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HomeMy WebLinkAboutCAG2024-084 - Change Order - #3 - Active Construction - Mill Creek 76th Avenue S Culvert Improvements - 1/13/25 - 1/7/25 Agreement Routing Form ■ For Approvals,Signatures and Records Management ��T This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. W A S H I N G T O N (Print on pink or cherry colored paper) Originator: Department: S.Anderson PW Engineering Date Sent: Date Required: > 1/8/25 N/A 0 h. CL Authorized to Sign: Date of Council Approval: Q 0 Director or Designee ❑Mayor 5/7/24 a Budget Account Number: Grant? 0 Yes ❑No D90121.64110 330 Budget? 0 Yes ❑No Type: N/A Vendor Name: Category: Active Construction Contract Vendor Number: Sub-Category: C Change Order#3 0 Project Name: Mill Creek/ 76th Avenue S Culvert Improvements E L Project Details:Additional work necessary to install the side sewer at STA 6+75 including 00 over excavation of subgrade and core drilling of the existing manhole. C Go C Agreement Amount: $2,357.22 Basis for Selection of Contractor: Bid Start Date: N/A Termination Date: 400 Working Days Ch Local Business? ❑Yes ❑No* *Ifineets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions"form on Cityspoce. Notice required prior to disclosure? Contract Number: ❑Yes 0 No CAG2024-084 Date Received by City Attorney: Comments: 01 C f+ 7 3 0 ar inc IM Date Routed to the Mayor's Office: 1/13/25 N Date Routed to the City Clerk's Office: adccW22373_1.20 Visit Documents.KentWA.gov to obtain copies of all agreements ■ KENT WASHINGTON CHANGE ORDER NO. #3 NAME OF CONTRACTOR: Active Construction Inc. ("Contractor") CONTRACT NAME & PROJECT NUMBER: Mill Creek 7V Avenue S Culvert Improvements ORIGINAL CONTRACT DATE: February_26, 2024 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: Additional work necessary to install the side sewer at STA 6+75 including over excavation of subgrade and core drilling of the existing sewer manhole. This work was tracked as force account on sheet #22. 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, $13,825,727.17 (including applicable alternates and WSST) Net Change by Previous Change Orders $49,970.72 (incl. applicable WSST) Current Contract Amount $13,875,697.89 (incl. Previous Change Orders) Current Change Order $2,357.22 Applicable WSST Tax on this Change $0.00 Order Revised Contract Sum $13,878,055.11 CHANGE ORDER - 1 OF 3 Original Time for Completion 400 working days (insert date) Revised Time for Completion under 0 working days prior Change Orders (insert date) Days Required (f) under Minor Change 0 working days Orders Days Required (f) for this Change Order 0 working days Revised Time for Completion 400 working days (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, the Contractor accepts all requirements of this Change Order by signing below. Also, pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this contract modification, which is binding on the parties of this contract. 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: Code Ares By, Chad Bieren"10`signed by WOO o �,..�,. �.... By: n.eanae,wioaxuvr COd(signature) sign trey (signature) Print Name: Y Y Print Name: Chad Bieren. P.E. Its Project Manager Its Public Works Director (title) (title) DATE: 1/2/25 DATE: Ar— EC KP CHANGE ORDER - 2 OF 3 ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent City Clerk Kent Law Department C[In this field,you may enter the electronic filepath where the contract has been saved] CHANGE ORDER - 3 OF 3 File No. 200.2 400 — " aKENT WISHINOT0H CHANGE ORDER 1 ORKSHEET NO, 3 Construction Engineering Division - Public Works Project: 76th Ave Culvert Improvements Project No: 20-3028 Project Engineer: Mark Madfai TIB-Aid No: N/A Capital Projects Jason Bryant Contractor: ACI Manager: Date: 9/10/2024 I. Proposed Change Additional work necessary to install the side sewer at STA 6+75 including over-excavation of subgrade and core drilling of the existing sewer manhole. This work was tracked as force acount on sheets #22 and #23. II. Reason and Background for Change During installation of the new side sewer at STA 6+75 unsuitable foundation material was discovered. The unsuitable material was removed and hauled off and crews placed fabric and quarry spalls. The original contract did not have a bid item for unsuitable material removal resulting in this extra work being tracked on force account sheet # 23. The original design elevation for the side sewer tie in was also incorrect. This resulted in the need to core drill the existing sewer manhole at the correct elevation. This extra work was tracked on force account sheet # 22. III. Method of Payment NEW PAY ITEMS ❑ Not applicable If Sch. Item Description Total Est. Unit Unit Price Total Estimated Cost of No Qty Item 1 Side Sewer Over Excavation and MH Core 1 FA $2,357.22 $ 2,357.22 Drill at STA 6+75. New Pay Items Total: $ 2,357.22 DELETE EXISTING PAY ITEMS) per 1-09.5 ❑� Not applicable Sch Bid Item No. Item Description Qty Unit Unit Price Cost of Item No. $ - i _ $ Page 1 i $ - Delete Existing Pay Items Total: $ - INCREASE/DECREASE TO EXISTING PAY ITEM(S) ❑� Notapplicable Soh No. Bid Item No. Item Description Qty Unit Unit Price Cost of Item $ - $ Increase / Decrease to Existing Pay Items Total: $ *TOTAL ESTIMATED COST OF CHANGE ORDER: $2,357.22 * Total of the Cost of Item Columns IV. WORKING DAYS Original Contract: 400 Due This Change Order: 0 Previous Total: 400 Explanation/Justification for Additional Working Days: *TOTAL WORKING DAYS: 400 * This Change Order + Previous Total Capital Projects Manager: r -- Date: Jason B ant Construction Engineering Date: Supervisor: aeon Barry Construction Manager: Date: z3 Eric Connor Page 2 FA Sheet No.: 22 DAILY REPORT OF FORCE ACCOUNT WORKED � Mr Project Name: Mill Creek/76th Avenue Culvert Improve Project No: 20-3028 Item No.. Date: 7/17/2024 Description of Work core drilling existing SSMH to install 6"sewer pipe Work by Subcontractor?: no Prime Contractor: ACI Sub-Contractor: LABOR STRAIGHT TIME OVERTIME DOLLAR NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT BRETT VANHOOF .4MAN OP-FOREMAN 1 101 96 $ 101.96 JOSHUA TEODORO QP2 OPERATOR-2 1 9697 $ 96-97 ANDREW STARKS LAB4 LABORER 4 1 7469 $ 7469 EASTON WESTLING I LAB3 I LABORER 3 1 7342 $ 7342 AUGUST WOLFF OP2 OPERATOR-2 1 9697 $ 96-97 $ 7194 $ SUBTOTAL-LABOR: $ 444.01 LABOR OVERHEAD&PROFIT @ 31% $ 137.64 LABOR TOTAL $ 581.65 EQUIPMENT EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT 511 ON-HWY TRUCK 1 2533 $ 25.33 566 245 EXJD 1 99.09 $ 99.09 is SUBTOTAL-EQUIPMENT $ 124.42 EQUIPMENT OVERHEAD&PROFIT @ 21% $ 26.13 EQUIPMENT TOTAL $ 150.56 MATERiALS1Sl RVICESIRENTALS MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT DELMAR Core Drill 1 EA $ 625.00 $ 625.00 EA $ LOAD $ HRS $ Is SUBTOTAL $ 625.00 OVERHEAD&PROFIT @ 21% $ 131.25 TOTAL $ 766.25 Verification of Hours Worked: TOTAL: $ 1,488.45 12%MARKUP (for prime when subcontract work) $ - Jason Eley• ri,W mow..• 12/23/24 SHEET TOTAL: $ 1,488.45 , Contractors Representative,7/�( Date , Owners Representative zoo ��ya�t Date12/23/2024 Pay Estimate Entered: Date By EquipmentWatch_ www.equ ipmentwatch-com All prices shown in US dollars($) Adjustments for 511 in All Saved Models June 27,2024 Miscellaneous 4X2 15KGVW DSL On-Highway Flatbed Trucks Size Class: 14,001-16.000 Ibs - Weight: 52141bs Configuration for 4X215KGVW DSL Axle Configuration 4X2 Horsepower 200.0 Maximum Gross Vehicle Weight 15000.0 Ibs Power Made Diesel Blue Book Rates Non-current(i.e.archived)rates:Jan 1,2022-Mar 31,2022 **FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated Operating FHWA Rate- Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates USD$1,055.00 USD$295.00 USD$74.00 USD$11.00 USD$19 13 USD$25.12 Adjustments Region(Washington: USD$43.26 USD$12 10 USD$3.03 USD$0 45 104 1%) Model Year(2017:99.4%) (USD$6..62) (USD$1.85) (USD$0 46) (USD$0.07) Adjusted Hourly Ownership - - - Cost(100%) Hourly Operating Cost(100%) Total: USD$1,091.63 USD$305.24 USD$76.57 USD$11.38 USD$19.13 USD$25.33 Non-Active Use Rates Hourly Standby Rate USD$4.53 Idling Rate USD$20 50 Rate Element Allocation Element Percentage Value Depreciation(ownership) 55% USD$580 25/mo Overhaul(ownership) 27% USD$284.85/mo CFC(ownership) 4% USD$42.20/mo Indirect(ownership) 14% USD$147 70/mo Fuel(operating)@ USD 3.65 74.75% USD$14 30/hr Revised Date:1st quarter 2022 These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book® Print.Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com) All material herein O 2003-2024 Randall-Reilly All rights reserved- Page 1 of 1 EquipmentWatch_ www.equipmentwatch com All prices shown in US dollars($) Adjustments for 566 in All Saved Models July 2,2024 Deere 245G LC Crawler Mounted Hydraulic Excavators � I Size Class: 24.5-2B.4 mt Weight: NIA Configuration for 245G LC Horsepower 159.0 hp Blue Book Rates **FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated Operating FHWA Rate" Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates USD$11,295.00 USD$3,165.00 USD$790.00 USD$120.00 USD$33.16 USD$97 34 Adjustments Region(Washington: USD$316,26 USD$88 62 USD$22.12 USD$3.36 102 8%) Model Year(2021:99,94%) (USD$6.76) (USD$1 89) (USD$0 47) (USD$0-07) Adjusted Hourly Ownership - - Cost(100%) Hourly Operating Cost(100%) - Total: USD$11,604,50 USD$3,251.73 USD$811.65 USD$123.29 USD$33.16 USD$99.09 Non-Active Use Rates Hourly Standby Rate USD$32.97 Idling Rate USD W&N Rate Element Allocation Element Percentage Value Depreciation(ownership) 31% USD$3,50L45/mo Overhaul(ownership) 41% USD$4,630.95/mo CFC(ownership) 17% USD$1,920.15/mo Indirect(ownership) 11% USD$1,242.45/mo Fuel(operating)@ USD 3.66 33 32% USD$11.05/hr Revised Date:3rd quarter 2024 These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book® Print-Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com) All material herein©2003-2024 Randall-Reilly All rights reserved. Page 1 of 1 _ DEL-MAR CONCRETE Invoice 41 9 9- CUTTING & CORING 152 100th St. S. RECEIVED Tacoma. WA 98444 JUL 24 2024 Ph # (253) 537-0109 FAX # (253) 535-0507 ADI r d ! S 3 TO DATE � I��Z JOB NO. � L D + O c "Fa r,- 413-o CONTACT PERSON -pV t W r(- ��> JOB LOCATION �cL C 7` S TERMS: NET 30 DAYS,UNLESS OTHERWISE NOTED. • • • DATE AA1 d1e f 3 r {artG //Vl A FINANCE CHARGE OF 1.5% ON THE UNPAID PREVIOUS BALANCE WILL BE /f COMPUTED AT THE END OF EACH MONTH. IF CUSTOMER DEFAULTS OR IF SUIT `�J IS BROUGHT TO COLLECT ANY OF THE PRINCIPAL OR INTEREST DUE OR OWING UNDER THIS BILL, DEL-MAR MAY CHARGE CUSTOMER REASONABLE ATTORNEY (/ FEES AND COLLECTION COSTS. ACTIVE Z ACICONSTRUCTION ADDITIONAL WORK AUTHORIZATION INC. A.C.I. PHASE AWA# PAGE# PROJECT FOREMAN: ;„ �_r_� CODE: DATE WORK ,; - OF PERFORMED: .__ , DESCRIPTION OF WORK LABOR CLASS&HOURS QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS FOREMAN -OPERATOR LABORER TCS FL AGGER EQUIP.NO. EQUIPMENT DESCRIPTION TOTAL HOURS i �-a!e- [ rr e t L !4^ t MATERIALS DELIVERED/USED UNITS TICKET# SERVICES PERFORMED UNITS MTICKET SUBCONTRACTORS UNITS TICKET# `Notes: ADDITIONAL CHARGE FOR ABOVE WORK IS: Payment will be made as follows: Above additional work to be performed under same conditions as specified in original contract untess otherwise stipulated Date: Authorizing Signature: - -- (OWNER SIGN HERE e agree to furnish labor and materials-complete in accordance with the.above specifeations;af.above stated price. Date: Authorizing Signature: •' NTR6 T R SIG H RE] NOTE:This revision becomes part of,and in conformance with,the existing contract FA Sheet No.. 23 DAILY REPORT OF .40 FORCE ACCOUNT WORKED ��ENT Project Name: Mill Creek/76th Avenue Culvert Improve Project No: 20-3028 Item No Date: 7/17/2024 Description of Work: SUB EX TRENCH LINE FOR THE 6"SEWER.Placed spalls and fabric. Work by Subcontractor?: no Prime Contractor: ACI Sub-Contractor: LABOR STRAIGHT TIME OVERTIME DOLLAR NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT BRETT VANHOOF 4MAN OP-FOREMAN 1 101.96 $ 10196 JOSHUA TEODORO OP2 OPERATOR-2 1 96.97 $ 96.97 ANDREW STARKS LAB4 LABORER 4 1 74.69 $ 7469 EASTON WESTLING LAB3 LABORER 3 1 73.42 $ 7342 AUGUST WOLFF OP2 OPERATOR-2 1 9697 $ 96.97 $ SUBTOTAL-LABOR: $ 444.01 LABOR OVERHEAD&PROFIT @ 31% $ 137.64 LABOR TOTAL $ 581.65 EQUIPMENT EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT 511 ON-HWY TRUCK 1 25.33 $ 25.33 512 VOLVO LOADER 1 10072 $ 100.72 566 245 EX JD 1 99.09 $ 99.09 $ - SUBTOTAL-EQUIPMENT $ 225.14 EQUIPMENT OVERHEAD&PROFIT @ 21% $ 4728 EQUIPMENT TOTAL $ 272.42 MATE R IALSIS E R V IC ESIR ENTA LS MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT EA $ - FABRIC 135 sf $ 009 $ 12.15 LOAD $ HRS I is SUBTOTAL $ 1215 OVERHEAD&PROFIT @ 21% $ 255 TOTAL $ 14.70 Verification of Hours Worked: TOTAL: $ 86877 12%MARKUP (for prime when subcontract work) $ - Contractors Representative Jason Eley ` Date 12/23/24 SHEET TOTAL: $ 868.77 L]aS011 gYyan� 12/23/2024 Owners Representative Date Pay Estimate Entered: Date: By: * EquipmentWatch_ www.equipmentwatch.com All prices shown in US dollars($) Adjustments for 511 in All Saved Models June 27,2024 Miscellaneous 4X2 15KGVW DSL On-Highway Flatbed Trucks Size Class: 14,001-16,000 Ibs Weigh[: 5214 Ibs Configuration for 4X2 15KGVW DSL Axle Configuration 4X2 Horsepower 200.0 Maximum Gross Vehicle Weight 15000.0 Ibs Power Mode Diesel Blue Book Rates Non-current(i.e.archived)rates:Jan 1,2022-Mar 31,2022 **FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated Operating FHWA Rate- Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates USD$1,055.00 USD$295 00 USD$74 00 USD$11,00 USD$19 13 USD$25 12 Adjustments Region(Washington: USD$43.26 USD$12.10 USD$3.03 USD$0,45 104.1%) Model Year(2017:99.4%) (USD$6.62) (USD$185) (USD$0.46) (USD$0.07) Adjusted Hourly Ownership - - Cost(100%) Hourly Operating Cost(100%) -i Total: USD$1,091.63 USD$305.24 USD$76.57 USD$11.38 USD$19.13 USD$25.33 Non-Active Use Rates Hourly Standby Rate USD$4.53 Idling Rate USD$20 50 Rate Element Allocation Element Percentage Value Depreciation(ownership) 55% USD$580.25/mo Overhaul(ownership) 27% USD$284.85/mo CFC(ownership) 4% USD$42.20/mo Indirect(ownership) 14% USD$147.70/mo Fuel(operating)@ USD 3.65 74,75% USD$14.30/hr Revised Date:1st quarter 2022 These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book® Print.Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com) All material herein @ 2003-2024 Randall-Reilly All rights reserved. Page 1 of 1 EquipmentWatch_ www.eq u ipme ntwatch.cam All prices shown in US dollars($) Adjustments for 512 in All Saved Models July 2,2024 Volvo L110H 4-Wd Articulated Wheel Loaders Size Class: �. _. 250-274 hp Weight: NIA Configuration for L110H Horsepower 258.0 hp Operator Protection ROPSIFOPS Power Mode Diesel Blue Book Rates *'FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated Operating FHWA Rate- Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates USD$10.355 00 USD$2.900.00 USD$725.00 USD$110.00 USD$41 08 USD$99 92 Adjustments Region(Washington: USD$196 74 USD$55.10 USD$13 77 USD$2.09 101.9%) Model Year(2017:99 4B%) (USD$54 77) (USD$15.34) (USD$3 83) (USD$0 5B) Adjusted Hourly Ownership - Cost(100%) Hourly Operating Cost(100%) Total: USD$10,496.98 USD$2,939.76 USD$734.94 USD$111.51 USD$41.08 USD$100.72 Non-Active Use Rates Hourly Standby Rate USD$41 15 Idling Rate USD$73 53 Rate Element Allocation Element Percentage Value Depreciation(ownership) 40% USD$4,142.00/mo Overhaul(ownership) 31% USD$3,210.051mo CFC(ownership) 18% USD$1,863.90/mo Indirect(ownership) 11% USD$1,139.05/mo Fuel(operating)@ USD 3.66 33-81% USD$13.891hr Revised Date:3rd quarter 2024 These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book" Print.Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com) All material herein @ 2003-2024 Randall-Reilly All rights reserved. Page 1 of 1 ' EquipmentWatch_ www.equ ipmentwatch.com All prices shown in US dollars($) Adjustments for 566 in All Saved Models July 2,2024 Deere 245G LC Crawler Mounted Hydraulic Excavators I Size Class: 24.5-28.4 mt Weight: N/A Configuration for 245G LC Horsepower 159.0 hp Blue Book Rates **FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Ownership Costs Estimated Operating FHWA Rate`" Costs Monthly Weekly Daily Hourly Hourly Hourly Published Rates USD$11.295,00 USD$3,165.00 USD$790.00 USD$120.00 USD$33.16 USD$97 34 Adjustments Region(Washington: USD$316.26 USD$88.62 USD$22.12 USD$3.36 102.8%) Model Year(2021:99 94%) (USD$6.76) (USD$1.89) (USD$0 47) (USD$0.07) Adjusted Hourly Ownership - - Cost(100%) Hourly Operating Cost(100%) Total: USD$11,604.50 USD$3,251.73 USD$611.65 USD$123.29 USD$33.16 USD$99.09 Non-Active Use Rates Hourly Standby Rate USD$32.97 Idling Rate USD$76.98 Rate Element Allocation Element Percentage Value Depreciation(ownership) 31% USD$3,50145/mo Overhaul(ownership) 41% USD$4,630.95/mo CFC(ownership) 17% USD$1,920.15/mo Indirect(ownership) 11% USD$1,242,45/mo Fuel(operating)@ USD 3 66 33.32% USD$11.05/hr Revised Date:3rd quarter 2024 These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book® Print.Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com) All material herein @ 2003-2024 Randall-Reilly All rights reserved. Page 1 of 1 ACF West, Inc. INVOICE NO AC"KESTINC. 494741 E G E O S Y N T H E T I C S Johnson Creek Industrial Park 8951 S.E.76th Drive, Portland,OR 97206 INVOICE DATE Phone:800-878-5115 Fax: 503-771-1161 6/28/24 ORDER DATE CUSTOMER PO# SOLD BY SHIPPED VIA TERMS 6/28/24 24-003 Cara Kryzsko Our Truck NET30 s ACTIVE CONSTRUCTION INC. ACT100 N ACTIVE CONSTRUCTION INC. o PO BOX 430 I Mill Creek&76th Ave S D PUYALLUP, WA 98371 P KENT,WA 98032 T T O o UNIT UNIT EXTENSION ORDERED B.O. SHIPPED ITEM NUMBER AND DESCRIPTION UNIT PRICE DISC 1 1 121161770-N140 Nonwoven Geotextile,12.5'x 360' RL $375.00 $0.00 $375.00 1 1 FREIGHT-Freight and Handling EA $35.00 $0.00 $35.00 Sale Amount: $375.00 Payment is due by Jul 28,2024 Discount Amount: $0.00 Tax Amount: $0.00 Freight Amount: $35.00 Invoice Total: $410.00 Amount Paid: $0.00 Balance Due: $410.00 PLEASE PAY FROM THIS INVOICE--STATEMENTS ARE SENT BY REQUEST ONLY. Invoices requiring corrections should be submitted to ACF West Inc.within a document's 30-day terms. Thank you for your continued business. RECEIVED A cj Page 1 of 1 Pages ACTIVE Z 3 ACICONSTRUCTION ADDITIONAL WORK AUTHORIZATION INC. A.C.I. FOREMAN: PHASE AWA# PAGE# PROJECT CODE: DATE WORK OF PERFORMED:I DESCRIPTION.OF WORK LABOR CLASS& HOURS QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS FOREMAN OPERATOR LABORER TCS FLAGGi`R EQUIP.NO. EQUIPMENT DESCRIPTION TOTAL HOURS � FA MATERIALS DELIVERED/USED UNITS TICKET# SERVICES PERFORMED UNITS TICKET# SUBCONTRACTORS UNITS TICKET# *Notes: ADDITIONAL CHARGE FOR ABOVE WORK IS: Payment will be made as follows: Above additional work to be performed under same conditions as specified in original contract unless.q►.I;Ittrwise stipulated Date: Authorizing Signature: — --OWNER SIGNS HERE We agree to furnish labor and materials-complete in accordance with the above specii;calions;atabove stated price. Date: _j; Authorizing Signature: c NTRACT0Q SIGNS HERE NOTE:This revision becomes part of,and in conformance with,the existing contract