HomeMy WebLinkAbout2004-060 CONT Chg Order #4/15 - LTM IncPROJECT:
LOCATION:
CONTRACTOR:
CITY OF ASHLAND
CONTRACT CHANGE ORDER NO.
SISKIYOU BOULEVARD CONSTRUCTION DATE: FEBRUARY 24, 2004
SISKIYOU BOULEVARD PROJECT NO.: 99-38, SCDL D
LTM INCORPORATED
You are requested to perform the following described work upon receipt of an approved copy of this
document or as described by the Engineer:
Item No. Description Quantity Unit Price Amount
CO 4 '
Item A Bus Shelter Benches Lump Sum $946.84 $946.84
Item B Preparation of bus stop landings Lump Sum $479.57 $479.57
Item C Clear bus shelter conduit, change lights and add wire Lump Sum $2505.50 $2,505.50
Original Contract
Total this Change Order
Previous Change Orders
Revised Contract Total
$1 74,600.00
$3,931.91
$1,413.71
$179,945.62
The time provided for completion of this contract is increased by no calendar days. This
document shall become an amendment to the contract and all provisions of the contract
Recommended By:
Approved By:
/F~gi ff'eer Date
Accepted By:
LTM Incorporated
PO Box 1145
Medford OR 97501
Contractor
Date
ENGINEERING Tel: 541-488-5347
20 E. Main Street Fax: 541-488-6006
Ashland, Oregon 97520 TTY: 800-735-2900
www.ash'land.or, us
\\COMPAQl\DATA\GOV~pub-wrks\eng\dept-admin\ENGINEER\PROJEC'P,1999\99-38 Change Orders\Schedule D\99-38 CO Sc D 4
A request for a Purchase Order
REQUISTION FORM
THIS IS A REQUEST FOR A:
[ X ] Change Order (existing PO#
3611 Schedule D)
CITY OF
SHLAND
Date of Request. I 02/24/20041
Required Date of Delivery/Service:
Vendor Name:
Address:
City, State, Zip
Phone:
Project Title:
Project Number:
LTM INCORPORATED
PO BOX 1145
MEDFORD OR 97501
SISKIYOU BOULEVARD RECONSTRUCTION
99-38
Solicitation Process:
Exempt [ ] 3 Written Quotes (copies
attached)
Sole Source [ X ] Invitation to Bid (copies on
file)
Less than $5000 [ ] Request for Proposal (copies
on file)
Services Only
Description Total Cost
Siskiyou BIvd/Ashland St Reconstruction Project $ 174,609.00 Original Contract Cost
Change Orders No. 1 through 3 $ 1,413.71 Prior Change Order
Change Order No. 4 Itemized Below (Total $3,931.91)
Bus shelter benches $ 946.84 ItemA
Preparation of bus stop landings $ 479.57 Item B
Clear bus shelter conduit, change lighbng and add w~re $ 2,505.50 Item C
$ 179,945.62 REVISED CONTRACT
Account Number 260.08.12.00.704200
Employee Signature: ~~//~~-~ s*Plueii~iiZirhltiiltf~iiia~'iiiln~iuriilndlnsurance~~
//
/
G:Pubwrks\Eng\99-38 CO 4 Sch D Requisition.xls Updated on: 7/15/02
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. D Job No.: 02271-605
Description of work: Bus Shelter Benches
Date: 12/2/2003
LABOR
'' '~A~:!i~i:''.:'~:.I::;I i~!..N~ME-::?' i ,O~S". ..:JH-~.e' ~"i ~.. '~': ~ ::i: :" ::~.'":.~;
LABOR TOTAL $0.00
EQUIPMENT
., DA..TE. ?: i':'~: ' I'I :'~i i;r' :;:'~:~' D..E~CRIPTiON :'!' ":!:;" ' :" Ni3.''.::'~' !': HO~'".:' i::?:.:~T~.':i': ['~ ';!" :":'"~ '~ ','~' "i:. .TOT~E "::'.
EQUIP. TOTAL $0.00
MATERIALS
12/02/03 Norton Lumber/wood for benches' 1 Ea $823.34 $823.34
MATERIAL TOTAL $823.34
SERVICES I MISC.
· "~. '~E~ ' ~:~:::~:':~?: ~?:~E~RI~ON''~ ~. :~"~..'?.: ~:~,'~:",?"::~': ~'~,~ ~';,?':":~ ~.~:'"~'~
SERVICES TOTAL $0.00
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment Mark-up 15%
$823.34
$0.00
$123.50
Submitted by:
Accepted by:
j~],~~~ TOTAL AMOUNT DUE
J~o/~,,~r - Construction Superintendent
~~~_ Date.
$946.84
NORIUN LUMBER CO. 'I002
DREGON 97535../~_~ ~'~,, WHITE CITY, OREGON 97503
535-1533 (541) 826-3144
.1) 776-9017 ~om quilI Roof& Floor Tru.e, F~ (541) 826-6586
SOLD z
TO CUST.
ADDRESS CASH
/'~ '; NET 1Other'
DELIVER ,' PURCHASE.
Or~ a~pt~ ~ubj~ to'fire, st~k~ ~ ~ ~ our ~tr~. ~CE: ~m~r ~ malefi~ ~em~ herein del~er~ l~ay al the
~ addr~ for ~ ~r~. A lien may ~ ~m~ for ~1 maledsI, I~r ~ supplie~ fumish~. --~n 10191 Or.on ~ws.
~O~ WE CAN ASSUME NO RES~NSIBIU~ F~ DELIVERY OF MATERIA~ B~OND ~E CURB LINE. CURBS AND SIDE-
WAMS ARE CROSSED BY OU~ TRUCKS AT ~E BUYER'8 RISK.
'HOI::NIX,
FAX (,~)
u
U
L
.I
..I
IMPORTANT: Purchase Order number must appear on invoices, packages, and correspondence.
Advise if unable to meet required date.
......................
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. Job No.: 02271-312
Description of work: Prep Busstop Landings
¢, VFr) Date: 1 ~6~2004
LABOR 1/8/2004
DATE, CLASS. NAME HOURS .HOURS RATE RATEi " ToTALs
01/06/04 Foreman McClaffert¥ 1.50 0.50 32.94 44.60 $71.71
01/06/04 Laborer Rodriguez 1.50 0.50 27.74 37.88 $60.55
01/08/04 Foreman McClaffert¥ 2.00 32.94 $65.88
01/08/04 Laborer Rodriguez 2.00 27.74 $55.48
LABOR TOTAL $253.62
EQUIPMENT
EQUIP? NO',.. OF.. ...· .. . .. ..... '
DATE DEscRIPTION NO. HOURS, .. RATE. TOTAL·
01/06/04 Pickup 20600 2.00 $8.25 $16.50
01/06/04 590SL Backhoe 110084 2.00 $32.60 $65.20
01/08/04 Pickup 20600 2.00 $8.25 $16.50
01/08/04 590SL Backhoe 110084 2.00 $32.60 $65.20
EQUIP. TOTAL $163.40
MATERIALS
DATE~" . DESCRIPTION QTy., . "UNIT" '" ;:;:,::PRICE.;" I" Discount "TOTAL
MATERIAL TOTAL $0.00
SERVICES / MISC.
SERVICES TOTAL $0.00
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment/Service Mark-up 15%
$417.02
$38.04
$24.51
Submitted by:
Accepted by:
TOTAL AMOUNT DUE
u-"~'o n Superintendent
Date: /~ ~Z¢ z2 y¢
$479,57
LTM
. DALLY EXTRA WORK REPORT
Job No: E)~F.~'~ ~---~\'"~.~ _
CRAFT ST.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
DESCRIPTION SUPPLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
copy
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQU,PMENT NO. HOURS
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report
LTM
DAILY EXTRA WORK REPORT
Forer, a.: .. % ~.,~c~.,C.¢,.~k., Job
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
DESCRIPTION i SUPPLIER
MIscELLANEOUS SUB, HAULERS, MOBS)
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO. HOURS
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contrac~ng/Jenn's Reports, etc./Mlsc Forms/Daily Extra Work Report
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. D Job No.: 02271-606
Description of work: Clear Bus Shelter Conduit ~,,3df ~iz3/C{~~
~'/~-,¢~¢~ '(~/1'/--~ ~'6,~' Date: 1/7/2004
LABOR
· . ST ·.... o~ .... .Si~ ..OT, ,..
DATE CLASS. NAME H .O...U, ~S '~O'0RS, .'RATE RA;T.I~ .TOTALS
01/07/04 Foreman McClaffert¥ 2.50 32.94 $~2.35
01/07/04 Laborer Rodriguez 2.50 27.74 $69.35
LABOR TOTAL $151.70
EQUIPMENT
01/07/04 Pickup 20600 2.50 $8.25 $20.63
01/07/04 LTM Air Compressor 160088 2.50 $12.27 $30.68
EQUIP. TOTAL $51.30
MATERIALS
UNIT I" . ....
DATE DESCRIPTION ...;,,,.'...,: :' QTY. ':'UNIT PRICEIDiscount. · TOTAL
MATERIAL TOTAL $0.00
SERVICES / MISC,
1/7/04 Mike Gatt Electric bus shed lights 12804 $2,272.05 $2,272.05
SERVICES TOTAL $2,272.05
Submitted by:
Accepted by:
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment Mark-up 15%
TOTAL AMOUNT DUE
ction Superintendent
Date:
$2,475.05
$22.76 ,/'
$7.70
$2,505.50
LTM
DAILY EXTRA WORK REPORT
Foreman: ~ ~ ¢~'%~ ¢":- Job No' ~.~ ~.f ~'C~ (~
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
DESCRIPTION SU PPLJER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO. HOURS
/
I ,,
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report
JOB. INVOICE
t -20-04
DATE ORDERED ORDER TAKEN BY
PHONE NO. CUSTOMER ORDER
03204 A E if. T
JOB LOCATION
Ashland bus shed - EXTRA
JOB PHONE STARTING DATE
TERMS
~..ii IE GATT
7~.0 ' ' '"'"~'"
x A~,C~-~O ¢ISTA
GRANTS 2ASS, OR 97526
TO
LTl.,' incorporated General Contractors
ADDRESS
3959 ~a~nriclc Rd.
~,iedford, OR 97502
ATTENTION
Joe Sores
~oo23~u;00 i0~0/' ~tPstall~.~ion and ~eraination of
862507700 5~61 feeders from power suppl-? tO
Pla'tn inv.#5i292i0 26~30 bus shed lights. Extra complete
..... 5031409 10~20~,
~ Pernits not include~5 in !
' ~ bid. Permit #'s
_ ~ ~ ~D-2003-02217 thru 02222 358~9C
! Babor 6 35 210 ~00
534165 1 , 378150
WORK ORDERED B',
Joe
DATE ORDERED
DATE COMPLETED
CUSTOMER APPROVAL
SIGNATURE
AUTHORIZED SIGNATURE
~,.:.~. adan'~' NC2817
MADE IN USA
i
TOTAL LABOR 1,37 d i 5 ,:3
I
TOTAL MATERIALS 534
TOTAL MISCELLANEOUS 35;3 901
SUBTOTAL
2,272 !05
i
TAX
GRAND TOTAL 2,272 jO5
CITY OF ASHLAND
DEPARTMENT OF PUBLIC WORK!
CONTRACT CHANGE ORDER NO.
SISKIYOU BLVD/OTIA
SISKIYOU BLVD. / 3RD STREET
DATE: FEBRUARY 23, 2004
PROJECT NO.: 99-38 (Schedule A)
PROJECT:
LOCATION:
CONTRACTOR: LTM INCORP~ORATED
You are requested to perform the following described work upon receipt of an approved copy of this document or as
described by the Engineer:
Item No. Description Quantity Unit Price Amount
co
Item A Expose & Cold Mix Manholes per City Request Lump Sum $601.46 $601.46
Item B Drain at 450 Siskiyou Boulevard Lump Sum $86.25 $86.25
item C Move ADA Ramps at Astro Station & Library for Drainage Correction Lump Sum $2,098.84 $2,098.84
Item D Area Drain at 450 Siskiyou Boulevard Lump Sum $110.00 $110.00
Item E Move ADA Ramps & Miscellaneous Concrete Lump Sum $2,606.08 $2,606.08
Item F Add Loops at Lithia Way Lump Sum $4,150.89 $4,150.89
Item G Add Loops at Third Street Lump Sum $2,736.22 $2,736.22
Original Contract
Total this Change Order
Previous Change Orders
Revised Contract Total
$802,592.60
$12,389.74
$22,377.50
$837,359.84
The time provided for completion of this contract is increased by no calendar days. This document
shall become an amen~m/e~h~ra~~rovisions of the contract will apply.
Er~gineer ~" ~ -- Dat
Approved By: F~gi neet Date
Accepted By:
LTM Incorporated
PO Box 1 145
Medford OR 97501
Contractor
Date
ENGINEERING Tel: 541-488-5347
20 E. Main Street Fax: 541488-6006
Ashland, Oregon 97520 TTY: 800-735-2900
ww~.ashland,or.us
\\COMPAQ1~DATA\GOV~pub-wrks\eng\dept-admin\ENGINEER~ROJECT~1999\99-38 Change Orders\Schedule A\99-38 Sch A CO
A request for a Purchase Order
REQUlSTION FORM
THIS IS A REQUEST FOR A:
[ X ] Change Order (existing PO#
3611 Schedule A)
CITY OF
SHLAND
Date of ReqL,est:I 02/23120041
Required Date of Delivery/Service:
Vendor Name:
Address:
City, State, Zip
Phone:
Project Title:
Project Number:
LTM INCORPORATED
PO BOX 1t45
MEDFORD OR 97501
SlSKIYOU BOULEVARD RECONSTRUCTION
99-38
Solicitation Process:
Exempt [ ] 3 Written Quotes (copies
attached)
Sole Source [ X ] Invitation to Bid (copies on
file)
Less than $5000 [ ] Request for Proposal (copies
on tile)
Services Only
Description Total Cost
Siskiyou Blvd/Ashland St Reconstruction Project $ 802,592.60 Original Contract Cost
Change Orders 1 thru 14 $ 22,377.50
Change Order 15 - Itemized Below (total $12,389.74)
Expose & cold mix maholes per City request $ 60t.46 co 15 ItemA
Dra~n at 450 Siskiyou Boulevard Materials $ 86.25 CO 15 Item B
Move ADA ramps at Astro Station & Library for Drainage Correction $ 2,095.84 CO Iterm C
Area Drain at 450 Siskiyou Installation
Move ADA ramps & miscellaneous concrete
$ 1t0.00 CO Item D
$ 2,606.08 CO item E
$
Add traffic loops at Lithia Way 4,~50.89 CO Item F
Add traffic loops at Third Street $ 2,735.22 CO Item G
$ 837,359.84 REVI~ED CONTRACT
Account Number 260.08.12.00.704200
~ / *Please attach the Original signed contract and Insurance Certificates.
Employ. Signature: ///'~ ,//~~ Supervisor/Dept. Head Signature: ~
NOTE: By signing this re~uis§ion f~, I ce~'J~e the above request meets with C#y of Ashland Solicitia~ion Precess mquiremenyand~an ~e provided when necessa/y.
G:Pubwrks\Eng~DeptAdmin~Engineer~Project~99-38 Schedule A Change Orders~99-38 CO 15 Sch A Requisition.xls Updated on: 10113/03
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-32
Description of work: Drain @ 450 Siskiyou Blvd.
Date: 1/6/2004
LABOR
' ~',.~'=::'";: ii'!-':e~'~'!'~ :'~"":~'"'." ':' rtO~.'t ?~OURS:~' :'~:':'"; ,~t'E'~'' : ~'.,~'~'!~ l.i:!'."i :~'"~.:' i'"':'~"' <" TOTALS.:
LABOR TOTAL $0.00
EQUIPMENT
. 'DATE!':',, .; .,: ',,:'..',," ':;:',:,, f.:"I~E~',RI~I'ON'., , , ;:'"~'. , ';. , ;':.:'. ':::' ND~::'..::,'" HOURS, , " :.,;: ~TE?.., ' I:.'.';!:.,. '~ .;..:;)/'.,'" ... :,'"..?. ',. TO,?.A..[."-., , ',,"1
EQUIP. TOTAL $0.00
MATERIALS
;" '. ~=:.~.:'.~,.:.~.~.; ,!~,. '..~.<.. '.'."....':..'.... '. ;...:.' '~i':.:~;~...' :,',; :.; ,'..' .i; .:' '..i~' ' ' '; ' '""" ; """ ~':' ' ':' ' ':' ~"~i.,.~',. '.";.,:;..'.~.;!? :'.
". ?DA~?;..~: ~':'. ".: :i:' ""~RiP?'.~H;.h :;.'."., ..." ~ .... QTy?..~.. :'d"UN~ .... ~.,~PR![C~:?.' ,.l:ii~; :;17"~'T07A.'-~;~;~;.,
01/06/04 United pipe/Frame and Grate 1 ea $75.00 $75.00
MATERIAL TOTAL $75.00
SERVICES / MISC.
"'.";:~":?/';~. ;' ' ;"'; ;]~ :!"?!':'i!i'~ ~¥'?iN~'::..:'L:: ~;~.~.,~E?~i!'!~' ?'?i": :i";~:! !' ~:']?i;~'
SERVICES TOTAL $0.00
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment/Services Mark-up 15%
$75.00
$o.oo
$11.25
Submitted by:
Accepted by:
hh~l ~.otito, J"-'<r-Construction Superintendent
~/~~ / Date:
$86.25
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.' 02271-29
Description of work: Expose & Cold Mix Manholes ~'er/~
Date: 12/16/2003
LABOR 12/17/2003
;.':..',,~,, ,~.,:c,, ';? '. :;.i~i~. '~"~,'~ . ~ ..'....i ':. ,,,'.:.',:.?:.:
~,',~,,~..~:..~..,~.,,.~ ;.-.'?i:i~',;';:i, ~ I ?~:i'~,...O_.,T.;?: ,',,', i~,~',,i?:;.-',,.,':' ',~' ........: ,........., ..,,,....
'.'~'"'".._~:~'. -~:!'.::~,~;'.:"~;~i"~M~,!~'~.:~ !i"-'.'~ .~ ~i'~~ ~i~'.::~'7'1:.="..' ~ '~""' ?":'"" :'~: ~'"'
12/16/03 Foreman McClaffert¥ 0.50 32.94 $16.47
12/16/03 Laborer ,Luster 2.00 27.74 $55.48
12/16/03 Laborer Maschme¥c 0.50 27.74 $13.87
12/17/03 Foreman McClafferty 2.00 32.94 $65.88
12/17/03 Laborer Luster 5.00 27.74 $138.70
12/17/03 Laborer Maschme¥c 2.00 27.74 $55.48
LABOR TOTAL $345.88
EQUIPMENT
_ .......... ,,, ,,,~..w. ~w.~,.. ~..: '-'~TE~'.,.':,, i::~,,~ ..,....',., :~. ,..,.:;.-.: ";:,'~ ;:'; TOTAl:: :;i:~
12/16/03 Pickup 20600 0.50 $8.25 $4.13
12/16/03 One Ton Flatbed 20605 0.50 $17.30 $8.65
1 2/17~03Pickup 20600 2.00 $8.25 $16.50
12/17/03 One Ton Flatbed 20606 5.00 $17.30 $86.50
12/17/03 LTM Air Compressor 160088 5.00 $12.27 $61.35
EQUIP. TOTAL $177.t3
MATERIALS
. · ~,:~,' .,~' ,,~..~ .-.~ ~:' .~,:..'~,,~..' ,~ '~.'., ~' ,; :~-' '.'.,,, ~.,'.~:,'.,,.?, '~:,~,~, ':~ .~,..'~'-' ~'.,'~;~., .?~. .............. ,:::~:.-.,~.~'~;.-.".~,:.J,..'~',;,~.~.;._.?;:~i.-. '.,:,;~,:':' ~:.:~'~':~': :'""" '...~"' ..~,,~,,.,::~.'., '~'' "":': "':..,
:~..... ;......... ~Rf~,~.,:~..~"~ .~"., ~!:;'!;'~?i ............. E~!~."i~!:'i:'i ,~.~,~.[~J~[~E~..~:~. ¥;...~.T~.,~.':'"~ '" ' '
MATERIAL TOTAL $0.00
SERVICES I MISC.
SERVICES TOTAL $0.00
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment/Services Mark-up 15%
$523.01
$51.88
$26.57
Submitted by:
TOTAL AMOUNT DUE
~/~_ Jr-Cll~nstmction Sup_erintendent
$601.46
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-33
Description of work: Move ADA Ramps @ Astro & Library
oc~r' ~?¢=c./,A~,,. ~-,,~,,~ ,,4~.s ~ ~o~ ¢'~-ef-~ Date: 1/13/2004
LABOR 1/19/2004
,',. 'ST OT ST. ' · . OT',.: · .:'
· ' DA~E C,LASS. : ..'NAME · HOURS HOURS RATE....: RATE" TOTALS .
01/13/04 Foreman McClaffert¥ ~ 1.00 32.94 $32.94
01/14/04 Foreman McClaffert¥ 1.50 32.94 $49.41
01/15/04 Foreman McClaffert¥ 8.00 0.50 32.94 44.60 $285.82
01/15/04 Laborer Rodriguez 8.00 27.74 $221.92
01/16/04 Foreman McClafferty 3.00 32.94 $98.82
01/16/04 Laborer Rodriguez 3.00 27.74 $83.22
01/19/04 Foreman McClaffert¥ 1.50 32.94 $49.41
01/19/04 Laborer Rodriguez 1.50 27.74 $41.61
01/26/04 Foreman McClafferty 1.50 32.94 $49.41
01/26/04 Laborer Rodriguez 2.00 27.74 $55.48
02/04/04 Foreman McClafferty 0.50 32.94 $16.47
02/04/04 Foreman Young 0.50 32.94 $16.47
02/04/04 Laborer Rund 0.50 27.74 $13.87
LABOR TOTAL $1,014.85
EQUIPMENT
: ' EQUIP: NO. OF ',i:. · ":: ,:'.'..
'DATE DESCRIPTION:::'::~ .' '"': '.. 'NO:: .' i HOUBS:~. :?;~:.RATE ....:....'.:.' ,'. j.,=.T .= TOTAL"
01/13/04 Pickup 20600 1.00 $8.25 $8.25
01/14/04 Pickup 20600 1.50~ $8.25 $12.38
01/15/04 Pickup 20600 8.00 $8.25 $66.00
01/15/04 JD 580SL Backhoe 110084 8.00 $32.60 $260.80
01/16/04 Pickup 20600 3.00 $8.25 $24.75
01/16/04 JD 580SL Backhoe 110084 3.00 $32.60 $97.80
01/19/04 Pickup 20600~ 1.50 $8.25 $12.38
01/19/04 JD 580SL Backhoe 110084 1.50 $32.60 $48.90
01/26/04 Pickup 20600 1.50 $8.25 $12.38
02/04/04 Pickup 20600 0.50 $8.25 $4.13
02/04/04~ JD 580SL Backhoe 110084 0.50 $32.60 $16.30
EQUIP. TOTAL $564.05
MATERIALS
DATE::.':i .,"' ~.. :'i;':' ::: .' ..~.,,-Sur~l'rT.IvN' '
MATERIAL TOTAL $0.00
SERVICES / MISC.
DATE. DESCRIPTION .'.' ,'NO..' 'i'..:I.AMOUNT ". '. TOTAL
01/14/04 LLAD Saw Cutting 5482 $51.18 $51.18
01/15/04 Johnny Cat 19691 $195.00 $195.00
SERVICES TOTAL $246.18
Costs Subtotal (no markup)
Labor Mark-up 15%
Materials/Equipment/Services Mark-up 15%
$1,825.08
$152.23
$121.53
Submitted by:
Accepted by:
TOTAL AMOUNT DUE
Loti Jr- Con,~ction Superintendent
~ - Date: I¢F¢0~
/
$2,098.84
LTM
DAILY EXTRA WORK REPORT
.... <~. O%_CC~-~-.~e.~.t Job No: O'ZTT[ ~,"- ~ ~
Foreman:
I -
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
........... C~' o,~k~'.,~..',~- ~--
MATERIALS USED
DESCRIF~T1ON SUPPLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS}
COPY
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO. HOURS
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenn's Reports, etc./Misc FormsJDaiiy Extra Work Report
LTM
DALLY EXTRA WORK REPORT
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
-j
MATERIALS USED
DESCRIPTION I SUP PLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
¥
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO.,. . j HOU, R.S
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contractin§/Jenn's Reports, etc,/Misc Fo"ms/Daily Extra Work Report
LTM
DAILY EXTRA WORK REPORT
CRAFT ST. 0%
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
DESCRIPTION SUPPLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
COMPANY EQUIPMENT
EQUIPMENT NO. ! HO_URS
//DDS/./ ¢'
CUSTOMER SIGNATURE
RENTAL EQUIPMENT
EQUIPMENT NE). HOURS
H:/Cantracdng/Jenn's Reperts, etc./Misc Forms/Daily Extr.~ Work Report
LTM
DAILY EXTRA WORK REPORT
Date: ~-" ~, (o- (_~-A, , Job Name: ~: ~G - ~O\v-c.~. _
Foreman: "~, ['vX. C C ~.&%-~ Job No: (~"~-'z,."-I ~,-- .~_ '-&
CRAFT ST. QT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
,DESCRIPTION
ISUPPLJER
MISCELLANEOUS (SUB, HAULERS, MOBS)
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO. HOURS
I RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenn's Repot[s, etc./Misc Forms/Daily Extra Work Report
ate:
ForemaR:
LTM
DAILY EXTRA WORK REPORT
JobName: .,¢~(t.
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
MATERIALS USED
DESCRIPTION SUPPLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT No. t HouRs
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenrfs Reports, etc./Misc Forms/Daily Extra Work Report
LTM
DAILY EXTRA WORK REPORT
Date: ~,: ~Z_.~;;;)¢ O~,,, JobName: ~t~.l't~JO~,~
CRAFT ST. OT.
EMPLOYEE NAME RATE HOURS HOURS DESCRIPTION OF WORK
, ~
iDESCRIPTION
MATERIALS USED
SUPPLIER QTY.
MISCELLANEOUS (SUB, HAULERS, MOBS)
CUSTOMER SIGNATURE
COMPANY EQUIPMENT
EQUIPMENT NO. HOURS
RENTAL EQUIPMENT
EQUIPMENT NO. HOURS
H:/Contracting/Jenn's Reperts, etc,/Misc Forms/Daily Extra Work Report
L.L.A.D. INC.
P.O. BOX 516
MEDFORD, OR 97501-8526
Invoice
DATE INVOICE #
1/20/2004 5482
BILL TO
L.T.M.
P.O. BOX 1145
MEDFORD, OR 97501
SHIP TO
L.T.M.
P.O. BOX 516
MEDFORD, OR 97501
P.O. NO~ TERMS ~ CODE#
HC240114 Net 30
DATE ORDERED DESCRIPTION AMOUNT
SISKIYOU, LIBRARY, ASHAND
1-14-03 Saw cut i52 ft. concrete ~ $1.50 ft. = $ 228.00 SAW CUT 313.00
4 curb cuts ~ $10.00 each = $ 40.00
Saw cut 60 ft. asphalt up to 10 in. deep ~ $ .75 ft. = $ 45.00
Thank you for your business. I
Total $313.00
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-34
Description of work: Area Drain @ 450 Siskiyou Blvd.
~',,~,~ ~¢, ~ .~ ~,..,,. o, ~c.~_ Date: 1/29/2004
LABOR
· · ' .... . ST OT' . .... ST OT' '1 .... '
DATE CLASS. ":"': NAME · HOURS i. HOURS .... '"'RATE. RA'i~E.". .. .TOTALS.
LABOR TOTAL $0.00
EQUIPMENT
EQUIP. NO. OF' ·.. '1
DATE DESCRIPTION NO. "'HOURS RATEI' 'TOTAL
EQUIP. TOTAL $0.00
MATERIALS
DATE' DESCRIPTION " QTY. UNIT PRICE TOTAL'
MATERIAL TOTAL $0.00
SERVICES / MISC.
DATE' :" :' '.'D'ESCR.!PTION.'. ~l .i. ;' ' : i ' '' ' "." ". :'.:.. 'No. : ':AMOUNT ...." .... AL.
01/~9/04 Purd¥ 'Extra Area Drain 90374 $'10(~.00 $100.00
SERVICES TOTAL $100.00
Costs Subtotal (no markup)
Labor Mark-up 15%
Sub Contract Mark-up 10%
$100.00
$0.00
$10.00
Submitted by:
Accepted by:
TOTAL AMOUNT DUE
Joh?,~r~: ~ruction Superintendent
Date: /~.~'~r_~ ~/
$110.00
JAN-29-2004 05:20 PM PURD¥ CONSTRUCTION INC
]an 29 2004 17:33
54 I 664 4124
P.02
PURDY CONSTRUCTION, INC.
3396 FREELAND ROAD
CENTRAL POINT, OR 97502
' SILL
!LTM INC.
, PO BOX 1'145
MEDFORD OR 97501
COPY
Invoice
DATE i INVOICE $
01129t04 90374
J
JOB NO,
02271
OU^.T,T~ , .~SCRIPTIO.
' 75 i it,40 cONCRETE ~ALK
60 I#?? BUS SHELTER COLORED
OZZ-P~t-'Z~-~, XTRA: CATCH AREA D~AIN
~Z~T~ -,.,~,.~,6YD CONC (~ 90/3'0 + 20 '/o & 5 WORKERS x
i HRS
TERMS
Net 30
RATE
THERE WILL BE A 2% SERVICE CHARGE ON ALL ACCOUNTS NOT PAIO WITHIN 30 DAYS
2.55
3.30
100,00
2.376.00'~'
PROJECT/JOB
Siak, Blvd-Sched A
UNIT j AMOUNT
SF ~
SF i 19800
EA 100.00
EA 2,376. O0
!Total Due:
$2,8§5.25 I
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD· SCH. A Job No.: 02271-35
Description of work: Move ADA Ramps & Misc· Concrete
LABOR
ST. CT ST .'CT ..I
.DATE" .CLASS' NAME · HoURs HOURS. .: RATE .., RATE,.,I .. TOTALS
LABOR TOTAL $0.00
EQUIPMENT
.. ..... . · EQUIP. .NO: OF "~" '"'i ' ' ,..
DATE : DESCRIPTION .... ..NO'.. HOURS. i'"' .RATE , ',.T.,OTAE..:''
EQUIP. TOTAL $0.00
MATERIALS
MATERIAL TOTAL $0.00
SERVICES / MISC.
DA~E ' :.DESCRIIISTION : · NO. AMOUNT TOTAL"
01/29/04 Purd¥ Move ADA & Misc. Concrete 90374 $2,376.00 $2,376.00
SERVICES TOTAL $2,376.00
Submitted by:
Accepted by:
Costs Subtotal (no markup)
Labor Mark-up 15%
Sub Contract Mark-up 10%
Sub Contract Mark-up
TOTAL AMOUNT DUE
$2,376·00
$o.oo
$200·00
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-37
Description of work: Add Loops @ Lithia Way
Date: 1/23/2004
LABOR
· . ST .. OF.:. :. .... ~'~' . ST . ... OT: I '.
"DATE'. "CLASS · '~AME'"':" ~ 'HOU'RS HOURS!i..i :?';.'. P,A. TE ' RATEI.: "TOTALS'
LABOR TOTAL $0.00
EQUIPMENT
DATE DESCRIPTION. .NO. HOURS :i'.. :TOTAL, '..
EQUIP. TOTAL $0.00
MATERIALS
, DAYE .. DESCR PTIO~:.......... :..; ',Q17Y.. · .:, ...UNIT.' mm '~ PRICE.... Discount ~ TOTAL. :..
MATERIAL TOTAL $0.00
SERVICES / MISC.
01/23/04 Marca Add Loops 12304 $3,806.38 $3,806.38
SERVICES TOTAL $3,806.38
Costs Subtotal (no markup)
Labor Mark-up 15%
Sub Contract Mark-up 10%
Sub Contract Mark-up 8%
$3,806.38
$0.00
$2OO.OO
$144.51,rb...~
Submitted by:
Accepted by:
TOTAL AMOUNT DUE
Construction Superintendent
$4,150.89
Feb 5 200~ 20:11
FEB-OS-2004 THU 08:IS PM M~RCA. ELECTRIC, INC S41 396 3821
P. 03
MARCA ELECTRIC INC.
PO BOX 628 - COQUILLE, OREGON 97423
541-396.~5271 FAX 541.396-3821
CCB#46575
TO: JOE SOARES- LTM, INC.
FROM: MARLENE
DA TE: JANUARY 23, 2004
PAGES:
RE: SISKIYOU BLVD.
EXTRA
EAST MAIN ~ LITHIA WA Y: ADD LOOPS
BORE 115" @ $12.00 PER FOOT
LOOPS 3 '~ $250.00 EACH
JBI-2
CONDUIT, FITTINGS & WIRE
LABOR 21 HRS @ $59.00 PER HOUR
TOTAL
MARLENE
$1.;80.00
750.00
174.80
262.58
$1239.00
oE27/
$J806.$8
LTM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-36
Description of work: Add Loops @ 3rd Street
Date: 1/23/2004
LABOR
DATE.': ... . O..LASS 'NAME' . HO.U'..~$ HOD'RS "' RATE i~E.'I'..'"..:.:::: · TOTA£S./: '
LABOR TOTAL $0.00
EQUIPMENT
DATE :: DESCR'PTION ..... ll~ 'NO. '1 ': ''~oURS' :, ''' ~'~TE"'' '1'J ;i : ~
: ....... .. ', " .T~x~.
EOU,P. TOTAL $0.00
MATERIALS
MATERIAL TOTAL $0.00
SERVICES / MISC.
DATE ' 'DESCRIPTION .. i::;!N.O.~.;; .." :AMQUNTi I" ''' : : .... TOTAL
01/23/04 Marca Add Loops 12304 $2,496.50 $2,496.50
SERVICES TOTAL $2,496.50
Costs Subtotal (no markup)
Labor Mark-up 15%
Sub Contract Mark-up 10%
Sub Contract Mark-up 8%
$2,496.50
$o.oo
$200.00
$39.72
Submitted by:
Accepted by:
TOTAL AMOUNT DUE
Construction Superintendent
//~/~ Date:
$2,736.22
FEB-OS-2004
Feb 5 2004
THU 08:15 PM MARCA, ELECTRIC. INC 541 396 3821
20:11
P, 02
MAR CA ELECTRIC INC.
PO BOX 628- COQUILLE, OREGON 97423
541-396-5271 FAX 541-396-3821
CCB#46575
TO: JOE SOARES- LTM, INC.
FROM: MARLENE
DATE: JANUARY23, 2004
PAGES: 1
RE: SISKIYOU BLVD.
EXTRA
EAST MAIN @"~-~"E~: ADD LOOPS.
BORE 60' @ $12.00 FT
LOOPS 3 @ $250.00 EACFI
JB1
CONDUIT & FITTINGS
LABOR 13.5 FIRS @ $59.00
TOTAL
$720.00
$142.60
$796.50
$2,496.50
MARLENE
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
ECORDER'S COPY
;;DATE
07/01/2003
Page 1
03611 J
VENDOR: 000100
LTM INC
P O BOX 1145
MEDFORD, OR 97501
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 10th of Month
Req. Del. Date: 09/09/2002
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
Quantity unit Description :Unit Price ' Ext; Price
THIS IS A REVISED PURCHASE ORDER
B~NKET PURCHASE ORDER
Contract for the Siskiyou Blvd Redesi.qn 802 592.60
Project 99-38B. This requisition is
applicable to Bid Schedules A, C, & D
only, Bid Schedule B Will mqui~ea
separate requisition.
Bid Schedu e A -
Bid Schedule C - 660,266.62
Bid Schedule D - ; 174,600.00
Bid
Contract date: Au.qust 28, 2002
· ,,: start datei' september 9, 2002 ·
Completion date: March 2003
Insurance required/On file ' ·
Revised purchase order 01-22-2003. 18,000.00
';" Change Order No. 1, CTB Excavation &
Haul Away
· Revised purchase order 01.22-2003, 13,964.08
Change Order No. 2, Multiple Proiects,
; ~ see attached list.
Revised purchase order 02-11-2003 960.00-
Schedule C
Chan.qe Order No. 3 - Si.qn Post Credit
· ChanCle Order No. 4 - Bi-Directional 970,i0
Markers
SUBTOTAL
BILL TO: TAX
FREIGHT
TOTAL
E 260.08.12.00.704200 1,715,534.50
Authorized Signature
VENDOR COPY
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
07/01/2003
Page 2 / 3
03611
VENDOR: 000100
LTM INC
P O BOX 1145
MEDFORD, OR 97501
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 10th of Month
Req. Del. Date: 09/09/2002
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
Quantity Unit Description Unit Price Ext. Price"
Change Order No. 5 1 457.69-
I (A) Bid Item 37 Arrows Marking : '
(B) Bid Item 38 Bicycle Lane Stencil
(C) Bidl~em 39b n~ Markin,qs ,
Change Order No. 6 - Joint Seal Bridge 1,471.13
" Revised purchase order 04/08/2003
Schedule A
· ' ' Change Orders No. 1 to 9
Please see attached for descriptions of
change orders 1 through 9.
Revised purchase order 05/13/2003 1,023.01
Schedu e A
Change Order No. 10, Items A & B
: Revised purchase order 05/13t2003 358.00
Schedule D
Change Order No. 1
Revised purchase order 08/01/2003 143.00
· Schedule A
Change Order #11
Revised purchase order 08/0tt2003 5,976.80
Schedule C
Change Order #7
Revised purchase order 08/01/2003 604.42
· Schedule D
Change Order #2
· i Rev sed purchase orde~ 11/18/2003 2;066.73
Change Order 12, Items A and B
SUBTOTAL
BILL TO: TAX
FREIGHT
TOTAL
Authorized Signature VENDOR COPY
CITY OF ASHLAND
20 E MAIN ST.
~½.~ ASHLAND, OR 97520
(541) 488-5300
Page 3 / 3
03611
VENDOR: 000100
LTM INC
P O BOX 1145
MEDFORD, OR 97501
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 10th of Month
Req. Del. Date: 09/09/2002
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
Quantity ' Unit Description Unit Price Ext. Price
Revised purchase order 01/15/2004 451.29
Schedule D
Change Order 3 - Electrical Boxes
Revised purchase' order 01/15/2004 i · . 2,633~
Schedule A
·: :: : ~ Change Order 13 (items A-E) :
Revised purchase order 01/22/2004 6,553.75
· Schedule A ':'" ;:
Chan.qe Order 14, Item A & B
:' ~ Revised purchase order 03/0512004 : · 12,389,74
Schedule A
Change Order 15, Items A-G ' ' ;
Revised purchase order 03/05/2004 3,931.91
: Schedule D
Change Order 4, Items A-C
SUBTOTAL 1,715,534.50
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 1,715,534.50
ASHLAND, OR 97520
Authoriz~!~ignature
VENDOR COPY