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Home My WebLink AboutWTR2700880(7) W-880 WELLS #1, #2, & #3 WELL HOUSE CONSTRUCTION WTR-9 1 Pay Estiri,ates BEGINNING OF FILE FILE TITLE WTp. Ly SoU � es (JeLLs I , a , d- 3 pcx�y Complete A mail entire ut WITH APPROVAL FEE TO: Affidavit of Department of ULae A Indaames PREVAILING WAGES PAID FSAC Dlviemn HC110 Public Works Contract 925 Plum Street INSERT CARBON PAPER Olympia,We. 98504.0611 (106)7534019 BEFORE COMPLETING (Type or print clearly--tbls In your mailing label) Con No.0 20 APPROVED FORMS TO BE RHRIRNED TO: O D -Bid use/yte ' _.�-_.__�u,o��/�aet/av/m�de�d Pau Pewsee May, IOC. 10L_l-ip/2L -s[[.,es(6/97 } 18009 let ATro N3.W. ertowenea l.LN_G be. ar .__---- S 8ntfle, WA M77 { {lime contractor INCO = 7 ��_ _ _.._ —u—_<__ Pre allow a minimam of 10 W I5 woreiAq days fo.j,'M.ing Jeom the Wu i iutement of inunt rW Ia dna reel? dwe like De tm w raervsd you,documoa wait I%,correct .oval ee. Yee No IJ CONIRACPAWARDINC (P. W. work cwnpyyd._._ __.._ eddies, �,I city 20o Tl(ll Ayr_St�. �REQ-1-00 h/wrN. GftoST SEE INSTRUCnONS ON REVERSE SIDE I.CRAFT .2.APPRENTICES: Name,rcgiao-uior:Y, SAIATEOF 4.RATE OF HOURLY .tees of progression A date of him JIDURLY PAY FRINGE BENEFITS �Rlc wll n�t_as I$Ply — Noo G.aalwas IS, bq . 3N3 — j i I hereby cerufy+hat the above information is correct and that all waken 1 employed on this Public Works Project were paid to less than the Prevailing Wage Rate as determined by the Industrial Statistician of thtlla merit of lah d a usaiet.4ftistaid that cone actor5 who violate Prevailing Wage Laws are subject to Contrem s 9 fines and/or debarment. y(N 7q complHe this form In trIpllGta and have itch noUrlred TYPY 18009 1st Ave. N.W. STATEOPWASHINGTON Add— Seattle, WA 98177 County of 7 1 r/.14 / City _�--Sam Zip Cnruulei%d Re�utrauon No. Signed or arrested beforeJ e me onA,:,4//f��p p� 7 1/ PATE-PN L 17l-LB (5ignuure of rotary publie)y4'11/1 ROVEDepartmenUseL A 1 U MY apponent eapires A Only PP un _z (y—� Dt of Labor A industries CONIRACIORS,MAIL AN APPROVED COPljTO THE r APR 2u '89 CONTRACT AWARDING FUBLIC A9TRY14111 By ---- a r, e F700.001-000 H[idavu of wagW 10.87 ta'�' 01/12/'88 S,Q ORIGINAL DATE: REVISION 1 5 DATE: 10/12/88 TO: Accounts Payable f�A�}�i� c , l%` FROM: Public Works V17' r� SUBJECT: Construction Contract CAC 1 064-87 Y im Project Name- Well Nos. 1-2-3 Rehabilitation and Construction Prime Contractor: Im60 General Construction DATE. RECEIVED DATF. RECEIVED PRIME CONTPACTOR L SUDCON"U%CTORS INTENT TO PAY AYYIOAVIT OF PREVAILING NACRS WAGES PAID Imco General Construction 11/23/87 09/20/88 Triad Electric 01/12/88 �09/20188 Pete Peterson Masonry 01/12/88 05/13/88 Mehrer Drywall, Inc. 12/14/87 06/18/88 Banker's Construction 01/21/83 10/12/88 Diamond "B" Plumbing 01/21/88 10/12/88 Insulation Service Company 04/29/B8 08/24/88 TMG Services ' 04/22/8s 09/19/88. LA-Russo Concrete 0 06/20/88 09/20/88 Rockeries, Inc. 08/24/88 06/29/88 Ed's Wholesale Nursury 09(20/88 Y 09/20/88 signe ec: Project File LLB '— Form: 2/15/05 / +) ,` A do IF 41,4Po 47A/cm/15.5%.36.i<15) 9 1,4155i ow. 5703) W-bSo RH2 ENGINEERING. P.S. P. 0. BOX 1180 1410 MARKET STREET KIRKLAND, WASHINGTON 98033 Project: l.:a.. 13.00 WELL HOUSE CONST. ENG Invoice No. 5703 N.>vember 28, 1988 Pane number 1 CITY OF RENTON 200 MILL AVENUE SOUTH RENTON WA 98055 ---------------------------------__________-______-----------_------------------- FOR ENGINLER.IN6 5ERVICEti THROUGH DECEMB6R 8, 1988. IN CONJUNCTION WITH SERVICES DURING G ;TRUCTION ON THE WELL NOS. INVO. 14 WO 88p PROFESSIONAL SERVICESr --------------------- Hours Rate Amount PRINCIPAL E IX 7.5V 65.06 487.50 PROJECT MAMAGER E V 14.00 54.00 756.00 WORD PROCESSOR li .bt) 26.V0 13.00 __ --SERVICES TOTAL: 2.Q11 N. 1,25G.54.1 1,256.50 -----_--_-_ REIMBURBADL£ EXPENSES: ---------------------- Gast Multiplier Amount In-house mi Aeage 21.).40 L.000 c 1.40 Telephvnu 15.00 1.000 15.VO M:scel 1.anecus lE.27 1. 150 14. 11 PROF. LIGBi LITY INSURANCE 1.(00 100.5� REIMBURSABLE TOTAL: 159.03 159.03 Total Due This Invoice: 1,415.53 t7 _ 0CH..I1TLt 116,LAWSOF 1465 CITY OF RENTON CERTIFICATION ja V 1`f�7 «rf.rn uYO:«fYIMrD T.rour�t�Yc,PilPn y«f,(P 0[" Nff9MfD. TM f[�[f R[.ro•PlD 011 MC '��rl '4N1 PIMMYLD N DC<GIW[D Nf 4r iN. 1W TM.1 a.mar Tw cm or PCNTO.L .ND n, 1 w .v..n.DtD fD :N:inrcfn wo cu.TTiv w CITY OF RENTON Enginoer.nl; Dept. ��..� owrW. STAn OF WASMYGTON DEPARTMENT OF LABOR AND INDUSTRIES C„ d' AdmMr~ IAA*W • OA mpa H'a.h�eta, A9i(4-44ol Decerter 20, 1988 City of Renton 200 Ni:l Avenue S Fenton, WA 99055 Re: Account ID 390,106-00-3 Imco General Construction Canpeny, Inc. Contract No. 880 Gentleoen: Please be advised that the Department of IAhor and Industries does hereby release the City of Renton from any further liability pursuant to RCW 51.12.050 and RCW 51.12.070 as would otherwise incur in connection with a contract calling for rehabilitation and construction of Wells 1, 2, and 3, in Renton. This certificate does not release Imco General Construction Company, Inc., from liability for additional contributions which later may be determined to be due with respect to the above mentioned contract or any other contracts said contractor may have performed. Very truly yours, Kaye 4jorlaug Administrative Assistant Contractor Coupliance Unit Phone. (206) 753-4398 CCUI.KK:+1cd.56 PENT ON PUPGNPy1NG pEP s• wox4e(,o 427/aoo/IS.S4s. 3A.(>S (Ts� I2sZo. So (100. \[J- bbo Protect : - t I 9 CHARTER 116,LAWS OF 1965 CITY OF RENTON CERTIFICATION CITY OF RENTON 1 M peelNplp w � c " m r. 200 MILL AVENUE SOLI i r ntu[TY Ix rEluullY. I.T Tw •.11.,u x,,vl - RENTON WA JBU55 u[x nlrnw4. Tw ".Me, ff w .E* w I.E 1�x411 MpMYIp ,V 4[SCIx![0 Mam" "D T 11 rx[ ctkm q A J T. WE .0 Ilxau4 GBtIW- •6UMST M CRY W pMM. 11q Tx[t 1 N WIIIMIEEp 1p yy�yy11111111�11IIfYlCAi[ MIY 4Pi1F TG 6VOQNE -------------------- �- ` _-- OR ENGINEERING SERVICES 'HRUU';, _" _aMLIUR Win. !'+R el. LP< CONJUNCTION WITH t.P7RH RELATED TL 7 iV 7,7ti`? OIJRImn CONS1- ?'JCT I ON WELL NOS.. ' ... INV. 1.5 W a ii1 PROFS^SIONI)L SC'QViCES: PRS NCIGA_ E IX •, " PROJECT MANAGER C V ':T. n' _ •,pi, :._1�;,•,,; STAFr ENGINEER I '. _.., ._..i•q '_1:;1,5i, ADMINISTRATIVE PSSiSTANT 3.110 430 R➢ .n5 c'n WORD PROCESSOR II ..7.0 ::G.Oi, 6^.iPl SERVICES TOTAL: 29.S•t L,901.Eli1 1.951.50 eEIMPURSADLC EXOCN1?ES: ----------------------- Cost Mult iDiAmr Amount In-houaa mileanp 43.50 1.000 42.51c, Telemnone 3,<,rQ 1.000 J. 01? !r.-ho,jFp Print Trm ._..6i, ..OOb 15.GU iri-nol.lae Convvrin-1 E::.6<r ..UI.•V G.i�i' In-house ComDuter .-,i:l _,Pfti_, Lt 00 M i scel1 ar,e::a,s ?-.q. t4 _. L-0 �'7. h" RePronraDhiC% Service-Cc.Pvinp :74.54 I. 15i1 ;nip.7,'. in-rn:.usF GAD 3y%tem Lh'lginals 15.<n'r 1.Oh'.'1 15.00 PRnF. LIABILITY INSURANCE _'6. !._ LOGY l5fi. 1 ' PF.`,r+URSAF'LE TOTPL:_..__F,79.7n 479.70 __---____-_ t SUECONSULTAN" sf `. tit► 5t ^rtltinller Alu„t,nt Z�1, Z�✓ Cons,.,I tart J i . 12_28-88 713. 89. 7n _ ?roiect: 1IZ5. 13.00 WELL HOUSE CON51. £NG Invoice No. 5746 Li cemoer 28. :988 Pane rowber SUSCONSULTANT SERVICES pane Cost Mu 1t 1a1 ter Amount Consultants toz a : 89.7v 89.70 Total Due Tn__. lovoice: k/o rt 4Sbo 4zi�000/,s �6. �b.bs C s) 737,746 'in2 ENGID.EERING. p.S. P. U. box 1.13f) 141Ci MP4KI:1 SSTRI'CT KIRKL-AND, WA ohs"_NG:ON 1:18033 Proiect: 11.25. 13.UU WELL HOUSE. CL?S, . E'Nd� Invoice No. 5i 9. _anuary .:7.. 1'3B9 Papp "UA,oe, CITY OF RENTON 21:10 MILL AVkNUE SCUT'I RENTON WA '+6055 F09 LNGINEERING `;f--HVICEg IN CONJIINCTIUN Wl'! WFL.I_ P.''i.i NG 'ZONSTRUCT. INV. NO. 15 W-otJt PROFESSIONnL SERVICES: _-____________________ ;3RINCIPAL E IX PROJECT MONCIGiER 'J STAFF ENGINEER 11 _.. uo ,,c.0" i PD',gi NIST'RATIVE ASSISTANT ..uU .-,o.00 -- WORD PROCESSOR I1 nl ..='E,.i� cr u 9ERVICE'9 T'OTP�: .. 47..=,r, 1.471.50 ._.__---__.._ AEIM5"URSABLE CXPEN'.iES: 1 CHARTER 116, LAWS OF 19GS CITY OF RENTON CERTIFICATION t nw uryMmwlm oo Iwllm Mrmn uryM. KxuTl a KMM TWr TIC wiE11Y4! T. Bffx TIIIIIxMlD, Try{ NIIYRN I�MO[IIfD ql ixT fw011 KIITD11ry�D NI MKAIIKD II�IIW, ND TII/.i M A AU CI,W MT. Rt II�RiDII ro YI�W DWD�TgM MWT Tf� CRY a �ryp TYT 1 W �..,� ,��--��Tu /jwRranrwn wo wlnrr ro RH2 ENGINEERING, P,S, P, a. Box Ilex 1410 MARKET STREET KIRKLAND, WASHINGTON 9eO33 Pro,7ect, 1123, 13,00 WELL HOUSE CONST. ENS I nyc.i ce No, 5eG6 February 24, 1939 page number 1 CITY OF RENTON 200 MILL AVENUE SOUTH RENTON WA 90n55 D `i �I- �' �✓ t' rfly QC pc••T FDA CNaINEERING SERVI^ES THROUGH FEBRUARY cq, 1909, 7N CONJUNCTION WITH SERVICES DURTNG CONSTRUCTION WORK RELATED TO AS-BUILT DRAWING PREPARATION AND COORDINATION WITH THE CONTRACTOR ON WARRANTY Issues. 'ROFESSIONAL SERVICES, ------------_—.._------ 3RINCIPAL E IX Hours Rate Amount PROJECT MANAGER E V 7.50 65.00 4e7.5O ',TAFF ENGINEER 11 12.00 ^4.00 64B.00 ADMINISTRATIVE ASSISTANT 19.O6 "3.00 A17 .IrP 4ORD PROCESSOR ?I 1.00 30.00 20,00 2.00 2£.On I 3?..00 SERVICES TOTAL! _ 41.30- ------___- 4EIMWRSABLE EXPENSES: 2,034.50 21031.en _ _ Cost Multiplier Amount In-house Ccmlp,it er Miscellaneous S.GO 1.O040 6.00 In-House CAD System 161.55 1. 1- - IIG.70 PROF. LIAAILITy INSURANCE 2Da.50 1.060 eim.50 `N'1 16S.76 I.000 1£2.76 ., 1�SHARTCR 116,LAWS OF 1-,� ITY OF RENTUN CERTIFICATWN��t MBURSAFLF TOTAL: _ 573—Oq 'P•+�M oiMOii«n,•fo 00 .rtircnr se,nrr wrone Total -_-___ TMe wn.-,ue „f Due This Invotes, 2,607.54 Invoice N0. 16 ,s"roweo w Toe _ .w_o" V "e• '.. f V " Wei. Wf"I\rD NF11e14, .ry0 iN4i •. -- wry MO VNi pµp,l WOO 4860 aiietio to'I' os "e4.4N, uw iN.r ui Water Project No._"'g9(}e � 'M0 " to GAG 079-84 `�- The work accomplished included negrtva{ing Warranty Claims for roof gutters, totalizers, and power meter and n review of IMCO's as-built information. Two meetings were held with the mated udgettaff and the contractor was contacted to supply additional as-built information. Estimated Budget: $115,000.00 Billed to Oate` 162,449.87 Year to Date 43,825.97 Fee Remaining: $12,550.13 a G it yd4U yj��0o4 j�S.S56•TD.4SGSJ y4/(� }L �IVJ ySS1� u- 8b0 L FEE kEMAINING: 12,133.67 4�CHARTER 1it, LAIv^C/ �Lw ITY OF RENION CG:TMC.ATIC'1 M�MfM�O 00*MHEIIt C •'i1 Nyt "MfgM...a.0 d1 gg��IM Y YJ nue so _ PAYMENT RECEIVED Complete a mall sell,# we WITH APPROVAL FEE TO: SEP 141988 AMdavit of Dcparm" '°'1ihot k Industries 60 ESAC HC�710 a►w&PREVAILING WAGES PAID ESA Dvision 925 Plum Strur INSERT CARBON PAPER (Public Works Contract) r rimp, we. %30c 0671 737d0I9 BEFORE COMPLETING (T7P1 or prlat rMeal)•••t►la Is your mairbe IJdS ComowtMPW No. APPROVED PORMS TO BE RETURNED TO: #880 name are contract eve ed Triad Eleatrieal Contractors, Inc. 10/16/87 10/26/87 -A�- County whore wort pawforow P.O. boa #4228 King County gmrc Bellingham# VA 98227 IMCO General Constr. Inc. Pour Blow a minimaw#J 10 b f3 wareAy day,for pracrnina pom Me u e euMrnt o tnratr t ar r leer do,rid D t r rec,i.•a/ dera it ar wi�A it,cenect «. Yea No CCXIIRACT AWARDING prone W stew PUBLIC AGENCY City of Renton 235-2631 add cr'ry 200 Hill Avenue - South Renton WA 98055 SEE INSTRUCTIONS ON REVERSE SIDE I.CAR APPRENTICES. None,regaruion a• 3.RATE OF a.RATE OP HOURLY serge of poareuion a doe of bin HOURLY PAY FRINGE BENEFITS Journeymen Electrician 18.97 3.96 Construction Stockman 1 9.43 7.64 i Owner / Operator I I hereby certify that the above infotmauon is waixt and that all workers I employed on this Public Works Projmt were paid no Iess than the Prevailing War Rate as determined by the Industrial Statisuctan of the loot and Industines. 1 understand :'gat conuacturs who violate Prevailing wage Laws are subject to Convector,i ianature _ fuKa mdkf debarment. •lype-oi Print Compm'�y Nrw.— —..-props_--e. Complete this form In triplicate and haw,each notarized Triad Electrical Contra, Inc. 671-3000 STATEOFWASII)IOTON Adbw .. .. _�_.__... ♦ P.O. Boa #4228 County of / 4t4 yn- CRy Scam Tip I Conaacurs Registration,No. $.aned or et sled beforeySy Bellingham NA 9622,h TRIADEC173M7 me on (Signoure not puMie) i,ljjfd A 4 A 1 Um Only APPROVED My ePP°Lnune Dcpertnttnl of Labor a Industnes CONTRA MA,11.AN APPROVED COPY TO THE SEP 141981 CONTRAI ARDING PUMIC AGENCY By t ;r F700.007-000 affidavit of wega I0J7 - i • l . i•' . , 1 1 i j t . Complete & mail entire net _ Willi APPROVAL FEE TO: Affidavit of ESAC enm HC.7 bdusu,ea d PREVAILING WAGES PAID ESAC Avision HC4:0 925 PI.Suut INSERT CARBON PAPER (Public Works Contract) OI m -a We 99504-0631 206 7534019 BEFORE COMPLETING ITypr or print r'early...l►la Is your railing Iaa ll ContrgVBPW Ne, APPROVED FORMS TO BE RETURNED TO: 880 naTAi� �B�dau ' OW Gararal Construction, Inc. 10/16/87 10/26/87 �M �ruuy wbere w 45" Out" Hartdtan Ring r-_ tialltngham, w 9g226 General IMCO Cnaral Construction Inc. Picot,draw a ssuvarw o/f0 So ivorasrit dap Jo,pro"e,aisg frost IAe r n jaVjyrN eo Intem ,I�i 'r pis j d—" drr IAe De Iwraf nv:riad slocrnw wiµ yin co,n"I rood fee. Yee No CONTRACT AWARDING as PUBLIC AGENCY O.r wark f41"aiie4 City of Benton 235_2646 _V 6/24/88 ny a up 200 Mill Avarua S., Renton, WA 98055 SEE INSTRUCTIONS ON REVERSE SIDE L CRAFT 12.APPREM7CES: Name,repatrrion N, I.PATE OF N.RATE OF HOURLY I rage of pngreuian a dw of Ain HOURLY PAY FRINGE BENEFITS Amer/Operator 1 I hereby cesufy drat the above info17114LIM is"Drat and that all workers 1 employed on This Public Works Project were paid n0 I= dwn the Prevailing Wage Rate as deurmined by the lndusuial Sudn1cian of the De went of labor and Ifdusu=. I u dee,"W ihal wnuacuys who violau:Prevadmg Wage Laws are subject to CpnypFW1 i Si noun Iircs ar4or debannen, 'Y A a 432-1266 I a Campan�Na. i __.._. ..- ..Complata We term In 1101cala ,it hm sign mounted yp r u PMn.i T M G Services STATE OF W Addresr _.___......, 21635 Maple Valley Hy. S.E. County of _ -__ City Sum i'p Contrgtari Beguuauon No. &trod or ute n Maple Palley, VA 98038 THGSEea141RT atol 6efurc me e 1511=me or wary Pohl") _L A 1 Ur Only I f np APPROVED My appolntmem sapun l i'D t of labor d Ifdustritn CONTRACTORS, MAIL AN APHIOVED COPY TOTHE E P 0 91988 CY`.MACT AWARDING PUBLIC AGENCY By • F700-001 000 affidavit of wages 10.67 r' Complete & mail active get AECFIV� APPROVAL FEE TO: tir De ' Affidavit of ESAC MC.710 w�`°`at lalm s I darmea 14 Iv, PREVAILING WAGES PAID Uvi+ion "� 935 Plum Street rit4Wrm INSERT CARBON PAPER (Public Works Contract) Olympia,We. 95504-0631 f206)7534019 BEFORE COMPLETING (Type or print clearly.--this is yom mailing label) Contrert/BPW No. APPROVED FORMS TO BE RETURNED To, n ` 13b duc°ent� —v�"! en e011nKt eWY LARUSSO CONCRETE CO., INC. (address CQM1y RItN work permed--lls:'Og' -- eI 6101 Y. I1tA.AVE. min' a coot•.ic�INB ..._.__._ NCO. _R0214 Pkmer allow a mir .w.of lot.15 waking days Jor procening Jrow rhs �e sn N t GI- NaI�po jee dar 1M Depudvnr received your doctwwm with the eci tip royal ee. Yes No hJ CCMRACT A—WARpp.(O TVRr phone no PUBLIC AOFNCY bite work compk� _.--- addrm --..._.-- +t a pnn Nn I avE S city SEE INSTRUCTIONS ON REVERSE SIDE 1,CRAFT ',i.APPRENTICES: Nerve,nglstrNon a, 1.RATE OF a.RATEOF HOURLY t nage of prognasion A dew of hve HOURLY PAY FRINGE BENEFITS OYNLR / ESTIMATOR / FINISHER -0' 16.35 1.10 CERTIFIED FINISHER "0- 21.61 -0- CERTIFIED LABORER I "0- 1B.e7 -a I I hereby e^relay that the eRabove W dam t i d correct and Thal all workers I a0ployed an Nts Public Works Project were paid no less than the Prevailing Wage Ram av determined by the Industrial SturTY ian 0f the Department of Labor nd Industries. I understand that mntractns who violate Prevailing Wage Laws are Subjecl toI arcs andlor debarment, tn�Complete this form In blplluts erW have each nonrlred ni m Phone e STATE GFVA4000ellBN-.CC ORii (:'.R"SSO CONCRETE CO., INC. 4303) 234-9074 Ld,yk,- ACounty of 1 Y. 11tN AYE�� $nw Zip Connectors Regntrauon No Sigrrcd or Mreau6 bNau,7 .� —I[1 (A.1 MOM (Signatue of mlasp pbblk L A I U t 0 1 APPROVED My appointment eapiraa O Department of labor A industries CONCONTR C MAIL.DI APPROVED LENOPY TO THE CONTRACT AWARDING PUBLIC AGENCY F700-007 000 afnawt of wages 10-97 iY Y. S 1 „t. A� Complete Qr mail entire net --- 47.�r Statement of WITH APPROVAL FEE TO: Sfp C)F/ DcpDrnov `len'a ENT TO PAY ESAC lvu HCIo rREVAILING WAGES 923 Plum Street INSERT CARBON P t"2mllbtlf Works Contract) Olympia Wa 9a3Md611 (20b)737J019 BEFORE COMPLETING 44 (Type or prime clearly--.Ibis b your mailing label) ContracVBPW No. APPROVED RAMS TO BE RETURNEDTO: nmrm dme �-'ilia nmca�ars3iid-" .t.wbtae pcZomKd��gZ- 51611 111trich R4. — e�IRatfp Timm Du ywin�m�Yee No No CONTRACT AWARDING rune pbqu number PUBIK AOENCIf Mir et! Aeryirn _ 200 rill Av,a_ 4n_- 11.1,M, RI 9HU5 SEE INSTRUCTIONS ON REVERSE SIDE 1.CRAFT 2.ESTIMATED NO. 7.RATE OF a.RATE OF HOURLY OF WORKERS HOURLY PAY PRINCE BENEFITS Blank parNanmad by OtOBiFO ra7OH[ I hereby ,certify that the above„dormaoon,s correct and that all workers 1 employ ore this Public Works Project will be paid no less Ihan the Prevailing Wage Rate"detemlmed by the Industrial tatishcian of the Department of l.ahor and Industries.)understand that contractors who violate Prcvaitmg Wage laws are L 01eT es gnahue subject w fines mnMor debarment. (complete all a copies men have each moierlaed) for M. .P y STATE.OF WA-SHINGTON kNep_le?tOlalm�e..fig _ County of �ldtAb/n. sign_ �� Aldrich"B`1Siu`e'L SipudornvatedkfomrK olt [ / `a� City P BiIWiiBY161K (Signature of t Mic) 1 My eppoinunmt _ - 'J APPR CONIRAM)RS, ®OrE APPROVED PIES Department of labors lndu tnes AS It)LLOWS:rr �'- 1.ewaacr-avarottem aorncv neat re-I a t, mMtOVK"area rc :. r- n HY e mK o>tneacttu �4198i a1W- mate.ttroonrmaeirt m a' FILq 029 000 intent to pay e27 i CotnPlete & mail entire set WITH APPROVAL FEE TO: Statement or Detainment of Labor A ltd J INTENT TO PAY ESACDivisbn-HC-710 PREVAILING WAGES 925 Plam Street INSERT CARBON PAPER ( Public Works Contract) Olymi Will 9r504-ill (216)713-4019 BEFORE COMPISTING IT ar plat ckarll lab b your rolllar LEell Co -r BPW TU N.. APPROVED FORM TO BE RERNED 10: tine Colaaya tiMalga C e areaft .eN -- �„�•.. �._ a 10-16-87 10-26-07 wil Pee't1W �_�_ .�acono.cty Iaoo Gen Coaata Ias. n111 NICIa b YK L MMRACp AWARDQiO ttmte Yu Q W PUBUL AGENCY City of Banton daafto nba ai ' — _ 200 (till ATOMO Oil rtak np SoutD A nton VA 98055 SEE INSTRUC71ONS ON REVERSE SIDE 1.CRAFT 2.ESTDAATED no 3.RATE OF 1.RATE OF HOURLY OF WORKERS HOURLY PAY Fli RENPFTfS ror! to be emplateA by oantera. I Li Irby certif"tiat tht above inrormmion is corral and IIWt all wnrkers I employ M Ihis Public Wtaks Pro3at wdl be paid nu k» th. the Prevating Wage Rate as dgetmined by the Int l taus0cian of the De tcm of Idtor and IWXCI-s.I e paista,l Ihat conVactne,who violate Prevailing Wage Iowa are on brr g etun sublat m fines and/or deharrn•nt. " (compkle all (oPlea ana bare each notarized) mpnN DH d --- STATEOFWA4RiPill .,, -0;, {co�loa_Dia_aeaalew Cwtill Coo o( SOZ 30"2 S{pNd ot anCated 1i rtNm ; ' 7•,.,., r!Y'tl11Rlda OR �97Z30 (Slgnatate of mury,Punic My appomanmteaPua_ " R VED r C S FOU11 URS, DI57RIB1TE APPROVED COPIES Deparma lof"ll hubNmes A.SF)LIAWS:auw: ,o•�amat mrnan-avaaoiNa•aenev P■ RR a5,'SV7tRJ `MN: 74111 W 1 [NT T,,, / caur nincan m auaworLnan-aua�L t B F700D29.0W uaw w Pap 447 MAR 2 5 t(m La/avW Sutaran ttan`stir MAIL TO: — AFh i)AVIT OF INULSTRIAL hTATLabor Indus WAGES PAID CIAN Departarena of Labor i Industries ' Egbyaint rest ds Senioas �wk ON FUBLIC WORKS CONTRACT 925 Plain Sweet Olyoeia, WA 98%"31 12ea1 753.4019 Contra_t/BPAr Number _ Contract Awarding Agency Date Bid Was Due --Latobe�.16, 1!i9g Due Contract Awarded -GO. A Cl - Ol A DLte Work Completed Address �W Mill lll AOtdirO :-tri1R11_ County in Which Work Performed gf ing t.rr4 9tr05> Prime Contractor Tekphorc nc Number _ ' ---- Your Contractor's Registration Certificate No.`0&UWS r12Ah;5 Was a Statement of Intent Filed For this project? Ya if No J In compliance with RCW 39.12.040 1, the undersigned, being a duly authorised represenlative of I(wlrbn w s.sa.kr,Vl tAWrwl do hereby certify that the following rates of hourly 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. PLEASE NOTE If apprentices base been employed on this project,prosidc this additional information:now,registration number,stage of progrthsion and dale of hiring. tnh Kok of Rate N Ilowy n.io P., t'". 9ewfiw 1'oW cork to be eospleted by owners. No,r Allah A 1G 1 Shrew in Needed _. Cnlsubia µcOw.l ga Conti_ e Subscribed and sworn to before me By�LLQ�yZ�LW�l� Pl��_ Likl this day of 1� �� ut tore Ow !�J I kawr rwwt llthat-IV aake v the rap rang m 2440 twdW kerb r.an to rW rrtwiGas�rgr rgeysmn N RCW 19I1nc0 Ywt bees saly(w6 Naary pays a cared swolic Suk d wa,a.egrua.raN,nr 'A wSaa.agrm ., _ INDUSTRIAL STATIMCIAN e•, ,• . DEPARTMENT OF LABOR AND INDU4TRIF$ INSTRUCTIONS: gyyl t By. _1 i. Pursuant to RCW 39.12.040 copies of this form must be completed b; the contractor and cm:h of hi, sub• contractors. 2. Complete this form in triplicate and have it notarized 3. SUBMIT ALL FORMS ALONG WITH APPROVAL FEE FOR CERi1FIC.ATION TO: Department tof labor and Industries, Employment Standards Section, Olympia, W'ashinglon 9 8 504-06 3 1. MAR 2 5 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 affid filed. caa/kty A mail Mire set WITH APPROVAL FEE TO: Statement Of D-Va4nr+d of tabor l santiea INTENT TO PAY ESAC DI.ktan,HC.710 PREVAILING WAGES 925 Rum SoeeU INSERT CARBON PAPER ( Public Works Contract) OlY°Rit Wa. "31141UL71 Clog)753.4019 BEFORE COMPLETING fT71 tearyaYb k )wr wo ulat tahell ConvacVBPW No. APPROVED PORMS 70 BE RETURNED TO: ColaaSda Sews Coatiap ,ays 10-16-87 10-26-t7 P.O. Salt 30602 "•e w�o„e7"—' cata.ctar Portla■i. en 72�0� laoo am Caart. 7ae. 7m mum o ue.-a,,, Ain �ONTRACD AWARDI7(' nrne Yu 0 PUBLIC AGENCY Clty 0f Renton .0an, nin°' 200 R UI AviltOaD Soath .i"aton sulF ,p aA 98055 SEE'NMUCTfONS ON REVERSE SIDE t.CRAFT 2 FSnMATFD NO. 3.RATE OF 7—RATE OF HOURLY OF WORKERS HOURLY PAY FRINGE BENEFrrS tork to be 0aayloted by tanners. 3 I hereby certify that OK abcne m4dmalion is LnrtIT1 and Ihal all Workers 1 cmpwJ rm Unit PYMIL Works PruJec'Will be pa,d nu k.w Ilan the Prevailing Wage Rate as slekrminM by the industrial Sla4sucian of the m of I.aMx and Industries.I ul piii tjhJM1In I`Ma dAXdho lale Revaiting Wage laws are o ts.Itnuute uh�l 4t finGc aruvor debarsncnL fcmpkee all a roplb and have each notarized) s'rATE0FvoA5H1NaroN ColaaDia_Saaalasa Coatings cosmtyof_ ...:.tour. Sas 3042 _. _ Slgsed Lr utralW 47ue me on " _ land• CR Sr1?LJO'C�tol:} o. ( pso.rr of notary public _ My amomonanl expires_ PPR CO\7RA.'TORS. DISTRIBUTE APPROVED COPIES A D Department M l.jW I nyLarm. A3 RJLL.IJWSI e:NIC- .pe:nmaL mNNuil-AV .'n a111, i fAYOIOY a�'LV7VR Set� "LF11r I.11 }SrLF. KUNM tY.Ta:rLKai[..al W.OeIIIt Are F7g1-019 Onn intent to pay 4.97 /'s rfaf Slwri°^ MAR 2 5 1988 aaiLadrr Complete k wall entire set rhT� Statement of WITH APPROVAL FEE TO: SFP �cy TENT TO PAY ESA ah.0 i HC710 t 141 RF,VAILING WAGES 925 Plan Sues INSERT CARBON Pdlt�Or, ublic Works Contract) Olympiti W.. 99504-0631 (206)7534019 BEFORE COMPLETING (Type or print tw.my...chi, is your moiling love[) Comran/BPW No. APPROVED PORMS TO BE RETURNED TO: ggB m0 due dll° �coeYrA nrmZ[3_..._ -adil .E:. a Mnl:.-Ala :ii<'zt_Y.. 0-IS-9I� in-zSC37�._...� U60 Aldrl,b Rd. min oonne M Do you immill m uie Y. Q No CONIRACTAWARDWG nome IpLwre number PUBLIC AGENCY d6aacity ]P . t _ M r1;m bP "ns SEE INSTRUMONS ON REVERSE SIDE ).CRAFT �2.ESTIMATED NO.j ?.RATE OF 1.RATE OF HOURLY OF WORKERS I HOURLY PAY FRINGE BENEFITS Work It fTr tott by 1 'i I hereby certify that the above information is correct and that all workers I employ on this Public Works Prof=t will be paid no kss than the Prevailing Wage Rate as determined by the Industrial tausucian of the De aracenl of Lahr`and Industries.I understand that Coto Fines who mid/or dehaLaw Prevailing Wagc laws arc onu.etorr uue4, � subjoctatmpkie alldebarment. (rompkm oil A copies and have each noWlaed) TYPO orPW °rnPmY ° STATE OF WASHINGION pt'.'ts i5'r21_r-sin County of C/✓.:K Sipwd a.ttwme vefwe mo / Cite' N. mj)jgiro-6,u,6 My .ppoietmme CONTRACTORVISTRIBUTE APPROVED IFS APPRU5'FD rynmcnt of latex&In tuRrira AS POLLOWS:rix nor uorrnAcr-wA.omc l LCA Acrncv wee Cy1S-L 1.. rM1DVMmR 6TD5 bAlL CUTAW- R�SU�gMRaAcma By F700.029 OM Manor m ter. Pay 447 llall. 10: AFr,JAVIT OF INDI STRIAI. SI%TISTICIAN - WAGES PAID Ile artment of Labor A Industries Employment Standards Secti,ms s ON PUBLIC WORKS C'ONTRACI 925 Plum Sirre1 Ohmpia, NA 995044M31 206, 753-4019 Contract/BPW Number See __ Date Bid Was Due Contract Awarding Agency Date Contract Awarded 494OU . -ZQB1j - :.Ity 91 !:9At= Date Work Completed .Address --Ob .VILI AVe1Bte -Oltih— County in Which Work Performed x4pa eAtun• oh 9b355 Prime Contractor Meg Call- &A Telephone Number _ Your Contractor's Registration Certificate No.CQ&MQ%1shc3 Was a Statement of Intent Filed For this project? Ya No In comp' na with RCW 39.12.040 1, the undersigned, being a duly authorized representative of Gr-a.G.ca tiLG2 iA "CIA.• ICwn„r w su4unirulwl IAN.mI do hereby certify that the following raxr of hourly 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 1my and hourly fringe benefits paid to each classification. PLEASE NOTE Ifapprentices have been employed on this project,provide this additional information:name.registration number,stage of progression and dale of hiring. t oft Rate of Its,,d Inum blob N, Fringe aetrM. Y,.d e.ork to be completed by owners. \nr An.ah Addnimvl Shret.ac \esird COLuslvla ::gsaLsa Coatings___ per nyny 4amr1 Subscribed and sworn to before me this day of - 19 LAI tin Orb I he►r mury rant"cardiy to tk ww nw sad Mope Inane,au�a av to Wa laaoibN pp te9111r9emata d RCW 39,12040 lure boa oW vd %w,q PuWn m and f4f,k slam uf w'oh.p on.m,,d,, „ wa>A,retwn. INDUSIALAL STATISTICIAN - r DEPAR-MF.NT OF LABOR AND INDUSTRIES INSTRUCTIONS: ■m �.vAR try: u.w. Ite 1, Pursuant to 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. IrM"613914 3. SUBMIT ALL FORMS ALONG WITH APPROVAL FEE FOR CERTIFICATION TO. Department of Lahr and Industries, Employment Standards Section, Olympia, Washington 98504-0631. MAR 2 5 4. Mail an approved copy to the Contract Awarding Public Agency CONTRACTORS ARE RESPONSIBLE FOR OBTAINING AND FILING AFFIDAVITS oftithe SOCB- COSTRACTORS.This is required by law and payments cannot lawfully be made until such alTid fc filed. -GE�t NUM ER PneialConstruchon coe•Inc °S^Q+uule M¢ndbn Bellingham,Y!A 98226 206.671-2936 a.rt«rio« TO p i R. ,F a GENTLEMEN WE ARE SENDING YOU VAIIAch&d Under HParAlp [Over vN ❑ SncO dnwmyt � Pants tM bllow.np IMHC 1 Plan Ssm : F] GoDY m Ieu Change � Des .l SpaedrDHrona 7 nange OrderCl Fw your immeduu anemlon cone oars «o I I ouu.no« vV I rn 9�91ee THESE ARE TRANSMITTED at cnecbd Mlaw ^7 For approval ❑ Approved as Suemdbd R Far our etuemu use py — �__coDrof for aoDroval P. DProrpe an nota0 WAS rpuevad A Returned !or corncUons Supmd__cPProt for amnpueon Cl For rq,,, and rommonl ^ RHum__[orrectad Dnn1f REMARKS it i t::Gi.iL:fif1�• r1. 'PIES TO--_ �wAayaaTa� ,... SIGNf n ENDING QF FIL FILE TITLE au $ gv br( �- 9 SSo�� es