HomeMy WebLinkAboutWWP2700181 SAN-1 HOUSER WAY SEWER REPAIR S-181
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CITY OF RENTON - UTILITIES DEPT. TREASURER'S STUB
200 WI Avenue So... Renton, weshingfon 98055 RENTON UTILITIES DEPT.
Phone 235-2527
PLEASE RETURN THIS STUB WITH REMITTANCE
MAKE CHECKS PAYABLE TO CITY TREASURER
DATE April 18, 19714 2C0 MIII Avenue So., Renton, Washington 98055
SUNDRY SALES BILL N2 3649 SUNDRY SALES BILL N2 3649
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r Washington State Department of Highways
Washington SV%te Department of 1i hways
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I� AMOUNT DUE $ 6424.44 � $ 6424e44-1
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W.G. 2929 Repairs on 8" sanitary sewer
Houser Way crossing under the North Renton
Interchange
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Labor $ 719 95
Material 35 82
Equipment 296 53
Overhead 5 37
Contractor Cost 5274 10 lI
Railroad Fla.-man Cost 92
167
6424 44 $ 6424 ' 44
S.S.BILL N° 3649
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ROSERT V GRAHAM RICHAWp L HUSK
aTF A. _ �R A m ASc TAP,, STATE AQ01T0R
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W STATE AUDITOR
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March 8, 1974
Mr. Warren C. Gonnason
City of Renton
200 Mill Avenue, S.
Renton, Washington 98055
Dear Mr, Gonnason:
This will acknowledge receipt of your claim against the State of
Y µ Washington in the amount of $6, 424. 44, received by this office on
March 7, 1974.
State liability has not been established; however a copy of your
claim has been forwarded to the Attorney General. Further cor
respondence or inquiries regarding the claim should be addressed
Tort Claims Division
Office of the Attorney General
5th Floor License Building
Olympia, Washington 98504
Very truly yours,
ROBERT S1.x GRAHAM, State Auditor
Byr4, e
R A. Bowen
puty State Auditor
RAB:hr
cc: Joseph S. Montecucco "
Assistant Attorney General
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I I N T E R O F F I C E C O R R E S P O .N D E N C E
_ _ _ _ _ _ _ _ Date_ y
Februar 26, 1974
TO: Warren C. Gonnason
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FROM: Richard C. Houghton
SUBJECT: Houser Way N. Billing
Enclosed please find the hilling from Coluccio Con-
struction on the sewer main break on House_ Way N.
As you know this was done under emergency procedures,
and the bill is now ready for signature and forwarding
to Finance foi pe.:yment.
We are in the process of communicating with the Statu
Highway Department requesting their forms that need to
be filled out for reimbursement for these repairs.
Recap of costs to date:
Coluccio $ 5,274.10
City Forces 1,057.67
Burlington RR
(not received)
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Enclosure
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(Claim mt a filed within 120 days of the date the cle arose.)
CLAIM FOR DAMAGES
NOTICE: For statutory provisions governing claims against the State of Washington, see other side and Ch.
4.92 RCW. I
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TO THE AUDITOR OF THE STATE OF WASHINGTON: i
City of Renton
(Name of claimant. If c arned, give came of spouse)
Residence of Claimant......__2QQ.M1l1 AVf.e..S..a. R.mtplt,._..Rashington __99055 ... .. _
` (State Present actual residence ey street, number and city)
and who for the six nionths' period prior to the date the claim arose, resided at...
., ......... ...... . . ... .. ........... ..- ....._.._. ....__...- ..$a9te
1Glve resldente by street, number and ctry)
' CLAIMS DAMAGES OF AND FROM THE STATE OF WASHINGTON IN THE SUM OF$.G 1/44...q-v
by reason of damages incurred on January_2.4e 19'74...... _ at 9-oo ___,_, ...A.M., P.M.
(date) (o'clock)
at......-...
�QgatK...I4♦111...N.a._.�IL._l�M.t...: It QaCh..tA_.I�4Q$.. - - -
.. ............. . .. ......
(7.ocatton)
Describe conduct and circumst: ces causing injury or damage — attach sheet if necessary:
9.1rLau...C.coats)ltim..nf..-tbs-nvezvets...nnr...8ousar_.tug...Which is the Heat approaoh.to .4k0S
at the.ltorth. llaator lcl2rslt amp......Pilisge...Were driven to supportthe false-wack._ 7br.. .
awatim.ma..hara.bad..&. ..atith...tbia...line Constantly needing to be clesaed.......afaelly
it plugged..aad_w..opnld...apt..opee_.os.-break it clear. The depthof the Uses, t- Ut..Am-we
had to call..lp.-a_Ooatsaotos_.v1th..ppoper egaitmont to-perfom the necesaalyr..vetAk.....-City
fc rces to assist.aa..atgak...aa-.pwalDla. The-line also is-about 12, away-fsea-s-ni line
railroad traek..and alaq....the..adye...of-Houaet..May-at, ..-iAte-sewer line-being s-tswdt win-
neceaai%.ated...Immediate...repsiso,-.._ay.sodding_in._both diseotions we wq-able to dater
i i' 4,Kitb..four__feet_of_Where._tha..blockage had oocurrsd......iacauss the_sail road tracks
Ware so cleem.me. useVeheet pilings and claimed down-te...the-main line. About 71 down
F; we ran into_.a._1li11ng..which .had been.cut off In p]aae...__Continuing dam we found it to
have been driven__through the sewer ..line. Rapsirs wM.Allide and system put back into
operation. _.... _....__._. _ _.._.
Names of all persons involved:
(a) Participants: ....._"%y.of._lbetes _ _.
.....-__..___...__...._..._................1Mta...Highway Departs t _............-._....._.._....._......_. _.
____. .......__.. -.. . .....___ ...... ...... _........... ........ ........... . - _ __.-_......._......__...._.__.....
(b) Witnesses:: Riahard..C. Houghton, Robert. Puhioh, Matt Kohl, Ada Rows and Hlaar Shaver
for the City of Rentaii.-......Lee..Itinchell and J. L. :ulliven-State highway Dept.
Dave Baker - Coluocio Conatruction
ci Other:
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Describe injury or daniage: A piling was driven through an 8' sanitary raster main, tharby
......GOVA& 4..AuAli/i"_.t.R.b0CgOe, pluggo41 and bask....Vve..... . _.............. _._._._ _........
..............._....... . .
........... _ .. .
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_._-_. .... . .. _..._._...._.._.__•__........_.............. _.__........_......__.....__._........._._....._...................................__.._._._._____.
... .__ .... ....._.. .... ._._.._ ._. ...-..._
(Sigoatura of claimant)
STATE. OF WASHINGTON Please submit claim ai duplicate.
COUNTY OF................._......
.._......._. ..._.................... 33.
_....N U, >.M._Ca.._Gotitla(lat,__...... _..___ ....._..._.._.__....„ being first duly sworn on oath odposes and says:
Ti.it....._.......... .....ba...._...... As the claimant named in the above Claim .or Damages, that
_._._...........__.....ba ........._..... has read the said claim, knows the contents thereof, anrl
believes the same to be true.
__.. ........ .........._......._..........._..__..._......_......
(slewtura of Claimant)
Subscribed and sworn to before me this. __.... .. ..... ....day of_.... . _ 19
...........I -......................._._................... I._.........._.......__.........
m........._... .
�5...-1., Notary Public in and for the State of Waahinpt�n,
residingat---------_.............._..................................................
STATE LAW
RCW 4.02.100 Clalms—Presentment and filing--contents. All claims against the state for damages arising out of tortious
nmrluct shall be presented to and filed with the state auditor within one hundred twenty days from the date that the
claim arose. All such claims shall be verified and shall accurately describe the conduct and circumstances which brought
about the injury or damage, describe the injury or damage, state the time and place the injury or damage occurred, state �..
the names of all persons involved, if known, and shall contain the amount of damages claimed, together with a statement
,f the actual residence of the claimant at the time of presenting and King -the claim and for a period of s,x months
immediately prior to the time the claim arose. if the claimant is incapacitated from verifying, presenting, and filing his
claim in the time prescribed or if the claimant is a minor, or is a nonresident of the state absent therefrom during the
time within which his claim is required to be filed, the claim may be verified, presented, and filed on behalf of the
claimant by any relative, attorney, or agent representing him.
RCW 4.92.110 Presentment and filing of claim Prerequisite to suit. No action shall be commenced against the state for
damages arising out of tortious conduct until a claim has first been presented to and filed with the state auditor. The
requirements of this section shall not affect the applicable period of limitations within shish an action must be commenced,
hot such period shall begin and shall continue to run as if no claim were required. 1
See also Chapter 4.92 RCW.
(This form is supplied for your convenience only. Use of this particular form is not mandatory.)
l�sR�aas'.zm:A31.�w".;iTAsaa.+2 .. .r�,yli"'aF.i'sc:.'rr'���. ryy.7<'s: v:aw, +..:i..:yoa.;gym' ,a.swaaaeatz�a:w@u.J..%'SJira?>#aC.'ivallr!?'4'�,r vi.¢r • tt
OWN
(Claim . be filed within 1211 d.t), of the dale the . to arow.)
CLAIM FOIL DANIACES
NOTICE: For statutory provisions governing claims agaiw.t the State tlf Washington, see other side and Ch.
4.92 RCW.
TO THE AuDrroR'OF THE STATE OF WASHIVGTON:
City of Renton
"y' _.._....._................... ... ..._._ _.. _...... ... ...... _..
Ia (Name o[ elalmanl. n m..anad. glva• umnc ul .Iwuael
Residence of Claimant........ 200 Hill Ave. S., iwittcri, Washington tmoir)
(Slate present wtual maldvuce by otrcal, nuudwr and city)
and who for the six months period prior to the date the claim arose, ivsided at..
4
Same
(Give re,J,1wue by :t,pet. nWUI.•, and olyl
CLAIMS DAMAGES OF AND FROM THE STATE OF W ASHINGTON IN THE SUM OF$_G+ W4(. ys/
by reason of damages incurred On.. _ January 24, 1974 ._,__. ..at. 9:00 ......A. M., Y. M.
I dalcl lo'chw•kl
at._._ Houser Way N. at west approach to 1-405
U-ua'abmq '
Describe conduct at.d circumstances causing injury or damage — attach sheet if necessary:
During construction of the overpass over Houser Way which is the west_approach to 405
r ..._ ... .... . .. . _. . ...
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t at the North Renton Interchange.. Pilings were driven to support the false work. For
sometime we have had problem_with this line constantly„needinq to, be cleared. Finally
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it_.plugged and_ae„could not.•opeq,,_or )?reak_it clear, The_,depth Of the line..if 15, so we
had to._call._ig__9. £S2FFt=4.Qt.4F_w_•}th...P£A.p4X..e�1+aiPtnenR. to_per.foim...the..necessary-.Y7ark,,.......Ci.ty .
forces to sexist, as. much .possible „..The_„line als4....is_abotat....12'....away...fxS�....d...AMAf,rl...11rla
.......__..._....
railroad track and_along. .tli4_. Sp .af._IIo!1a.ex..WAY...Nr_...Thc...aeWar .line..kein9..-.a._LSllitk..laain....
.__.._...._.__......._. _
necesaitat. plptllate_Fs+rairr......-BY..roddi ....in hoth.direc;iang we.N'.eFe. .aILI.EI.:_C�v..tlatez-..._
mine with four feet .of where the blockage_had..occurrQd•.4.__Ai- iuse,,.•t}1e.Aftilzgd,,,txpc>ly....,,.
'J were so. close we.,uaad_sheet„toilinga,._and_ clammed. down,...W..._the..Agin...ljne,.......ALcut_7_:
....dz>w�...
-.we ran into a piling which had Itace ..Conti,nuing.ci, _,yrc.,_fsdltrld_.it__tQ.....
have been driven through the sewer lane. _._Repairs_we.se_.mAda..And...sY.s.tem .sat.Dack...inta......
operation.
Names of all persons involved:
(a) Participants: ..._City.._of...Renton.....................__. __.... ...__. .. ......._......................... ... ......................._.................___.................
. . ...State,_Highway_Department......_....,....__...._..........
_....__.._....._..._.................._._.__........__.... ..._..___...__...._.........__ ...........__.__.____..__..___..__._.__. .__..._..._....
(b) Witnesses: R.ichgzSl._G._.I1on4hLon...RoberL_P.uhish....11aGt..Kohl._&da..Rotg..md_Elaaz.. .haver
for.-the.City of RAntca..._._.les_.Minchell_And...I._L...Stllliyaa..S.tate R; hWay.•,Daps_..._._._....__.._..._
Dave Baker - Coluccio Construction
(c) Other* ........... .----------._ .. ..
L ___.. . ...... ...... ....._..._.....,. ........._.-, ._. ..._ .. _ .. ........,.
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Describe iniury or damage: A piling was driven through an 8" sanitary sewe- i--nin, _thereby
_ causing the main to became plugged and back up.
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__....__... .._.... . ____ _._. _. _.. .. __.._... . ... .......... .. . .. ...._.._._.... . .....
_. __._ _. _ _..... . .. ...___. _.._._ _. ......-_. .._.. .._ ............. .................. .. ....... ..... .. ........... ...._...
.._........ _.........__. ..... .._..... ..._. ._... .. . ........ .. .... ......_....__'__.... ... _.__...._..... _.._._.... _...........
,
_ .._-..... ._............ ...___. _.._. _. .. __.. .___._.... ....__.......... .__..._.._. ........
CBgnnlarc of Clalmanll
STATE OF WASHINGTON Please submit elahn in duplicate.
88.
COUNTY OF
warren C. connason, being first duly sworn on oath deposes and says:
That.............__._.........he.._._.._ is the claimant named in the above Claim for Damages, that
_.................__.__...._l!€............. has read the said claim, knows the contents thereof, and
3
lalievcs the same to be true.
(signature of cauniond)
Subscribed and sworn to before me this 4 17'" . ._ day of.... M ..GH.--- --._.._., 19744
�SEA I Aota ublic in and for rite State of Washinet,n.
residingat.... ................................_.......
STATE LAW
Rr7W 4.".106 viaiens—Rmpoemrnl and filinr.—Canlri le. An chums agniroM the slate for damages arising out of teruous
eon '.nrl shall be pre•,mlyd to and (!tell with Ihr• malt, enditor within one hundred twenty days from the date that the
clam prow. All quell claims) .,D b, veril(ed and shrill accuintely describe the conduct and circumstances which brought
alund the inlury or d:onnitr, dc;crihe The minty or domaA.r, state the lime and place the injury or damage occurred, state
ill-, names of nil persons involved, it known, and shall contnm the amount of damages claimed, together with a statement
of Ore actual reridontc of ti,e claimant at um time of pre,enline and filing the claim and for a period of six months
immrlialrly prier In Ihr• lime the claim arose, If 11n• ,inle+nnl is incapacitated from verifying, presenting, and filing his
claim Tn •11, urn" Prorrrilsd rm if the claim,u,l u: n puma, er is a nonresident of the stale absent therefrom during the
time within which his claim is required le Ix• Tihvl, the ct:(im may he verified, presented, and filed on behalf of the
clnimant by any relative, attorney, or agent reprtrecnting him.
RCW CRAI8 1'relentmen{ and filing of claim precrgldalte to soft. No action shall be enmmencefl against the stale for
damnges r.rising out of lartioes r•vulvrt omit it claim Ims Iltst hecn presented to anti filed with the state monitor. The
reed rome•nts of (his section shall not alTrv•t the applicahle periral rd Ihnitotions within which an action must be commenced,
but such gvirui shall begin and shall continue to rim ns If no choln were required.
See also Chapter 4,92 RCW.
(This form is supplhd for you. convenirncr only. IN, of this particular farm is not m:mdolory.)
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4L NOTE TO FILE:
MLM XXXV X H MXWXXXNKXXXXX3 MX XXKH
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January 24th: Coluccio Constr. was on the job and they brought in a backi.oe,
one crane, 3 trucks, compressor, two pumps, sheet-pilina and a steel box. ;.
Excavation began setting the box over the main and proceeding to dig at _
and lower the box like a caison.
At about 8' depth skeetxptixgxmXs sheet-piling was driven on each side to
prevent any sloughing.
At approximately l8' of depth we encountered a piling. Apparently this
piling was driven to support False work for the bridge overhead.
January 25th: Continued to dig with same crews. We re:..ched the pipe at
approximately 3:00 p.m. The piling was driven through one piece of pipe
breaking one side of the pipe. We had to remove the piling so we could
continue to dig and clear the pipe.
By 4:30 p.m. we were down, had the pipe removed and accessim1m ascertained for
certain that the piling was driven skew through it.
This was witnessed by Dave Baker, Foreman for Coluccio, Matt Kohl, Bob Puhich,
and Ads Rowe of the Water Shop, and Elmer Shaver and myself of the Public works
Department.
cn,
We also had an inspector from the Burlington Northern Railroad on the site
all day. We also had two gentlemen from the State Highway Department:
J. L. Sullivan and Lee Minchell and one other man who's name I did not get.
Our crews will work overtime: Matt Kohl, Ht Gary Morrison, Ray Matson to
complete repairs on said lines.
On Monday, we will backfill and Coluccio Construction will pull their steel
box and sheet-piling and will clean up the area.
Frank Coluccio Construction Company, Inc.
4 SEWERS • WATERMAINS - UTILITIES
9600 EMPIRE Wn� SOUTH
SEATTLE, WASHINGTON 9811E
(206) 722-5306
February 6, 1974
City of Renton
Municipal Bldg.
Renton, Washington 98055
Attention: Dick Houghton
Repair of Sanitary Sewer
'an. 24, 1974;
Labor: Baker, Foreman 8 hrs. @ $8.39 = $67.04
Brown, Pipelayer 8 hrs. @ 6.10 = 48.80
Esperas, Pipefitter 8 hrs. @ 8.04 = 64.32
3lanken, Operator 8 hrs. @ 8.38 = 67.04
Aye, Truck Driver 3 hrs. @ 7.66 = 61.28
308.48
Travel pay, 4 men @ $1.50 pur day 6.00
314.48
i 25% Payroll Taxes and fringe benefits 78.62 $393.10
Equipment:
" 45-ton crane with clam bucket (Ness)
t 41� hrs.@ 62.00 = 279.00
Permit 10.00
Clam bucket - weekly minimum 54.00
' Dynahoe - backhoe 4 hrs. @ 15.00 - 60.00
10-yd. Dump Truck 8 hrs. @ 11.00 = 88.00
900 Air Compressor 4 hrs. @ 22.50 - 90.00
Air Hammer 4 hrs. @ 54.00
per da.= 27.00
Two (2) 1-ton Flatbed trucks,
8 hrs. each 16 hrs. @ 3.50 = 56.00
rutting torch, power saws, tools, etc. 25.00
Tank of oxygen and tank of acetylene 12.00
Truck and trailer (Van Dyke) 128.15
3" Pump 8 hrs. @ 3.10 . 24.80 $853.95
Material:
4 - 8'x20' steel sheets @ $12.50 per day per sheet-50.00
12 - 1'x20' interlocking sheets @ $3.00 per day
per sheet . 36.00
12 - 3'xl2"x10' wood plank @ $150 M - 54.00
1 - 32'x6' steel frame @ $50 per day = 50.00 $190.00
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� 3 Jan. 25, 1974: 12.57
Labor: Baker, Foreman 9 hrs. @ 8.38 = $79.61
Brown, Pipelayer 9 hrs. @ 9.15 = 57.95
610
Esperas, Pipefitter 8� hrs, @ 16.08 72.36
8.04
Blanken, Operator 8' hrs. @ 12.57 73.33
8.38 = 283.25
Travel pay, 4 men @ $1.50 per day 6.00
289.25
25% Payroll Taxes and fringe benefits 72.31 S361.56
Equipment:
45-ton crane (Ness) 8 hrs. @ 62.00 - 496.00
Dynahoe - backhoe 8 hrs. @ 15.00 - 120.00
900 Air Compressor 8 hrs. @ 22.50 - 180.00
Air hammer b hrs. @ 54.00
Two (2) 1-ton Flatbed trucks, 8 hrs. each.
16 hi-s. @ 3.50 = 56.00
Cutting torch, welder, powersaws,
tools, etc. 35.00
Oxygen and acetylene 12.00
4" Pump 8 hrs. @ 4.00 - 32.00
3" Pump 8 hrs. @ 3.10 - 24.80 1009.80
Material:
4 - 8'x2O' steel sheets @ $12.50/da. each - 50.00
4 - l'x20' interlocking steel sheets,
@ $3.00/da. each = 12.00
1 - 32'x6' steel frame = 50.00 112.00
Jan. 28, 1974:
Labor: Baker, Foreman 8 hrs. @ 8.38 = 67 .04
Brown, Pipelayer 8 hrs. @ 6.10 - 48.80
Esperas, Pipefitter 8 hrs. @ 8.04 - 64.32
Blanken, Operator 8 hrc . @ 8.38 - 67.04
Anderson, Truck Dr. 4 hrs. @ 7.66 - 30.64
Aye, Truck Dr. 4 hrs. @ 7.66 - 30.64
308.48
Travel pay, 4 men @ $1.50 per day 6.00
314.48
25% Payroll Taxes and fringe benefits 78.62 393.10
Equipment:
45-ton crs.ne (Ness) 4 hrs. @ 62.00 - 248.00
Dynahoe - backhoe 4 hrs. @ 15.00 - 60.00
900 air compressor 4 hrs. @ 22.50 - 90.00
Two (2) i-ton Flatbeds, 4 hrs. ea. @ 3.50 - 28.00
Cutting torch, tools, etc. 15.00
3" Pump 4 hrs. @ 3.10 - 12.40
Two (2) 1C-yd. dump trucks with
trLilers 8 hrs. @ 16.00 - 128.00 581.40
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Material: 4 - 8'x20' steel sheets @ 12.50 ea. - 50.00
4 - 1'x20' interlocking
�I .. sheets @ 3.00 ea. - 12.00
1 - 32'x6' steel frame 50.00 112.00
$4006.91
25% Overhead and Profit 1001.73
5008.64
dash. State Sales Tax 265.46
$ 5274.10
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UTILITIES
CITY OF
RENTON WORK ORDER - DISTRIBUTION DEPARTMENT No 2929
PROJECT NO. DATE CU 194
PROJECT NAME —
YYY - FUNCTION OR DESCRIPTION OF PROJECT n /` �` F rV �^ �r. �". 4•^� —
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V EY CITY FOPCES ❑ CONTE_CT IF CONTRACT NO. _ --
CONTRACTOR'S NAME r^�_ -.! / n n -
- CONTR<.CT ORS ADDEESS _L Z_7
ESIIM,AIED COST FUNDING SOURCE __ACTUAL COST
AGBEEM.ENTS CJ IF $0, NO. SPECIAL BILLING ❑ IF 50,
TO
COMPLETED
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APPROVED BY
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DISTRIBUTION SHEET
WORK ORDER No. MONTH
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EMPLOYEE & HR. TOTAL 'O. HR. TOURS DATE HOUR AMOUNT
TITLE RATE I DATE HOURS AMOUNT NO RATE
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TOTAL Ap TOTAL i
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WORK ORDER
DISTRIBUTION SHEET
WORK ORDER No. <f MONTH' TOTAL
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EMPLOYEE 6 HR. iOTAI co. HR. DATE HOURS (AMOUNT
TITLE RATE DATE HOURS AMOUNT RATE
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TOTAL TOTAL
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' TY OF RENTON MATERIALS ISSUED S.o N.
ATERWORKS UTILITY w O N.,
L STOREKEEPER;
�q UANI ACCOUNI
UVEREDI UNIT . NUMBER MATERIAL COST AMOUNT
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MATERIALS ISSUED s D N..
TY OF RENTON
'ATERWORKS UTILITY w D N.. 2 2 S
STOREKEEPER: S�r-+� •'/1 �l X On I A D. C 7
Dw�..r M.NB•.:nR mw.,i.lw �1�L'(t,;E/1 Cr. [�_ �f,.11 rl, --i—m�-
g+ u"Ni. UNIT Af:000Nl MATERIAI UNIT
AMOUNT
LIVERED NUMBER
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ae• MNI :r•w:r.d u yed wddrn .V+ Y)
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TY OF RENTON MATERIALS ISSUED B 0.N..-
iATERWORKS UTILITY w.o-N.. 7I 2 !/
STOREKEEPER: r], l - l �/ '" hi
W6.i.B.,.,.n.�a L Ci • 4 _It_ , '% 1
vANi. UNIT AccoUNi MATERIAI UNIT AMOUNT
UVBRED NUMBER COST
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• AM good mnd rion Ab.v. V pibon Nt«I W Ab~ rio ,d.,` V 'r
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PLEASE REMIT TO:
Burlington Northern Inc. BILL NO B
MANN
BURLINGTON LOCK BOX 3270 I)DA — Dept.No. 244
NORTHERN St.Paul, Minnesota 55101
Date Prepared February 25, 1974
Renton, City of
City Hall
LL
Renton, Nash. PLEASE COPY OfF BILLOTE IT NO.N RfM/TTAN OR RETURN
I BILL W/7 Cf
L— J
For expenses incurred by B. N. Inc. furces flagging of trains where
crane, working for Colluchiu Const. Co., was digging out sewer line
tur city of Renton over & along R. R. tracks. Jm,, ,,', r
t Total labor 92.67
Pue . c 'T
Total Amount of Bill $ 92.67
i
DISTRIBUTION:
PA•esr address all rnpuiries to:
x DIRECTOR, DISBURSEMENTS ACCOUNTING
DIRECTOR. JOINT FACILITIES AND CONTRACTS
Burhn9ton Nurthem Inc.
176 East Fifth Street
St.Paul, Minnesota 56101
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+ ;a7�;lC N( CiFO{iM[_t ► ow IP ,jUSTRY THACKS OI'I `
r DltanustElA 'FOR OTHFT "OMPANIES AND INDIVIDUALS C=..\ _--� nDaTacry
NOTE: This wport must Induda all work performed and nutcrial used and released on industry tracks or for othsr I v`iP mk IC SPparale
report to he nude for each industry or company. Equipment to he reported by unit numbers letter of euthpnty for work mu"t
be secured from owner or party in charge of Industry or company and attac.hrd to this report.
I-- - —._'- / �1Ciarx No Mrn Ip �--�'--- 1
l r Location .• .>^ i 1 J� r rl I
Division �..: '/J �r• _r ._.`qTB/ !
MAIL TO: � i/
❑ So,it Offieu (CBO. Dist 1 Cicrro, Illinois ❑ Dist Accountim (Lines East GN Dist.) WN111jr, h1injiw Jra
❑ Supt. Office (CBO Dist.) Hatmbal, Missouri U Dist. Accounting (Lines West GN Dist.) Whitefish, Mon'ana
❑ Supt. Office (CBO Dist.l Ottumwa, Iowa ❑ Dir. Dist). Accou ring (NPSP&S Dist.) St. Paul, Minuescta
❑ Supt. Office (CBO Dist 1 Lincoln, Nebrasks Attn: Bill Buteau
[_]Supt Ofhre (COO Dist.I Alliance, Nebraska
Reslsrsnsdde Party
Zip Code
Address
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AUTHORITY FOR BILLING: JJ
❑ A.F.E. ❑Work Order ❑ Contract VOther (Attach Copyl No.
f /
Location' �;� / [ 4!/ brief Elescriplion of work/� C'la.[7C it,
[ r• �Tti %1tC 111:: •e �:+�/. . r' . [
AIC
list a'Ty other kn awn Dept myci'vor
LABOR LABOR at SINESS
I JSINESS
HOURS 1 %YENSE HOURS RATE E .PENSE
CAT TITLE WORKED RATE OATI. TITLE WORKED
/ URA9� RICH lt_WR ... CJ -5 .J
� T
4 ,
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MATERIAL USED (Including Local Pvchaws) MATERIAL RECOVERED
NEW UR CAI nLu:; TM
ATALOG
OUANTITT OF'CRIPTPON NURINE II •,IIS•HER
$ H
EOUIPMFUT USED (Other then Mend Toolsl
-- Ul"Ty.
TRANSPORTATION E.I)1+ir1aENT HOW VlytI, I FIEI1,HI
TYPE ANDUSED SUYPNF i t rvTM IO UR WOIU. Ilk 11'.
T
FuierrISQ'' "r�fG Date Completed_.___
YORM 13051 a TI -==� Pnnlal iI U.S.A. _.
ki •
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MWO PLEASE REMIT TO r..r _
BILL NO. E _—
� Burlington Northern Inc.
DDA Dept,Nu 244
` BURLINGTON rock box ono — -
NORTHERN St.Paul, Minnesota 55101
�..�� Date Prepared February 25, 1y74
Renton, City of
City Hall
Renton, Wash. PLEASE QUOTE BILL N0. OR RET(LRN
COPY Of BILL WITN REMITTANCE
i For expenses incurred by B. N. Inc forces flagging of trains where
crane, working for Culluchiu Const. Co. , was digging out eewer line
i.,r city of Benton over & along R. R. tracks.
l�
Total Labor 92.67
! I Jf. $
' Iota! Amount D7 Bill '. 92.67
DISTRIBUTION:
Please address 711 inquiries to:
x DIRECTOR, DISt.'1RSEMENTS ACCOUNTING
DIRECTOR, JOINT FACILITIES AND CONTRACTS
Burlington Northern Inc.
176 East Fifth Street
St.Paul, Minnesota 55101 .-
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f G�Fi(i I'E fiFURP.ALl1 (l(J Ih,.AU FRY TIIACKS UFi f
OFt " 1MPANILS AND INUIVIDUALS G. . :..�
. OTHER •;/'. ,, : ..; ,.
NOTE: Thi•,report must include all work performed and material used and released on industry tracks or for oths- cm.q;Ini, s. Separate
report to he undo for each Industry or company. Equipmunt to he reported by unit numbers. letter of authnnty for vrRrk inure
bo secured Ifunl oweL, or party it, chan7f of indus..y car company and attached to this report.
_ 'tf
r r Locah„n / Gang No. 7/ f•!Y J Mnnh r 19 ;`
1 Qivi;ion
MAIL TO: % y'
U Supt. Off'e/(COO Dist.) Cicrro, Illinois ❑ Dist Accoomin, (Lines East GN Dist.) W..Iw. Minuutria
[] Supt. Office (CBO Dist I Hat mbal, Missouri ❑ Dist. Aceounlinl (Lines We,t GN Dist.1 Whitefish, Mon ana
❑ Supt. Office (C60 Dist.l Ottumwa, Iowa ❑ Du. Dish. ADCOI' Iting INP$PRAS Dist.) St. Paul, Minnescta
❑ Supt.Office ICBQ Dist.l Lincoln, Nebraska Attn. Bill Bureau
L)Supt. Office (CBO Dist.I Alliance, Netaa keFlospnn —
slble Party
Addfes i/ (r �' .'!:/ '. / r!i•' .
AAdresS ' / Zip Co �_de
AUTHORITY FOR BILLING
❑ A.F.E. ❑ Wow It Order_, Contract Other (Attach Copyl No.
LACa[IDn� /./ / rr. r ". /! Or ief descnptinn of wo,k/ Is 1r �.r)(it,
to L ' ' �f` ?1t.c.-• Af.�rrcc•• ,,r ,..r(/. rI' . r �<< f <
` r(� / r ( r(/ r v , .ram✓• �_�
r(i�a_( 7 �,. .r 'i 1�/, .p,,<C .'�-:: 4 Ir rd, •:r fl—
List a'Ty other knawn Dept. invnwPd
LABOR LABOR Eli
F7
SINES.
f JSINESS
MOORS IIPENSE .iOUH' RATE E .PENSF
DATA rITLE RATE DAYI I TiE WORKFO
WOPKED
-&-fe -* !1, S t
_T-
r ;Y, —
MATERIgncludingl Purchases) MATERIAL RECOVERED
NEW ORCATALOG Sly. UP CATAEQG
QUANTITY NUMIIFR OWMITY SCRAP DESCRIPTION yUMaER
5 N
EOUIPMENI USED (Other thsa Hand Took)
UNIT NUMBl.P INAN`:PDnTATIUN E00'r MENT 140W VITVEU I nr P.'"I
TYPE AND CAPACITY DAY S USlO SUPVLIES FRgM TO Un W Irm IRA'S
Foreman's Signatlr'I'- r / �J a'( �(`! Date Completed
FORM 13067 3 ]IU.S.A..-
i4aoMMN71,
(Claim Le fil(d within IN flays M the date the n arose.)
CLAIM FOR DAMAGES
NOTICE: For statutory provisions goeernlntt cklims against the State of Washington, see othrr side and Ch.
4.92 RCW.
TO THE AUDITOR OF THE STATE OF WASHING71)%:
I ti,w f 41gnmarl if munaed,gue n.nne of blwmol
Residence of Claimant.
c'tor prrwnl urfual nro ul.nu• b3 blle t, number and uiyl .
and who for the six months period prior to the date the claim arose, resided at. ..
IGlve n^I�Iourc M' �tn�rl, rluuJrer and ell}1
CLAIMS DAMAGES OF AND FROM THE STATE OF WASHINGTON IN THE SUM OF $' a`: < 4l I
by reason of damages incurred on _s.j y -4, . ., at.
(dale A. P. M.
t 1 (o'clock
at. �-ri G.�,i ..t.Y..__.. A_ I... tom!,. rr. AL' .VV�S A_ D1 t-p C l-1 1O -7/t05
��� l Ilnra4onl ��
Describe conduct and circumstances causing injure or damage — attach sheet if necessary:
........�..L%-CZ..i..A 1..�a...... _Lf'2,fJ_S�'f..I�..�.C._..—j t Ci ^J ��_ —.�C•.... . Q•.:�. .��. F'f-,�.� :..r . O`%GTZ
f� .• 'a.t._.\A,_)F�Y_7 C.1-1 . ..1� -. �-:t- �r.r b�— � :�7 r� l '�
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Y__C''t'�.._.1...\i...._1���?.TGti . t, }r-'✓r . � Fa.�.�� ,r� 1%r`If..>�S WQ.t2o 1'1. lZtVblJ
4S"V�. .V.\ J 1:, ,a.. �r�b!ctl , ;' ::ne .:.;' .� E CtI..IJ�� ....4. .....
t i ,�
Z'
G1Qq,rr 1 I -
._ .A.� .T\NE.. .1�2.. 15..__lri'.._'.... . ..S.tafL...Y"1.t4.f>._To . A, AC
_U tt3la ?SX,_ Q Ur,YI.W�, ...'"4� !•rV.'£2.W..1_.1_N Ne C e.. .S. .. .. .�" ... "1l?.......... ,� l
6 F GiT. .
1 Ham.... Lt.�e._ iat 9�.......:_�e _ btw t _ 12' Ad
_`k:•rA.r^ A Y ......... ,12A4-.Vf.�.. Atit?..... �+.�-- .✓�5.... �,..J�k .��.Cst_L.. 04 ..
��@^?�rw ��Jet�� ._1_?, _ 1Na✓ �a.Wfv 1, 1t�t ,_�Qalnft ". _.... M�l.... ._.
Names of all persons involved:
(a) Participants
. . _.._
......... ._. .. _............... . _ ..
.......
(b) Witnesses: r tclin p ius� t o.� • '-vu ✓r _+ t ln_,.:.f... Y ,hl ..�. cl� . 1r;.v?rLr let tn�ae
VC,.+'r .... /__.. _. i.
(c) Other: .....
/ 1
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Describe injury or damage:^ ' i.wl .t,)u; artue �}t rCvCel( ^8" �ovU-t¢� �s� L_ ,
,; — ._ _.-r _11..4.dnf�tl,......*..kk_ _�y.'..G+�✓, �U_
C
It
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t<
. - .... it
k Moisture of Clmm:,nli �
CT::F. OF WA$IIINCTON Ill submit cfahn ill durlirtle.
f i
53.
COUNTY OF... _._._._..._.._ .
............._.._-._........._.............. being first duly sworn on oath deposes and says:
That. _. _ ...........__.. ..... is the claitnanl named in the above Claim for Dam:,ges, that
.................___........._.... ....... .......... has read tiro said claim, knows the contents thereof, arri
believes the same to 14, true.
I51gn:durc of Clalmantl
Subscribed and shorn to before me this .. ._ ..._.... ._ day of lg
ISF.ALj Notary Public in and for rise Srul(, of Was).into[ it.
residing at .........._ ....._._. ... ....
t
STATE LAW
RSIV 0.92-100 Claims--Presenlmerd and filing—Contents. All rintms ❑galn,t the state for drmlaKes _rising out of tortious
c;� uct shall be nrescntcd to and filt•d with the state auditor within one hundred twenty items from the date that the
chin arose. All such claims sbnll b. verifed and shall acrurately de,eribe the conduct :md eircurnslances which hrought
the iuimy m damaPe, (1,'w1 fw the iejury or damage, state the tulle and playa the miur) >>r damage occur, 1. stale
ILL namel of all persons invvlv.•d, if known, and shall contour the awounl of damage. chinned, tugether with U: statt-ment
of the actual retidena• of the elmmant at the lira, of presenting :utd fihnF the claim Unit fur a period of six months
ims%erhately prior to the time the claim rouse. If the chlimant is ineaparitaled from verifying presenting, and filing his
claim in the linen prescribed ar if the• claimant is a minor, or is a nonresident of the state absent therefrom during the
titn,- %%,thin which his claim Is required (n be titer', the claim ntav Uc verified, prr;anled, and filed on behalf of the
claimant by any ,clause, attorney, or agent representing him.
RC%V 4.92.It0 Presentment and sling of claim prerequisite to suit. No action shall be cnnunarcad against the slate for
tlan� Cc t"Ing out t If t n'lim" c,ndt.ct until a claw has llet I yen litetivrded W end n,ed %%ibis the stole auditor. The
rryui,v Ina or tli 1. 1 G m sh:dl nul affect t!m applit Uble In-11W 14 linotulinns wither %%: irh an action must be cnmmeueed,
bat ruth jwrimi :.hall btgin and shall continue to run us if n, (flint wire required.
Sec also Chapter 4.92 RCW.
(This form is supplied for your convenience only 1::,' of this particular form is not mandatory,)
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