HomeMy WebLinkAboutCAG2020-137 - Change Order - #9 - Active Construction, Inc. - Willis St & 4th Ave S Roundabout - 08/19/2021KENT
Agreement Routing Form
For Approvals, Signatures and Records Management
This form -ombines & replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)WasHtNcroN
3
oLco.
Originator:
C. Frame
Department:
PW Engineering
Date Sent:
8t2412021
Date Required
N/A
Authorized to Sign:
E Director or Designee E Mayor
Date of Council Approval
N/A
Budget Account Number
R901 1 2.641 1 0.1 20
Budget? EYes ENo
Grant? EYes ENo
Type: N/A
co
,Po
ELo5
E{)tro
EooLgl
Vendor Name:
Active Construction, lnc
Category:
Contract
Vendor Number:
231 9336
Sub-Category:
Change Order #9
Project Name: Willis Street and 4th Ave S. Roundabout
projecr oetaits:Adjust J-boxes and Luminaire base due to the layout of the swale creating a
conflict with the proposed grade causing them to settle.
Agreement Amount: $4,385. 1 6
Start Date: N/A
Basis for Selection of Contractor: $id
Termination Date: NiA
Local Business? El Yes El No*
*lf meets requirements per KCC 3.70.100, please complete "Vendor Purchase-Local Exceptions" form on Cityspace.
Notice required prior to disclosure?
EYes ENo
Contract Number:
cAG2020-137
otc
jy:
E$o=Ei
IEc
.9tn
Date Received by City Attorney:Comments:
Date Routed to the Mayort Office:
Date Routed to the City Clerk's Office:
adril22l/l 1,20 Visit Documents.KentWA.gov to obtain copies of all agreements
Cww
KENT
WAsqrNdron
This change order amends the above-referenced contract; all other provisions of the
contract that are not inconsistent with this change oia", shall remain in effect' For valuable
consideration and by mutuar .onr"ni'or tne parties-, the proiect contract is modified as follows:
1. Section t of the Agreement, entitled "Description of work," is hereby modified to add
additional work or revise existing work as follows:
InadditiontoworkrequiredundertheoriginalAgreementandanyprior
Amendments, contractor shall provide all iabor, materials' and
equiPment necessary to:
Adjust J-boxes and Luminaire base due to the layout of the swale
creatl;;u *nni.i witn tne pioposed grade causing the J-boxes to settle'
z. The contract amount and time for peformance provisions of section II "Time of
Completio n," andiection III, "Compensation," are hereby modified as follows:
CHANGE ORDER NO. 9
NAME OF CONTRACTOR: Acllve Construction' Inc' ("Contractor")
coNTRAcr NAME & PRoJEcr NUMBER: Willig street and 4th Ave' s' Roundabout
ORIGINAL CONTRACT DATE: MAY 15, 2O2O
$4,759,759.00Original Co
(including
ntract Sum,
applicable alternates and
wssr)
$246,495.25Change Orders
incl. applicable
Net Change by Previous
(wssr)
$s,oo6,zsa.zsCurrent Contract Amoun
incl. Previous Change Orders)
t
(
$4,385.16Current Change Order
$oApplicable WSST
Order
this ChangeTax on
$5,010,639.41Revised Contract Sum
CHANGE ORDER - 1 OF 3
100Original Time for
(insert date)
Completion
100
prior Change Orders
letion underRevised Time for Comp
(insert date)
0 calendar daYsardroetsI+ChangthforReuired()DA qys
100Revised Time
(insert date)
for ComPletion
inaccordancewithSectionsL-o4.4and1-04.5oftheKentandWsDoTStandard
specificationr, anJ s"ction vrr of th"e ngi"ur";t, the contractor accepts all requirements of this
change order by signing berow. nrsoi pursuant to the ibove-referenced contract, contractor
agrees to waive any prote-st.it may'-#[ tipttding ihl Cn"ngt Older and acknowledges and
accepts that this change order constiiutes finar r.tttlr.nt orltt craims of any kind or nature
arising from or connectJd with any work either .ou"r"i'oi affected by this change order, including'
without rimitation, craims rerated to contract time, .ontri.t accereration, onsite or home office
overhead, or rost profits. This chJng; i;iJ"r, uni*r oinerwise provided, does not relieve the
contractor from strict comprianc" *iin the guarantee and warranty provisions of the original
contract, particutJrl; th;;; pertaining to subsiantial completion date'
Ail acts consistent with the authority of the Agreement, previous change orders (if any),
and this change order, prior to tn"lri"iiive date oiinir cnanie order, are hereby ratified and
affirmed, and the terms of the ngr""rn'"r,t"-previous cnangebrd#s (if any), and this change order
shall be deemed to have aPPlied'
The parties whose names appear belo.w swear under penalty of perjury that they are
authorized to enter into this.ontruillr'.,odification, whichls 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 *-iif', ifre revised contract sum shown in section 2' above'
INwlTNEss,thepartiesbelowhaveexecutedthisAgreement,whichwill
become effective on the last date written below'
DATE:
(title)
Print Name:C ndBi
e /at
CITY OF KE NT:
(signature)
ame:
'r-
I
CONT RACTOR:
DATE:
Prin
By:
CHANGE ORDER - 2OF 3
ccun lhls lield, you may enter the etectrcnic filePath whec the contrad has been savedl
Kent Law DePaftment
APPROVED AS
(applicable if MaYor's
TO FORM:
slgnature required)ATTEST:
Kent Clerk
I
CHANGE ORDER. 3 OF 3
File No. 2OO.2
KENT
CHANGE ORDER
Construction Engineeri
Project: Wilt is St & 4th Ave S Roundabout
Project Engineer: Thomas Leyrer
Capital projects
WORKSHEET NO.9
ng Division - public Works
Project No:
Fed-Aid No:
Contractor:
1B-3020
Brian Shields
ACI
Date:021
I.P Cha e
ust J aoxes nd a numi at re ba s ae fter the s WA e W s co n structe dum eTh Wsinane a ebas con stes runda ctionJthe-b exp osedoxestosettle
If, Rea so n and round for Chan
ffl, Method of payment
NEW PAy ITEMS l Nota pplicable
is c h a onge rder ls to cover th e add oiti n a ma rite a ls la b or a dnu umna neireeg totsbaepm rserathta eth Jrea OXb esa aacent nddjtotheWNbioretenntiodtarheponA4thsaWVCSle&wilt screateda Stconft Thict e lawith ofttheyouproosedpdofe9raerhJcoTheaboxesnflctndunrminaaedbreaIcausentsedhatethJlocatino-boxes to settle as th e wereanchY inset erh soerd eger fo tcostop he swa3B e T561ota$4,
Sch
No ftem Description Total Est.Unit Unit Price Total E stim ated Cost of
Item
FA $4,385.16
J-Box and Luminaire Base Raisin g 1 4,395.16$
$
$
New Pay ftems Total; $
)ELETE EXISTING PAY ITEM(S) per t-O9.5 D Not
No.
Page 1-
applicable
4,395.16
Sch Bid ftem No.ftem Description Qtv Unit Unit Price Cost of ltem
Delete Existing Pay ftems Total: $
INCREASE/DECREASE TO EXISTING PAY ITEM(S) ri Notappricabre
Sch
No.Bid ltem No.Item Description Qtv Unit Unit Price Cost of Item
$
$
$
Increase / Decrease to Existing Pay ltems Total:
*TOTAL ESTIMATED COST OF CHANGE ORDER:
IV, WORKING DAYS
$
* Total of the Cost of ltem Columns
$4,385.16
Original Contract:100 Due This Change Order:o Previous Total 100
Explanation/Justification for Additional Working Days:
*TOTAL WORKING DAYS:100
* This Change Order + Previous Total
Capital Projects Manager:Date
Date: ilr/et
Date:
,il1u
-
f-,
Construction Engineering -/ -/Supervisor: -4.-- -424---
Brai iel
Construction Manager:
tu-Paul Kuehne
Eric Connor
Page 2
ACI ACTTVE
CONSTRUCTION
INC.
CII^A}IGE ORI}ER / ADI'ITIONAL WORK
SUMMARY
A.C,I.
PROJECT
JOB # 20.014
EQUTP. NO,
Willis St. and 4th Ave. S Roundabout
DATE WORK PERFORMED: I l22l2l to2l3l21
DESCRIPTION OF WORK
J-Box, Street Light Base Adjustment and Carnera Credit/Charge for Willis Strect (updated 3/5/2 l)
A.C,I. PHASE
CODE
TBD
MANPOWER
woRKlNC FOREMAN @ r.0 0
oPERATOR @ r.0 ()
otlcRAroR @ l-o o
oPERATOR @ r.0 0
LABORUR @ l.o 0
L-ABORER @ 1,0 0
LABOR CLASS 1 RATLS
HOURS
0.0
0.0
0.0
0,0
0.0
0.0
$85.82
$82. I 7
$82. I 7
$82. I 7
$64.49
$64,49
SUBTO'NAL LABOR
@ RATE
LS @ $o,oo
SUBTOTAL MATERIALS
@ RATE
SERVICE SUETOTAL
@ RATE
LS @ $3,915.32
SUB CONTRACTOR SUBTOTAL
@
at
@
@
(n
@
a9
TOTAI,
$0.00
s0.00
$0.00
$0.00
$0.00
s0.00
$0.00
EQUIPIV1ENT DESCRIPTION / RATES
EQUTPiVTENT DESCRIPTION HOURS @ RATE
SUA'TOTAL EQUIPIVISNT
TOTAI,
$0.00
TOTAL
$0.00
$0.00
DESCRIPTION
MATSRIAI, COSTS
UNIT
1.00
DBSCRTPTION
SERVICE COSTS
UNtT
SUB CONTRACTOR
DESCRIPTION UNIT
l-otem Elcct.ic {.l-Box, Slreet Light Basc Adjushenl ond Camerr Credil) 1.00
I\IARK-UP ON LABOR 29%
SUBTOTAL LAEOR
MARK-UP ON EQUIPMENT 2I%
SUBTOTAL EQUIPI\'IENT
TAX ON MATERTALS (N/A ON WATER & SE}VER) O,OO%
MARK.UP ON MATERIALS 2I%
SUBTOTAL MATERIALS
MARK-UP ON SERYICI COST 2I%
SUBTOTAI- SERVICE COST
12 % MARK-UP ON SUB-CONTRACTOR COST (>$25'000 = 10%) 12%
SUBTOTAL SUB-CONTRACTOR COST
TOTAL
$1,91 5.12
$3,915.12
50.00
$0.00
$0.00
$0.00
TOTAL
s0,00
s0.00
$0.00
$0.00
$0.00
$0,00
s469.84
$4,3E5. I 6
GRAND TOTAL $4,385.1 6
%
{A rtEcTRtc
Phone (1$31 383.$0t2
f*x {z$$} 272-5214
Transmittal
(}F TACOittr\, lNC,
4696 - Willis Street & 4th Ave S. Roundabout Subject : Totem Labor & Equipment Rates
To Jim Holland
ACt
5110 River Road East
Tacoma, WA 98443
Phone No:253-248-1090
Mobile: 253-495'8286
Fax No: 253.248'1093
j imh@activeconstruction.com
Contract No:
Transmittal Number :
Spec Section No :
Transmittal Date :
TYPe :
Method Sent:
Reason For Sending :
Status :
1 8-3020
4696-16
713112020
Original Transmittal
Email
As Requested
To Be Submitted
Return To Roger Palfenier
Totem Electric of Tacoma lnc
2332 Jefferson Ave
Tacoma, WA 98402
Phone No:253-722'2838
Mobile: 253-678-1504
Fax No: 253-272-5214
Rpalfen ier@totemelectric.com
GoPY To Fred Duke
Details
Line
No Item Copies Date Reference No Description
001 Project
Documents
1 7t3112020 Totem Labor Rates
002 Project
Documents
1 7t3112020 Totem Equipment List
Notes
Jim - Attached are Totem's Labor & Equipment Rates for the willis Street project
sisnedBy: b \ P"ll--=
Roger Palfenier
HighwaY Division Manager
Dated:713112020
%tV ttEcrRtc
l,n0nS lufi$ 5UE'illzE
Fax f253! 272-6214
Items
{ 1l 1,,\i irit.i,\. [l]1..
Line Number: 1
Item: Project Documents
Gopies: 1
Date:713112020
Description: Totem Labor Rates
IBEW Local #46
HighwaY Electrician
Wages Effective 08/03/20 through 0113112021
(Next L&l and State lJnemployment Rate Changes 1/1/21)
Joumeynan [.oadnan Foreman
Gangrsl
u n Rate $ 58.78 58.78 61.72 64.66 70.54
Health & Welfare hour 9.80 9.80 9.80 9.80
Local Pension hour 9.88 9.88 9.88 9.88
Annuitv-401K per hour 2.AO 2.00 2,00 2.00
Traini hour 0.83 0.83 0.83 0.83
National Emplovee Benefit Fund 3.00%1.76 1.85 1.94 2.12
N.E.C.A./A.M,F 1.000k 0.59 0,62 0.65 0.71
Substance Abuse hour 0.10 0.10 0.'10 0.10
L.M.C.C hour 0,10 0.10 0.10 0.10
L.M.C.C.hour 0.01 0.01 0.01 0.01
id Sick Leave 1.47 1.54 1.62 1,76
Total Benefits 26.54 26.73 26.93 27.31
al & Medicare 7.65%4.50 4.72 4.95 5,40
3.96%
I Unem nt 0.600%
2.33 2.44 2.56 2.79
0.35 0.37 0.39 0.42
Labor and lndustries hour 1.57325 1.57325 1.57325 'l,57325
Fam & MedicalLeave t's s hour 0.08622 0.09053 0.09484 0.1 0347
Total Iaxes 8.84 9.20 9.56 10.29
Cost Hour 94.16 97.65 101.15 {08.14
TotalF Benefits and Taxes 35.38 35.93 36.49 37.60
Labor Burden Pe 60,180/o 58.22o/o 56.430/o 53.31%
Tlme One-Half Rates
Premium Portion of Time & One-Half Rates 29.39 30.86 s2.33 35.27
and rollTaxese 4.76 5.00 5,24 5.72
Total Additional Cost Hour 34.1 5 35.86 37.57 40.99
Labor Burden 16.21%16.21%16.21o/o 16.21o/o
I Gost r Hour 129.31 133.51 138.72 r49.t3
Rates
remiu m Portion of Double Time Rates 58.78 61.72 64,66 70.54
Fri and I Taxes 9.53 10.00 10.48 11.43
otalAdditional Cost Hour 68.31 71.72 75,14 81 97
Labor Burden 16.2104 16.21o/o 16.21o/"16.21%
Total Cost per Hour 162.46 {69.38 176.29 1s0.12
Holidays - New year,s Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, Day after Thanksgiving Day'
Christmas Day, Martin Luther King's Birthday 7t3112020
IBEW Local#46
Highway Electrician' APPrentice
Wages Effective 08/03/20 through 0113112021
(Next L&t and State llnemptoyment Rate Changes 1/1/21)
if!
Second Pe{iodPorlod
49.964.1.0927.6358.Rate
9.809.80I9.80& Welfare hour
7.41 8.4060.10 14
1.50 1.701.300.25 .040.25hourK
0.83 0.8300.83hour
1.32 1.500.0.83Em3,Benefit
0.500.28F 0.100.100.10 100.1hourAbuse
0.10 0.100.10 0.100hourc
0.010.010,01 0.0't0.0hour
1,2510.69 0.760.Leave 24.1912.99 9.011Benefits
2.922.11 21.89& Medicare 7
1.09 1.210,983.
260.18 230,17U
173251.57325 11Labor and lndustries
0.056050.044840.& Modical
7.757.025.35 6.29984.63Total
81.8965.54 73.7254.934542.27HourCost ,t o?27.33 29.6324.36117.58TaxesFBenefits 63.92%67.21o/o79,71.530/o71Burden
Rater 24.9819.11 22.0515.29822.35& One-HalfPortion of 4.053.572.48 3.10242.00Taxes
29.0322.20 25,62170514.35Additional Cost Hour
18.2116.21%1%'t6.21121o/"16.21%Burden {0.9299.3472.89 87.746156.61I Cost Hour
Rateg 49.9644.0938.2127.63 30.57of 8.10154.96 6.194.48Taxesand 061.2444.4032.11 35.53CostH
1Yo16,21 16.21o/o16.2111
139.9s124.9690.45 109.9477.7170,96CostHour
Holidays - New Year's Day, Memorial Day, Fourth of July' Labor Day, Thanksgiving Day' Day after Thanksgiving Day'
Christmas Day, Martin Luther King's Bitthday
7t31t2020
Locals #252 and #440
Laborers and Flaggers
Wages Effective June 1,2020 through May 31 ,2021
(Next L&l and Sfafe llnemployment Rate Changes 1/1/21)
viltlv
Trafflc
Conbol
41.4339.81 40.7734.9031.82Rate
g
6.706.706.706,70 6.70r hourHealth & Welfare
4.794.794.794,79 4.79hourPension
0.950.950.950,95 0,95hourTrain
0.060.060.06 006hourc.l.s.A.P ai40.140.140,14 0.14hourN.W.t.E.C.E.T
1.041.020.87 1.000.80Paid Sick Leave
13.6813.6613.51 13.6413.4TotalBenefifs
3.173.05 3.122.672.437.650/o& MedicareSocial
1.641.58 1.611,381.263.96%Unem ent
0,24 o.25o.24D.210.190.60%ederal Unem
1.773851,771.773851.773851.77385hourr and lndustries
0.060770,059800.058390.04667 0.05119r hour& Medical Leave
6.89.816.695.71 6,09TaxesTotal
62.0061.2460.1450.s7 54.50HourCost
20.5720.4720.3319.15 19.60Benefits and Taxes
49.64%50.21%56.17o/o 51.06%6A.17o/oLabor Burden Perce
Tlme &Rates
2A.7220.391719.9115.91Premium Portion of Time & One-Half Rates
2.532.492.13 2.431.94TaxesFriand
23.2522.34 22.8819.58'17.85otalAdditional Cost Hour
12,21%12.21o/o12.210/o 12.210h12.19o/oBurden Pe
85.2484.1174.08 82.4768.82CostHour
Double TIme
41.4340.7734.90 39.813'1,82Premium Portion of Double Time Rates
5,064.984.863.89 4.26Taxesand
46.4945.7539.16 44.6735.71HourAdditionalCost
12.2112.21o/o12.21o/o 12.21%12.23o/oLabor Burden Perce 108.49106.99104.8193.6686.68r HourTotal Cost
Holidays - New Yeat's Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, Day afterThanksgiving Day'
Christmas Day
7t3112020
Locals #612 and #302
Operators
Wages Effective 06101120 through 05131121
(Next L&l and State Unemployment Rate Changes 1/1/21)
King, Pierce, Snohomish,
ODsrator! I Oporatort ll ODontor!lU
Base Hourlv Rate 48.77 48.15 47.60
Frinqe Benefits
Health & Welfare per hour 8.57 8.57 8.57
Pension per hour 13.15 13.15 13.15
Apprentice Trainino per hour 0.70 0.70 0.70
NationalTraininq Fund per hour 0.05 0.05 0.05
Paid Sick Leave 1,22 1.20 1.19
Total Frlnge Benefits 23.69 23.67 23.66
Pavroll Taxes
Social SecuriU & Medicare 7.65%3.73 3,68 3.64
State Unemployment 3.96%1.93 1.91 1.88
Federal Unemployment 0.60%a.29 0.29 0.29
Labor and lndustries (emplover's portion) per hour '1.77385 1.77385 1.77385
Familv & Medical Leave (emplove/s share) per hour 0.07154 0.07063 0.06982
Total Pavroll laxes 7.80 7.72 7.66
Total Gost Der Hour 80.26 79.54 78.92
Total Frinqe Benefits and PavrollTaxes 31,49 31.39 31.32
Labor Burden Percentage 64.57o/o 65.2A%65.807o
Tlme E One-Half Rates
Premium Portion of Time & One-Half Rates 24.35 24.48 23.80
Aoplicable Frinqes and Pavroll Taxes 2.98 2.94 2.91
Total Additional Cost per Hour 27,36 27.01 26.71
Labor Burden Percentage '12.21%12.21%12.21%
Total Cost per Hour 107.62 106.56 105.63
Double Tlme Ratee
Premium Portion of Double Time Rates 48.77 48.15 47.60
Applicable Fringes and Payroll Taxes s.95 5.88 5.81
Total Additional Cost per Hour 54.72 54.03 53.41
Labor Burden Percentage 12.21o/o 12.21o/o 12.21%
Total Cost per Hour 134.98 133.57 132.33
Holidays - New Year's Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, Day after Thanksgiving Day,
Christmas Day
7t3',112020
tsnOFa t3[$] rU$'ilJza
Fex {15$} 212-6211
Items
%V e-trcrRtc
r lt I,\{ ()l\r^. l";i
Line Number: 2
Item: Project Documents
Gopies: 1
Date: 713112020
Description: Totem EquiPment List
cosrPER HOURs16.32s'16.65s16.51516.65514.32$ 16.75518.50s16.50$10.82510 82sla a5s1 8.85s1 8.505',I /.gttE15.0051U.r?s1e65s1 8.6s$12_73911 1351 5./2919.0!s1s,05s18.72519"05s13.10s19^3_ffiFs1/.34s15_6i51 t.92s'ta.J?$1 08.25$6.32s3E r/s6.50s27.88s38 88ATrACHMENINONENENONENONENONENONENONE\]ONEIIONENbNE-NONENONEI NONENONENONEtoNhNONENUNLNONE\]oNE\ONE\ONE\ONENONENONENONENiJNENONENONENONf\(]Nh\ONENONENONEEM3SOOSX EAIVNONE\IQNENONE14000 FtLbl{000 FtLb'1400c FlLb\ONEEH4cooesfiAt\QNhiM3800sx 490{sER*g923700€ATTACHMEN| *1!ONE\ONE\ONENONFNCNENONLNONENONEt']ONENONTEM3800SX 1057603GCBhTNONENONE-M3aOOSX GOCA4843/8CNONENONElrovbuiltxD'7000wNONEEM38005X 1008177NONENONENONENONENONENONEEi/14000sx EBRC10073t3:M4000SX EBRC100776€Elv13800SX EAi/lC1 o120/111400OSX FBRCl004606NONENONENONE:r\,14000s,( EBRC100t 7 87EM4000sx EBRCI 007234:M4000sx E8Rc100187514EMSOOOSXEir3500s 4583647erexfes c4047 ser#2060531019\ONE\ONEeTl3TlH se#071 1C78254ITONES0. istel@ R2450-TGTelelect TL38P ser#207033339'lolan H-237\ational - 425 ser#27392BOOMNANANANAiNANANANANANANAr.tANANAMNAINANANANANA i IlANANANANANANANANANANANANA2:NAJMiNANANANANA47'42?5'HAULCAPLIFTCAP.NANANANANANANANANA200 li 60002NA]NANANT.NANAINANANANAINA2\NANANANANANA.NANANANANANANA2NAINANANANANANA240442400024000300300300NAM2)i.'lAMNANANANANA2iNANA2NANA2NANANANANANA2INANA2tMNANANANA2NANANANANANANANA2 I FIXEDFIXFD10000FIXE2i 4000226000 i 24000 I 2600022221 00002222222222222222i95001222222t226000 I 260000315000 2z2GVW600c1000060G500040004000400002051ZO{JO600012000100001 00006000120008000I 600c12UU0! ]2OOU'100001 DOOU80001rJODO1700080001 000017000230 i1000026000170001 700026000'10090I 100004400033000I 36000400u260001 /50u40000GVWR210 l230215710230 ilectnc250HP240zo5)iesel i 205230234GAS2U532514023032523022023D210211)4202404t0210245cAs : 30s3U530523065210Diesel I 225896119H Diesel 325245PWR.GASGASGASc01109G rcAsDleselDieselASASCASJAS3ASGAS;ASGAS5AS3ASiASDieselGA5GASD!eselGA5)iewlJreselureselLjreselLiASGA5UAS2574 t1HTGGG3ROLH260923 i8257651 tDieselDiesel)resel-PGlectncDreselDreselLPGf,reslfaeselLtdc9s761Jc1722548798197:26471C814275F )a07620UJ604€0G31072eU32C855t-r810259U810270U It10727U451374Xl/3994CJ9383tsa51J/ Ixd513 /5Xa'43122E51312X842722t1c00323c843123E)26470C:00315C26472Cts8778€PcaD324Cc396atHc94/gH8559252ts341 31KIti /!'ttoKl6l959Kts441 tgUa€5924t.4513/6Xts44T4?-Uts431 85UF27430G8250411\AIN,A;28300H;a3cr54NNAA70306D:00322C\32299t\4v-t-N-1500 1GCNCNEH7GZ194640NDRA 5TFUM5F17CXO35102Rrdaeline I2HJYKi651 811531 78215005TETX22N9825630244400 :1HTMKADN42I-1528574:550 1FDAF56FX3[A233153500 :1GB3CZCG5DF110155Chevr1500 ilGCNCPEXXCZ2758721500 r 1GtsJC3gDl /tl4535/25001GtsHU24UE6h'19',]2/912500,1G8HC24K44E141660'1 FTYR t0C21 PA645431 G8JC34KX7E52431 s1GBHC24K68E141 1091GC2CUEG0FZ52731 31 GBoCUEG0FZs17439c-2500 1G8hc24U97E114356c-4500 t1G8E481173F5113853500 1GC3CYCG7GZ3090141 GB3CYC80GF2020454300 ilHTMIVIAAL95H156sl33500,lGts3KVCYlKF1/5/86F-700 :1FDNF8oOBIvA165131c-3500 l1GBJC34U/6E18555s1 GaHC24U55E 1 62093:-2500 1GCHC24KAAE1732lE3FRXF/5R87V514€743FRXF75R17V418634FGC2oK AF82C{18793219 ;2491672529545500 3D6WA7EL78G591s84T440 r3BKBLJ0X6KE2E9264350C-2 ,K400090F8OO 1FDXK84N4FVA53529Ford iF45o 1FDXF45P37FE349071 FDAF56F /YLA45295700 1FDPF80C6WA04517FordiRANGERc-350025002ilO3500:-2500t-tbt)3219F550TAKEChevChevChev,-;hevNFIITYChevTOYOTAl-iondaChevChevTovotaniFord:ihevChevFordChevChevChevlhevOhevUhevChevChevchevUhev.ihevlhev:hevShevShevCnevIntChevChev:ordlhev]hevShevChevintFlatbedI FordFordMltsu:vtackSkviackJoqaeKenwofflDeawcoFordFqrdFordTYPEPickupckuoSUVPickupPickupPickupiPickuplaibecPrckuDJtjlitFickuoutrlrwPICKUPPJCKUPjlatbedUtilityUtilityUtilityitrlrtvUtlliiyStakebedP ckuol.JhlrtvFlatbedJtrhNijtilitv VanFlatbedF latoedUtrliwVanUtilitvFlatbedUblriyFlatDedFlatbedforkliftScissore LiftSerya€ BucketFletbedFOTHftFlatbedServi€ Bucketieryr€ tsucKetFlatbedFlafbedFlatbedFlatbedurilityBoofiYAuqs 'lruckBoom/AuqerTruckF orktltlScissor LiftScissor LifiB!cket TruckBoom TtuckForkliftBucket Truck8lckel Truck3ucket Truckaoom TruckD€SCRoickupPickupPickup2015SUVPickupPickuoFlatbedLJtll rtyiqupFlatbedJtilitvPlgkupUtlity1999 iP|CKUPP'CKUPFldJ]edUnlityJlilityUtilityPickupUtilityFlatbedYEAR2018-7615-201 120162012i33 I 200824122008200820132A4 1 2412207 200t2AA /20ori200€20042004200120i5ZUr52015200320112047201620 1620142005201924142006271 \ 2(fr52008200720m20D220052005201 l2U1b20619852oo7'D1it11211512s1?1*1391421441462002412022t:?15217226230231231238242246252234260252zii32t630'1304305306307319329
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Fhone {2631 }83.S022
Fax {25.3) 272-$214
Change Order Request
OF TAC$frtA" h\D^
4696 - Willis Street & 4th Ave S.
Roundabout
COR Subject: T&M - raise j-boxes & light pole fndtn.
230+67 +l-
To Jim Holland
ACr
5110 River Road East
Tacoma, WA 98443
253-248-1090
253-248-1Oe3 (FAX)
Contract No: 18-3020
COR Number: 4696-10
COR Revision Number: 0
COR Date: 211712021
work rype: Fiejd work order /-. T&M
Days Valid; 5
Return To Fred Duke
Totem Electric of Tacoma lnc
2332 Jefferson Ave
Tacoma, WA 98402
253-722-2840
253-272-5214 (FAX)
fduke@totemelectric.com
Details
Oescription
Cost
/ Rate I
otv
Hrs Workers Ext
Foreman, Schaun Brodie 1122121 $101.71
4.00
Hrs
1.00 $406.84
remove j-boxes, add material
Laborer group 3, Justin Flint
1t22t21 $62.68
4.00
Hrs
1.00 $250.72
remove j-boxes, add material
Foreman, Schaun Brodie 1126121 $101.71
4.00
Hrs 1.00 $406 84
raise pipe & fndtn. I place boxes,
Operator, Roland Palfenier
1t26121
$81.08
4.00
Hrs
1.00 $324.32
raise pipe & fndtn. / place boxes,
Foreman, Schaun Brodie 213121 $106.09
4.00
Hrs 1.00 $424.36
Descrlption
Cost
/ Rate I
Qtv
Hrs Workers Ext
form I pour conc. / finish
Laborer group 3, Justin Flint
2t3t21
$62.68
2.00
Hrs
1.00 $125.36
form / pour conc. / finish
T228 - 2008 Utility Truck $18.72 10.00 $ 187.20
j-box and fndtn. work 230+67 L
T639 - 1999 Backhoe $36.47 4,00 $145.88
j-box and fndtn. work 230+67 L
T641 - 2006 Track Excavator $22.05 4.00 $88.20
j-box and fndtn. work 230+67 L
couplers and allthread $615.8B
1.00
LUMP SUM
$615.88
rebar, formwork, conduit fittings $ 100.00
1.00
LUMP SUM
$ 100.00
credit for COR#9 add COHU
camera
$524.08
-1.00
LUMP SUM
$-524.08
reverse above credit (back to
original)
$524.08
1.00
LUMP SUM
$524.08
Breakout
Labor:
Markup @ 31%:
Equipment:
Markup @ 21%:
Material :
Markup @ 21%:
$1,938.44
$600.92
$421.28
$88.47
$715.88
$150.33
Total: $3,915.32
Reservation of Rights
This COR does not include any amount for impacts such as interference, disruptions, rescheduling, changes in the
sequence of work, delays andior associated acceleration. We expressly reserve the right to submit our request for
any of these items.
? f- P,(*
Fred Duke
Project Manager
Signed By:Dated: 211712021
\
ilrL3 Portland Bolt
& MANUFTCTI'RING COMPANV
goo-gnz-oZgo I w*'".porllandboll,co m
cusT. No.58888 tNVorcE N0.138292
TERMS Net 30 lNvolcE DATE 1./t81202L
PAGE 1of 1
TOTEM ELECTRIC
4310 TOTH AVENUE EAST
FIFE, WA,98424
ORDERED ON 7173/202L sALESPERsON Gary
]NACKING NO.L29456440365660522 WEIGHT 24 lbs.
oFa
o
TOTEM ELECI-RIC
PO BOX 1093
TACOMA, WA,98401
oF
&
n
CIJSTOMER PO 4596-t4A
SHIP UPS
ORDERED Jane
QUANTITY
ORDERED
QUANTTY PRODUCT
BACKORDERED CODE DESCRIPTION
QUANT]TY UNIT PRICE
sHIPPED TOTAL
Portland Bolt & Manufacturing Co.
3441 NW Guam St.
Portland, OR,972LO
oF
L
u
4
4
L2378 1 X 20 GALV F1554G105 ALL THREAD ROD
L2343 1 X 3 DOM GALV A553.DH HVY HEX COUPLER
4
4
S101.7s
S48,ss
$qoz,to
$rg+.zo
FREIGHT CHARGES
No credit will be lssued for goods teturned without our permlsslon. Speclal order merchandlse wlll not be accepted
for credlt, No claim for shortages allowed unless reported immedlately upon receipt of shlpment' A servlce charge of
on" inJ on"-fr.f f percentlr-i2x) per month whic'h ls an APR of elghteen percent (18%) will be charged on all past
due accounts. We hereby certlfy tiat th".e goodt were produced ln compliance wlth all appllcable requlrements of
Section E, 7 and 12 of the Fair Libor standards Act as amended and of regulatlons and orders of the US oepartment
of Labor issued under Sectlon 14 there of.
46qu-tq
S14,s2
$61s.88
I
rtrvorcr rotet I
AMOUNT PAID
AMOUNT DUE s61s.88
l+*