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Home My WebLink About2002-202 CONT Chg Order #1-9 - LTM IncCITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS CONTRACT CHANGE ORDER NO. 1, 2, 3.4, 5, 6, 7, 8 , 9 LL °«T Mr-.`-N INTGLSEGZ'r4Q orA PROJECT: 'k ig) `'T LOCATION: StS K ? Yo V ML-\/D DATE: MARCH 27, 2003 PROJECT NO.: 99-38 (Schedule A) 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 Concrete removal at median under asphalt Lump Sum $346.75 $346.75 CO 2 Utility trenching on 3rd St. 11 +52 extra crossing (electric to reimburse) Lump Sum $4,656.88 $4,656.88 CO 3 Sub-Excavation Christmas Tree Island Lump Sum $1,702.14 $1,702.14 CO 4 Regrade curb & sidewalk at 3'd St. curb height issue w/ W&H Sta 10+50 Lump Sum $379.16 $379.16 CO 5 Remove curb & sidewalk at 3`d St Lump Sum $1,000.00 $1,000.00 CO 6 Fire line testing Sta 8+70 Lump Sum $380.00 $380.00 CO 7 Regrade curb @ 3rd and Lithia Way curb height issue w/ W&H Sta 11 + 75 (power pole) Lump Sum $310.50 $310.50 CO 8 Replacement traffic control signs Lump Sum $213.90 $213.90 CO 9 Curb form removal at 3rd St and Lithia Way Lump Sum $966.24 $966.24 Original Contract Total these Change Orders Previous Change Order j)6U2, 7y2.bU $9,955.57 $0.00 Revised Contract Total $812,548.17 The time provided for completion of this contract is increased by no calendar days. This document shall become an ame d ent to the contract an II provisions of the contract will apply. Recommended By: 3 3/ a3 ngineer Da Approved By: f E gineer Date Accepted By: LTM Incorporated PO Box 1145 Medfo OR 97501 "/ a ??? 34 W0 3 Contractor Date ENGINEERING Tel: 541-488-5347 20 E. Main Street Fax: 541-488-6006 Ashland, Oregon 97520 TTY: 800-7355-2900 -2900 www.ashland.or.us G:1pub-wrkslengldept-admin\ENGINEERIPROJECT11999199-38 Sch A C01 thru 9.doc TM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Description of work: Concrete Removal @ Median LAN PFa t A-S'FG40A T LABOR Job No.: 02271-01 Date: 01/07/2003 ST OT ST OT .,, DATE CLASS N/AMf= HOURS HOURS RATE RATE:, ". TOTALS 01107/03 Foreman L. Battenfield 2.00 32.94 $65.88 01/07/03 Teamster G. Kerth 2.00 24.59 $49.18 LABOR TOTAL $115.06 EOUIPMENT E.QUIP.. ,. NO.OF DATA. DESCRIPTION NP,'!::' HOURS RATE TOTAL:. 01/07/03 Cat 320CL Excavator 150062 2.00 $60.48 $120.96 01/07/03 LTM 12 yd Super 31081 2.00 $32.75 $65.50 EQUIP. TO TAL $186.46 MATERIALS UNIT. DATE -' DESCRIPTION ` QTY: UNIT ; PRICE' ,Discount' TOTAL MATERIAL TOTAL $0.00 SFRVICES / MISC_ , iNV. DATP Q .:'SCRIPTION .. N.O. .. AMOUNT TOTAL ; SERVICES TOTAL $0.00 Costs Subtotal (no markup) $301.52 Labor Mark-up 15% $17.26 Materials/Equipment/Services Mark-up 15% $27.97 TOTAL AMOUNT DUE Submitted by: Q34_L?-- hn Lo i o, Jr - C struction Superintendent Accepted by: _ Date: _1?4 ??? / / CZ $346.75 2 1 AA 4.i2 0 3 TM DAILY EXTRA WORK REPORT Date: c Foreman: ?j. r-"cc N?? Job Name: lj -sK-`7CD D 6kvj Job No: OZZ-1 k - 0l EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK V ? y 4 I- MATERIALS USED DESCRIPTION SUPPLIER QTY. MISC LLANEOUS SUB, HAULERS, MOBS ok e r CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS Z-- RENTAL EQUIPMENT EQUIPMENT NO. HOURS K/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report LTM Incorporated Time and Materials Billing Summary Project Name: Description of work LABOR SISKIYOU BLVD. SCH. A Utility Trenching on 3rd St. t14-07. E?Cr2?cR-oss c. - 9Z4Lr "C, 17D /1&1 M (3 Job No.: 02271-04 Date: 02/05/2003 02/10/2003 ST OT ST OT. ` DATE `CLASS NAME. HOURS HOURS RATE " RATE TOTALS . 02/05/03 Foreman Miller 2.50 32.94 $82.35 02/05/03 Operator Thoren 2.50 32.37 $80.93 02/05/03 Operator Butler 2.50 32.37 $80.93 02/05/03 Teamster Fulton 3.00 24.59 $73.77 02/06/03 Foreman Miller 8.00 32.94 $263.52 02/06/03 Operator Thoren 8.00 32.37 $258.96 02/06/03 Operator Butler 8.00 32.37 $258.96 02/06/03 Teamster Fulton 7.25 24.59 $178.28 02/07/03 Foreman Miller 1.50 32.94 $49.41 02/07/03 Operator Thoren 1.50 32.37 $48.56 02/07/03 Operator Butler 1.50 32.37 $48.56 02/10/03 Operator Marez 6.00 32.37 $194.22 02/10/03 Laborer Farris 5.00 27.74 $138.70 02/10/03 Foreman Easter 5.00 32.94 $164.70 02/10/03 Foreman Miller 1.00 32.94 $32.94 02/10/03 Operator Thoren 1.00 32.37 $32.37 02/10/03 Operator Butler 1.00 32.37 $32.37 02/10/03 Teamster Johnson 1.00 24.59 $24.59 LABOR TOTAL $2,044.10 EQUIPMENT EQUIP. NO. OF :" bATE DESCRIPTION . N6.77. , HOURS' RAATE :'. -7' TOTAL ` :. 02/05/03 Pickup 20124 2.50 $8.25 $20.63 02/05/03 JD 410E Backhoe 110083 2.50 $29.07 $72.68 02/05/03 LTM Transfer 31058 3.00 $47.94 $143.82 02/06/03 Pickup 20124 8.00 $8.25 $66.00 02/06/03 JD 410E Backhoe 110079 7.00 $29.07 $203.49 02/06/03 LTM Transfer 31058 7.25 $47.94 $347.57 02/07/03 Pickup 20124 1.00 $8.25 $8.25 02/07/03 JD 410E Backhoe 110079 0.50 $29.07 $14.54 02/10/03 JD 410E Backhoe 110079 6.00 $29.07 $174.42 02/10/03 Pickup 20124 1.00 $8.25 $8.25 02/10/03 JD 410E Backhoe 110079 0.50 $29.07 $14.54 02/10/03 LTM Transfer 31082 1.00 $47.94 $47.94 EQUIP. TO TAL $1,122.11 MATERIALS UNIT DATE DESCRIPTION QTY. UNIT PRICE Discount TOTAL 02/07/03 Slur 5 c $45.60 $228.00 02/10/03 Rogue A Sand 14.67 ton $4.00 $58.68 02/10/03 Slur 9 c $45.60 $410.40 MATERIAL TOTAL $697.08 SERVICES / MISC. INV.. DATA,', DESMOTION NO.<.: AMOUNT TOTAL ;. 02/05/03 LLAD/ Saw Cutting 221 FT 4348 $194.70 $194.70 SERVICES TOTAL $194.70 Costs Subtotal (no markup) $4,057.98 Labor Mark-up 15% $306.61 Materials/Equipment/Services Mark-up t5f/o 10 $302.08 ?v LF•& s066, 04v, TOTAL AMOUNT DUE Submitted by: ?? 4M ? A&V J Lotit r - Co truction Superintendent Accepted by: Date: $4,666.68 { -10 `?'? ? L`StO •g? ?w A,0-1 03 LTM DAILY EXTRA WORK REPORT Date: Z- j =0 3 Foreman: Ili Job Name: /% 41 Job No: a z i 71-0 Y EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK la.r! MATERIALS USED (DESCRIPTION SUPPLIER - QTY- I MISCELLANEOUS SUB, HAULERS, MOBS no T)V CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS r-L c, Z ?. c `AZ 3 !v a g( O 4c.1 `v RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report ; LTM DAILY EXTRA WORK REPORT Date: Foreman: Job Name: ?";•r,(r •?,? Job No: 2 -?/-0 Y- EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK / ti G+ 11 • / ? L L- .1 MATERIALS USED DESCRIPTION SUPPLIER QTY, I COMPANY EQUIPMENT EQUIPMENT NO. HOURS MISCELLANEOUS (SUB, HAULERS, MOBS) I CUSTOMER SIGNATURE RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report LTM DAILY EXTRA WORK REPORT Date: a v X c 5 Foreman: ,llle?,. Job Name: ?'; _r ?c 'c,• /5?.: Y Job No: -'- 7 /_` "/- EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK Gra-?? ? CJ 3 /-mow 5 - MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS SUB, HAULERS, MOBS CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS RENTAL EQUIPMENT EQUIPMENT NO. HOURS K/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report TM DAILY EXTRA WORK REPORT Date: 7,-10-63 Foreman: . &-, -:-? / Job Name: Job No: 0071-- 0 & EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK P? 1# 4 e LsYs P 98 ?"?r 7'2 So C t.s ., e P ' rZJk? ?r ?' ,?[> V1- /,a9L < w MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS (SUB, HAULERS, MOBS) CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS MOC7 ? to RENTAL EQUIPMENT EQUIPMENT NO. HOURS K/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report TM DAILY EXTRA WORK REPORT Date: p 3 Foreman: Job Name: Job No: G Z 7- 7 / - o ?- EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK It / C v > / < li s MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS (SUB. HAULERS. MOBS) CUSTOMER SIGNATURE I COMPANY EQUIPMENT EQUIPMENT NO. HOURS RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report ?L.L.A.D. INC. P.O. BOX 516 MEDFORD, OR 97501-8526 BILL TO L.T.M. P.O. BOX 1145 MEDFORD, OR 97501 Invoice DATE INVOICE # 2/11/2003 4348 SHIP TO L.T.M. P.O. BOX 516 MEDFORD, OR 97501 P.O. NO. TERMS CODE # K2-))lSJ Net 30 02271-04 20500 DATE ORDERED DESCRIPTION SS AMOUNT 3RD ST., ASHLAND. 2-5-03 Saw cut 221 ft. of 7 in. asphalt @ $ .70 ft. = $ 154.70 SAW CUT 194.70 4 curb & gutter cuts @ $ 10.00 each = $ 40.00 Thank you for your business. Total $194.70 LOCATION OF JOB aC?iC?iG3C?C?Q?C??4 arc P.O. BOX 4430 • MEDFORD, OR 97501 R/ A K I FZT AND ].'i-t 1 iknfI Rgrad Jq , Mec'.l'ord, OR 97501 120329 120829 Operations Phone (541) 664-4155 EQUAL OPPORTUNITY EMPLOYER DATE TIME CUSTOMER PRODUCT HAULER TRUCK P.O. NO. LOCATION 0 =f .I. III / 0,-3 1:44 61 I i /j 1082' 1. 9-.lItiiq lir4.?ORPORAi-E.0 Glttvloclay: 14.67 m i-2ER": T 1--04 • : 2.4171.1.5 POUNDS TONS ,.... GROSS: 5 c ?v w ti I SV OYOU AND 3RD ST. DELIVER TO TARE: 24520 1 ??. ;?6 NET 29340 14.67 PA- LUNI) WEIGHMASTER CUSTOMER SIGNATURE DRIVER r QUANTITY QUANTITY THIS LOAD ORDERED QUANTITY PRODUCE DELIVERED CODE PRODUCT UNIT OF" DESCRIPTION MEASURE TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE; . :OMMERCIAL RESIDENTIAL EXTRA ADMIX ARRIVE JOB; LEFT JOB: IELIVERY INSTRUCTIONS TOTAL ;PECIAL INSTRUCTIONS A 'W rAn Equal Opportunity Employer TICKET # 79437 "Rock Solid Quality and Service" TERMS: Net 10th day of month following date of invoice. A late payment Service Charge of 2% per month will be charged on accounts 30 days past due from date of billing. This Service Charge is an Annual Percentage Rate of 24%. Minimum Service Charge $1.00. CAUTION May cause eye or skin injury. Contains Portland cement. Freshly mixed cement, mortar, concrete, or grout may cause skin injury. TAKE THESE PRECAUTIONS: 1. Avoid all contact with eyes. 2. Wear rubber boots and qloves, and avoid prolonged contact TELI Concrete and Rock Dispatch Concrete Store ............ Operations and Asphalt ..... Administration and Business. General Contractor P.O. www.itminc.com UNLOAI Drivers are prohibited from delivering co power, and where site conditions permi his equipment. Drivers are not permitter the maximum slump nor to go beyond thl zation of the customer and his acceptal directly with skin or through porous materials. WATER ADDED AT 3. In case of contact with skin or eyes, FLUSH THOROUGHLY CUSTOMERS REQUEST WITH WATER. tl If irritation ersists et medical attention rom 4 _-gals. to full load p , g p p . y. * 5. Keep children away. NEED 2/3 Joaq t1 ' ---gals. to '1/3 load c "WHERE WOULD CUSTOMER ID PA: NUMBER ZONE JOB NUMBER TIME DATE 6 00'-1 02271-04 10 FJ SOLD TO DELIVER TO LTM INC. SISKIYOU BLVD NEAR 3RD ST PLEA! P 0 BOX 1145 ASHLAND DRIVER MEDFORD, OR 97501 PHASE: 24015 6 LI QUANTITY THIS LOAD QUANTITY ORDERED QUANTITY DELIVERED PRODUCT CODE PRODUCT DESCRIPTION UNIT O' MEASU 9.00 9.00 9.00 3SK SK SLURRY Y TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE C AL REST EXTRA AA N ARR JO LEFT JOB: TOTAL DELIVERY INSTRUCTIONS SPECIAL INSTRUCTIONS LTM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-07 Description of work: Sub Excavation Christmas Tree Island Date: 02/12/2003 LABOR ST ..; O ST.... OT DATE <. CLASS " :.':NAME : HOURS HCJtJ:RS RATE. RATE TOTALS' 02/12/03 Foreman Miller 6.00 32.94 $197.64 02/12/03 Operator Thoren 6.00 32.37 $194.22 02/12/03 Operator Butler 6.00 32.37 $194.22 02/12/03 Teamster Groom 7.75 24.59 $190.57 LABOR TOTAL $776.65 EQUIPMENT EQUIP. NQ-, OF DATE . DESCRIPTION NO... " HOURS RATE' _77777 TOTAL 02/12/03 pickup 20124 6.00 $8.25 $49.50 02/12/03 JD 410E Backhoe 110079 5.00 $29.07 $145.35 02/12/03 DD35 Roller 120020 3.00 $20.16 $60.48 02/12/03 LTM 12 d 31042 7.75 $32.75 1 1 $253.81 EQUIP. TO TAL $509.14 MATERIALS UNIT . DATE DESCRIPTION QTY; -" ; UNIT PRICE DIsCOunt TOTAL" 02/12/03 Quality Rock/ 3/4"-0 rock 41.79 ton $4.65 $194.33 02/12/03 LTM/Fabric 110 d $0.00 $0.00 MATERIAL TOTAL $194.33 SERVICES / MISC. INV. DATE DESCRIPTION NO. AMOUNT TOTAL SERVICES TOTAL $0.00 Submitted by: Accepted by: Costs Subtotal (no markup) Labor Mark-up 15% Materials/Equipment/Services Mark-up 15% TOTAL AMOUNT DUE tendent Date: -u A4-o" d 3 $1,480.12 $116.50 $105.52 $1,702.14 LTM DAILY EXTRA WORK REPORT Date: z - / Z -v 3 Foreman: Z e Z-- Job Name: Job No: a z z-2/- p 7 EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK / e FU S? -e -•St ?r4 (? v U s-a 16 MATERIALS USED DESCRIPTION SUPPLIER QTY. .-•'c &-v- s 2?j e / MISCELLANEOUS (SUB, HAULERS, MOBS) gap'v CUSTOMER SIGNATURE 'l?dr lt?.s COMPANY EQUIP MENT EQUIPMENT NO. HOURS 7 3ivYZ ? ? 3 RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report • z 0 Y cr_ - cc T CL a:i l W a u1 ti C) a 0 r4 __. ? U Q ? W 0 IL V Z o, N W Lu LO V ? 2 O z (l O C) ? O -• m m O EL 0 c W Q) cc: O 0) LL V ¢ O wc G m cm O • f+ ? p F Lu C ,T J o a ' x ma o I II I I i I LD w ? g i 7 U I I 1 i J '? I tom. f 1 ?„? I I • i • H U ? C7 ?I , w I C= i I .. i z M O C) O C J a.` h i3 Li 'U, 11"USU i?a.. w r._ 10 ` a . o ? O W Q d • L N Lij CY) v z ci O : U DA °' 00 ?Y 0) O z . - ,. Q f U Q 0 LL -. " v 0 ea - LL O M O 4iJ '?'' ''_ L LL! • w Q C7 ? ? i Il i I 00 M CD CY 1t. tr ., ?.i ? Y Y U " W O W J D// V Z Q Q -? U j ? Q ? W O W a u N O T F- W w v ° z ci O U w 0?cr- m?O > Q C1 c f: W cr w 2 O)o ?C p 0) LL u f ' Q 0 0 (D m O • ?cc C> lzr F O Cl) 0 4 W i- - (O C JO d> o _ x y O > m ;r i CJ e I ii I W ' H Q J ? 3 I Ir ¢ W 0 - r-- z LTM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A S%Uoo totso Job No.: 02271-09 6 _$ „? Job No.: 02271-09 Description of work: Regrade Curb & Sidewalk @ 3rd Street -- CU (L6 q&tt, "'r v5suz - w Date: 02/20/2003 LABOR ST OT. ST .:> QT PATE: CLASS " NAME HOURS HOURS: RATE RATE:. T.C)1'AES 02/20/03 Foreman Miller 2.50 32.94 $82.35 02/20/03 Operator Thoren 1.50 32.37 $48.56 02/20/03 Operator Butler 1.50 32.37 $48.56 02/20/03 Teamster Patee 1.501 1 24.591 1 $36.89 LABOR TOTAL $216.35 EQUIPMENT EQUIP N.Q< OF l it. DATE DESCRIPTION NO ; HOURS RATE TOTAL 02/20/03 pickup 20124 2.50 $8.25 $20.63 02/20/03 JD 410E Backhoe 110079 1.50 $29.07 $43.61 02/20/03 LTM Bobtail 31078 1.50 $32.75 $49.13 EQUIP. TO TAL $113.36 MATERIALS UNIT. . DATE DESCRIPTION ; QTY. 1, ::UNIT " PRICE'. ' Discount 70TAL' MATERIAL TOTAL $0.00 SERVICES / MISC. GATE I5:EsCRIPTION, , NO. AMOUNT.:. TOTAL SERVICES TOTAL $0.00 Costs Subtotal (no markup) Labor Mark-up 15% Material s/Equ ipment/Services Mark-up 15% TOTAL AMOUNT DUE Submitted by: in W) I "/ J Lotito, r - Construction Superintendent Accepted by: Date: $329.70 $32.45 $17.00 $379.16 LTM DAILY EXTRA WORK REPORT Date: 2 - Zu - v 3 Foreman: xyz-11lec.- Job Name: Job No: v z z 71- a 9 EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK ?- O Z' Z•- ? s ct?i-? MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS SUB, HAULERS, MOBS j?dv?? CUSTOMER SIGNATURE COMPANY EQUIP MENT EQUIPMENT NO. HOURS Z,V 1 -2 S4 < Z L-- / f uli7'I te.G c (v7 /J« J?G? ? l G ec' 2 RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report LTM Incorporated Time and Materials Billing Summary Project Name: Description of work: LABOR SISKIYOU BLVD. SCH. A Rem9?ve Curb & Sidewalk @ 3rd Street 1rt., P??t- 2bd2.tJF?35" Job No.: 02271-10 Date: 02/20/2003 02/24/2003 ST.,. OT.., . : ST OT.: DATE . CLASS. .. NAME HOURS HOURS RATE.. ` RATE' TOTALS 02/20/03 Foreman Miller 2.50 32.94 $82.35 02/20/03 Operator Thoren 2.00 32.37 $64.74 02/20/03 Operator Butler 2.00 32.37 $64.74 02/20/03 Teamster Patee 2.75 24.59 $67.62 02/24/03 Foreman Miller 3.00 32.94 $98.82 02/24/03 Operator Thoren 3.00 32.37 $97.11 02/24/03 Operator Butler 3.00 32.37 $97.11 LABOR TOTAL $572.49 EQUIPMENT EQUIP. OF. DATE DESCRIPTION NO HOURS RATE. TOTAL 02/20/03 pickup 20124 2.50 $8.25 $20.63 02/20/03 JD 410E Backhoe 110079 2.00 $29.07 $58.14 02/20/03 LTM Bobtail 31078 2.75 $32.75 $90.06 02/24/03 pickup 20124 3.00 $8.25 $24.75 02/24/03 JD 410E Backhoe 110079 3.00 $29.07 $87.21 EQUIP. TO TAL $280.79 MATERIALS UNIT' DATE DESCRIPTION QTY.` l1NIT ;° F?RfCE pisaount TOTAL MATERIAL TOTAL $0.00 SERVICES / MISC. INV. DATE DESCRIPTION NO. AMOUNT TOTAL 02/20/03 LLAD/Saw Cutting 81ft A/C 4381 $85.00 $85.00 SERVICES TOTAL $85.00 Costs Subtotal (no markup) Labor Mark-up 15% Materials/Eauiament/Services Mark-uD 15% Submitted by: Accepted by: TOTAL AMOUNT DUE tendent $938.28 $85.87 $54.87 $1 .02 I,- T, W Date: ::xl k0 L^ 0-5 TM DAILY EXTRA WORK REPORT Date: z - zc' -0 3 Foreman: /l-le/,, - Job Name: 5i:y4 ' Job No: d Z- Z7/- /O EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK 2-7 -c Z 3? uv? ? C?..c?•..T-• MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS SUB, HAULERS, MOBS _ 541 / ^f ? =?sT L..e G 4 3 COO pS1 CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS ?? G e 2 Y6 RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report LTM DAILY EXTRA WORK REPORT Date: Foreman: Job Name:/S/<< Job No: p) Z.7/-/0 EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK I MATERIALS USED DESCRIPTION SUPPLIER QTY. I MISCELLANEOUS (SUB, HAULERS, MOBS) I PGvv??C it /?u?l? c7 St, 3 i?Gc icy yc 2c? Cv jz ?? 77e CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS v 2 3 l? 7 3 RENTAL EQUIPMENT EQUIPMENT NO. HOURS H:/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report L.L.A.D.1NC. P.O. BOX 516 MEDFORD, OR 97501-8526 BILL TO L.T.M. P.O. BOX 1145 MEDFORD, OR 97501 1? \ Invoice DATE INVOICE # 2/24/2003 4381 SHIP TO L.T.M. P.O. BOX 516 MEDFORD, OR 97501 P.O. N N\ TERMS JOB # CODE # HC230139 Net 30 DATE ORDERED DESCRIPTION CLASS AMOUNT 2-20-03 3RD ST & SISIKYOU BLVD., ASHLAND. Saw cut 81 8. asphalt & concrete. SAW CUT 85.00 Thank you for your business. Total $85.00 LOCATION OF JOB COPY TM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Description of work: Fire Line Testing LABOR Job No.: 02271-11 Date: 02/21/2003 ST... OT ::ST OT:'' . DATE CLASS NAME HOURS HOURS".` RATE RATE TOTALS 02/21/03 Foreman Miller 6.50 32.94 $214.11 02/21/03 Foreman Easter 4.00 32.94 $131.76 LABOR TOTAL $345.87 EQUIPMENT ' EQUIP NO. OF DATE . DESCRIPTION NO. . < ..HOURS ROTE `TOTAL 02/21/03 pickup 20124 4.00 $8.25 $33.00 02/21/03 pickup 20078 6.00 $8.25 $49.50 EQUIP. TO TAL $82.50 MATERIALS UNIT DATE DESCRIPTION QTY. UNIT PRICE ' Discount ` "TOTAL ' MATERIAL TOTAL $0.00 SERVICES / MISC. INV. DATA DESCRIPTION NO. AMOUNT. TCT l..".. SERVICES TOTAL $0.00 Submitted by: Accepted by: Costs Subtotal (no markup) Labor Mark-up 15% Material s/Equ ipment/Services Mark-up 15% TOTAL AMOUNT DUE tendent $428.37 $51.88 $12.38 $4 Vt_3 Date: .2 / AAA,& 03 TM DAILY EXTRA WORK REPORT Date: z - ??- 03 Foreman: ?,?j?`? Job Name: ql ,'U /3 4 eo Job No: 0Z 27 / - EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK . C: I S ra-?K ?L ae7 r MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS (SUB. HAULERS. MOBS) COO p?' CUSTOMER SIGNATURE COMPANY EQUIPMENT EQUIPMENT NO. HOURS 7iJa7 f 1 (10 RENTAL EQUIPMENT EQUIPMENT NO. HOURS 1114 K/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report r> . LTM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Job No.: 02271-14 Description of work: Replacement Signs Date: 03/06/2003 LABOR ST OT -ST QT DATE CLA$S'.. NAME HOURS HOURS RATE: RATE ":: TQTAIS,: LABOR TOTAL $0.00 EQUIPMENT EQUIP NO OF DATE DESCRIPTION. NO. HOURS . RATE TOTAL EQUIP. TOTAL $0.00 MATERIALS UNIT DATE DESCRIPTION QTY.. UNIT PRICE Discount TOTAL. MATERIAL TOTAL $0.00 SERVICES / MISC. INV. . DATE DESCRIPTION NO: :AMEOU. NT TOTAL,. 03/07/03 Cantel/(6) 12"x24" Sidewalk Closed 14832 $186.00 $186.00 SERVICES TOTAL $186.00 Costs Subtotal (no markup) $186.00 Labor Mark-up 15% $0.00 Materials/Equipment/Services Mark-up 15% $27.90 Submitted by: Accepted by: TOTAL AMOUNT DUE $213.90 tendent Date: 3 TM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Description of work: Regrade curb @ 3rd & Lithia St. po-%2 fOUS w¢6 rt&«1+U 15S C- ,J (1+'7?i LABOR W S µ sr w P?J-&W ?u a o y's c&si sZ& FoR Job No.: 02271-12 Date: 02/25/2003 ST OT: .ST OT . DATE GLASS NAME HOURS HOURS RATE RATE TOTALS. 02/25/03 Foreman Miller 2.00 32.94 $65.88 02/25/03 Operator Thoren 2.00 32.37 $64.74 02/25/03 Operator Butler 2.00 32.37 $64.74 LABOR TOTAL $195.36 EQUIPMENT EQUIP _ NO.OF DATE DESCRIPTION NO. : HOURS RATE TOTAL : . 02/25/03 pickup 20124 2.00 $8.25 $16.50 02/25/03 JD 410E Backhoe 110079 2.00 $29.07 $58.14 EQUIP. TO TAL $74.64 MATERIALS UNIT:.. DATE DESCRIPTION QTY. UNIT PRICE Discount TOTAL° MATERIAL TOTAL $0.00 SERVICES / MISC. INV. DATE DESCRIPTION NO.: AMOUNT T.OTAL.' SERVICES TOTAL $0.00 Costs Subtotal (no markup) $270.00 Labor Mark-up 15% $29.30 Materials/Equipment/Services Mark-up 15% $11.20 TOTAL AMOUNT DUE $310.50 Submitted by: ` J n Lotit r - Construction Superintendent Accepted by: n Date: 2-1 A4J1" °3 LTM DAILY EXTRA WORK REPORT Date: Z._ z ?3 Foreman: , /l/l, /?,, , Job Name: 5,5 yvc. 131,,1 7 Job No: _Q Z 17 /-/ Z EMPLOYEE NAME CRAFT RATE ST. HOURS OT. HOURS DESCRIPTION OF WORK w MATERIALS USED DESCRIPTION SUPPLIER QTY. MISCELLANEOUS SUB, HAULERS, MOBS COO Gp5`7 CUSTOMER SIGNATURE X-1/r, COMPANY EQUIPMENT EQUIPMENT NO. HOURS 2vr Z ,'!G ?G? riv7 7 ?? o ?G ?. Z.. I?- RENTAL EQUIPMENT (EQUIPMENT NO. HOURS K/Contracting/Jenn's Reports, etc./Misc Forms/Daily Extra Work Report q__ LA fu gr? F M E D F O R , I N C LTM, INC. PO BOX 1145 Medford, OR CANTEL OF MEDFORD, INC. 3981 CRATER LAKE HWY. MEDFORD, OREGON 97504 (541) 773-2765 97501 Telephone: 541-779-6304 Page Number........ 1 Invoice Number..... 014832 Invoice Date..... 3/ 7/03 P.O. # HC230205 P.O. Date: 3/ 6/03 SALES CHARGES 5111883 Sd 1211242 SIDEYAL[ CLOSED SOLD 6 31.90 186. N SALES SUBTOTAL: 186.00 Terms: Net 30 days from date of invoice. 11/2% per month will be charged if not paid within 30 days of invoice date. 011151mL THANK YOU - We Appreciate Your TOTAL N111hTAYABLE: Ta: IYVOICE TOTAL: 186.80 9.90 186.90 E-SEE 186.90 LTM Incorporated Time and Materials Billing Summary Project Name: SISKIYOU BLVD. SCH. A Description of work: Curb Form Removal LABOR Job No.: 02271-15 Date: 03/25/2003 OT ST OT'. DATE CLASS NAME HOURS MQURS RATE ] RITE < TOTALS LABOR TOTAL $0.00 EQUIPMENT EIIF N0 0.;.., DATE : DESCRIPTION NO: HOURS '..; RATE TOTAL..: EQUIP. TOTAL $0.00 MATERIALS UNIT DATE. 618CRIPTIO.N QTY UNIT PRICE Discount TOTAL MATERIAL TOTAL $0.00 SERVICES / MISC. INV '`. DATE. DESCRIPTION N:O:. AMQUNT: TOTAL 03/25/03 Purdy/Curb Removal 32503 $878.40 $878.40 SERVICES TOTAL $878.40 Costs Subtotal (no markup) Labor Mark-up 0% Materials/Equipment/Services Mark-up 0% Sub Mark-up 10% Submitted by: Accepted by: TOTAL AMOUNT DUE tendent Date as $878.40 $0.00 $0.00 $87.84 a (" 6 .2, Mme. ;AR-25-2003 11:24 AM PURDY CONSTRUCTION INC 541 664 4124 P.02 O 1 s CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 CiTY RECORDER'S COPY Page 1 /2 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 THIS IS A REVISED PURCHASE ORDER · ·BLANKET PURCHASE· ORDER· : I , " · Contract for the Siskivou BIvd Redes .qn 802 592.60 · Proiect 99-38B."'This requisition is · , · ':~' . . · applicable to Bid Schedules A, C, & D only, Bid'Schedule B will require a · ' '~' · separate requisition. Bid Schedule C - 660,266.62 · · Bid Schedule D - . ! 74~600,00 ;:. '""' Bid :~: Contract date: Au.qust 28, 2002 · .start date: September.'9, '2002 · ": ~... Completion date: March 2003 Insurance required/On file Revised purchase order 01-22-2003. 18,000.00 " Chan.qe Order No. 1,.CTB Excavation & Haul Away Revised purchase order 01-22-2003, · . ' : !3,96~4,08 Chan.qe Order No. 2, Multiple Proiects, · '" " See attached list ' '~ ' · Revised purchase order 02-11-2003 960.00- Schedule C · Change Order No. 3 - Siqn Post Credit .. c~ange Order NO, 4 - B -DirectiOnal ':· : 940.10 Markers SUBTOTAL BILL TO: TAX FREIGHT TOTAL AccoUnt Number ........ Amount Account Number "Amount E 260.08.12.00.704200 1,679,402.41 Authorized Signature VENDOR COPY v??y P A OREGo?.. CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 FOB Point: Terms: Net 10th of Month Req. Del. Date: 09/09/2002 Special Inst: Page 2 / 2 DATE PO NUMBER 09/17/2002 03611 SHIP TO: Ashland Public Works (541) 488-5587 27-1/2 N MAIN STREET ASHLAND, OR 97520 Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Quantity Unit Description Unit Price ut: Price Change Order No. 5 1,457.69- (A) Bid Item 37 Arrows Marking (B) Bid Item 38 Bicycle Lane Stencil (C) Bid Item 39 Line Markings Change Order No. 6 - Joint Seal Bridge 1,471.13 Revised purchase order 04/08/2003 9,955.57 Schedule A Change orders No. 1 to 9 Please see attached for descriptions of change orders 1 through 9. SUBTOTAL 1,67 9 402.41 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 1,679,402.41 ASHLAND, OR 97520 CITY OF ASHLAND A request for a Purchase Order REQUISTION FORM THIS IS A REQUEST FOR A: [ X ] Change Order (existing PO# 3611 Schedule A) Date of Request: 3/27/03 Required Date of Delivery/Service ASAP Vendor Name: LTM INCORPORATED Address: PO BOX 1145 City, State, Zip MEDFORD OR 97501 Phone: Project Title: SISKIYOU BOULEVARD RECONSTRUCTION Project Number: 99-38 Services Only 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) Description Tntal Cnct Siskiyou Blvd/ Ashland St Reconstruction Project $ 802,592.60 Original Contract Cost Change Order No. 1 $ 346.75 Change Order No. 2 $ 4,656.88 Change Order No. 3 $ 1,702.14 Change Order No. 4 $ 379.16 Change Order No. 5 $ 1,000.00 Change Order No. 6 $ 380.00 Change Order No. 7 $ 310.50 Change Order No. 8 $ 213.90 Change Order No. 9 $ 966.24 $ 812,548.17 REVISED CONTRACT Account Number 260.08.12.00.704200 Please attach the Original signed contract and Insurance Certificates. Account Number // Employee Signature: Supervisor/ Dept. Head Signature: pyt,[s??? NOTE. By signing this requistiion fo , 1 ce tha the above request meets with Ctiy of Ashland Solicitiation Process requirem is and can be provided when necessary. G:Pubwrks\Eng\99-38 CO 1 2 3 4 5 6 7 8 9 Sch A Requisition.xls Updated on: 7/15/02