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HomeMy WebLinkAboutCAG-20-065 - Duvall - Progress Payment 8 6 TO: FINANCE DIRECTOR Date: 08/04/2022 FROM: TRANSPORTATION DESIGN MANAGER CONTRACTOR: Reed Trucking&Excavating,Inc. 2207 Inter Ave,Suite A,Puyallup,WA 98372 CONTRACT NO. CAG-20-065 ESTIMATE NO. 8 PROJECT: Duvall Ave NE Project 1. CONTRACTOR EARNINGS THIS ESTIMATE $ 405,572.08 2. SALES TAX @ 10.10% $ 900.92 3. TOTAL CONTRACT AMOUNT THIS ESTIMATE $ 406,473.00 4. EARNINGS PREVIOUSLY PAID CONTRACTOR $ 2,977,441.03 5. EARNINGS DUE CONTRACTOR THIS ESTIMATE $ 405,572.08 6. SUBTOTAL-CONTRACTOR PAYMENTS $ 3,383,013.11 7. RETAINAGE ON PREVIOUS EARNINGS S - 8. * RETAINAGE ON EARNINGS THIS ESTIMATE $ - 9. SUBTOTAL-RETAINAGE $ 10. SALES TAX PREVIOUSLY PAID $ 37,298.13 11. SALES TAX DUE THIS ESTIMATE $ 900.92 12. SUBTOTAL-SALES TAX $ 38,199.05 * Contractor has a retainage bond on file with the City, retainage=0% GRAND TOTAL: S 3,421,212.16 FINANCE DEPARTMENT ACTION: PAYMENT TO CONTRACTOR(Lines 5 and 11): SCHEDULE A ACCOUNT: 317.122702.015.595.30.63.001 $ 396,652.08 Schedule A Sub-Totals $ 406,697.28 Schedule A Materials on Hand(MOH) $ (10,045.20) SCHEDULE B ACCOUNT: 425.455580.015.594.34.63.000 WATER UTILITY el Schedule B Sub-Totals $ 4,350.00 $ 4,789.35 agafou r 08/05/2022 Sales Tax $ 439.35 SCHEDULE C ACCOUNT: 317.122702.015.595.30.63.001 Schedule C Sub-Totals $ 4,570.00 $ 5,031.57 Sales Tax $ 461.57 TOTAL THIS ESTIMATE: $ 406,473.00 ., .,!Pi .. N. w ti � oZ a� P w " L L SD t' " >H + N> > u a .,.. c a' 1 11FP1 """1 iWiTillgi s Mil HUU3 .VUIV ?asP i zoa gg ° 6 U pz zIIP ! ¢PP Q ! g g E .i p W N C D 1 8 i NJd m s $ m §<1 g: r< rr n ,q§44. pNf.aGG G > GGFG GF -. 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Red'i'IlIKMIRiillid r FHWA: Pay Period 7/1/2022 to7/28/2D22 No. Completed Project Estimates Date: August 3,2022 Paymentr includes.,lma led overruns,und.rr<.,1_ Contract This Proms:Payment PreW,us Payments Payments to Oat* Estimate.,Complete Estimateat Completion Change Bid Item l OesodptI0n I Unit I unit Price J Quantity I Cost Quantity Cost Quantity I Cost Duen5Ry j Cost Quantity I Cost Quantity I Cost %d Contr0 Orders Schedule A Change Orders Schedule A Change Orders C0.1 R.uen1. 1499 Rota/ewe Sond 1.5. $2,583.00 1.00 52,585.00 0 50.03 1 52.5E5.00 1.00 52,535.00 0 5000 100 52,583.00 100.00 C.O.1Tot.1, $1,565.03 50.02 $2.515.00 52.535.00 50.00 52,585.00` 100.00 C.O.2 FO TrwRwbn Panel awe N/A No Cost Change Order $0.00 1.00 5000 0 50.Do 1 $0.00 1.00 50.m 0 50.00 1.03 5000 10100 C0.2 Taub 50.60 $0(0 50.a0 $0.00 $0.00 $000 100.00 C0.3 T,ipk Tree Remote. 3-A100 Triple Tn.Removal LS. 53,339.00 1.00 $3,339.00 0 S0.00 1 53,339.00 1.00 $3,339.00 0 5000 100 $3,33920 10020 C.0.3 Totals 53,339.130 S0.00 53,339.03 53339.00 50.00 53,339.00 100.00 C.O.4 Tee 1 Red endon CSEC N/A No Cost Chance Order $0.00_ 120 $0.00 0 50.00 1 5000 1.00 $0.00 0 50.110 1A0 50.00 103.00 CO.4 Tools $0.00 SOAR 5000 50.00 S0.00 50.00 100.00 C0.3 WetComilla. _ 541101 Natural M Lieu d Recycled CSTC TON $14.62 1,16003 $16,302.00 0 5020 0 50.00 0.00 $0.00 0 $000 0.00 $0.00 0.00 6 5.9102 Water Control PA 513,691.00 120 523,E98.00 0 5020 0.6671 515,30627 0.6671 $15,806.27 0.34 96.057.32 1.01 523,66559 10371_ C0.5 Totals 540,023.00 50.00 $15,80627 515,801327 $1,057.32 $13,66539 Sim GO.6 CO to CS6Ae.ld.n 5-0101 Nalurd In lieu of Ritoyded 6TC TON $14.12 .1,100.00 -$16,302.00 0 50.00 0 50.00 0.00 $0.00 0 $0.00 0.03 $0.00 0.00 6•6101 Natural I.Uw 34 Renyded OTC 'TON 514.12 1,153.00 517,017.46 0 30.03 791117 511.710.32 730.17 511.710.32 377 43 05,594.25 1167.65 517.30457 101.37 AS Welty Coma.Resolution PA. 524003.0D -1.00 414,00003 0 50.00 0 S000 0.00 S000 O 50.00 0.00 Saco 0.00 6•40 Utility Collect Resolution P.A. 524,21454 1.0 $14,214.54 0.09903 $2,397.97 0.41848 510,13312 0.517507 511,531.19 0.49 $11,1/5.12 101 924,39631 1C0.75 A28 Unsuitable Founded,.Eaow6en C.V. 56000 -40000 -524,030.0D D $0.00 0 $020 0.03 $0.00 0 50.00 0.00 50.00 0.00 6.A21 Unsuitable Foundation Eacmticn LT. 560.00 430.00 $25,1303.00 96.87 55,93220 13.05 54,91303 161.92 $10,915.20 160 515.63300 441.92 516,515_70 102.77 C.O.6 Totals 52,320.00 $3,33017 $16,82654 535,156.71 533,05931 $64116.08 2436.15 CO.7 Stern.Resider et ell A24 REMOVING CEMENT CONC.CURS Li. $MOOD .190 -$1,903.00 0.00 $0.00 003 50.00 0.00 50.03 0.03 50.00 0.00 50.00 0.00 7.174 REMOVING CEMEMCONC CURE Li. 010.0 70S 52,050.00 000 50.00 000 50.00 0.00 50.00 205.00 52,050.00 205.00 _ 52_05003 100.00 A1$ REMOVING ASPHALT CONC. PAVEMENT 39. 525.00 -1,230 -530,750.00 0.03 $0.03 000 00.00 000 50.00 020 $0.00 0.00 $0.00 0.00 7425 REMOVING ASPHALT CONC PAVEMENT S.T. 525(0 1.31D 532,750.03 57.55 51,438.75 123.15 510578.75 10170 011,01750 450.00 511,25003 1,330.70 533,26750 101.58 A35 CRUSHED SURFACING TOP COURSE TON $40.00 .2,570 .5102,900:0 000 50.00 000 So co 000 MCC 000 5000 000 50.00 010 2.435 CRUSHED SURFACING TOP COURSE TON 54000 2,543 5203,32000 1,294.92 $51,796.80 511.90 $10,47620 1,806.32 572,171.80 10000 532,00003 1,60662 $104,172.60 103.92 A37 NAM CL 1/2 IN.PG 6422 TON $103 00 -7,410 .1763130 CO 000 50.00 003 50.00 0.00 50.00 0.00 50.03 000 5000 0.00 7.1137 AMA CL 1/210.PG 6421 TON $103co 7,445 5766.835 D0 4.15 54277.45 617.17 563,56131 62132 $63,99596 6,12100 5703,19403 7,44931 0797,179.96 100.06 A48 DDCTLE IRON SEWER PIPE 11 IN. 04934. LF. 590,00 -210 -525,20020 0.00 50.00 0,03 50.00 020 3020 000 $0.00 0.00 90.00 0.00 • 0 City of Renton Progress Payment No 8 Project Name: Duvall Avenue NE CAG: CAA2o$5' TIB: N/A Contractor: Reed Trading and extrados FHWA: Pay Period: 7/1/2022 to 7/28/2022 No. Completed Project Estimates Date: August 3,2022 Payments Includes ntknat.dov.Fmn,,undo rn.ns. Contract This Provos Paymot Previous Paynnnts Payments tooate Estimate to ComtNet. Es:Anat.at Comd.tlan Chan.. Old Item Dnotnion Unit Unit Price Quantity Cost Quantity Cost Quantity Cott Quantity Cod Quantity Cost Quantity Cost If of Contract Orden .74/6 OIJCTR!CON SEWER PIPE 12 IN. DIM, LF. $9020 400 536,0[0.00 000 50.03 296,10 $26,649.00 296.10 526,64900 104.00 59,360.00 400.10 53620920 100.03 AS6 CATCH BASIN TYPE 1 EACH $1,400.02 .25 5$35,00100 0.m $002 0.00 $0.m 0.03 $0.01 0.00 $0.00 Om 50.00 0.m '7-ASO CATCH 1ASIN TYPE 1 EACH $1,4m.00 It 539,100.02 003 50.00 25110 $35,0m.00 25.m $35,00000 4.00 $5,600.00 29.00 540,020.02 103.57 A75 CEMENT CONC.TRAFFIC CURB AND WTTEII LF. $2520 -4,600 4115,000.00 0.m 5002 0.00 $0.02 0.00 $0.00 0.00 $0.m 000 $0.00 0.00 74173 CEMENT CONC TRAFFIC CURS AND GUTTER L.F. 525130 015 5115375.00 2213.50 552.967.50 1,61200 541,200.00 3.76750 594,117.50 90702 $22,500.02 4,667.50 9116,63730 101.14 __ 7-A103 ADDITIONAL SURVEY 1.5. 51,680.m 1 51,630.00 0.m $0.m 1.00 $1,680.00 1.02 51,560.m 000 $0.m 6.m 51,660.m 10000__ C0.7 Totals 523330.00 5106,650.50 $209,152.26 $315,802.76 5736,044.03 $1,101,346.76 4722.18 COO Co e.nt Covet.Poke Adp,gnwnb br Wert Seep A and C 3A104 CEMENT CONCRETE PRICE ADJUSTMENTS FOR WORK 20.4E5 A AND C C.y, 584.29 21335 518,000.13 030 20.00 185.75 $24,085.37 215.75 524,08527 220.00 $18,543.10 5C6.75 012,629.67 236.13 C0.4 101.k $18200.13 50.02 524,015.82 524,08547 516.543.60 $42,529.67 236.33 C.O.9 SIdounluttiol Fasting 9-16105 90EWAUFWAU FOOTING LF. $15.41 1,455.00 022,42155 134.10 02,061.94 6m30 $12,328.00 934.00 514,352.94 525.00 $6,090.25 1,459.02 222,413.19 10027 C.0.11 Teton 022,42155 52.064.91 512,32820 114,392.94 53,09025 $22,43319 10027 CO.10 R.M.F.112 Fw,6.Me Eats 10v3106 RELOCATE 112FOIINO4T1ON FORM FA $2,500.0) 1.00 52,500.00 020 00.00 125 54,626.93 1.65 $4,626.93 0.00 $0.00 1.85 $4,626.93 115.01 C0.10Tota $2,500.01 0000 54.626.93 54,526.93 5002 54,52633 145.08 CO.LE M.It..br.Tree R.momt 11-A107 MULTIPLE STEM TIME REMOVAL L5. 54,937.23 1.00 54.90723 0.00 50.m 1.m $4,907.21 1.01 01,907.38 0M $0.m 100 51,907.11 100.10 CO.11 To1.k 04.907.20 500 $4,307.23 $4,907.28 50.00 54,907.28 107.00 C0.12 s&n.n woos....Tc Msa6ewM 32-6106 ADOMONA1 CNANNn12A7roN DEVICES IA 311,00100 100 311,000.00 0.00. 30.00 04838 05,322.19 0.4131 55,322.19 0.01 50310 0.48 35,322.29 48.36 12-A109 SIGNAL 61001NCATION ASSISTANCE FA 33,500.02 1.m S3,500.00 0.00 5000 0.63 52E16.88 0.63 32,216.88 047 $1,645.00 110 33,862.88 110.34 C.0.12 Teets 511,500.02 50.90 $7,539.07 57,535.07 $1,645.03 $9,124.07 5150.72 Schedule A Plus C.O.Totals $4,824,135.4E- $406,697.28 2,341,825.2' $2,748,622.50 $2,216,550.15 $4,965,07I.65 $0.00 , QCity of Renton Progress Payment No 8 • Project Name: Duvall Avenue NE CAG: CAG20.065 n8: N/A Contractor. Reed Trucking and Excavating FNWA: Pay Period: 7/1/2022 to 7/28/2022 No. Completed Project Estimates Date: August 3,2022 Payments Includes estimated vnnurn,und.Nrna. C0n31aCt mit Progress Payment Previous Payments Payments to Date ESBnata to Compel Estimate at Completion Chang old Kent l Desalptlon l Unit I Unit vricr I Quantity I Cost Qum tty I Cost Quantity l Cost Quantity I Cost Quenelle l Cost Quntty l Cost 3 of Contract Orden Schedule 8 Schedule B a1 1 MOBILIZATION AND DEMOImON (NOT TO EXCEED 10%Of TOTAL Of BO SCHEDULE II LS. $15,03040 $15,000.03 0.00 50.m 0.50 512Dm.00 0.80 512,000.03 020 $3,000.00 1.m 515,00000 1m.00 32 TRENCH SAFETY SYSTEMS LS. $2,000.03 1 $1,000.00 0.m $0.00 0.96 51,920.00 0.96 $1,920.00 0.04 580.03 1.0) $2,000.00 103.03 REMOVAL AND REPLACEMENT OF 13 VNA1TIAeLFfOUNCATION TON 560.00 100 $6,000.00 0.00 S0.m 0.00 $0.03 0.03 $O.03 Imm $6,C00.m 100.m $b000.00 10103 BA SELECT IMPORTED TRENCH 6ACONLL TON 539.m 1,265 541,275.m 0.00 SO.m 1,0 1.19 $36,441.65 1,041.19 $36,441.65 221.61 ST.533.35 1,265.00 561.275A0 1m.00 /1`i >< $0.00 50.m $o.00 0.00 $0.00 $0.00 0.00 $0.00 000 56 FURMSH AND INSTALL LINO.'Cl 52 20 WATER MAIN WITH RESTRAINED/COO FITTINGS A410 POLYETHYLENE ENCASEMENT I.P. 1140.00 52,803.00 0.00 Sam 24,45 $3,623.00 24.15 $3,423.00 10m $2,em.m 44.A5 56.723D0 222.15 MO FURNISH O INSTALL OI NC1 CL 52 62 _ WATER MAIN WITH RESTRAIN E0.1OIOINT FITTINGS AND POLYETHYLENEFNCA0EMENT LF. $125D0 $7,750120 0.03 $0.02 62.95 57,668.75 62.95 $7,666.71 Om $0.m 62.95 $7,868.75 10153 NC LNO 6e FURNISH A INSTALL 14 CI.52 740 WATER MAIN WITH RESTRAINED-4MT FITTINGS AND POLYETHYLENE ENCASEMENT LF. $135D0 $99,91D0 0m $am 729.50 593,68230 729.50 598,482.50 0.00 $0.00 72930 5911,48230 9E58 B9 A00nIONAL DUCTILE IRONRTTINGS 18S *CO 3600 $18,001.m 0m $0.00 632.00 63,16003 612.00 $3,160.m Om $0.00 632.00 53,160D0 17.56 510 CONOIETE FORTHR05T 6LO0I13G CY. $100 0 27 $2,70D0 0.00 50.00 1632 $1,612.03 1531 51,652.00 5.03 $500.00 21.52 52,152.m 79.70 B11 CONNECTION TO mow WATER A MAN EACH 53,50010 $11.m0.00, am $O.m ID0 $14,020.03 4.00 514,030.m 003 $000 4.00 $14,000.00 100.00 512 CUT AND CAP EXISTING WATER 11 MAN AND AI ANOON E10SIING WATER FA0UTIE5 EACH $650m $7,110.m A.00 $1,600.0 9.00 55,830.m 13.00 $8,450420 9m 55,850.00 12.00 S14,30100 200.m ~ >"< 5000 $D.m Saco moo So co Sono am SOLO 0.00 a14 PUMAS/1 MM N57A11 LINO.'GATE 2 VALVE ASSEMBLY EACH 5L400.00 526m.m 0.m 50.03 2.00 52,800.00 2.m 52,900.00 Om $0.00 2.m $2,e07.m 100.m on FURNISH AND INSTALL 11.N0H GATE 1 VALVE ASS106113 EA01 $2,Smm $2.50000 0.03 50.00_ 1.m $2,500.m 1.m 52,100.03 0.03 $0.03 1.03 $2,500.m 303.m 316 FURNISHANO INSTALL 16-0101 GATE 1 VALVE ASSEMBLY EACH 51.colco $I,o03.00 0.03 $0D0 1.120 $$00300 1.00 58,003m 0.00 $0 0 l.m $9.000.02 100.120 517 FURNISH ANC INSTALL F9tE 2 HYDRANT ASSEM6Iy ON NEW WATER MAIN EACH $9,00000 $I6,030.m 0.03 $0.00 2.m $16,1100.00 2.00 $16.000.00 0.m S0.03 2.03 516,000.00 100m •®- City of Renton Progress Payment No B Project Name: Duvall Avenue NE CAG: CAG2E6065 TIC: N/A Contractor: Reed Trucking and Eacavating FHWA: Pay Period: 7/1/2022 to 7/28/2022 No. Completed Project Estimates Date: August 3,2022 Payments Indud.s«nmat.d mrn.,:,und.muns. Contract This Progress earn we Previous Payments Payments to Dale Estimate to CampMt. Estimate at Cornpl.dan Chang* Lid n.m I Desvlptlon Un.I Unt Price 3,,aninyr I Cost Quantity Cost Quantity Cost Quantity Cost Quantity Cost Quantity Cost 76 or Contract Orden •818 FURN19t ANO INSIAATTRE 70 HYDRANT ASSEMKY ON ECM-TWO WATER MAN INCLUDING WET TAP EY APPROVED WET-TAP CONTRACTOR EACH 53,000130 556,000.00 003 5000 5.00 510,003.00 5.00 51Q000.00 2.00 516,000.00 7.00 556,000.00 100.00 $19 FU6A6511 AND INSTAt.1J0101 1 WATER SERVICE CONNECTION EACH 51,70900 51.70000 0.00 50.00 100 51,700.03 100 $1,700.00 0.03 $0.03 1.00 51,700.0D 100.03 820 STORMWATER POLLUTION 1 PREVENTION(AND TESC)PLAN ANO IMPIEME00AT09S1 L5. 51p00 CO 51.000.00 0007 50.00 0.960 5960.00 0.56 596000 0.01 540.00 1.03 51.000.00 100.03 FURNISH AND INSTALL I.INCH 831 PERMANENT$IDW-0FF ASSEM6IY EACH 53,500.00 1 53500.00 050 $1,750.00 0.50 $1,750.00 1.00 $3,500.00 0.00 Saco, 1.00 53,503.00 100.00 Sub-Totals S311,075.00 $4,350.03 5258.507.30 5262,857.90 542,10335 5304.96125 9803 Washington Stat.Sales Tax 101% S31,118.58 $139.3S $25,109.30 S26518.65 54.25I.44 530.1101.09 Schedule I Totals $347,191.51 $1,78935 $M1,617.20 $2g9,408.3S $11,35579 5335,752.34 91.03 City of Renton �'nta" Progress Payment No 8 Project Name: Duvall Avenue NE CAG: CAG20.065 TIB: N/A Contractor: Reed Trucking and Excavating FHWA: Pay Period: 7/1/2022 to 7/28/2022 No. Completed Project Estimates Date: August 3,2022 Payments Indudes estimated 0Pe.,,,n.,und.nvna. Contract TNs Prope"Payment Previous Payments Payments to Otte Estimate to Complete E,tanal..1ComplNbn Otani. Old Item I OHefp0on I unit I Unit Pde.I Quantity I Cost Chantey I Cost Quantity I Cost Quantity I Colt Qtannty I Cost Quantrty I Cost %of Contract Orden Schedule B Change Orders Schedule B Change Orders co.x Sam SOLO $0.00 am SO.m 50.m 0m Saco 'mot 50.00 $0.m Sam SO.m O.m $0.60 8ON/01 Sam Sam $0.m 0m 50.m $0.03 0.m 50m 1131v/01 CO.x Tote% I sum $0.03 5003 S0.07 SCAM Sam 81V/SI C.O.xx $0m $am 50.00 0.m Sam saw am $0m ON/01 $0.m taco $0m am $0.m 50.m O.m 50m mEg/0I $0m _ 50.m 50.m am 50.00 50.00 am Sum 40N/01 co.xx Taub I $0.00 Sam $am 0.03 5000 $0.m $am SON/01 Schedule a C.O.sudr.lr. Sam Sam $o.m• $0 CO Sam Sam IIDN/OI Washington state Sales Tea 10.1% $0.m 50.m $0.00 50.03 $0.00 $Om Schedule a Change order Totals 50.m Sam Saco Sam Stem $0.00 IDN/OI Schedule B Pius Schedule B C.O.Totals $342,493.58 $4,789.35 $284,617,20 $289,406.55 $46,355.79 $335,762.34 91.03 Schedule C Schedule C a 9KCPWI Le. 5903.00 1m 5300.00 0.m $C.m 1.m $503.m 1.00 $500.m am $a.m 1.07 5503m 1m.m C2 111061.1101014 U. $10,00000 1.00 $10.000m 0.00 Sam 1.m $10,000.03 1.00 510,003.03 MOO $0.00 1.00 $10,000m 103.00 • CI 1004TVTIUT7 TRENCH V. $1mm 110.03 51e.m0.m Om sum 200m S2a,003.03 im.m 520,m3m 3100 $3,200.00 732.00 523,20003 121119 Co LATERAL TRENCH LF. 57500 1,13000 $66.25000 0.00 Sam 669193 550,175.03 669m 550,175.00 48000 536,075.03 1.150.00 506.250.03 10100 INSTALL VAULT•P5E TM Cs 2'6'a2'6S2-0' EACH $amen 2.03 51,60D.00 0m $0.00 000 $a.m moo Sato 2.m 51.600 00 2.00 $s.603.m 103.m INSTALL VAULT.PSE ME CO a'S'itSt65'S' EACH $1.000m 4.D0 5e,m0.m 1.m 51.020.00 1m $1,m0m 2m $2,Cm.m lm $2,0m.m 4.00 5440000 100.00 INSTALL VAULT-PSC TYPE 07 5'3'22'9'12'Y EACH $1,000m 1m 51,0m.m ow Sam am $0.00 0.03 $0.m 1.00 $1.000.m 1.130 $1.Om.m 100.m IN37111.1 VAULT•COMCASTME CI 1'6Y7e'PEDESTAL EACH $750.m 1,00 575003 040 $000 am 50.m 0.03 SO.m 1.03 $750.00 1.03 $750.00 100.00 INSTAL r'°°'S 1T PIPE-2IN.NMI.- a MA LF. 512.00 30.110 5360.03 000 Sum 103.03 5163603 203.03 32,436.00 003 50.00 203.00 52,06.03 676.67 INSTALL CONDUIT PIPE•31N.MAIN.- a0 ME L f. $13m 27000 53,51000 360.2 $466.03 010 50.00 36.00 5461.03 34000 $3,120.00 176.00 53,555,0 102.22 INSTALL CON01x7 PSI-a IN,DAM.• a1 PSE 001. Sum 3,280A0 536,090.00 12203 51,342.00 1,22950 $24,524.50 1.351.50 $25.666.50 1,020.00 $111:00.07 3,35150 $36,366.50 102.16 *WALL CONOIXT PPE-6 IN.DIAN.. 0.12 95E LF. $22m 22a00 Kamm g0.00 $1,760.m CUM $0.03 10.00 $1.760.m 140.03 $3,08000 220.00 54,5.000 100.00 0 City of Renton Progress Payment No 8 Project Name: Duvall Avenue NE CAG: ,CAG 20.065 Tie: N/A Contractor: NsalTomailigand elicavoliing FHWA: " Pay Period: 7/1/2022 to 7/21/2021 Na. _ Completed Project Estimates Elate: August 3,2022 Payments Induda minuted au.rruna,undarons. Contract This Progress Payment Previous Payments Payments to Clete Estimate to Complain Estimate at Cos plied.+ Ch.ng* Miler" Oacriabon Unit UntPO.Quantity Cost Quantity Coat Quantity Cost Quantity Cost �au.ntity Cost Quantity Cost %of Contract Aden aa5TA11rva11ATPR.4111 t1U61.• c$300g1CAST U. $1 loon $1,sam00 000 $0.00 195.00 $2,145.03 095.00 $2,115.00 000 50.00 195.00 52,145.00 103.33 Sub-Totals 5163,870.00 54,570.00 5110,780.50 5115,350.50 561,825.02 5177,17550 104.91 Washington Stele Saiet 10.1% 517,055.17 5461.57 511,18923 $11,650.40 $6,24433 $17,894.73 3,h.dul.C Totals 5185,925.32 55031.57 5121,96933 3127.00190 560,00133 519507023 104.92 Schedule C Change Orders Schedule C Change Orders Co.vac Saco $0.00 50.00 OM Saco S0.c0 moo $0.0o $01 VN1 $0.03 $0.30 $0.00 50.00 0.00 50.00 /DI IOI $0.00 50.00 50.00 0.00 50.00 50.00 000 50.00 eOIVrol C.O.nxa Tat.h $0.00 50.00 $000 $0.00 Sa00 $0.00 1101V101 COX= $000 $0.00 50A7 0.00 30.00 50.03 000 $0.00 301Vro1 $0.00 50.00 50.03 0.00 50.00 50.89 0.00 50.00 001V/01 50.00 50.00 50.00 000 50.00 50.00 0.00 50.00 eONrol C0.%1000 Totals 50.00 50.00 50.03 O.CO 50.03 50.00 5000 304V/01 Washington Statasra Tax 101% 50.00 $0.00 $0.00 $o.co 50.0o SO.00 Schedule C Owtge Order Taub $0.00 50.00 SO.o0 50.00 Schedule C Plus Schedule C C.O.Totals j185,925.81 $5,031.51 3121,365.13 $127,000.40 $68,069.39.33 $195,070.2� 9 Se.co +olvrol Total Schedule A,B and C Pius Change Orders $5,352,554.90 0 City of Renton Progress Payment No 8 Project Name: Duvall Avenue NE CAG: LAG 20-065 T13, N/A Contractor: Reed Malin/and Excavating THWA: Pay Period: 7/1/2022 to 7/28/2022 No. Completed Project Estimates Date: August 3,2022 Payments s,cs,da,r,t:oated teeny n,ocderranc Contract Ttv,P,oere,t Payment Previous Payments Payments to Date E,tnnate to CoogHt. Estimate et Caveletion Chem. Pad Item 1 Geunr,n., I Gels I wake.I Quantity I Coil OVan:ny I Coat Quantity I Coat 'auanttly I Coat Dnant r i coat Qua.,I Cost Saatraaer,o drain •Schedule A Materials on Hand(MOH for BI A44 Storm Sewer Pipe,to AS9 Tree Box Unit,HI ABS Electrical System Complete and BI B18 FH stub) -S10,045.20 S266,327.40 S256,282.20 e•Deferral $0.00 $0.001 $0.00 Schedule A Plus Schedule A C.O.Totals $406,697.28 $2 341,825.23J $2,748,522.50 Schedule B Plus schedule B CO.Totals S4,789.35 $284,617.20 $239,406.55 Schedule C Plus Schedule C CO.Totals $5,031.57 S121,969.33 $127,000.90 Total All Schedules and Change Orders,MOH and Deferrals $406,473.00 S3,014,739.16 S3,421,212.15 Retainage 0%due to Retalnag4 Bond S0.00 SO.63 50.00 Pay This Amount $406,473.00 Approvals For This Progress Payment Signatur_ �— Date Resident Engineer r t — 2,1* Contractor s ltue___ --- Date :ate''" __.. ,� T. R.V-i41,A/, +e0.e.— Project Manager ;,_-..ie8/5/2022 Transportation Design Mgr. 4o6Yt M.Reason 1 V7Am Washington State 47,1 Department of Transportation ' Field Note Record (Sketch Grid) - Renton - Duvall Avenue NE Book No. Page No. 55 Contract No. Station 1 Line C/S CAG 20-065 King County Staked By Date Work Started Work Completed 8/3/22 7/1/22 7/28/22 Calculated By 1 Date Checked By TLS Date Inspector's Signature Date MB 8/3/22 8/3/22 135.5 Da-s Expi ed A3 -Typ: B Pr•gress Schedule= 80% [Schedule Submitted] + 0% [80% Contract Work Com- pleted] = 80% o date - 80% pr v= 0%this estirr ate A4 : Proj-ct Re• Line Dr �in s = 75% [135.5/262 s +j a g / days] 0% [Record Drawings not submitted] ' = 38.79'/o to d:te - 33.06% prey= 5.73% this estimate A5 -Cont actor Surveying = 1*(13.0%[Start up/Mob]+9.4%[Saw Cut Limits]+0 75x9.4%[HVF] +0.90x10.•%[St•rm/Satitary Sewer]+3.8%[Water Vlain]+0.90x5.8%[Ut lity Vaults]) + : w.r. - ' , - • 1 ••- - :. --.- 'o :. :v :.;e , • Ain/Traffic Sig- _ I.- 11 -.•°,[Monuments]++fl*( ind oanrne.izat n/Signs )V = 78.66'o to date -69.51% prey= 9.15%this estimate A6 -ADA Featu e Surveying = 0.751x75%for work complete+ 0x25%.upon completion = 56.3°. to da - - 43.8% pre = 12.5% this estimate V A9 -Covi•-19 H-alth aeld Safety Plan= 25% for approved plan + 75% [135.5/262 days] = 63.79'/o to d:to - 5 .06% prey= 5.73% this estimate A10 - Ot er Te pora Traffic Control = 100% [135.5/262 days] = 51.72%to d:te -4 .08% prey= 7.64% this estimate All -Tra lc Co trol S pervisor 100% [135.5/262 days] LZ- • = 51.72/o to d.:te -4 .08% prey= 7.64% this estimate • Group Basis of Material CAPS Entry _ Initials Item No. Item No Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. A3 Type B erogress 7/28/22 LS 0% N/A Calc Mg TLS 8 SchPA4 Project Red Line 7/28/22 LS 5.73% N/A Calc MB TLS 8 Drawings A5 Contractor Surveying 7/28/22 LS 9.15% N/A Calc M B TLS 8 A6 ADA Feature Surveying 7/28/22 LS 12.5% N/A Calc Mg TLs 8 A9Cov Safety Plan Health and 7/28/22 LS 5.73% N/A Calc 1 MB TLS 8 Safety Plan A10 Other temporary Traffic 7/28/22 LS 7.64% N/A Calc MB TLS 8 Control Traffic Control A11 7/28/22 LS 7.64% N/A Calc MB TLS 8 Supervisor DOT Form 422-636 EF Revised 9/96 _ s Wil Washington State Department of Transportation Field Note Record (Sketch Grid) Renton - Duvall Avenue NE - Book No. Page No. 54 Contract No. Station Line C/S CAG 20-065 King County Staked By Date Work Started Work Completed 8/3/22 7/1/22 7/28/22 Calculated By 1 Date Checked By Date Inspector's Signature 1 Date MB 8/3/22 TLS 8/3/22 A^. - el-vi-io Inspectioi = ::5. % or oik •m•let-d 8-.1°. to da e -85.1% pr:v= 0° thse-ti at: , _ _r _ 0.0 t.R , -lpI -u Gc . _ '•• 1•;iiiuuniiiiiuiu iiiii- d-.4, i ;poi° t giusimiliiiiiiiiii jt' d- le ri - 0°-,tp r-vI - is - 1sti °• tionf• :10y :ete•,fl . . • •e=_Co(1 • 880. • II ■og 0nf ..i, 9-c Ji _1' M sot orosi . 9. '% •u•co tr to s 0:: - ot:m] + Ii.7°o[L•t d-m• e isti g o po er s] 0 (30.:% Ins all lig t st• &fi rel+ 1.4°.[R-lo• -t: se ic- o •ntrelle ] + 4.0'/o[I, st.:ll s•la po e ed rad:r -ignl + 3.4./o[1 stall -yst-m •ir- a d er in-tios] ' 0. %[Lo te'.tint a d -Ok- i •:]) 51.6 % io d:te -4'.3:% •re = 6.30%thi• esim:te Group Basis of Material CAPS Entry Initials ' Item No. Item No. Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. A62 Television Inspection 7/28/22 LS 0% N/A Calc MB TLS 8 A63 Erosion Control and Water 7/28/22 LS 7.64% N/A Calc MB TLS 8 Pollution Prevention A68 Plants for Landscaping 7/28/22 LS 0% N/A Calc MB TLS 8 A71 Irrigation System 7/28/22 LS 0% N/A Calc MB TLS 8 Restoration A72 Irrigation System 7/28/22 LS 0% N/A Calc MB TLS 8 A85 Electrical System, 7/28/22 LS 3.35% N/A Calc MB TLS 8 Complete DOT Form 422-636 EF Revised 9/96 Washington State �/ Department of Transportation Field Note Record (Sketch Grid) Renton - Duvall Avenue NE Book No. Page No. 53 Contract No. Station Line C/S CAG 20-065 King County Staked By Date Work Started Work Completed 8/3/22 7/1/22 7/28/22 Calculated By Date Checked By Date Inspector's Signature Date M B 8/3/22 TLS 8/3/22 A: • - -e a en Si_ning = 10%for work completed 10 A t• d:to 1 1% prey= 0% this estimate A:i - -e o ing Pa ement Markings = 10.0%for work completed 16.0°. to da e - 10% prey'= 0% this estimate B1 - ob iz- io a d Demobilization = 40% [5%contract work completed] + 40% [10% contract w• • - e• + ;I•0 upon completion L/ : % . - e -8 0% prey=0%this estimate B- - re ch • =ty System = 96.0%for work completed •;.0'o t• d- e - •.D°/c prey= 0% this estimate B.0-St•rm at-r •ollution Prevention Plan and Implementation = 5.0%for work completed •;.0% t• d- e -96.0% prey= 0%this estimate A107 Multi le to Tree Removal = 100%for work completed 160%to •at- - 00% prey= 0% this estimate if- Group Basis of Material CAPS Entry Initials Item No. Item No Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. A86 Permanent Signing 7/28/22 LS 0% N/A Calc MB TLS 8 A87 Removing Pavement 7/28/22 LS 0% N/A Calc MB TLS 8 Markings B1 Mobilization and De- 7/28/22 LS 0% N/A Calc MB TLS mobilization 8 B2 Trench Safety Systems 7/28/22 LS 0% N/A Calc MB TLS 8 B20rermwatnrPollution Plan 7/28/22 LS 0% N/A Calc MB TLS 8 Prevention A107 Multiple Stem Tree 7/28/22 LS 0% N/A Calc MB TLS 8 Removal _ DOT Form 422-636 EF Revised 9/96 1( . 1 City of Renton Duvall Ave NE G&O#20593 PP8 Working Days expired= 135.5 A3 Min Bid Req-Type B Progress Schedule 80%at first est,20%at 80%contract Complete 0% A4 Project Red Line Drawings $13,000•.75'(135.5/262)-prev paid 5.73% AS Contractor Surveying %sub item %sub kern to %sub item Completed per prey $to be paid be paid this Sub Items LS Price %of LS Item Completed to Date period this period period Mob $6,500.00 13.00% 100% 100.00% $0.00 0.00% Sawcut limits $4,700.00 9.40% 100% 100.00% $0.00 0.00% HVF $4,700.00 9.40% 75.0000% 75.0000% $0.00 0.00% Storm and San. $5,300.00 10.60% 90.0000% 90.0000% $0.00 0.00% Water Main $1,900.00 3.80% 100.0000% 100.0000% $0.00 0.00%FHS and Conne Utility Vaults $2,900.00 5.80% 90% 90.00% $0.00 0.00%Jbox and PSE v: Curb/E pay $11,000.00 22.00% 81.7592% 40.1675% $4,575.08 41.59% Walls $1,600.00 3.20% 54.9828% 54.9828% $0.00 0.00%Sidewalk-Wall I Illumination/Signals $5,400.00 10.80% 77.7778% 77.7778% $0.00 0.00% Final Chan/Signs $3,500.00 7.00% 0% 0.00% $0.00 0.00% Monuments $2,500.00 5.00% 50% 50.00% $0.00 0.00%Control Total $50,000.00 100% $ 4,575.08 Total This Period 9.15% A6 ADA Features Survey 75%for ADA survey complete,25%for ADA measurements-prey paid 12.50% A9 Covid HSP 25%at plan submittal,75%(prorated working days)-prey paid 5.73% A10 Other Temp Traffic Control prorate by working days-prey paid 7.64% All Traffic Control Supervisor prorate by working days-prey paid 7.64% A21 Removal of Structure and Obstruction 100%paid out 0% A62 Television Inspection Percentage of work complete-prey paid 0% A63 Erosion Control and Water Pollution Prevention Prorage by working day-prey paid 7.64% A68 Plants for Landscaping Percentage of work complete-prey paid 0% A71 Irrigation System Restoration Percentage of work complete-prey paid 0% A72 Irrigation System Percentage of work complete-prey paid 0% A85 Electrical System,Complete 825000 %sub item %sub item to I %sub item Completed per prey $to be paid be paid this Sub Items LS Price %of LS Item Completed to Date period this period period Install Light Pole Foundations $180,000.00 21.82% 72.00% 60.00% $21,600.00 12.00% Install Foundation for Flasing beaconB $15,500.00 1.88% 100.00% 100.00% $0.00 0.00% Install new light Std and fixture $254,000.00 30.79% 0.00% 0.00% $0.00 0.00% Install Foundation for relocated HAWK signal $11,000.00 1.33% 50.00% 50.00% $0.00 0.00% Relocate Existing HAWK Signal $1,500.00 0.18% 50.00% 50.00% $0.00 0.00% Relocate Flashing Beacon pole $1,500.00 0.18% 100.00% 100.00% $0.00 0.00% Install conc pad for service or controller $3,500.00 0.42% 50.00% 50.00% $0.00 0.00% Relocate controller or service $3,500.00 0.42% 0.00% 0.00% $0.00 0.00% Install solar powered radar sign $33,000.00 4.00% 0.00% 0.00% $0.00 0.00% Install conduit and boxes per trench foot $205,879.00 24.96% 86.078886% 86.08% $0.00 0.00% Install system wire and terminations $27,821.00 3.37% 0.00% 0.00% $0.00 0.00% Lot demo existing components $6,000.00 0.73% 100.00% 0.00% $6,000.00 100.00% Lot testing and splicing $1,800.00 0.22% 0.00% 0.00% $0.00 0.00% Subcontractors MOB-Totem $80,000.00 9.70% 100.00% 100.00%, $0.00 0.00% Total $825,000.00 100% $ 27,600.00 . Total This Period 3.345% ie A86 Permanent Signing Percentage of work complete-prey paid 0% A87 Remove Pavement Markings Percentage of work complete-prey paid 0% B1 Mobilzation and Demob-Water System 80%for mob and'20%for final cleanup 0% B2 Trench Safety Systems Percentage of work complete-prey paid 0% B20 SPPC Plan Percentage of work complete-prey paid 0% CI SPCC Plan 100%paid out 0% C2 Mobilization 100%paid out 0% Washington State AlW / Department of Transportation Field Note Record (Sketch Grid) Renton - Duvall Avenue NE Book No. Page No. 52 Contract No. 'Station Line C/S CAG 20-06.5 King County Staked By Date Work Started Work Completed 8/3/22 7/1/22 7/28/22 Calculated By Date Checked By Date Inspector's Signature Date MB 8/3/22 TLS 8/3/22 Material On -land text in italics are previous MOH deductions Totem Invoices: PP1 =$16,800 conduit: 86%installed to date*$16,800=-$14,516.83 -(-$14,516.83) Net change = 0 PP2 = $18,121 jboxes : 86%installed to date*$18,121=-$15,584.08-(-$15,584.08) Net change = 0 PP3 = $11,987 for wire : (19/EA/25EA)*$11,987 installed=-$9,389.04-(-$9,389.04) Net change = 0 PP5=$41,855 Anchor Bolts: (19EA/25EA*$41,855 install WZC&B=-31809.80-(-$21,764.60), Net change=-$10,04520 PP5=$114,860 Light Poles:Zero installed. Net change=$0 Ferguson Invoices: PP2 :$36,112(pipe): =90%installed*($36,112) installed =-$35,575.01-(-$35,575.01) Net change = 0 PP4 = $82,556- (100%installed*$82,556-(-$82,556) Net Change = 0 Ferguson Invoice: PP5 = S218,530 (Filterra): (10EA/13EA)*S218,530 =-$168,100-(-$168,100) Net change = 0 Net change to MOH: = (0- 0-0-$10,045.20-0)+(0- 0- 0) _ (Totem) +(Ferguson) = -510,045.20 r �- Group Basis of Material CAPS Entry Initials Item No. Item No. Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. MOH Totem (PP1) 7/1/22 LS -$0 Visual TLS •8 MOH Totem (PP2) 7/1/22 LS -$0 Visual TLS 8 MOH Totem (PP3) 7/1/22 LS -$0 Visual TLS 8 MOH Totem (PP5) 7/1/22 LS -$10,045.20 Visual TLS 8 MOH Totem (PP5) 7/1/22 LS -$0 Visual TLS 8 ,MOH Ferguson (PP2) 7/1/22 LS -$0 Visual TLS 8 MOH Ferguson (PP4) 7/1/22 LS -$0 Visual TLS 8 `MOH Ferguson (PP5) 7/1/22 LS -$0 Visual TLS 8 I I DOT Form 422-636 EF Revised 9/96 • City of Renton Duvall Ave NE G&O 420593 0.24 PP8 Materials On Hand Yet To be Invoice Description PP1 PP2 PP3(+) PP3)-) PP4(+) PP4(-) PPS(+) PP5(-) PP6(+) PP6(•) PP7(-) PP8(-) installed Totem(PP1)49323272584 (Conduit) $16,880.03 41,132.70 -$2,350.00 -$1,057.30 •$426.00 49,550.83 $2,363.20 Totem(PP2)49324949716 (box and vaults) $18,121.68 •$7,973.24 -$1,449.68 -$6,161.72 $2,537.04 Totem(PP3)42934755 and 4325478145(wire and Jbox lids) $20,594.37 -$8,607.84 4781.20 $11,205.33 Totem(PP5)2926217 (Anchor Bolts) $41,855.00 •$16,742.00 -$5,022.60 -$10,045.20 $20,090.40 Totem(pp5)2926217-01 (street light poles) $114,860.00 $114,860.00 Totem(PP6)(street light fixtures) $60,868.62 $60,868.62 Ferguson(PP2)1028177 and 1061343(PP Storm Pipe) _ $39,527,79 48,076.14 -$3,566.00 -$4,607.57 -$18,021.29 -$1,304.01 $3,952.78 Ferguson(PP4)(DI water and storm pipe) $82,556.00 -$10,442.00 -$15,039.00 -$57,075.00 $0.00 Ferguson(PPS)1058045 (Filterre) $218,530.00 -$100,860.00 -$67,240.00 $50,430.00 Shope(PP2)10015802 and 10015804(CBs) 55,621.12 -53,563.10 -$396.40 -$1,361.62 $0.00 Total This Period $16,880.03 $63,270.59 -$1,085.41 $65,801.60 $343,503.27 -$79,949.95 -$142,112.76 410,045.20 411 h. v7/ Washington State Department of Transportation Field Note Record (Sketch Grid) Renton - Duvall Avenue NE Book No. Page No. 51 Contract No. I Station Line C/S CAG 20-065 J King County Staked By Date Work Started Work Completed 8/1/22 7/1/22 7/28/22 Calculated By Date Checked By Date Inspector's Signature Date MB 8/1/22 TLS 8/3/22 Force AccoL nt Summary A8 - Resolution of Utility Conflicts 6/30/22 = $266.32 -$238.10 (prey pad on PP7) = $28 22 7/18 -$115812 7/19 -$1211,63 Total = $2397.97 Group Basis of Material CAPS Entry Initials Item No. Item No. Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. Resolution of Utility 7/28/22 FA $2397.97 N/A Calc MB TLS 8 A8 Conflicts DOT Form 422-636 EF Revised 9/96 Washington State Field Note Record (Sketch Grid) Department of Transportation Renton - Duvall Avenue NE Book No. Page No. 50 Contract No. Station Line C/S CAG 20-065 King County Staked By Date Work Started Work Completed 8/3/22 7/1/22 7/28/22 Calculated By Date Checked By Date Inspector's Signature Date MB 8/3/22 TLS 8/3/22 A39 -Asphalt Price Adjustment July- $58.74 A96 Fuel Cost Adjustment July - $2789.52 Group Basis of Material CAPS Entry Initials Item No. Item No. Date Unit Quantity RAMS No. Acceptance No. Post OK Est.No. Asphalt Price 7/28/22 CalC $58.74 N/A Est. MB TLS 8 A39 Adjustment A96 Fuel Cost Adjustment 7/28/22 Calc $2789.52 N/A Est. M B TLS 8 DOT Form 422-636 EF Revised 9/96 I � PP8 Asphalt Cost Price Adjustment (Worksheet) BASE COST $445.00 UPPER THRESHOLD Note:Base Cost and Current Reference Cost to be taken from WSDOT website below LOWER THRESHOLD http:/Nwwv.wsdot.wa.siov/biz/construction/pdf/referencecosts.pdf CURRENT REFERENCE COST $720.00 ELIGIBLE BID ITEM UOM Qty This Est. Used$720.00 effective date 7/18. May need to revise for PP9. HMA CI. 1/2 In. PG 64-22 Ton 4.15 HMA for Approach Cl. PG HMA for Preleveling Cl. PG HMA for Pavement Repair Cl. PG Commercial HMA Sum of Quantities 4.15 Asphalt Cost Price Adjustment $58.74 For Current Estimate(Payment/Credit) Note: Base Cost=the reference cost posted on the Agency website for the period immediately preceding the bid opening date. Current Reference Cost=the most current cost posted on the Agency website on the day of estimate cut-off. Asphalt binder reference cost WSDOT https://wsdot.wa.govi • Less-wsdot/how-do-business-us/public-works-... Search Q Asphalt binder reference cost Find the latest average selling price of asphalt cement for both eastern and western Washington. An asphalt cost price adjustment provision is included in all of our contracts that use hot mix asphalt.The prices published below are used to determine the credit or payment amount when there are qualifying changes in the reference cost of asphalt binder, as specified in the contract special provisions.This information is updated frequently, however,there is no set schedule.The reference cost posted is for the period immediately preceding the bid opening date. We establish the asphalt binder reference cost from the selling price of asphalt cement furnished by Poten and Partners, Inc.for the Pacific Northwest: • Western reference cost is based on the selling price for the Seattle,Washington area • Eastern reference cost is based on the selling price for the eastern Washington area, including northern Idaho The asphalt binder reference cost will be the average of the selling price for each Friday during the specified period.Asphalt binder reference costs are posted at the end of the period. Date Effective Begin Period End Period Eastern Western 07/18/2022 07/01/2022 07/15/2022 $762.50 $720.00 07/11/2022 06/16/2022 06/30/2022 $759.17 $700.83 06/14/2022 06/01/2022 06/15/2022 $743.75 $690.00 1 of 15 8/1/2022. 12:09 PM FUEL COST ADJUSTMENT PP8 (WORKSHEET) BASE FUEL COST 3.41 dollars http://wvwv.eia.aov/petroleum/QasdieseU U.S.On-Highway Diesel Fuel Prices(dollars per gallon) Upper Threshold West Coast less California Lower Threshold Monthly Fuel Cost 5.84 dollars http://vwvw.eia.gov/petroleum/gasdiesel/ U.S.On-Highway Diesel Fuel Prices(dollars per gallon) West Coast less California ELIGIBLE BID ITEM UOM Qty This Est. Factor Q BI 26 Roadway Excavation Incl. Haul CY 2302 0.29 gal/cy 667.58 6-A 28 Unsuitable F Excavation Incl. Haul CY 98.87 0.29 gal/cy 28.6723 Excavation Incl. Haul-Area CY 0.29 gal/cy 0 Borrow Incl. Haul CY 0.25 gal/cy 0 BI 27 Gravel Borrow Incl. Haul Ton 73.12 0.17 gal/ton 12.4304 BI 31 Structure Excavation Class IB Incl. Haul CY 0.25 gal/cy 0 Shoring Or Extra Excavation Class A L.S. 0.04 gal/dollar 0 7-A 35 Crushed Surfacing Top Course Ton 808.30 0.70 gal/ton 565.81 Crushed Surfacing CY 1.02 gal/cy 0 Processing And Finshing MI 270.00 gal/mile 0 Agg.From Stockpile For BST CY 0.61 gal/cy 0 Furnishing And Placing Crushed CY 1.02 gal/cy 0 7-A 37 HMA Cl. 1/2 In. PG 64-22 Ton 4.15 0.90 gal/ton 3.735 HMA For Ton 0.90 gal/ton 0 Commercial HMA Ton 0.90 gal/ton 0 Cement Concrete Pavement CY 1.00 gal/cy 0 Cement Concrete Pavement-Including Dowels CY 1.00 gal/cy 0 BI 42 Concrete Class 4000 CY 1.00 gal/cy 0 Commercial Concrete CY 1.00 gal/cy 0 Superstructure L.S. 0.02 gal/dollar 0 St. Reinf. Bar LB. 0.02 gal/lb 0 Epoxy-Coated St. Reinf. Bar LB. 0.02 gal/lb 0 Sum Of Q 1278.23 Monthly Fuel Cost Payment/Credit $2,671.50 + $68.15 + $49.87 = $2,789.52 IMP NOTE: Base Fuel Cost=Weekly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon)dated on the nearest Monday occuring three weeks prior to bid opening. Monthly Fuel Cost=Most recent Monthly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon). FUEL COST ADJUSTMENT PP7 (WORKSHEET) BASE FUEL COST 3.41 dollars http://wvwv.eia.aov/petroleum/aasdieseU U.S.On-Highway Diesel Fuel Prices(dollars per gallon) Upper Threshold West Coast less California Lower Threshold Monthly Fuel Cost 6.08 dollars htto://vwwv.eia.aov/petroleum/aasdiesel/ U.S.On-Highway Diesel Fuel Prices(dollars per gallon) West Coast less California ELIGIBLE BID ITEM UOM Qty This Est. Factor Q BI 26 Roadway Excavation Incl. Haul CY 0.29 gal/cy 0 BI 28 Unsuitable F Excavation Incl. Haul CY 13.18 0.29 gal/cy 3.8222 _ Excavation Incl. Haul-Area CY 0.29 gal/cy 0 Borrow Incl. Haul CY 0.25 galley 0 BI 27 Gravel Borrow Incl. Haul Ton 1090.99 0.17 gal/ton 185.468 BI 31 Structure Excavation Class B Incl. Haul CY 0.25 gal/cy 0 Shoring Or Extra Excavation Class A I L.S. 0.04 gal/dollar 0 7-A 35 Crushed Surfacing Top Course Ton 0.70 gal/ton 0 Crushed Surfacing CY 1.02 gal/cy 0 Processing And Finshing MI 270.00 gal/mile 0 Agg.From Stockpile For BST CY 0.61 gal/cy 0 Furnishing And Placing Crushed CY 1.02 gal/cy 0 BI 37 HMA Cl. 1/2 In. PG 64-22 Ton 0.90 gal/ton 0 HMA For Ton 0.90 gal/ton 0 Commercial HMA Ton 0.90 gal/ton 0 Cement Concrete Pavement CY 1.00 gal/cy 0 Cement Concrete Pavement-Including Dowels CY 1.00 gal/cy 0 BI 42 Concrete Class I 40001 CY 1.00 gal/cy 0 Commercial Concrete CY 1.00 galley 0 Superstructure L.S. 0.02 gal/dollar 0 St. Reinf. Bar LB. 0.02 gal/lb 0 Epoxy-Coated St.Reinf. Bar LB. 0.02 gal/lb 0 Sum Of Q 189.291 Monthly Fuel Cost Payment/Credit $441.05 Total NOTE: $372.90 included in PP7 Base Fuel Cost=Weekly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon)dated on the nearest Monday occuring three weeks prior to bid opening. Monthly Fuel Cost=Most recent Monthly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon). $68.15 additional in PP8 r FUEL COST ADJUSTMENT PP6 (WORKSHEET) BASE FUEL COST 3.41 dollars htto://www.eia.gov/petroleum/gasdieseU U.S.On-Highway Diesel Fuel Prices(dollars per gallon) Upper Threshold West Coast less California Lower Threshold Monthly Fuel Cost 5.62 dollars http://www.eia.qov/petroleum/aasdiesel/ U.S.On-Highway Diesel Fuel Prices(dollars per gallon) West Coast less California ELIGIBLE BID ITEM UOM Qty This Est. Factor Q BI 26 Roadway Excavation Incl. Haul CY 0.29 gal/cy 0 BI 28 Unsuitable F Excavation Incl. Haul CY 2.86 0.29 gal/cy 0.8294 Excavation Incl. Haul-Area CY 0.29 gal/cy 0 Borrow Incl. Haul CY 0.25 gal/cy 0 BI 27 Gravel Borrow Incl. Haul Ton 0.17 gal/ton 0 BI 31 Structure Excavation Class lB Incl. Haul CY 0.25 gal/cy 0 Shoring Or Extra Excavation Class A L.S. 0.04 gal/dollar 0 7-A 35 Crushed Surfacing Top Course Ton 102.57 0.70 gal/ton 71.799 Crushed Surfacing CY 1.02 gal/cy 0 Processing And Finshing MI 270.00 gal/mile 0 Agg.From Stockpile For BST CY 0.61 gal/cy 0 Furnishing And Placing Crushed CY 1.02 gal/cy 0 BI 37 HMA Cl. 1/2 In. PG 64-22 Ton 591.37 0.90 gal/ton 532.233 HMA For Ton 0.90 gal/ton 0 Commercial HMA Ton 0.90 gal/ton 0 Cement Concrete Pavement CY 1.00 gal/cy 0 Cement Concrete Pavement-Including Dowels CY 1.00 gal/cy 0 BI 42 Concrete Class 4000 CY 18.5 1.00 gal/cy 18.5 Commercial Concrete CY 1.00 gal/cy 0 Superstructure L.S. 0.02 gal/dollar 0 St. Reinf. Bar LB. 0.02 gal/lb 0 Epoxy-Coated St.Reinf. Bar LB. 0.02 gal/lb 0 Sum Of Q 623.361 Monthly Fuel Cost Payment/Credit $1,165.69 Total $1,115.82 included in PP6 NOTE: Base Fuel Cost=Weekly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon)dated on the nearest Monday occuring three weeks prior to bid opening. Monthly Fuel Cost=Most recent Monthly U.S.On-Highway Diesel Fuel Prices(Dollars per Gallon). $49.87 additional in PP8 • + West Coast less California Gasoline and Diesel R- Prices https://ww---!-.gov/dnav/pet/pet_pri_gnd dcus_r5xca_m.htm eiiU.S. Energy Information Administration PETROLEUM & OTHER LIQUIDS OVERVIEW DATA ANALYSIS&PROJECTIONS Weekly Retail Gasoline and Diesel Prices (Dollars per Gallon, Including Taxes) Area: r West Coast less California v Period: Monthly Show Data By: PP6 PP7 j PP8 View (? Product C Area Graph Clear Feb-22 Mar-22 Apr-22 May-22 Jun-22 1 Jul-22 History Gasoline-All Grades 0 3.916 4.670 4.703 4.956 5.469 5.208 1998-2022 All Grades-Conventional l Areas 0 3.941 4.698 4.720 4.964 5.443 5.237 2000-2022 All Grades-Reformulated Areas 0 3.814 4.557 4.629 4.917 5.577 5.081 1998-2022 Regular i' 0 3.840 4.595 4.623 4.878 5.392 5,128 1998-2022 Conventional Areas 0 3.8651 4.622 4,640 4.885 5.363 5,156 2000-2022 Reformulated Areas 0 3.742, 4.487 4.557 4.850' 5.511 5.012 1998-2022 - Mid grade rode 0 4.890 4.940 5.175 5.688 5,468 1998-2022 4.155❑ Conventional Areas 4.902 4.946 5.178 5.663 5.486 2000-2022 Reformulated Areas 0 4.1071 4.829i 4.902 5.160 5.825' 5.372 1998-2022 Premium 0 4.304 54062 5.104 5.357 5.864 5.605 1998-2022 Conventional Areas 0 4.307 54671 5.102 5.352 5.835 5.618 2000-2022 Reformulated Areas ❑ 4.286 5.033! 5.1141 5.384 6.031 5.529 1998-2022 Diesel(On-Highway)-All Types 0 4.266 5.279 5.293 5.619 6.080 5.840 2011-2022 Ultra Low Sulfur(15 ppm and I I Under) 0 4.266 5.279 5.293 5.619 6.080 5.840 2011-2022 Click on the source key icon to learn how to download series into Excel,or to embed a chart or map on your website. -=No Data Reported; --=Not Applicable; NA=Not Available; W=Withheld to avoid disclosure of individual company data. Notes:Conventional area is any area that does not require the sale of reformulated gasoline.All types of finished motor gasoline may be sold in this area.RFG area is an ozone nonattainment area designated by the U.S.Environmental Protection Agency(EPA),which requires the use of reformulated gasoline.We stopped publishing Low Sulfur On-Highway Diesel(LSD)prices at the U.S.level on December 8,2008,because fewer stations were selling LSD as a result of EPA diesel fuel regulations.We continued to coiled LSD prices from retail outlets and included them in the Diesel Average All Types price until July 26,2010, when no more outlets reported LSD sales.Beginning July 26,2010,publication of Ultra Low Sulfur Diesel(ULSD)price became fully represented by the Diesel Average All Types price.As of December 1,2010(September 1,2006 in California),any on-highway diesel fuel sold is ULSD as mandated by EPA on-highway diesel fuel regulations.We did not collect weekly retail motor gasoline data between December 10,1990,and January 14,1991.Monthly and annual averages are simple averages of the weekly data.For months and years with Incomplete weekly data series,the monthly and/or annual averages are not available.On May 14,2018,we implemented statistical methodology changes to improve the accuracy of the weekly retail gasoline price estimates.As a result of these statistical methodology changes,the published retail gasoline estimates for May 14,2018,are not directly comparable to those published for May 7,2018.On June 13,2022,we implemented statistical methodology changes to improve the accuracy of the weekly retail on-highway diesel fuel price estimates.As a result of these statistical methodology changes,the published retail on-highway diesel fuel prices for June 13,2022 are not directly comparable to those published for June 6,2022. See Definitions,Sources,and Notes link above for more information on this table. Release Date:7/25/2022 Next Release Date:8/1/2022 1 of 1 8/1/2022, 11:02 AM • • West Coast less California Gasoline and Dies'" tail Prices https://-----.eia.gov/dnav/pet/pet_pri_gnd dcus_r5xca m.htm e-T) U.S. Energy Information ", Administration PETROLEUM & OTHER LIQUIDS OVERVIEW DATA ANALYSIS&PROJECTIONS Weekly Retail Gasoline and Diesel Prices (Dollars per Gallon, Including Taxes) Area: West Coast less California s, Period; Monthly Show Data By: i PP6 PP7 PP8 View ( Product Q Area Graph Gear Feb-22 Mar-22 Apr-22 May-22 Jun-22 Jul-22 History Gasoline-AllGrades 0 3.916, 4.670 4.703 4• .956 5.469 5.208 1998-2022 All Grades-Conventional 1 I I Areas 0 j 3.941 4.698 4,720 4.964 5.443! 5.237I 2000-2022 . All Grades-Reformulated Areas 0 3.814 4.557 4.629 4.917 5.577 5.081 1998-2022 Regular 0 3.840 4.595 4,623 4.878 5.392 5,128 1998-2022 Conventional Areas ❑ 3,865 4.622 4.640 4.885 5.363 5.156 2000-2022 Reformulated Areas 0 3.742 4.487 4.557 4.8501 5.511' 5.012 1998-2022 Midgrade 0 4.147 4,890 4.940 5.1751 5.688 5.468 1998-2022 Conventional Areas El 4.155 4.902 4.946 5.178 5.6631 5.486 2000-2022 Reformulated Areas 0 4.107 4.829i 4.902 5.1601 5.8251 5.372 1996-2022 Premium 0 4.304 5.062 5.104 5.357 5.864 5.605 1998-2022 Conventional Areas 0 4.307 5.067 5.102 5.352 5.835 5.618 2000-2022 Reformulated Areas ❑ 4.286 5.033 5.114 5.384 6.031 5,529 1998-2022 Diesel(On-Highway)-All Types 0 4.266 5.279 5,293 5.619 6.080 5.8401 2011-2022 Ultra Low Sulfur(15 ppm and I Under) 0 4.266 5.279; 5.293 5.619 6.080 5.8401 2011-2022 Click on the source key icon to learn how to download series into Excel,or to embed a chart or map on your website. -=No Data Reported; --=Not Applicable; NA=Not Available; W=Withheld to avoid disclosure of individual company data. Notes:Conventional area is any area that does not require the sale of reformulated gasoline.All types of finished motor gasoline may be sold in this area.RFG area is an ozone nonattainment area designated by the U.S.Environmental Protection Agency(EPA),which requires the use of reformulated gasoline.We stopped publishing Low Sulfur On-Highway Diesel(LSD)prices at the U.S.level on December 8,2008,because fewer stations were selling LSD as a result of EPA diesel fuel regulations.We continued to collect LSD prices from retail outlets and included them in the Diesel Average All Types price until July 26,2010, when no more outlets reported LSD sales.Beginning July 26,2010,publication of Ultra Low Sulfur Diesel(ULSD)price became fully represented by the Diesel Average All Types price.As of December 1,2010(September 1,2006 in California),any on-highway diesel fuel sold is ULSD as mandated by EPA on-highway diesel fuel regulations.We did not collect weekly retail motor gasoline data between December 10,1990,and January 14,1991.Monthly and annual averages are simple averages of the weekly data.For months and years with Incomplete weekly data series,the monthly and/or annual averages are not available.On May 14,2018,we implemented statistical methodoogy changes to improve the accuracy of the weekly retail gasoline price estimates.As a result of these statistical methodology changes,the published retail gasoline estimates for May 14,2018,are not directly comparable to those published for May 7,2018.On June 13,2022,we implemented statistical methodology changes to improve the accuracy of the weekly retail on-highway diesel fuel price estimates.As a result of these statistical methodology changes,the published retail on-highway diesel fuel prices for June 13,2022 are not directly comparable to those published for June 6,2022. See Definitions,Sources,and Notes link above for more information on this table. Release Date:7/25/2022 Next Release Date:8/1/2022 1 of 1 8/1/2022, 11:02 AM Weekly West Coast(PADD 5)Except California"r-^Diesel Retail Price... https://www.eia.gov/d- 'let/test/LeafHandler.ashx?npet&s=elmd_epd... ela U.S. Energy Information Administration PETROLEUM & OTHER LIQUIDS OVERVIEW DATA ANALYSIS&PROJECTIONS GLOSSARY t FAOS h Referring Pages' • Retail Prices for Diesel(On-hilg!y)-All Typgs • West Coast less California Gasoline and Diesel Retail Prices [ .NYbfy_•Weekly O Monthly ()Annual Download Data_(XLS File) Weekly West Coast(PADD 5)Except California No 2 Diesel Retail Prices I DOWNLOAD Dollars per Gallon 4 - -- 2 o 20.12 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 � -Weekly West Coast(PADD 5)Except California No 2 Diesel Retail Prices eyS1 Sourco:U.S.Energy Information Administration rChart Tools fro analysis applied "i Ttls series is available through the EIA open data API and can be downloaded to FYrel or embedded as an interactive chart or map on your webslte. Weekly West Coast(PADD 5)Except California No 2 Diesel Retail Prices(Dollars per Gallon) Week 1 Week 2 Week 3 Week 4 Week 5 Year-Month End Date Value End Date Value End Date Value End Date Value End Date Value 2011-Dec 12/12 3.990 12/19 3.928 12'26 3906 2012-Jan 01/02 3.900 01/09 3.927 01/16 3.945 01/23 3.938 01/30 3930 2012-Feb 02/06 3.928 02/13 4.017 02/20 4.054 02127 4.227 2012-Mar 03/05 4.275 03/12 4.348 03/19 4.372 03/26 4383 2012-Apr 04/02 4.378 04/09 4.377 04/16 4.356 04123 4.299 04/30 4.232 2012-May 05/07 4.226 05/14 4.192 05/21 4.152 05/28 4.089 2012-Jun 06/04 4.022 06/11 3.902 06/18 3.820 06/25 3.758 2012-Jul 07/02 3.682 07/09 3.698 07/16 3.705 07/23 3.812 07/30 3.816 2012-Mg 08/06 3.883 08/13 4.078 08/20 4,184 08/27 4.288 2012-Sep 09/03 4.343 09/10 4.358 09/17 4.321 09/24 4.249 2012-Oct 10/01 4.212 10/08 4.207 10/15 4.238 10/22 4.195 10/29 4.092 2012-Nov 11/05 4.068 11/12 4.098 11/19 4.038 11/26 4.070 2012-Dec 12/03 4.046 12/10 3.982 12/17 3.933 12/24 3.915 12/31 3.928 2013-Jan 01/07 3.918 01/14 3.900 01/21 3.911 01/28 3.946 2013-Feb 02/04 4.076 02/11 4.187 02/18 4.236 02/25 4.221 2013-Mar 03/04 4.207 03/11 4.165 03/18 4.105 03/25 4.046 2013-Apr 04/01 4.016 04/08 4.023 04/15 3.970 0422 3.885 0429 3.833 2013-May 05/06 3.830 05/13 3.883 05/20 3.932 05/27 3.917 2013-Jun 06/03 3.899 06/10 3.870 06117 3.874 06/24 3.879 2013Jut 07/01 3.856 07/08 3.864 07/15 3.917 07/22 3.956 0729 3.970 2013-Aug 08/05 3.961 08/12 3.946 08/19 3.965 08,'26 3,973 2013-Sep 09/02 4.032 09/09 4.045 09116 4.032 09/23 3.995 09/30 3961 2013-Oct 10/07 3.936 10/14 3.939 10/21 3.954 10/28 3.941 2013-Nov 11/04 3.923 11/11 3.:r:1 11/18 3.872 I1125 3.872 2013-Dec 12/02 3.929 12/09 3.906 12/16 3.884 12f23 3.883 12/30 3930 2014-Jan 01/06 3.934 01/13 3.891 01220 3.861 01/27 3.875 2014-Feb 02/03 3.902 02/10 3.901 02/17 3.911 02/24 3.948 1 of 3 4/7/2022, 1:54 PM e e Weekly West Coast(PADD 5)Except Califor ' 'To 2 Diesel Retail Price... https://vwvw.eia.go--"--tv/pet/hist/LeafHandler.ashx?n=pet&s=emd epd... End Date : Value End Date I Value End Date I. Value End Date I Value End Date I Value Year-Month End Date Value End Date Value End Date Value End Date Value End Date Value 2014-Mar 03/03 3943 03/10 3.960 03/17 3.942 03/24 3.925 03/31 3.908 2014-Apr 04/07 3.894 04/14 3.893 04/21 3.945 04/28 3.954 2014-May 05/05 3.944 05/12 3.928 05/19 3.923 05/26 3.929 2014-Jun 06/02 3.923 06/09 3.899 06/16 3.903 06/23 3.973 06/30 3.994 2014-Jul 07/07 3985 07/14 3.971 07/21 3.942 07/28 3.928 2014-Aug 08/04 3.930 08/11 3.935 08/18 3.930 08/25 3.921 2014-Sep 09/01 3 973 09/08 3.979 09/15 3.967 09/22 3.929 09/29 3.876 2014-Oct 10/06 3.855 10/13 3.802 10/20 3.742 10/27 3.706 2014-Nov 11/03 3.704 11/10 3.712 11/17 3.720 11/24 3.682 2014-Dec 12/01 3.651 12/08 3.519 12115 3.371 12/22 3.228 12/29 3.155 2015-Jan 01/05 3.074 01/12 2.978 01/19 2.826 01/26 2.763 2015-Feb 02/02 2 716 02/09 2.756 02/16 2.817 0123 2 889 2015-Mar 03/02 2.934 03/09 2.926 03/16 2.894 03/23 2.815 03/30 2 758 2015-Apr 04/06 2.742 04/13 2.720 04/20 2.796 04/27 2.865 2015-May 05/04 2.971 05/11 3.002 05/18 3.033 05/25 3.057 2015-Jun 06/01 3.055 06/08 3.001 06/15 3.001 06/22 3.007 06/29 2.978 2015-Jul 07/06 2.978 07/13 2.919 07/20 2.873 07/27 2.814 2015-Aug 08/03 2 761 08/10 2.706 08/17 2.690 08/24 2 610 08/31 2.564 2015-Sep 09/07 2.590 09/14 2.571 09/21 2.550 09/28 2541 2015-Oct 10/05 2.560 10/12 2.603 10/19 2.576 10/26 2.567 2015-Nov 11/02 2.549 11/09 2.607 11/16 2.602 11/23 2.555 11/30 2.510 2015-Dec 12/07 2.477 12/14 2.431 12/21 2.373 12/28 2.318 2016-Jan 01/04 2.303 01/11 2.258 01/18 2.198 01/25 2.160 2016-Feb 02/01 2.117 02/08 2.073 02/15 2.043 02/22 2.050 02/29 2.054 2016-Mar 03/07 2.097 03/14 2.153 03/21 2.179 03/28 2.177 2016-Apr 04/04 2.179 04/11 2.200 04/18 2.251 04/25 2.282 2016-May 05/02 2.357 05/09 2.368 05/16 2.425 05/23 2.502 05/30 2.565 2016-Jun 06/06 2.600 06/13 2.610 06/20 2.606 06/27 2.600 2016-Jul 07/04 2.599 07/11 2.596 07/18 2.569 07/25 2.536 2016-Aug 08/01 2.492 08/08 2.454 08/15 2.441 08/22 2.498 08/29 2.555 2016-Sep 09/05 2.563 09/12 2.553 09/19 2.524 09/26 2.515 2016-Oct 10/03 2.524 10/10 2.591 10/17 2.635 10/24 2.645 10/31 2 655 2016-Nov 11/07 2.673 11/14 2.657 11/21 2.637 11/28 2.635 2016-Dec 12/05 2.679 12/12 2.690 12/19 2.705 12/26 2.727 2017-Jan 01/02 2.757 01/09 2.774 01/16 2.755 01/23 2.750 01/30 2.744 2017-Feb 02/06 2.748 02/13 2.761 02/20 2.767 02/27 2.772 2017-Mar 03/06 2.779 03/13 2.736 03/20 2.702 03/27 2.703 2017-Apr 04/03 2.735 04/10 2.772 04/17 2.791 04/24 2.786 2017-May 05/01 2.775 05/08 2.747 05/15 2.728 05/22 2.725 05/29 2.735 2017-Jun 06/05 2.724 06/12 2.681 06/19 2.655 06/26 2.626 2017-Jul 07/03 2.628 07/10 2.653 07/17 2.656 07/24 2.678 07/31 2.704 2017-Aug 08/07 2.747 08/14 2.7:4 08/21 2.786 08/28 2.806 2017-Sep 09/04 2.931 09/11 3.007 09/18 3.009 09/25 3.008 2017-Oct 10/02 3.018 10/09 2.993 10/16 3.003 10/23 3.015 10/30 3.020 2017-Nov 11/06 3.075 11/13 3.120 11/20 3.107 11/27 3.113 2017-Dec 12/04 3.106 12/11 3.072 12/18 3.044 12/25 3.026 2018-Jan 01/01 3.073 01/08 3087 01/15 3098 01/22 3.083 01/29 3.120 2018-Feb 02/05 3.144 02/12 3.107 02/19 3.072 02126 3.064 2018-Mar 03/05 3.064 03/12 3.052 03/19 3.060 03/26 3.147 2018-Apr 04/02 3.202 04/09 3 226 04/16 3.326 04/23 3.366 04/30 3.394 2018-May 05/07 3.409 05/14 3.482 05/21 3.503 05/28 3.514 2018-Jun 06/04 3.508 06/11 3.489 06/18 3.473 06/25 3.453 2018-Jul 07/02 3.475 07/09 3.471 07/16 3.456 07/23 3.436 07/30 3.437 2018-Aug 08/06 3.432 08/13 3.425 08/20 3.423 08/27 3.433 2018-Sep 09/03 3.469 09/10 3.465 09/17 3.473 09/24 3.473 2018-Oct 10/01 3.506 10/08 3.558 10/15 3.591 10/22 3.587 10/29 3.564 2018-Nov 11/05 3.538 11/12 3.514 11/19 3.475 11/26 3.455 2018-Dec 12/03 3 406 12/10 3.357 12/17 3.313 12/24 3.281 12/31 3.246 Yew-Month Week 1 Week 2 Week 3 Week 4 Week 5 2019-Jan UI/u/ 3.111U U1/14 .1.I31.) Ul(21 3.11) 01/21 3.099 2019-Feb 02/04 3.087 02/11 3.084 02/18 3.104 02/25 3.141 2019-Mar 03/04 3.155 03/11 3.162 03/18 3.139 03/25 3.156 2019-Apr 04/01 3.153 04/08 3.189 04/15 3.252 04/22 3.309 04/29 3.346 2019-May 05/06 3.345 05/13 3 355 05/20 3.352 05/27 3.338 2019-Jun 06/03 3.320 06/10 3.282 06/17 3.238 06/24 3.206 2019-Jul 07/01 3.205 07/08 3.208 07/15 3.209 07/22 3.198 07/29 3.186 2019-Aug 08/05 3.182 08/12 3.164 08/19 3.158 08/26 3.139 2019-Sep 09/02 3.139 09/09 3.131 09/16 3.161 09/23 3.238 09/30 3.228 2019-Oct 10/07 3.215 10/14 3.240 10/21 3.290 10/28 3.379 2019-Nov 11/04 3.413 11/11 3.435 11/18 3.444 11/25 3.387 2019-Dec 12/02 3 382 12/09 3.323 12/16 3.280 12/23 3.252 12/30 3.274 2020-Jan 01/06 3.264 01/13 3.241 01/20 3.206 01/27 3.198 2020-Feb 02/03 3.146 02/10 3.098 02/17 3.081 02/24 3.072 2020-Mar 03/02 3.054 03/09 3.026 03/16 2.954 03123 2.879 03/30 2.798 2020-Apr 04/06 2.754 04/13 2.695 04/20 2.640 04/27 2.593 2020-May 05/04 2.545 05/11 2.557 05/18 2.543 05/25 2.561 2020-Jun 06/01 2.560 06/08 2.578 06/15 2.579 06/22 2.591 0629 2.586 2020-Jul 07/06 2.596 07/13 2.594 07/20 2.597 07/27 2.586 2020-Aug 08/03 2.592 08/10 2.5:4 08/17 2.586 08/24 2.590 08/31 2.603 2020-Sep 09/07 2.584 09/14 2 575 09/21 2.557 09/28 2.554 2020-Oct 10/05 2.534 10/12 2.538 10/19 2.542 10/26 2.537 2020-Nov 11/02 2.541 11/09 2.572 11/16 2.686 11/23 2.713 11/30 2.742 2020-Dec 12/07 2.724 12/14 2.751 12/21 2.768 12/28 2.770 2 of 3 4/7/2022, 1:54 PM e Weekly West Coast(PADD 5)Except California" "Diesel Retail Price... https://www.eia.gov/di ' et/hist/LeafHandler.ashx?n=pet&s=emit epd... Week 1 Week2 Week3 Week4 Weeks Upper Threshold =3.75 Year-Month End Date Value End Date Value End Date Value End Date Value End Date Value 2021-Jan 01/04 2.771 01/11 2.793 01/18 2.804 01/25 2.816 Lower Threshold=3.07 2021-Feb 02/01 2.841 02/08 2.897 02/15 2.960 02/22 3.063 2021-Mar 03/01 3.174 03/08 3.228 03/15 3.270 03/22 3.315 03/29 3.272 2021-Apr 04/05 3.259 04/12 3.248 04/19 3.248 04/26 3.250 2021-May 05/03 3.282 05/10 3.313 05/17 3,383 05/24 3.395 05/31 3.410 Base Price 2021-Jun 06/07 3.446 06/14 3.465 06/21 3.462 06/28 3.494 2021-Jul 07/05 3.550 07/12 3.568 07/19 3.598 07/26 3.610 2021-Aug 08/02 3.661 08/09 3.675 08/16 3.682 08/23 3.643 08/30 3.645 2021-Sep 09/06 3.664 09/13 3.661 09/20 3.663 09/27 3.664 2021-Oct 10/04 3.717 10/11 3.784 10/18 3.860 10/25 3.891 2021-Nov 11/01 3.932 11/08 3.974 11/15 4.009 11/22 4.009 11/29 4.032 2021-Dec 12/06 3.992 12/13 3.970 12/20 3.941 12/27 3.917 2022-Jan 01/03 3.927 01/10 4.002 01/17 4.067 01/24 4.110 01/31 4.184 2022-Feb 02/07 4.250 02/14 4.261 02/21 4.256 0/28 4.295 2022-Mar 03/07 4.978 03/14 5.416 03/21 5.319 03/28 5.402 2022-Apr 04/04 5.312 -=No Data Reported; -=Not Applicable; NA=Not Available;W=Withheld to avoid disclosure of individual company data. Release Date:4/4/2022 Next Release Date:4/11/2022 Referring Pages: • Retail Prices for Diesel(On-Higwy)-All Tyt • Vlkst Coast less California Gasoline and Diesel RetaH Prices 3 of 3 4/7/2022, 1:54 PM State . i �' of Transportation - ► Field Note-Record (Sketch Grid) f 49 " Book No. / Page No. /Vt.. 0.,7 cFi-- ,Contract No. Station • toe -- OS. CG-20-a&s yD6 (go Fd yd t , Lv�A�� 4,,c: , 1f. Co , - Staked BY Data' Work Star ad Work Completed ZIIC ` (A)_c Cc cs 7- //- Z 2 -25-- ze 7- 25. zZ___ - - C)c ita/te/d/By Date C Checked By J i Data Ins ctoes Signature - 'Date K'.( (//rt'/�,�fZ /"p'�O'7� TLS I 7i3022 � ' � �.ZBTZ r , _ I !HIHVHHH I E I � �" li 1 I I 1 . 4- Z -7-2 5 ( 5z.00 i.216C 3 _ o7-27(y,�o� +'.ea(''34.., ) I I - 7 c1/ u ! i 7-4. 50 1 V !I I I 1 1 I 1 A- (3 or -7- SC z^, 7}) - 6 (2,So) 1 7�z . 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No. A1.2- 477 A1"rrs nI. 7.J(i. /4.0''J:,Z.!-7::i.' -- _'Y•Sveti,' iITLS :MB • 8 . •1'A-l1 D rc/ii y. .'7:.6 ?4 1;1. ,r!:/4 .-- r/ :!_i) f 1'TLS 'MB 8 . - A-.rs f)CIhS 8bA4J 1-(7- /40' '.3. 6.. . — Vr l,vV=.4( I,TLS MB 8 :�,/S P„ova e..0 7-fS-Z4' ' i rc14/ TLS MB 8 `7 is S e,A4 Act. .,_i r•26 S•YJS 4a• t _ (l.i•S•c):4'> TLS MB:• 8 _37, iNt'A.. ( i&% y 'S• ,i , t orK TLS MB;- 8 446, i.:1(•.✓. A., r f . 1_;_1+_ZZ, .G� l Z�r I ` v f' s 1/..ill ;TLS MB 8 - A., 3S C,5 f L - . 77=;($4 ...7017 j522.63 -tf/.Y.ii.di' _ - . ..I TLS M B 8 OT.Eorrii422436Fr - i ' -'- - - I Y . � n l = .c c • - - { .,4ik:Z. . � �v -. Boa�t�a. �.�_. Fag�No: 7 44 Contract Station. Late • -- C75. Date Woi kStyted WbFk Comgtet64. Staked By.- • .72.AC� . Gv-r coAfer s-Z�"z 77-4. :z k. _ . 77- q - Z _ - - ` Bate:- lnsper=s signature Dais 'Pk/ ' ild," Cafc� .B Dade C�iet�Sy - _2 "TLS - 7/30/22 I . 7-F-2 - . 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HR 131° N/A - VISUAL TLS M B 8 A27 r GRAVEL BORROW 7/9/22 TN - 71.12 : COMPACTION TLS .MB 8 A35 CSTC 7/9/22 TN 2` �6 COMPACTION s TL-S .mg 8 A25 ASPHALT CONC.REMOVAL 7/9/22 I SY ' 2{J.22 N/A - VISUAL ' TLS . MB : 8 A28 - UNSUITABLE EXC. • ` 7/9/22 . CY ' 31 I45 • N/A VISUAL TLS M,B,' 8 A29 SUBGRADE PREP '7/9/22 SY 22 .88 N/A PROOF ROLL . • TLS MB - 8 DOT For 617 . . I ( - • - - WI' Deierhneit of Tterworiation -Field Note_Record (Sketch Grid) u BookNo. -.---/ Page No. 43 Contract No. Station L#ne -' CIS. CA ( -20 vc,5 J27f5Q 4- 9064'80 v •✓4i( Auk'_ , ,lc,,,-) co. . Staked By Date' Work Started Work ompteted ZA6.1- \ lnJ.l � COS s 5 -23 -- Z 6 7- / - zz 7 - /- ze-- - Calculated By Date Checked By 1 !Oats 7r's Signatzr 1 Odic;Px, 1 A✓CA 7-/ "?LMB 7/11/22 4 t 7 / z�i / X1 - e-el--SI -7-A- z (4/.4-cii, i J 1 , { I 1 1 { I fib I 1 11 ! 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Acceptance No. Pflsi {);: _ TLS MB 8 7-l-?L Ne. i/So J J-y 1 a S TLS MB 8 �- 1-2e_ ge Z., NIi-t s u A r # K `} I / rLs MB 8 7-I-rL EK1- -i s v.a A-?< Z.tAQ4. ilit'h.Jfi,'' 7-in- S 197- 3 .37 J V sc� t TLS MB 8 rLs MB 8 "7'/-?z I51 IL J ilifad / _ 1 ! �-a5 SL ti Gz�J� J�� r'p s � TLS M B 8 Ar/z C‘; ( I '7- )-77 CA ' - y.,' Y4 TLS MB 8 12 DOT Perm 422-6261"r I .i I DELIVERY RECEIPT CUSTOMER COPY OFFICE:253.833.3705 FAX:253.833.3746 MILES 400 Valley Ave NE SAND&GRAVEL Puyallup,WA 98372-2516 DATE CUSTOMER# ORDER# CUSTOMER P.O. 'JOB# PLANT# TICKET# 7/28/22 054990 903334 22-021 000289 202 278180 LOAD# CY ORDERED CY DLVRD SLUMP LOAD TIME TAX CODE CYL TAKEN PLT TIME OUT FULL LOAD 1 2.00 2.00 5 9:51 AM 01 GALS CUSTOMER NAME AIR% JOB TIME IN 2/3 LOAD TRANSPORTATION SYSTEMS, INC GALS JOB ADDRESS SLUMP PLOD JOB TIME OUT 1/3 LOAD DUVALL AVE NE & NE 12TH ST GALS CITY WORK TYPE REV COUNT WATER ADDED AUTHORIZED BY: PLT TIME IN RENTON CAISSON/PIER QUANTITY UNITS PRODUCT CODE DESCRIPTION UNIT PRICE AMOUNT 2.00 yd 04432F 04432F 1.00 EA 5100 MIN LOAD CHARGE 2.00 CY 5300 ENVIRONMENTAL COMPLIANCE - RM 1.00 LD 5401 FUEL SURCHARGE-READY MIX DRIVER# TRUCK# PREV TRUCK DELIVERY INSTRUCTIONS SUB TOTAL 3106 1146 POURING SONO TUBE DRIVER NAME • SALES TAX COLEMAN, DANIEL SUPERP ADDED SUBGRADE LOAD 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,Miles Sand&Gravel Company(Miles)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 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.ADDITON 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 AGG02 PEA#8 1750 lb 3509 lb 3460 lb -0.62% 0.23%M 1 g! AGG04 SAND CLASS 2 1360 lb 2789 lb 2820 lb 1.10% 2.54%A 8 gl CEM01 IL AG IM 2022-GUL-05 560 lb 1120 lb 1135 lb 1.34% CEM04 CLASS F LAF 06-22 100 lb 200 lb 195 lb -2.50% ADXO3 MPOLYHEED 997 20 oz 40 oz 36 oz -10.00% ADXO5 MSET DELVO 40 oz 80 oz 80 oz 0.00% WATO1 WATER 1 290 lb 444 lb 430 lb -3.09% 52 gl WATO4 WATER 3R % # lb lb WATO2 HOT WATER % # lb lb WATO3 WATER 2 % # lb lb Actual Num Batches: 1 Load 8067 lb Design W/C: 0.439 Water/Cement: 0.382 A Design 69.6 gl Actual 61.0 gl To Add: 8.6 gl Slump: 5.00 in # Water in Truck: 0.0 gl Adjust Water 0.0 gl 1 Load Trim Water: -3.5 gl / CY Actual W/C Ratio: 0.382 Actual Water: 61 gl Batched Cement: 1330 lb Miles Sand&Gravel Company W W W.MILES.ROCKS DELIVERY RECtlIn CUSTOMER COPY OFFICE:253.833.3705 FAX:253.833.3746 MILES400 Valley Ave NE SAND&GRAVEL Puyallup,WA 98372-2516 DATE CUSTOMER# ORDER# CUSTOMER P.O. JOB# PLANT# TICKET# 7/27/22 054990 903331 22-021 000289 202 278145 LOAD# CY ORDERED CY DLVRD SLUMP LOAD TIME TAX CODE FULL LOAD CYL TAKEN PLT TIME OUT 1 11.00 11.00 5 9:57 AM 01 GALS CUSTOMER NAME 2/3 LOAD AIR% JOB TIME IN TRANSPORTATION SYSTEMS, INC GALS JOB ADDRESS 1!3 LOAD SLUMP PLCD JOB TIME OUT NE 12TH ST& DUVALL AVE NE GALS CITY WORK TYPE REV COUNT WATER ADDED AUTHORIZED BY: PLT TIME IN RENTON OUTSIDE FLAT QUANTITY UNITS PRODUCT CODE DESCRIPTION UNIT PRICE AMOUNT 11.00 yd 04432F 04432F 11.00 CY 5300 ENVIRONMENTAL COMPLIANCE - RM 1.00 LD 5401 FUEL SURCHARGE-READY MIX DRIVER# TRUCK# PREV TRUCK DELIVERY INSTRUCTIONS SUB TOTAL 2640 1152 DRIVER NAME - SALES TAX SOKIMI,_SELESESE - SUPERP ADDED SUBGRADE LOAD 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,Miles Sand&Gravel Company(Miles)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 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.ADDITON 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 AGGO2 PEA#8 1750 lb 19296 lb 19360 lb 0.32% 0.25%M 6 gl AGG04 SAND CLASS 2 1360 lb 15420 lb 15280 lb -0.91% 3.06%A 55 gl CEN101 IL AG IM 2022-GUL-05 560 lb 6160 lb 6135 lb -0.41% CEM04 CLASS F LAF 06-22 100 lb 1100 lb 1085 lb -1.36% ADX03 MPOLYHEED 997 20 oz 220 oz 216 oz -1.82% ADX05 MSET DELVO 40 oz 440 oz 440 oz 0.00% WATO1 WATER 1 290 lb 2544 lb 2535 lb -0.35% 304 gl WATO4 WATER 3R % # lb lb WATO2 HOT WATER % # lb lb WATO3 WATER 2 % # lb lb Actual Num Batches: 1 Load 44436 lb Design W/C: 0.439 Water/Cement 0.421 A Design 382.8 gl Actual 364.8 gl To Add: 18.1 gl Slump: 5.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl/Load Trim Water. -1.5 gl / CY Actual WIC Ratio: 0.421 Actual Water. 365 gl Batched Cement 7220 lb Mites Sand&Gravel Company WWW.MILES.ROCKS CADMAN CUSTOMER Toll Free to(.;aaman: 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIDELBERGCEP.1ENTGroup' Dispatch: 425-961-7100 30 Sky River 50 Redmond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue PLANT# Cadman Administration: 425-867-1234 34 Everett 54 Seattle DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD `r ' . i DATE 'CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# iORDER# SLUMP USE _. DRIVER SPACING PROJECT# t JOB ADDRESS MAP PAGE . TRUCK PR ion TRUCK# TIME DUE INSTRUCTIONS LOAD QUANTITY QUANTITY PRODUCT SIZE DELIVERED ORDERED CODE DESCRIPTION U.M. AMOUNT ACE Y WP41211 iP,, t Ca.me Bo7 Gtt4,!, • • flr_r 1111111111111111111111 tiM 11111 tIll tilt _ :) SUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. gals.to 2/3 load Pump Blow-Back/ WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any _W B R equipment damage for any deliveries beyond the curb line. Additions to Order AUTHORIZED BY: Type Qty ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Taken DYes la No HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? 2.Is there a hazard that should be communicated 0 Yes ❑No 7.Am I aware of my pinch points? 0 Yes ❑No to Dispatch/others? D Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? ❑Yes ❑No 11.Additional comments: =omoi.••=• - ..•-•a 1 CAD LUG i Uh1LR Toll Free to Cad 1 888 322 6847 Plant Locations: DELIVERY TICKET HEIDELBERGCEMENTGro.p° Dispatch: 425-961-7100 30 Sky River 50 ,..—mond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOE BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER S CUSTOMER NAME ORDERED BY JOB P.O. ORDER# SLUMP USE DRIVER SPACING PROJECT# JOB ADDRESS MAP PAGE TRUCK# PRIOR TRUCK# TINE DUE • INSTRUCTIONS LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE 111111111111111/11111111111111 liii! Ill 1111 SUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R — equipment damage for any delIvenes beyond the curb line. Additions to Order Type Qty AUTHORIZED BY: ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested faYes ❑No r is PRINT NAME DATE Cylinders Taken ❑Yes Q No HAZARD AdSt,SMEN I I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE. 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes 0 No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No (` to Dispatch/others? ❑Yes U No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? U Yes U No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No ' 4.Is there a transition shield in place? LI Yes U No 10.The reason I will work safely today is: - 5.Is there a spotter to back me in? ❑Yes U No 11.Additional comments: s--, r • CADMmCUSTOMERToll Free to Cadman: 1-888-322-6847 Plant Locations: HEIDELBERGCEMENTGroupr Dispatch: 425-961-7100 30 Sky River 50 Redmond DELIVERY TICKET www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah Cadman Administration: 425-867-1234 34 EverettWoodnville 54 Seattle PLANT# 34 54 Seattle DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD --..) / DATE CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# ORDER# SLUMP USE DRIVER SPACING PROJECT# JOB ADDRESS MAP PAGE TRUCK# i 1t/ „is l i ," ,rl( PRIOR TRUCK# TIME DUE INSTRUCTIONS ' ' 4f LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE I .. . . i(IiiiiIiIitIIjiIiItiiI; • 1I1111I iI11 ',di.f. i.:,-t 1 st ndiTv f. C; ':1- �a: �,:; t�:�si '-~? SUBTOTAL 1•`i, �.,. - ,'1 C .1 (..�_-'TI.4 -_ rtt�is. _ TA X �� ,. 1, TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. - - WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. - NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load . WARNING: Wash-up gals.to 1/3 load- ; IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete - WBR LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any equipment damage for any deliveries beyond the curb line. Additions to Order AUTHORIZED BY: Type Qty ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PIIINT NAME DATE Gyllnahsra TeKen 0 res 0 Nu HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THEJOB IF If BECOMES UNSAFE 1.Do I have adequate directions? ❑Yes CI No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes U No 8.Are ground conditions adequate for the weight of my truck? ❑Yes 0 No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes 0 No 11.Additional comments: (,;U6 i UMJiLF4 CADMAN Toll Free to Cad 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIDELBERGCEt. N- i,,I,,p Dispatch: 425-961-7100 30 Sky River 50 ..__mond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD III DATE CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# ORDER# SLUMP USE DRIVER SPACING PROJECT S JOB ADDRESS MAP PAGE 1 TRUCK N PRIOR TRUCK It TIME DUE INSTRUCTIONS LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE I';" III iI;1 iii i, IIiI ��I IIIII,:,. ;III ;,•j. -;. ... I -. .. SUBTOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMERS OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. gals.to 2/3 load Pump Blow-Back/ WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any --- W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type Qty AUTHORIZED BY: ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes a No PRINT NAML DATE Oy lima..a Tulwn 01'ca QM] HAZARD ASSESSMENT IAMRESPONSIBLEFORMYPERSONALSAFEfYANDIWILLSTOPTHEJOBIFITBECOMESUNSAFE. 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes U No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes 0 No 11.Additional comments: CADMAN Toll Free to C .,,,an: 1-888-322-6847 Plant Locations: CU TOP/lER HEIDELBERGCEMENTGroupr Dispatch: 425-961-7100 30 Sky River 50 Redmond DELIVERY TICKET www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah Cadman Administration: 425 867 1234 32 Woodinville 53 Bellevue 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER* CUSTOMER NAME ORDERED BY 'i�t'�ki"'''_i%i i'�'';CR[TE.. ,l C:(1 JOB P.O.It ORDER I SLUMP USE DRIVER SPACING PROJECT it JOB_ADDRESS MAP PAGE TRUCK* PRIOR TRUC - )11),rF4..: r:`�`�- i�l�- :�, t f'L 10TH ti{ Lfi TIME DUE a INSTRUCTIONS --- --- _:'i - +ai jt"t I /'ft 1 .1krei tC_., i. ! i.:,; ._, t t.- l .. . .4 1 LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE f•. • 11111 ICI SUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. — WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. Pump Blow-Back! gals.to 2r3 load WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIADILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order AUTHORIZED BY: ape Qty ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. —TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No DP inn'NAME DATE Cy lit,.h....,Mk," . Yea C3 no HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I1MLI..STOP THE JOB IF IT BECOMES UNSAFE. 1.Do I have adequate directions? ❑Yes U No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes 0 No to Dispatch/others? ❑Yes 0 No 8.Are ground conditions adequate for the weight of my truck? U Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? 0 Yes U No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes 0 No 11.Additional comments: INVOICE COPY CADMAN Toll Free to Cad: 1-888 322 6847 Plant Locations: 'DELIVERY TICKET HEIDELBERGCEMENTGroup' Dispatch: 425-961-7100 30 Sky River 50 .___.-pond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# 54 .. DELIVERY TICKET NO. 1296947 LOAD TO JO8 ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD LJ c / TE ER# NAME ORDERED BY JOB P.O.# l?l7/25/202 7840598 CONCRETE SERVICES IN ADBA WILSON CO ORDER# SLUMP USE DRIVER SPACING PROJECT t le 4. 00 in SDWAL K ANTHONY SCHM I DT C78405982 JOB ADDRESS MAP PAGE TRUCK* PRIOR TRUCK• TIME DUE DLIVALL AVE NE & NE 10TH ST K626H7 300 309 ASAP INSTRUCTIONS RENTON - WHEELCHAIR RAMPS - WORKING FROM INTERSECTION ON 10TH WBTO SUNSET BL .D LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE ^- 1. 10. 00 20. 00 70. 0C WF 4000� WSDOT CL 4000 A I P , r a 1. 00 0. 00 6075 FUEL SURCHARGE - R e. , 10. 00 0. 00 6045 WA ST SICK LEAVE S e:; 4. ENVIRONMENTAL SUF'j -; . = 3 * 1 **Additional standby & OT charges may be applied** SUBTOTAL ' TAX DUE TO FUEL PRICE FLUCTUATIONS, A FUEL SURCHARGE TOTAL MAYBE APPLIED Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. — WATER ADDED ON-SITE ADDON OF WATER WILL REDUCE STRENGTH,WATER Standby Time fTI AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order AUTHORIZED BY: typeOty — ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Gylindcra Talton ❑Y . a NV HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILLSTOPTHEJOB IF FT BECOMES UNSAFE 1.Do I have adequate directions? U Yes ❑No 6.Are there any slip,trip or fall hazards'? U Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? 0 Yes ❑No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes ❑No 11.Additional comments: —, l.+tJOIIJMVitl-t , , CADMAN Toll Free tot an: 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIOELBERGCEMENI Dispatch: 425-961-7100 30 Sky River 3edmond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER# CUSTOMER NAME 7�Lt,^ORDERED BY 1 JOB P.O.# ' 'T l_ .'.-C• 'ti i•D61-1 WJ T LSON i_I ORDER Y SLUMP USE DRIVER SPACING PROJECT# JOB ADDRESS MAP PAGE TRUCKS PRIOR TRUCK# TINE DUE _ '.it_ _,l- ,4, i,l t 0: -, 7 r •F .30'-3 7 'D INSTRUCTIONS :!I!E£.L.f a•it=i<r :.44ir{4•' i W'=IRF::INN IROM INTERSECTION ON 1 tLtTH t4BTO SUNSET 131 ' LOAD QUANTITY QUANTITY PRODUCT i DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE i 10. 00 ' .` AF`4000,7!, ' :- . _ 10. Otn 6045 EN+ PaT?(;f 1 ldilI 1141iIIIUIIII l Il1J1 vAAdda.i; zatla1 aL-andby & UT charge;; naV oe applied*- SUBTOTAL TAX DUE TO FUEL P2Trr .-; t,.-:T .nT ;-,rlr- 0 r3 :+_I SuRctiPllr„ TOTAL MAYBE APPL I R'. Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. NOT RESPONSIBLE FOR COLOR VARIATION OR Overtime gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIARII ITV WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or an W B R _ equipment damage for any deliveries beyond the curb line. Additions to Order AUTHORIZED BY: Type Qty ACKNOWLEDGE MEN 1 Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. - TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Token I�No I ❑Yes HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE. 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? LI Yes ❑No 4.Is there a transition shield in place? ❑Yes _J No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? D Yes U No 11.Additional comments: ! . ---.. z---\\ I . . . .. .. .. . . Truck Dryer CONCRETE -SERVICES INC PLANT 54 3 , 4I Ton SPRAGUE' . 129-9: 22. 7/25./22 15: 0.1 Load Size ..Mix. Code DUVALL AVE NE 'gc NE. 10TH 'ST' Load, To ..... . . 10 . do. d5CDS. tet7P-40.00' RENTON' - WHEELCI-tAIR -RAMPS - .14ORkiNd 3:0"22.32. .. .. ... ... ! .. . .. . . . . Material Description 'Design Qty' Required • Batched 'Vro Mplatute _ ACtual •Wat '-apap.pray 1301 3-SAND• 1228 lb 12584:lb 12580 lb ' 3.0,0%M ' 44 gl ' 265 1051 ,314 17.72•iti 1804. 0, '1782o lb 2.007-d M '42 gl 276 .. 1151 '3i8 160 lb, 102-lb 1610 lb 2.000.4 4,gl 278 6540 CEMENT IL Plq, 470'lb 470u lb .4745 lb 2:0 6,500 FLY ASh 94 lb 940.lb 950 lb 256,' 6411 AEA 5 CZ .53 ez 54*.Oz, 1.00 6410 ,P022-80 '0,-oz :60'oz '60 CZ 1.00 6499 WATER 245 lb lb r lb 1,00, 6413 'GLEN7500. ;f5 oz -50 oz 52 Ot i.o6 , 090 DELVO 11 oz 110.9; 14 oz 1:00: COLD : oLb 50 V.. 773 lb'. -7.72 lb iO'.41, 1.90 13EDEI-120 50':°/0 887:lb .842 lb :93',g1 1.05 I ! Actual 1Iym,13elp,he§:, 1- Load 39336 lb Dasign-WID:' 0.434. -Water/Cerrieht .0 430 Ti 'Design 293,6:gl Actual .2754 gl To Add 1.Ei8,gl SlUnip: :4:00 in 'Tani Watee, t15:0' lb I.CY:o.8 . . • • • . i . --. Truek- . Driver CONCRETE SERVICES INC PLANT' 54 .. ,..„ „....‘. , .. ... 309 • ARMANDO CORRAL .1.2.993,01 • 7/25722 1 ::52 . .. . Load Size Mix Code' nuvLi., AVE t , .4 NE l'OTH ST Load' ID ..,. - . , la_00 CD _. WP4070 RENTON - WHEELCUAIR RAMPS - 'WORKING 3_02225 • 1 .. . . . Material Descriatloti pe.si0.QtV ReOuired Batched °A-Moisture,. Aciiiai. Wat Spec:Gray. 1301 B-SAND. 1,228 lb "12584.1b: 12690 lb 340%MI 44,91 2.65 .. 1051 3/4' 1772 lb 18074 lb, 17820 lb ?AWN, 42.gl. 2:76 1151 :3/8 160 lb . 1632 lb 160,lb 240%M, 4 gl 2.78. 6540 C,EMENT1L PLC 470 lb 4700'lb 4690, lb 3.15 6600 FLY.ASH 94 lb 940 Jb 935 lb 2.56' '6'41f 'AEA 5 oz :53.oz 54 oz 1:00'•6410 POZZ-80 . 6 oz '60 az 60 oz. 1.00, 6.499 WATER '245,lb lb 'I lb 1.00' 6413 .GLEN7500 5 oz '80.o,z' pz 1:00: ... . 6200 DELVO 11,az 110.oz 110'az + 1.00. 'COLD 'COLD50 % 773 ll:, 766,lb 92 gr 100'. RECLH2O 50 % 837 lb "850r,lb -94 gl 1..05, 1 Actual Min Batches: 1 _ Load, 39329. lb Design WIC :0.434 Water/Cement: 0.436 T Design 293.6 gl- Actual ,275.6-gl To Add 180.gl ,.. . Slump: -4.00•in Trim Water: -15.0. ..lb./ CYDS 1 I • • • . . .• b • 1 ----, . . .... ... . .. Truck Driver Q.P.N.C.RETE1 SERVICES INC PLANT' -54. 05 DENNIS, EMERSON - 1.299.1 ., . 72 22/::: n ' 31 ' --. 4 7 5,,. .,, . _ _.. . .. . Load Size Mix Code. DUVALL AVE .1\TE & :NE 10TH ST Load ID . . „. . ... ,...- .! 10. 00 CYDE. WP4000,3- .RENTON .- WHEELCHAIR RAMPS - WORKING '3.022.16 , ._ . , ... I ..„, ....., mioeiii 'aescifOtion D'esign,Qhy IROntitred Batched !,X,Moietu're .ACttial- Wet, Bke&Gfav- 1301- 13,SAND 1228 lb 1,2584 lb: 1.250 0 3..q0ydm 44,gi • " :2'.65i 1051 3/4 1772 lb 18074 0: 1781Q lb- i01:1°4-,M .42:gt. :2.76! 1151 3/8; 'MO'lb 1632 lb, 1720,:lb .-t• 2,00WM 4.-0 'us': 650 -cEltAENT1L PLC. 470 lb .4700 lbi 47b5,:lb, 3.15:. .0600. FLY,ASH 04,lb 946 lb. 956,6 .256' 0411, AEA' . :5'.oz. 53,loz 54-ciz •'6411:y PQZ2480 ...,0•oz, 6.0.,9?. 0.9z + '140. 6499 WATER 245,,Ild lb t'lb 1100 6413 GLEN7500 5!oz ' 50 .oz ,52"oz. 1-.0.0 6200' P.ELVO, 11 oz 110 OZ '1'1 6!,.oz + 1.:00 cciLb eOLD 50 % '77 3 lb .„ .. , 768:lb. 92,41 1;60 ;RECLH20 80:V.. 837 lb ,6,52lb„ 94 gl 1.05 I ' . , Acitial •.Num-Batche 1 ' Load ,30383.14 Nsign VVIC:: 0.434 Water/Cement- 0.433' Ti- Deeldn 293.6 -j1. Actual 2760-g TO AO: 11.5 gl. Skinifif 4.00 in Thin Witei-:.; £15.0. 16-1-.CY.D. • -.',V_ • . r•-----.?:.: ° -,,.F..-. -. •FiNe,...,t...-_,--,--.:-ii,,,, --• .. • t ‘ . , ., . Truck PaNTOr. CONCRETE SERVICES INC PLANT 54 309 • ARMANDO. CORRAL 1299063 7t25/22 11:: 01 . .. . . .. . .. . . I Load Size Mi4c, Code DWALL AVE N ..5; Na .a.OTH $T Load ID. ,. . . . .. , - - 1D.. 00 CYDE WP40003. RENTON - WHEELCHAIR RAMPS - WORKING. 302,204 .. _. . . . • i • . Matgrial, Description Design 4:4y Required Batched %MolptUre Actual Wat Spec.Grav, 1301 • B-,SANID 1226 lb 12584 lb 125801 lb ,3.00%M 44 gl 265 1051 314 1772* 18074 lb 177801.lb .200%M 42.gl 2.76 -1151 3/6 160.l '24 b- 1632. lb 16101 lb- 0%M 4 ti .,2.74 .,. ._.. 664o. CFMENT 1 L-PLC • 470.lb 4700 lb 47'2Qi Ab: .;3.15 6600 ELY ASH. 94.lb, .940 lb 94 lb '256 6411. AEA. 5 oz 53 ot 5416z .I too 5410, POZZ-80. 6 oz 60 .pz 641oz ,+ 1:00 6499 WATER 245:16: lb llb 10 6413 GLEN7500 5 QZ 50 oz '..52;di 1:00 . _.. . 6200 DELVO 11 oz 110 oz 112!'oz 1:00 ,COLD COLD 50 % 773 lb 772 lb 93 gl too kEcLF129 50:'96. WA? ; 8501 lb • 94 gl 1.05 Actual 'Wpm lilatchs: 1 Load :3927.5".113: Design W/C: 0.434 Watdr/Cerneti1: 0.433 T Deign 293.6 'gl Actuil 276:0/61: To:Addi. 17,5 1 'Iuri*: 4.00 iii Trlrh Water': ;15.0 lb'/ CYDS • . . • • • Ttuek Driver .N.CRE.TE, .512.17.,11C $. INC PLANT 84 !VENNEL. • 129.8 :20 Load Size Mix Code tii3VAL.1; AVE 1IE & NE'.. 1071,1 .$.T Load :ID .:LO.0O, CY.DE WP4 0,0 RENTON "WREELCHAIR RAMPS •-• 'WORKING 36 •1'9 Material 0nbtricitiod 134ibri Qty 8Nuieed BalChek:i %•MoistLieb' Actual Wbt soo,cfav 1301 B-SANP 12_4;•lb.;' 12584 lb '12590 lb 3:00%14 44. gl .2`.66 1051 3/4 1772.11? 18074,112 '17860 lb' .410WM 42 91. 276 1151 ;3/8 '160 lb 1632.115 '1,740 lb t' 200%M 4 gl •ps 6540. CEMENTI(.15.i.c, 470 lb. 4709'16 ,4695i 315 6600" FLY_ASH 94 lb ,040I lb. 940.lb 256 6411 AEA. cg: 54 oz 100 64.10 POZZ-fig F6 bz '60-dz 64.bz + 6499 WATER 45, (b. - lb j.lb 1.06 6413 •GLEN7500' '5 oz 50 dz: 56,pz + 1,00 COLD COLD 50:°/0 773.it> • '766,lb '0„gl 1.00. 837 lb, .846,lb ,94:91' 1.05' Mtu4 Ogrrk Batgp: Load 39446 it? „0434- Wa-teelCe'rriert '0435 T Design 2936 gl Actual 2754 gl ToAdch 182;gl 4;00,in' Trifn.Watd-r. 45:0 Ili./ Verks • . . i --, Truck ;Driver CONCRETE SERVICES INC PLANT $.4, 1 300 :ANTHONY. 8CARIbT ,1298947 7/25/22 8 :44 - . - • Load Size Mix. Code DWALL AVE: NE & NE 10TH .ST- Load 'ID - • , 10 , 06 CYDE WP4000$ RE ON - WIMELQ171AIRRAMPS --WORKLMI 3021:92 :1 Material DeadriptiO6 Design Clty, Required , 13,atChed- ,%Moistiro: ActUal Wat: SOeb:Grav , 1301 13;SAND 1226.1b 12584 lb 12550 Th. 3.00%M. 44 gl 2.65 1051 '3/4 1772 lb 18074:lb 17750.lb 2,00%M 42 gl 2.76 .1151, 3/8 160 lb 163'2;10 1760 lb -t, 2.00%M 4:gl 2.178 ' 6540 CEMENT 1 L PLC 470 lb 4709 lb .4719 lb .315 6690 FLY ASH 94 lb 940'lb 949 lb 2.56 6411 .AEA. .5 oz 53 oz 54 oz i.do 64.10 POZZ-80 6 6z 60 oz 'Sp oz 1.00 • 6499 WATER. 245 lb lb ' 1 lb 140. 6413. G1017506 5.oz 50;oz .52 oZ 1-00 Mb. •COLD" 50'76, 773 lb 77'2 lb 03 gl 1.00 Rtp1-120 50,%:: 837'lb .836 lb 93 gl 1.05 • I Actual, Num Batehet '1 Load 39328 lb DetigriW/C: 0.434 Water/Cement: 0.434: T. Design .2936 gl Actual 274.7•gl -To Add:, ma.gl ,siutho: 400 In Triiii1P/atOt -15.0 lb/ Ci'DE. I . . • . i . • • • . . i Truck Driver CONCRETE SERVICES INC PLANT 54 309 ARMANDO CORRAL 1298912 7/25/22 8 : 06 Load Size Mix Code DUVALL AVE NE & NE 10TH ST Load ID 10 . 00 CYDE WP40003 RENTON - WHEELCHAIR RAMPS - WORKING 302189 Material Description Design Qty Required Batched %Moisture Actual Wat Spec.Grav 1301 B-SAND 1228 lb 12584 lb 12560 lb 3.00%M 44 gl 2.65 1051 3/4 1772 lb 18074 lb 17790 lb 2.00%M 42 gl 2.76 1151 3/8 160 lb 1632 lb 1680 lb + 2.00%M 4 gl 2.78 6540 CEMENT 1L PLC 470 lb 4700 lb 4710 lb 3.15 6600 FLY ASH 94 lb 940 lb 935 lb 2.56 6411 AEA 5 oz 53 oz 54 oz 1.00 6410 POZZ-80 6 oz 60 oz 64 oz + 1.00 6499 WATER 245 lb lb lb 1.00 6413 GLEN7500 5 oz 50 oz 52 oz 1.00 COLD COLD 50 % # 773 lb 774 lb 93 gl 1.00 RECLH2O 50 % # 837 lb 846 lb 94 gl 1.05 Actual Num Batches: 1 Load 39306 lb Design W/C: 0.434 Water/Cement: 0.434 T Design 293.6 gl Actual 276.0 gl To Add: 17.6 gl Slump: 4.00 in Trim Water: -15.0 lb/ CYDE INVOICE COPY CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELI VERY TICKET HEIDELSERGCEMENTGroup° Dispatch: 425-961-7100 30 Sky River 50 Redmond 31 Mill Crook 51 Issaquah www.cadman.com Building Materials: 425-868-7334 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. 1;_,r�;if7,1 ;-, , LOAD TO JOB ON,OF BEGIN POUR MOH POUR TO PLANT *YARD /"J/�'� / / DATE/ CUSTOMER S CU' • ER NAME ORDERED BY JOB P.O.# ORDERS SLUMP USE DRIVER SPACING PROJECT# , '..7:!f7.I i 1-: CPR/1TP i)( '.`7 rl H6 RTNTI? ("7141 5.:.; JOB ADDRESS MAP PAGE TRUCKS PRIOR TRUCKS 111111.1111111 'c;; f - ill:: I v I c: r GH1 -, <<, ;mac ft-ci ' INSTRUCTIONS ill. - Di Vi11__L I•}i!1= NE PPEI) WI-1(3F JOB START" ON NC 10TH CT- nl_L. THE Wi w..l TO r-.,`(t.lSE i C.LVP LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE B3. 50 83. 50 14PS -i -Ja00T SLIPFORN „,I i, . 0 Os 6075 UEL ,t RCHORGE- :_.w 4,44i. il) ii7. 1,E'. :,l l4; `JI"I JT s;c:1-` LE1I'"s". a• 1 - i -- .xJq:p r .t..r I ., • m .L Utilli111il1l1141111111111111 Wulf I '=i e.idil: ion i ::'L'anciL-iV & Cif ci-i.;:i1- :}:_•_ i7 IDSi Li* cipa ! °=d SUBTOTAL TAX IJE TO FUEL_ E",r,' (TE - , nr iC c, ri 10 tF HI ROE" •' - TOTAL MorBE I PP'L 1 E1'- I Additional — 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby lime AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ • gals.to 2/3 load• WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVFR Cadman Materials,(Inc.)will not assume liability for any property damage or any W s R equipment damage for any deliveries beyond the curb line. Additions to Order Type Qty AUTHORIZED BY: ! ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE --------- Concrete Tested ❑Yes Li No PRINT NAME DATEi cy lit aeraTaken 0Yv3 ❑Nv HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE. 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? 0 Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes 0 No 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely today Is: 5.Is there a spotter to back me in? 0 Yes 0 No - 11.Additional comments: CUSTOMER CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIDELBERGS-,'':1,-t,C',rc,em Dispatch: 425-961-7100 30 Sky River 50 Redmond 31 Mill Creek 51 Issaquah v,vvi.c,dman.c:;n Building Materials: 425-868-7334 i32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 i 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN1POUR • FINISH POUR TO PLANT IN YARD _2_3 2 DATE CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# ORDER# SLUMP USE DRIVER SPACING PROJECT it JOB ADDRESS MAP PAGE TRUCK# PRIOR TRUCK# TIME DUE INSTRUCTIONS LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE - W'-; UT L tf'ri tFYt rUE1 :::: 1f2CHi Pt .. 41A `'.7 sin,.. LEAVE I 1lluI1J1111 UUI1 1ffl I1lt!.1i1 f1I1I 11111111 '- - } SUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. " Returned Concrete (ABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type_ Oty AUTHORIZED BY: - Ai:KNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. - TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Taken CI Yoe O No HAZARD ASSESSMENT IAMRESPONSIBLEFORMYPERSONALSAFETYANDIWILLSTOPTHEJOBIFITBECOMESUNSAFE 1.Do I have adequate directions? ❑Yes J No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes U No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes U No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? ❑Yes ❑No 11.Additional comments: CUSTOMER CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY' TICKET HEIDELBERGCEMENTGroup* Dispatch: 425-961-7100 30 Sky River 50 Redmond 31 Mill Creek 51 Issaquah www.cadman.com Building Materials: 425-868-7334 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# I DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# E y 1 ORDER# SLUMP USE DRIVER SPACING PROJECTS 1 1 , 0'71 I CRP, TIME DUE j JOB ADDRESS 7 MAP PAGE TRUCKS PRIOR TRUCK# b.. i . i `- I ii. INSTRUCTIONS RE'ITON - DUVALL N'.'E" ME PREV wnr I: 11W f.31APP.; 13'4 NC 1 OM `.iT i li. . i HE- !••I - DOWN TO SUNSET BLVD LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE . : • 0¢ ic.:.. 'It) 70. ta.?, 'jpS4 IP LJE3DOT St IPFOPM 1 . O0 0. 0i. ...O75 •cJJ[:t_ SURCHARGE.i 1. Ok4 G'I.00 Y.645 1rli t SICK LEAvE itrt:' i PONME:NTPL '31.1 I1tIiI11i1iiI11iilii th llW 1 Ar 1111111111W 1. :*17iJijit irana1 standb4 +s, 01 t:Ila+) tie. Rio, iJt 4;Pp1led*•x SUBTOTAL TAX I)UE TO FUEL PRICE F"LUC TI.IAT I`iWt3. i7 r1.1t=t_ surcHnPnr TOTAL MAYBE corm_ zrr' Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMERS OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. • Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 113 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVE r. Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type_ Qt- AUTHORIZED BY: ACKNOWLEDGEMEN 1 Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Tsitkor. ❑VP, ❑No HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF ff BECOMES UNSAFE 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes 0 No to Dispatch/others? i.Yes ❑No 8.Are ground conditions adequate for the weight of my truck? 0 Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes 0 No 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes ❑No 11_Additional comments: i CUSTOMER CADMANN Toll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIDELBERGCEMEN"Coup' Dispatch: 425-961-7100 30 Sky River 50 Redmond www.cadman.com Building Materials: 425-868-7334 31 Mill Creek 51 Issaquah 32 Woodinville 53 Bellevue PLANT Cadman Administration: 425-867-1234 34 Everett 54 Seattle 1 DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD I DATE CUSTOMER k CUSTOMER NAME ORDERED BY JOB P.O.A . ! I is ORDER tl SLUMP USE DRIVER SPACING PROJECT S . CIO Ii AN - . . - JOB ADDRESS MAP PAGE r TRUCK# PRIOR TRUCK a TIME DUE INSTRUCTIONS no“oLI tlYr Ht- PI4E-:v WilOf ?OP CTi1RT7- ON NE 1t TTH `:-,- At. l THE WAY , r i ,,I LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE • 70, ( I.! JG:L1OT sL It,FC1P±.I ' 0. 1.) rUE:t SUfCt-tff _:, : . . qt. el, i F;T 1 CK L E I I iI , ' 4, 44 4 i1 111111 11111 ItlIl(fIll Iii II 1111111111 lIlt IJl! SUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMER'S OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type Qty AUTHORIZED BY: ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Taken CI Yes ❑No HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE 1.Do I have adequate directions? 0 Yes 0 No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated .7.Am I aware of my pinch points? 0 Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes U No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes ❑No 11.Additional comments: INVOICE COPY CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY TICKET HEIDELBERGCElv1ENTGrOu Dispatch: 425-961-7100 30 Sky River 50 Redmond l'" p 31 Mill Creek 51 Issaquah www.cadman.com Building Materials: 425, 868-7334 32 Woodinville 53 Bellevue Cadman Administration:425-867-1234 - PLANT# 34 Everett 54 Seattle 51 DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD 9 li ." /13- DATE CUSTOMER# CUSTOMER NAME '1. -s.'fkORDERED BY JOB P.O.i 1...7i7 13/E• 122 7134Q538 -oNrr; R.Y10ES TN Ala WTL_`ON 1.70 ORDER# SLUMP USE l DRIVER SPACING PROJECT* 17 1 . I?tt� i n 17PP1GGTP FRANII WILL IS C784 +5-,.-:-.r JOB ADDRESS WARPAGE TRUCK* PRIOR TRUCK If THE DUE 01_11,1ALL. a NE 10TH T K65 Hi 365 .<J2 2 :50 INSTRUCTIONS PENTON - DUVALL AVE NE PREV WAGE - J STARTS ON - LOTH . ALL TOF WAY DOWN TO SUNSET BLUC) LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION `oe + U.M. 'IK^r AMOUNT SIZE DELIVERED ORDERED CODE - I. i.t213Z1 1+4. 0171 70. 0I0 l lP':.;L_if 17' WSDOT SLIP ORR1 v ;� 4a_ - 1. 00 0. 00 6075 FUEL SUR6t4MR 3E - ea- r 1.. IZ1V1 Qt.. 00 5 h45 tIJA ST S;[CK. tVE , e a s ;'` :" `t ti T '. m r MIAAL SU CI-If ,. 117. ~ S *a T H:xyr ` 111111111 1I1ll11111r 11 �I1 IIIII_ c '� t + * 4 -'ikIditional standby g. UT charges may be applied*x SUBTOTAL TAX 7"-UE'nTTO FUEL PRICE FLUCTUATIONS. A FUE_f '.SURCHARGE TOTAL '1fl BE APPLIED I Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ONSITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMERS OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load I Wash-up WARNING: gals.to t/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVER Cadman Materials,Onc.)will not assume liability for any property damage or any W B R 1"" equipment damage for any deliveries beyond the curb line. Additions to Order Type- Qty AUTHORIZED BY: ACKNOWL E DGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE 4Concrete Tested ❑Yes ❑No PRINT NAME DATE Cylinders Taken r-1 Yes j No I; f1 HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE l: 1.Do I have adequate directions? ❑Yes 0 No 6.Are there any slip,trip or fall hazards? O Yes 0 No 11 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? _ ❑Yes 0 No to Dispatch/others? ❑Yes 0 No 8.Are ground conditions adequate;for the weight of my truck? ❑Yes 0 No i3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 1 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely toddy is: j, 5.Is there a spotter to back me in? 0 Yes 0 No 11.Additional comments: Otte:. CUSTOMER CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY' TICKET- HElDELBERGc-==>:•:ENT-?_o= Dispatch: . 425-961-7100 30 Sky River 50 Redmond 31 Mill Creek 51 Issaquah www.cadman.c rn Building Materials: 425-868-7334 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT# DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER C CUSTOMER NAME ORDERED BY JOB P.O.C . . .,-' .; LII IL.PI- 'i -31t?I,IICES 10 fillet'. -1 c::'i ORDER C SLUMP USE DRIVER SPACING PROJECT it 1 7 ii�l 1 . l 1 ri t.Pll 131 r Dm)ill LUDO T4 E'781+0 19805 JOB ADDRESS MAP PAGE TRUCK C PRIOR TRUCK C TIRE DUE Rill, L. >< NE 1 k'tali ;"f' VE.,56M11 tO: 40 INSTRUCTIONS , I'i7.'NTOI'l D1Ut'ftLL AVE Hi PVC" Wf 1 L JOB STARTS ON NE I ltTH ST- ALL. THE WA'i CROWN TO SUNSET E:L.VJD . LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE • t_ 'lf; i '{ t t.. 00 . .� , __ L Caiil'1.R(.. , I ii'., iE , 1111111 IIlI /1111 IIM 011111 .4 " ,.11ddtiiOr,a1 5tandbv & 0T Chal gri:tE ta:,' ;a� L1 p1ie.d* • SUBTOTAL TAX - ;.:: IC, rt_iE't. r'P,I f"F" tit I WW'TIJt tT 1 OH ft FI AEI, -"t.)RCHARGE TOTAL 11i` `?_ iti ri. ?E Additional ' 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby lime AUTHORIZED BY: ADDED AT CUSTOMERS OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load WARNING: Wash-up gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILITY WAIVE it Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type_ Qty AUTHORIZED BY: • ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. TOTAL CUSTOMER SIGNATURE Concrete Tested 0 Yes U No PRINT NAME DATE Cylinders Taken ❑Yes ❑No HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFE I Y AND I WILL STOP THE JOB IF R BECOMES UNSAFE. 1.Do I have adequate directions? ❑Yes 0 No 6.Are there any slip,trip or fall hazards? ❑Yes Li No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? 0 Yes ❑No to Dispatch/others? 0 Yes ❑No 8.Are ground conditions adequate for the weight of my truck'? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes D No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No Is there a transition shield in place? ❑Yes 0 No 10.The reason I will work safely today is: there a spotter to back me in? ❑Yes 0 No 11.Additional comments: i- CUSTOMER CADMANToll Free to Cadman: 1-888-322-6847 Plant Locations: DELIVERY TICKET: HE1DELBERGCEM€NTGroup4 Dispatch: 425-961-7100 30 Sky River 50 Redmond www.cadman.com Building Materials: 425 868 7334 31 Mill Creek 51 Issaquah • 32 Woodinville 53 Bellevue PLANT Cadman Administration: 425-867-1234 34 Everett 54 Seattle DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER# CUSTOMER NAME ORDERED BY JOB P.O.# ORDER# SLUMP USE DRIVER SPACING 1` PROJECT# JOB ADDRESS MAP PAGE TRUCK# PRIOR TRUCK# TIME DUE INSTRUCTIONS LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE : r Y l , 1 I - (f'tI. [1. __ y -- , i t 1.f1 - 1 l� I Ili Ail(lilt IIii1 i(1li i $i III ""),V1 t ' .1 , • . 414ASUB TOTAL TAX TOTAL Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE. WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTOMERS OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILI re WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment dams a for anydeliveries Additions to Order g beyond the curb line. Type Qty AUTHORIZED BY: ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. ---- TOTAL CUSTOMER SIGNATURE Concrete Tested D Yes ❑No PRINT NAME OATS Oygndw�TaMn U V.. QNv HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE 1.Do I have adequate directions? LI Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes ❑No to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes ❑No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes ❑No 4.Is there a transition shield in place? ❑Yes ❑No 10.The reason I will work safely today is: 5.Is there a spotter to back me in? 0 Yes 0 No 11.Additional comments: INVOICE COPY CADMANToll Free to Cadman: 1-B88-322-6847 Plant Locations: DELIVERY TICKET I-IEIDELBERGCEMENTGroup- Dispatch: 425-961-7100 30 Sky River 50 Redmond 31 Mill Creek 51 Issaquah www.cadman.com Building Materials: 425-868-7334 32 Woodinville 53 Bellevue Cadman Administration: 425-867-1234 34 Everett 54 Seattle PLANT DELIVERY TICKET NO. LOAD TO JOB ON JOB BEGIN/POUR FINISH POUR TO PLANT IN YARD DATE CUSTOMER* CUSTOMER NAME ORDERED BY JOB P.O.* -. . ,. .,; , L11.. t,r-r, jrE .; Ir041 s" ,--3t ORDER I SLUMP USE T DRIVER tic r SPACING PROJECT# .`,Al 1 r11N I F DE PO:. ,r 0.' _�-, , _ l JOB ADDRESS MAP PAG I TRUCK! PRIOR TRUCK* TIME DUE ISO NE °1Tf =? I..C•c- .L'11. 3c`3 ,'Ifl INSTRUCTIONS -- -- OI 1tt4'l _l_ CV-IFII-.).•? :-?IAPT ON 3 I h4 `_ ALL THE t4(( ` DOWN ':.;L;.,.:.v.:s BLVD • LOAD QUANTITY QUANTITY PRODUCT DESCRIPTION U.M. AMOUNT SIZE DELIVERED ORDERED CODE 1 t7TI7i -7IL'I, Oil trig:;.31_ I I"' l4911rftOT SL tP'>~OP01 v._1 l +b. 00 f',k1'4'_;-1 414-+ i _;lr't. (.E.-FiVE . Vstil - _ ' W�.,1 2 b Ate' i'r rya ;:rev [4-:.0, 0,.- d t'N4KF:-:i:S1'4►ENT IL SUEC}-i c 4! £ i-xnddit tonal s•t.ndbv . OT charges Ill' b._ aft pl f ed*54 SUBTOTAL TAX DUE TO FUEL. PRICE FLUCTUATIONS, A ruEL_ 'SURCHARGE TOTAL •-,A( Yv?E Or'F 0_..T i D Additional 7 MINUTES PER CUBIC YARD UNLOADING TIME INCLUDED. Chargeable Items ADDITIONAL UNLOADING TIME CHARGED AT CURRENT HOURLY TRUCK RATE-SEE REVERSE WATER ADDED ON-SITE ADDITION OF WATER WILL REDUCE STRENGTH,WATER Standby Time AUTHORIZED BY: ADDED AT CUSTCMER'S OWN RISK. Overtime NOT RESPONSIBLE FOR COLOR VARIATION OR gals.to full load SURFACE DISCOLORATION. Pump Blow-Back/ gals.to 2/3 load Wash-up WARNING: gals.to 1/3 load IRRITATION TO SKIN AND EYES-SEE REVERSE. Returned Concrete LIABILI-Y WAIVER Cadman Materials,(Inc.)will not assume liability for any property damage or any W B R equipment damage for any deliveries beyond the curb line. Additions to Order Type Oty AUTHORIZED BY:_ ACKNOWLEDGEMENT Signature acknowledges receipt of concrete,water addition,hazard warning, Sales Tax and acceptance of terms and conditions printed on the back of this document. i TOTAL I CUSTOMER SIGNATURE Concrete Tested ❑Yes ❑No ' PRINT NAME DATE Cylindora Takon DING., d bin HAZARD ASSESSMENT I AM RESPONSIBLE FOR MY PERSONAL SAFETY AND I WILL STOP THE JOB IF IT BECOMES UNSAFE li 1.Do I have adequate directions? ❑Yes ❑No 6.Are there any slip,trip or fall hazards? ❑Yes ❑No 1, 2.Is there a hazard that should be communicated 7.Am I aware of my pinch points? ❑Yes U No i' to Dispatch/others? ❑Yes ❑No 8.Are ground conditions adequate for the weight of my truck? ❑Yes 0 No 3.Do I have all my required PPE? ❑Yes ❑No 9.Is there any type of equipment that poses a hazard on this project? ❑Yes 0 No 4.Is there a transition shield in place? ❑Yes 0 No 10.The reason I will work safely today is: ti 5.Is there a spotter to back me in? ❑Yes 0 No 11.Additional comments:••"' 1 Truck DRIVER NAME Plant Nam Disp Ticket Num Time Date 298 DAVID HARTWIG PLT. 51 1294618 15 : 02 7/13/22 Load Size Mix Code CONCRETE SERVIC S INC Load ID 6. 50 CYDE WPSLIP RENTON — DUVALL AVE NE — PREV 178891 Material Description Design Qty Required Batched I %Moisture Actual Wat Spec.Grav 1307 SECHELT SAND 1460 lb 9778 lb 9720 lb 3.30%M 37 gl 2.65 1051 3/4" 1215 lb 7945 lb 7940 Ib 0.60%M 6 gl 2.75 1151 3/8" 475 lb 3106 lb 3100 lb 0.60%M 2 gl 2.70 6540 CEM PLC D2L133 564 lb 3666 lb 3650 lb 3.15 6411 AE-90 7 oz 46 az 46 oz 1.00 6410 POZ2-80 22 oz 143 oz 140 oz 1.00 6499 WATER 240 lb lb lb 1.00 HOT COLD 50 % 525 lb 528 lb 63 gl 1.00 RECLH2O RECLH2O 50 % # 551 lb 552 lb 63 gl 1.03 Actual Num Batches: 2 Load 25502 lb Design W/C: 0.426 Water/Cement: 0.427 T Design 188.9 gl Actual 171.4 gl To Add: 15.5 gl Slump: 1.00 in Trim Water. -20.0 lb/ CYDS • i 1 • DRIVER NAME Plai N:arãe Disp. TlcketNi TiiDt•6. 35:6 MIT,CH REED •P LT. i5.1 12.94,5 98 1 : 25 7/1.312.2 • :SiLpä z ê Mix crQN QuTE .U,RVIOES. C ID 11_ 00 CYDE WPSLI P REN,TON - DUNT.41a, AVE NE - EREV i 78885 :Material :Desdaffition . Deaign.clijr; -Ref:Of:rad Batchad. %'MaiattireI Actual Wat. 'Speh:Gratt:. 1307 SECHELTSAND 1450 lb, 116547 lb 16560 I 3:30°) M 63,,gl 265' 1051 115 lb. 13445 i6 13*° 0.6'0%to 10 gl 2.0 1151 475 lb 5256 lb 5240..lb. 0.60%M 4,01 2-70, 6540 'QEMPri:d.,C21:05 '554 lb 004 lb 61554. 315, • 6411 AE-90 7 oz 77 l'Oz 77 cfz • 1.00 ,e4io .POz2-s0 ,f22.ai 242'02, 240:oz 1.002 64:99 WATER 1,00. HOT tab '50' .859 fb .890 i 107:gl RECLH2O. RECLH2O :50, 988 lb ‘932:16, 100!gl .A04.0 Nurn3a(chesf 3 bppign. 31154 . „. 'Load 43207 lb, Design 'Wetar/come:It 2:59:8.91 To Add 2575 gl .Slump: 1.00.in Trim Water:. • • , . • • • • r • s .---. Tracic DRIVER NAME Pla,1-1 Name ID- 13' T4..oket .t\TI.44 Time Date, ... . 319 ED BILISKE PLT. 51 12,94.537 13-t11 i/13./22. Load Size Mix• Code CONCRETE SERVICE8 INCLoad ID . ... 11-00 CYDE WPSLIP RENTON - DUVALL AVE NE - PREV 11.015 ., 'Material Dqsalptiart , Design CIty' Required Batclled• '%'Moj§.ture; iNd tual Wat• Spec:Gray 1307. ,SEC.H4T:SAND 1460, lb' 16547 lb 16440 I. _. 3:30%K4 63 gl ' 265 1051 3/4" 1215;lb ' 13445'Ib• •fap.6a lb. th6004 AA, '10 gl 4151 3/.8" 475 lb. 5256 lip' 520 lb' PA%M. 4'gl 2.7o, 654'0 .CEIVIr PLC D2r133 _664. lb 62°4 lb 6195 16 3:15' 6411 AE-90 7 oz 77. siz 77.i3z 1.00 . 6410 POZZ=80. 22 oz. 242 oz .240.oz < 1.00: 6499 .W.ATM :240. lb. lb .1 , 100' HOT .COLD. 59 %s 869 lb, 692.] .107-gl 1,0p, RECL.H0 .13E0.170 50 % 9.30 lb 932 lb 108 gl 1.03 Actual* MO Mph : 3' Lc4a. 43099 lb Design W/C:. .0426' ,WatelCOmerit, 0.426 'T Design_ 316..4 gl Actual' 289.6:gl To Add: 267 gl Slunip; 1.00:In Trim Water.. 40.1(.1 II?./'CYI . —'" • . • • . '_._ • - . - . . ., ' . - ' _ . : • . , ' 1 10 l 1 • .- .... -T .1.1Olt. DRIVER N.P.EE Plat Noitt . Tilfte tata D'i$p, ILojc.07E, XMI. 323 ANTOINE HENDER8ON PLT. 51 129.4.495 '1 ;.2.1):, 71.1 /22 .. , Tycyati.-s'ize Mix' Code CONCRETE ':$gmi,T.Qn, INC ' Load ID. ... .., .. . ... ....... ... . ,... . . ., - 11..00 cYpa WpaLIR RENTON' - DOALT-4 `AVE, 11-.E - 5:REV I.J7.. 0 ..... . .. ..: Mgtenal Description Design dly. Required . Batched °A,Molture. iNchal Iil/gi Spec Gray 1-307 'SECHW--§ANIO 1460:gr .1650 6 16500 lb: 3:30%..M 53,gl .-65 1051 3/4" .12i.5.lb; 13445 lb- 13400 lb. '6:6,0°4`M' 10'.91 275 _ . 1151 ..3/8 , '475 lb• 5255 lb: 5240 lb' 0,60W* 4'bl 2:70. ' 6540 CEM,Ptd D2L133 :564 lb. 6204 lb' 6205 lb 315 641.1 0E 7 oz 77 oz -77,iiz 1:00 . . ,. 6410 P.022,50 .22.64 242.07 236;oz .: ,i:00; '040' WATER 240'Ili lb' JO, HOT ,COLD. Bro.% Be? lb. 868 ll2. '106 gl Oa RECLH2O 'RECLH2O 50"% it 933 lb. =926:lb' .106,91 143, Actual MAO BgfChes 3; • Load 43:i51' lb: clesign;.ikOl: :Q:420: Water/Cement OpB T• 'Opgigg. 3164'gl Acktil 249!ar TOMd! :27.4. 1.. Sion* 1.00 in 'Tritii Water:. ,2010 .113`1"CYDS .• • . • . ._ .... .. • . . .51 - . . :.a...-- '!1., • . 1. • ' ill. . „ - • • ; : . • a #, ---s— - 1 wiv is:3:-.-n--.!•,, , . , . ... • Tr4Ok DRIVER NAME Plant Name ti:sp:,Ticket Num TiMe D,ate 365 FRANKWILLIS. pt,T, .51 . 12 Y41136 11:19 7 413/22 . ., „., • • •...... _. , • 1 L" Load Size Mix. Code CONCRETE SERVIC INC ES . IJo4.0. .ip ii.00 C•Y bS WPSIAP PENTON - DtVALL •AVE: NET, - .PREV 17813 62 Material •Desdrlption 'Design QW ReUtiired Batotied, %Meiaturei: Adual Wat SPed:Grel",... 1307 ,SCHELT SANb 146.0 lb 16547 lb Iwo 3.3o%m, ,6.3.,g1 2-6.5 ' 1.0,51 3/4" 12;15 lb 13445 lb 13460 l g•:5".d%"..AA IQ gl 2,75, 1151 .318" 475.lb. 5256 lb 5260 lb. • 6,0%M 4 gl 227.0: 6540 CEM PLC D2L133 564- lb 6204 lb 6195 lb 6411 AE-.60; 719z- 77 oz 77 . dz . 1,00, • . 84-16 POZ1-60 22 oz •:24,2 az ;240 oz < 1.00 '6499 WATER 240:lb' lb . lb Fi1-90; gr6 . COLD .50 % #' 69 lb• 892.lb: . I o7.,gi 1.0 RECLH2O REQLFI20 50 % 983 lb 00;Ii) 106.gl 1.03 . - Actual' Nufn Batches: 3 Load 43217 lb Declgn W/C:- :0.426 _Water/Ceti:fent 0.426 I Design 316,4 gl ,Actual 289.5 gl To Add: 26,8 gl Slump; 1,00-in Trire,Waierf. 4:1‘,.0‘ li3/ c'er4 ,... 1 • - . .z1 . . ' • . "...,-1.-...r. . .' .. . . • , . ' • .., . ..,, . . . r . • • • . . - .- . , , •'-',. ' 1 T -LI.:tk DRIVER WOE Plat IUMpl 1--).,i4P- t:3,c'kOt .N,P.IT). T4.111.e bate 352 DAVILYIUDWTG PLT. 51 i252078 10- 09 7/23/22 ....... .. ... . . . ., . . .. . . , . . ... .. .... ... ..,. .. . ,. Load Size Sj.0e Mix 7 Cale -CONCRETE, SERVICES INC Load ID: _. ...... .. ..„. . ., .... ..,.. ...._ LL.,(10 CYDS NPSLI2 RENTON - Ot,VALL AVE Ng PREV i7SS4-9 _... , . ... .. _ . „.,... .. Material ,Dascriptiarl 'Design dle: -Required Batahed, -3/4 Molature: Actual Wat. $.pec. ray. 1.307' • ECFp.T wip 1460.lb. 46445 lb. 1.6360 lb• 3;09%_M 63i gl 265 .• 1051 3./4 1215;lb '13445 lb. 13380 lb. 1:160.9/9M' r10_i gl -2.7..5. • 1151 ;3/8', _ :474:lb' 3250 lb', . 52404 •:0,•,6.0.°!.9'M: 4'gl 270 6540 CEM:01:C D2L133 5P+lb 6204- lb. 619'a'ib- .. . xis 6441, Ag•Gd T oi .77'az 77 opz 1.00 .226 040 ,POZ-80 . , , Z, 242.6z -240,.dz •<, 4-00 6499' WATER: ,240:lb, lb, lb- ,. 1.00 y:::::..,--z,7,f'',•1. HOT, :-COLD,. 30 534 ib ,6,32,lb,• 64;gl 1.04 _ ,_,_ ,,,,,...f::,.. ::::''•••. RECI.H20, RECLH20 '70;%, -19. Lb 13.04-,li? iso:- 1 ---1:cri, - .. ---,--- -- • ',T.f;;-•-• k' . - . . .A.- • A.,,04! . NOrri Mafia: 3• , i ...., . -_-. Load .43116 lb Design WIC ":0'.4$ :Water/Cement: 0427 T Design316.4;gl. ,P4ual 289.3 gl To Add ;Z71 gl -',-a: ., . .., ... .„. „. ... ,Slaat 1:00 In 17-dm VV"?.teP •'*0 lki I OYOS „. - • •Ftl; . , „ • . . i?... • , . • I . . 1' •, . . . , . . ... • . 1 I . . . .• _ .•-,,..4" ,. • ', ,, - • . . . . . . ' '',,/".•• . . , • ,.:. .;.7,--,„„•:•,fer•elty: ,••••;•,:•,:V.:•tf.•7?, -'1:-.1 ,1e:7•:•;..i..:.!''.'.--..-,!, - ' -':;'7-47• :::,"•,7• 1"7.-:-."•• •••••"'",-- ‘,, :-. . . . ' . •,. ,,..,„ . . 7tutk DRIVER NAME Plant Name: Nurr( V40 O4t0. 356 EITCH REED' ELT. 51 1294352 9 t3,9. 7/1,3/22 Load. Size Mix. Code CONCRETE SERVICES INC Load ID 11 . 00 CYDS. wp$7,Iri •REN.ToN — DOVATA AVE NE P.REV 17.8-a4 4 • •- • ' Material Description Design Qty. Required 0atdied -%Moistare /.7k.gtqa) VVat pecrav 1307 SECHELT8AND 1460 lb 16445 lb -16440 lb 3.30%M 63 41 2,65. 1051 314" 1215.1b. 13.445 lb 13420 16 0.60%M. 102.7P' Op§ lb :5240 ni 0A0.v411 4'gl 6540 CMPLqD2LI33 5.64,lb 6204 lb 00'0 lb • 15 6411 AE-90 7 oz 77.oz. 77 di 1,60 6410 134022,80 22 oz 242 6z 236•olz <• 1.00 649,9 WATER 240 lb lb 16 1.00' HOT COLD 30 % 534,lb .534 16 6411 1.00 RECLH2O RECLH2O 70 V..- 13,90 lb 19;g1 1.07 - • • ACtilet Nani BeteheS: ;3 Load 43238 lb 'DpOgriVVIC:- 0,426 WaterlCement. 0427 T ' Design ,3164 gl Actual 2699 gl ToAdd 26.5 gl Slump: 1:.(10 in Trim Water -?q,Q ,dYDE • - • • .• - • • — • • • • • . • .- • • 1 , 77-,.:,.- 4."''''7'..rtr ' ' --'44-.--)...,,--,-_---..4,-`,...",--- Th.7'..-.,...2.,:i..."--7- ''- ."''.:••,-•''''-..-'' '''''- - -'''''' '''• . 'W•I''''\ - --' ' - _ . . I . . - '-,. _'• . • - .1• • • ..- ...,--, ,. • ••• •.." • • --• • Truck •DRIVE-R, NAME Plant• Narile"--" •Bltsp Ticket Nutt Time bato, ... ... .. ,.. ......... . ... ... : .. „. ... , .•. , .. .. ....._ .3., .3: ANTOINE' 'RENDEON PLT- '_ 51 .12.9-.4 29...5, ri3.!25: 7/13/22 • Load Size, Mit Cade- CONCRETE SERVICES; INC Lbad ID. 11 .00' .CYD_LS,, WPSLIR RENT ON — DPV2g4 AVE NE .-- "PlIqV. 1 7"P'P. 7 I Material .DescrTption beiign:?tty Required Batched %-Mois.tbre Actual Wet, Specpraw •13(:)7•. 'PCJ-lEl..TSA1,k,115 1460 lb 71.6446-11) 104e0 lb .?3*-4%-M '55,.r6-1:. -265 1051'. ;.. 5/4.! 1216 lb 1445':lizi 13380 lb ip.'quikm lo gl 27,5 115,1, -! Ii3" 475 lb, 5?55;lb, 5260i lb'- P;00%'M :4,-,gl-, .479 6.640 GEM PLC D2L1:3:57 04 lb 6204 lb. E:04 lb .'; :5.15 6411 ... .-AE-:40, .7 Oi .17:cit. '75 oz. :" 1,09.• 6410. .S.r. -13,tW:150. 22,oz .g42'oz 44.'qz < ' 100' 609' ' WATER 240 lb - -- 'lb .lb' .1;00 . HOT - OOLD: . ,-30--:%, - ,53,4;.11'.C, .530!lb . 14:al 4.0 FtEctHgo, REopip 7Ci %, 1300 ita. __ 1390'lb 140-gl l.07 , Actual . -N_,tn.Pa„tc.1)PP: _3 . -. ..... ... . . ....._ _. Load .483-----lb:., Design WG, . i):46. waio/Cement: 0,425 T Design ,q16,.:4 gl Actual '290'.0,gl To Add 64 gl- . , ,. • :.:': - ... ., .. Sliiiiip:, '1.00:.iry Trim Water- -20.0 lb 1.C_YDE: • . • ----. - --, - - ' -••-...=- • -- -...,_ z ... '- . . , • . . • • , • . • e i . _.-- • . , . -.r. ... ' '.5"iT--,11:','-'',-...4.,:.•:•'" :-.7.E,sc:0:! 5! ' •''': •- .!;.:,. • '. , . 1 OFFICE COPY . Ticket: 45078216 . rtN,74.0:4.7:tjcpy rriot: ci , , . - , . ,o45op,,,Auburn Asphalt. . - Date: 7:%3.2/ 022 . • -4040 Kersey Time 2(21:23PM ,'?":7 ICON' Auburri,Mkp80p2 Vehicle. • -Vehi REED614 •,'.4.:'-0.:Eit:‘444.•,.q . . . - - • t.,tre4;O••••eri 60430 Order:. - • ".4•St:Name: Reed Trucking 4 )fcavating iiiisp#: Potinds Ton. ., Aciress A:Iristructicins: Job: Gross ,40a40 20.12 Renton P.O.: #156 I Tare . 31,94Q ' 15.97 • I , I Net 8,300 We•ghrngster: Mike Morris Orbduct Loads Tota.I dtv Tidket Qty. .UM • : ".:.: . 121,442 .5 i/2"PG 581142g Mil-2 ) 1 4.15 4A5 Ton -; -_ i . • . .• . . . ,....: .i. . . Thank yOu for yo(nhutin 's! • -.4.WiRR19:!VEAWASPHAI:TiHMA)TEMPEMTURES CAN EXCEED 3E0bEGREEE.lisp 4aMniqriate protective equipment when working will nm4,.See reverse side for warranra An..1,,,".•-'•'-''' '" --,.. KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY 32500 SPR (Planck 21) BLACK RIVER Kent-KangleyE Plant#22,-R(206i 58-0912 98051avensdale.WA DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUN I ING (206)768-1000 22501 SE Lake Francis Rd Maple Valley.WA 98038 FAX (206)763-2/30 , A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY,INC- Cedar Mountain Reclamation SAL ES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 Plant#20-(206)658-0913 ' ORDER DESK (206)768-1000 I MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. KNG&EXCAVAT1W '• JOB ADDRESS COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK?: ❑CHARGE CARD II EXP. SPECIAL INSTRUCTIONS El VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS 4I UNIT PRICE AMOUNT . 11 5J8'1~ 29.42 IN 10010 WA SI ATE SICK LtAVI Sl1R4: 2: 29 42 TN 70015 ENVIRONMENTAL SLRC HAR •2Q 42 29 42 TN 70020 AGGREGATE FUEL 51JRCHX- 29.42 DRIVER , TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE— -LS,C1v!ER RE_EASES ANL AORLES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING A DIVISiON Of 'aARY YERLINO CONSt-U::TON CCIMPA•iv COP A'tiV AM.AG£ TO REAL.OR PERSONAL PROPERTY BALANCE FORWARD - 5y"'_L':'ER"DE MATERIALS LB' RE.'ERSE CUSTOMER SIEttpiE /� TOTAL PRINT NAME wY DATE ' ) .i^y( c AMOUNT ems— �� REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations y KANGLEY PIT(Plant#21) ROCK & RECYCLING 32500SE Kent-Kangley Rd.,Ravensdale,WA98051 DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant n 22)-(805)658-0912 510 Monster Rd.Renton,WA 98055 SEATTLE.WA 98108 • (206)768-1000 LAKE FRANCIS (Plant 0 23)-(206)658-0872 I ACCOUN 1 ING 1206) 768-1000 ' 22501 SE Lake Francis Rd.Maple Valley.WA 98038 i FAX (206)763-2730 1 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY.INC. Cedar Mountain Reclamation I SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant 420-(206)658-0913 , ORDER DI Si: ,',.-.)6;768-1000 I MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# i.:U 1:31 CUSTOMER NAME CUSTOMER P.O. JOB NO. I DELIVERY TICKET NO. ,,sic,8 EYrrat;; INC JOB ADDRESS V ALL A. r i, , COLLECT ON DELIVERY(C.O.D.) O CASH ❑CHECK# ❑CHARGE INENTON CARD# EXP. Y SPECIAL INSTRUCTIONS El VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS I UNIT PRICE AMOUNT 31 , , 3171 TN 70010 WA STATE SICK LI-AVE SUR( . 31.71 3171 TN 70015 ENVROMADITAL SURCHARG& 31.71 31.71 TN 70020 AGGREGATE FUEL SUN3CHAR( 3171 DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE — CUSTOMER"1ELEASES ANC AGF1 Fi,�1`1_c E.S KANGLEY ROCK&RECYCLING.A DIVISION .ADY NF ILINO C0rNSTPoc-ric V cc; i'ti Y '-}�1C.^`_.P ANY DAN1A3L '0 HIS REAL DR PERSONAL PROPERTY BALANCE FORWARD 3-` 'EL.,.EPv^ TERIALSI V• AILS ON RE;EPSE. CUSTOMER SIGNATURE , �� TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations KANGLEY PIT (Planck 21) ROCK & RECYCLING ''r+.. 32500 SE Kent-Kangley Rd,Ravensdale,WA 96051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant k 23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant 420-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT N 07,27,2022. 130100 7 74;i CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. ;TTCKNG 8 EXCAVATING INC C:AG-20-065 000155 - JOB ADDRESS DUVALL AVENUE COLLECT ON DELIVERY(C.O.D.) F'F!1fT1?NI CASH ❑CHECK# ❑CHARGE CARD# EXP. ! SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL ' QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT 30 52 TN 65021 RCA TYPE 17 COS A-516 30.52 214.1P 30.52 TN 70010 WA STATE SICK LEAVE SUCH 3052 3052 TN 70015 ENVIRONM EP4TAL SURCt hrlr—' 3.052 30.52 TN 70020 AGGREGATE FUEL 9.IPr' ' !52 I I ,,1 4 ,% i >I . `;rr ea 1102 74t` Tare 41700.C.0 Ne,t 61040 00 DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 1 13.4 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING ; KANGLEY PIT (Plant#21) �..— 32800 SE Kenl-Kangley Rd..Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plan!#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 ORDER DESK 206 PIrnt 82O (206)898.OB13 ( )768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT n 07:27;20V 730100 7-37497 .-,, CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. PEED TTCICWG&EXCAVATING /NC CAG-20-065 " ' ,56 JOB ADDRESS [1UVALL,AVENUE COLLECT ON DELIVERY(C.O.D.) RENTC1N ❑CASH ❑CHECK# - - - ❑CHARGE CARD# EXP. / SPECIAL INSTRUCTIONS El VISA ❑MASTERCARD El DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT TN 135021 RCA TYPE 17 COS A-516 '3121 1S2. +-, 3121 TN 70010 WA STATE SICK LEAVE SUM!'1 3121 3121 TN 70015 ENVIRONIMENTAL SURCHARGE 3121 3121 TN 70020 AGGREGATE KIEL S&JRCHARC 3121 - • 1.1r.-;!_: c' .041 Twro 41260,00 Net 62420 00 DRIVER TRUCK NO. ORDERED BY --t,Kx-<c`_-•; REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 V/A 1 12:15 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPAN , FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS L -:I$ II• AI, z N REVERSE. CUSTOMER SIGNATURE / 41�iN� ' TOTAL � AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING �r KANGLEY PIT(Plant y21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 �" ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET SEATTLE,125 WA AVENUE 510 Monster Rd.Renton,WA 98055 • (206)768-1000 LAKE FRANCIS(Rant#23)-(206)668-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17577 Cedar Grove Hd,SE,Maple Valley,WA98038 Plant#20-(20C)050-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# '2022 730t00 7^74; _ CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. PEED TRCKN s EXCAVATING INC ":AI 20-065 000156 409573 J . .5kVE COLLECT ON DELIVERY(C.O.D.) -iEMTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP.SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT 29.40 Ttt, 65021 RCA TYPE 17 COS A-516 29.43 152.45 .43 .I:, 70010 WA STATE SICK LEAVE SURCh "29.43 29 43 TN 70015 ENVIRONMENTAL WIC-MARGIE 29.43 29.43 TN 70020 AGGREGATE FUEL.SURCI-IARC 2943 77-....' / / 1___./ 1*. 3 J 1 Tara 4 7 ILA!`1S' 144.'t rJ,r,i i ifri DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT (Plant21) 32500 SE Kent-Kangley Rd..Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER IPlant9 22)-(206)650-0912 DELIVERY TICKET 510 Monster Rd Renton,WWA95055 , SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant 8 23)-(206)655-0872 I ACCOUNTING (206)768-1000 2'2501 SE Lake Francis Rd.Maple Valley,WA 90030 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 rlR(1FR fIESK //206``!768_ nnn Otant 670 (006)660-0010 1 _-. MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 07/2712022 790100 7 497 CUSTOMER NAME CUSTOMER P.O. JOB NO- DELIVERY TICKET NO. NI 11 EXCAVATING INC CAG-20-065 JOB ADDRESS !ALL COLLECT ON DELIVERY(C.O.D.) !ENTON ❑CASH ❑CHECK# E CHARGE CARD# EXP. / - SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD L I DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT CODE • , 3.02 TN 65021 RCA TYPE 17 COS A-516 30.02 '""r-) 30.02 TN 70010 WA STATE SICK LEAVE SlIICH 30.02 30.02 TN 70015 ENVIRONMENTAL SURCHARGE 30.02 30 02 TN 70020 AGGREGATE FUEL SURCHARC 30.02 Gross 101300 00 Tare 41260.00 Net 60040 00 DRIVER TRUCK NO.t ORDERED BY REMIT PAYMENT TO #Oil:', SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX c00E TIME DUE SEATTLE,WA 98108 ill' 1 10.11 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREE 7I'O HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION'CIN ' •R ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MAT AL 1ST ETAILS ON REVERSE. zER1 CUSTOMER SIGNATURE TOTAL PRINT NAME ''� DATE 7..t' J--gl AMOUNT REV 04-2009 CUSTOMER COPY • KANGLEY Kangley Rock&Recycling Locations - ROCK & RECYCLING `...- KANGLEY PIT(Plant*21) 32500 SE Kenl-Kangley Rd.,Ravensdale,WA 98051 ACCOUNTING:9125 AVENUE SOUTH BLACK RIVER(Plant*22)-(206)658-0912 DELIVERY TICKET SEATTLE,125 TENTHA AVENUE 98108 510 Monster Rd.Renton,WA 98055 • (206)768-1000 LAKE FRANCIS (Plant*23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 Pianc d-eu-le0ti)85a-0913 URDEFi DISK (206)766-1 UUU MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT#. - 'n 1 p,{; >;•�,,I- CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. :r_, ;t T',"KNG N ._Xf.AI: ,114... EAsr CAG-20,0FIS 000156 sr- sr* , JQQ ADDRESS l r:-+-t n1;�[ 7 If', COLLECT ON DELIVERY(C.O.D.) r-'+ r'.JN ❑CASH ❑CHECK# ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP. 0 VISA 0 MASTERCARD 0 DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS • UNIT PRICE AMOUNT II. ?• RCA TYPE 17 COS A-S16 31.0E ^1 C} ht : . WA STATE SICK LEAVE S t'CH 31-O;E5 1 15 -Ni ENVIRONMENTAL SURCHARGE 31.05 AGGPEr;ATE FUEL SUPCHAR. 31.05 /. i -_ !1 vT ')tY, !Y.,,l 1::7 1&. .si DRIVER TR CK NO, ORDERED BY REMIT PAYMENT TO 912510th AVE.S. SUB-TOTAL DISPATCHER TAX 09DF TIME,pUE. SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING „— 3 500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ±�f' ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plant 922)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant*23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Wiley,WA 98038 Plant @20-(206)652-0013 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE - CUSTOMER NO. ORDER NO. PROJECT PLANT 4 "t7 [7.?0 ;1100 737497 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. ''.EECI TRCKN( &EXCAVATING INC "Ali 10 4*.:: ;0;a4 'in D RESS ----_—_ n�`� (-• t4vIctit IF COLLECT ON DELIVERY(C.O.D.) L,- .`III`r ❑CASH ❑CHECK# ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXp / 0 VISA 0 MASTERCARD 0 DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT 30 87 TN 6502 C Rf"A TYPE 17 COS A 5it.3 30.37 ,i i, 30 37 I 70010 WA STATE SiC K LEAVE SUfk h 30.37 3037 TN 70015 ENVIRONMENTAL SURCHARG1 30.37 30.e7 70(Y2P. ACTGREOATE FUEL SUPCNARC 30.Q7 DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX COQ TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE-CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLIN()CONSTRUCTION f {INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATE R OVE: ETAILS ON REVERSE. CUSTOMER SI,GD5URE /�`...._ TOTAL PRINT NAME AMOUNT DATE "/-.�'f- ,�,,7,.:.� REV 04-2009 /7 CUSTOMER COPY r _ KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT(Plant,:21) �� 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant A 22)-(206)658-0912 DELIVERY TICKET SEATTEN WA 98108 • (206)768-1000 510 Monster Rd.Rentcn,W A98055 LAKE PRANCIS (PIaM,R`23)-(2G6)658-Og72 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA98038 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation FAX (206)763-2730 17877 Cedar Grnve Rd SF Marva lion wn oe000 SALE& Plant#20-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTO ER NO. ORIJER.NO. PROJECT l: i,�U ...1PLANT# CUSTOMER NAME FTL S TWANG j 8 EX( AV4TINt j INC CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. JOB ADDRESS+,,r. COLLECT ON DELIVERY(C.O.D.) ❑CASH L.CHECK#— — ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP.—L—_ 0 VISA 0 MASTERCARD 0 DISCOVER PRODUCT QUANTITY U.M. CODE DESCRIPTION TONS TOTAL UNIT PRICE I AMOUNT RCA M+ , .. 31 0$ TN 740: WA 5TATF. - s ,t:t l .1 31.08 10015 ENVIRONMENTAL i SURC • •t 31-08 7002'0 A CirPFi;ATF FUEL SURell • `7 ' r t t 1 1 417c, DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO I !— DISPATCHER TAX CODE9125 10th AVE.S. l+ ° - SUB—TOTAL TIME.DUE SEATTLE,WA 98108 RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD TERMS ON REVERSE SALES TAX ,F GARY MERLINO CONSTRUCTION COMPANY. INC. FOR Y DAMAG OLEY R KORRPERSON PA ROPERTY BALANCE FORWARD 'USED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. DIVISION OMER SIGNATURE �ME DATE TOTAL AMOUNT CUSTOMER COPY 1 KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT(Plant#21) 32500 SE Kent-Kangley Rd. Ravensdale,WA 98051 \iei-i ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton.WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)656-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA98338 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 Plant 020-(206)058-09 13 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO., PROJECT PLANT# CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCKNG &EXCAVAT4 INC CAG-20-065 000156 _.2"7 J¢B WAVE COLLECT ON DELIVERY(C.O.D.) RFC JTON ❑CASH ❑CHECK# — ❑CHARGE CARD# EXP. SPECIAL INSTRUCTIONS D VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT II k n 6 IN 6501 "RCA TOP CIS A-516 TYPE 2326 116.03 2326 TN 70010 WA STATE SICK LEAVE SURCt+ 2326 23.26 TN 70015 ENVIRONWNTAL SURCHARGE 23.2+6 73.26 TN 70020 AGGREGATE FUEL SURCHARr_ 23.26 (jw'r}s` ;;?w)(1.00 Tart 31980 00 NPt. 035;; DRIVER TRUCK NO. ORDERED BY tPri,Fn�.i ' REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX C,QQk t 11ME..UEA, SEATTLE,WA 98108 • Y'1 ,`{ TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE,DETAILS ON REVERSE. - CUSTOMER SIGNATURE ( �`` - TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY - Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT(Plant#21) 32500SE Kent-Kangley Rd.,Ravensdale,WA 98051 �- ACCOUNTING:9125TENTHAVENUESOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 Plant#20-(206)558-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE GUSTO sIE NO. ORDER NO. PROJECT PLANT# 730100 73 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. g-'EE � EgDTTsRCKNG&EXC:AVATIN INC 4092O ' J sAVENUE COLLECT ON DELIVERY(C.O.D.) RFNTON ❑CASH ❑CHECK# - — ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP. / ❑VISA ❑MASTERCARD ❑ DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT 22.3 V C 11 5J C RCA TOP S A.-516 TYPE 22.33 94.77 12 33 70010 WA STATE SICK LEAVE S1 CH 2233 22.33 1 1!15 ENVIRONMENTAL&,ARC/ ARC, 22.33 ?? :�0 AGGREGATE FUEL SUR f-4AR= 22.33 Nrt iS c a,. DRIVER TRUCK NO. ORDERED BY ' REMIT PAYMENT TO 9125 10th AVE.S. SUB-IOTA! DISPATCHER TM CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURES ( TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ` KANGLEY PIT (Plant#21) ROCK & RECYCLING ft.,..., 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)558-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant#20-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CL16td ER)JO. ORDER NO. PROJECT PLANT# 07.226:2022 7 7 a _? CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCKNG 8t EXCAVATI '.NC - CAG-20-08S 000156 409123 JOB ADDRESSDUVALL AVENUE COLLECT ON DELIVERY(C.O.D.) RENTON ❑CASH ❑CHECK# - ❑CHARGE CARD# EXP. / SPECIAL INSTRUCTIONS El VISA VISA ❑MASTERCARD ❑DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT CODE .. 24.14 TN 6.)i I a$`RCA TOP CPS A-516 24.14 72.44 24.14 TN 70010 WA STATE SICK LEAVE SURC:N 24.14 24.14 TN 70015 ENVM004 NTAL SURCHARGE 2414 24.14 TN 70020 AGGREGATE FUEL SURCHAR1 2414 -if.7.4.301 Tare 31990OO Net 4:3280 00 DRIVER (BUCK NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB TOTAL DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 10 14 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED.ABOVE.DETAILS ON REVERSE. r CUSTOMER SIGNATURE Z f L_ TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY 1 KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING �' 3 500 SE Keint-Kangieytt Rd,Ravensdale,WA 98051 ACCOUNTING:912STENTHAVENUESOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton.WA98055. SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant4 23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 ORDER DESK 1I206 768-1000 Plant420-(206)658-0913 l_-- ) MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT.# CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. . .;WI I S EXCAVATING INC C:AG-20-065 000156 409040 JOB ADDRESS ."_N COLLECT ON DELIVERY(C.O.D.) CASH ❑CHECK# ❑CHARGE CARD# EXP. SPECIAL INSTRUCTIONS 0 VISA ❑MASTERCARD E DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT 24,70 TN 65011 5ir RCA TOP CRS A-516 TYPE" 24.70 43 N 24.70 TN 70010 WA STATE SICK LEAVE SUR( 24 7C: 24.70 TN 70015 ENVIRONMENTAL SURCt-IA,Rf 24.70 '*.!?rt TN 7tX)2O AGGREGATE FUEL SURCHAF: 24_70 NPr -.44(X)vt' DRIVER .TRJCK NO ORDERED BY ' REMIT PAYMENT TO SUB-TOTAL 9128 10th AVE.S. DISPATCHER TAX CODS TIMF,.QUk, SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE — `-'" - ( -' TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT (Plant y21) ' .•' 32500 SE Kent Kangley Rd.,Ravensdala,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plant 22A(805)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC- Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant HQO (206)65S-0013 ORDER DESK (206)768-1 000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT#y} CUSTOMER NAME CUSTOMER P.O. JOB NO, DELIVERY TICKET NO. I:EFL►TfCKNG EXCAVATING INC :-:At-' :70-065 O(i0156 JOB ADDRESS DUVALL AVENUE-. COLLECT ON DELIVERY(C.O.D.) 1E 4 roN ❑CASH ❑CHECK#—-- ❑CHARGE t CARD# EXP. J S SPECIAL INSTRUCTIO E VISA ❑MASTERCARD 0 DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS I TOTAL UNIT PRICE AMOUNT CODE I •1. 23.60 TN 65011 541"RCA TOP CRS A-516 TYPE 23.60 't t:! 21 TN 70010 WA STATE SICK LEAVE SU t(1i 23.60 23-MD TN 70015 ENVIRONMENTAL SURCHARG* 23 60 23.40 TN 70020 AGGREGATE FUEL SURCHAR( 23.60 +ten:.,, +1 '',) T- 11r,C0Ol') Nei 4 17>' DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX COPE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX I RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK 8 RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED-ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING BLKAN GL EY P IT i(Palnang:te#y 21)4CKRIVER (Plant#22) Ravensdale,WA (206)658.091298051 L+.. . DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA98355 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant It 23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 Fln,�l#20-(200)et:0 0013 ORpR DF. EK___ 06)-7_01-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 0:. -3r,'-, 0100 737'242 —r-7 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. -LO TRCKNG &FXCAVATBVG INC: CRAG-20•-065 001015E 40 ;; JOB ADDRESS AVENUE COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK# --- ❑CHARGE p CARD# EXP. SPECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. *DE DESCRIPTION TONS • UNIT PRICE AMOUNT 3024 TN 6i0i1 5, "RCA TOP CRS.A--516 TYP 3024 is, 3024 TN 70010 WA STATE SICK LEAVE SURCti 3024 3024 TN 70015 ENVIRONMENTAL SURC 30 24 3024 TN 70020 AGGREGATE FUEL SURCHARC 3024 77 ( t '1 t,X1 Y1 Tare 41920 00 Net t+' DRIVER TRUCK NO- ORDERED BY REMIT PAYMENT TO , � ._ SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX 19pg TIM DUE 1 SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANOLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS USTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE —_ TOTAL AMOUNT PRINT NAME DATE - REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING ,.^" KANGLEY PIT(Plant#21) 32500 SE Kam-Kangley Rd..Havensdale,WA 98051 s'""' ACCOUNTING:9125TENTHAVENUESOUTH BLACK RIVER (Plant d22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 - SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 1. 22501 SE Lake Francis Rd.Maple Valley,WA98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plani#70-(2po1 bn#-U913 ORDER DEOK (20G)700-1000 I MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO, PROJECT PLANT# CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. :ri r; i-,i'KNls&EXC.AVAPWi INC CAG-2t r.-.,)1z, JOB ADDRESS.A S MJF COLLECT ON DELIVERY(C.O.D.) 1!-N1(3N ❑CASH ❑CHECK# - CI CHARGE SPECIAL INSTRUCTIONS — CARD# ---- EXP. y ❑VISA E MASTERCARD ❑ DISCOVER PRODUCT I TOTAL QUANTITY U.M. CODE DESCRIPTION TONS I , UNIT PRICE AMOUNT • :t1 `N : t; J.6'.€ CA TOP CRS A•516 TYPE 30.19 1 7.7's 30.19 ITV 70010 WA STATE SICK LEAVE RCN 30.19 30,19 TN 70015 ENVIRONMENTAL SURCHARtC 30_19 30.19 TN 70020 AGGREGATE FUEL SURCHARC 30,19 7- 7/ , • 1 I 41920 00 DRIVER TRUDKNO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX C I0 TIME DUE SEATTLE,WA 98108 A TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO((OLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING ,.w• KANGLEY PIT (Pl ant y 21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 08051 +�►". ACCUUNTING:9125TENTHAVENUESOUTH BLACK RIVER (Plant k22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE.WA 98108 • (2C6)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 5E Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 ORDER DESK (206)768-1000 Plant!IT()-(206)658-0913 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT)) 07,25/2072 730100 73724? CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. rt4CY.NG &EXCAVATING I4C CAG-20-0 000156 JOB ADDRESS DUVALL AVENUE COLLECT ON DELIVERY(C.O.D.) R1'4TON ❑CASH O CHECK# — ❑CHARGE CARD 4 EXP.—/----- SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT '�)i) 5/8'RCA TOP CTIS A-516 TYPE ,-/, 30 67 TN 70010 WA STATE SICK LEAVE SURCH 30.61 30.67 TN 70015 ENVIRONMENTAL SURCHARGE 30.67 30.67 TN 70070 AGGREGATE FUEL SURCHAP( 30.67 \ ,,,IN �� l Tare 4192'0 00 Net 61340.00 DRIVER TRUCK NO.. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX cQRE I TIME DUE SEATTLE,WA 98108 +f/' SALES TAX TERMS ON REVERSE RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATEPIALS LISTED ABOVE.DETAILS ON REVERSE CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 . CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK KANGLEY PIT (Plant S 21) RECYCLING ,.. 32500 SE Kent-Kangley Rd.,Ravensdale.WA98051 "'N.-- DELIVERY TICKETBLACK RIVER (Plant,C 222)-(206)658-0912 ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS(Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley.WA 98038 ORDER DESK _TOE)7Fi8-1 QOO Plant 020-(206)658 0913 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 07.1A,2022 'JO 100 737242 =Y CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. ' ''gCKNG 3 EXCAVATING IN,. CAG-�r!' i 00013- Jpp �DpRES _ —.. EI�` N COLLECT ON DELIVERY(C.O.D.) RF.IV ."' ❑CASH ❑CHECK# - ❑CHARGE CARD# EXP.—I--- SPECIAL INSTRUCTIONS ❑VISA 0 MASTERCARD ❑DISCOVER PRODUCT TOTAL ' QUANTITY U.M. •,a E DESCRIPTION TONS UNIT PRICE AMOUNT -„o 11 Yr RCA TOP ._, A-5I.i TYPE 15.46 46 887 15.46 TN 70010 WA STATE SICK LEAVE SURCI- 15.46 15.46 TN 70015 ENVIRONMENTAL SURCHARGE 15 46 15.46 7' 70020 AGGREGATE FUEL SURCHART- 15.46 N,.t -AG DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 912510th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO LD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLIN() CONSTRUCTIO IN OR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MA CI -DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL ►y AMOUNT PRINT NAME DATE /�...• -eC , REV p 1-2006 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING ..".' KANGLEY PIT (P ant#21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ' '" ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(2U6)658-0912 DELIVERY TICKET 510 Monster Rd-Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 I ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 I FAX (206)763-2730 A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY.INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plr,t 650•-(2013)c.1e-0e13 ORDER DESK (20G)768 1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO.20 ORDE NO. PROJECT PLANT.". 07;2522 7 /t�t2 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. r -r?OlNG$EXCAVATING SkK' C.Ala 'tt-C I ,JOH ADDRESS AYES COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK# -- ❑CHARGE CARD# EXP. SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑ DISCOVER 1 PRODUCT TOTAL QUANTITY U.M. ODE DESCRIPTION TONS UNIT PRICE AMOUNT '41 41 TI• !.i,;:t,-y Sir RCA TOP CRS A 516 TYPE 31.41 31.41 31 TN 0010 WA STATE Sri(LEAVE SUCH 31.41 -i1 41 TN 70015 ENVIPOM4ENTAL SURCHARGE 31.41 3141 TN 70020 AGGREGATE FUEL SURCHARC 31.41 / i /// �� r' 'nn TRrn 4197.0 00 NE:.' DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO - SUB-TOTAL 912510th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK 8 RECYCLING,A DIVISION OF GARY MERUNO CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO I lIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE _ TOTAL • AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY $ • KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING KANCLEYPIT (Plant#21) 32500 SE Kent•Kanglay Rd,Ravensdafe,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS(Plant#23)-(206)-658-0872 ACCOUNTING (206)768=100(r 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 ORDER DESK 206 760-1000 riarn irrO-(eun)nno-f1`Jt:7 ) MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CU O NO. ORD51A6 PROJECT PLANT# CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. ,Nti LX1.A'VATINGi INC CA6-20-065 000156 JOB ADDRESS FNUE COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT • 4 RCA _,.).A-516TYPE 31.01 93.05 WA STATE SICK LEAVE SURCH 31.01 ENVIRONMENTAL SURCHARCI 31:01 AGGiEGATE FUEL SIJRCHAR 31.01 I ; Tare 41780 00 �4 DRIVER TRUCK NO. ORDERED BY . REMIT PAYMENT TO - SUB-TOTAL 9125 10th AVE-S. DISPATCHER TAX CODE TIME.DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERUNO CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING 1.,...+ KANGLEY PIT(Plant#21) 32500 SE Kent-Kangley Rd.,Ravensdale.WA98051 t BLACK RIVER (Plant#22)-(206)558-0912 DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING 1206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98039 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Greve Rd.SE,Maple Valley,WA 98038. Plant#20-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE _ CUSTOMER NO. ORDER NO. PROJECT PLANT# 4.1 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. JOB ADDRESS i;;1VR1 _ t:rt tyr t: COLLECT ON DELIVERY(C.O.D.) r,_Rd_,,,t,, ❑CASH ❑CHECK# ❑CHARGE CARD# -- EXP. V SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT - TN ►5011 &V"RCA TOP C RS A-516 TYPE 3128 iN 70010 YYA STATE SICK LF11VE Si1IGH 312E 7N 70015 ENVIRONMENTAL SURC1-IARGI 31.28 -: TN 70020 AGGREGATE FUEL SURCHARC 31.28 / ' /I . DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 �~.rat I SALES TAX TERMS ON REVERSE RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY , KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING 'a„r, KANGLEY PIT(Plant N 21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ww,. ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(208)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 l Plant 1/20•(206)668,0013 ORDER DESK (206)768 1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT 4 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. JOB ADDRESS COLLECT ON DELIVERY(C.O.D.) ' ❑CASH ❑CHECK# O CHARGE CARD# EXP. 1 SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑DISCOVER PRODUCT TOTAL QUANTITY U.M. 0 DE DESCRIPTION TONS UNIT PRICE AMOUNT tt 1O010 ti 4 . i Ali_ ;. ._ . 30 1-- 70015 ENVIHONMENTAL S:1RC,I-tARt1 30.75 70020 A':�.,::E f iAT:L rig.- ^I fir>;t-i API: 10"N / � 1 .1 b.\ i!,, 1 7 _ ,/, . • DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS CN REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY , Kangley Rock&Recycling Locations KANGLE ROCK & RECYCLING 325U02500 YPIT (Plant#21) SE Ken!-Kangley Rd.,Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plant#22)-(206).658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant 46-23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 206 DES K SK 768 1000 Plant#20-(2061 658-0913 ( ) MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT ' PLANT# pit 'II,:!;-: 100 .. 4,) .7°) CUSTOMER NAME CUSTOMER P.O. 'JOB NO. DELIVERY TICKET NO. REED PlCKNG P EXCAVATING INC CAC L0-0435 0001S 407&A JOB ADDRESS rANACI..AVIE'N11E COLLECT ON DELIVERY(C.O.D.) P,E T:N ❑CASH ❑CHECK#- --- ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP. f ❑VISA ❑MASTERCARD 0 DISCOVER PRODUCT TOTAL QUANTITY U.M. ODE DESCRIPTION TONS • UNIT PRICE I AMOUNT •rN 65011 . 'J-i *-itjA i ti1' 4$'):a at'J!Li t a="i. ;.Ai..)^i t:�re_4i ).54 TN 70010 WA STATE SICK LEAVE SURCH 30.54 30.5.4 TN 70015 ENVIRONMENTAL SURCHARGI 30.54 V.54 TN 70020 AGGREGATE FUEL SURCHARC 30 54 • f /" r , � / Gras 1 d 3 Tare 41740 ' t.t ,,10 0.PO DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 47 SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 WA 1 13.52 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY �*,, Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT (Plant#21) 32500 SE Kent-Kangley Rd.,Rarensdale,WA 93051 ACCOUNTING:9125 TENTH AVENUE SOUTH SLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23) (206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 08038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley;WA 98038 Plant#20-(206)653-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 0 7"A)7'07'7 730100 ? CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCING ti EXCAVATING INC $7.:AG-20 :5 000'156 4076+Y; JOB ADDRESS +iADDRE AVER COLLECT ON DELIVERY(C.O.D.) PENT 0 CASH 0 CHECK# -- ❑CHARGE CARD# EXP. 1 SPECIAL INSTRUCTIONS D VISA D MASTERCARD C1 DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS ` UNIT PRICE AMOUNT v _ . t .. S- v I- _ 30V TN 70010 WA STATE WIC LEAVE SU Ci 0,62 30 62 TN 70015 MRC} N TAL SURCHAR th 30-62 30 62 TN 70020 AGGREGATE FUEL ' * 2 J r .:.may., i fires, 1029 0.O0 Tare. 41740 00 - Net 161240.00 DRIVER TRUCK NO. ORDERED BY • ••'MENT TO t '4Pr'47.~ SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 WA 1 ' -45 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DNISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 • CUSTOMER COPY 1 • KANGLEY „ Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT(Plant i21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ACCOUNIING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)650-0912 DELIVERY TICKET 510 Monster Rd.Rerton,WA96055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant$23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY,INC Cedar Mountain Reclamation SALES& 17877 Ceuar G-ove Rd.SE,Maple Valley,WA 98038 Plant#20-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 17,20 2(122 730100 73 5 rm CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. • REED TRCKNG&EXCAVATING INC CAG-20-065 000156 407450 JOB ADDRESS DUVALL AVENUE COLLECT ON DELIVERY(C.O.D.) RENTON 0 CASH C-I CHECK# --- ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP. ! ❑VISA El MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. COD DESCRIPTION TONS UNIT PRICE AMOUNT • 3124 114 70010 WA STATE SICK LEAVE SURC ' 3124 3124 TN 70015 ENVIRONMENTAL SURD-Mt 3124 31 ?4 TN 70020 AGGREGATE FUEL.SURC .• 3124 , ,. 1 f I /7/1'. / Tare 417.01 On Net 62490.00 DRPJ_H TRUCK NO. ORDERED BY --e}/t747 REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME DUE SEATTLE,WA 98108 WA 1 9:35 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASESAND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY t KANGLEY --r, Kangley Rock&Recycling Locations ROCK & RECYCLING KANGLEY PIT(Plant#21) 32500-SE Kent-KangNy Rd..Raver:dale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(205)658-0912 DELIVERY TICKET 513 Monster Rd.Renton,WA 93055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS(Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98036 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant#20-(206)858-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# -n < 111 CUSTOMER NAME - CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. 11 I. 'r KNI. ?t. —# -;Wt.I:M.4 iNC 17 ti; tt-t`? ik01 1t - JOB ADDRESS - COLLECT ON DELIVERY(C.O.D.) ' +. :N _ ❑CASH O CHECK t( ❑CHARGE SPECIAL INSTRUCTIONS - CARD# - - EXP.—/ ❑VISA ❑MASTERCARD ❑DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL . . • UNIT PRICE . AMOUNT TN 70010 WA STATE SICKLdWE WWI 30.07 3t) TN 5 ENVIRONMENTAL SURCHAR,dC 30A)7 • 30.4 i 7N 70020 AGGREGATE FUEL SUS: 3007 ''..,. 77/1 ,-. 1 :ra• _a' ;01W 00 Fare 4174000 Ni , 't1t47tf ) DRIVER TRUCK NO. ORDERED BY ._ R7.1 REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE i TIME.DUE SEATTLE,WA 98108 WTERMS ON REVERSE SALES TAX RELEASE-CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC.FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE _ TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY ;ANGLEY Kangley Rock&Recycling Locations LOCK & RECYCLING KANGLEY PIT (Plant y21) 32500 SE Kent-Kangley Rd.Ravensdale,WA 98051 BLACK RIVER (Plant r 22)•(206)658-0912 DELIVERY TICKET ;COUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton.WA98055 I ACCOUNTING (206)768 1 G00 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658.0872 22501 SE Lake Francis Rd-Maple Valley,WA 98038 ', FAX (206)763-2 7 30 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 ORDER DESK (206)768-1000 Plant 820-(206)658-0913 - - _ 1AP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT )Ar.TE. 1, CUS j.1O. ORDER PROJECT PLANT# ` ,� :USTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRC:KNG &EXCAVAT1N6 INC- C AG 201)65 000156 i u'us'r Melia.TSAVENUE COLLECT ON DELIVERY(C.O.D.) RFNTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP ;PECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD 0 DISCOVER PRODUCT ' TOTAL QUANTITY U.M. CODE DESCRIPTION TONS • UNIT PRICE AMOUNT i '. • ..*11 •': "fir +< try , • ' I.. , . !h 32 78 TN 70010 WA STATE SICK LEAVE SURCI^ 32 76 32.76 TN 70015 ENVIRONMENTAL SURCHARa 32.76 32_76 TN 70020 AGGREGATE FUEL SURCHN:K 32.76 Goss '07500 00 Tr-.? 41980 00 Net h552 ►rX DRIVER "79U 1910.. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. I DISPATCHER TAX G 1 TIME l SEATTLE,WA 98108 I TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION BALANCE FORWARD OF GARY MERLIN()CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS REAL OR PCRSONAL 'POPETITY CAUSED BY DEL:VERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE.L _- CUSTOMER SIGNATURE C L-- -- I ~ TOTAL AMOUNT PRINT NAME DATE REV 04-2009 INVOICE COPY ANGLEY Kangley Rock&Recycling Locations Plant KANGLEY PIT ( #21) OCK & RECYCLING 32500 SE Kent-Kangley(Plant Rd.,Ravensdale,WA 98051 DELIVERY TICKET BLACK RIVER (Plant#22)-(206)658-0912 COUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton.WA 98055 0 00 ACCOUNTING (206)7681 • SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS(Plant#23)-(206)658-0872 206 763-2730 22501 SE Lake Francis Rd.Maple Valley,WA 96038 FAX (206) IIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation I SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 IORDER DESK (206)768-1 CUO__ Plant#20-(206)658-0913 AP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT '-;IF CUSI 1 10. ORI PROJECT PLANT# _ ,, t� USTOMER NAME CUSTOMER P.O. JOB NO. I DELIVERY TICKET NO. FAD TRC-KNG &EXCAVA1IN(I iNC- r -- "Y) i) • -)0015:1 1 i0S014 OataarAVENUE COLLECT ON DELIVERY(C.O.D.) PPFNTON ❑CASH ❑CHECK# ❑CHARGE CARD# EX PECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD . 0 DISCOVER • PRODUCT TOTAL UNIT PRICE AMOUNT QUANTITY U.M CODE DESCRIPTION TONS a, 1 651011 or,: ''• It' 3138 TN 70010 WA STATE SICK LEAVE SURC1" 31 38 3138 TN 70015 ENVRONIAENTAL SURCHARG 3138 31.38 TN 10020 AGGiIEGATE REL SLIRCHAR 31 38 4. 1. /- /---./ r GFOSS '04' 'i0 Tare 4 4 I Net 67760.00 DRIVER ,S u ORDERED BY REMIT PAYMENT TO �, ?�) SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX GM ' `''TIM DUE: SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUS(C.'AER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK at RECYCLING.A DIVISION BALANCE FORWARD CI- GARY MERLIN()CONSTRUCTION COMPANY. INC FOR ANY DAE.'AGE TO HIS REAL OR PEFSONA_ PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTEC ABOVE.DETAILS ON REVERSE. -- CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE REV 04-2009 INVOICE COPY AANGLEY Kangley Rock&Recycling Locations LOCK & RECYCLING KANGLEY PIT (Plant it;21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET :COUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA 98055 ACCOUNTING (206)768 1000 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)650-0872 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 )IVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cr Mounta RecmoLES& 17877 Cedar Grove Rd.in SE,Maplelaati Valleny,WA SA 98038 I Plant#20-(206)658-0913 ORDER DESK (206)768-1000 IAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT ATE CUSp9140,f10. ORDaLtJp., PROJECT PLANT# USTOMER NAME CUSTOMER P.O. JOB NO. I DELIVERY TICKET NO. V E i TWANG EX(AVATIN6 AO C:AG•20-065 000156 I 405022 NAMTAVENUF COLLECT ON DELIVERY(C.O.D.) PENT N ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. t IPECIAL INSTRUCTIONS # 0 VISA ❑MASTERCARD , 0 DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS • UNIT PRICE AMOUNT bdt. ti5O11 4; 'Sr . 1.4 . 3162 TN 70010 WA STATE SICK LEAVE SLW CP- 31.62 31.C2 TN 70015 ENVIRONMENTAL SURCHARCil 31.62 3162 T14 70020 AGGREGATE FUEL Sl%2CHARG 31,62 :II oss "0522000 Tam 41900.00 Ne +7a ,:t?P' DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX F'YA 1 TIME P SEATTLE,WA 98108 "tt TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A A .SKY'. OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY D.AMA F .IIS REAL OP PERSONA. pP BALANCE FORWARD CAUSED BY DELVERY OF MATERALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE '! ` A TOTAL AMOUNT PRINT NAME DATE REV 04-2009 INVOICE COPY I(ANGLEY Kangley Rock&Recycling Locations IOCK & RECYCLING KANGLEY PIT (Plant 821) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 CCOU yTING:9125 TENTH AVENUE SOUTH 510 RIVER (Plant a 22)-(2061 658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 _ SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant N 23)-(206)658-0872 ACCOUNTING (206)768-10001 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206)763-2730 j DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 Plant#20-(206)658-0913 ORDER DESK (206)768-1000 NAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT Jn t2' CU3�iOME$NO. ORDFEi pI PROJECT PLANT# 7-> �77��WW rxl'JU u CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRC.KN( &EXCAVATING, ' A 'f) €A.-A WO i56 1 4050 +. "p.UNTSAVENt1F COLLECT ON DELIVERY(C.O.D.) PENTON ❑CASH ❑CHECK# 0 CHARGE CARD# EXP. SPECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD • El DISCOVER PRODUCT TOTAL QUANTITY I U.M. CODE DESCRIPTION TONS • UNIT PRICE AMOUNT tO1I '1;- • A tO t_i-Ca r •' ' t -4V, }', 29.96 TN 70010 WA STATE SICK LEAVE SLPC11 2 98 29.96 TN 70015 ENVE ONN NTAL SURCHARGE 2996 29 9E TN 70020 AGATE REEL.SURCHAR 29.98 / / --1 7/ I (.moss '0103:10 00 T 21et 41720 OC 144.# %19P30 00 DRIVER .,TRUCKNO,- ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX cm 1 TIM6)UE SEATTLE,WA 98108 cm, I TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLir..L DF SARY MERLINO CONSTRUCTION COMPANY, 'NC. FOR ANY DAMAGE TO OS 7E4'(. ^P 'FPr=' ' BALANCE FORWARD CALSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE 1EV C4-2009 INVOICE COPY I • ANGLEY Kangley Rock&Recycling Locations KANGLEY PIT (Plant it 21) ;OCK & RECYCLING 32500SEKent•KangieyRd..Ravensdale,WA98051 DELIVERY TICKET BLACK RIVER (Plant$22)-(206)658-0912 ._C._.. COUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton.WA 98055 ACCOUNTING (206)768 1000 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS(Plants 23)-(206)658.0872 I 22501 SE Lake Francis Rd.Maple Valley.WA 98038 ' FAX (2C6)763-2730 )IVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation I SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 L ORDER DESK (2C6)763-100.0 Plant$20-(206)658.0913 1. AP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT ATE CUEFi NO. ORQAQ._ PROJECT PLANT# USTOMER NAME CUSTOMER P.O. JOB NO. I DELIVERY TICKET NO. IRK}TRCPIG &EXCAVATII!4.I INC C`AG-20 065 O001`06 I 405079.EIWAre i►VENUE COLLECT ON DELIVERY(C.O.D.) RENTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXR 7 PECIAL INSTRUCTIONS ❑VISA 0 MASTERCARD • 0 DISCOVER TOTAL UNIT PRICE AMOUNT CODEPRODUCT DESCRIPTION TONS QUANTITY U.M. •i. .96 1 N i36011 : RCA TOE'C1 S A-518 ' 29 96 178.55 24 96 T1r 70010 WA STATE SICK LEAVE St%CN 29.9.6 29.96 TN 70015 ENVIRONMENTAL SURCKARGI 29.96 29 96 TN 70020 AGGREGATE FUEL SURCHAR( Z9 96 s Gross '01900 00 T Af. 41930.00 Not 59920 00 i . DRIVER .IRlWNO., ORDERED BY REMIT PAYMENT TO SUB-TOTAL iG+ 9125 10th AVE.S. DISPATCHER TAX To EE TIM SEATTLE,WA 98108 j A TERMS ON REVERSE SALES TAX RELEASE—CUS'OI:1EP RELEASES AND AGRLES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS PEAL OR PFPSONAL P9OnEHT`! BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LIS. ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE (— L. i - TOTAL AMOUNT PRINT NAME DATE REV 04-2009 INVOICE COPY • I(ANGtEY Kangley Rock&Recycling Locations BOCK & RECYCLING KANGLEY PIT (Plant21) 32500 SE Kent-Kangley Rd..Ravensdale.WA 98051 CCOUryTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant A 22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton.WA98055 ACCOUNTING SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant A 23)-(206)658-0872 (206)768--1 C30 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206)763-2 7 30 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 ORDER DESK !206 768-1 Q(10 Plant A20-(206)658-0913 _. ) _.. VIAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE 07 12202'' CUMfj N0. OR� PROJECT PLANT# 7., CUSTOMER NAME CUSTOMER P.O. JOB NO. 'DELIVERY TICKET NO. REED TRCI(NIG&EXCAVAT 4G*it c k•r ow' �lu;*, • 405135 'INg1 CIS vE-NuE COLLECT ON DELIVERY(C.O.D.) RENTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. 7 SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD , ❑ DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT .: 11 TN 65011 mr RCA TOP CRS A-516 '' 29.11 207.66 29.11 IN 70010 WA STATE SICK LEAVE SURC.t+ 2911 2911 TN 70015 EN/PO*ENTAL SURCt1ARCA 291 2911 TN 70020 AGGREGATE FUEL S&ECHAW 2991 4 / f Gross 9C#44000 Tarr 4172000 Net 5 '2000 DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO ",I:.OF"�� SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CM811TIME DUE SEATTLE,WA 98108 1 0' TERMS ON REVERSE SALES TAX ;ELFL-CF— :'4 e LASES AND AGREES TO HOLD-(ARMLESS KANGLEY ROCK&RECYCLING ^_'I DE GARY '..L-4L .0 CC ...E.;CTiON COMPANY INC. FOR ANY DA'.'A;E TO --.S PF.:,:. OR PERSONA, PROPERTY BALANCE FORWARD 7AUSED BY DELIVERY OF 1'ATER'ALS LISTED ABOVE.DETAILS ON REVERSE CUSTOMER SIGNATURE TOTAL AMOUNT DRINT-NAME DATE EV 0d-20C9 INVOICE COPY CANGLEY Kangley Rock&Recycling Locations KANGSEYent (PlantyR1) IOCK & RECYCLING 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 CCOU TING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET I`!. 510 Monster Rd.Renton,WA 98055 I SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant#20-(206)658-0913 ORDER DESK (206`.738-1',CD AAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT )ATE CUSTOtMIF. WO. ORDE1,N.O,„ PROJECT PLANT# a,, ;USTOMER NAME mu `�•� CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCkNG&EXCAVATNt INC CAG-20-066 000156 406137 ICI VENUE COLLECT ON DELIVERY(C.O.D.) PF.P4TON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. J iPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL QUANTITY U M. CODE DESCRIPTION TONS UNIT PRICE AMOUNT k. s2 TN 6�11 srRCA •TOP C• A- 1 =•_ 29 :: ` 29 8i TN 70010 WA STATE SICK LEAVE SURC1i 29112 29 32 TN 70015 ENVIROMAEWIAL SURCHARGE 29.82 29 V TN 70020 AGGREGATE FUEL SLIRC HAR r 29 82 t. .47 gross 01620 " <1 a; I Net 59640.00 JRIVER TA ORDERED BY st.K REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL )ISPATCHER TAX WA 1 TIME,p,�)E SEATTLE,WA 98108 ii� l TERMS ON REVERSE SALES TAX 1ELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION )F GARY I'AFRI...INC CONSTRUCTION COMPANY, INC_ FOR ANY DAMAGE TO HIS REAL OR PERSONA_ PROPERTY BALANCE FORWARD :JIUSED BY DELIVERY OF YATERIAI S LISrtU ABOVE.DETAILS ON REVERSE. USTOMER SIGNATURE ( ( i -, - TOTAL AMOUNT DRINT NAME DATE E'J Co!-2C09 INVOICE COPY CANGLEY Kangley Rock&Recycling Locations IOW( & RECYCLING KANGLEY PIT (Plant21) 32500 SE Kent-Kangley Rd..Ravensdale.WA 98051 COUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant 6 22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant R 23)-(206)658.0872 ACCOUNTING (206)i 68-1000 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206)763-2730 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY.INC. Cedar Mountain Reclamation SALES 8 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 ORDER DESK (206)/68-1 ODO Plant.120-(206)658-0913 AAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT ATE;T�E CU$rTOFjj-NO. ORQF,Jj N-Q..r PROJECT PLANT X 'USTOMER NAME CUSTOMER P.O. JOB NO. r DELIVERY TICKET NO. PEED TRCKNG &EXCAVATING INC LA:r?"t r iS 000156 405195 Eitan VENUE COLLECT ON DELIVERY(C.O.D.) RENTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. y iPECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD , 0 DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT CODE •► � 85011 • •'v 1'4 • _ ••'; 1 466.15 2927 TN 70010 WA STATE SICK LEAVE SURCt+ 2927 2927 TN 70015 ENVIRONMENTAL SIPCHA Gi 2927 2927 TN 70020 AGGREGATE FUEL SUF CHAR: 2927 % r I rocs 100620.II 1 Tara 41%0-00 I -b 3'i4a4C.1. 7 DRIVER TRUCK NO. ORDERED BY liU.='•-- REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. )ISPATCHER TAX wA TIMEEL),UE SEATTLE,WA 98108 1h TERMS ON REVERSE SALES TAX RELEASE — O',IER RELEASES AND AGREES TO HC_D(✓ARMLESS KANGLEY ROCK&RECYCLING A DIV:SION )F GA-./Y ',ERL"O CONSTRUCTION COMPANY, :NC. FOR ANY DAMAGE TO KS REAL OR PERSONA_ PROPERTY BALANCE FORWARD ;AUSED BY DF.L'VERY Cc`.1AIEHtALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE • V 1 `-__ -I TOTAL AMOUNT PRINT NAME DATE EV 04-2009 INVOICE COPY (ANGLEY Kangley Rock&Recycling Locations JOCK & RECYCLING KANGSEKentY PIT (angleyPlant#R1) 32500 SE Kent-Kangley Rd..Ravensdale.WA 98051 CCOU yTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton,WA98055 l SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley.WA 98038 FAX (206) /63-2 f30 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 Plant#20-(206)658-0913 L ORDER DESK (206)768-1000 WAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATEt CUSJ(�p �LNO. ORDFR NQ._ PROJECT PLANT# DUSTOMER NAME ` lW � [' CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. gq REED 1�RC1C NG &EXCAVATING INC. C,AG-2U-065 000156, 405196 )Ul1YAtt.AVE E COLLECT ON DELIVERY(C.O.D.) RENT(_)N 0 CASH ❑CHECK# ❑CHARGE CARD# EXP. / SPECIAL INSTRUCTIONS • Cl VISA ❑MASTERCARD . 0 DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS Q UNIT PRICE AMOUNT 65011 ' -.- , i • "Iit, • 4: 1• -.1 2916 TN 70010 WA STATE SICK LEAVE SURCF' 2916 29.16 TN 70015 ENVIRONI€NTA.SURCHARG( 29.16 2916 TN 70020 AGGREGATE FUEL SURCHAR1 291a1 1 1 / ,., LI , : t /. d Gross 00040 00 ; Tr• 41720.00 N, it DRIVER TRU DLO. ORDERED BY ;. REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. )ISPATCHER TAX so TIME f(E18 SEATTLE,WA 98108 �{P TERMS ON REVERSE SALES TAX IELEASE —CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIV C'. )F GARY MEPL:NO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL CR PERSONA;_ PROPERTY BALANCE FORWARD ;A.USED BY DELIVERY OF MATERIALS LISTED ABOVE DETAILS ON REVERSE • CUSTOMER SIGNATURE TOTAL AMOUNT 'RINT NAME DATE EV 0.1-2009 INVOICE COPY ANGLEY Kangley Rock&Recycling Locations KANGLEY PIT(Plant#21) 32500 SE Kent•Kan9ley Rd..Ravensdale,WA 98051 OCK RECYCLING BLACK RIVER (Plant#22)•(206)658-0912 DELIVERY TICKET COUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 [-ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 )(VISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. C Moun Reclamtio SALES& I 17877edar Cedar Grove Rd.tain SE.Maplea Valey,n WA 98038 ORDER DESK (206)76_8-1000_1 Plant#20-(206)658-0913 AP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT 671vz0n GUSIQJ)i{� O. OROitli Y PROJECT PLANT# rU /l 7avv f�W rRt` CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCKNG EXCAVATING INC NAME CAG-20- r)1 e1Srj 4{SZ.: . REED1 -T Vatidis11VENLIE COLLECT ON DELIVERY(C.O.D.) PFNTON ❑CASH ❑CHECK# ❑CHARGE CARD# EXP PECIAL INSTRUCTIONS 0 VISA 0 MASTERCARD . 0 DISCOVER PRODUCT TONS TOTAL UNIT PRICE i AMOUNT QUANTITY U.M. CODE DESGRIPTI-)f, / •. yN 65011 4;_ •& ;;• I•1.. • •' 1i 24 1 24 TN 70010 WA STATE SICK LEAVE S$J4C14 2824 2 24 TN 70015 Eli1MRCINIA WITM.SURCHARG1 28,2E 2c^.24 TN 70020 AGGREGATE FUEL SURCHARC 2824 1 r (. , (*.MSS 96460 OC as 41960 IX Nit 56,480 00 DRIVER *TNR., ORDERED BY REMIT PAYMENT TO SUB-TOTAL + � 9125 10th AVE.S. DISPATCHER TAX CO y TIME 3IJE,7 SEATTLE,WA 98108 SALES TAX Y A TERMS ON REVERSE RELEASE-CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION BALANCE FORWARD OF GARY MERLINC CONSTRUCTION COMPANY. INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY _ CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. r . CUSTOMER SIGNATURE - — TOTAL AMOUNT PRINT NAME DATE REV 04-2009 INVOICE COPY CANGLEY Kangley Rock&Recycling Locations . 1OCIC & RECYCLING KANGLEY PIT (Plant 4 21) 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 ING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant p 22)-(206)658-0912 DELIVERY TICKET CCOU (kT 510 Monster Rd.Renton.WA98055 SEATTLE.WA 98108 • (206)768-1000 LAKE FRANCS (Plant k 23)-(206)658-0872 ACCOUNTING (206)768 1000 22501 SE Lake Frarcis Rd.Maple Valley.WA 98038 FAX (206)763-2730 DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE.Maple Valley,WA 98038 Plant 420-(206)658-0913 ORDER DESK (206)768-1000 v1AP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT )ATE CU NO. OR PROJECT PLANT# 07;122022 � ► :USTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED IRO:141:i &EXCAVATING INC CAG-20-065 000156 405232 Bum as . 1'.1E COLLECT ON DELIVERY(C.O.D.) RENTS - ❑CASH ❑CHECK# ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP. • - - - - . .❑VISA ❑MASTERCARD 0 DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL c UNIT PRICE AMOUNT 31 14 TN 6'>5011 se-RCA TOP CRS A-516 TYPE 31 14 3 79 46 31 14 TN 7U010 WA STATE SVC LEAVE SURCr 31 14 31.14 TN 70015 ENVIRONMENTAL SURC-HARCi4 31.14 31.14 TN 70020 AGGREGATE FUEL SURCHAR y 31 14 1 4 4 1- 4/ ' '1. f i • i i tr� 1 alI S- 'M W i:) Tare 41720.0E Net tQ230.00 DRIVER ,1RUG3.NO: ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX CQQf TIMEDUE SEATTLE,WA 98108 4'1'' SALES TAX ` TERMS ON REVERSE RELEASE—CUSTOMER RELEASES AND AGREES TO HOW HAW,' - • '. )F GARY MERLw0 CONSTRUCTION COMPANY, !NC FOR ANY C ... ;: --., :- BALANCE FORWARD 3AUSED BY 3ELVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME DATE EV 0--2009 INVOICE COPY KANGLEY Kangley Rock&Recycling Locations A t ROCK & RECYCLING3 32500 EY PIT (Plant Kenl-Kangley 21 j BLACK RIVER (Plant#22)(206)�658-091251 DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Renton.WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant X 23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francs Rd.Maple Valley.WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 , ORDER DESK (206)768-1000 Plant eno (206)sea-0013 ---..E - MAP L OCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 07'1'2:' _32. 730100 736250 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. F;EFF)T RCKN1 a EXCAVATING INC C;AG 20-065 405023 Jei. R s 1VENLJE COLLECT ON DELIVERY(C.O.D.) PFNTON ❑CASH ❑CHECK# U CHARGE CARD# EXP. y SPECIAL INSTRUCTIONS ❑VISA ❑MASTERCARD El DISCOVER • PRODUCT y TOTAL QUANTITY U.M.? CODE RCA is 1�T TONS • UNIT PRICE AMOUNT 1 i tise i l 5�i'1,CA-i o ,, tom: •-4-5 tV f;f'17'. .-c....,7 i v.61 -. - IN 70010 WA STA1F SICK LEAVE SURC H 22.85 .: :. :) TN 70015 ENVIRONMENTAL SURCN iR( 22..85 72'44 TN 70020 AGGREGATE FUEL SURC fA : 22.85 • • ,:, 7- - DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO - = - SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX CODE TIME_DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX pp Fi4F—CUSTOMER RELEASES AND AGREES TO)IOLD HARMLESS KANGL.EY ROCK 8 RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION R DAMAGE TO IHS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS,,_ •, Air O N REVERSE. CUSTOMER SIGNATURE TOTAL AMOUNT PRINT NAME /DATE ' —/•7f . 4 REV 04-2009 (,/ CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations r 11 "�6 ROCK RECYCLING 32500 SE KANGLEY PITKcnt(Plant yR1) d. R ( r` BLACK RIVER (Plant#22)-(206)6588-0912 9805� ""'� i� DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd-Renton,WA980SS SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant 4 23)-(206)658-0872 ACCOUNTING (206)768-1000 .,,I 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& i 17877 CedarGrova Rd.SE,Maple Valley,WA 98038 ORDER DESK (206)768-1000 Plant esa-12021 eso-osla MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 01;1?"20.7? 0100 73h CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TPC!(NG II EXCAVATING IN(' CMG- f25 M i vE E - - COLLECT ON DELIVERY(C.O.D.) PENT ON • 0 CASH ElCHECK# ❑CHARGE CARD# — EXP. SPECIAL INSTRUCTIONS , , ❑VISA ❑MASTERCARD 0 DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT ..4 :e "_' . , 1 5,1"RCA TOP CR S A-516 Mk. .- 4 17 N 70010 WA STATE SICK LEAVE SURC?1 24.17 }4.17 TN 70015 ENVIRONMENTAL SURCHPPGL 2417 .--4.17 TN 70420 AGGREGATE FUEL SUPCHARic 2417 L • -•jc>. - 1.4 .f i 0 32140,00 Net 48340-00 DRIVER ..Tlj_VSJ�1Q• ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX C2.111 nME.D)JE_ SEATTLE,WA 98108 TERMS ON REVERSE I SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COIy1P NY, IN .FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATEI3►AE t B ETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL / AMOUNT PRINT NAME DATE a REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations /)'5s ROCK & RECYCLING KANGLEYS PIT( 21) /� 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 '`.—, ACCOUNTING:9125 TENTH SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET SEATTLE,WA AVENUE98108 510 Monster Rd.Renton,WA 98055 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant rzo-IcoeJ a e-oo o ORDER DESK (20r5)106-I WU MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMS NO. OR R.N . PROJECT PLANT 130100 i 16 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. PF`L1 i1 CKNG&EXC:AVAT1NG INC CAt --20 OtY# 5- JQB-A 5 VENUE COLLECT ON DELIVERY(C.O.D.) ' '' "< ❑CASH L 1 Ci IECK-Ir— - ❑CHARGE SPECIAL INSTRUCTIONS CARD#-- p / ❑VISA ❑MASTERCARD El DISCOVER PRODUCT TOTAL QUANTITY U.M. CODE DESCRIPTION TONS ` UNIT PRICE AMOUNT S'E"f?t'A TOP'CPS A-516 ' 31.70 31 70 N 10010 WA : :ATE SICK LEAVE Si FICI 31-70 ._ "N 70015 EN RONMENTAL SURCHARGE 31.70 70020 AGGREGATE FUEL SURCF _ 31.70 44.04---,!.111141111111K WIP11101110POINIVT. ,''"er.-_.,,.. - - s 1 r 1A► r- - j Tare 42300.00 Net 6340(100 r DRIVER _TRUCK.NO. ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX COOS TIME, E. SEATTLE,WA 98108 -• TERMS ON REVERSE SALES TAX RELEASE —CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY _.' a- KANGLEY Kangley Rock&Recycling Locations A -3S ROCK & RECYCLING 32500 SE Kent-Kaing eyff Rd.,Ravensdale,WA98051 `-- ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)558-0912 DELIVERY TICKET SEATTLE,WA 98108 • (206)768-1000 L LAKE FRANMonster CISd. (Plant WA 98055 FRANCIS (Plant k 23)-(206)658-0872 1 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation (206)763 2730 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 SALES& Plant#20-(206)658-0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT TARRIVE JOB LEAVE JOB ARRIVE PLANT DATE � CUGTl7ft�V)NO. ORD.EPINQ_ PROJECT ���00 ! t J�} PLANT�'�t -71 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. ED TRC KNG 4 EXCAVATING IkC CAG-20-0t- 1 01015E 404762 jPRNattsikVENI.IE COLLECT ON DELIVERY(C.O.D.) 'EN TON ❑CASH ❑CHECK# — ❑CHARGE SPECIAL INSTRUCTIONS CARD#-- EXP. ❑VISA 0 MASTERCARD 0 DISCOVER f QUANTITY PRODUCT DESCRIPTION TOTAL CODE TONS UNIT PRICE AMOUNT 541"RCA -r ,4 A-516 327.3 .33 9-.ii 32 n TN 70010 WA STATE WICLEAVE St}RC*1 3223 3223 TN 70015 ENYSIONMENTAL SURCHARGE 3223 32.23 TN 70020 AGGREGATEFUEL SURCHAR': 3223 A • 1 ; / I • / :;l us 0.137130 tX / Tare 42 ( DRIVER TALI (N0,, ORDERED BY - �fi'+ REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX WA, . TIMEiQUE_,i SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE— CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KAt4GLEY ROCK A RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY — - - — - _ r KANGLEY Kangley Rock&Recycling Locations p ,55 ROCK & RECYCLING 3500SE Kent-Kangley Rd..Ravensdale,WA98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET SEATTLE,WA 98108 • )768-1000 510 Monster Rd.Renton,WA 95055 206 ( LAKE FRANCIS (Plant#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd-Maple Valley,WA 98038 FAX A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation (206)763-2730 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 SALES& Plant#20-(206)658-0E13 ORDER DESK (206)768-1000 MAP LOCATE I LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CU TO R NO. ORDER N . PROJECT PLANT# t�7 1;2Q _ d:. CUSTOMER NAME REED �AVA CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. T/NG INC CAG-20-046 000156 404851 JQ6.4DpE3ES5� COLLECT ON DELIVERY(C.O.D.) 1RENTON ❑CASH ❑CHECK# - - ❑CHARGE SPECIAL INSTRUCTIONS CARD#-- EXP. ❑VISA 0 MASTERCARD ❑ DISCOVER QUANTITY i U.M. PRO CDDUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT 3 51S`RCA TOP CRS A-516 TYPE 32.09 96.02 32.09 -TN 70010 WA,STATE SICK LEAVE SURCH 32.09 32.09 TN 70015 ENVIRONMENTAL SURCHARGE 32.09 �2* TN 70020 AGGREGATE FUEL SURCHARC 32.09 • • • • • 1C 34`0 O Tare 42300 00 Net 6-4100-011 DRIVER TRUCK NO. `ORDERED BY _ TRUCK "O. REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX TIME Q DUE C„ 1 2. SEATTLE,WA 98108 1'.r - TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC- FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING �"'" KANGLEY P32500SEKent-Kangley Rd.,Ravensdale,WA 93051 \‘.., �� ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plant Renton, 22)-(206)658-0912 DELIVERY TICKET SEATTLE,WA 98108 (206)768-1000 610 Monier Rd.Renton,WA 23)- 55 LAKE FRANCIS(Plant;*23)-(206)658-0872 ACCOUNTING (206)768-1000 1 22501 SE Lake Francis Rd Maple Valley,WA 98038 FAX (206)763-2730 i A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 SALES& Plant#20-(206)653-0913 ORDER DESK (206)768-1000 J MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT 17Ei 1 0 � CU$ F�3 N0. OROFR t t PROJECT PLANT# II UUUU CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED TRCKNG&EXCAVATING INC CAG-20-065 000156 404912 jaNanVENLIE COLLECT ON DELIVERY(C.O.D.) ?ENTC1N ❑CASH ❑CHECK# ❑CHARGE SPECIAL INSTRUCTIONS CARD# EXP / El VISA 0 MASTERCARD 0 DISCOVER QUANTITY U.M. PRODU CODE T DESCRIPTION TONS i TOTAL UNIT PRICE AMOUNT -., TN 65011 ,.s. :-it.,A i UP CRS A-516 60 1 62 29.60 TN 70010 WA STATE SICK LEAVE SURCH 29.60 29.60 TN 70015 ENVIRONMENTAL SURCHARGI 29.60 29.60 TN 4020 AGGREGATE FUEL SURCHARE 29.60 .. ,,� ct_ I (/ ( • ;\ .:., 101 c;t`. ,:),) Tare 42300,00 \ Net 592U0.00 DRIVER -T a N, ORDERED BY , oq, REMIT PAYMENT TO • 9125 10tlt AVE.S. SUB-TOTAL DISPATCHER TAX WOE TIM U 4 A 1 �°;li..`h SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION J OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME DATE AMOUNT REV 04-2009 CUSTOMER COPY • KANGLEY Kangley Rock&Recycling Locations r;)5 ROCK KANGLEY PIT (Plant it 21) RECYCLING 'ti..,.-- 32500 SE Kent-Kangley(Plant it 22 Rd.-200)658-0912,Ravensda'e,WA 98051 ' BLACK RIVER DELIVERY TICKET ACCOUNTING:9125 TENTH AVENUE SOUTH 510 Monster Rd.Revlon,WA 98055 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCIS (Plant#23)-(206)658.0872 I ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Va'Iey,WA 98038 Plant#20-(206)SG8-0013 L ORDER DESK (206)768 1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# 07111/20 '. 730100 7361 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED �TRCKN, &EXCAVATING INC CAG-20-065 000156 JOB kg iSSVENU COLLECT ON DELIVERY(C.O.D.) RENTON ❑CASH ❑CHECK# ----- - ❑CHARGE SPECIAL INSTRUCTIONS CARD#- EXP. I ❑VISA ❑MASTERCARD ❑ DISCOVER PRODUCT TOTAL I QUANTITY U.M. ,� DESCRIPTION TONS �, UNIT PRICE AMOUNT 1. a =-,, ,v;;:v WA STATE SICK LEAVE SLIRCI1 17.55 • . 17.55 TN 70015 ENVIRONMENTAL SURCMARGI. 1755 •±I,,., -7.55. TN 70020 ' AGGREGATE FUEL SURE)-ARC 17.56 17.55 TN 65011 5J ""RCA TOP CRS A-516 TYPE 17.55 143.17 , •:. 1. 7 . 1 t t G,oss 107560.0) Tare 72460.00 Ntyt 351a `.0;; DRIVER 1R KF(O. ORDERED BY >r ;_ �' REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. ,,b, DISPATCHER TAX WA1T1ME1D1JE4 SEATTLE,WA 98108 $Q W TERMS ON REVERSE j SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE _- TOTAL AMOUNT PRINT NAME DATE REV 04-2009 CUSTOMER COPY , 1 t 45 KANGLEY Kangley Rock&Recycling Locations ' y nr� ROCK & RECYCLING KANGLEY PIT(Plant#21) i -U.{ 32500 SE Kent-Kangley Rd.,Ravensdale,WA 98051 `4� ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER(Plan!#22)-(206)658-0912 DELIVERY TICKET 510 55 SEATTLE,WA 98108 • (206)768-1000 LAMonster (Plant 23)WA-)206 LAKE FRANCIS (Plant¥23J-(206)658-0872 ACCOUNTING (206)768-1000 i 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 ORDER DESK ("LU(o)fbB-1 11UU Ntant.:LU-(2W ti7ti-U913 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUiTAFI=LNO,. OR( �1Q PROJECT PLANT O)(0) �7�rtrtJ CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. . f.Av4T1NG INC CAG-20-065 000156 40 1 i JOB ADDHESS COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK# ❑CHARGE SPECIAL INSTRUCTIONS CARD# IXp / El VISA 0 MASTERCARD El DISCOVER PRODUCT TOTAL QUANTITY U.M. DESCRIPTION TONS UNIT PRICE AMOUNT CODE 25.46 TN 65011 `RCA TOP CRS A.516 TYPE 25 • 46 •49 40 25.46 TN 70010 WA STATE SICK LEAVE S IB 25 ' . 25.46 TN 70015 EN11IRONI ENTAL SURCHARGJ 25.46 25.46 TN 70020 AGGREGATE FUEL SURCMAW 25 46 • c GI ri5S e T . 32240 t_tfr , + DRIVER TRUCK NO. ORDERED BY REMIT PAYMENT TO 912510th AVE.S. SUB-TOTAL DISPATCHER TAX pi:2u TIME WE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE-CUSTOMER RELEASES AND AGR 0 HO1;D HARMLESS KANGLEY ROCK&RECYCLING.A DIVISION OF GARY MERLINO CONSTRUCTION COMP OR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS D DETAILS ON REVERSE. i CUSTOMER SIGNATURE I TOTAL / PRINT NAME t DATE AMOUNT REV 04-2C09 CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations I�Y �� • ROCK & RECYCLING '�..• 325 SE KentKangley Rd),Havensdale,WA98051 \,... Y/�► ACCOUNTING:9125TENTHAVENUESOUTH BLACK RIVER(Plant#22)-(206)658-0912 DELIVERY TICKET S125 T EN WA AVENUE 98108 510 Monster Rd.Renton,WA 98055 • (206)768-1000 LAKE FRANCIS (Marl#23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis1Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley,WA 98038 Plant ago-(PM)050.0813 ORDER DESK (200)768-1000 . MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOM/3 NO. ORDER NO, PROJECT PLANT i# b.7:O82O 7?�0"100 73g135 22 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. PEED TRCKNG &EXCAVATING INC CAG-20-0R5 I 410156 0)4181 JLIi �3SAVENUE COLLECT ON DELIVERY(C.O.D.) KENTON ❑CASH ❑CHECK 4 -- ❑CHARGE SPECIAL INSTRUCTIONS CARD 4-- EXP. I ❑VISA 0 MASTERCARD ❑DISCOVER PRODUCT DESCRIPTION 1 QUANTITY U.M. TOTAL •. 5/Er OP may[ tQ t7R�C �YT3Ortl�r.S UNIT PRICE AMOUNT "-•'`i I:li ry.,4)t i 518 'T ' C�'f J A-5 t V I I PE 23.94 6,1 23 94 TN 70010 WA STATE SICK LEAVE SORCil 23,E+4 23.94 TN 70015 ENNAROI*.IENTAL SURCHARGF 23.94 2394 TN 70020 AGGREGATE FUEL SUR 23,94 H,120.00) '$?240.00 1�`P 1 art '; 'a:,i'f' I DRIVER B)JcFw., ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX cpp€ , TIME•DUE SEATTLE,WA 98108 t.� , TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMP Y INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIAL .E.DETAILS ON REVERSE. CUSTOMER SIGNATURE �_ TOTAL PRINT NAME f AMOUNT , f�,� DATE ", ic —mot ' REV 04-2009 V CUSTOMER COPY KANGLEY Kangley Rock&Recycling Locations 9D1(.9 f -/'A'11-€ �/ KANGLEY PIT(Plant 21) i • 1 i 2 ROCK RECYCLING 32500SE Kent-KangleyRd.,Ravensdale,WA98051 Y 1 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant/!22)-(206)658-0912 DELIVERY TICKET SEATTLE,WA 98108 • (206)768-1000 LA Monster CI (Plantn.WA98205 LAKEFRANCIS (Plantk23)-(206)658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 ORDER DESK 768-1 000 Plant W20 (206)659-0910 j06 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMER NO. ORDER NO. PROJECT PLANT# C17 1 7,207" 730100 776.4- :,- CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. PE1[ + '2C:KNG &EXCAVATING INC CAG-20.-065 000156 JPk jpR}5 VF - COLLECT ON DELIVERY(C.O.D.) -N I-IN ❑CASH ❑CHECK# ❑CHARGE CARD# EXP. / SPECIAL INSTRUCTIONS El VISA 0 MASTERCARD ❑ DISCOVER QUANTITY U.M. PCODDCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT .3-1 T ICU I i J:'.,'i ZLA i 1 tip i i-(6 A-518 TYPE 22.27 «.0 t' 22.87 .(1. 70010 WA STATE SICK LEAVE SU C1-i 22'7 22.87 TN 70015 ENVIRONMENTAL SURCHARG I 22.87 22.87 TN 70020 AGGREGATE FUEL SURCMARi 22.87 -- -- -+- w.00+4,.wv#p4.-.., .,. . - -..-.._._ _ . . • "�.. -1r t' `i,'::1' ip1 Net 4574000 DRIVER TfliPSAIQ,y ORDERED BY REMIT PAYMENT TO SUB-TOTAL 9125 10th AVE.S. DISPATCHER TAX Cop 1 TIMEpl1E, SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES- HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLIN()CONSTRUCTION COMPANY .F - NY DAMAGE TO HIS-REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LIS- ILS ON REVERSE. CUSTOMER SIGNATURE -! TOTAL PRINT NAME I L.e DATE ' '' AMOUNT REV 04-2009 - 1 CUSTOMER COPY KANGLEY . K a gle pRocka&Recycling Locations ;\"-Y l A�" '�? ROCK 8e RECYCLING 32500 SE Kent-Kangley Rd.,Ravensdale.WA 98051 ' ICE VV jrrr'777 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-1(206)658-0912 DELIVERY TICKET 510 Monster Rd.Renton, 55 SEATTLE,WA 98108 • (206)768-1000 LAKE FRANCS (Pant#23)'- 658-0872 ACCOUNTING (206)768-1000 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd.SE,Maple Valley.WA 98038 Plant#20-(206)658.0913 ORDER DESK (206)768-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT DATE CUSTOMCUS.IgAiibNO. ORr ;.►•, PROJECT PLANT 41 CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. REED T RC:KNG&EXC.AVATU G INC C'AG-20-065 1+)0156 40 t763. jbEUVR.E5WENUE COLLECT ON DELIVERY(C.O.D.) REi9 O N EI CASH ❑CHECK;# ❑CHARGE CARD# EXP. SPECIAL INSTRUCTIONS 0 VISA ❑MASTERCARD 0 DISCOVER QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL s I_ UNIT PRICE AMOUNT 76 31 ,„_:y.: . 51E"RCA TOP a A-516 TYPE 26.31 '1 26.31 IN 70010 WA STATE SICK LEAVE SURCH 26.31 26:31 TN 70015 ENVIRONMENTAL SURCHARGE 26.31 26.31 TN 70020 AGGREGATE FUEL SURCHAR: 26.31 • ,,..__ `. !t''0 r>il. Tare 32000.00 , Net 5262000 . f I DRIVER _?11PrcJ149., ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX ,Q,>�G D TIME , ��-�; SEATTLE,WA 98t08 SALES TAX TERMS ON REVERSE RELEASE—CUSTOMER RELEASES AND AG• -• OLD '•RMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUC I• ..• may. .); • Y DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD f CAUSED BY DELIVERY O RIAL D :T s b AIL ON REVERSE. t . F 11pk CUSTOMEIj,SIGN TURRE /��(/7 I TOTAL r ( /J PRINT NAME * DATE ' 0' AMOUNT , REV 04-2009 I CUSTOMER COPY C , ) D _ ) 1 . 'Z KANGLEY Kangley Rock&Recycling Locations ROCK & RECYCLING — KANGLEYKen:PIT `an9IeyRd. 32500 SE Kerr-Kangley Rd.,Ravensdale,WA 98051 ACCOUNTING:9125 TENTH AVENUE SOUTH BLACK RIVER (Plant#22)-(206)658-0912 DELIVERY TICKET SEATTLE,WA 98108 (206)768-1000 L LAKEM FRA CISd. (RPlan( WA 99205 0 FRANCIS (Plant#23)-(206)65$-0872 ACCOUNTING (206)76II-1000� 22501 SE Lake Francis Rd.Maple Valley,WA 98038 FAX (206)763-2730 A DIVISION OF GARY ME-RLINO CONSTRUCTION COMPANY,INC. Cedar Mountain Reclamation SALES& 17877 Cedar Grove Rd SE,Maple Valev,WA 98038 Tian[d26-(Z08)658-0013 OHUtH DESK (206)766-1000 MAP LOCATE LEAVE PLANT ARRIVE JOB LEAVE JOB ARRIVE PLANT Dt 11120 ? CUSTQMEI.tNO. ORD, JQ. PROJECT PLANT# rc CUSTOMER NAME ((/�;/ /�� INC 1 CUSTOMER PO. JOB NO. DELIVERY TICKET NO. ',.NIGJ Q EXC-.AVATINCi N{- CAG.20-VW 40:X! 56 ,it!.3.947, JOR ADDRESS COLLECT ON DELIVERY(C.O.D.) ❑CASH ❑CHECK# - ❑CHARGE SPECIAL INSTRUCTIONS CARD#— EXP. 0 VISA ❑MASTERCARD 0 DISCOVER w QUANTITY U.M. PRODUCT DESCRIPTION TONS TOTAL UNIT PRICE AMOUNT CODE iii ,1,,; TN r(.:h)14 ..STATE SICK LEA SURC 1 .08 1508 TN 70015 ENVIRONMENTAL SURCHARQ 15.08 15-oe TN 70020 AGGREGATE FUEL SURCNAM: 15.08 15 3 TN -_4202 UTILITY WORE I_SAM) 15.08 15.08 ) • ,;.,,,:. ;2490.K T.re 42300 00 • DRIVER x ORDERED BY REMIT PAYMENT TO 9125 10th AVE.S. SUB-TOTAL DISPATCHER TAX ODE TIME DUE SEATTLE,WA 98108 TERMS ON REVERSE SALES TAX RELEASE—CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS KANGLEY ROCK&RECYCLING,A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY BALANCE FORWARD CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE.DETAILS ON REVERSE. CUSTOMER SIGNATURE TOTAL PRINT NAME— DATE AMOUNT REV 04-2009 CUSTOMER COPY • 9FNTOr Force Account Summary Contract Number Date Change Order No. CAG-20-065 8/3/2022 A8-Utility Conflict Resolution Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Labor Date Amount 1 7/18/2022 S 706.56 2 7/19/2022 $ 722.34 3 4 5 6 7 8 9 8 Total S 1,428.90 9 31%Overhead,Profit,Etc. S 442.96 10 Labor Total S 1,871.86 Equipment Date Amount 11 7/18/2022 S 89.62 12 7/19/2022 $ 112.03 13 14 15 16 17 18 Total S 201.65 19 21%Overhead,Profit,Etc. S 42.35 20 Equipment Total $ 243.99 Materials Date Amount 21 22 23 24 25 26 27 28 Total $ 29 21%Overhead,Profit,Etc. $ 30 Materials Total $ 31 Mobilization $ - 32 Subcontractor S 2.115.85 Subcontractor Markup 12%/10%/7% 253.90 33 525,000/$100,000/Over S 34 Force Account Total S 2,369.75 Inspector Date Contractor Date c9 Daily Report of Force Account Labor Contract Number Date Change Order No. CAG-20-065 7/18/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Worked Worker Occupation,Use Prevailing Wage Description Reg.Rate O.T.Rate Amount Reg. O.T. 1 Schaun Brodie Foreman 2.0 0 $ 107.24 $ - $ 214.48 2 Chad Crandall Operator 2.0 0 $ 83.43 $ - $ 166.86 3 Brian Grohs Laborer 2.0 0 $ 62.81 $ - $ 125.62 4 Nicholas Jonas Electrician 2.0 0 $ 99.80 $ - $ 199.60 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - 10 $ - Inspector Date Contractor Date $ 706.56 Total Daily Report of Force Account Labgr Contract Number • Date Change Order No. CA &- Z0- ob5 7- 43_ZZ L.eweZ Cast AP S7[. 22_ . Prime Contractor Subcontractor/Lower Tler Subcontractor P ut4ty-- 7-4 /eovt e/rL�isL /J Hours Worked Worker Occupation,Use Prevailing Wage Description Reg.Rate O.T.Rate Amount Ce Reg. O.T. 1 rJGk"u (_.1�1 oleC /Q2/I/Cc. 2 $ 2 i✓ (� $ i c.�Lea�(/� C/lCG Y Yt c7�n"' rL 3 C L ( �11A,sc�c( drr` 2 4 U.( (c}.� n n4t S Los r A-- $ S • 6 • $ 7 $ - 8 $ - 9 $ - 10 • InsyQt/for Date �i Contract � J/ ; $ J �h� �� 7`li -22i G�(�r / Dat f/ (/ dZ Total (;) Daily Report of Force Account Equipment Contract Number Dat€� Change Order No, CAG-20-10("cob /"/S-Z Z_ L o e• Prime Contractor wL CA r c h✓ <STL Z Z� /t rd TeUc,4-, Subcontra�(Qr/Lower TierSubc9ntracor y / a f-ent_ e/aG /, L Equipment Number Description(/ Hours WorkingHours Standby Reg,Rate Standby Rate Amount 1 1-241� 6/rtc.iry 771ocic 2 3 ,i Ne EK .a - 2- $ 3 • $ . 4 $ . 5 . $ - • 7 - 8 9 _ S . $- - - 10 - S Total S - • Inspect Date ,�/N I J A tro4,aµ 7-/I k J /< 0G�2L Contrtor / U Date / '�7 J / 4rY�a Daily Report of Force Account Equipment Contract Number Date Change Order No. CAG-20-065 7/18/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Equipment Number Description Hours Working Standby Reg.Rate Standby Rate Amount 1 646 JD 35 Mini Ex. 2.0 0 $ 29.20 $ - $ 58.40 2 246 Service Truck 2.0 0 $ 15.61 $ - $ 31.22 3 4 5 - 5 S - 6 $ 7 S 8 S 9 S - 10 S Total s 89.62 Inspector Date Contractor Date • Daily Report of Force Account labor Contract Number Date ChepIge Order No. CA6,- av- 0c.5 7—/ f - ZoZ eesc.,- J-,8aw zS` Prime Contractor /� Sub.ontra for/LowerTierSubcontractor X P[r% T'e v c k r�� f o fern , Hours Worked Worker Occupation,Use Prevailing Wage Description Reg.Rate 0.T.Rate Amount Reg. 0.T. 1 S(,havn.) -roCif C P'�1..-t I • $ . • 2 , V;G/L Jv/,./AE eltr/fe10/t--' 2,S $ • 3 ??CLt c( C N�e( 6Pe°.may-6_ �,S $ ' 4 _ D act r tis 6?rt>I,S 1 a 2{ (1— 2 ,_ $ S $ - 6 $ _ 7 $ - 8 $ 9 $ 30 J $ - Ins Zr / Date Contractor �� Dat J�V dN E�Rr-µme '-i!`-?y 6h6vo✓ /J/'cr%/L t7I /)2 Total $ - • LIR Daily Report of Force Account Labor Contract Number Date Change Order No. CAG-20-065 7/19/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Worked Worker Occupation,Use Prevailing Wage Description Reg.Rate O.T.Rate Amount Reg. O.T. 1 Schaun Brodie Foreman 1.0 0 $ 107.24 $ - $ 107.24 2 Chad Crandall Operator 2.5 0 $ 83.43 $ - $ 208.58 3 Brian Grohs Laborer 2.5 0 $ 62.81 $ - $ 157.03 4 Nicholas Jonas Electrician 2.5 0 $ 99.80 $ - $ 249.50 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - 10 $ - Inspector Date Contractor Date $ 722.34 Total • 0 • Daily Report of Force Account Equipment Contract Number Date Change Order N . CAG-20-i�4p(ob i(is ei-- U -Qo 2 5 Prime Contractor R ce,0 -i',e v c ke. Subcoytractggr/Lower Tier Subcontractor . P r-f t .Nt.c. I /D 1-67r1 C/f C,, Equipment Number Description Hours Workin Hours g Standby Reg.Rate Standby Rate Amount 1 M.i/Je e>FA-U44oL 2 ,T s - 2 -r2t-,c, 4.,-Lt4y -r,�v<<< _ 2.6 s - 3 S . 4 5 S S 7 $ - 8 _ . $ - 9 $ - • SO • $ - Total S - Date Contractor /� 4!/�%J Date p 7 .2 In oA A Ai EA 2w� _ —7-/l.o Z t� (� c - 7(J 2 Y ■f Daily Report of Force Account Equipment Contract Number Date Change Order No. CAG-20-065 7/19/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Equipment Number Description Hours Working Standby Reg.Rate Standby Rate Amount 1 646 JD 35 Mini Ex 2.5 0 $ 29.20 $ - $ 73.00 2 246 Service Truck 2.5 0 $ 15.61 $ - $ 39.03 3 4 S - 5 S - 6 S - 7 S - 8 S - 9 S - 10 S - Total S 112.03 Inspector Date Contractor Date Force Account Summary Contract Number Date Change Order No. CAG-20-065 7/6/2022 A8-Utility Conflict Resolution Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Labor Date Amount 1 6/30/2022 S 126.74 2 3 4 5 6 7 8 9 g Total S 126.74 9 31%Overhead,Profit,Etc. S 39.29 10 Labor Total S 166.03 Equipment Date Amount 11 6/30/2022 S 59.31 12 13 14 15 16 17 18 Total S 59.31 19 21%Overhead,Profit,Etc. S 12.45 20 Equipment Total S 71.76 Materials Date Amount 21 5/13/2022 S - 22 23 24 25 26 27 28 Total S 29 21%Overhead,Profit,Etc. S - 30 Materials Total 5 31 Mobilization $ 32 Subcontractor S 237.79 Subcontractor Markup 12%/10%/7% 33 $25,000/$100,000/Over S '3 53 34 Force Account Total $ 266.32 Inspector •Date Contractor Date 4 GI Daily Report of Force Account Labor Contract Number Date Change Order No. CA6.- zo- 065 6 - 30- 2z • D?;/' Co...44c/- ee.� ��.-4/:. . Prime Contract-or //�� Subcont actor/Lowe/rTierSubcontractor PPU .0 Gk:v -T-rC� To/F..t £7 (. Hours Worked Worker Occupation,Use Prevailing Wage Description Reg.Rate 0.T.Rate Amount I/ Reg. O.T. - 1 IC �it �OrrPus 4,-) •So _ $ 2 IZUf) Art-,Ql,;f OPeial:."-- , So $ - 3 Chr c/ 7-cty(,.1..)t(L 4,6b 6, .ti . SO $ - q 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - Ins or Date Contractor Date _ Jp r✓ �ALy wp / �-S Z2/ C., l(/ �' • 22 Total $ 4 Wit',{ TY 0d i 9C• FNTO# Daily Report of Force Account Labor Contract Number Date Change Order No. CAG-20-065 7/6/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Worked Worker Occupation,Use Prevailing Wage Description - Reg.Rate O.T.Rate Amount Reg. O.T. 1 Blake Ellis Foreman 0.5 0 $ 107.24 $ - $ 53.62 2 Rob Arvuld Operator 0.5 0 $ 83.43 $ - $ 41.72 3 Chad Turner Laborer 0.5 0 $ 62.81 $ - $ 31.41 4 $ - 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - 10 $ - Inspector Date Contractor Date $ 126.74 Total Daily Report of Force Account Equipment Contract Number Datee Change Order No. CAG-20- Q(o) � (o -.3o- ZZ_ 07i/ 1 C°o ���zG C l Prime Contractor 1 O¢luc Subcontractor/Lower Tier Subcontractor ' h+Yiwe rhi m Inc. TG/r M F/p C Hours Equipment Number Description Hours Working Standby Reg.Rate Standby Rate Amount 1 £C)6C-t- , so $ 2 g41Z1 111bio 'Durt.n T,evck. , Sa $ 3 ZULU:CC Ti h _ So $ 4 • $ - 5 $ . a $ - 9 $ - ao $ - Total $ in S$ 4 /i Da1-s z Contractor j( /' Date, y,a sT 0 Daily Report of Force Account Equipment Contract Number Date Change Order No. CAG-20-065 7/6/2022 Prime Contractor Subcontractor/Lower Tier Subcontractor Reed Trucking and Excavating,Inc. Totem Electric Hours Equipment Number Description Hours Working Standby Reg.Rate Standby Rate Amount 1 Bobcat 35 0.5 0 $ 71.00 $ - $ 35.50 2 246 Service Truck 0.5 0 $ 15.61 $ - $ 7.81 3 406 Dump Truck 0.5 0 $ 32.00 $ - $ 16.00 4 $ - 5 $ - 6 $ - 7 $ - 8 $ - 9 S - 10 $ - Total $ 59.31 Inspector Date Contractor Date