Interwest Construction Inc. 4/1/2020 Change Order 21

FA Sheet No: 2806.02 0,14 DAILY REPORT OF CONSTRUCTION FORCE ACCOUNT WORKED MANAGEMENT Project Name. Grand Ave Park Bridge Project No PW 3588 Item No.: A002 Unexpected Site Changes Date: 12/20/2019 Description of Work' ADA Ramp/Landing Work for Upper and Lower Deck Bushing Landing on Lower Deck Work by Subcontractor° (mark'x"if yes) Prime Contractor ICI Sub-Contractor: LABOR STRAIGHT TIME OVERTIME DOLLAR NAME OCCUPATION HOURS WWR HOURS WWR AMOUNT Parker Peck Carpenter/Piledriver $ 71 92 $ 98.20 $ - Nate Hastings Carpenter Foreman $ 76.86 $ 105 61 $ - John Weitzel Carpenter Leadman $ 74.25 $ 101.69 $ - Darrell Brown Carpenter Leadman $ 74.25 $ 101.69 $ - Brett Lamb Carpenter Foreman $ 76.86 $ 105.61 $ - DustinHufferd Carpenter Appr-90% $ 61.25 $ 82.20 $ - Rene Martinez Carpenter Journeyman $ 71.63 $ 97.77 $ - Randy Eco Carpenter Journeyman $ 71.63 $ 97.77 $ - Andreas Gonsolez Carpenter Journeyman $ 71.63 $ 97.77 $ - Bill Watts Laborer-Group 3 $ 5538 $ 75.60 $Michael Calkins Laborer-Group 3 $ 55.38 $ 75.60 $ - Justin Kalkins Laborer-Group 3 $ 55.38 $ 75.60 $ - Mike Schumacher Operator-Group 1A $ 71.75 $ 95.60 $ - Nick Anderson Carpenter Supt. $ 82.08 $ 113.44 $Pat Story Carpenter Journeyman $ 71.63 $ 97.77 $ - Justin Gandy Carpenter Leadman $ 74.25 $ 101.69 $ - Samantha LeVine Laborer-Apprentice 4 $ 51.33 $ 69.55 $ - Tyler Ensley Laborer-Group 3 $ 55.38 $ 97.77 $ - Ryan Morgan Laborer-Group 3 6 $ 55.38 $ 75.60 $ 332.28 SUBTOTAL-LABOR $ 332 28 LABOR OVERHEAD&PROFIT @ 29% $ 96.36 LABOR TOTAL $ 428.64 EQUIPMENT HOURS HOURS ADJUSTED STANDBY DOLLAR EQUIPMENT AND ATTACHMENTS WORKING STANDBY RATE RATE AMOUNT 08-67 RAM 3500 Crew Cab Service Box 0 $ 31.62 $ - 08-70 Chevy Silverado HD2500 Crew 0 $ 23.53 $ - 08-151 Ram Truck 3500 Service Box $ 29.82 $ - 14-14 CAT Generator $ 16.02 $ - 26-04 Linkbelt 100RT Crane HSL Series 0 $ 232.52 $ 116.97 $ - 0 - $ - SUBTOTAL-EQUIPMENT $ - EQUIPMENT OVERHEAD&PROFIT @ 21% $ - EQUIPMENT TOTAL $ - MATERIALS/SERVICE MATERIALS/SERVICE DESCRIPTION QUANTITY UNIT PRICE AMOUNT $ $ $ WSST(9.8%) $ - SUBTOTAL-MATERIALS $ - MATERIALS OVERHEAD&PROFIT @ 21% $ - MATERIALS TOTAL $ - Verification of Hours Worked: TOTAL $ 428.64 12%MARKUP(for pnme when subcontract work) $ - Contractors Representative(printed name) SHEET TOTAL: $ 428.64 Contractor's Representative Signature Date Owner's Representative(printed name) Pnme Markup on Subcontractor 12% <$25,000 Owner's Representative Signature Date 10% $25,000 to$100,000 Pay Estimate Entered 7% >$100,000 Date ❑ If checked,this work is in dispute. By signing this form, parties are agreeing to the time and effort needed to accomplish the task By Entitlement to be determined at a later date. r oT au P-13(Rev 2017 April)