HomeMy WebLinkAbout2003-011 CONT Chg Order #1-2 - LTM Inc CITY OF ASHLAND
DEPARTMENT OF PUBLIC WORKS
CONTRACT CHANGE ORDER NO. I
ASHLAND STREET REDESIGN
ASHLAND STREET
DATE:
PROJECT NO.:
DECEMBER 26, 2002
99-38
PROJECT:
LOCATION:
CONTRACTOR: 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 1 CTB Excavation & Haul Away Lump Sum $18,000.00 $18,000.00
Total this Change Order $18,000.00
Previous Change Order 0.00
Revised Contract Total $678,266.60
Recommended By:
Approved By:
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 will apply.
En~,~Yj D at e///~'/~'3'
E er Date
Accepted By:
LTM Incorporated
PO Box 1145
Medford OR 97501
Contractor
Date
ENGINEERING Tel: 541488-5347
20 E Main Street Fax: 541-488-6006
Ashland, Oregon 97520 TTY: 800-735-2900
www.ashland.or.us
G:/pub-wrks\eng\dept-admin\ENGINEER\PROdEC'R1999\99-38 CO 1.doc
Cc..o*-I
L TM Incorporated
Time and Materials Billing Summary
Project Name:
Description of work:
LABOR
Siskiyou Blvd.
Sishiyou CTB Excavation and haul away
\=, ~ VlUZ-l Fl JC.-Q ~ (t.O(,frl1.-
MrJ)I,I>-", CON CIT&4i!. ~~# l4<..
Job No.:
02271-401
Date:
09/12/2002
09/12/02 foreman McClafferty 3.00 32.94 $98.82
09/12/02 teamster Strickland 2.50 24.59 $61 .48
09/12/02 teamster B. Allen 3.50 24.59 $86.07
09/12/02 teamster T. Whitcomb 3.50 24.59 $86.07
09/13/02 foreman McClafferty 2.00 32.94 $65.88
09/13/02 teamster Strickland 3.50 24.59 $86.07
09/16/02 foreman McClafferty 2.50 32.94 $82.35
09/16/02 operator Brambora 4.00 32.37 $129.48
09/16/02 operator R. Young 2.00 32.37 $64.74
09/16/02 laborer R. Luster 1.00 32.37 $32.37
09/16/02 laborer D. Donald 3.00 32.37 $97.11
09/19/02 teamster F. Patte 3.00 24.59 $73.77
09/18/02 foreman McClafferty 3.00 32.94 $98.82
09/18/02 operator Brambora 4.00 32.37 $129.48
09/18/02 laborer R. Luster 6.50 32.37 $210.41
09/18/02 laborer R. Dougham 2.50 32.37 $80.93
09/19/02 foreman McClafferty 0.50 32.94 $16.47
09/19/02 operator R. Young 6.00 32.37 $194.22
09/20/02 foreman McClafferty 0.50 32.94 $16.47
09/20/02 operator R. Young 8.00 32.37 $258.96
09/23/02 foreman McClafferty 0.50 32.94 $16.47
09/23/02 operator R. Young 8.00 32.37 $258.96
09/24/02 foreman McClafferty 0.50 32.94 $16.47
09/24/02 operator R. Young 8.00 32.37 $258.96
09/25/02 foreman McClafferty 0.50 32.94 $16.47
09/25/02 operator R. Young 8.00 32.37 $258.96
09/26/02 foreman McClafferty 0.50 32.94 $16.47
09/26/02 operator R. Young 3.00 32.37 $97.11
09/27/02 foreman McClafferty 0.50 32.94 $16.47
09/27/02 operator R. Young 2.00 32.37 $64.74
09/30/02 operator R. Young 1.00 32.37 $32.37
LABOR TOTAL $3,023.39
EQUIPMENT
20123
140100
32013
32055
32044
20123
$8.25
$490.00
$34.50
$34.50
$34.50
$8.25
$12.38
$3,920.00
$120.75
$86.25
$120.75
$16.50
,..... ..
#
09/13/02 belly dump 32055 3.50 $34.50 $120.75
09/16/02 pick up 20123 2.50 $8.25 $20.63
09/16/02 backhoe 110081 4.00 $29.07 $116.28
09/16/02 12 yd dump 31078 3.00 $32.75 $98.25
09/18/02 Ipick up 20123 1.00 $8.25 $8.25
09/18/02 backhoe 110081 4.00 $29.07 $116.28
09/18/02 12 yd dump 31081 3.00 $32.75 $98.25
09/18/02 air compressor 160089 6.50 $12.27 $79.76
09/19/02 pick up 20123 0.50 $8.25 $4.13
09/20/02 pick up 20123 0.50 $8.25 $4.13
09/23/02 pick UP 20123 0.50 $8.25 $4.13
09/24/02 Ipick up 20123 0.50 $8.25 $4.13
09/25/02 Ipick up 20123 0.50 $8.25 $4.13
09/26/02 pick up 20123 0.50 $8.25 $4.13
09/27/02 Ipick UP 20123 0.50 $8.25 $4.13
EQUIP. TOTAL $4,963.94
MATERIALS
SERVICES I MISC.
3893 $2,004.80
$330.00
$120.00
$180.00
$165.00
3939 $773.70
$78.14
2293 $5,097.50
$312.56
SERVICES TOTAL
$2,004.80
$330.00
$120.00
$180.00
$165.00
$773.70
$78.14
$5,097.50
$312.56
$9,061.70
Costs Subtotal (no markup) $17,049.03
Labor Mark_uP""t-'~~ $665.15
Materials/Equipment/Services Mark-up /( /% $2,384.36
Submitted by:
TOTAL AMOUNT DUE
ruction Superintendent
Accepted by:
Date: /7 Pt:UJz--
.,..."
$20,098.53
~~
t;, 'OlP ~
I
18,ofX)
oK
~S#-
CITY OF ASHLAND
DEPARTMENT OF PUBLIC WORKS
CONTRACT CHANGE ORDER NO. 2
ASHLAND STREET REDESIGN
ASHLAND STREET
PROJECT:
LOCATION:
CONTRACTOR: 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 U n it Price Amount
CO 2 Multiple Projects (see attached) Lump Sum $13,964.08 $13,964.08
Total this Change Order $13,964.08
Previous Change Order $18,000.00
Revised Contract Total $692,230.70
DATE:
PROJECT NO.:
DECEMBER 26, 2002
99-38
Recommended By:
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 will apply.
E n ~r'///y~/ Dat/c~,'~/''~'
Approved By:
Date
Accepted By:
LTM Incorporated
PO Box 1145
Medford OR 97501
Contractor
Date
ENGINEERING Tel: 541-488-5347
20 E. Main Street Fax: 541488-6006
Ashland, Oregon 97520 TTY: 800-735-2900
www.ashland.or.us
~\COMPAQ1~DATA\GOV~pub-wrks\eng\dept-admin\ENGINEER\PROJECT~1999\99-38 CO 2.doc
L TM Incorporated
Time and Materials Billing Summary
Project Name: Siskiyou Blvd.
Description of work: Siskiyou Concrete Cap
Job No.:
02271-403
Date: 10/29/2002
LABOR
09/30/02 foreman McClafferty 0.50 32.94 $16.47
09/30/02 laborer Bramford 1.00 32.37 $32.37
09/30/02 laborer D. Donald 1.50 27.74 $41.61
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
LABOR TOTAL $90.45
EQUIPMENT
EQUIP. TOTAL
$4.13
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4.13
1"".'
t'
MATERIALS
!'(
f.I) IV
pc ~o
,<,./",\ttf
"
MATERIAL TOTAL
$337.14
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$337.14
SERVICES J MISC.
$42.60
Costs Subtotal (no mark)> J $474.32
Labor Mark-up , Y< ~'10 $19.90
Materials/Equipment/Services Mark-up J $65.26
Submitted by:
TOTAL AMOUNT DUE
$559.47
~-
515.00
Accepted by:
Date:
11 Peco?
,...... ,.
DEG-17-2002 TUE 01:32 PM LTM INC
FAX NO, 1541 664 4567
p, 02
L TM Incorporated
Time and Materials Billing Summary
Project Name: SisKiyou Blvd.
Description of worle Simenson Funeral Home
Job No.:
02271-405
Date: 12/17/2002
LABOR
. .re- . ..-;-.......:., ....;'-';~:S~r ;;::t \.~::'.:~:.:;' '::;:I:.oar~" .'g:':.,~'i. :':J"<.::l1$r[;)ii:~:.' :::! :,<OT/:' ].,'''' '; . . . ': ..
.",,", . . ;
PATE .;'CLASS;i . NA~.!n: ...!H'aUR$:;:: :':\::fif~NR$;Jj; .ti1;:~S11E;J:iL ,,;,,;\gATt:: ':'r .;..... -.; .c' . L:'TOTALS....
. ..
,,: ':.+ I. "..., :.~..: .:
10/17/02 Foreman McClafferty 2,00 32.94 $65.88
10/17/02 Operator Walker 3.50 32.37 $113.30
10/17/02 Laborer Luster 3.50 27.74 $97.09
11/06/02 Foreman McClaffertv 0.50 32.94 $16.47
1 t/06/02 Doerator Marez 1.00 32.37 $32.37
1V06/02 Laborer Donald 1.00 27.74 $27.74
LABOR TOTAL $352.85
EQUIPMENT
. :.; ...,.;.:;.:.....::<}';:,./;:: )!EQU1P/Yf ;-. :riN'O.';Q'F'//' ',:~:" ":.:'.:;,: ,. ':.:..):..,:........ '?"':i..:;.::'.:.
'..:.'DATE, ;. . , .P.ESCRIPTION":;.,, ,:i'j ,\:';!.' 0: :{?:~:':\;;.;~~'r{.:.. ::.~'.4 ;:~~..;:;hfa(!tRSi~;.;;' .,;:';~.MJ;~::;':,;i 1,.:/::,:>';:;' /,.,~TOTAI+
10/17/02 oickuo 20123 2.00 $8.25 $16.50
10/17/02 IR Compressor 160089 0.50 $12.27 $6.14
10/17/02 Cat 950B Whl Ldr 130018 1.00 $42.00 $42.00
11/06/02 I pickUP 20123 0.50 $8.25 $4.13
11/06/02 JD 410E Bhoe 11 0081 1.00 $29.07 $29.07
EQUIP. TOTAL $97.83
" " '1'1
'.' "
.. ."
..., . :..' . ",
DATE
.... ; DESCRIPTION;
. TOTAL..'
$0.00
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark~up 15%
Materials/EquipmenUServices Mark-up 15%
$518.82
$52.93
$24.90
Submitted by:
TOTAL AMOUNT DUE
$596.64
ruction Superintendent
D P-~ /9JJtLo2-
DFC-17-2002 TUE 01:33 PM LTM INC
FAX NO, 1541 664 4567
Accepted by:
Date:
p, 03
L TM Incorporated
Time and Materials Billing Summary
Project Name: Siskiyou Blvd.
Description of work: Driveway @ Fashion for Windows & All State
61-rn+ ,,..,,.; cvr _ ""~~w....., $/hltfl:-Al,/J....
~ S eb,AJ flIoi.-
Job No.: 02271-406
Date: 10/29/2002
LABOR
10/29/02 Foreman
10/29/02 0 erator
10/29/02 Laborer
McClafferty
Marez
Donald
0.50
0.50
1.00
32.94
32.37
27.74
LABOR TOTAL
$16.47
$16.19
$27.74
$0.00
$60.40
EQUIPMENT
EQUIP. TOTAL
MATERIALS
$0.00
$0.00
$0.00
MATERIAL TOTAL $0.00
SERVICES I MISC.
Costs Subtotal (no markup) $79.06
Labor Mark-up 22~ f $13.29
Materials/Equipment/Services Mark~up )1% , $3.17
Submitted by:
TOTAL AMOUNT DUE
$95.51
qO
ction Superintendent
Accepted by:
Date:
/1 pet:, () Z-
,.......
L TM Incorporated
Time and Materials Billing Summary
Project Name:
Description of work:
Siskiyou Blvd.
Driveway at 3 Harmonics Fe. ()pS
Job No.:
02271-407
Date:
10/10/02-
10/11/2002
LABOR
McClaffe
Walker
Luster
McClafferty
Walker
Luster
LABOR TOTAL
$82.35
$145.67
$110.96
$16.47
$32.37
$27.74
$0.00
$415.56
EQUIPMENT
10/10/02 Pick u
10/10/02 Backhoe
10/10/02 Loader
10/11/02 Pick u
10/11/02 Backhoe
EQUIP. TOTAL
$20.63
$87.21
$63.00
$4.13
$29.07
$0.00
$204.03
MATERIALS
MATERIAL TOTAL
SERVICES I MISC.
,.... .
Submitted by:
Accepted by:
Costs Subtotal (no markup) $619.59
Labor Mark-up ~ ~6t $91.42
Materials/Equipment/Services Mark-up ~ () $34.69
TOTAL AMOUNT DUE
$745.69
1(~ -
Date:
/1 per;.~'2-
,....
L TM Incorporated
Time and Materials Billing Summary
Project Name:
Description of work:
LABOR
Siskiyou Blvd.
Curb & Gutter Removal @ Ray Lane
J'!!Dtt. /J1:fZ4) 610e-w~/ OtlAvt:-w"'1 C(.D!.vtt~
ftj OO~
Job No.:
02271-408
Date:
10/11/2002
LABOR TOTAL
$16.47
$48.56
$41.61
$0.00
$106.64
10/11/02 Pick u
1 0/11/02 Backhoe
10/11/02 Air Com ressor
EQUIP. TOTAL
MATERIALS
$0.00
$0.00
$0.00
MATERIAL TOTAL $0.00
SERVICES I MISC.
SERVICES TOTAL $0.00
J . ~
Submitted by:
Accepted by:
Costs Subtotal (no markup)
Labor Mark-up 22%
Materials/Equipment/Services Mark-up 17%
TOTAL AMOUNT DUE
16
Date:
n17a" z.
,.....
$166.64
$23.46
$10.20
$200.29
l't,-
L TM Incorporated
Time and Materials Billing Summary
Project Name: Siskiyou Blvd.
Description of work: ADA at Sidewalk @ Sta. 23+00RT
fC.. tl4
Job No.: 02271-409
LABOR
Date: 10/15/2002-
10/18/2002
McClaffert
Marez
Donald
McClaffert
Marez
Donald
McClaffe
Donald
32.94
32.37
27.74
32.94
32.37
27.74
32.94
27.74
LABOR TOTAL
$98.82
$97.11
$83.22
$32.94
$32.37
$27.74
$16.47
$83.22
$0.00
$471.89
EQUIPMENT
10/15/02 Pick u
10/15/02 Backhoe
10/16/02 Pick u
10/16/02 Backhoe
10/18/02 Pick u
EQUIP. TOTAL
$24.75
$43.61
$8.25
$29.07
$4.13
$0.00
$109.80
MATERIALS
$0.00
$0.00
$0.00
MATERIAL TOTAL $0.00
SERVICES I MISC.
Submitted by:
Accepted by:
Costs Subtotal (no markup)
Labor Mark-up 22%
Materials/Equipment/Services Mark-up 17%
TOTAL AMOUNT DUE
Date:
/7 /J~()Z-
$581.69
$103.82
$18.67
$704.17
(,61,00
L TM Incorporated
Time and Materials Billing Summary
Project Name: Siskiyou Blvd.
Description of work: Re-install Driveway
I " +il oF<:- 7
Job No.: 02271-412
Date: 10/23/2002
LABOR
LABOR TOTAL
$65.88
$129.48
$110.96
$27.74
$0.00
$334.06
EQUIPMENT
10/23/02 Pick u
10/23/02 Backhoe
10/23/02 Loader
EQUIP. TOTAL
$16.50
$58.14
$84.00
$0.00
$158.64
MATERIALS
$0.00
$0.00
$0.00
MATERIAL TOTAL $0.00
SERVICES I MISC.
Costs Subtotal (no markup) $492.70
Labor Mark-up 2~ l~ $73.49
Materials/Equipment/Services Mark-up )1% $26.97
Submitted by:
TOTAL AMOUNT DUE
$593.16
5(,(, -
Accepted by:
Date:
/7 Pe:l:L;'Z-.
r..
L TM Incorporated
Time and Materials Billing Summary
Project Name:
Description of work:
LABOR
Siskiyou Blvd.
Taper at E. Ashland Street
Af' ~ ~I""e - A.1)Qcno~ 6fZ,IM~II.l("
p~ \/&f(.,c,A(. f"G~ IDII-l//Dt.--
Job No.:
02271-413
Date:
10/28/02-
10/30/2002
2.00 32.94 $65.88
4.00 32.37 $129.48
4.50 27.74 $124.83
3.25 24.59 $79.92
1.50 32.94 $49.41
3.50 32.37 $113.30
3.50 27.74 $97.09
6.00 32.94 $197.64
4.00 32.37 $129.48
6.00 0.50 27.74 37.88 $185.38
4.00 27.74 $110.96
8.00 0.50 41.22 56.26 $357.89
6.50 24.59 $159.84
$0.00
LABOR TOTAL $1,801.09
EQUIPMENT
10/28/02 Pick u 20123 2.00 $8.25 $16.50
10/28/02 Backhoe 110081 4.00 $29.07 $116.28
10/28/02 12 d Dum 31040 3.25 $32.75 $106.44
10/29/02 Pick u 20123 1.50 $8.25 $12.38
10/29/02 Backhoe 11 0081 3.00 $29.07 $87.21
10/29/02 Broom 90085 0.50 $17.63 $8.82
10/30/02 Pick u 20123 6.00 $8.25 $49.50
10/30/02 Backhoe 11 0081 4.00 $29.07 $116.28
10/30/02 Broom 90085 4.00 $17.63 $70.52
10/30/02 Grinder 140100 6.00 $58.95 $353.70
10/30/02 Transfer & Trailer 31082 4.00 $47.94 $191.76
$0.00
EQUIP. TOTAL $1,129.38
MATERIALS
$0.00
$0.00
$0.00
MATERIAL TOTAL $0.00
r".
, n
SERVICES I MISC.
Costs Subtotal (no markup) $3,017.97
Labor Mark-up I~~ 4 $396.24
Materials/EquipmenVServices Mark-up ,~~ $206.87
Submitted by:
TOTAL AMOUNT DUE
fi
$3Ji2-t:07
~ 30470."7
3410. -
4-n.'
Accepted by:
Date:
11 ~2-
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD. oM 1/ ~
Description of work: Valve Switching (CZ-F"1 l ~) INo/qfCP-;. :L7,JrV#Z..
Job No.:
02271-420
Date: 12/16/2002
LABOR
EQUIPMENT
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 0%
Materials/Equipment/Services Mark-up 0%
Subcontract Mark-up 1 0%
$650.00
$0.00
$0.00
$65.00
Submitted by:
TOTAL AMOUNT DUE
$715.00
J
ruction Superintendent
Accepted by:
k') ~
!
Date:
17 'i}tuJ 2.
'r- ""^
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD.
Description of work: Tree Removal & replant ,Ale /2..':;'
~ ,.a~ (~~ '/'I,/#lc6 %1 NIH' "2-)
M "'....
Job No.:
02271-419
Date:
12/16/2002
LABOR
EQUIPMENT
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 0%
Materials/Equipment/Services Mark-up 0%
Subcontract Mark-up 10%
$650.00
$0.00
$0.00
$65.00
Submitted by:
TOTAL AMOUNT DUE
$715.00
ruction Superintendent
Accepted by:
Date:
/7 {?EC oz.
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD.
Description of work: Irrigation RFI 006 + 0 1\
M"L _ IAltJ" eF- '2. 7 "'otl 02.
Job No.:
02271-418
Date:
12/16/2002
LABOR
EQUIPMENT
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 0%
Materials/Equipment/Services Mark-up 0%
Subcontract Mark-up 10%
$3,000.00
$0.00
$0.00
$300.00
Submitted by:
TOTAL AMOUNT DUE
$3,300.00
Accepted by:
. Jr - Co struction Superintendent
f() ~ Date: (7pE!Z.OZ--
/
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD.
Description of work: Soil & mulch testing Mv/.. 11J~t)IC.fD. 27 #fT\I02
Job No.:
02271-417
Date: 12/16/2002
LABOR
EQUIPMENT
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 0%
Materials/Equipment/Services Mark-up 0%
Subcontract Mark-up 10%
$1,194.00
$0.00
$0.00
$119.40
Submitted by:
TOTAL AMOUNT DUE
$1,313.40
onstruction Superintendent
Accepted by:
Date:
11 A::ez:. tJ "Z-
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD.
Description of work: Paul McCarrall Sub work
FC.~
Job No.:
02271-415
Date:
12/16/2002
LABOR
EQUIPMENT
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 0%
Materials/Equipment/Services Mark-up ~
Subcontract Mark-up 10%
$884.92
$0.00
$150.44
$71.72
rfc.--
Submitted by:
TOTAL AMOUNT DUE
$1,107.08
Accepted by:
Date:
/1 pb{., o-z-.
,.....
CITY RECORDER'S COpy Page 1 /2
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520 03611
(541) 488-5300
VENDOR: 000100
L TM INC
POBOX 1145
MEDFORD, OR 97501
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 10th of Month
Req. Del. Date: 09/09/2002
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
SUBTOTAL
TAX
FREIGHT
TOTAL
BILL TO:
~COU(lt Number
E 260.08.12.00.704200
~
;/.f6k Z-
Authorized Signature
VENDOR COPY
.1'.-
Page 2 / 2
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541 ) 488-5300
"bd?'I!!lIill#I!JMae~' .' . 'j
03611
09/17/2002
VENDOR: 000100
L TM INC
POBOX 1145
MEDFORD, OR 97501
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net 10th of Month
Req. Del. Date: 09/09/2002
Speciallnst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown
Confirming? No
U rilt
Change Order NO.5
(A) Bid.Jtem37Arrows Marking
(B) Bid Item 38 Bicycle Lane Stencil
(C) Bid Item 39 Une Markings
Change Order NO.6 - Joint Seal Bridge
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2010
ASHLAND, OR 97520
Accourit.Number
SUBTOTAL
TAX
FREIGHT
TOTAL
1 669 446.84
0.00
0.00
1,669,446.84
Amount '
VENDOR COPY
..,.....---
CITY OF
ASHLAND
A request for a Purchase Order
REQUISTION FORM
Date of Request:
THIS IS A REQUEST FOR A:
Required Date of DeliveryIServicel~$AP 'j
[X ] Change Order (existing PO# 3611 Schedule C)
Vendor Name:
Address:
City, State, Zip
Phone:
Project Title:
Project Number:
LTM INCORPORATED
PO BOX 1145
MEDFORD OR 91501
ASHLAND STREET RECONSTRUCTION
99-38
Services Only Solicitation Proces$:
[ ] Exempt ( ] 3 Written Quotes (copies
attached)
[ ] Sole Source (X] Invitation to Bid (copies on
file)
[ ] Less than $5000 ( ] Request for Proposal (copies
on file)
Description
Total Cost
B. Bid Item 38 Bicycle Lane Stencil
Siskiyou Blvdl Ashland St Reconstruction Project
Change Order No.3-Sign Post Credit
Change Order NO.4 -Bi-Directional Markers
Change Order NO.5 ( Items A, B & C Total)
A. Bid Item 37 Arrows Markings
C. Bid Item 39 Line Markings
Change Order NO.6 - Joint Seal Bridge
Total Prior Change Orders Nos. 1 & 2
Account Number
260.08.12.00.104200
Employee Signature:
NOTE: By signing this requistiion form
Supervisorl Dept. Head Signature:
the above request meets with Gtiy of Ashland Solicitiation Process requirement and can
GPubwrkslEngl99-38 L TM CO 3 4 5 6 Requisition xis
Updated on: 7/15/02
-" '.'1"""- --, ---.. '"-
CITY OF
ASHLAND
CITY OF ASHLAND
DEPARTMENT OF PUBLIC WORKS
PROJECT:
LOCATION:
CONTRACT CHANGE ORDER NOS. 3,4. 5 & 6
ASHLAND STREET REDESIGN DATE: JANUARY 23,2003
ASHLAND STREET
PROJECT NO.: 99-38
CONTRACTOR: 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 Description Quantity Unit Price Amount
No.
CO 3 Sign post credit Lump Sum $ -(960.00) $ -(960.00)
C04 Bi-directional markers 1 78 EA $5.45 $970.10
CO 5 Adjustments to Bid Items 37,38 & 39
Item 37 Arrow Markings Credits 8 EA $351.00 $688.00
Item 38 Bicycle Lane Stencil Credit 8 EA $405.00 $945.00
Item 39 Line Markings 1291 SF $8.91 $-(3,090.69)
CO 6 Bridge Joint Sealing Lump Sum $1,471.13 $1,471.13
Total this Change Order
Previous Change Order
Revised Contract Total
$23.44
$31,964.08
$692,254.14
Recommended By:
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 will apply.
;(J (J PL -
Engineer P' t:/
~
jEngineer
13/~3
Dat
Approved By:
f~O?/
Date
Accepted By:
L TM Incorporated
PO Box 1145
Medford OR 97501
~ tt:.~-..
on tractor
/~I/() :5
Date
ENGINEERING
20 E. Main Street
Ashland, Or~on 97520
WWW.aShland.or.us
Glpub-wrkslengldepl-adminIENGINEERIPROJECT\1999199-38 L TM Sch C CO 3 4 5 6.doc
Tel: 541-488-5347
Fax: 541-488-6006
TTY: 800-735-2900
r.,
'..,.-..............--.-.
, Szigeti Construction Inc.
6684 Table Rock RD
Central Point, Oregon 97502
" IClli-BAN"
Invoice
DATE INVOICE NO.
1212012002 12066
BILL TO
LTM
POBOX 1145
MEDFORD, OR 97501
SERVICED
TERMS
JOB NO.
Net 15
ITEM
DESCRIPTION
QTY
RATE
AMOUNT
12/1812002
ASHLAND ST - BRIDGE
BRIDGE JOINT cm, WASH, DRY, SEAL AlC
135
8.00
1,08(
~,,\
I\\"
Ol}.~ 0
bO
TIIANK YOU
Total
$1,080.00
Phone #
Fax #
y
541-8~O-5733
541-830-8733
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CONTRACTORS
LIC. 62352
PROPOSAL
APPL Y..A-LINE, INC.
PO Box 905n
PortJand, OR 97290
(503) n7-4228 · FAX (503) m....390
ATTENTION:
LTU
*" ONI--i UjEP /78 HIJRKE1?S.
/JI:J:j Q~5 /9 - /CT/#L 11F7FR
nlff?KVP Or $ 770 ~
PROJECT:
lib-.
If
Siaklyou Blvd. ADO
11/1212002
DE8cRPnoN
PLAN
QTY
UNIT
~
TOTAL
BID
BIO DATE:
ADO ~ra 215 IEA- 4.950 $ 1 361.25
I .
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.
;
!
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lOTAL :miWI
81puUTIONS~ GENERAL CONTRACTOR TO PROVIDE UYOtIt .. TRAFFIC CONTROL
EXClUDES FU:XllLf.IWU(aW
IDO/o nV.\t.K~
li ~ L(.~ fAG~
THANK YOU FOR THE OPPORTUNITY TO Quott THIS PROJEOT WITH
YOUR COMPANY.
p~IIES INCLUDE IIATE~N,
WSi,AlLATION. BONr). .&
INS4RANCE. PRICES GOOD ~
CO~TRACT IS RECEIVED WITHIN
30 $. l'S OF AWAAD, AFTER 30
DA . PRICES MUST BE
REN GOTlATED.
SltfCEREL Y,
/1JJAA,r
MARK tENNING
ESTIMATOR
"'"T""'""'---' _....~ 0..
ceo ~ (p
L TM Incorporated
Time and Materials Billing Summary
Project Name: SISKIYOU BLVD/A?t-H.ANO S~ f)1t(obT; Job No.:
Description of work: TP & DT Falgging for Zsigeti Construction
~\D~b GC2AaL SlE::iALI 4.'- Date:
02271-421
LABOR
32.94
0.50 27.74 37.88
LABOR TOTAL
EQUIPMENT
$8.25
0.50 $8.25
EQUIP. TOTAL
MATERIALS
SERVICES I MISC.
Costs Subtotal (no markup)
Labor Mark-up 22%
Materials/Equipment/Services Mark-up 17%
$1,251.12
$32.20
$187.81
TOTAL AMOUNT DUE
Submitted by:
$1,471.13
John Lotito, Jr - Construction Superintendent
Accepted by:
Date:
~ ..,...----. ..._- ..
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER'S COPY Page 1,1
0-~~ j 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 Pr ~ Ext Price
THIS IS A REVISED PURCHASE ORDER
BLANKET PURCHASE ORDER
Contract for the Siskivou BIvd Redesi.qn 802 592.60
Pro ect 99-38B. This requisition is
applicable to Bid Schedules A, C, & D
only, Bid Schedule B will require a
separate requisition.
Bid Schedule A -
Bid Schedule C - 660,266.62
Bid Schedule D - :~ 174,600.00
Contract date: Au.qust 28, 2002
Start date: September 9, 2002
Completion date: March 2003
I Insurance required/On file
Revised purchase order 01-22-2003. 18,000.00
Ohan.qe Order No. 1, CTB Excavation &
Haul Away
Revised purchase order 01-22-2003 13,964 08
Chan.qe Order No. 2, Multiple Proiects,
I See attached list.
SUBTOTAL 1,669,423.30
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 1,669,423.30
ASHLAND, OR 97520
E 260.08.12.00.704200 1,669,423.30
Au~[7~'d"~ i g n a t u~e
VENDORCOPY
A request for a Purchase Order
REQUISTION FORM
THIS IS A REQUEST FOR A:
[X ] Change Order (existing PO# 3611
CITY OF
-ASHLAND
Required Date of Delivery/Sew celASAB ]
Vendor Name: LTM INCORPORATED
Address: PO BOX 1145
City, State, Zip MEDFORD OR 97501
Phone:
Project Title: ASHLAND STREET RECONSTRUCTION
Project Number: 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 0nly
Description Total Cost
Siskiyou Blvd/Ashland St Reconstruction Project
Change Order No. 1
Change Order No. 2
Account Number 260.08.12.00.704200
*Please attach the Original s)gned contract and Insurance Certificates
Account Number
/,,. ," / .? ,~'
Employee Signature: [),~.,~/~' ; ,;;'~'. ~ Supervisor/Dept. Head Signature:
NOTE: By signing this requistiion fon'n, ~ cedif~ tha the ab~ve request meets with Ctiy ~f Ash~and $~i¢itiati~n Pr~cess requiremeFfs and can 5e pr~vided when necessary.
G Pubwrks\Eng~99-38 CO 1 & 2 Requisition xls
Updated on: 7/15/02