County of Sonoma Agenda Item Summary Report

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1 Revision No County of Sonoma Agenda Item Summary Report Agenda Item Number: 29 (This Section for use by Clerk of the Board Only.) Clerk of the Board 575 Administration Drive Santa Rosa, CA To: Board of Supervisors Board Agenda September 12, 2017 Vote Requirement: Majority Department or Agency Name(s): Transportation and Public Works Staff Name and Phone Number: Susan R. Klassen Supervisorial District(s): Fifth Title: Graton American Disabilities Act Improvements - Phase 2, Change Order No. 3 Recommended Actions: Approve and authorize the Chair to sign Change Order Number 3 to the construction agreement with Piazza Construction in the amount of $78, for additional paving work for a revised contract total amount of $691, Executive Summary: The Department of Transportation and Public Works is requesting the Board approve a change order to the Graton Americans with Disabilities Act Improvements - Phase 2 project with Piazza Construction, in the amount of $78, The improvements associated with this project are necessary to meet the terms and conditions of the settlement agreement between the County of Sonoma and Hollylyn Delil on March 11, The work consists of reconstruction or retrofitting existing pedestrian and roadway items or removal of accessibility barriers, specified in the Settlement Agreement and meeting the requirements of the Americans with Disabilities Act. The extra paving work covered by this change resulted from a delay in completing items subject to deadlines. Discussion: Phase 2 of the project continued the reconstruction and retrofitting of pedestrian and roadway improvements in the Town of Graton initiated in Phase 1 of the project. Phase 2 of the project included elements of work that were required to be complete by December 31, 2016, but were delayed due to the heavy rains experienced last winter. The project schedule was also impacted by the discovery of utilities which were previously unmarked and were beyond the County s control, leading to a delay in the completion of the time sensitive items. The additional paving work was constructed on Edison Street between Graton Road and Shirley Street and on Shirley Street between South Brush Street and Edison Street. The third and final phase of the work is in the Town of Occidental and is planned to begin later this summer and continue over the winter into spring or early summer The expected start date is in August or possibly September and will require approximately nine months or more to complete

2 Revision No depending on weather and other construction related issues. That work will complete all of the work items required by the Settlement Agreement. Prior Board Actions: 8/1/17 Board awarded contract for Occidental ADA Improvements Phase 3 C /15/16 Board awarded Contract for Graton ADA Improvements Phase 2 C /20/15 Board awarded Contract for Graton ADA Improvements Phase 1 - C /10/15 Board approved Settlement Agreement between Hollynn Delil and the County of Sonoma Strategic Plan Alignment Goal 1: Safe, Healthy, and Caring Community This project will improve accessibility in the town of Occidental. Fiscal Summary Expenditures Funding Sources FY Adopted Budgeted Expenses $78, Additional Appropriation Requested Total Expenditures $78, General Fund/WA GF State/Federal Fees/Other Use of Fund Balance $78, Contingencies Total Sources $78, FY Projected FY Projected Narrative Explanation of Fiscal Impacts: Appropriations for the project are included the FY 17/18 Road Division Capital Improvements budget utilizing available road fund balance. Staffing Impacts Position Title (Payroll Classification) Monthly Salary Range (A I Step) Additions (Number) Deletions (Number)

3 Revision No Narrative Explanation of Staffing Impacts (If Required): Attachments: Change Order #3 Related Items On File with the Clerk of the Board:

4 COUNTY OF SONOMA DEPARTMENT OF TRANSPORTATION AND PUBLIC WORKS CONTRACT CHANGE ORDER NO. 3 SHEET 1 OF 13 SHEETS CONTRACT FOR: Graton ADA Improvements, Phase II JOB NO.: C15016 AWARDED: November 2016 TO: Piazza Construction Company, Inc. You are hereby directed to make the herein described changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: This change order is not effective until approved by the Director of Public Works. Change requested by the County. Estimated Cost: $78, By reason of this order, the time of completion will be adjusted as follows: 9 Working Days Submitted by: Stephen B. Urbanek, P.E. (Project Manager, Transportation and Public Works) Approved By: Susan R. Klassen, P.E. (Director of Transportation and Public Works) Board Action No.: Dated: By: _ (Chair of the Board of Supervisors) We, the undersigned contractor, have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted herein, and perform all services necessary for the work herein specified, and will accept as full payment thereafter the prices shown herein. Accepted, By: _ Contractor: Piazza Construction Company, Inc. Title: If the Contractor does not sign acceptance of this order, his attention is directed to the requirements of the specifications as to proceeding with the ordered work and filing a written protest within the time therein specified.

5 Section A Change in Plan (Shirley Street and Edison Street) The Contractor shall construct a concrete valley gutter across Edison Street that drains east to west. The contractor shall perform a two inch asphalt overlay on portions of Edison and Shirley Street. All as directed by the Engineer. All work to be in accordance with applicable portions of the Standard Specifications and Special Provisions. Labor, equipment and materials approved by the Engineer as necessary will be paid in accordance with the contract relative to force account work as tracked in the field (supporting documentation attached Piazza Extra Work Report #8, 9, and # for work performed between 5/18/17 and 6/8/17). No additional compensation shall be allowed for work under this Section A of Change Order No. 2. Force Account: New Item: Valley gutter and asphalt overlay (Shirley and Edison Street) FA $78, Nine (9) additional working days will be granted for work done under this Section A of Change Order No. 2. CONTRACT CHANGE ORDER NO. 1 SUMMARY SECTION AMOUNT DAYS A $78, $78,

6 County of Sonoma Department of Transportation and Public Works 2300 County Center Drive, Suite B Santa Rosa, California (707) , Fax (707) Memorandum To: Susan R. Klassen, P.E., Director of Transportation and Public Works From: Stephen B. Urbanek, P.E. Project Manager, Transportation and Public Works August 13, 2017 Subject:Contract Change Order No. 3 Graton ADA Improvements, Phase 2, C15016 Section A Additional paving was subsequently agreed upon between the County and plaintiff of original settlement agreement. Asphalt overlay paving on Edison Street beginning at the termination of the Phase I and continuing to Shirley Street as well as on Shirley Street east to the intersection with Brush Street. Valley Gutter added across Edison Street between existing alleys to alleviate sediment buildup on and in front of ADA ramp installed in Phase I. The Asphalt overlay and valley gutter construction work were tracked in the field under Force Account.

7 CONTRACT FUNDING DESCRIPTION COST % BID A ORIGINAL BID $574, % B CONTINGENCY $57, % C ADDITIONAL FUNDS $ % D TOTAL APPROVED FUNDING A+B+C $632, % CONTRACT MODIFICATION SUMMARY E CONTRACT CHANGE ORDERS I $116, % F ENGINEER ADJUSTMENTS J $0 0.00% G REVISED CONTRACT COST A+E+F $691, % H REMAINING FUNDING D-G ($58,912.52) (10.25%) CONTRACT CHANGE ORDERS NO DESCRIPTION COST % BID 1 Various Items at Bowen/Shirley Intersection $10, % 2 Valley Gutter, Misc. $27, % 3 Edison/ Shirley Valley Gutter and Paving $78, % I TOTAL $116, % ENGINEER ADJUSTMENTS NO DESCRIPTION COST % BID 1 N/A $0 0.00% J TOTAL $ % Note: The Director of Public Works is authorized to approve change orders, $5,000 for contracts up to $50,000, 10% on contracts up to $250,000, and $25,000 plus 5% of the original contract amount on contracts over $250,000, not to exceed a maximum of $50,000. This contract the Director of Transportation and Public Works is authorized to approve change orders up to the amount of $50,

8 County Of Sonoma Contractor Job: GRATON ADA- Graton ADA work Performed By: Piazza Construction Description of Work: Grinding Layout, Signs And No Parking Signs DAILY EXTRA WORK REPORT Contract: Billing Number 8.0 Report Date 5/18/2017 Perform Date 5/16/2017 Craft ID L01 OEOF2 L02 OELCS L03 OE04 L04 OELCS Employee Name J Piazza Jr T Singleton J Matassarin RHammoudeh Equipment ID Class Make E01 PT01 TRUCKT&TT Model RT Hrs A1 A2 RT Hrs 2.00 OT Hrs Subs Units RTRate OT Hrs RTRate OT Rate Subs Rate Extended OT Rate Delay Factor Extended RT labor SC 11.00% OT Labor 0.00 Subtotal Labor Subsistence 0.00 Other Expenses 0.00 MU 15.00% Labor Total Subtotal MU 10.00% Equipment Total Activity Total Bill Subtotal ONewBill For Owner/Resident Engineer's Use Only D Approved for Payment Date of Action: D Resubmittal D Returned for Correction Page_1 Accepted: Customer: Bill Total Date Received: Contractor: NTS Universal Bill Form

9 County Of Sonoma Contractor Job: GRA TON ADA - Graton ADA Work Perfonned By: Piazza Construction Description of Work: Grinding ABSL Street Sweeping And SkidSteer Grinding, Signs, Flagging DAILY EXTRA WORK REPORT Contract: Billing Number 9.0 Report Date 5/18/2017 Perfonn Date 5/17/2017 Craft ID L01 OE04 Employee Name J Matassarin Number Date Vendor Name and Descriotion S /17/2017 ABSL Construction I 3 Hours Of Road Grinding RT Hrs 3.00 L02 OEOF2 J Piazza Jr 3.00 L03 OEL3 J Loughlin 3.00 L04 OEL2 R Rossi 3.00 L05 OELCS T Singleton 3.00 L06 OELCS J Anderson 3.00 OT Hrs Equipment ID Class Make Model A1 A2. RT Hrs OT Hrs E01 DT03A TRUONTRUN 3AXL 3.00 E02 DT02A TRUONTRUN 3AXL 3.00 E03 SS04 TRACS >50 A 3.00 E04 SS05 TRACS >50 A 3.00 E05 PT01 TRUCKT&TT E06 GD03 TBD TBD TBD 3.00 Material/Specialist Work/Lump Sum or Unit Price Payment Number Date Vendor Name and Descriotion M /17/2017 ABSL Construction I 50% Daily Cost Of Street Grinding Subcontract/Specialist Work Subs Units RTRate OT Rate Subs Rate Extended RT Rate OT Rate Delay Factor Extended Units Unit Price Extended LS 1, , Units Unit Price Extended LS RT Labor SC OT Labor Subtotal Labor Subsistence 11.00% Other Expenses MU 15.00% Labor Total 1, , , Subtotal MU 10.00% Equipment Total Subtotal 1, MU 15.00% Material Total 1, Subtotal 1.00 MU 5.00% 0.05 Subcontract Total 1.05 Activity Total 3, Bill Subtotal 3, For Owner/Resident Engineer's Use Only Accepted: Bill Total + 3, LJNewBill LJ Approved for Payment Date of Action: Customer: LJ Resubmittal LJ Returned for Correction Date Received: C-Ontractor: Page_1 NTS Universal 8111 Form

10 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA - Graton ADA Work Performed By: Piazi:a Construction Description of Work: Dig For V Ditch, Dig To Sub Grade And Fill With Base Rock To Subgrade Craft ID Employee Name RT Hrs OT Hrs Subs Units RTRate OT Rate Subs Rate Extended L01 OE04 J Matassarin L02 OEOF2 J Piazza L03 OELCS RHammoudeh L04 OELCS T Singleton LOS OEL3 J Loughlin L06 OEL3 S Carmona L07 OEL3 RDouglas-Nielsen LOS OEL3 J Samansky Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RTRate OT Rate Delay Factor Extended E01 EX05 HCECL DEER 50DZT E02 PT08 TRUCKT&TT E03 WT02 TRAIW WATR E04 DT06 TRUONTRUN 2AXL E05 PT01 TRUCKT&TT E06 SS05 TRACS >50 A E07 GD03 TRACS CAT PC306B E08 WW01 TRAFA TRFX TL Material/Specialist Work/Lump Sum or Unit Price Payment Number Date Vendor Name and Description Units Unit Price Extended M /24/2017 Canyon Rock Inc I Base Rock LS M /24/2017 Canyon Rock Inc I Dump Fee LS M /24/2017 Canyon Rock Inc I Dump Fee LS Billing Number 15.0 Report Date 6/07/2017 Perform Date 5/24/2017 RT Labor 3, SC 11.00% OT Labor 0.00 Subtotal Labor 3, Subsistence 0.00 Other Expenses 0.00 MU 15.00% Labor Total 4, Subtotal MU 10.00% Equipment Total Subtotal 1, MU 15.00% Material Total Activity Total 5, Bill.Subtotal 5, ONewBill For Owner/Resident Engineer's Use Only Accepted: Bill Total + 5, D Approved for Payment Date of Action: Customer: D Resubmittal O Returned for Correction Date Received: Page_1 Contractor: NTS Universal Bill Form

11 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA - Graton ADA work Performed By: Piazza Construction Description of Work: Finish Grade Rock, Set Strings And Forms, Set Rebar, Get Plates From TBC, Get Boomtruck To Move Plat Craft ID Emolovee Name RT Hrs OT Hrs Subs Units RTRate OT Rate Subs Rate Extended L01 OEOF2 J Piazza Jr L02 OEL3 J Samansky L03 OEL3 R Douglas-Nielsen L04 OE L3 S Carmona LOS OEL3 J Loughlin L06 OE LC8 T Singleton Equipment ID Class Make Model A1 A2. RT Hrs OT Hrs RT Rate OT Rate Delay Factor Extended E01 EX05 HCECL DEER 50DZT E TRAC8 >50 A E03 WW01 TRAFA TRFX TL E04 DT06 TRUONTRUN 2AXL E05 DT03A TRUONTRUN 3AXL E06 BT01 HCETD NATL E07 WT02 TRAIW WATR Material/Specialist Work/Lump Sum or Unit Price Payment **MATERIAL INVOICE(S) TO FOLLOW** Number Date Vendor Name and Description Units M /25/2017 The Barricade Company And Traffic Supply, Inc. I Plate Renta LS M /25/2017 Canyon Rock Inc I Base Rock LS Unit Price Extended Billing Number 16.0 Report Date 6/07/2017 Perform Date 5/25/2017 RT Labor 2, SC 11.00% OT Labor SC 11.00% Subtotal Labor 2, Subsistence 0.00 Other Expenses 0.00 MU 15.00% Labor Total 3, Subtotal MU 10.00% Equipment Total Subtotal MU 15.00% Material Total ' Activity Total 4, Bill Subtotal 4, ONewBill For Owner/Resident Engineer's Use Only D Approved for Payment Date of Action: D Resubmittal D Returned for Correction Page_1 Accepted: Customer: Bill Total + 4, NTS Umversal Bdl Form Date Received: Contractor:

12 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRA TON ADA - Graton ADA Work Performed By: Piazza Construction Description of Work: Place Concrete In V Ditch Traffic Controil, Pull Plates And Put Them Back At End Of Day Craft ID Emolovee Name RT Hrs OT Hrs Subs Units RT Rate OT Rate Subs Rate Extended L01 OEOF2 J Piazza Jr L02 OEL3 J Loughlin L03 OEL3 S Carmona L04 OEL3 R Douglas-Nielsen Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RT Rate OT Rate Delay Factor Extended E01 EX05 HCECL DEER 50DZT E02 BT01 HCETD NATL E03 PT01 TRUCKT&TT E LDRRT DEER E05 WW01 TRAFA TRFX TL Material/Specialist Work/Lump Suni or Unit Price Payment **MATERIAL INVOJCE(S) TO FOLLOW** Number Date Vendor Name and Description Units Unit Price Extended M /26/2017 River Readey Mix Co I V Ditch LS 1, , Subcontract/Specialist Work Number Date Vendor Name and Description Units Unit Price Extended S /31/2017 Harris Construction I Concrete Work LS 2, , Billing Number 17,0 Report Date Perform Date 6/07/2017 5/26/2017 RT Labor SC OT Labor Subtotal Labor Subsistence 11.00% Other Expenses MU 15.00% Labor Total 1, , , Subtotal MU 10.00% Equipment Total Subtotal 1, MU 15.00% Material Total 1, Subtotal 2, MU 5.00% Subcontract Total 3, Activity Total 6, Bill Subtotal 6, ONewBill D Resubmittal For Owner/Resident Engineer's Use Only 0 Approved for Payment Date of Action: D Returned for Correction Date Received: Accepted: Customer: Contractor: Bill Total + 6, Page_1 NTS Universal Bill Form

13 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA- Graton ADA work Performed By: Piazza Construction Description of Work: Over Ex Area And Regeade North Side Of V Ditch, Backfill With Base Craft ID Employee Name RT Hrs OT Hrs Subs Units RT Rate OT Rate Subs Rate Extended L01 OE04 J Matassarin L02 OEOF2 J Piazza Jr L03 OELCS J Anderson L04 OELCS R Hammoudeh LOS OEL3 J Loughlin L06 OEL3 S Carmona L07 OEL3 R Douglas-Nielsen Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RTRate OT Rate Delay Factor Extended E01 EX05 HCECL DEER 50DZT E02 SS05 TRACS >50 A E03 GD03 TRACS CAT PC306B E04 WW01 TRAFA TRFX TL E05 DT03A TRUONTRUN 3AXL E06 DT02A TRUONTRUN 3AXL E07 PT01 TRUCKT&TT E08 PT08 TRUCKT&TT E09 BS01 LDRRT DEER E10 WT02 TRAIW WATR Material/Specialist Work/Lump Sum or Unit Price Payment **MATERIAL INVOICE(S) TO FOLLOW'* Number Date Vendor Name and Description Units Unit Price Extended Billing Number 18.0 Report Date. 6/07/2017 Perform Date 6/01/2017 RT Labor 3, SC 11.00% OT Labor SC 11.00% Subtotal Labor 4, Subsistence MU 15.00% , Other Expenses Labor Total Subtotal 1, MU 10.00% , Equipment Total Activity Total 7, Bill Subtotal 7, For Owner/Resident Engineer's Use Only Accepted: Bill Total + 7, D Resubmittal D Returned for Correction Date Received: Contractor: Page_1_ NTS Universal Bill Form ONewBill D Approved for Payment Date of Action: Customer:

14 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA - Graton ADA Work Performed By: Piazza Construction Description of Work: Pave North Of Valley Gutter Craft ID Emoloyee Name RT Hrs OT Hrs Subs Units RT Rate OT Rate Subs Rate Extended L01 OEOF2 J Piazza L02 OELC8 C Hendrickson L03 OE04 J Matassarin L04 OEOF2 J Piazza Jr L05 OEL3 J Galvez L06 OEL3 J Loughlin L07 OEL3 S Carmona LOS OEL3 R Douglas-Nielsen L09 OEL3 J Samansky Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RT Rate OT Rate Delay Factor E~ended E01 EX05 HCECL DEER 50DZT E02 WC01 COMHGCOMP E LDRRT DEER E04 RR01 ROVIB CAT 8031E EOS RR03 ROVIB CAT E06 DT05 TRUONTRUN 2AXL E07 DT02A TRUONTRUN 3AXL E08 DT03A TRUONTRUN 3AXL E09 PT01 TRUCKT&TT E10 PT02 TRUCKT&TT E11 PT08 TRUCKT&TT E TRAC8 >50 A E13 GD03 TRAC8 CAT PC306B E14 AP02 A8PAV B-K PF , Material/Specialist Work/Lump Sum or Unit Price Payment **MATERIAL INVOICE(S) TO FOLLOW** Number Date Vendor Name and Description Units Unit Price Extended M /05/2017 Bodean Company I HMA LS 3, , Billing Number 19.0 Report Date 6/07/2017 Perform Date 6/05/2017 RT Labor 4, SC 11.00% OT Labor 1, SC 11.00% Subtotal Labor 5, Subsistence 0.00 Other Expenses 0.00 MU 15.00% Labor Total 6, Subtotal 4, MU 10.00% Equipment Total 4, Subtotal 3, MU 15.00% Material Total 4, Activity Total 15, Bill Subtotal 15, ONewBill D Approved for Payment Date of Action: Customer: For Owner/Resident Engineer's Use Only Accepted: Bill Total + 15, O Resubmittal D Returned for Correction Date Received: Contractor: Page_1_ NTS Universal Bill Form

15 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA - Graton ADA work Performed By: Piazza Construction Description of Work: Grind And Sweep Edison St, Overlay Edision St, Over Ex Along South Side Of V Ditch Craft ID Employee Name RT Hrs OT Hrs Subs Units RT Rate OT Rate Subs Rate Extended L01 OEOF2 J Piazza L02 OE LCS C Hendrickson L03 OE04 J Matassarin L04 OELCS J Anderson L05 OELCS R Hammoudeh L06 OEL3 J Loughlin L07 'OE L3 S Carmona LOS OE L3 R Douglas-Nielsen ' L09 OE L3 J Samansky Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RT Rate OT Rate Delay Factor Extended E01 WT02 TRAIW WATR E02 EX05 HCECL DEER 50DZT E03 SS05 TRACS >50 A E04 AP02 ASPAV B-K PF , E05 DT05 TRUONTRUN 2AXL E06 DT08 TRUONTRUN 2AXL E07 DT03A TRUONTRUN 3AXL E08 DT02B TRUONTRUN 5AXL E09 PT01 TRUCKT&TT E10 PT03 TRUCKT&TT E11 PT08 TRUCKT&TT E12 BS01 LDRRT DEER E13 RR01 ROVIB CAT 8031E E14 RR03 ROVIB CAT 8062D Material/Specialist Work/Lump Sum or Unit Price Payment **MATERIAL INVO/CE(S) TO FOLLOW** Number Date Vendor Name and Descriotion Units Unit Price Extended M /06/2017 Bodean Company I HMA LS 4, , Billing Number 20.0 Report Date 6/07/2017 Perform Date 6/06/2017. RT Labor 4, SC 11.00% OT Labor SC 11.00% Subtotal Labor 5, Subsistence 0.00 Other Expenses 0.00 MU 15.00% Labor Total 6, Subtotal 4, MU 10.00% Equipment Total 4, Subtotal 4, MU 15.00% Material Total 5, Activity Total 16, Bill Subtotal 16, For Owner/Resident Engineer's Use Only Accepted: ONewBill O Approved for Payment Date of Action: Customer: Bill Total + 16, O Resubmittal 0 Returned for Correction Date Received: Contractor: Page_1_ NTS Universal Bill Form

16 DAILY EXTRA WORK REPORT County Of Sonoma Contract: Contractor Job: GRATON ADA - Graton ADA Work Performed By: Piazza Construction Description of Work: Pave Edison St, Back Asphalt Edges. Craft ID Employee Name RT Hrs OT Hrs Subs Units RTRate OT Rate Subs Rate Extended L01 OEOF2 J Piazza Jr L02 OE04 J Matassarin L03 OELCS C Hendrickson L04 OEOF2 J Piazza LOS OELCS R Hammoudeh LOS OEL3 J Clay L07 OEL3 J Loughlin LOS OEL3 S Carmona L09 OE L3 R Douglas-Nielsen L10 OEL3 J Samansky Equipment ID Class Make Model A1 A2 RT Hrs OT Hrs RTRate OT Rate Delay Factor Extended E01 EX05 HCECL DEER 50DZT EOZ SS05 TRACS >50 A E03 GD03 TRACS CAT PC306B E04 DT05 TRUONTRUN 2AXL EOS DT06 TRUONTRUN 2AXL E06 DT02A TRUONTRUN 3AXL E07 DT02B TRUONTRUN 5AXL E08 BS01 LDRRT DEER E09 AP02 ASPAV B-K PF , E10 RR01 ROVIB CAT 8031E E 1 1 RR03 ROVIB CAT 8062D E12 PT01 TRUCKT&TT Material/Specialist Work/Lump Sum or Unit Price Payment **MATERIAL INVOICE(S) TO FOLLOW** Number Date Vendor Name and Description Units Unit Price Extended M /07/2017 Bodean Company I HMA LS 4, , Subcontract/Specialist Work Number Date Vendor Name and Description Units Unit Price Extended S /07/2017 Striping Graphics I Extra Striping LS Billing Number 21.0 Report Date Perform Date 6/08/2017 6/07/2017 RT Labor 4,700,.88 SC 11.00% OT Labor SC 11.00% Subtotal Labor 6, Subsistence 0.00 other Expenses 0.00 MU 15.00% Labor Total 6, Subtotal 4, MU 10.00% Equipment Total 4, Subtotal 4, MU 15.00% Material Total 5, Subtotal MU 5.00% Subcontract Total Activity Total 17, Bill Subtotal 17, ' ONewBill For Owner/Resident Engineer's Use Only D Approved for Payment Date of Action: Accepted: Customer: Bill Total + 17~ O Resubmittal D Returned for Correction Date Received: Contractor: Page_1_ NTS Universal Bill Form

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