HomeMy WebLinkAboutCAG2024-084 - Change Order - #7 - Active Construction - Mill Creek 76th Avenue S Culvert Improvements - 1/10/25 140 Agreement Routing Farm
For Approvals,Signatures and Records Management
\L
KF N 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:
1/13/25 N/A
0
L
QAuthorized to Sign: Date of Council Approval:
a 0 Director or Designee ❑Mayor 5/7/24
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#7
0
Project Name: Mill Creek/ 76th Avenue S Culvert Improvements
to
Project Details: Emergency repair of Zayo cross bored side sewer lateral of 21719 84th
c
Avenue S. Cost include work tracked on FA sheet#32.
C
0 Agreement Amount: $47,102.57 Basis for Selection of Contractor Bid
d
i Start Date: N/A Termination Date: 400 Working Days
a
Local Business? ❑Yes ❑No*
*Ifineets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions'form on Cityspace.
Notice required prior to disclosure? Contract Number:
❑Yes 17 No CAG2024-084
Date Received by City Attorney: Comments:
✓m
C
7
30
a,
� 3
f+
R
CCn Date Routed to the Mayor's Office:
V!
Date Routed to the City Clerk's Office: 1/13/25
ad«W22373 1_20 Visit Documents.KentWA.gov to obtain copies of all agreements
•
KENT
W A 5 H I N O T O N
CHANGE ORDER NO. #7
NAME OF CONTRACTOR: Active Construction Inc. ("Contractor")
CONTRACT NAME & PROJECT NUMBER: Mill Creek 761h 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:
Emergency repair of 84th Avenue side sewer for 21719 property. Cost
include work tracked on FA sheet #32.
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 $135,600.47
(incl. applicable WSST)
Current Contract Amount $13,961,327.64
(incl. Previous Change Orders)
Current Change Order $42,742.80
Applicable WSST Tax on this Change $4,359.77
Order
Revised Contract Sum $14,008,430.21
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:
❑i&Wly signed by Chad Sieren
B Codey Ayres °�" `�""°�'" """"o-"" 13 Chad
lad BledGr en Vale 2025.01.1009:33:a&08'00'
(signature) (signature)
Print Name:Codev Ayres Print Name: Chad Bieren P.E.
Its Project Manager Its Public Works Director
(title) (title)
DATE: 116/24, _ DATE:
EC
CHANGE ORDER - 2 OF 3
ATTEST: APPROVED AS TO FORM:
(applicable if Mayor's signature required)
Kent City Clerk Kent Law Department
1
C[In this field,you may enter the electronic nlepath where the contract has been saved]
CHANGE ORDER - 3 OF 3
/ File No. 200.2
KENT
CHANGE ORDER WORKSHEET NO. 7
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: 12/10/2024
I. Proposed Change
Emergency repair of 84th Ave side sewer for 21719 property. Costs include work tracked on the
following FA sheets: #32
II. Reason and Background for Change
During installation of a private power conduit on 84th Avenue, crews discovered a sink hole in front of
the 21719 property while potholing other utilties. Power crews notified the City of their discovery. Kent
Sewer crews Wed the adjacent side sewer and found a broken pipe. Due to location and potential
depths of excavation, the City requested ACI crews provide emergency support and repair. Existing
asphalt was removed and the side sewer pipe exposed. At this time, it was discovered the side sewer
had actually been cross bored during installation of a Zayo fiber line. ACI crews repaired the pipe and
backfilled the trench. CDF was used to ensure the sink hole was completely filled while reducing overall
surface impacts. ACI then restored the trench line with hot mix asphalt. This change order is complete
compensation for the 21719 emergency repair.
III. Method of Payment
NEW PAY ITEMS ❑ Notapplicable
Sch. Item Description Total Est. Unit Unit Price Total Estimated Cost of
No Qty Item
84th Ave Emergency side sewer repair at 1 LS $42,742.80 $ 42,742.80
21719
New Pay Items Total: $ 42,742.80
DELETE EXISTING PAY ITEM(S) per 1-09.5 ❑� Notapplicable
Sch Bid Item No. Item Description Qty Unit Unit Price Cost of Item
No.
Page 1
$
Delete Existing Pay Items Total: $ -
INCREASE/DECREASE TO EXISTING PAY ITEM(S) ❑✓ Notapplicable
Sch Bid Item No. Item Description
No. QtY Unit Unit Price Cost of Item
$
Increase / Decrease to Existing Pay Items Total: $ _
*TOTAL ESTIMATED COST OF CHANGE ORDER: $42,742.80
* 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: Date: Z"/-Y- X-
Jason ant
Construction Engineering Date:
Supervisor: 1Z i7 Z
] on Barry
Construction Manager: Date:
ric Connor
Page 2
FA Sheet No.: 32
DAILY REPORT OF
FORCE ACCOUNT WORKED � KEr
Project Name: Mill Creekl76th Avenue Culvert Improve Project No: 20-3028
Item No.: Date: 9/16-20/2024
Description of Work: 84th Street setup traffic control,sawcut,equipment.remove asphalt,dug to break,vac truck,repair pipe.
back fill.Cleaned and tv sewer line.Dug back through backfill for COK to jet and TV line.Backfill to
elevationfor install of power condults.Backfilled rest with CDF.Prepped for pave back.Place CSTC then
pave.Load out steel sheets,boxes,equipmentand traffic control,removed road signage
Work by Subcontractor?: no
Prime Contractor: ACI Sub-Contractor:
LABOR
STRAIGHTTIME OVERTIME DOLLAR
NAME CODE OCCUPATION Hrs 1 Hourly Rate Hrs OT Rate AMOUNT
BRETT VANHOOF 4MAN OP-FOREMAN 19 101.96 0.5 137.55 $ 2.006.02
JOSHUA TEODORO OP2 OPERATOR-2 25 96.97 1 130.13 $ 2.554.38
ANDREW STARKS OP4 OPERATOR-4 22 91.93 0.5 122.62 $ 2.083.77
DYLAN SLATER OP-APP -OPERATOR-APP 70% 76.05 $ -
SAM BOGERT OP2 OPERATOR-2 96.97 $ -
EASTON WESTLING LAB3 'LABORER-3 31 73.421 0.5 100.631$ 270.58
JEFFREY MILLER I OP2 I OPERATOR-2 1 15.51 96.971 0.5 130.13 $ 1,568.10
SUBTOTAL-LABOR: $ 8,482,85
LABOR OVERHEAD&PROFIT @ 31% $ 2.629.68
LABOR TOTAL S 11,112.53
EQUIPMENT
EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR
Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT
511 ON-HWYTRUCK 19.5 25.33 $ 493.94
415 CAT BACKHOE 3 54.95 $ 164.85
534 JD 85 EX 71.25 $ -
566 JD 245 EX 99.09 $ -
512 VOLVO LOADER 91 100.72 IS 906.48
SUBTOTAL-EQUIPMENT $ 1,565.27
EQUIPMENT OVERHEAD&PROFIT @ 21% $ 328.71
EQUIPMENT TOTAL S 1.893.98
MATERIA LWSERVIC EWRENTALS
MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT
Lakeside-Asphalt 5.03 ton $ 84.00 S 422.52
Core&Main-Dive and fittings 1 Is $ 464.48 $ 464.48
Del-Mar-Sawc�ut 1 Is $ 525.00 S 525.00
Miles-CDF I Is $ 11855.00 $ 1,855.00
Icon-cstc 15.0 'ton $ 16.35 S 246.72
Highway Specialties-rental boards Is $ 3.192.90 $ 3,192.90
Highway specialties-tubeEfand base 50 Be $ 24.50 $ 1.225.00
united rentals-trench boxes.gear 1 Is $ 3.776.33 $ 3,776.33
Tunista trucking 47.75 Hrs $ 190.00 $ 9.072.50
Tunista trucking OT 2 Hrs $ 205.00 1 S 410.00
Badger Vac Truck 1 's $ 3,385.00 1$ 3,385.00
SUBTOTAL $ 24,575.45
OVERHEAD&PROFIT @ 21% $ 5;160.84
TOTAL $ 29,736.29
Verification of Hours Worked TOTAL: $ 42,742.80
12%MARKUP (for prime when
subcontract work) $ -
CentractorsRepresentD4ve Jason Eleyp=r,=,-�7:rw�- Date 12/16/24 SHEET TOTAL: $ 42,742.80
owne�s Re Drprosent0ve aim r/y, t Date 12116/202
Pay Estimate Entered:
Date:
By:
ACTIVE
ACI-, CONSTRUCTION ADDITIONALWORK-AUTHORIZATiON
INC.
A.C.I. AN: I PHASE
FOREM AWA# PAGE#
PROJECT re- T �A H I CODE:
DATE# 2 Y1 ' UG I PE FORMED: �. c tWOR , I G L` Z C) C k 3G 2--r OF
DESCRIPTION OF WORK
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LABOR CLASS& HOURS
QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS
FOREMAN ! 6 -: 6 . -:)
OPERATOR 1 =f J, -�
LABORER d J
TCS
FLAGGER
EQUIP.NO. EQUIPMENT DESCRIPTION TOTAL HOURS
i cry CrJ Cc
245
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 w rk to be performed under same conditions as specified in original contract unless otherwise stipulated
Date: � � /Z � Authorizing Signature:
(OWNER SIGNS HER
We agree to furnish labor and materials-complete in accordance with the above spec} :a#' a ove stated price. =
Date: Authorizing Signature:
f ONTRACT R SI N ERE
NOTE:This revision becomes part of,and in conformance with,the existing contract
ACTIVE
ACI CONSTRUCTION ADDITIONAL WORK'AUTKORIZATION
INC.
A.C.I. FOREMAN: ! r { PHASE AWA# PAGE#
PROJECT CODE:
DATE WORK OF
PERFORMED• C,r� r 27
DESCRIPTION OF WORK --
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Y LABOR CLASS&HOURS
QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS
FOREMAN '
OPERATOR 2
LABORER t i
TCS
FLAGGER
EQUIP.NO. EQUIPMENT DESCRIPTION TOTAL HOURS
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Y c. �_ t
? iJ C,! D
MATERIALS DELIVERED/USED UNITS TICKET#
SERVICES PERFORMED UNITS I 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 otherwise stipulated
Date: /I r Authorizing Signature:
! &W-SMS HERE
We agree to fu(nigh labor and materials-complete in accordance with the above specirlcativrrs, d above stated prie
Date: Authorizing Signature:
NTRA TOR Z ERE
NOTE:This revision becomes part of,and in conformance with,the existing contract
ACTIVE
ACICONSTRUCTION ADDITIONAL WORK AUTHORIZATION-
INC.
A.C.I. FOREMAN. l 1 PHASE AWA# PAGE#
PROJECT G�Va rfc�G?� CODE:
DATE WORK ' p ,';-�
f PERFORMED:I i f- c. -a�' I �� F,'o 2 � OF
rr + DESCRIPTION OF WORK
fC� ❑[ Trot G1Vt~ �G�,� f-:,-P-cA CST .. +kfV``1 IJGr�Ar�
-a4 <° r 1f +1 - c, LJ -L,<- O� Y fC��� �0Ae S l-� �GCrdG Qt�. C = CGIUCs4vr`
LABOR CLASS& HOURS
QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS
FOREMAN
OPERATOR '.c., -� !
LABORER
TCS
FLAGGER
EQUIP.NO. .EQUIPMENT DESCRIPTION TOTAL HOURS
f 1 o rG L r ; e_ r:.,k,
E U r
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::rods to be performed under same conditions as specified in original contract unless otherwise stipulated
Date: Authorizing Signature:
OWNER SIGNS HER
We agree to furnish labor and materials-complete in accordance wEth the above speci r Wvns;'at above stated p iCe.
Date: Authorizing Signature, } �
(CONTIR6UPIG HERE
NOTE:This revision becomes part of,and in conformance with,the existing contract
ACTIVE
ACICONSTRUCTION ADDITIONAL WORK AUTHORIZATION
INC.
A.C.I. FOREMAN: f <. 4- 1 PHASE AWA# PAGE#
PROJECT fir, I CODE:
DATE WORK I
# -Z;�;� PERFORMED: c =? %C�' 2 U � L� I OF
DESCRIPTION OF WORK
+ f' .a rCxGtC� 17 Lct C—
J
LABOR CLASS&HOURS
QTY STRAIGHT OVERTIME DOUBLE TOTAL HOURS
FOREMAN l
OPERATOR
LABORER
TCS `
FLAGGER
EQUIP.NO. EQUIPMENT DESCRIPTION TOTAL HOURS
rLA
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 otherwise stipulated
Date: Authorizing Signature: �-
(OWNER SIGNS HEREr
We agree to furnish labor and materials-complete in accordance with the above specificatlons.,at andGe stated price.
Date: Authorizin Signature: �---
CONTRACTOR VMS HERE)
NOTE:This revision becomes part of,and in conformance with,the existing contract v
EquipmentWatch_
www.equipment6vatch.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 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 Operaling FHWA Rate"
Costs
Monthly Weekly Daily Hourly Hourly Hourly
Published Rates USD:1.055.00 USD$295.00 USD$74.00 USD SILD0 USD$19.13 USD$25.12
Adjustments
Region(Washington: USD$43.26 USD$12.10 USD$3.03 USO 50.45
104.1%)
Model Year(2017:99.4%) (USD$6.62) (USD$1.85) (USD$0.46) (USD 5Q.07)
Adjusted Hourly Ownership
Cost(100%)
Hourly Operating Cost(100%)
Total: USD$1,091.63 USD$305.24 USD 576.57 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$580.251mo
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$14.30/hr
Revised Date:1st quarter 2022
These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Book®
Print.Visit the Cost Recovery Product Guide on our Help page for more information.
The equipment represented in-this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com)
All material herein®2003-2024 Randall-Reilly All rights reserved. Page 1 of 1
2"1" EquipmentWatch_
www.equ ipm entwatch.com
All prices shown in US dollars($)
Adjustments for 415 in All Saved Models June 27,2024
Caterpillar 420E(disc.2012)
Tractor-Load er-Backh oes
Size Class: -
13.5-14.4ft t I�
Weight:
15474lbs e—
Configuration for 420E(disc.2012)
Drive 4WD Horsepower 93.3 hp
Operator Protection ROPS 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$4,530.00 USD$1,270.00 USD$320.00 USD$48.00 USD$29.73 USD S55.47
Adjustments
Region(Washington: USD$113.25 USD$31.75 USD$8.00 USD$1.20
102.5%)
Model Year(2008:95.6%) (USD$204.10) (USD$57.22) (USD$14.42) (USD$2:16)
Adjusted Hourly Ownership - -
Cost(100%)
Hourly Operating Cost(100%)
Total: USD$4,439.15 USD$1,244.53 USD$313.58 USD$47.04 USD$29.731 USD$54.95
Non-Active Use Rates Hourly
Standby Rate USD$13.62
Idling Rate USD$39.B4
Rate Element Allocation
Element Percentage Value
Depreciation(ownership) 25% USD$1,132.50/mo
Overhaul(ownership) 46% USD$2,083.80/mo
CFC(ownership) 17% USD$770.30/mo
Indirect(ownership) 12% USD$543.60/mo
Fuel(operating)@ USD 4.03 49.18% USD$14.62/hr
Revised Date:2nd quarter 2024
These are the most accurate rates for the selected Revision Date(s).However,due to more frequent online updates,these rates may not match Rental Rate Blue Booke
Print.Visit the Cost Recovery Product Guide on our Help page for more information.
The equipment represented in this report has been exclusively prepared for Mike Rote(mikero@activeconstruction.com)
All material herein O 2003-2024 Randall-Reilly All rights reserved. Page 1 of 1
EquipmentWatch.
www.equipmentwatch.com
All prices shown in US dollars($)
Adjustments for 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(2017:99.48%) (USD$54.77) (USD$15.34) (USD$3.83) (USD$0.58)
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$4,142.001mo
Overhaul(ownership) 31% USD$3,210.05/mo
CFC(ownership) 18% USD$1,863.90/mo
Indirect(ownership) 11% USD$1,139.05/mo
Fuel(operating)@ USD 3.66 33.81% USD$13.89/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 Booke
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 0 2003-2024 Randall-Reilly All rights reserved. Page 1 of 1
IfLffLAKESIDE Kent Division
INDUSTRIES INVOICE 290010
Remit to: LB# 1086, Lakeside Industries Invoice Date: OW2124
PO Box 35143 Customer No: 104746
Seattle, WA 98124-5143 Job#: 24.003
Sold To: Delivered To:
Active Construction Inc-WA
""'apOactiveconstruction.com""
Puyallup, WA 98371
We welcome your EFT payment IACH and Wire).Please contact AROIakesldeindustries.com.
Tax
&Ile Oak Ticket f i ('nrlw lax Tj*1
PO A:
MATERIAL: 106-WA CLASS B MODIFIED
0911924 4094753 Kent Asphalt Plant 5.030 TON $ 84.00 422.52 0.00 71712 0.00 422.52
Total: WA CLASS B MODIFIED 5.D30 TON 422.52 422.52 0.00 422.52
Total: Cuat Job: 244M3 422.52 0.00 0.00 422.52
Total Invoice: 422.52 0.00 0.00 422.52
RECEIVED
SIP 2 5 2324
ACI
Payment Type: On Account
❑10 Pay Terms 10th Total: $ 422.52
Kent Division'18808 SE 257th street-Covington WA 98042`253.631.3611
Page 1 of 1
Lr LAKESIDE KENT DIVISION Ticket#: 4094753
INDUSTRIES 18808 SE 256th STREET Covington, WA 98042 Date: 9/19/24
253-631-3611 Time: 9:51 am
*** Silo 2 Loadout***
Customer Information Job Information
ID: 104746 ID: 24-003 PO#:
Name: Active Construction Inc-WA Name: 24-003
Address: PO Box 430 Location:
Puyallup,WA 98371
Phone: 253-248-1091 Item: 0-
Truck and Carrier Information Truck Wei hts
Truck ID: TUNISTA Gross Tare Net
Descript: TUNISTA 15 5 AXLE 35560 lb 25500 Ib 10060 Ib
Carrier ID: 1 17.78 Tn 12.75 Tn 5.03 Tn
Name: 0 16.13 Mg 11.57 Mg 4.56 Mg
Product and Load Totals
ID: 106 JMF#:
Name: 1/2 HMA 50 gryo
Today: 1 Loads 5.03 Tn 4.56 Mg
To Date: 1 Loads 5.03 Tn 4.56 Mg
Seal: 307
Weighmaster: chris gross
Customer Copy
AN EQUAL OPPORTUNITY EMPLOYER-WA ST.CONT.REG.#LAKESI*274JD-OR CCB# 108542
For a Safety Data Sheet call 425-313-2600 or download at www.lakesideindustries.com
LLAKESIDE KENT DIVISION Ticket#: 4094753
INDUSTRIES 18808 SE 256th STREET Covington, WA 98042 Date: 9/19/24
253-631-3611 Time: 9:51 am
*** Silo 2 Loadout***
Customer Information Job Information
ID: 104746 ID: 24-003 PO#:
Name: Active Construction Inc-WA Name: 24-003
Address: PO Box 430 Location:
Puyallup, WA 98371
Phone: 253-248-1091 Item: 0-
Truck and Carrier Information Truck Weights
Truck ID: TUNISTA Gross Tare Net
Descript: TUNISTA 15 5 AXLE 35560 lb 25500 lb 10060 Ib
Carrier ID: 1 17.78 Tn 12.75 Tn 5.03 Tn
Name: 0 16.13 Mg 11.57 Mg 4.56 Mg
Product and Load Totals
ID: 106 JMF#:
Name: 1/2 HMA 50 gryo
Today: 1 Loads 5,03 Tn 4.56 Mg
To Date: 1 Loads 5.03 Tn 4.56 Mg
Seal: 307
Weighmaster: chris gross
Driver Copy
Invoice # V634655
a INVOICE Invoice Date 9/16/24
Account # 114482
Sales Rep JOHNNY SPENCER
Phone # 253-840-8558
1830 Craig Park Court Branch #302 Puyallup, NA
at. Loafs, no 63us Total Amount Due
Remit To s
CORE a MAIN LP
PO BOX 26330
ST. LOWS, NO 63146
Shipped To:
ACTIVE CONSTRUCTION, INC. 000/0000 22114 76TH AVE S
ACCOUNTS PAYABLE 00000 KENT, WA
PO BOX 430
PUYALLUP WA 98371 0162
CUSTOMER JOB-, 24-003 MILL CREEK/76TH 24-003
------------------------------------------------------------------- - ------- ------_------
Thank you for the opportunity to serve your We appreciate your prompt Payment.
Date Ordered Data Shipped Customer PO # Job Name Job # Bill of Lading Shipped Via Invoice#
9/12/24 9/13/24 SEE BELOW MILL CREEK/76TH 24-003 CORE & MAIN LP V634655
anaatity
Product Code Description Ordered Shipped B/O Price UM Extended Price
CUSTOMER PO#- 24-003 EM. SWR REPAIR
04083514 8 PVC SDR35 SWR PIPE (G) 14' 28 28 10.58000 FT 296.24 ✓
281068BASR 106-88ASR 8 CONCXCl/PVC CLPG 2 2 64.12000 EA 168.24
AMAZON SHEAR RING
29APLQ LUBE 1 QT F/WATER/SWR PIPE 1 1 N/C EA
FOR EMERGENCY SEWER REPAIR
PER JESSE M. 09/12/24
RECEIVED
SEP 17 202�
A ",i
Freight Delivery Handling Restock Misc Subtotals
Other:
Tax:
Teraas N=T 30
Ordered e=ays Jis M. ZS=G. SNMM R=PAXR Invoice Total:
rsaa This taction is governed by and subject to core t Main's standard terns and conditions, which an incorporated by reference and accepted.
To review these tss and condition, pleas visit: http://taadc.coreaadsain.coe/
00000 Page: 1
i ! ] �o Z tfTr 24 M-1&4 AVIn"
.DEL-NEAR CONCRETE ]Invoice
CUTTING & CORING 42151
iaz tooth St. S. RECEIVED
Tacoma. WA 98444
Ph # (253) 537-0109 SEP 2 3 2024
FAX # (253) 535-0507
ACI
TO V� _ DATE j2y� JOB NO. `
CONTACT PERSON
JOB LOCATION
TERMS: 30 DAYS, UNLESS OTHERWISE NOTED.
9s�
sas
7
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
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.
i•'
. Date: ; �� t- i,,� WORK ORDER
DEL-IIAR CONCRETE
CUTTING A CORIIIU i
152 100th�.S
Job# Tacoma,WA 98444 Contact j
(253)537-0109 Fax(253)535-0507
Phone# +
r
3
t
j
1I A
i
I
Any co West one.brick paving,sand cushion,dirtig rave I layers,railroad ties,rails or other
miscellaneous materials.or objects encfluntered during sawingldrilling operations will result in
additfonal charges
Signature of this worts order will be considered your notice of our intent to lien this project if
necessary. Interest at 1.5%per month will be charged on all past due accounts.
400 Valley Ave.N.E■
Puyallup,WA,M72
2538333705
http!/miles.rocks
MILES
SAND A GRAVEL Invoice#:10047585
Customer#:001700
ACTIVE CONSTRUCTION INC PROJEcr 84th AVE S&S 216TH ST
PO BOX 430, -KENT(2402831)
PUYALLUP,WA,98371 PURCHASE ORDER NUMB 24003
TmETS 2
RECEIVED nws 3
BLOQVLOT /
SEP 19 2024 TAXvrAXcom 0.00%/
21609 84th Avenue
40 DEUVERYADOREss South,Kent,WA,98032
INvOICE DATE 18 Sep 2024
Product Recap
PRODUCT CODE PRODUCT NAME QUANTITY UOM UNIT PRICE PRE-TAX TAX TOTAL
11 CDADUN 5.32SK CDF AIR 13.00 CY S132.00 $1,716.00 $0.00 $1,716.00
RMC100 ENVIRONMENTAL COMPLIANCE-RM 13.00 CY $8.00 $104.00 $0.00 $104.00
RMC101 FUEL SURCHARGE-READY MIX 2.00 LD $17.50 $35.00 $0.00 $35.00
TOTAL $1A55.00 $0.00 $1,855.00
Ticket details
PLANT TICKET PRODUCT QUANTITY UOM UNIT PRICE PRE-TAX TAX TOTAL
202 1149693 11 CDADUN(5.32SK CDF AIR) 10.00 CY $132.00 $1,320.00 $0.00 $1,320.00
RMC100(ENVIRONMENTAL 1.00 CY $8.00 $80.00 $0.00 $80.00
COMPLIANCE-RM)
RMC101(FUEL SURCHARGE-READY MIX) 1.00 LD $17.50 $17.50 $0.00 $17.50
TICKET TOTAL $1,417.50 $0.00 $1,417.50
202 1149755 11 CDADUN(5.32SK CDF AIR) 3.00 CY $132.00 $396.00 $0.00 $396.00
RMC100(ENVIRONMENTAL 1.00 CY $8.00 $24.00 $0.00 $24.00
COMPLIANCE-RM)
RMC101(FUEL SURCHARGE-READY MIX) 1.00 LD $17.50 $17.50 $0.00 $17.50
TICKET TOTAL $437.50 $0.00 $437.50
• r
Page 1/1
. DELIVERY RECEIPT
CUSTOMER COPY
OFFICE:253.833.3705
FAX:253.833.3746
MILES 400 Valley Ave ICE
SAND&GRAVEL Puyallup,WA 98372-2.516
DATE CUSTOMER# ORDER# CUSTOMER P.0 JOB# PLANT# TICKET#
9/18/24 001700 1074515 24003 223471 202 1149693
LOAD# CY ORDERED ICY OLVRD SLUMP LOAD TIME TAX CODE OYL TAKEN iPLT TIME OUT
1 10.00 10.00 7 12:55 PM FULL
UGALSAD
CUSTOMER NAME AIR% JOB TIME IN
2/3 LOAD
ACTIVE CONSTRUCTION GALS
JOB ADDRESS 1l3 LOAD SLUMP PLCD JOB TIME OUT
21609 84th Avenue South GALS
CITY I'
WORK TYPE REV COUNT HATER ADDED AUTHORIZED BY: PLT TIME IN
Kent, WA UTILITY TRENCH
QUANTITY UNITS I PRODUCT CODE DESCRIPTION UNIT PRICE AMOUNT
10.00 yd 11CDADUN 5.32SK CDF AIR
10.00 CY RMC100 ENVIRONMENTAL COMPLIANCE - RM
1.00 LD RMC101 FUEL SURCHARGE-READY MIX
DRIVER# TRUCK# PREVTRUCK DELIVERY INSTRUCTIONS SUB TOTAL
11663 1192 Trench in the middle of 84th.They will be just South of 84thAve S 8r,
DRIVER NAME S 216th St SALES TAX
Scott Shaw
SUPERP ADDED SUBGRADE I-OAD TOTAL
TERMS AND CONDITIONS GRAND TOTAL
1.HAZARDOUS MATERIALS. Concrete contains cement which may cause skin irritation.Avoid contact with skin and eyes.if you should come in contact with
fresh concrete,rinse/flush skin and eyes immediately. Seek prompt medical attention if required. Do not use without proper personal protective equipment(PPE).
2.DELIVERY CONDITIONS. All concrete deliveries will be made in concrete transit mixer trucks unless otherwise noted. The Customer agrees to provide
suitable roadways or approaches to the point of delivery. If unsuitable roadways or approaches are provided,Mlles Sand&Gravel Company(Niles)reserves the
right to stop deliveries until the conditions are remedied. In the event the Customer orders the delivery beyond the curb line,Customer will hold Miles harmless
against all liability resulting from damage to sidewalks,driveways or to the premises. In addition,if a mixer truck gets stunk and needs a tow of is damaged during
delivery.the expenses of that service and repairs to the truck associated with this incident shall be the responsibility of the Customer.
3.WASH OUT AREA. It will be the Customer's responsibility to provide a suitable area for the trucks to rinse and clean before leaving the job site.Additional
charges may apply it a wash out area Is not provided.
4.ADDITION OF WATER AND/OR FOREIGN MATERIAL. If water and/or foreign material is added to the concrete by or at the request of the Customer,its
employees,agents,contractors or subcontractors,Customer accepts the concrete as delivered and waives all right to reject,revoke acceptance or assert any
claim for breach of any warranty and Miles is not responsible for strength or properties of the Concrete.
5.See additional TERMS AND CONDITIONS on reverse.
I have read and agree to the terms and conditions on the delivery ticket.
X
Material Description Design Qty Required Batched %Var%Moisture Actual Wat
AGG001 SAND CLASS 2 2420 lb 25229 lb 25100 lb -0.51% 4.25%E 123 gI
CEM102 ASH GROVE SEATTLE I 150 lb 1500 lb 1505 lb 0.33%
CEM400 LAF 09-23 CLASS F 350 lb 3500 lb 3480 lb -0.57%
WAT001 WATER 1 350 lb 2055 lb 2025 to -1.45% 243 gl
ADX001 MAIR AE90 10.0 oz 100.0 oz 100.0 oz 0.00%
Actual Num Batches: 1
Load 32116 lb Design W/C: 0.700 Water/Cement: • 0.612 A Design 420.0-gl Actual 365.8 gl To Add: 54.4 gl
Slump: 7 00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gI /Load Trim Water: -5.0 gl / CY
Actual W/C Ratio:0.611 Actual Water: 366 gI Batched Cement: 4985 lb
W W W.MILE5.ROCKS
■ DELIVERY RECEIPT
CUSTOMER COPY
OFFICE:253.833,3705
FAX:253.833.3746
SAND i GRAVEL 400 Valley Ave NE
Puyallup,WA 98372-2516
'DATE CUSTOMER# ORDER# CUSTOMER P 0 JOB# IPLA202
NT# 1"'1149756
9/18/24 1 001700 1074615 24003 223471
LOAD# 2 CY ORDERED100 ICY DLVRID
13.00 SLUM 7 LOA TIME P M TAX CODE GALS 'CYL TAKEN PLT TIME OUT
. FULL LOAD
CUSTOMER NAME AIR% JOB TIME IN
ACTIVE CONSTRUCTION INC uGALSD
JOB ADDRESS SLUMP PLCD JOB TIME OUT
21609 84th Avenue South 11GALSD
CITY 'WORK TYPE REV COUNT 'WATER ADDED AUTHORIZED BY: PLT TIME IN
Kent, WA UTILITY TRENCH
QUANTITY UNITS PRODUCT CODE DESCRIPTION UNIT PRICE AMOUNT
3.00 yd 11CDADUN 5.32SK CDF AIR
3.00 CY RMC100 ENVIRONMENTAL COMPLIANCE - RM
1.00 LD RMC101 FUEL SURCHARGE-READY MIX
DRIVER# TRUCK# PREV TRUCK DELIVERY INSTRUCTIONS SUB TOTAL
13386 1149 1192 Trench in the middle of 84th.They will be just South of 84thAve S &
DRIVER NAME aS' 216th St SALES TAX
Mark Van Beek
SUPERPADDED SUBGRADE LOAD TOTAL
TERMS AND CONDITIONS iGRANDTOTAL
1.HAZARDOUS MATERIALS. Concrete contains cement which may cause skin Irritation.Avoid Contact with skin and eyes.If you should come in contact with
fresh concrete,rinse/flush skin and eyes immediately. Seek prompl medical attention if required. Do not use without proper personal protective equipment(PPE),
2.DELIVERY CONDITIONS. All concrete deliveries will be made in concrete transit mixer trucks unless otherwise rented. The Customer agrees to provide
suitable roadways cr approaches to the point of delivery. If unsuitable roadwaysAr approaches are provided,Miles Sand&Gravel Cam pany(Miles)reserves the
right to stop deliveries until the condilions are remedied. In the event the Customer orders the delivery beyond the curb line.Customer will hold Miles harmless
against all liability resulting from damage to sidewalks,driveways or to the premises. In addition,if a mixer truck gets stuck and needs a tow or is damaged during
delivery,the expenses of that service and repairs to the truck associated with this incident shall be the responsibility of the Customer.
3.WASH OUT AREA. It will be the Customer's responsibility to provide a suitable area for the trucks to rinse and clean before leaving the job site.Additional
charges may apply if a wash out area is not provided.
4.ADDITION OF WATER ANDIOR FOREIGN MATERIAL. If water andlor foreign material is added to the concrete by or at the request of the Customer,its
employees,agents,contractors or subcontractors.Customer accepts the concrete as delivered and waives all right to reject,revoke acceptance or assert any
claim for breach of any warranty and Miles is not responsible for simngth or properties of the concrete.
5.See additional TERMS AND CONDITIONS on reverse.
I have read and agree to the terms and conditions on the delivery ticket.
X
Material Description Design Qty Required Batched %Var%Moisture Actual Wat
AGG001 SAND CLASS 2 2420 Ib 7673 lb 7560 lb -1.47% 5.69%A 49 gl
CEM102 ASH GROVE SEATTLE 1 150 lb 450 lb 435 lb -3.33%
CEM400 LAF 09-23 CLASS F 360 lb 1050 lb 1035 lb -1.43%
WAT001 WATER 1 300 lb # 362 lb 365 lb 0.77% 44 gl
ADX001 MAIR AE90 10.0 0z 30.0 oz 31.0 oz 3.33%
Actual Num Batches: 1
oad 9397 lb Design W/C 0.600 Water/Cement 0.525. A Design 108.0 gl Actual 92.6 gl To Add: 15.5 gl
Slump 7.00 in # Water in Truck: 0.0 gl Adjust Water 0.0 gl /Load Trim Water: -5.0 gl / CY
Actual W/C Ratio 0.525 Actual Water 93 gl Batched Cement: 1470 lb
Miles Sand&Gravel Company
W W W.MILES.ROCKS
Ciss-tomer No: 600::D
Irvaice No: 31341)2'16
Irx Date: 091'.8,124
F1,111313:
S1
Cusbomer PO: 241:�3
I U Wimi'lire Ave SE Customer Job: MILL.("REEH'.176THAVE
P;iclft ffil 99:147
ACC
.0,CTlYl::::ONSTRUCT'.()N INC ICDN h4a,miEds
PO Hex,1130 1508 MaltinlineAve SE
Puyallup WA 98371
Ya Pecific.V.A 98047
208-57&::.200
aplamrineconallniction.corn
Dolhieredl;D., 76'rH AVE S.K;:NIT
Date Gtode -IM"Descrip QTY Um Unit Price Mad Tcillal Tax Total
Plant 011500 Aaburn SlLG
0911624 23S-5lIV-0'CRUSHED ROOK 15-D9 TON 15.50 23:..60 0.00 M.90
09118V 411TOCC-Em4owerdalSurcharge 46,14 E4 0.50 2:A'14 0.00 23.08
(1911824 4677!i0-I:uel Surctspe-Ton 46.14 Eh 0.35 1.".15 0.00 16.15
Tobil Irmate: 1:38.412 52:1.53 0.00 MI-53
Ticket number(s)shipped front plant 01500-Auburn-SAG
1 5013<0 191 *1150099W12
We Aplyaaaee You and Your f Wmeost
I?egisto.tribt*crux Customer Portal stri-,joniah!irioilsportai.myarr.ostpi)rtigl.4;orr.- llibuld you thila;tour immicin ilimailed or to make a
;mymeot om,the phone?Please imilsel Axcounts Receivable rat 59,41.536 31042
Finance,Chargas will:is apptiml to any late irvokes at it rate of 1 !:%per monti par cr,,di,:agniefmirit:or the States I-MAlful arnouni
IrivolmAinourit
AntountIF-iii1d:
Customer NgW11111: ACTIVE C014,1-
,rRUCTION INC
Curstooner No: 1141020 If you have um!t questions about your vvok*091DIrse call 206-575-3200
Involcallf: :84021 13
Data: (4/1812-4 Remit lNument To: ICON M;uWftIrl
Customer John IMIJ.CREEK/76TH AVE PO Bal 7424121
CUSU)'Iner PG: 24003 Los ArlIvIn.CA, 90074
Due Data: 10110.02.4
Pus-im-diii.rac M adchom beim-it yuu1119-Uld 11111 W 81M—41*4 it wi.-OK'm'w W-1a
..............
ICON Materials OFFICE COPY Ticket: 150099212
01500-Auburn S&G Date: 9/18/2024
4040 Kersey Way SE Time: 7:17:20AM
1 Auburn,WA 98092 Vehicle: REVENANTI3
Customer: 60020 Order: ACTIVE2404-MILL CREEK/76TH AVE AGG (FOB)
Cust.Name: Active Construction Inc Disp#: Pounds Tons
Address&Instructions: Job: MILL CREEK/76TH AVE Gross 54,780 27.39
76TH AVE 5,KENT P.O.: 24003 Tare 24,600 12.30
Net 30,180 15.09
Weighmaster: Crystal Swartz
Product Loads Total Qty Ticket UOM
2350 5/8"-0"CRUSHED ROCK 1 1509 15.09 Ton
Thank you for your business!
WARNING:NOT MIN ASPHALT(HMA)TEMPERATURES CAN EXCEED 330 DEGREES.Use appropriate protective equipment when working with HMA. See reverse side for warranty and shipment delivery conditions.
ICON Materials CUSTOMER COPY Ticket: 150099212
01500-Auburn S&G Date: 9/18/2024
4040 Kersey Way SE Time: 7:17:20AM
Auburn,WA 98092 Vehicle: REVENANTI3
Customer: 60020 Order: ACTIVE2404-MILL CREEK/76TH AVE AGG (FOB)
Cust.Name: Active Construction Inc Disp#: Pounds Tons
Address&Instructions: Job: MILL CREEK/76TH AVE Gross 54,780 27.39
76TH AVE S,KENT P.O.: 24003 Tare 24,600 12.30
Net 30,180 15.09
Weighmaster: Crystal Swartz
Product Loads Total Qty Ticket Qty UOM
2350 5/8"-0"CRUSHED ROCK 1 15.09 1509 Ton
Thank you for your business!
WARNING:HOT MIX ASPHALT(HMA)TEMPERATURES CAN EXCEED 330 DEGREES Use appropriate protective equipment when working with HMA. See reverse side for warranty and shipment delivery conditions.
ICON Materials CUSTOMER COPY Ticket: 150099212
01500-Auburn S&G Date: 9/18/2024
4040 Kersey Way SE Time: 7:17:20AM
Auburn,WA 98092 Vehicle: REVENANTI3
Customer: 60020 Order: ACTIVE2404-MILL CREEK/76TH AVE AGG (FOB)
Cust.Name: Active Construction Inc Disp#: Pounds Tons
Address&Instructions: Job: MILL CREEK/76TH AVE Gross 54,780 27.39
76TH AVE 5,KENT P.O.: 24003 Tare 24,600 12.30
Net 30,180 15.09
Weighmaster: Crystal Swartz
Product Loads Total Qjy Ticket Qy UOM
2350 5/8"-0"CRUSHED ROCK 1 15.09 15.09 Ton
Thank you for your business!
WARNING H01 MIX ASPHALT(HMA)TEMPERATURES CAN EXCEED 330 DEGREES Use appropriate protective equipment when working with HMA. See reverse side for warranty and shipment delivery conditions.
Page:
Invoice
S P�Cv I A L T I E S L L C NEW PAYMENT ADDRESS: Invoice Date: 09/24/2024
Highway Specialties LLC
P.O.Box 9094 PO Box 76660 Order Number: R017805
Brooks,OR 97305 Chicago IL 60675-6560 Order Date: 09/12/2024
Invoice Number: 0117514-IN
Customer Number: ACTIVECONSTRUCTION
Salesperson:
BIII To: Ship To:
Active Construction,Inc. Highway Specialties-Will Call
PO BOX 430 7220 River Rd E
Puyallup,WA 98371 Puyallup,WA 98371
Customer .0. ship VIA Rep Contact Contact Phone Teens
24-003 Cody-206-724-2245 ( ;;� NET 30
Item Cady Description Shipped Returned Rate Amount
Return Invoice
PCAAS/MB PCMS/MB-150 1 1 1,100.00 1,100.00
Daily: 200.00 Weekly 600.00 Monthty:1,100.00
Reri Penad: 09/13/2024 to 09/23/2024
a s Billed: 11
9/17/24-MB-150 SWAPPED TO MB-187,
CUSTOMER NEEDED A MINI FOR THIS JOB
SITE
Serial MB-187
Number.
PCMS/AAB PCMS/MB-170 1 1 600.00 1,200.00
Daily: 200.00 Weekly; 600.00 Monthty:1,30C.00
Rental Period 0911312024 to D9/2312024
Days Billed 11
'MB-170
Serial MB-1170
Number:
ARROW BOARDS Arrow Board-154 1 1 150.00 300.00
Daily: 85.00 Weekly 150.00 MonthlyA50.00
Rental Period 09/132024 to 0923/2024
Days Billed 11
AB-154
Serial AB-1
Number.
ARROW BOARDS Arrow Board-152 1 1 150.00 300.00
Daily: 85.00 Weekly: 150.00 Monthly:450.00
Rental Period: 09/1312024 to 09232024
Days Billed: 11
AB-152
Serial / AB-152
Nun* CEI Y C ED
SEP 2 4 2024
AN
Past due invoices and subject to a 2%Finance Charge per month Net Invoice: 2,900.00
- WA-PIERCE-2727 292.90
Cnl...Tn..
Invoice Totat 3,192.90
f C �ro 2-7
wInvoice
I�r��y
s - c C I Al ' i E S L L C NEW PAYMENT ADDRESS:
Date Invoice#
P.O.Box 9094 PO Box 75550
Brooks,OR 97305 Chicago IL 606764MO 9/17/2024 0014479-IN
Bill To Ship To
Active Construction,Inc. HIGHWAY SPECIALTIES
PO BOX 430 7220 RIVER ROAD E
Puyallup,WA 98371 Puyallup,WA 98371
S O No. P O No. Terms Rep Ship Date Contact Phone Reseller Permit Contact Name
0015751 24-003 NET 30 mschulty 9J172024 A16039625 CODY
206-724-2245
ftem 90Lption Ordered Invoiced Rate Amount
CONES:42133-TSO Tube,42-Grabber Tube w/refl.bands and no 50.00 50.00 13.50 675.00
base
CONES:4200-TB12 Base,12 lb.Rubber for Grabber or Looper tubes 50.00 50.00 11.00 550.00
SEP 17 2024
Past due invoices are subject to a 2%Finance Charge per month Subtotal 1,225.00
A-PIERCE-2727 Sales 0.00
Total 1,225.00
Payments/Credits 0.00
Balance Due 1,225.00
V02-7— 1 11Igg
0 United Rentals �II� ���������������II���I�I��II�� RENTAL RETURN
TRENCH SAFETY INVOICE
BiLt"M H52
7135 SzA7 9TS AVE s # 238913321-001
ssATTLa pa 9e10e-3431 _ —_--_-_._
206-767-3121 - - -
Customer $ : 227217
Invoice Date 09/19/24
9MERGENCY SINKHOLE REPAIR Rental Out : 09/16/24 02:00 PM
Rental In 09/18/24 01:56 PM
21609 8 4 TH AVE S UR Job Loc - AVE S,
WA 98032-2467 t7R Job S 76
customer Job ID
O Ordered By BILLIARD
h Office: 253-248-1091 Reserved By AARON
Salesperson TvLER rKAN
ACTIVE CONSTRUCTION INC V Invoice Amount: $3,776.33
PO BOX 430
rem,s: Ccn DuoUponReceiPt
PUYALLUP WA 9 8 3 71-016 2
Payment options: onbcl our reedit o1Fee 980304-8925
REMIT TO: UN[TED RENTALS(NORTH AMERICA),INC.
P O.BOX 051122
LOS ANGELES CA 90074-1122
RENTAL ITEMS:
Qty Equipment Description N.inlmllm .. Dav __ Week - - Month Amount
1 10230155 TRENCH BOX 8' X 20' (4" FB) 351.00 351.00 1,109.00 2,681.00 702.00
Make: SPEEDSHORE Model: TS-0820UR4
Serial: U-13-7361-S
1 11476688 TRENCH BOX 8' X 20, (4" FB) 351.00 351.00 1,109.00 2,681.00 702.00
Make: GME Model: 8X20 NKE
Serial: UM22041182G
8 940/5504 SPREADER BAR (KIT) 8" X 3'
4 941/9103 STACKING PINS FOR STEEL BOXES N!C
4 944/9946 ROAD PLATE 8' X 20' 101.00 101-00 298.00 613.00 808.00
2 330/7050 LIFTING BRIDLE 2 LEG X 8' 52-00 52.00 142.00 402.00 208.00
Rental Subtotal: 2,420.00
SALES/MISCELLANEOUS ITEMS:
Qty Item Price Unit of Measure Extended Amt.
8 NON-SKID PAINT ORANGE ;X-7102-5/FRWSTI 45.000 GALLON 360.00
1 WA HEAVY EQUIP. RENTAL TAX iDRSURWA/MCI] 37.905 EACH 37.91
1 DELIVERY CHARGE 306.200 EACH 306.20
1 PICKUP CHARGE 306.200 EACH 306.20
Sales/Misc Subtotal: 1,010.31
� V��V�� Agreement Subcotal: 3,430.31
Tax: 346.02
Total: 3,776.33
1
COMMENTS/NOTES: S E P 2_ 3 2024
CONTACT: JESSIE MARTIN ���
CELLO: 253-606-6909
Effective February 1, 2024 and where permitted by law, United Rentaln may impose a surcharge of 2.0% for credit card payments on
charge accounts. This lurch, go is not greater than our merchant discount rate for credit card transactions and is subject to sales
tax.
NOTICE: This invoice is subject to the tarns and conditions of the Rental and Service Agreement, which are available a.t
httpe://www-unitedrentals.com/legal/rental-service-tares-US and which are incorporated herein by reference. A COPY OF TEM RENTAL
A>® SERVICE AGREE MT TERKS ARE AVAILABLE LV PAPER FORK UPON REQUEST- Page: -
TLON RUs ITA C INVOICE
Tuniste Construction,LLC invoice No: 242907-01
4425 S.Orchard St. Date:9/24/2024
Tacoma,WA 98466
253-517-9988 Customer ID:Active
Active Construction Inc.
PO Box 430
Puyallup,WA 98371
24-003 MILL CREEK(AUBURN-KENT) Due upon receipt 101412024
-�-.00 5•*Sby TT-SS-SD RATE 9/17/2024 TX#:27832 gOZ"� $190.00 $1,520.00
Y6.00 G h/j TT-SS-SD RATE 9/1912024 TX#:28049 90?' $190 00 $1,140.00
Delivery / Tonnage Ticket No. 2°� �3?
CONSTRUCTION , LLC
JUNIST. A Date: Pre Trip: Post Trip:
J AM AM
Truck#: i PM PM
Leave Yard: Back to Yard.
253-517-9988 1 trucking@tcicon.com Trailer#: 1 V AM
www.tunistaconstruction.com I— --- Down Time:Truck Type: PM_ PM
4425 S Orchard St. Tacoma, WA 98466 Reason:
Super Solo T&T Onsite Hours:
Customer: Side Dump Solo
Travel Hours:
Job Name: Other:
r
aily
On the Job Injury? Yes Total D Hours:
Job Number: � / "� � �fV9"
MATERIAL FROM IN/OUT HAULED TO IN/OUT COST CODE TONS
'V Ile
i
i
i
Driver Signature: / Authorized Rep.Signature
Signature of this truck invoice will b6 considered your notice of our intent to lien this project, if necessary. Interest at 1-1/2%
per month will be charged on all past due accounts. Charges are due by the tenth of the month following date of this billing.
Delivery / Tonnage Ticket No. a`
CONSTRUCTION LLC
TiUNISTA Date: Pre Trip: Post Trip:
ff AM AM
Truck#: f PM PM
Leave Yard: Back to Yard:
253-517-9988 1 trucking@tcicon.com Trailer#: AM AM
www.tunistaconstruction.com —" — Down Time: --
4425 S Orchard St. Tacoma, WA 98466 Truck Type: PM PM
Reason:
T Super Solo T&T Onsite Hours:
Customer: Side Dump Solo
Job Name: Other: Travel Hours:
On the Job Injury? Yes Total Daily Hours: S f�
Job Number: i, No
MATERIAL FROM IN/OUT HAULED TO IN/OUT COST CODE TONS
�-,5-Vel
Driver Signature: Authorized Rep.Signature.
x X
Signature of this truck invoice will be considered your notice of our intent to lien this project, if necessary. Interest at 1-1/2%
per month will be charged on all past due accounts. Charges are due by the tenth of& month following date of this billing
�'STA"Cr;°"�`IC INVOICE
TUNISTA
Tunista Construction,LLC Invoice No: 242999-01
4425 S.Orchard St.
T Date: 10/29/2024
Tacoma,WA 98466
253-517-9988 Customer ID: Active
Active Construction Inc.
PO Box 430
Puyallup,WA 98371
o •
24-003 MILL CREEK(AUBURN-KENT) Due upon receipt 11/8/2024
2.00 TT-SS-SD OT RATE 9/18/2024 TX#:5164 CCC $205.00 $410.00
WWI f � ;' NO 5164
R�ON CAN TWFIM
OONSTRUCTI tw Svc, + r 7 M1Y SteewW CMq
OAIa 259�47 0730.mwAT
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to 259•A4?D Tox
• PO G"I"89 EdDnYAe,WA 9M • CeD:253•649'9474
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TCONSTRUCTION I.LC INVOICE
UNISTA
Tunista Construction,LLC Invoice No: 242999-01
4425 S.Orchard St. Date: 10/29/2024
Tacoma,WA 98466
253-517-9988 Customer ID: Active
Active Construction Inc.
PO Box 430
Puyallup,WA 98371
•■ Payment Terms Due Date
24-003 MILL CREEK(AUBURN-KENT) Due upon receipt 11/8/2024
• Descvin!ion Uri-Price Line Total TT-SS-SD RATE 9/17/2024 TX#:0580 RT $190.00 $475.00
6.50 TT-SS-SD RATE 9/17/2024 TX#: 01601 PNW $190 00 $1,235.00
7.00 TT-SS-SD RATE 9/18/2024 TX#: 0936 RT $190.00 $1,330.00,V-**
8.00 TT-SS-SD RATE 9/18/2024 TX#: 5164 CCC $190.00 $1,520.00
FA 0sv z7
Revenant Trucking LLC Truck Rental Ticket
718 Griffin Ave #911 Date: Truck No:
Enumclaw, WA 98022 Name:
(360)932-2666 Truck Type: Solo T&T Transfer Sde
revenanttrucking@gmail.com Start Time: '.La End Time: .
Total Hours: Job No:
Customer: �.;�, c�'�C_.. .Job Location:
Material From Arrive To Arrive Ticket# T
C7 r r`, i `tJ
77
Z .5
PNW Ground Works LLC DELIVERY TICKET DATE:
4227 S Meridian #C282
Puyallup WA 98373
253-448-1675 Truck No:
aIex@pnwgroundworks.com NO. y TruokType: T&T
GROUND WORKS
Customer: Truck Rate: Truck He
Job Location: Job Number: Billing Address:
Stag: AM PM Stop: AM PM Lunch: Downtime: Reason:
Material From To TonNard Load Time
Remarks:
Driver Signature:
Auth.Co.Prop.Signature: ;
NOTES: 1.PNW GROUND WORKS LLC will not be tpSpOn&Ve for damage caused by delivery inside curb line and/or property line
2.Any towing lees far vehicle inside oropeny is Ihi responsibility of customer
3.Interest of 1.5%will be charged per month foroulslanding invoices.
4.Signature of this truck invoice will be considered your notice of our intent to lien this project,if necessary.
5.Changes due by the tenth of the rnonlh following date of this billing.
Revenant Trucking LLC 'Truck Rental Ticket
718 Griffin Ave #911
Date: ITruck No:
Enumclaw, WA 98022 Name: -�
(360)932-2666
Truck Type: ;rSa6 ` T&T Transfer Super
revenanttrucking@gmail:com Start Time: �-. � End Time: •.d0
Total Hours: --IJob No:
Customer. Job Location: o r
Material From Arrive To Arrive Ticket# Tons/Yds
c 5 Cl
2759569
invoice DateNumber 30-2024
ktvoit�pate 09-30-2024
Payment Terms 30 Net
r Amount Due $ 3,385.00
o�
BILL TO hh V 1 REMIT TO
ACTIVE CONSTRUCTION 1"� Badger Daylighting Corp
P.O.BOX 430 PO Box 95000
Puyallup,WA 98371 LB# 1627
Philadelphia, PA 19195-0001
Bank Routing#:026013673
Account#: 03248177952
Customer Number PO/Work Order AFE/Job Badger Sales Area
10589057 24-003 24-003 40100
Service Ticket# Unit Item Description Qty Unit of Unit Price Amount
Date Measure
09-17-2024 TKT-091624-1312329 2238 Badger Hydrovac 5 Hour 265.00 1,325.00
With Operator
09-17-2024 TKT-091624-1312329 2238 Disposition 1 Each 450.00 450.00
09-17-2024 TKT-091624-1312329 2238 Supply Water 1 Each 50.00 50.00
09-17-2024 TKT-091624-1312330 2490 Badger Hydrovac 4 Hour 265.00 1,060.00
With Operator
09-17-2024 TKT-091624-1312330 2490 Disposition 1 Each 450.00 450.00
{ 09-17-2024 TKT-091624-1312330 2490 Supply Water 1 Each 50.00 50.00
Total Due USD 3,385-00
For your convenience,Badger accepts payment in multiple forms including check,ACH,EFT,and certain credit cards To
the extent permitted by applicable law, payments made by credit card are subject to a surcharge equal to 3% of the
transaction amount(or the highest percentage permitted by applicable law,if less than 3%) Please see attached tickets
for additional detail. Please direct all invoicing inquiries to accountsreceivable@badgerinc.com or(877) 322-3437 and
remittances to remittance@badgerinc.com Page 1 of 1
Delivery / Tonnage Ticket No. 29','e'"'�i
CONSTRUCTION I LLC
Date: Pre Trip: Post Trip:
TA
AM AM
T-UNISTruck#: PM PM
Leave Yard: Back to Yard:
253-517-9988 1 trucking@tcicon.com Trailer#: AM AM
PM PM
www.tunistaconstruction.com Down Time:
Truck Type:
4425 S Orchard St. Tacoma, WA 98466 Reason:
Super Solo T&T Onsite Hours:
Comer: Side Dump Solo
Travel Hours:
Job Name:
Other:
On the Job Injury? Yes Total Daily Hours:
Job Number: No
MATERIAL FROM 1IN/OUTI HAULED TO IN/OUT COST CODE TONS
I
Driver Signature. Authorized Rep.Signature:
X x
Signature of this truck invoice will be considered your notice of our intent to lien this project, if necessary. Interest at 1-1/2%
Baer month will be charged on all past due accounts. Charges are due by the tenth of the month following date of this billing.
No.
LR TRUCKING Truck No.: 3 Truck Charges:
PO BOX 851 -tuck T : fit' Dnver Chu -
Buckley,WA98321 Tnrdcpate; Y '(� subtotal:
Phone 253-218-7743
Truck Hours: r -Add.
Ddm Hours Tali -
'f3111fng
Customer _
Job .lob
Location: Number,
Stag I ♦1 tJ Lunch: Downtlmc: Reason:
MATERIAL mom t NO LOADS
Fuel: ofk Tole)!rifles: Totes Wes QY-Htway.
'Remarks
Diners signalura. Ruth.Co. nature:
SFgnatum of this truck molce will he considered your notice of our Intent to lien this project,If necessary.
Interest at 1%per month will be charged on all past due accounts.Changes due by the tenth of the month following date of this bllgng.
I
DiBella Enterprises Inc.
i
CLIENT
I
718 Griffin Ave. DATE No.
PUB 410
Enumclaw WA,98022
206-423-5980 LOT JBLK roBLocAnON JJOB#
TONNAGE HOURLY DRIVER'S COMPANY DRIVER'S NAME
i
START STOP TOTAL HAULED FROM HAULED TO
I
EQUIP# MATERIALTYPE
S�O TNT X-FER S DUMP BELLY j EXCAV I DOZER I ROLLER I BOBCAT I LOADER
LOAD COUNT
TIME TICKET NET T9,1E I TIME 11CKET NET TBAE
(LOAD) NO WT (DUMP) (LOAD) NO WE (DUMP)
1 13
2 14
9 15
4 18
6 117
fi 18
7 19
B 20
3 21
10 22
11 23
12 24
TOTAL LOp0.S IMPORT TOTAL HOURS /
FOREMAH'SSIGNATURE DATE TOTAL LOADS EXPORT INVOICElI ('
WHITE-OFFICE YELLOW-DRIVER
PINK-CONTRACTOR
Signature of dus Muck trwolee WWI be considered W police of our etterlt to men this project 4 necessary.
Maenset at I%per month will be charged on all past due accamt`Charges due by the lerah of go month fcAowmg dste Of ttds b0ft
DiBella Enterprises Inc.Is not responsible for Any Damage to any property,personal or real.
Customer is Allowed 10 minutes to unload truck,After that Standby time is$120.00 Der hour.