIL at INFRASTRUCTURE 640 ZONE PRESSURE REDUCING
4403 20TH STREET EASI 3450 S 344TH WAY SUITE 115 BE 232ND Pl. Y* 1081 H AVE SE
FIFE, WA 98424 FEDERAL WAY, WA 98001 KENT, WA 98030
253-922-3852 I
253-606-6284
DESCRIPTION/CHARGES �
I
EST START: 5/20/16 7:00 EST RETURN: 6118/15 7:00 DROP DATE: 50011 R
SHIPPED BY: 38677 ORDERED BY: HEINTZ, MARK DROPTIME: 12�00
ORDER DATE: 5/19/15 SALESPERSON: 747 SALES COORDINATOR: JAMFS H. BLISS
I
I
POA!JOBN: 11 -640 ZONE.PRESSUR
Rates include maintenance Service
Qty equipment $ 1I min Hour Pay Week 4 Week Amount
w#'k**kx'*%"***£**xwww******"A**%'%'*'*********#****#k#**kkk****#%w*k*************%.•k k'*****w*4*£kk********** '
* Givc vs your feedback! Go to www,hercBurvey.com or. call 1-600-451-2208 and take our short surveyl*
* Hertz location: 722 %
I
I
I
I
i
For GREAT DEALS on USED EQUIPMENT-visit us on-line at www.hertzenuio.cum !
CAREFULLY READ TERMS AND CONDITIONS ON REVERSE SIDE OF THIS PAGE
Notwithstandin0 Payment al the LDW fee,Customer Is liable for all damage to the Erlulement and expense of HERC caused by lire Equipment Going usod ar.,.rated In vlolatlon of the trams end conditions
on the Reverse Side of this page m In vluiaR,m of the LOSS AND DAMAGE WAIVER GUIDE.
PARAGRAPH 12.ON THE REVERSE SIDE OF THIS PAGE IS IN LIEU OF 111 ALL WARRANTIES,EXPRESS,IMPUFD OR STATUTORY,INCLUDING,BUT HOT LIMITED TO,THE IMPLIED WARRANTY OF
MERCHANFABILITY AND THE IMPLIED WARRANTY OF FEENESS FOR A PARTICULAR PURPOSE;AND lip ALL OBLIGATIONS ON THE PART OF HERC TO CUSTOMER FOR DAMAGES,INCLUDING,HUT
NOT LIMITED TO,INDIRECT,INCIDENTAL.CONSEQUENTIAL OR SPECIAL DAMAGES AHIGMC OUT OF OR Ild CONNECTION WITH THE LEASING,MAINTENANCE, USE, OPERATION,STORAGE, I
ERECTION,DISMANTLING OR TRANSPORTATION OF THE EQUIPMENT,CUSTOMER REPRESENTS THAT HE HAS FULLY INSPECTED THE EQUIPMENT AND THAT SAME IS IN GOOD CONDITION AND !
REPAIR.CUSTOMER IS LIABLE FOR ALL VIOLATIONS OF IZV ARISING OUT CUSTOMER'S USE,POSSESSION OR OPERATION OF THE EGUIPMENT,THE EQUIPMENT DESCRIBED HEREIN IS RENTED
PURSUANT TO AND IN ACCORDANCE WITH THE TERMS AND CONDITIONS SET FORTH ABOVE AND ON THE REVERSE SIDE OF THIS PAGE.CUSTOMER REPRESENTS HAVING READ AND AGREED
TO SAME.
I
e Environmental Recovery Fee--If an Environmental Recovery Fee is LOSS AND DAMAGE WAIVER ILDWI IS NOT INSURANCE.The Chatge far LDW Is 16.00% of
charged, It is a recovery by HERC of its expenses and costs for handling, gross rental choTaa.cvatamar accepts cr deaunae LOW.If Caatemer errepta LOW,In consideration
managing, and/or disposing of waste materials associated with the rented of the charge shown above,Lessor agrees to waive certain claims e0aiusl customer for lose of or
e u1 moot that Contain hazardous substances, such as motor oil,grease, damage to Equipment,In accordance with the terms and Comedians e01 forth In Pa'aPfauh E,an He i
Q P g Reverse Side of this pogo and In the LOSS AND DAMAGE WAIVER GUIDE which Customer hereby
and/or hydfaulic fluid, as well as related administrative cost. THIS IS NOT acknowledges rece'.viag, -
A GOVERNMENT I✓IAIJDATED CHARGE. Customer ocknowiad3es that lira equlpereat will he returned In a eased,clean,and uncertarainated
condllion,free of any and all hazardous substances- i
Terms are Net 10 Days Not valid without Barcode
Print Customer Name Title
IpI �
Customer Signature Dan, III II I II II III III II II III i
Carefully read the terms and conditions on reverse side of this page j
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WATCH
www.equ i pmentwatch.com
Rental Rate Blue Book@ June 29,2015
On-Highway Flatbed Trucks
Miscellaneous Models
Size Class:
Gross Vehicle Weight 19,501 .26,000 GVW
Configuration for On-Highway Flatbed Trucks
Power Mode Gasoline Axle Configuration 4X2
Maximum Gross Vehicle Weight 25,000 Ilse Horsepower 275.0
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 $1,275.00 $355.00 $89.00 $13.00 S40.00 $47.24
Adjustments
Region(Kennewick: $8.92 $2.48 S0.62 $0.09
100.7%)
Model Year(2015: - - - -
100%)
Ownership(100%) - - - -
Operating(100%)
Total, $1,283.92 $357.48 $89.62 $13.09 $40.00 $47.29
Rate Element Allocation
Element Percentage Value
Depreciation(ownership) 51% $660.251 me
Overhaul(ownership) 31% $395.251 me
CFC(ownership) 5% $63.751 mo
Indirect(ownership) 13% $165.75/mo
Fuel(operating)@$3.51 81% $32.43/hr
Revised Date: 21nd Half 2014
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