HomeMy WebLinkAboutWWP2700442(9) S. 2 nd 5t. Repairs Correspond. I I S--+-50 q-42- 1+
BEGINNING
OF FIL
FILE TITLE U
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Cp Y re 5� otia!
uG 4csb 42i/oov//S-, —4'c. 3�. C�s.�r9� 8` ZO1-7S
HORTON [1ENkiS & ASSOCIATES, INC.
120 SECOND AVENUE SOUTH
KIRKLAND, WASHINGTON 98033-8887
(206) 822-2525
December 31, 1988
Invoice No. 5483.88.12
CHARTER 716, LAWS OF 19G5
CITY OF RENTON CITY OF RENTON CERTIFICATION
Public Works Department "HALTp EI%KIM THAT�THISs,MTEnwe��e
BEEN E NJSMED, THE S[A,H,e$ AENDEMED 011 THE
Municipal Building u60M PEAfoANED AS DEBCE11BE0 MEAEIM, AMO THAT
200 Mill Avenue South THE EAAr IS A iaT. " AN0 UNPWO eBuOATHMI
AOAMAT TM( CTE TK MINT01k AMD THAT 1 AN
Renton, Washington 98055 "AVT�%W TO Hon1CAT{ AND/)"RTWI EC
Attention: Mr. Ron Olson L '
- c —
Job No. 5483.00
Professional. Services: Lake Washington/Kennydale Sanitary Sewer Study,
. Asbuilting aE,d Filed Location Sewer Line
under Lake Washington.
. Notice to Property Owner.
Collected Existing Information.
Completed Hydraulic Study.
Completed Report to City.
Coordinating with Gelco Side Sewer Locations.
. Prepare Plans and Specifications for
Bidding for Side Sewer Valves.
FINAL BILLING
LUMP SUM AGREEMENT: $ 20,175.00
TOTAL COMPLETE DATE(1001) : $ 20,175.00
LESS PRIOR BILLING (99%) 19,97J.25
�P�f)��j �ar1
[� `^ :, (g
TOTAL DUE: � � $ 201.75
Jrjl1 g1S3q
ci rr OF RENTON
L'ng'r„carin; Dept.
v o Z 4 sU
HOR fON DENNIS A ASSOCIATES, INL:.
320 SECOND AVENUE SOUTH
KiRKLAND, WASHINGTON 88033-6687
(206) 822-2525
December 31, 1988
7 Invoice Nc 5483.88.12
ll CHARTER 116, LAWS OF 1965
CITY OF RENTON CITY OF RENTON CERTIFICATION
Oh"
1. TV IIIEDf WOW. E10 MT)W GEMIA,' MMOVE
Public Works Department BEMyrr or rC, THe, l/ur TMt M EAED HAVE
BEEN rPeW MEr, t" t[IC"E ACMD IK EMI THE
Municipal Building uew re+v'•o�r� ,u xscrisco M[Mt,M. AND rM.r
200 Mill Avenue Sout}, WE OWN T�� 4W M Mro,�rroNDW T10I i,M
Renton, Washington 98055 "�t� To 1°Er't"'t '� T1^' EQ
Attention: Mr. Ron Olson
,
Job No. 5483.00
Professional. Services: Lake Washington/Kennydale Sanitary Sewer Study.
Asbuilting and Filed Location Sewer Line
under Lake Washington.
Notice to Property Owner.
. Collected Existing Inl -rmation.
Completed Hydraulic Study.
Completed Report to City.
Coordinating with Gelco Side Sewer Locations.
. Prepare Plans and Specifications for
Bidding for Side Sewer Valves.
FINAL BILLING
LUMP SUM AGREEMENT: $ 20,175.00
TOTAL COMPLETE TO DATE(1009) : _ $ 20,175.00
LESS PRIOR BILLING (99%) 1Q,973.25
TOTAL_ L
�1 .__....._._
201.75
DUE.
TOTAL $DUE:
Cff; 0`: I:ENTON
LnG';ux:r•nI, U�"pt.
q*'R CITY OF RENTON
PUBLIC WORKS DEPARTMENT
Earl Clymer, Mayor Design/Utility Engineering
MEMORANDUM
DATE: July 26, 1988
TO: Larry Warren, City Attorney
Dick Houghton, Public Works Director
FROM: Bob Bergstrom, Engineering Supervisor
SUBJECT: Gelco Grouting Contract CAG 005-87
1987 Sewer Cleaning, TV and Grouting
As I previously reported, Gelco Grouting substituted non-approved grout on
their project in Renton. We have been negotiating a settlement and
reduction in the project to accommodate the use of the cheaper yellow
grout. Gelco offered a $5,000 credit in March, I suggested in June a
$22,676 credit. Gelco counter offered an $8,000 settlement credit today -
July 26th.
I would like to final this project. Should we accept the $8,000 credit or
continue to press for a higher amount? Please advise.
1D. 1 ) . 13.REB:mf '4-------
200 Mill Avenue South - Renton, Washington 98055 - (206) 235-2631
HURTON DENNIS & ASSOCIATES, INC.
320 SECOND AVENUE SOUTH
KIRKLAND, WASHINGTON 98033-8887
(206) 822-2525
U � July 31, 1988
Invoice No. 5791 .88.07
City of Renton
Public Works Department
Municiple Building
20 Mill Avenue South
Renton, Washington 98055
Job No. 5791 .00
Professional Services: Kennydal, Sewer inspection
Inspection Flow Study
Progress Bi I I ino
For the Month of June, 1988
Project Engineer 11 .0 Hrs. @ E 55.00/dr. = $ 605.00
Total Due: 605_00 sevaansaave
2�14
AUG 1988
CITY OF RENTON
Engineering Dept,
;E 4-13-88 L I T Y OF RENTON P,O.No. 41592
REQUISITION
3T, Public Works/Utility Engineering
ZT. 421/000/15.596.38,65.19 $ 2 ,756.70 VENDOR NO._
CT. $-_-__— PHONE NO. (503) 364-1198
VENDOR NAME AND ADDRESS VENDOR "REMITTANCE" ADDRESS
Gelco Grw 'ng Service SAME
P.O. Box 7247 -
Salem OR 97303
AMaINT
TY. DESCRIPTION IN DETAIL
Clean Kennydale Lake Front Sewer in Renton dnOOIO
Lump Sum
1 Fixed Fee
Hourl Fee
6.5 Hrs @ 85.00/Hr.
Washington State Sales Ta
Confirmin
TOTAL pp
AHTH
PURCHASING TO ORDER .
Gelco Grouting Service P.O. BOX7247
SALEM, OR 97303
TEL 503/364-1198
MARCH 30, 19 88
CITY OF RENTON
200 MILL AVE S PLEASE PAY ON INVOICE
— ------- ------------ NO STATEMENT ISSUED
F:ENTON, WA 98055 un;ess requested
GELCO JOB NO: 88013 INVOI- NO. B80126 _
TERMS.NET CASH
RE: CLEAN KENNYDALE LAKE FRONT SEWER
RENTON, WASHINGTON
R , i K G ! I ' I. 1 N G
II
1
1 FIXED FEE LUMP SUM 2,00 .00
2 HOURLY FEE 6.5 HOURS @ 85.00/HOUR 552.50
2,55 .50
WSST (1725) 204 .20
TOTAL AMOUNT DUE '2,75 .70)j
ITY OF RENTON
Engineering Dept
PAYMENT SHALL BE MADE WI"HIN, . DAYS FOLLOWINGTNE DATE OF INVOICE ORCOMPLETION OF WORK WHICHE AIR I(
15 EARLIER A LATE CHARGE OF TR PERCENT PER MONTH WILL BE ASSESSED ON UNPAID BALANCES IN THE EVENT SUIT
OR ACTION INCLUDING ANY APPEAL THEREFROM.IS BROUGH T TOE NFORCE ANY TERMS OF THIS AGREEMENT.THE PRE-
iy INC,I'Anly SHAL I TIT,ENT I? ED Tb SUCH REASONABLE ATTORNEYS FEES AND COSTS AF MAY BF.AWARDED BY THI'
ADDITIONAL INSURED
�PAM ADDITIONAL INSURED—OWNERS OR CONTR. GLAIO 0487 02
INSI'RAN'F.C OMP.AV\
i{iO4 MiM1 ba' wnYh.t i1NN1
Na.N.,i�.rr,..n�nNruNr+ UNITED PACIFIC INS. CO.
POLICY AMENDMENT 7
I0"kssEFFECTIVE 06/18/87
i
POIJCY NUAIREII POLICY PERIOD AGENCY NUMBER
UP 0365091 00 FROM: 05/06/87 TO: 05/06/88 0587136
NAME OF INSURED AND ADDRESS A;,ENCY NAME AND ADDRESS
— 1
V G J• INC. STANLEY T. SCOTT G CO• INC.
4616 S. 200TH ST. 2312 EASTLAKE AVE. E.
KENT* WA SEATTLE• WA.
48032 98102
APPLICABLE ONLY TO ADDITIONAL INSURED• OWNERS D4 CO4TRACTORS9 FORM SL 2009.
SCHEDULE
NAME OF PERSON! OR ORGANIZATION
( ADDITIONAL INSURED( L3CATION OF COVERED OPERATIONS
-------------------•---------------------------------------------------------
CIT" OF RENT04 RE: EMERGE SEWER REPAIR
200 MILL AVE. S. CITY (IF RENTON
RENT049 WA 98055
r -_ It7r F Xip :.r
AN
G
ENGINEMN6 DER,
CITY Of REMON
------------------------------------------------------------------------------
1 PREMIUM BASES I RATES 1 ADVANCE PREMIUM
-----------------1-----------------
1----------------------
53DILY INJURY I COST ( 5100 OF COST I
LIABILITY I AT AUDIT 1 .333 1 S AT AUDIT
_ .---------------1-----------------1-----------------1----------------------
PROPERTY DAMAGE I COST ( $100 OF C05T 1
LIABILITY I AT AUDIT I ---_029--------1 f AT AUDIT
-------------------- ----------------------
TOTAL ADVANCE PREMIUM S AT AUDIT
07/07/AT
DATE
Woo-
in-ff.Tm
0
EXTRA COPY ADDITIONAL 14SURED
SWAM ADDITIONAL INSURFO—JwNFRS OR CO'JTR. ,LA I(1 0487 05
I! URANCE COMPANY
kk is"`v :98M.4 UNITED PACIFIC INS. 'O.
P'iLICY AMENDMENT
**EFFECTIVL O6/Id/d7
POLICY NUMBER POLICY PERIOD I AGO=NUAWN
UP U.165041 0 FROM: 0`,/( 6/ TO:
NAME OF INSUKL:' 4 .1, AJDH.ESS A ;FNCY NAME AND ADDRESS
V L J* INC. STANLEY T. SCOTT F. CO. INC.
4616 S. 200TH ST. 2312 EASTLAKE AVE. E.
KENT* WA SEATTLE* WA.
9dD32 98102
APPLICABLE ONLY TO ADDITIONAL INSURED• 16NIFRS OR CONTRACTORS* FORM GL 2009.
SCHEDULE
NAME OF PERSON OR ORGANI7ATION
( 40JITIONAL I,NSURL31 LJCATION OF COVERED OPERATIONS
----------------------------------------------------------------------------
CITY 5F RENTON 2': FMFRGF SE4ER REPAIR
230 MILL AVE. S. CITY OF RENTON
RENTON, hA 9505`.
TALL ENDORSEMENT RFPLAL, GLAIO 02.
-------------- -- - _ —
--------------------
---� : - 'AAS1_S 1 wATES 1 ADVANC.
-----------------1-----------------1—__------- --
BJDILY INJURY 1 LUST I $100 OF COST 1
LIABILITY 1 AT AUDIT I .033 i S AT A'J011
1-----------------i-----------------1--------------- ------
PROPERTY—DAMAGE 1 COST I S10D OF COST 1
LIABILITY 1 NO COVERED I NOT COVFRED I S NOT COVERED
-----------------------------------------------------------------------------
TOTAL ADVANCE PRFMIUM S AT AUDIT
11/11/87
l � � V
�� n DATE
0 5015(U 1 E
GL 20 09
(Ed. 01 73
This endorsement forms a part of the pnl,cy to which attached.effective on the Inception date of the policy unless otherwise stated herein
(The following information is required only when this endorsement is issued subsequent to preparation of policy.)
Endorsement effective policy No. Endorsement No
Named Insured
Additional Premium 9 Countersigned by
(Authorized Representative)
This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following
COMPREHENSIVE GENERAL LIABILITY INSURANCE
MANUFACTURERS AND CONTRACTORS LIABILITY INSURANCE
ADDITIONAL INSURED
(Owners or Contractors)
Schedule
Name of Person or Organization
(Additional Insured) Location of Covered Operations
Premium Bases Rates Advance Premium
Bodily Injury Liability Cost $100 of cost S
Property Damage tnah,hfy Cost $100 of cost $
Total Advance Premium S
It,s*greed that
I. The 'Persons Insured provision s amended to include as an insured the person or organization named above(hereinafter called additional insured-1,
but only with respect to liability arising out of (I)operations performed for the additional insured by the named insured at the location designated above
or(2)acts or omissions of the additional insured n,connection with his general supervision of such operations.
2. None of the exclusions of the policy,except axclus,ons(a),(c),(f),(g),(1),(1)and(m),apply to,ha insurance
3. Additional Exclusions This insurance does not apply.
(a) to bodily injury or property damage occurring after
(1) all work on the project(other than service,maintenance or repairs)to he performed by or on behalf of the additional insured at the site of the
covered operations has been completed or
(2) that portion of the named insured's work out of which the injury or damage arises has been put to its Intended use by any person or organization
other than another contr3cfor or subcontractor engaged in performing operations for a principal as a part of The same project.
(b) to bodily injury or property damage arising out of any act or omission of the additional insured or any of his employees,other than general super
vision of work performed for the additional insured by the named insured;
(0 to property damage to
(I) properly owned or occupied by or rented to the additional insured.
(2) property used by the additional insured.
(3) property ,n the care-custody or rontrol of the additional insured or as to which the additional insured is for any purpose exercising physical
control,or
(4) work performed for the additional insured by the named insured.
4 Additional Definition When used,n reference to this insurance."work"includes materials.Darts and equipment furnished,n connection therewith
GL 20 09 01 73
• • '96
11, TO: "" AFFIDAVIT OF ?iF
USTRIAL STATISTICIAN ` ; ✓G/ � ,
Department of labor & Industries WAGES PAID ..
Fmploymcnt Standards Sections 'gG�CF/'�. ,,„..•� ON PUBLIC WORKS CONTRACT
925 Plum Street
Olympia, WA 98504-0631 �s �` °rr, +flEP 0
12(t6) 753-4019 r J,9y� C;
Al tract;BPW Number Rent on Emergency Sewer Repair
.'.bate Bid Was Due
Contract Awarding Agency Date Contract Awarded 6/18/87
City of Renton 7�7�87
Date Work Completed
Address 200 Mi11 Ave. S.
County in Which Work Performed Kina
Renton , wash 98055
Prime Contractor v � .T_ Ilrr•
Telephone Number 235-2631
Your Contractor's Registration Certificate NovJ TN r�, aa.TK
Was a Statement of Intent Filed
For this project') Yes C)d No ❑
In compliance with RCW 39.12.040 I, the undersigned, being a duly authorized representative of
V re J Inc, 4616 S. 200th. Kent , Wash_. 98032
(Contract. or \ubeonuaclor) (Add,m)
do hereby certify that the following rates of hourly wage and hourly fringe benefits have been pr.id to the laborers,
workmen and mechanics actually employed by me upon the project described above and that no laborer, workman or
mechanic has been paid less than the "prevailing rate of wage" as determined by the Industrial Statistician of the
Department of Labor and Industries.
List below each classification of labor employed by you upon the project described above and the rate of hourly pay
and hourly fringe benefits paid to each classification.
PLEASE NOTE
If apprentices have been employed on this project,provide this additional information:name,registration number,stage
of progressiwe and date of hiring.
Craft Rue of Rile of Finally
Hourly Piz Fringe Reaefils Paid
Trk. Driver — 10 Yd, 17. 74 3 .71
Laborer 14.08 3 . 43
Operator. . . . Cast, 17 .17 4.21
UTILITY CONTRACT
UTILTTv CONTRACT
Nae: Attach Additional Shms as Needed.
(C ny Name)
Subscribed and sworn to before me yy / L R` //'�/e(7Pra■idwnr
this ._LS day of " (Tine)
19 I eel fie are
1 hereby certify that according to the was,nta and!rinse bonents herein swoto
_ It, the prevailing wage requircslsenU of RCW 19.12.00 Inv, ham satlaned.
lL
Notary Pubhe in} roe the Sate of shington. residing
in 1Vashington. INDUSTRIAL STATISTICIAN
DF.P4RTN%'NT OB LA AND IND15 RISC
INSTRUCTIONS. ` � QVG 12187
aY: .—... tole',
1
I. Pure.o,. . RCW 39.12.040 copies of this form must be completed by the contractor and each of his sub-
contractors.
2. Complete this form in triplicate and have it notarized.
3. SUBMIT ALL Fq�I�S.tl_ gNG WITH APPROVAL FEE FOR CERTIFICATION TO: Depar�ment of Labor
and Indust Bea, Elrploy Standards Section, Olympia, Washington 98504-0631.
4. Mail an approved copy to the Contract Awarding Public Agency
CONTRACTORS ARE RESPONSIBLE FOR OBTAINING AND FILING AFFIDAVITS of the SUB-
CONTRACTORS.This is required by law and payments call not lawfully be made until such affidavits are filed.
I1a1A114101 Afld.,.x.+ WW 111/a1) QXA]
dB',�/�-��/�d��,/�di� d�,?/�tdR�,�e�,./�•,1!� d� did elm der/�dY�! ,a,�,/�dilf,�/!��1 eWl��/!�
,16F7 !6R ,1619 •�1 dT�,`, OOP! .FiP +i OOP 16P7 •� 06C
A. � y1 A A NAUEWGbEKC w—.
ix..
AUG 17 1987 NVOICE
ENGINEERING DEPT.
SOLD TO. Cit of RSAq' ENTGN DATE: 8/12/87
Robert Bergstrom
c/o Engineering Department JOB A 100
200 Mill Avenue So, 7��
Renton , WA 98055 PURCHASE ORDER #: N° 1238
SHIP BY.'
*** FINAL BILLING ***
Materials .•
Stoneway $ 121. 15
McLendon 3 . 78
Sub Total $ 124 . 93
+ 15% 18 .14
Total Materials $ 143 . 67
Miscellaneous Expenses :
Interstate $ 184 .05
Cascade Sawing & Drilling 680. 00
Cascade West Const. 300.00
McLendcn 59 . 99
Total Miscellaneous Expenses 1 ,224 .04
TOTAL AMOUNT DUE : : , 36.1 .71
TAX @ '08A616 SOUTH 2O0th, KENT WA98031 20"72-W2 110.78
cc26187 1 478.44_
MAIL ', p • Statement of
INDUSTRIAL STATISTICIAN �rMFdr INTENT TO PAY
Department of Labor & Industries AAA. ,� PREVAILING WAGES
Employment Standards Section (/� ( �
Generel AdminiP'-ation Building 0 y bF� (Public Works Contract)
Olympia, WA 8L504.06211 e ti J9
(20G) 753-4019
ContractBPW Number SOUTH 2nd St. Sanitary Sewer
Date Bid Was Due Repair
Contract Awarding Public Agency Date Contract Awarded jupp l987
CITY OF RENTON County in Which Work Performed King
Address Prime Contractor y g zI, Ina.
Renton, WA, 95055 Your Contractors Registration Certificate No.
Phone Z35 1569 — Do You Intend To Use Subcontractors? Yes No Ll
In compliance with RCW 39,12,040 I, the undersigned, being a duly authorized representative of
IConreeor or liod ,riwo
do hereby certify that the following rates of hourly wage and hourly fringe benefits will be paid to all
laborers, workers and mechanics employed by me upon the public works project described above and that
no laborer, worker or mechanic will be paid less than the "prevailing rate of wage" as determined by the
Industrial Statistician of the Department of Labor and Industries.
PLEASE NOTE: If apprentices are to be used they must be registered with the State Ap-
prenticeship Council within 60 days of hiring or they must be paid prevailing journeyman
wages for the time preceding the date of registration.
CRAFT ESTIMATED NUMBER RATE OF RATE OF HOt1RLY
OF WORKERS HOURLY PAY FRINGE BENEFITS
IRK DRIVER 10 yd 6 Pup 2 17.74 3.71 -
LABORERS 4 14.56 , 3.43 -
OPERATERS 2 17.17 4,21
UTILITY CONTRACT '
NOTE: Attach Additional Sheets as Needed.
_SECRETARY
Subscribed and sworn to before me (Tides
this day of
_�� For L & I Use Only
�11— �'
J APPROVED
19 SZ Department of Labor & Industries
i
Industrial Statistician
�@tt a�i
N p Publi n and/or the State Washington,resid-
ing in Washington.
`Alnz JUL 2 4 '8/
By: Date:
BEFORE FINAL SETTLEMENT can be made on any public works project, the prime contractor and each
and every subcontractor must submit form LI-700-7 (F700-007-000)"Affidavit of Wages Paid"to the officer
charged with the disbursement of public funds. EACH AFFIDAVIT OF WAGES PAID MUST BE CERTI-
FIED BY THE INDUSTRIAL STATISTICIAN OF THE DEPARTMENT OF LABOR AND INDUS-
TRIES BEFORE IT IS SUBMITTED TO SAID OFFICER.
PROGRESS PAYMENTS: Each voucher claim submitted to an owner by a contractor for payment on a
project estimate shall state that prevailing wages have been paid in accordance with the prefiled statement
or statements of intent to pay prevailing wages on file with the public agency.
COMPLETE AND MAIL ENTIRE SET FOR APPROVAL TO:
Employment Standards Section, Department of Labor and Industries,
Olympia, Washington 98504-0631
CONTRACTORS, DISTRIBUTE APPROVED STATEMENTS AS FOLLOWS:
(PINK COPY) ORIGINAL CONTRACT—AWARDING AGENCY
(GREEN COPY) DUPLICATE—INDUSTRIAL STATISTICIAN !Retained by Department) AUG 51987
(BLUE COPY) TRIPLICATE—PRIME CONTRACTOR
(YELLOW COPY-QUADRUPLICATI,—SUBCONTRACTOR f1i61NEERiNG OEPT.
P700 WA IM Inunt m Pw rarest Qs A7s a w a CITY OF RE41ON
MAIL TO: • h'iiLr!V.r + • - — --
INDUSTRIAL STATISTICIAN AUs AFFIDAVIT OF
Department of Labor & Industries ` 7 � WAGES PAID 7506
Employment Standards Sections 1=4f '-. ,;,. ON PUBLIC WORKS CONTRACT
92S Puuw Street MFN
Olympia, WA 98504-0631 rp�'
(206' ';y 4019 ^�C�ECJ
�3 )9ej Contract/BPW Number ="• 2nd St. Sanitary Sewer Repai)
Date Bid Was Due
Contract Awarding Agency Date Contract Awarded 6-I8-87
City Renton
Date Work Completed 7-7-87
Address 200 Mill Ave. Su,
Renton, WA 98055
County in Which Work Performed King_
235-2631 Prime Contractor V 6 J, Inc.
Telephone Number 223-01-SE-V-.LM-A372NO
Your Contractor's Registration ert iczte 0
Was a Statement of Intent Filed
For this project" Yes lia No ❑
In compliance with RCW 39.12.040 I, the undersigned, being a duly authorized representative of
M. A. Segale, Inc. P. 0. Box 86050 Tukwila, WA 98188
IContnMw m Subcontn<twl (Add—,)
do hereby certify that the following rates of hcurly wage and hourly fringe benefits have been paid to the laborers,
workmen and mechanics actually employed by me upon the project described above and that no laborer, workman or
mechanic has been paid less than the "prevailing rate of wage" as determined by the Industrial Statistician of the
Department of Labor and Industries.
List below each classification of labor employed by you upon the project described above and the rate of hourly pay
and hourly fringe benefits paid to each classification,
Pe EASE NOTE.
If apprentices have been employed on this protect, provide this additional information:name, registration number,stage
of progression and date of hiring.
Craft Rate of Rate of Hoarly
Hourly Pay Fringe Reteenta PAN
Screedman (2) 18.04 — 4.21
Roller Operator on Plant Mix (2) 17.68 4.21-
Paving Machine Operator (1) 17.68 4.21—
Dump Trucks: 5 to 6 Incl. 12 Yds. (6) 17,63 - 3.71-
Dump Trucks: 16 thru 20 Yds. (4) 17.74 - 3.71-
W, -er Truck: 3000 Gals. 6 Over (1) 17.74 — 3.71 -
General Laborer (1) 15.21 - 3.43-
Raker (2) 15.69 - 3.43`
Flagger (2) 10.78 3.43 -
223-01-SE-GA-LM-A372NO
Note. .4uac) Additional Sheets as Needed
M. A. Seciale, Inc-
�rr (co m ny N.mr) —�
Subscribed and sworn to before me Bv,L1l�� w�F� 7/10/n7
this loth day of July
19 87 . tat ur ony
I hereby oonify that aocoruina to the trgo rates and rrfillt MatNtta aessla tesora
to the fswiina wage requirements of RCW 39,12040 ►art been ndafkd
Nwar bM1c m en !ot the Stet,of Washrogton, residing INDUSTRIAL STATISTICIAN
m y shingmn.
DEPARTMENT OF LABOR AND INDUSTRIFS
INSTRUCTIONS: Dau3 tUp7
te. -AUGNW
I. Pursuant to RCW 39A 2.040 copies of this form must be completed by the contractor and each of his scb-
contractors.
2. Complete this form in triplicate and have it notarized.
3. SUBMIT ALL FORMS ALONG WITH APPROVAL FEE FOR CERTIFICATION TO: Department of Labor
and Industries, Employment Standards Section, Olympia, Washington 98504.0631.
4. Mail an approved copy to the Contract Awarding Public Agency
CONTRACTORS ARE RESPONSIBLE FOR OBTAINING AND FILING AFFIDAVITS of the SUB-
CONTRACTORS. This is required by law and payments can not lawfully be made until such affidavits are filed.
ate► s
M"Ilml lndua,M w,p, 0116V O+o-c
Complete R mail entire set PAYMENT RVOEN
WITA APPROVAL FEE TO: JULStatement of
Department of Labor&Industries 1987 INTENT TO PAY 7506
ESAC Division-HC-710 PREVAILING WAGES
925 Plum Street 1 a I FW
INSERT CARBON PAPER ( Public Works Contract)
Olympia.Wa. 98504-0631 (206)753d019 BEFORE COMPLETING
(Type or print clearly---this is your mailing label) ContracVBPW No. So. 2nd Street
APPROVED FORMS~� TO BE RETURNED TO: _ �dt11LaY3t Sew
m-._...b„«...,-..�...«.....�..«�„«.....�-,.,�.p»,.d.r gip
..,..,,.,.,.. Bid due date -- ITite�o `"ormaa-`wad
M. A. Segale, Inc.
wrywhaa .__..
P. O. Box 88050 _ ..,,v.. . ...A.y._... Kin
c°ntractur
you intrnd to we stthcontractaa���f-�
Yes Q No
CONTRACT AWARDING ttrncphatentmbe
PUBLIC AGENCY „-
dbey6_•.._. - �iS 9fi�l
my atata Lp
200 MILL AVE. So. Renton WA 98055
SEE INSTRUCTIONS ON REVERSE SIDE
1.CRAFT 2.ESTIMATED NO. 3. RATE OF 4.RATE OF HOURLY
OF WORKERS ;. HOURLY PAY FRINGE BENEFITS
Screedman 2 18.04 4.21
Roller Operator on Plant Mix 2 17.68 4.21-
Paving Machine Operator I t 17.68 4.21-
Dump Trucks: 5 to & Incl. 12 Yds. 6 17.63- 3.71_.
Dump Trucks: 16 thru 20 Yds. t 4 17.74' 3.71-
Water Truck: 3000 Gals. & Over 1 17.74— 3.71
General Laborer 1 15.21- 3.43 -
Raker 2 15.69- 3.43
Flagger ? 2 10.78 3.43
t
F
3 }
I hereby certify that the above information is correct and that all workers I employ on this Public Works Proi^-t will br paid no less
than the Prevailing Wage Rate as determined by the Industrial Statistician of the Department of l.a..,r and Indnstrie&I understand
that contractors who violate Prevailing Wage Laws are L o mr's tgn
subject to fines and/or debarment. re
(complete all 4 copies and have each notarlied) °mPmY
STATE OF WASHINGTON M. A. ,Seale, Inc.
County of_ King P. 0. Sox 88050 _
City ___.-.... ���� ~ uti��ip C°ntracmTi egutretion Igo.
Signed or attested lxforemeon Ttilcwila WA 9818& 223-0l-SE-GA-LM-A372N0
(Signature of notary _
My appoinonenlexpires r- - 0 Vit Onl
APPR
CONTRACTORS, DISTRIBUTE APPRO 0 COPIES f ED, Department of Labor& Industries
AS FOLLOWS: p1,R - ,11RIGINa,CONTRACT- AMARDING AGFNCV JUL a��
-REFN DUPLICATe -L a 1, FMPLOYMENT STnt: G�/ `I' //IUGf V(
ALUF - - TRIPLICATL-PRIME CONTRACTOR CANARY-QUADRUPLICATE-SUBCONTRACTOR By
F'100.029-000 intent to pay 4 87 -"'
INSTRUCTIONS TO COMPLETE THE
STATEMENT OF INTENT TO PAY PREVAILING WAGES
1. Enter each craft you intend to employ on this project.
If the work will be done by owners or partners please state so.
If the work is done by owners or partners, #2,#3 and#4 need not be completed.
Partners who own less than 30 percent of a partnership are considered to be employees.
2. Enter the estimated number of workers for each craft or classification.
3. Enter the rate of hourly pay for eat h craft or classification.
4. Enter the rate of hourly fringe benefits only if you are paying one or more of the following benefits:
vacation,group medical insurance (e.g., Blue Cross, County Medical,etc.), pension and/or an
apprentice training fund.
a. Individual company pension plans must be approved by the Industrial Statistician for Public
Works Projects.
b. Apprentice training programs must be approved by the State Apprenticeship Council.
PLEASE NOTE: The sum of#3 plus#d must equal or exceed the prevailing rate of wage.
IMPORTANT:
ANY WORKER NOT REGISTERED WITH THE STATE APPRENTICESHIP COUNCIL MUST
BE PAID PREVAILING JOURNEYMAN WAGES. ANY APPRENTICE NOT REGISTERED
WITH THE STATE APPRENTICESHIP COUNCIL WITHIN 60 DAYS OF HIRING MUST BE
PAID PREVAILING JOURNEYMAN WAGES FOR THE TIME PRECEDING THE DATE OF
REGISTRATION.
PROGRESS PAYMENTS:
Each voucher claim submitted by a contractor for payment on a project estimate shall state that
prevailing wages have been paid in accordance with the prefiled Satement(s)of Intent to Pay
Prevailing Wages on file with the public agency.
t
DATE 24-871 CITY OF RENTON P.O.No. 40721
REQUISITION
DEPT. Public Works - !Itilities
ACCT. 421/000/15.596.35.65.19 $ 92,789.44 VENDOR NO.
ACCT. $ PHONE NO. 872-8622
VENDOR NkIE AND ADDRESS VENDOR "REMITTANCE" ADDRESS
V & .J Construction
4616 South 200th
Kent WA 93031
Y. DESCRIPTION IN DETAIL AMOUNT
L.S. Emernency Sanitary Cevjer Repair on South Ind Street - City Council Resolution
{ P2683 June 18, 1987 ( tax)
Invotce / Subtotal Tax (Total)
1270 $ 7,943.90 643.45 $ 8,587.35
1392 12,383.14 1,003.03 13,386.17
1393 2,827.50 229.03 3.056.53
1390 11,528.95 933.34 12.462.77
13911 22,260.06 1 .803.06 24,063.12
1397 28,893.15 2,340.35 31,233.50
Partial Payment 92,7 a 44
r
PURCHASING 'TO ORDER
AUTHC-8Y.
f
0A � A. i (d!P A s a A NAUIiNG 6 FNL AVAnN(;
tea, 06P OCP
INVOICE PAGE 1 OF 2
SOLD TO : City of Renton DATE : 7/2o/87
Robert Bergstrom
c/o Engineering Dept. JOB M : 100
200 Mill Avenue So,
Renton, WA 98055 PURCHASE ORDER N : 1397
---------------------------------------------------------------------
Emergency Sanitary Sewer Repair - South Second Street : ON ALL PAST DU'-tS PER MONi
ALL ACCOUNTSDUE INVOICES.
THE 'Cth OFTHEUE AND PAYAB,
E MONTH,
Equipment Rental .
Star Rental Case 580 $ 325 .49
Fray Equipment Dynahoe 160 4 , 230 .40
McDonald Industries 082 Hitachi 2 ,447.68
National Barricade Signs 1 ,171.92
Forte Rentals Air Breaker 20 .00
Total $ 8 , 195 .49
+ 15% 1,229 . 32
Total Equipment Rental $ 9 ,424.81
V & J' s Equipment Rental
580 Case - 12 days @ $ 275 .00/day $ 3, 300 .00
108 hrs @ $ 6. 50/hr 702 .00
Total 580 Case $ 4 ,002.00
Concrete Saw & Van - 3 days @ $100.00/day 300. 00
3/4 Ton Pick-up & Tools -
13 days @ $ 50. 00/day $ 650. 00
10 days @ $ 50. 00/day 500.00
8 days @ $ 50. 00/day 400 .00
Total 3/4 Ton Pick-up & Tools 1,55C . 00
Penzoil Truck - 12 days @ $ 25.00/day 300.00
966 Loader - 11 days @ $ 720. 00/day $ 7 ,920.00
102 hrs @ $ 20. 07/hr 2 ,047 . 14
Total 966 Loader 9 ,967. 14
Com_iresser & Accessories - 10 days @ $ 45 .00/day 450 .Q0
Arrow Board - 14 days @ $ 35 .00/day I475' Cr
2 Ton Flatbed & Tools - 1 day @ $ 50. 00/day 50.0�; n r
Steel Sheets - iWLEIVED
2 Sheets - 13 days @ $ 40. 00/day $ 520. 00
2 sheets - 9 days @ $ 40 . 00/day 360.00 JUL 2 i 198T
1 Sheets - 1 day @ $ 20 . 00/day 20 .00 ,
Total Steel Sheets 900.0BN:INEERING DEPT.
fR\go Compactor - 320 H Roller -
1. 75 days @ $ 480 . 00/day $ 840 .00 C0 O`ffhTON
14 hrs @ $ 10 . 30/hr 144 .20
Total Rago Compactor ygq , 20
Total V & J' s Equipment Rental 18 , 993. 34
4616 SOUTH 2t3OLh, KENT,,WA 98031 206-872-W2
Forward This Balance to Next Page 28 ,418 . 15
PAGE 2 OF 2
Invoice #1397 Continued
City of Renton
Emergency Sanitary Sewer Repair - South Second Street
Forwarding Balance From Page 1 $ 28 ,418. 15
Miscellaneous Expenses :
United Services Incorporated $ 100. 19
Interstate Heavy Hauling Moving 966 Loader 190. 50
McDonald Industries Moving Hitachi 184. 31
Total Miscellaneous Expenses 475 .00
Sub Total $ 28 ,893. 15
+ Tax @ 8. 1% 2 ,340. 35
Total Amount Due $ 31 ,233 . 50
*�• Note : This billing does not contain all bills , some have not
been billed to us yet.
t�
Q� r2 ! 7 s/-
RECEIVED 1.'L'IJI
E IL1 O C H V . M A F F E O PUBUC WORKS DEPT.
ATTORNEY AT LAW CITY OF RENTON
a HATTUCK BUILDING
400 SHATTUCK AVENUE SOUTH
RENTON. WASH. 98055.2425
PHON!
�zoa� zze-iaao
July 17 , 1987
Mr . Richard Houghton
Board of Public Works
4th Floor, City Hall
Renton, WA 98055
Re: Rental Agreement
City of Renton/James Van Osdell
Main Street Property
Dear Mr. Houghton:
On behalf of my client, Jim Van Osdell , thank you to the
city for leaving the property in such good shape as well as
leveling and grading and the addition of crushed rock,
Would you kindly return one of the original, executed rental
agreements to my office in the self-addressed, stamped envelope .
Thanking you in advance for your cooperation .
Verb truly yours,
ENOCH V. MAFFEO v
EVM: tf
Enc . 1
cc: Jim Van Osdell
RENTAL AGREEMENT
THIS AGREEMENT, made and entered into this ;_',3AO day of
198T, by and between JAMES VAN--OS-DELL, here-
inafter referred to as "Grantor", and the CITY OF RENPON, herein-
after referred to as "Renton";
WITNESSETH:
WHEREAS, Grantor owns or controls real property in Renton ,
Washington, more particularly described as:
Lot 16 of Block 13, Plat of Town of Renton, as
laid out by E.M. Smithers, I.B. Morris and C.B.
Shattuck, as per plat thereof recorded in Volume 1
of Plats, page 135, records of said ounty.
Situate in the City of Renton, County of King,
State of Washington;
and
WHEREAS, Renton needs the use of said property for the
purpose of temporary storage of pipe , equipment and other
material for street purposes in the vicinity of said real
property; and
WHEREAS, Grantor is willing to make said real property
available to Renton, including its contractors, licensees and
permittees, for the purpose of temporary stoiaS,�;
NOW , THEREFORE , for good and valuable consideration ,
received by Grantor and the mutual covenants hereinafter set
forth, the parties mutually agree as follows:
1 . The Grantor grants to Renton, including its contractors,
licensees and permittees, a nonexclusive right to use
the real property for the purpose of temporary storage
of pipe , equipment and other materials during the
following times:
From the date of this Rental Agreeme t until ninety (90)
days from the date hereof.
2 . The Grantor agrees to permit Renton, including its con-
to enter upon the
real tp opertyCensees and for the purpose permittees,,f p preparing the property
for storage, ingress and egress using the stored proper-
ty for street purposes.
3 . Renton shall inform its contracto-s, licensees and per-
mittees of the provisions of this Agreement, and shall
require its contractors, licensees and permittees to
comply with its provisions.
4 . Renton is to remove from the property , within five ( 5)
working days from the term of this Agreement, all
material , equipment and debris, including any and all
personal property, by reason of its use of said land.
5 . Renton will indemnify the Grantor for any damage to the
land and improvements of the property permitted to be
used for storage purposes, and Renton also agrees to
indemnify Grantor agains' any and all claims for
damages, injuries, compensation , etc., to person or
property of any person whomsoever, and agrees to defend
at its own expense in the nau:e of and on behalf of the
Grantor any suit against the Grantor alleging injury and
seeking damages, or either, on account of or in any way
arising out of the use of the real property even if such
suit be groundless, false or fraudulent; but the Grantor
shall have the right ;,o make suc!. investigations, neg—
tiations and settlements of any claim or suit as may be
deemed -xpedient by the Grantor.
Renton shall compensate Grantor for any loss suffered by
Grantor resulting from any damage to the property herein
temporarily allowed to be used by Renton for storage
purposes.
7. If any claim for damages or injuries has been asserted
by anyone against Grantor, or if any suit therefor shall
be brought against Grantor arising out of the use of
said real property, then Grantor shall promptly notify
Renton in writing of such assertion or suit. Such
notice shall be mailed to Richard Houghton, Renton City
Hall , 200 Mill Avenue South, Renton, WA 98055 , by
registt:red mail, and if Renton fails to defend any such
action , then Grantor may defend the same and Renton
shall pay any judgment rendered against Grantor and
shall reimburse Grantor for any and all expenses, inclu-
ding attorneys' fees.
8 . At the expiration of the term of the Rental Agreement,
Renton will quit and surrender Grantor's rral property
after restoring the property to the Grantor's satisfac-
tion, ordinary wear and damage by the elements or fir.
excepted .
IN WITNESS WHEREOF, the parties hereto have caused this
instrument to be executed in duplicate as of the date first above
written .
CITY OF RENTON
J TiCr�� ATT-6 � ;UU1�!Vr U N , ti's-
authorized signatory
7/v 2
(J C7"( r.. o"`c i; /4f 7
A —�!:! A ek" wt A LW
Hunrva�w'-
INVOICE
SOLD TO: ATTENTION: ROBERT BERGSTROM DATE: 7/16/87
CITY OF RENTON
Engineering Department JOB #: 100
200 Mill Ave. S.
Renton, WA. PU,?CHASE ORDER#: I1j;' 1270
Renton,
SHIP BY.)y�L; LATE CHARGES PER MONTH
_EMERGENCY SANITARY -$-Mj_BEPAIB �S0llTI1SECOND STREET — ON ALL PA51 DUE INVOICE,.
ALL ACMMTS-WE-AND PAYABLE
PAVING STREET: THE 101h W THE MONTH.
107 .35 tens Pave with asphalt concrete @ $74.00 per ton $7,943.90
.081 tax 643.45
TOTAI, THIS PORTION OF BILLING $8,587.35
4616SOUTH2O2h,KENT,WA98031 :'O"72-W2
cc2G187
i6t at�j�dA� wt. A y-y��y
YYf'i ", YV�i YY� YY� •`�• YV� VV�. sit. �.�.1 1 VO—i "`z � AP A, LW.
IlAl1l INC. p�•a(i
INVOICE
SOLD TO: City of Renton DATE: 7/15/67
Robert Bergstrom
c/o Engineering Department JOB *: 100
200 Mill Avenue So, 7.10
Renton , WA 98055 PURCHASE ORDER #: N . 1392
SHIP BY IV,"' LATE CHARGES PER MONTH
UN ALL ;'AST D'UL INVOICES.
ALL .ACCOUNTS DUL AND PAYABLE
b•ONTH.
Emergency Sanitary Sewer Repair - South Second Street .
Truck Rental .
T & T -
110� hrs @ $ 72 . 02/hr $ 7 , 958.21
solo -
35 hrs @ $ 60. 29/hr 2 , 110 . 15
Outside Truck, Rivera & Green - 252 .07
O.T. - Rate diff in payroll after O.T. starts
21 � hrs @ $ 8 .87/hr 190.71
Total Truck Rental $ 10 , 511. 14
Material Dumped in V & J Pit
936 cy @ $ 2 .00/cy **returned to V 6 J as 1 ,872 .00
there was not another dump site in instructions.
TOTAL AMOUNT DUE $ 12 , 383 . 14
4616 SOU THMh,KEN T, WA98031 206-872-8622
cc2W87
d!H •v` d16® ,,;ate" !N® •���'M---
at at
V&J
A OO CI -"1r A A sv� A OO C'i �" 'r A A at at44 ' p� A A ��a�.rN n r Cava�iHG
INVOICE
SOLD TO: City of Renton DATE: 7/15/87
Robert Bergstrom
c/o 8ngineering Dept. JOB #: 100
200 Mill Avenue So.
Renton , WA 98055 PURCHASE ORDER*: N° 1393
SHIPBY.' 1140C LATE CHARGES PER MONTH
ON ALL PAST DUE INVOICES.
----- _. ALI ACCOUMT-S [)- E-ANOPAYABLE
T!T 10M OF THE MONTH.
Emergency Sanitary Sewer Repair - South Second Street .
Eaptic Cervices -
43 11 hrs @ $65 . 00/hr $ 2 ,827 .50
+ Tax @ .081 229, 03
TOTAL AMOUNT DUE : $ 3 ,056 . 53
,1616 SOUTH 200th, KENT.WA 98031 206-872-6622
cc26t87 3
AIAA. dWP ,v�rad� eW($ del � dui ,:1i� d➢�? d� �! � � ��' ��? d� � d�' ,� ��
AVLj
July 16, 1987
SOLD TO: CITY OF RENTON JOB #100
Robert Bergstrom
C/o Engineering Department INVOICE: 1390
Renton, WA. 98055
-
EMERGENCY SANITARY SEWER REPAIR - SOUTH SECOND STREET:` -
MATERIALS USED ON JOB SITE: 7K o LATE CHARGES PER MONTH
ON ALL PAST DUE INVOICES.
ALL ACCOUNTS DUE ANU PAYAELE
B & J: $ 58.32 THE 10th OF THE NIONT!t,
H. D. Fowler 514.37
McLendon Hardwares 33.33
Pacific Water Works 2,052.76
Segale, Inc. 2,124.00
Stoneway 4,334.14
Manufacturing Minerals 463.79
Rivera-Green 310,75
Coluccio Construction 133.70
$ 10,025.16
15% profit S overhead _ 1,503,77
$ 11,528.95
Tax: .081% 933.84
TOTAL DUE THIS PORTION $ 12 462.77
46165 TH h, KENT,WA S 72$622
a` ��� �4y � 3� p'.') �
? «� WE' AA OVA A A141AAA . z~, A
HAUI.:N �..
INWICT.
SOLD TO ; City of Renton DATE: 7/1.5/67
Robert Bergstrom
C/o Engineering Dept . JOB N : 100
Renton , WA 98055
PURCHASE ORDER N : 1391
--------- -- 7Y� tAl'ES•HGGGE.51':r2 A10N7H
ALL r.0 L',"� 7-S DUE AND PAYABLE
Emergency Sanitary Sewer Repair - South Second Streek- }u u, OF liiL"
Payroll
Foreman -
R.T. 79 hrs @ $ 28. 39/hr $ 2 ,242 . 81
O. T. 23 hrs @ $ 42 .43/hr 975.89
Total Foreman. $ 3 ,218. 70
Leadman -
R,T. 78 hrs @ $ 24.27/hr $ 2 ,693.06
O.T. 21ti hrs @ $ 36.41/hz 782.82
Total Leadman 2 ,675.68
Pipelayers -
R. T. 180 hrs @ $ 1 . 90/hr $ 3 ,582.00
O.T. 46"1 hrs @ $ 28 . 14/hr 1,308.51
Total Pipelayer 4 ,390.51
Laborers -
R.T. 16 hrs @ $ 19. 36/hr 309.76
Flaggers -
R.T. 64 hrs @ $ 15. 62/hr $ 999.68
O. T. 13 hrs @ 5' 21.73/hr 282.49
Total Flagger 1,282 . 17
Operators -
R.T. 140 hrs @ 5 23 .64/hr $ 3 ,309.60
O.T. 42 hrs @ $ 33. 36/hr 11 01. 12
Total Operator 4 ,710 .72
Ind, Ins . -
703 his @ $ 1.6747/hr 1, 177 . 31
Live Sewer Pay 285. 00
Total Payroll $ 18,550.05
+ 20 0 3 ,710 .01
Total $ 22 ,260 .06
+ 6. 1 Tax 1,803 .06
TOTAL AMOUNT DUE: 24 063 . 12
4616 SOUTH 2O0th, KENT,,WA 98031 206-872-W2 Z
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a� al4 alb alp a ? alb s alb al4 al?� a? a;? alb W4 aA a b at -`
07A, 4WL IPA alp A VRJ
FAl PVA,INF AIPVA,INe4•
�P liil �rH .V.{IO/� �l-di OOv Y�il w'r_"
INVOICE PAGE 1 OF 2
SOLD TO: City of Renton DATE : 7/20/87
Robert Bergstrom
C/o Engineering Dept. JOB 8 : 100
200 Mill Avenue So.
Renton, 11 98055 PURCHASE ORDER k : 1397
------------------------------- ----------
Emergency Sanitary_Sewer Repair - South Second Street ON ALLAF'.,,STr DOES PER MON
ALL A^COUNT$UE INVOICES.
THE 10"I OF THDUE AND PAYAI
E MONTH,
Equipment Rental .
Star Rental Case 580 $ 325 .49
Fray Equipment Dynahoe 160 4 ,230 .40
McDonald Industries 082 Hitachi 2 ,447 .68
National Barricade Signs 1 ,171.92
Forte Rentals Air Breaker 20. 00
Total $ 8 , 195 .49
+ 15% 1_j_229.32
Total Equipment Rental $ 9 , 424.81
V & J' s Equipment Rental
580 Case - 12 days @ $ 275.00/day $ 3, 300 .00
108 hrs @ $ 6. 50/hr 702.00
Total 560 Case $ 4 ,002.00
Concrete Saw & Van - 3 days @ $100. 00/day 300. 00
3/4 Ton Pick-up & Tools -
13 days @ $ 50.00/day $ 650. 00
10 days @ $ 50. 00/day 500 .00
8 days @ $ 50. 00/day 400 .00
Total 3/4 Ton Pick-up & Tools 1, 550 . 00
Penzoil Truck - 12 days @ $ 25. 00/day 300.00
966 Loader - 11 days @ $ 720 .00/day $ 7 ,920.00
102 hrs @ $ 20.07/hr 2 ,047 . 14
Total 966 Loader 9 ,967 . 14
Compresser & Accessories - 10 days @ $ 45. 00/day 450. 00
Arrow Board - 14 days @ $ 35 .00/day 14Y9U(r-
2 Ton Flatbed & Tools - 1 day @ $ 50. 00/day 50.001
Steel Sheets - i: LiVFD
2 Sheets - 13 days @ $ 40 .00/day $ 520. 00
2 Sheets - 9 days @ $ 40 . 00/day 360.00 JUL 2 3 i98T 1 Sheets - 1 day @ $ 20 . 00/day 20 .00 ,
Total Steel Sheets �900.0 4 ERINGOEPi.
7R1<go Compactor - 320 H Roller - C NEERIY OF GDEP
1.75 days @ $ 480 .00/day $ 840 .00
ENTON
14 hrs (a. $ 10 . 30/hr 144 .20
Total Rago Compactor 984.20
Total V & J' s Equipment Rental 18 , 993. 34
4616 SOUTH 2O0th,)ENT, WA 98031 206-872-8622
Forward This Balance to Next Paqe 28 ,418 . 15
PACE 2 or
Invoice #1397 Continued
City of Renton
Emergency Sanitary Sewer Repair - South Second Street ,
Forwarding Balance From Page 1 : $ 28, 418. 15
Miscellaneous Expenses :
United Services Incorporated $ 100 . 19
Interstate Heavy Hauling Moving 966 Loader 190 . 50
McDonald Industries Moving Hitachi 184. 31
Total Miscellaneous Expenses 475 . 00
Sub Total
$ 28 ,893. 15
+ Tax @ 8. 1% 2 ,340 . 35
Total Amount Due $ 31 ,233 . 50
•'• Note : This billing does not contain all bills , some have not
been billed to us yet,
r
t
STATEMENT OF CO1w.wL(AHCE
P arwou ....Sara Parwo. v. Y[FT oar[ —
1
) COMTn.CT MVV[(w/-16-8
Date July 16, 198 2 -
1. Rebecca A. Duerst Payroll Processor e. hereby ,•. .
(bane .I aid.roar Sarre) (7u1e)
(1) That 1 pay of supervise the P., ent of the persons employe, M. A. Segaie, Iric
(C onrracror e. rater onracrorl
.nth* q,.,W. ZITd St. Sanitary Sti.'r. Repair that di. .ne the Psymll period commenctnt on the 5t1T da or
/Isw lalwg er reMl
jlj�j 19 $Z and ending the —11t , of _Ju1y_, 19 87 all Persons
employed on and Dmlect have been paid the tall weekly wages . -d, 'hat no rebates have been or will be made either dlreiely or in.
directly to or on behalf of said M_ A. Fr,alp. In from the full weekly wage[ famed by any person
(Convacrer ar me ecwq
and that mi deductions have been made either directly of adm :..y from the full wages tamed by any person• other than permissible de-
duct,.oa as def.ned in Regulations, Pan I(29 CFR 5ubn11e A). ..Sued by the Secretary of Lab., under the Copeland Act, as ameoded
(43 Stu 948.67 Seat 108, 77 Star 967. 76 $tw 357. 40 U S.0 2760, and described below
-
Withholding
i^ FICA
Ned Aid
(2) That any Payrolls otherwise under this contract required to be Submitted for the above poriud are collect aid complete, that the
wage rates for laborers of mechanics contained there'" We not less than the opplicabla wage rates contained in soy wage delermmatmn
incorporated into the contract.that the classifications set forth therein for each laborer or mechanic conform with the work he performed.
(3) That ally apprentices employed in the above period are duly registered in a bons fide apprenllceshlp pmtfam reglst,y,d wit a
Stott aPprentncashlp agenq• mc.gniaad by the Bureau of ApprenticnNip and Training. United StateS Department of Labor, or ,f nI such
(4)recognizedMe agency exist. m •State, ore registered with the Bureau of ApprenUcexhip and Training, United States Department Of Labor.
N) Thwc
(s) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
In addition to the basic hourly wage rates paid to each labereT or mechanic listed in the above referenced paymtl,payments
of fringe benefits am Lsted in the contact have been .v will be made to OPPmpnate programs for the benefit of such aroploy.
tea, except as noted in Section g(c)below.
(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
L]- Each taborer or mechanic listed in the above mferernced poymll has been paid as indicated on the payroll, an amount not
less than the a. of the applicable basic hourly wage rate plus the am...t of the required fringe benefits as listed in the
contract, except as noted in section e(c)below.
(c)ESCr.PTIONS
[[C[PTION 1C.11) (aYl awaTOa
w to awes //A
.AM[ aMp TITL( al U
Rebecca A. Duerst, Payroll Processor
TAe wilful lal Safi..lion of any .1 the above statements may aubleci a ,cnfroctor or subcontract r so civil or,criminal Prvatcuboo
See Sec lion f00![[ofkk ri Ue IS and Secrion 231 Of Tige 71 of the Un ed State*Code.
DD, wp�a 87-, Pwcv oua cpinows oosDA
INSTRUCTIONS FOR PREPARATION OF
STATEMENT OF COMPLIANCE
This statement of compliance meets needs resulting from the amendment of the DtVis-Bacon Act to
intiude fringe benefits provisions Under this amended law,the contractor is required to pay fringe
benefits as predetermined by the Department of Labor, in addition to payment of the minimum rates.
The contrector's obligation to pay fringe benefits may be met by payment of the fringes to the vari-
ous Plans, funds, or programs or by nuking these payments to the employees as cash in lieu of
(fifteen.
The contractor should show on the face of his payroll all mantes paid to the employees whether as
basic rates or as cash in lieu of fringes The contractor shall represent in the stateme•' of com-
pliance that he is paying to others fringes required by the contract and not paid as cash in lieu of
(tinges. Detailed instructions follow.
CONTRACTORS WHO PAY ALL REQUIRED FRINGE BENEFITS.
A contractor who pays fringe benefits to approved plans, funds, or programs in amounts not less
than were determined in the applicable wage decision of the Secretary of Labor shall continue to
show on the face of his payroll the basic cash hourly rate and overtime rate paid to his employees,
just as he has always done. Such a contractor shall check paragraph 4(a) of the statement to indi-
cate that he is also paying to approved plans. funds, or programs not less than the amount pre-
determined as fringe benefits for each craft. Any exception shall be noted in Section 4(c).
CONTRACTORS W14O PAY NO FRINGE BENEFITS:
A contractor who pays no fr.nge benefits shall pay to the employee and insert in the straight time
bomrly rate column of his payroll an amount not less than the preLecermined rate for each classifi-
cation plus the amount of fringe benefits determined for each classification in the applicable wage
decision. Inasmuch as R is not necessary to pay time and a half or, cash paid in lieu of tinge%,
the overtime rate shall be not less than the sum of the basic predetermined rate, elus the f,alf time
premium on the basic of regular rate, plus the required cash in lieu of fringes at the stralelt time
rate. To simplify computation of overtime, it is suggested that the straight time basic rate and
cash in lieu of fringes be separately stated in the hourly rate column, thus $3.25i40. In addition,
the contractor shall check paragraph 4(b) of the statement to indicate that he is paying fringe bene-
fits it cash directly to his employees. Any exceptions shall be noted in Section 4(c),
USE OF SECTION 4(c), EXCEPTIONS:
Any contractor who is making payment to approved plans, funds, or programs in amounts less then
the wage determination requires is obliged to pay the deficiency directly to the employees as cash
in lieu of fringes. Any exceptions to Section 4(a)or 4(b), whichever the contractor may check.
shell be entered in Section 4(c) Enter in the Exception column the craft, and enter in the Explane
thin colu-nn the hourly amount paid the employees as cash in lieu of fringes, and the hourly amount
paid to plans, funds, or programs as fringes.
O U.S. G.P.O. 1276-745-124/37
q M.A. SegaIt, Inc. ++a CERTIFIED PAYROLL REGISTER +4+ PAYROLL PERIOD PAGE 27
18016 SoatAcentwr Parkway 7/0THRU 7r11
Twtwiia WA 90 8a JOB CODE 00?506 PAYROLL# 03
- - JOB NAME 2ND i BENNETi -RESTORE
Vw INC - CITY RENTON
S i,- i - * - w - w - * - 4 - w - w - w - w - + - + - + _ + - + - * _ * - w - a - * - * - a - a - ■ - * - 4 - 4 - w - * • a - w
EE NAME i ADDRESS *------- - H O U R S W O R K E D- -- -+ TOTAL PAY GROSS PAT GROSS PAY
-SCt i t MtVi T JOt CLASS A* MOO TUF WEA i>1R FRI SAT- HOURS RATE -TiW JOB- OT+N+_JOBS _
P JIT+W N CARLSEN 5705755 PAVG MACH S �0 ,.?p
t t2618 125TH AVENUE CT ; 0 1.50 1.50 26.150 39- 3
R�PUYALLUP MA 98374 5705755 PAVG MAkt S ?.56 -2a56 14,430 43.56
539-70-606A M-02 C M
° TOTALS- S1,50 84.10 822.44
*---------------I E P U C T I 0 N S----------------+ _
FRINGE FICA FED O/H SDI UNION OTHER TOTAL NET FAY
4.16 64.82 t5t 22 Q.7B 36.50 .00 266.32 640.32
r `- - - - - - ..,___- __ - -- -- -- - - _ _-.- - - - -
"EMPLOYEE NAME L ADDRESS *-----------H O U R S W 0 R K E D----------+ TOTAL PAY GROSS PAY GROSS PAY
{ SOCIAL SEC 4 6 EXEMPT JOB CLASS SUN MON TOE WED THR FRI SAT HOURS RATE THIS JOB OTHR JOBS
SYLVESTEr T CUGINI 7300210 SOLO TRUCK S 1.00 1.00 17.630 !7.63
353 VUE ,ONT PLACE NE 0 Z G0 2.86 2b.445 r^ 39
RErN1ON.. . _. WA 9B056
534-36-994# S-96 C M
TOTALS- 92.00 70.52 872.35
' 4----------------D E D U C T 1 0 N 5-------
TINGE FICA FED W/H SDI UNION OTHER TOTAL NET PAY
3,'.t 67.43 146.06 7.45 .00 .00 320.44 621.13
' EAPLOYEE NAME 6 ADDRESS *-----------H O U R S W O R K E D-----------* TOTAL PAY GROSS PAY SROSS PAY
e+ SOCIAL SEC ; b EXEMPT JOB CLASS SUN MON TUE WED TNR FR; SAT FURS RATE THIS JOB On* JOBS
{ EICHELBERGER 358" RAKER _ 2.50 2.50 45.690
A1.
21845 240TH PL SE 0 1,50 1 50 23,535 35.30
( MAPLE VALLEY WA 98038
I*t •-539-88-6354 S-0 CA
a
TOTALS 50.50 718.98
' + -- ------- D E a u c T I o N s--------- -----+
FRINGE FICA FEt *A+ SDI ONION OTHER TOTAL NET T'AY
- 3.43 56.74 193 9' 13.5r 65.63 .0329.84 443.70
411" - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
p tifh{WE2 NAME i ABBRESS +r--_------+t 6 U k S W O R-4 E-5-------s .TOT& PAY "OSS PAY-Wx&
_-
SOCIAL SEC # i EXEMPT JOB CLASS SUN MON TUE WED THR FRI SAT HOURS RATE THIS JOB OTHA JOIS
_9ON ERICKSON 5705740 HOTROLLER S
1165
u
RFflMOND WAY it-SO4 5705740 NOTAOLLEN S 3a0... �
REDMOND WA 9Ph.
i•+�S 535-0-5S70 M-00 C F
37-.56 97.52---- 567,-7-
*at *----------------
- - - - - FRINGE FICA FF9 W/HD E D SDI T (UNIONS-- OTHER - TOTAL NET PAY
- - - - - - - - - - - - - - - - - - - -
_ .4.16 47.". 143 9t3 t0,N6 28.i3 .99 +89. - 475.A4
�aa EMPLOYE; NAME b ADDRESS +-----------H 0 U R S W 0 R K E B --- -----+ TOTAL PAY GROSS PAY GROSS PAY
r, aOCIAL SEC 0 i EXEMPT JOB CLASS -AiW MN T6E WG# T+w Fki SAT +iO" RATE- T*U,A B- WTNR-dO➢S __._. __ .�..
4*-, STEVEN D EICHELBERGER 3500050 RAKER S 2.50 2.50 15.6" 39.23
;s4 304 NE 50TO 0 2.08 2.60 23.535 47.67
'• S;ATTLE WA 98105
�- 516-76-9928 S 01 C n
TOTALS- 52.01 At, 3 716.84
*------- - ---- D E D.0 C T I _O.M a --'- - -#
FRINGE FICA FED W:H SDI UNION OTHER T07 MET PAY
3_43 58.86 - 19! .46- 13.91 67.66 .08 335, 491.31
- - - - - - - - - - - - - - - - - - - - - - - - - --- - - --
W-D)YEE NAME 6 ADDRESS +-----------H 0 U R S W U t K E D-----------a TOTAL PAL' GROSS f' GROSS PA'
SOCIAL SEC # + EXEMPT JOB CIAS* SUN NON T!c W%D W =Ri SAT HOURS RACE THI.. JU" OTHP .LOBS
7MOOTHY 3 ENGLISH 7300236 SEMI TRUCK S 2.50 ..SB 17,740 44.X
Y..A. Sl94le, Inc. *** CERTIFIED PAYROLL REGISTER *** PAYROLL PERIOD PAGE 28
' i80i0 Soutncente. Parkway 7/eS THRU 7111
TuLwiia WA 98188 JOB CODE 607566 PAYROLL. 03
AD 40E-208 6 SE14NETT RiSTONE
Yid INC - CITY RENTON
f EMPLOYEE NAME d ADDRESS *---- -----H O U R S W 0 R k E 0-----------* TOTAL PAY GRASS PAN GROSS PAY
FN6tAl:-SEC t A EXEMPT. JOB i.ASS EL44 MOIi_. TUF WEB THR _ RI ;AT . .H"S RATE T4ZS dam- 9THR .4M
3281H NE
a
r
'� 93a-i8-i548 M-02 C M .
TOTALS- 49.00 44.35 866.58
Of.RlNU FICA iEL W!H SDI UNION OTHER TOTA+_ NET PAY
3.71 65.+3 152.34 7.02 .00 i60.00 324.4c 586.44
c YEE 4AME 6 ADDRESS *----------H O U R S W 0 R k E D----------* TOTAL PAY GMZ GROSS PAY
SOCIAL SEC f b EXEMPT JOB CLASS SUN MON TUE WED THR FRI :AT HOURS RATE THIS ,Wf OTtN JOBS
. AONAL$-G-HELM SR 5T095'7 fORENAN S 400 ?6
!3404 162ND SE 5709577 FOP,EMAN 2.5? 2.56 '8.29e 45.
. ;RiNTDN WA 98056
514^36-8526 W42 C N _ _
TOTALS- 40.00 46.48 609.17
*----------------D E D U C T 1 0 N S-------- - - -
FRINGE f3C4 FED *!N- FBI UNIOM OTHER T04Ai. NH FAY -
4.16 52.60 103.34 10.70 28.60 .00 )4.64 541.01
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - -
xy! NW L01Es 6AM1: b ADDRESS + - ---ii 0-U R S W 0 R M £ D-'--'-+ TOTAL PAY GRUB-PRY GROS&?m
SOCIAL SEC f 6 EXEMPT JOP CLASS SUN MON TUE WED THR FRI SAT HOURS RATE THIS A OTHR JOTS
T}ERYN PAMNT 1308210 SOLO TRUCk S 2.50 2.50 17.63o 44.68
S*43R9 ST.,SU1TE 207 0 1 0h i.90 %:445 36:45
a+, RENTON WA 96655
3oj 545-86-9487 M-01 C i
TOTALS- .50.75 ___ .._. ._.:W.16 fr32a4
a�� • * ------------D E D Q C T 1 0 N 3---- ------^--*
FRINGE FICA FED W/H Sfj UNION OTHEF TOTr:: NET PAY
3.71 64.59 46B:46 - -9: - f 4" H�r31 67eR3-- _. _._...
- - - - - - - - - - - - . . - - - - - - - - ' - - -
�9eI EM'LOYEE NAME 6 ADDRESS + -------H 0 U R S W 0 R k D-- - -* TOTAL PAY GROSS PAY LROSS PAY
M ;� , iKiAL SEC 4 6 EXEMPT JOB CLASS SUN NON THE -4---44 FkF qAT- MBUMs RhfE--4HI•d sw 6THk Jew--- ^.-•�•
5705740 iWTRLLLER S 000 1.42
w
Sf323 24i11 AYE 10 f301 5745740 NOTROLLER S 2.50 2.50 17.439 43.
SEATTLE, WA 98i&B
Iti-6B 0bt7 S-06 B M
TOTALS- 51.5r 410.76 906.28
*------ ------ D c D U C T 1 0 N S----- ----------*
FRINGE FICA FED WfH SDI UNION OTHER TOTAL MET PAY
4.16 65.56 236,96 13.78 36.63 60 352.93 56401
DiPLOYEE NAMES ADDRESS *----------H O U R S W 0 R k E D--- - ---+ TOTAL PAY GROSS PAY GROSS PAY
SOCIAi SEC . 6 EX74PT JO5 CLASS SUN MON TUE WED THR FRI SAT HOURS RATE THIS JOB OTHR JOBS
STEMEM D THOMPSON 73" i3 SOLO TR'.uk S 3.00 3,06 17.630 52.81
sift SOUTH 1257H
SEATTLf
2 c P M*A "168
� -286i 00 TOTALS- 50.5E, 52.P 841.93
--------- .D E D U C I 1 0 A
. - FRINGE FICA FED WIN SDI UNION OTHER AL NET PAY
3_7i - 63.98 229.26 7.23 .00 .00 47 S94.35
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . _ - - - - - -
TOTAL HOURS 37.50 TOTAL WAGES F'AID- 711.J�
• �P.fi. Se9aie, Irrc. +++ CERTIFIED PAYROLL REGISTEP. +*+ PAYROLL PERIOD PALE 2q
180ie Soa:hcenter Parkrav 7105 THRU 7!it
Tokwiia WA 98i88 ,iOB CODE 697512 PAYROLL4 e3
- -• JOB NAME 09KAN 1Ai_NISCNL 1;1066 ?
Y' ► ' e - * - e . * - + ' + - e - e - e - * - * - + -
A , . WhE 6 40DWS a-------N 0 U R S Y 0 R K E D-----------+ TOTAL PAY GROSS PAY GROSS PAY
-SEE 4 6 EXEMPF JOB CLASS SUN MON TUE YFD TNp ---fR2- SAT +HUBS RATE T4Rg NAP-_ OT+P JOBS
4 LOUIS E BLOUNT 730021e SOLO TRUCK S 1_25 1.25 1T.630 22.04
0' fiW - 1ST OR SE
EIERETT, NA 9844
�A 512-14-4866 S-eB CM TOTALS- 59.e0 22.04 960.94
-------D E D U C T I 0 N r S------ -- - e
FRINGE
FICA
FED Y.'H SDI UNION OTHER TOTAL NET PA1
I 227.86 7.16 .00 .er 299.73 :,J2,25
sh- - - __ - - -_____...-. - -- - - --- --- -- - -EKP .. , .
OYEE NAME 6 ADDRESS +----------H C U R S N 0 R K E D-----------+ TOTAL PAY GROSS PAY j PA?
SOCIAL SEC i 6 EXEMPT JOB CLASS SUN MOM TUE YED THR FRI SAT HOURS RATE THIS JOB QT1� JOB
VICTOR H EST A_ 3500056 RAKER ° .50 .50 15.6?0 7.4i5
, 110922 - q5 H ST SE 3506050 RAKER S 3.56 3.50 15.690 A °2
p r?N8lI0NiSN7 YA 9829d -
534-72-1978 H-09 C M
TOTALS- 49.50 62.77 725.36
x. ----_- ----.D E B U C T 1 0 M S- -
FRINGE FICA FEt J/H .,DI UNION OTHER TONAL NET PAT
- - - - 3,43 56.36 138.74 1315 64.35 .69 2r.39 515.e5
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - -
:£MkOYEE MAME 6 ADDRESS A-----•--- H 0 L' R S Y 0 R K E D-----------a TOTAL PAY GROSS" PAY GROSt PAY
SOCIAL SEC 4 6 EXEMPT JOB CLASS SUN MON TUE YED THR FRI SAT !OURS RA1� THIS JOB DIjou
?t4Itwt E HELM 570"77 FOREMAN S .4 Se i8.2% 9.1!r__
1 1136 94T- PL SE 57e9577 FOREMAN S Qe0 i.2e
5799577 FOREMAN S 4.8i J,66 +a.<9e ?3'16
EVERETT YA 98205 5709577 FOREMAN S 9 < 5
e y.<.. . 369e M-ei ti M
TOTALS- 51.50 83.66 891.61
k *- ------ -----D E DLCC T I 0 N S-----^ ----
FRIN6E FICA Ffati YfH 61 ONION- .BTAER_ -TOTAL - WT PAY
4.16 69.73 16F.28 15.78 36.63 .W 3e7.42 671.85 - -- -
'+ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I�
r;-HN%L.'OYEE~MIME 6 ADDRESS * - _h-O Oil SF -4F8-f A E 6 --a 194AL AV - GRBSa PAY,-i',Rm PAY
' SOCIAL SEC S d EXEMPT J08 CLASS SUN Mon TUE WED THR FRI SAT OAS RATE THIS JOB OTHR JOBS
,.;
L JAMES 57e5740 FOTROLLER S .56 .50 17.430 8.12
YN RUB Off
.STEP. 4A 99579
se-e943 M-05 C A
_ TOTALS- 4i,56 13.:4,-,.-_=.jm-
+
----------------D E D U C T I 0 N S ---------------�
FRINGE FICA FED WIN SDI UNION OTHER TOl MET PAY
• - 4,46 54.46 79M - ff.iD 25.50 98 178. --648,84
_ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4 - - - - - - - - - - . - - - - - - - - -
0PLOYEE NAME 6 ADDRESS *-----------H 0 U R S tt 0 R K E D---------+ TOTAL PAY GROSS PAY GROSS PAT
G&:IAL SEC 4 6 EXEMPT JOB CLASS SUN MON TUE iu _THR_.-.. FRI ;AT NDURS .RATE..TNiS,i88- OINR-dDDS _
T KRUSE 7306218 30LO TRUCK S 4,25 4.25 17.630 1.91
0 BOX 606
W�KLEa 534-50Y-9462 H_00 4832'
.� TOTALS 53.80 '4.43 896.57
_ ___...
4 FRINGE FICA FED W'S SDI t1NION OTHER TOT% NET PAY
3.71 - - - - - - - - - 7S9 _ _ _ Be` - ,D0 - '- -1. - 649.62-
EMPLOYEY HAW 6 ADDRESS -----------H O U R S Y 0 R K E D-----------r TOTAL PAY GROSS Pay GROSS PAY
_,,.SOCIAL SEC ft 4 EXEMPT JOB CLASS SUN "Do TOE WED THR FRI SAT NOUR. RATE THIS JOB OTHR JOBS
GLEN : Mi CONA68Y SM740 HOTROLLER S
S,94ac, Inc. rttrt CERTIFIED FAYROLL REGISIEP ++. PAYPO L PERIOD PAGE 30
(•'- `091& .'.�^�Ahcenter PtrzMa: 71A THRU 'ill
TuMri.. HA 95i:+b JOB CODE 007512 PAYROLLO 93
JOi NAME 6If0KM IIEi-44144k RO6bi6
'� l - R - t - rt - + - rt - rt - rt - rt - rt - rt - a - t - ► - rt - rt - rt - rt - + - rt - t - rt - ° - rt - , - t - t - t - rt - ■ _ • _ rt _ t _
01PLOYEE NAMES ADDRESS + - ----- -H 0 U R S N 0 R K E D-------- -+ TOTAL PAY GROSS PAY GROSS PAY
W44L SfG #-S EXEMPT- - JOB-CLASS SUN WA T71E - WED INR - -PRi -SAT HOURS RATE..T+t 1 491 VAR J885
423 - 2ND ST HE 5705740 HOTROLLER S 3.50 3.50 17.436 61.0
e 5705755 FAVG MACH S .000
__-_1iA.pq;7r-5J051SS?AY:_AAW--S
� ` 443-54-3083 M-03 C M
$ TOTALS- 41.00 74.91 623.71
_ s--._.Y_--------D £ 8 0 C T I 0 N 5------ w
;RfNGE FICA FED N/H SDI UNION OTHF3 TOTAL NET PAY
f 4.16 49.6: 81.4 10.97 20,50 .00 162.0 532.80
- - - - - - - - - - - - - - - - - - - -
". .EMPL^YEf NAMES ADDRESS rt-----------H 0 U R S N 0 R K E 0-----------rt TOTAL PAY GROSS Y GROSS PAY
SOCIAL SEC 4 S EXEMPT JOB CLASS SUN MON TUE iED ?NR .-RI SAT HGURS RATE THIS A OTHR JOBS
YAUF+M - 35W" RAKER S Sr 50 45.499 1
0 80)' S22
SUMMER WI 99396
° ' e3p^ai+SYA4•--1-44_ 1-4 70TALS 42.00 7.05 600.79
rt----------------D E D T I O N S-- -t
FWT E FICA FED 410 SD1 U019 OTHER 1'M_ NET PAY
?,4' 43.52 ?8.Q f4.24 $4.60 .00 181.4P 421.16
ke TOTAL HOURS M" TOTAL WKES FAD,- 330.92
liq
1 i
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•
n
Av_y.YWw..W-..v.w....rw...._......._u.. .__.. _ ,...... ._.. .. . . . �.,.-w c. -r.....-._._.. �.._ _� . .......... _ ...--...rr-......--.... ....
•
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INVOICE NUMBER
994899
M.A. SEGALE, INC.
ANC ASPHALT DIVISION
SOLD TO: V & J, Inc. DATE: 7-10-87
4616 So. 200th
Kent, WA 98032 7`,06 JOB' City oY Renton, 2nd Ave. &
Terms: Net30 Days Sennett, Restoration
107.35 tons Pave with asphalt concrete only 74,00 7,943.90
I
I
�_' Sub Tatty S 7,943.90
Remit To. M.A.SEGALE, INC.
P.O.Box 88050 CT
Tukwila,WA 90188
Retainage S
Total Due $ 7,943 90
6r> y�5
80 P.O.BOX 850 18500 SOUTHCENTER PARKWAY-TUKWILA,WASHINGTON 98188- ("615754150 .J,Jy7.a`�
223-01 SE-GA•LM A372N0
wn win .."I am am am wM am _�%m am am am am am aw am am AR AP qwR 41W
t�i t� � �� � �► �! � tipf�l ,pia .`ifs � ell 1 till �! ��
A A �� IE! �I . �� mil'° EFL �t•I w!"It •RF
'•• '-1 A IVA A __• A A VA 441 A A -'NR am A MIIIIINCi/fICAV11/N.i
Controdor !/fJ Z.
Address C-i6/6 2 u
Job Me.
City /c State .4
— paro ?-N- Ij '
PEOJE[T NUY6ER PROJECT TITLf
DEXfI►TION OF WORK (�'_. . /-F ab.i R.,7„�
l
TIME ^ IfEO RECORD
CODE WORKMAN ANOIOR EOUI MFNI WORKING DCONATION OF WORKMAN OR FOUIF S17t COOL CODI RAIF AMOUNT
7
3 L. a✓
_A
6
IG
II
t �7 •o
11
5 _
16
17
!
70
71 _�
75
76
77
76
79 ��
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REMARKS. UN, 91 Codet,
IOTA15
FRINGE 6EN(FiTS
M:DICAI AID tHw's) a_
_ INSF1[IOR
INWSTRIM INSURANCE INoolsl
NI AIIN AND WEIr ARE (Neylq Contractor's Representotrve
PENSION INoUlsl
TRAVEL TIME (D9yLl
I.I.C.A,
IUGNA UIH III ltl
uNFWLOTYE MT COWENUTION PATE
19
}an wn nrw 'RAM IMM AM "M r11M 41M I&dM jXM "M TOM "M ..;%Po OJM "M rdM W{M WM �`'W
A A "OAM A A R11'1 A dui ""Nm A A A ap -�,jm 4A n,+„iNGal.CAVA,Wf:
REPORT OF FORCE ACCOUNT WORKID
ContrOctor (/4i c,
Address
Job No.
City State— A Doti Z- 7- 97
PRDJE'T NUM\ER y'ROJECT TI tlE
Dfscnmary 0! woeR ...�--'i.fr ._✓... e . i'...,. r, �A A.,.e i.A.'r oti
i1ME WORKED WORD
C001 Wp[MAN AND/q !WelMlNl WOIRrNL OCCUlA(ION Of WORSMAN 01 fOu�. Siff CODI Cop! RAiI A..11,A.1
e
10
I
7 c. F
1•
le
19 C.C.
70
71
•
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:V
REMARKS IF.pb.n Vr of CR.nI
TOTALS
FRINGE KNEFIrS
a
MfD+CAI AID INowN
Nf•lCIOR
NDUSraIAI INSURANCE INwnt
of ACTH AND WE4ARf IN~.I Confroctor s RepfnenlaElve
+(NSIGN WwIN
)RAVEf TIME ID..l1
I.I.C.A. lip
MNMU•1'. Iry fll
ONEAMIOTMf NT COWENSATION OAIE 19
're" ..r, wn an wn wn wn « w wn an wr. 06PR OR .zw an Ran vom "m VGM n+1RI
�I I�it�1 R1 I Rl�l � rile AP A A A �klo A�,�!A .fit 1-14 A A�e'Am
R al�r a A swrin -!ao A A A R1t A �� A A 4A
d➢!pI R1 I A A A Rai A A ,ma A A A ,gyp lip .qua A
+ � R R4 A Rk ,-!,4 A A A A A ,.�� A A I•I/WtC�AIZ
REPORT Of FORCE ACC40UNT WORKED
Contractor
Address _ C/6 16 Su oo Job No.
City /� --t State D" 1 7-57
PROJECT NUIERER PROJECT TITLE
DESCRIPTION Or WORK
�r_ _ TIME WORKED, RECORD
ITIZ CM WgarAN ANOIOR EQUVNlNI WORKUNO OCNhIION CO WOUWAN Or IQWr Sill 1COVI COOL qi! ♦MOUNI
7
'•o G
e
v /
o _
1
4 i a w0
1-4
16
IV
LD
I
75
7/
Je
7v
REMAR[S If•plo.n Uw of Code,1
TOIw;S
FRINGE BENEFITS
MEDICAL AID INwl,l
_ _ Iwrluos
•'OUSTRIAL INSUTANCE lhixol
NEALTN AND WEL/ARE INWI,I COnI1QC1OT S RRpresenT011ae
PENSION INa,lq
{RAVEL TIME IDorU
,,I,C.A, ISI • UR11 ITI lQ
UNHIQLOTMENT COENENSASION DATE 19
t
IN i ERSTATE HEAVY HAULING INC. }
P.O.Bc,20536 Portland,Oregon 97220-0536 256.335S
7-7-87 10�J81
Truck No. _Trader No. Date FRE' 1T BILL NO._
V&J Const Renton, Bash
Shipper Shipper's No.
Same Kent, wash
Consignee
c To, V&J
4616 S 200th
Kent, Wash 98031 I
3k0
' Description of Article load and Per Hour Miles Per Mile We t Rate Per
PM nloadin Tm Rat• Hauled Rete PR cwt LRarges
1 Ukl Ot
1 .0c
Shipper-- Removed the above freight in tioparent good order. PAY
LAST AIR NY
SHOWN
Per— Oate—
TRe emfetl or fa:ad vflue of the property is hereby speed¢ally e
stateQ by the ipoor to be not exMifing:
PAYABLE 7 DAYS
$— Per_._ Per g
RETURN ONE COPY WITH PAYMENT
1
INVOICE
ACCOUNTING ,62.2566
SroNEws►Y SALES/PLANT 226 loco
CONCRETE ORDERDESK 226-1oon
1915 MAPLE VALLEY HWY,RENTON,WA 98055
INVOICE UN ACCOT CODE
V S J iMILRPRI°:ES 95 cat O
SOLD TO 161i SOUTH 2.00Tti
FNr WA 98a3/ e
A
T
INVOICE NO DATE C
DELIVERED TO
CraLl_ 1 + A
TAXMEE—•y CREOrt
QUANTITY PRODUCT DESCRIPTION U MICE •* EXTENYION CA
231 1 lON3 TOP C'OAI;�'E ;1 �4 121115
I '
j I
} i
1 � !
1 ,
;
� 1
I
;
1 ,
1
f
STONEWAY CONCRETE SALES TAX I
Please Reltlli To 9125 1081 AveDDe Swth
• Seattle,WA 9810.9 TAZABLE TOTAL OUE 121 1.+
10"W 01 * *jV NL 4OR LB
STO N EWAY
ennenere - I I
?.O.BOX 509 RENTON,WASHII'll 93067
2261000
��]]JJ
DATE_ 19
We. ''�$.� t JKAN�T 0
SOLD TO--1�f—V 1 LLJ'C �a F�(�c St
ADDRESS
CITY
DELIVER
TO.
PUPNTIiv pESC NIP\IPN NiCL MMO\INi
CO r05 SAND
GRAVEL
CRUSHED ROCK
SUB
NkC'0 X l TOTAL
Br
TAX
DRIVER TOTAL
No. G 65230
sit spnificady greed that STONMAY CONCRFTE INC.will no a heid Valle for any
damage to shrubbery,finwers,city adewalKs,roadway or private propw.y in delivering mar
trial listed above,on These premises.
' - PLEASE PAY FROM THIS INVOICE
Dt c INC
00
� 275 )6N Are So. •P D 80•3757 3157•Kent. WA 98032�047A
WALL SAWING (206)8727578 1.800228-9612 tm
{{{CORE FIRILLINC LUa. *CA-SC.AS-D/89JN d"
LAB SAWING
1hd Invoice No. 14144
r Invoice Date
SOLD TO: JOB: Vendor No. VJHO10
V & J HAVLING & EXCAVATING 2nd AVE. SO.
l 4616 SO. ?OOth RENTON,WAUM
!CENT, WASh 98032
I
Ts.ms Gueromer 01M,No Cueiomxr you
RwiA No
C600-196-208
DATE QUANTITY DESCRIPTION UNIT PRICE NET PRICE
7/6 267 L/F1 i. OF 311 - 411 [SPHALT SLAB SAWING AS DIRECTED $680.0(
I
i
I
I
� f
I
Sub Total S680.00
"NOTE:Invoice Due On Or Before' y G IST 17. 1287 Tax
— TOTAL
AUTOMATIC LIEN FILED 75 DAYS FROM INVOIC7,DATE IF UNPAID
(WE DO NOT ASSUME RESPONSIBILITY FOR DAMAGE CAUSED BY CUTTING BURIEL PIPE,CONDUIT.VOIDS.WOOD AND STEEL BEAMS.)
r .
e�
. .Job No. Comoiany
... . .
•1
�'Ay�..yy`�y�i,/�..'✓ ��i('�r 11�'�[�r�.tt S ��r A l�Yi��11..
r2{fATl.C./S•141�Xn�a•,011• �F`r ,�ry�}r- �'•♦• . ej �S[i.
R
Y•'�'�.�.`'CLNt�4K�{��'��'r`��t�)'+!.i+idt°'-`Ki���4��;1r
'� {`�CT.r `S,,�vim� .. 1.;,r• �C ��.`}''��^` j.'i'�
s��,�w•-•thy. .ri.:riL JL :..F' .. !♦ ��jr,,;i�y.wr ..�.
r �.'/ry�[G _ r!�yViA ri•� r� i IFi t/H•,,
ry ..yhv Irey'; ?yj n11t r�E.�,11 rY`J,^ ♦ 1L \It'�1R.(.
_i yi�[^rf`l" '�t'Y[.tl_`�"'.� r • .la�?'Frye: �� ..
�;1 �,.SI r♦��..`.y,t)vyl ► t, �y5f r`en6`i. ����.
4.yv�r��•°� .�r�#+�•4i4.�'I�`/.:y r't6:.1�lu��y{��'n
4 ♦ f.i� tTJ n l! �,E t{.����C K ��1..n l'1� It
..v.r..+_,�`y:� ..:.5��111Jjr"t`7„'=A�{:'x`.y.��, :�,�°=t' f .•
°."'::L•t,J•IY'4 ^�Ai3 ,;.a1'+lY•�AnVt:7i`TrR^i:�t.�..;.��'
4 260 - uuT
25 tju*
260 . 00*
300 • ou* [
19000 - uo• '
1
1 .080 • uu=
2u •=
54 • 0P!
hA.A. SEGALE INC.
S ASPHALT DIVISION
PC) dOK 88050s 18500 SOUTHCENTER PARKWAY
N TUKWILA.WA 98188 . 1206)575.0150
223-01-SE-GA LM-A372NO
DATE
-- ` rPLANT
ITFM NUMBER
PURCHASE
ORDER NO.
TIME AND DATE WEIGHT
GROSS
TARE
NET
QUANTITY UNIT DESCRIPi'ION Una Pme AMOUNT
LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
TONS STATE SPECIFICATION CLASS
GALS.EMULSION . -AR4000 ASPHALT
OTNEP MrECIFYJ a
r
� - 1
STA+ION MILE TIT SALES ;
P=CEIVED P.M. TAX I
TRUCK NO. I x —
RECEIVED BY 1
Cialms for adjustmsnt must 'TOTAL
be acrompamed by this ticket.
* 1 A White:Custan•-l Y01o.Offce I P n*.Job i Goldenrod:Plans
192,37
'_.A._♦ Ni. A. SEGALE INC.
ASPHALT DIVISION . '
P.O.BOX 8805J• 18500SOOTHCENTER PARKWAY
TUKWILA.WA 98188 • (206)575 0150
221 01.$E GA-LM A372NO
DA rE 7 7 0
PLANT
TUKWILA
- 2601
ITEM NUMBER
PURCHASE
ORDER NO. —
TIME AND DATE WEIGHT
GROSS
TARE
NET
QUANTITY UNIT - DESCRIPTION Umt Pica AMOUNT I
LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
TONS STATE SPECIFICATION CLASS
GALS. FMULSION "1A1140W ASPHALT
OTHER 5v wall t,4
J 1
� _ 1
STATION—MILS TTIME
RECEIVED, J —PM. TAXES ; —
TP rCK NO. x 1
RECEIVED BY 1
Claims for adjustme
m nt mmt TOTAL {
be accoPanlad by this ticket.
law. 192440
White Cwome./Yellow:Ot1¢e/Pmk:Job l Goldenrod:Plant j
,. to,. A. SEGALE INC.
ASPHALT WVISION ,
PO.BOX 88060.18500SOUTHCENTER PARKWAY
iNC TUKWILA,WA 98188 • (206)575 0150
223-01 SE-GA-LM A371NO
- i DATE ] I
,j
PLANT
kli,A
ITEM NUMBER
PURCHASE
ORDER NO.
TIME AND DATE WEIGHT
- 1
GROSS I
TARE i1
a NET i
OVANTITY UNIT DESCRIPTION U• Pme AMOUNT
LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
TONS STATE SPECIFICATION CLASS _—
GALS. EMULSION AR 4000 ASPHALT
I OTHEN tl6e.illj
_ I
STATION MILEI
TIME C p SALES i
RECEIVED • V 9 �� PM. TAX
TRUCK NO. x
RECEIVED BY
Claims/or adjustment must T074L
be arrotnpanred by this ticket.
•i.I 192444 W1ntr:Customer;Ye0ow'01 f ice/Pink:Job/Goldenrod Plant
0- - N -
�►,_ M. A. SEGALE INC.
r' ASPHALT DIVISION -
P.O.BOX 88050.18500SOUTHCENTER PARKWAY 11
NC, TUKWILA,WA 98188 . (206)575 0150
223 01-SE GA LM A372NO
DATE
PANT '
fl � F
ITEM NUMBER
PURCHASE
ORDE'1 NO. - !
TIME AND DATE WEIGHT
GROSS
TARE
S
NE'f
f
_ OIIANTITY UNIT OESCR!PTION Unit Price AMOUNT i
LBS.MC COLD WX 1
TANS ASPHALT TREATED BASE
TONS STATE SPECIFICATION CLASS
GALS.EMULSION, ...AR4000 ASPHALT
E OTHF
STATION MILE SLEA
RECEIVSD t P.M 11 t
TRUCK
_� RECEIVED BY
- Claims for adjustmaot must TOTAL
be a,,,inp ,ed by this tiekat. t
.+ White:Custom,,l Yellow.-Office I Pink Job I G "d:Plant
�.M 192446
Wrr Y.�._�..a-.. .w�vi"�u...��a+i��n....r.-.�i�.�u.r. ..s.W.+•.�.r.
a
ti
! 1
260 - 00
r.
1 ,
1
4
i
1� r
<
• J
J `
h
M. A. SEGALE INC.
S ASPHALT IVISION
tE M PO.BOX 08050. 13500 SOUTHCENI'ER PARKWAY
{ 'i U K A'I LA,WA 98183 . 12061 575-0 150
}F!i 223.01-SE-GA LM 1.372N0
DATE 1 -7 � E•�7
PLANT
TuKWILA
2601
-- ITEM NUMBER
PURCHASE
DRCER NO.
TIME AND DATE WEIGHT
GROSS
TARE
NET
QUANTITY UNIT DESCRIPTION 11Mn Price AMOUNT
LBS.19C COLD MIX
TONS ASPHAL7 TREATED BASF
TONS STATE SPECIFICATION CLASS -
GALS.EMULSION hA 40M ASPHALT
OIHER SeEtl tt,
_ 4 -----------------------------
r y
1
STATION MILE I E I , % 'I SALES
RECEIVED
1
TRUCK NO. X I j
RECEIVED By
Claims lo•adjos•ment m• IM TOTAL
be accompanied by th• cket.
�M ��� Whrte:Customer/Yellow:Olhce/Ank:lob l Goldenrod.'Plant
N: $
s:+ut..:aw. -=z:�..tar..s:.,......a....... .....a:..,,,,�...._......sw,...�.rr.'.
1
SEGALE INC.
ASPHALT DIVISION _
P.O.BOX$8050. 185GO SOUL NC ENT.R PAR K W AY
TUKWILA.WA 98188 . 12061,575 0150
223 01-SE-GA LM A372N^ }
DATE
PLANT
--- ---- T U K ?
--�t 2501 ;
ITEM NUMBER -
' PURCHASE '
ORDER NO.
TIME AND DATE WEIGHT
_ 1
GROSS
TARE
N:ET
QUANTITY UNIT DESCRIPTION Unit Pries AMOUNT
LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
TONSSTATE SPECIFICATION CLASS I s
GALS EMULSION __ '%ITt QAS HALT
or7 H1 aCir ,e
t w
�1 F —
�TAiIONMILE • C� SALES i
RECEIVED n7i;iTOTAL
TAX TRUCK NO. ECEIVED BY
Claims 1 ar"pin nmt M.-
be accoMPaorall by this ticket.
Where:Cuslorner/Ye//mv.Ottiee 1Ank:Job l Goldenrod:Plant
i Y.e
.....arsr.r..Wr.�....... - - .:...:ra.urYa..+�+.e�.,...a. .,".,.... •- - ...: _ - - _.'. . a_r
M.A. SEGALE INC.
ASPHALT DIVISION
�ess P.O.BOX 88050.18500 SOUTHCENTER PARKWAY
Nty TUKWILA,WA 98189 . (206)575 0150
223 01-SE GA LM A372NO
_ DATE 7 67
PLANT
7UKti1ILA
2601
- ---- ITEM NUMBER
PURCHASE
ORDER NO.
TIME AND DATE WEIGHT
GROSS
TARE
NET
r
QUANTITY UNIT DESCRIPTION L'nit Price I AMOUNT
111 LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
TOI ISSTATE SPECIFICATION CLASS
GALS.EML;LSION AR 4000 ASPHALT
OTH4R VECIFY ��_ � 1.
t �
I STATION MILE SALES + M
RECEIVED •"{ vo P.M. TAX t
TRUCK NO. X t .It I I —
RECEIVEDBY
Claims for atllostntent must 41P- TOTAL
be accompanier)by this racket.
11►p 1(1,fy } 1 44 Wit, Custo ner I Yellow.Office/Pink:Job!Goldevod:Plant
9
M�
x
A M. A. SEGALE INC.
ASPHALT DIViSICN
P.O.BOX 88050. 18500SOUTHCENTER PARKWAY
Mrr TUKWILA,WA 98188 • (206)575 0150
223.01 SE-GA-LM-A372NO
DATE
- - TOKMItrT
2601
— __ EM NUMBER
PURCHASE
ORDER NO.
TIME AND DATE WEIGHT
GROSS
E TARE
NET
nUANTITV UNIT - DESCRIPTION Umt Price AMOUNT
LBS.MC COLD MIX
TONS ASPHALT TREATED BASE
i ONS STATE SPECIFICATION CLASS
GALS. EMULSION ..•,kRGQDO ASPHALT
� f1
IFI
OTHER VECIF Ft � 'It
\ t
V
STATION—MIL E TIM�—u� SALES 1
RECEIVE
4
i TRUCK NO. X
RECEIVED By
Claims for adjustment mutt 11W TOTAL
be arconipamvi by this ticket.
}►n 9 2 4
fE 6Whrfe:Custer er/Y,,ow.dfflce I Pink:Job I Goldenrod:Plant
(lov"4 Or
1420 010I6ml (jifrotv TV. t2^.lf,
STATEMEM —1
V 4� �J.•..�lt.. T E'�lCs9Jcl�q) 1
m.an•��r� -ns•.�e wn�.00v.e.m•..0 •oo.u..ceuenc.eca u.o,.v.ern f4:e—^1
` ffm Kim
i
C� ai Ip
REDIFORM OSS72 rwbonfc s
POi\ PAK (50 SETS) QP872
— McLendon Hardware Inc. McLendon Hardware Inc.
RentonW [V
Sumner236-3510 843.226410 So.2nd St. 236 1111 Fryer Ave.Renton,We. o. dSt. Sumn.er,We.
9M21% Renton,
open every day! 6 16 91 21� 74669
rr }} open every day) ) .�
V
CVfT p11�
I
SMELL
;µ s
ALL CLAMS Am eme►®00ODe W-W K ACCOM►AMW eY Tx5 BILL. OOOOM T eE OV
u ae� TNIe 0U.
A OWMAPOM NOWT M W T"to alcwrs �m
Wf=s DiLacT to All wsca�AuaEa 1eu6T
OAS► I 0)egNl 61MOxO
NONSENSE
r
T.
t
rAIKULL I.,v, %pp.o..A.
WAGE AMU HOUR DIVISION, S.ASM Iu.�w Mw 4"1093
(for ContraelE/s a~ lse I Soo Instruction,Farm MM1I-347 tegt.)
:"a of CONTINCTOI on wlco"TwTM ^DORM
V S J, INC. 4616 S. 200th, Kent, WA. 98032
PAYROLL Np COI FEEX EAMND fIww? MID LOCATION -8111RaCT NO.
3 7/8/87 1 7 SOUTH SECOND STREET SANITARY SEWER EMERGE WY REPAIR _
(D Ir ( QO fe Dar AND CAM M i "0 1 O7 A lfl
IMLIL AOOW[sl AMC t W GROS/ DEDU ONs — MET
1.3' MOTH )orAL bli[ WAGES
Sacm Sacum" Numa W oz
: CLASSIFICATION MOIIRI OI ff1Y FARMED rrrtIf *arN. PAID
OF EMPLOYEE g MOWS WON® I I d EAAMO FICA NOME M.A. oT)I[ll OmuLT101W FOR WEEa
0
1 1
I•
Ray Graeber 10. Gen. Su t . 1 1 a
s °
32.1
Greg Prater 0.4 Foreman s 6 8 14 21 .45
0
4 4 25 ,76
Richard Henderson 3M Operator 8 8 17. 17
0
7 '
I
Kenneth Tonsgard 12M Pit Oper, s 8 210 25 .7 _
0
3 3'. 22.84
Brian Bowman ffOS Pipelayer I 5 8 6 20 14.56
0
4tera Danylyszyn 2M Fiagger s 8 8 10.7
0
I
.TAm-e Huhlstz `,a borer 8 8 14.G
0
Peter Ozolin=_ 8S Pipelayer • 8 8 14.5
0
n Thorne 4S Laborer I 8 8 14,0
FOI Wnaq Uiq—fOIWOM.Y *X IIr—PVRCNASE THJS FORM DIRECTLY fow rim Swr. or DocumemrS
a.
7/10/87
JUDY COLUCCIO PRF4IDFNT
1otMe9'e.ror Isnf (b) tMERE FRINGEBENEF)TS ARE PAID IN CA
me"M W do Mraby#Der O -Each Naar or mechanic'rftd in the alms referenced payroll has been peid, as
irdinted on the payroN, an anauM not aM than the su-, of tlr applicable basic
(1) That 1 pay w wperolee the psyrM^t of the persona anybyed b VV fm Tr= why wage raft pars the arneMA of the ro lO ed MrKo berNflb *a Iishd in the
centrrLC @=W as naiad In SKthm d(c)balm.
Br SOUTH Ind STRUT SANTTARY CFLIER
K,ne.enn « aracwre,tetM raeerwa«.veer (t) ERCEMIOIR
EMERGENCY (EPAIR .Mat during ft Pay psAad oaennrerri0 an tad 1
day of `I't Y _ Id 8 7 end ending the g -day of . 64 E,)i - 11 mmulm (CUM QrLANAtM
FN persons ser' on sad project hn-e been Paid the hdl rwoAty wagme snared.that no rebates,
how ben r , 11 .,thar dl<otlly or indirectly to or an bebop of add RAY GRAEBER _JREMAN BEEEFITS PAID TN CASH
htwnUr to GREGORY PRAYER LEAD MAN BEREFIT - N CASH
S UID r
.. ov any anon ant Mat e—daductions haw boon mode ether areeny or Wtdww*y
-vales serned by any person, ati— than permissible deductions as defined in
Rod& ..t 3 (29 CFR Suftit*y,issued by tat Gecrotsry of labor enler the Copeland Act.as
amended (48 Star. 948, St Stet. 10& 72 Stitt. 967; M Start. 377; 40 U.S.C.276c),and described --
below.
FISH- - - --- --
WHHD -'- ---- ---- -
?1ED. INS _--- - ----- - — -- - --
UNIONS ,—
(2) That any paymns othervem under this contrite iauirsd to be s a for the slime
period an correct and complete:"the wage watts for laborers w:rw—.tiatieT L .aired therein are
not lest ecru the apphcobler wage rates conto,nsd in awry wage debrmmatian incorporated etto Nr
contract:that the ctamficetiore wit Oath therein for each lebo-er or mtclrnrc conform with the work ,
he parfortnid.
(3) That any appnnton snployed In Lard above period are duly rWsend A a bath '^+
opprenticaship prognrn registered with a State apprenticeship agency ra ogn red by the Suroev >
Apir.",coshio and training, United States Department of labor, or if so such recogriaw agency '
a,sts in a State. en registered with the Bureau at Apprentir slip W Training, United States
Department to Labor.
(y That rota Arc Iota T me
(a) WHERE FRINGE BEh:EFRS ARE PAID t0 APPROVED PLANS,FUNDS, Old iMtOGq,aMb -
)(1( M MLULL eAterrICAV OR err ANT OF "d Asaea'atAMAJ T MAT SUBLIM TMa CORTSACTah rat
Q� --In addrlron to the it br hoary+Hair m, r pad to arch leaere or n r atlw+ic Wait is Sm"WTse mm To my On corium t FNOaaeurrDR sad saeT wool w TR11 10 AND SEtrrOrr 231 or
the above lAerenced payroll, Iryments of fringe bnrfift as wed In the contract �lsninalNeurTmeutucdad
MMOL +1M0 MOIIR OMSIOM •..asp a"nw ra.M-IIIOq
(for Cotltr•d�"•Optiswd U•q S+o M•tructien,form NI1t-347 imL)
K"t 0r cowm-4'Mw , a s0•COK"MCTM .00•rs.
V h J, :Nc. 4616 S. 200th, Keat, WA. 98032
nT.soa►w '3 Tra•�[pc �wo�,w " PKOAXr swa w:Anow �c cu"IT
"na
/S/e ( COSQ CTUEt SANITARY SE4'ER EMERGEl Y REPAIR
q! f as IN M►/ala Yl• w I (Y IT A (11
w.rc s0o•rsGES
t .«0 T N a•os otoLperxm MIT .
SOCWL SSCUI•lY MUYW 3 C4�nCwnpl 2 "s 5 6 7 8 omm of mY Vrrft "To sMoiawr rnT(► (OT+a ►A
aI EMPLOYER lets w0U••wo•sm nor OP� EAM$M ncA polo=1(•TPA M.A. OTwO
•OfYCjL /dr wsG
a
_ Rc -_t McDowell k OM Trk. Drivers 17. 741
o
Dar-el Seawell 1S Trk. Driver s -42 li 17 ,74
0
s
0
s
_ 0
0
' s
— o
•
0
•
0
•
Taas1 w( w II/sue—."Nifty sm t•m-PUI(CPAM TIIR FOAM DIRECTLY F*M r1f SWr. OF OOCUMEMTS
4 JUDY COLUCCIO - FRINGE PRE STOFNr
tMear at wear sire QeY p) tekERFRINGEBENTFM ARE PM N CASH .w1
�hereby State. D --Sash WkWW or r,echenac liked in the ation wterrY,ad payroll has been ppn, as
ied.cow on the pryroi, an eminurR not Yes t' n the ii of ie applicable bias
(1) Thet 1 pay or aup"ies the pryment of the persons cmobyed kr v it inn Mu Ay we& nbs wA Cr anwunt at the nt0uind hedge benefits be :-Mad N tlM
Contract,smost as rsrd In Section 4(c)balm.
theSOUTH Znd STRFFT SANTTARY CFLR'R
adwenrtM M a,re[anrrwred E/eaai.e er vismid 4C) 17tC'ElTklrtS -
EMERGENCY REPAIR .WtdarfngUle psyrdf prfod 1dry finums J
dal'of TJLY 111 8: end eriding the g—by of r/i r Y 19-9z- EXCA PTICN (CRkf7) OIhANATM
all person erllployed on said project have boon paid the tuft weekly wegee aarrta4 _xrt me nbotss
have been or pill bt made Mthr dirw* or indirectly to or an beruMf of MW RAY GRAEBER FORE"'.AN BENEFITS PAID IN CASH
c o....tr re~ *Wm the two GREGORY PRATER LEAD ` kN BENe'_rI'IS PAIU
weekty wages earned by any person and that no de l,�*tione haw berm mode WOW dira11y or r.Mrectly ------- `-- - --
from the `..i, wages earned by any person. other than permissible deductions As defined in
Regulations. Art 3 !29 r'FR Subtitle A).issued by the Sec-rooary of labor ander the Copeland Act,as
amended (48 Stat 948. 63 SCR 2061, 77 Seat. 967; 76 rt. 357, 40 U.SC.276c),and descnbe0 -- - -- - --- -- ---
below:
FICA _ - �_ - -----
_- WHHD - - -- -- -- - --- --
MED. INS. - - — --- --
CN,ONS
(3) That any payrMa otMrwin under this c-.1rract r"wrwd to be suMNlYd for the aoow REMARKS
perod an rvrect and cwraaplYts;that the wage rates iwr laborers or nle ienotta amm"ned tha ain am
not lass Man the applicable sets rates contained in any wage 3eterm,nar n Yrnrporated into the
coMrbd;that the clossibcabons tH forth therein for each Poorer or mochwwc orloom with the work
he performed.
(3) That any apprentices aml-,ad in the abow pence -ra duly ragisterd Y a bons lids
spprent onhap program radistCrsd with a Sate apprsraticeshic rgnic'y moignime, by the Bureau of
Apprenticeship all Training, United States Depart-ant of tabor, or it ao such tec aed eiiamy -
exists in a State, we apsttred wYn the Burg• r of Apprenticeship sad Training, United Ststes
Department of Labor.
(a) That IL*M AND TITLE ItiMA USE
(a) WHERE FRINGE BEMEFRS ARE PAID TO APPROVED PLAINS,PUVM OR PROGR"S frMy •
n XX TM w1UFUL IAtaaFICATTOM OF AIIT OF THEAMOVE IFTATIEy ITS MAT SUWE' it COMT11ACTOR On
Q� -bl addition to the basic hourly wage'ate%p.,4 to a ii Wares ar eschanr_gstsd i1 st ac wr*ACTOe room ON C*JMuuu.0`e0"Min0et all fECTIOer a0o1 of TI: -♦AMo SEMOM 231 OF
the abOw nfef~payroll. paymetats 01 fringe bene(da as listed In the Contract TMA 34 OF TIE Wm STATU COOS.
S. 2 nd St. Repairs Correspond. I I -1#5 2
JOB I00 PERIOD ENGINE
CERTIFIED PAYPOLL REGISTER 07/08/87
E?D NME t A^DRESS S. T 1.5 T 2 T S. T 1.5 T 2 T GROSS FEDERAL MEDICAL M19C NET
NO. WAGE-:ODE DATE HAS HRS HRS RATE RATE RATE PAY WITH FICA RID DEDUC RAY
156 GREGORY N. PRATER
533-50-60%
22618 94TH S.
RENT, WA, 98031
60 07/09 14.6 .0 .6 21.45 3%.30 21.47 3,92 .00 274.91
60 07/09 .e 4.0 .0 32.18 128.70 9.21 1.12 .90 118.37
156 N TOTAL N i 4.0 4.A .0 429.00 .M 30.68 5.04 .00 393.28
PERIOD ENDING
JOB 190 CERTIFIED PAYROLL, REGISTER 07/98/87
EMP NAIIE 8 ADDRESS S. T 1.5 T 2 T S. i 1.5 T 2 T GROSS FEDERAL MEDICAL RISC NET
HC WGE-CODE DATE HRS 4RS HAS RATE RATE RATE PAY WITH FICA AID DEDIIC MY
IN RAY B. GRAEBER, A
541-54-8004
211 S. I71ND. ST.
SCOT-ILE, WA. 98146
Be 07/69 14.0 .6 .0 M.00 350.00 25.02 3.78 .01 321.20
80 07/09 .0 6.0 .0 37.50 225.00 16.09 1.62 .00 207.29
IN H TOTAL H 14.0 6.@ .0. S75.00 .00 41.11 5.40 .00 528.49
N JOB TOTAL sf 108.5 31.0 .0 2752.10 81.72 1%.77 38,53 93.15 2341.97
JOF 100 RERIM NMI*
CERTIFIED PAYROLL RESIT-R 01i08!87
EID NA14 6 ADDRESS S. T 1.5 T 2 1 S. T 1.5 T 2 T GROSS FEDERAL MEDICAL MIT !JFT
No. NRGE-CME DATE HRS MRS HRS RATE RATE RATE RAY WITH FIM AID DEDOC PAY
121 RICHARD F. HEND E0
U3-30-8271
12923 18TH ST. N,E,
LN. STFVEWS, WA.
98258
56 01709 8,0 .0 .0 17.17 137.36 9.62 2.24 6.06 119.30
50 07109 .0 4.0 .0 25.76 103.02 7.37 1.12 3.80 91.5,
121 M TOTAL N 8.0 4.0 .0 240.38 11.94 17.19 3.36 9.00 198.89
199 HENNETH A. TONSSARD
537-72-7739
1"0 56TH S.E. N
SNOHC 1% WA. %290
50 07/09 10.0 .0 .0 17.17 171.70 12.28 2.70 7.51 149.22
50 07i09 ,0 6.0 .0 25.76 154.53 11.05 1.62 4.50 137.36
199 N TOTAL M 0.0 6.0 .0 326,23 ,00 23.33 4.32 moo 286.58
PERIM ENDING
JOB IN CERTIFIED PAYROLL REGISTER 17/6817
EPP MW 6 ADDRESS S. 7 1.5 T 2 T S. T 1.5 T 2 T GROSS FEDERAL IEDICAL RISC NET
NO. WAGE-CODE DATE IRIS HAS HRS RATE RATE RATE PAY WITH FICA AID DEBUG PAY
010 BRIAN G. 60NIAN
537-50-9415
3993 :NALLENGER RD,
COWRETE, WA. 98237
40 0749 20.0 .0 .0 14.5E 291.20 21.62 `,.60 26.00 238.78
40 07/09 .0 3.5 .0 21.84 76.44 5.4E .96 4.55 65.45
010 TOTAL M 20.0 3.5 ,0 367.64 56,11 26.28 6.58 31.55 249.12
43 VERA DANYLYSZYN
535-80-2178
4232 -112 S. SRANAN
STREET
SEATTLE, WA. 98118
40 B7/09 0.0 .0 .0 10.78 B6.24 6.17 2.24 18.50 67.43
053 w TOTAL K B.0 .0 .0 86.24 ,88 6.17 2.24 10.40 67,43
125 JAES H101.ITZ
491-64-OM
504 TERRY 03M
SEATTLE, WA. 98194
40 07/09 8.0 .0 .0 14.08 112.64 8.05 2.24 16,4C 91.95
125 H TOTAL H 6.0 .0 .0 112.64 13.67 8.05 2.24 10.40 78.28
162 PETER OZOLINS
091-30-8141
1604 TURNER ST.
FAIRBANIS, AR 9970:
40 07/09 8.0 .0 .0 14.56 116.48 8.33 2.24 10.40 95.51
162 44 TOTAL 44 8.0 .0 .0 116.48 .N 8.33 2.24 10.40 95.51
M DAN THORNE
554-88-9401
P.D. BOX 514
GRANITE FALLS, WA.
96252
40 07/09 8.0 .0 .0 14.0B 112.64 8.P5 2.24 10.48 91.95
M 44 TOTAL 44 6.0 .0 .0 60 .00 8.05 2.24 10.40 91.35
PERIM ENDING
JOB 100 CERTIFIED PAYROLL REGISTER 07/08/87
EMP NAME 4 ADDRESS S. T 1.5 T 2 T S. T 1.5 T 2 T GROSS FEDERAL MEDICAL 1419C 'WT
NO. WAGE-CODE DATE HRS HRS HRS RATE RATE RATE PAY WITH FICA AID DEDUC PAY
157 ROBERT W. IICDOIELL
538-28-8185
12563 18TH ST. E.P
PUYALLUP, WA. 98372
10 07/09 8.9 .0 .0 17.74 141.92 10.14 2.16 .N 129.62
10 0749 .0 4.0 .0 26.61 106.44 7.61 1.08 .88 97.75
157 M TOTAL H 8.0 4.0 .0 248.36 .0B 17.75 3.24 .00 227.37
168 DARCEL RETE SEAWEL
536-66-9219
16M SE. NEWPORT WY
MSS 6-0, WA. 98027
10 07109 2.5 .0 .0 17.74 44.35 3.17 .68 .00 40.50
10 97/09 .0 3.5 .0 26.61 93.14 6.66 .95 .00 85.53
188 TOTAL N 2.5 3.5 .0 137.49 .00 9.83 1.63 .00 126.93
N° 927
RD
w.IIVERA & GREEN, INC. WHOSE WA
RFNION,WA 0805N
RIVE RI'2240
July 8, 1987
TEl (206)271 1041
CONTRACTOR V & J Excavating
ADDRESS 4616 So. 200th
Kent, Wa. 98031
)OF,
Second Avenue_ 8 Burnett - Renb3n _ " ""'" ' ' -f
--- INVOICE NO SCALE HOURS AMOUNT
CAT(_---I - -
252.07
6/30!87 3581 72.02 3t} _
252.07
Total I
I
RIVERA & GREEN, INC. m5TOtal
3581
D81e11 S2S E Margigaj`hay S Truck NpsSeattle,Washington 98168 Truck T pe 1242-4848 Truck RateRI-VE-RI-•224LT Truck HomsAmer Hours
Customer. — Billing Address:
Job Location: Job Number
o
$ Lunch. Cowl me Reason
'.gp8 Om r TO N(` I,OBftS �JWa
Fuel Oil Total Mies Total Miles 0d-Hrwa
'Rernerks }
I lg � ,' -j � Auth Co Rep S�gnaturl
r Ot this Iru<• ca Cie wdl be consicered y0al notice or our intent 10 ben this project itnacas'i Interest a 'is per month wm 66 6ha,w on all pest due accounts
Charges due by the tenor of the month tolbwing date of tors billing
ENDING
TITLEF FILE
FILE fir
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Repa , rr
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