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AG 10-025 ' � RETURN TO: �/L� � ' � EXT: � ��,.� CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / 5 T�'"e� 1 S ORIGINATING STAFF PERSON: (� r� cr �� jZ o�> � EXT: Z 7�� 3. DATE REQ. BY: 4. TYPE OF DOCUMENT �CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT �E.Cz BOND RELATED DOCUMENTS� O ORDINANCE ❑ RESOLUTION CONTRACT AMENDMENT , ��A ^ �G#�: f� - 02 S ❑ INTERLOCAL ❑ THER (~�a yca� P !'/ r�� ���_t`� Pu a�_^� Snu.,�� �'ti P�a �d _ 5. PROJECT NAME: Po�C l 6. NAME OF ADDRESS: SIGNATURE N 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL , EXP. 12/31/ UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:_�� , 9. TOTAL COMPENSATION: $ S�/� / G/ q�-{- �� -,� s�y ,�q q� (INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMLTM DOLLAR AMOUNT: $ _ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ TELEPHONE: ?_�,� �3�PS-('o8(0 7 Fax: TITLE: Max�cr vo[ I C�[ai sea /"tarl` PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: 3'(�'.�-G(�f D"D" � S ' S 3O '�r� 3� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER �DEPUTY DIRECTOR �a � wm H � crL�W�EPT' IN L / DATE VIEWED 1 z 2 INITIAL / DATE APPROVED 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED COUNCIL APPROVAL DATE: DATE REC'D: �SIGNATORY (MAYOR OR RECTOR ,Q � {Z ,�CITY CLERK �1 ASSIGNEDAG# AG# !�� � SIGNED COPY RETURNED DATE SENT: �RETURN ONE ORIGINAL COMMENTS: EXECUTE " " ORIGINALS 1r���1: Q5� C�s�� . 11/9 PUGET SOUND ENERGY To: City of Federal Way 33325 8th Avenue S Federal Way, WA 98063-9718 CHANGE ORDER Number # 20 Date: 2/1 /2012 Project Number: 101046016 Attn: Brian Roberts, P.E. ProJect Manager: Bill Thwi�g Street Systems Project Engineer Project: Hwy 99, 310th to 18th Phase 4 Sch 74 Conversion Description of work: Replace broken lid on 4'8" square vault. Location: Hwy 99 8� 310th by Family Dental Office. C�=�� ��are r�,����+ v�t�1l ������c�l e ��r�� eo►�s`�r��rn� � �-toDK Item Amount Comments Company Labor Materials $ 822 Service Provider Outside Services $ 1,919 includes sales tax Operating Rights $ - Overtiead $ 493 Company Total S 3,234 Government Entity Labor $ - Opecating Rights $ - Govemment Entity Total S - Change Order Total S 3,234 Allocation of Change Order Total Company 100% $ 3,234 Govemment Entity 0% $ - Change Order Total _ E_ 3,234 Note: This change order will be effective only when signed by both parties: Puget Sound ergy Signed: ' � � , Title: Date: y� (Please sign and return one copy) City of Federa ay Signed: � ► `� — Title: c5 Date: PUGET SOUND ENERGY �y� �_� Puget Sound Energy PO Box 90868 Bellewe, WA 98009-0868 a subsidiary oi PUGETENERGY '� �TUluv To: _ S ExT: �� ��-�.._. CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / �� tr �P`�� � ORIGINATING STAFF PERSON: Y' I GL 1.� 1'( D 49 E? if�C EXT: Z 7 Z-3 3. DATE REQ. BY: TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE � RESOLUTION �CONTRACT AMENDMENT �AG#�:� C� Z S ❑ INTERLOc c^ ❑ OTHER C�a ua � � Y'r�t P_ t` �-[- l� (�r �p e;T �7o u k� � k P_ !'C'/ � 5. PROJECT NAME: 6. NAME OF ADDRESS: SIGNATURE N ��! TELEPHONE: �S3' 39S-6S(o7 TITLE:/Murrict �.. �tlsOh l�ptscc�+>' 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # > E�• � � 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:�� = s� � ��� 9. TOTAL COMPENSATION: $�( ��, C( �� �-�'.� � Z�-I �� �(INCLUDE EXPBNSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: .�- ���� 1 S�� S� ,�' 3O' � 3� lO. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER �-�,=:�:��,�.����- DEPUTYDIRECTOR j�(��� r, T A t r� - ae�w �� �ii— ��' � ��t�=Je , �' r--- _ � ��lR�� � i 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: IY 12 . CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR ATE SENT: ❑ ATTACH: SIGIVATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED INITIAL / DATE APPROVED COUNCILAPPROVALDATE: /v DATE REC'D: -�r�ir"'vra�z-r= , � (MAYOR O DIRECTOR� � �Z �CITY CLERK � ASSIGNEDAG# AG# �C� SIGNED COPY RETURNED DATE SENT: �RETURN ONE ORIG[NAL COMMENTS: EXECUTE ° G�;=ORIGINALS 11/9 PUGET SOUND ENERGY To: City of Federal Way -P6�daR'97`t8-' Federal Way, WA 98063 Attn: Brian Roberts Project: Hwy 99, 310th to 18th Phase 4 Sch 74 Conversion Date: 11/30/2017 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Install 17 bollards with vactor truck to protect transformers and PSE electrical equipment on Hwy 99, 310th to 18th Conversion Project. Item Amount Comments Company Labor Materials $ 822 Service Provider Outside Services $ 10,280 includes sales tax Operating Rights $ - Overhead $ 1,998 Company Total S 13,100 Govemment Entity Labor $ - Opereting Rights $ - Government Entity Total S - Change Order Total CHANGE ORDER Number # 19 $ 13,700 Aliocation of Change Order Total Company 60% $ 7,860 Govemment Entity 40% $ 5,240 Change Order Total E 13,1 Note: This change order will be effective only when signed by both parties: Puget Sound nergy City of Fede ay Signed: . � Signed: / '� V "' ' Title: i(.1.LM TiUe: f Date: T�,t. / i L Date: 2 2_ (Please sign and retum one copy) 3:,e� ��oa PUtiET SOUND ENERGY Puget Sound Errergy PO Box 90868 Bellevue, WA 98009-0888 a subsidiary of PUGET ENERGY I GZ RETURN TO: -� � EXT: r� � i�; � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / � 1 ► �.P'�r 2. ORIGINATING STAFF PERSON: T I GL 1.'j !'( D 9, T�C EXT: � 7 G�- 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACT AMENDMENT (AG#�: "O � ❑ INTERLO AL ❑ OTxEx Cl�iaust{ _ �? -��1 __� � � (?uae.� �oe.��cc� � Kerc'/ N 5. PROJECT N 6. NAME OF CONTRACTOR: t,l ADDRESS: 5 � E- G'I 7 TELEPHONE: �S3' 3�(S-�S(o7 E-MAtL: N s c: r.•-r F�.x: SIGNATURE N � �b�d �' ( �n TITLE: /�'l� a� L_ �a�SOH /�/uu�r 7. EXHIBTTS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES o COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPL�ION DATE:� 9. TOTAL COMPENSATION: $� � ( G{ � -�- .��, 7 �{ S � � � � �� � INCLUDE EXP$NSES AND SALES TAX, IF ANY (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: .�'' ���I'� � S� S S� 30 - (0 3� lO. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER c �r '" �o"rri+iiciiicQnx`� DEPUTYDIRECTOR M�� r, T n��r- �r�e� ' � �� • i i7��f • . �, — 11. COUNCII.APPROVAL (IF APPLICABLE� COMMITTEEAPPROVAL DATE: /� 12. CONTRACT SIGNATURE ROUTING � ❑ SENT TO VENDOR/CONTRACTOR ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED T . T+- � �MAYOR O DIRECTOR� � � Z �CITY CLERK � ASSIGNED AG # AG# �D�U 'L S R SIGNED COPY RETURNED DATE SENT: � � �ETURN ONE ORIG[NAL /� INITIAL / DATEAPPROVED COUNCIL APPROVAL DATE: N DATE REC'D: COMMENTS: $XECUTE "2," ORIGINALS 1 on l, c. '�- Co et'_ 11/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts CHANGE ORDER Number # 18 Project: SR-99 Sch 74 Relocation Phase 4 Date: 11 /17/2011 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Per City request, adjust 1 lid at J06 to lower vaults to sidewalk grade for city contractor. Also raise 1 secondary handhole at H13. Both needed elevation adjustments and had already been energized. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 2,326 includes sales tax Operating Rights $ - "" Overhead $ 419 Company Total $ 2,745 Government Entity Labor $ - Operating Rights $ - Govemment Entity Total � - Change Order Total $ 2,745 Allocation of Change Order Totai Company 0% $ - Govemment Entity 1A0% $ 2,745 Change Order Total S 2,745 Note: This change order will be effective only when signed by both parties: Puget Sound erg Signed: Title: � Date: (Please sign and retum one eopy) City of Fede I Way Signed: �"" " Title: f � � Date: PUGET SOUND ENERGY asa� �-oa Puget Sound Energy PO Box 90868 Bellewe, WA 9800&0868 a subsidiary of PUGET ENERGY C� RETURN TO: `� EXT: L "� �,; "Z____ CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / �� t��P�'� 2. ORIGINATING STAFF PERSON: T' I Gi l.� 1'( O�� E'_ f�; EXT: � 7 Z-3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT � GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� � ORDINANCE ❑ RESOLUTION �CONTRACT AMENDMENT (AG#�: ` � ❑ INTERLO o OTxEx C l.�a�c _ �_cc�e�__� � 7 Puae:i' Cvou�.cd � rc� y 5. PROJECT NAME: 6. NAME OF ADD�ss: SIGNATURE N � INITIAL / DATE SIGNED .,� 2 � 7. EXHIBTTS APiD ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS '❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES � PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPLET�ION DATE: �� � +y- �1 �t � � I ` — I. TOTAL COMPENSATION: $ Svlp , 3 �0 ��- O,/ SS �^ ��INCLUDE EXPBNSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOU LYLR ABOR CHARGE -�AT ACH S�ULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: O YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: .�CYi o' ��G� I S�' S� �' 3O' �O 3� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER $ vi ii3'`ioiti�i+irtiiitei`�' DEPUTYDIRECTOR N(�rc�ra,� � r �.,�-�:'.�-� il . COLINCIL APPROVAL �IF APPLICABLE� . « ,:, +-��' �1 � ,,.— — COMMITTEE APPROVAL DATE:�l�_ 12 . CONTRACT SIGNATURE ROUTING x ❑ SENT TO VENDOR/CONTRACTOR� ��� ATE SENT: ❑ ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS T � Tlr- �'SIGNATORY (MAYOR O DIRECTOR� �CITY CLERK � ASSIGNED AG # SIGNED COPY RETURNED � � �RETURN ONE ORIGINAL COMMENTS: � � *'----------- « � « <,�_��. . . ,. AG# I� �2S Q DATE SEN � TELEPHONE: ZS3 3clS-�S(o 7 TITLE:/yluN;ci pal �.. �ci�so�, !�/QUS�s' INITIAL / DATE APPROVED COUNCILAPPROVALDATE: /V DATE REC'D: C„ (- . 11/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 CHANGE ORDER Number # 17 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 Date: 9/27/2011 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Credit for flagging not used when City contractor flagging was used. City will bill PSE for it's share of flagging contractor used. Item Amount Comments Company Labor Materials Service Provider Outside Services $ (21,515) includes sales tax Operating Rights $ - Overhead $ (3,873) Company Total S (25,388) Government Entity Labor $ - Operating Rights $ - Govemment Entity Total S - Change Order Total 5 (25,388) Allocation of Change Order Total Company 60% $ (15,233) Govemment Entity 40% $ (10,155) Change Order Total S (25,388) Note: This change oMer will be effective only when signed by both parties: Puget Soun nergy City of Fede y ./� � � �t3.� Signed: Signed: Title: t Title: J� L, N� � � Date: � Z T� Date: (Please sign and return one eopy) PUGET SOUND ENERGY �e� �� Puget Sound Energy PO Bo�c 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY 1 RETURN TO: ExT: � . -l� Z CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. �RIGINATING DEPT/DIV: PUBLIC WORKS / ��/ eC� — 2. ORIGINATING STAFF PERSON: � 7 t Gl � 1'( D�i � r' ��; EXT: Z 7 Z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMEIVT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� � PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE O RESOLUTION �CONTRACT AMENDMENT �AG#�: f� � �� ❑ INTERLO AL �^ s o OTHER C L'tl.tl.td P �(`rA f f =�FF-` l� �GiQ �-� J�u t2� [►-� fT _ S. PROJECT N 6. NAME OF CONTRACTOR: ADDRESS: SSD � M 1 ELEPHONE: a S 3 3qS - 6�Slo l FAx: TITLE:MuH;c��va� L �a�soh !�'(u��, 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL , EXP. 12/31/ UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:� � 9. TOTAL COMPENSATION: $ S , 3 �� `k��,,�SZ�G � �T � (INCLUDE EXP$NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: o YES ❑ NO IF YES, MAXIMUM DOLLAR AMOiJNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: �'��l�J � ��'�' �� ` � "��'� 10. DOCUMENT / CONTRACT REVIEW �ROJECT MANAGER 7�ri�1c...�.�rTif�** n n °fl�D�9i�ZTZiiSV T�c�7 - DEPUTYDIRECTOR MQ� �- 9I�-+ n T e � ��i T r- INI L / DAT VIEWED r��s i r t "L Z`� `1 � 11 . COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: l`� �`T' 12. CONTRACT SIGNATURE ROUTING �, f_ ,, ," �� ❑ SENT TO VENDOR/CONTRACTOR "� ��� ' ' ATE E T: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED INITIAL / DATE APPROVED COUNCILAPPROVALDATE: N DATE REC'D: T Tlrn-r — �^t �DL'I'Z � �SIGNATORY (MAYOR O DIRECTOR) � Z (I Z �CITY CLERK --"'� � � � ASSIGNEDAG # AG# 1D-D�,� P SIGNED COPY RETURNED DATE SENT: �RETURN ONE ORIGINAL COMMENTS: EXECUTE " „° ORIGINALS - �QO �,S'L ��s'r lli PUGET SOUND ENERGY CHANGE ORDER Number # 16 To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 Date: 10/24/2011 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Replace 400 ft of 750 cable and 12' of conduit. Cable and riser were cut and stolen at the termination pole. Theft: Weekend of 7/15/11-7/77/11 Item Amount Comments Company Labor Materials $ 1,994 Service Provider Outside Services $ 5,532 includes sales tax Operafing Rights $ - Overhead $ 1,355 Company Total $ 8,880 Government Entity Labor $ - Operating Rights $ - Govemment Entity Total $ - Change Order Total $ 8,880 � Allocation of Change Order Total Company 100% $ 8,880 Govemment Entity 0% $ - Change Order Total S� 8��0 Note: This change order will be Puget Sound EJ�erg .✓-d� � r Signed: —(��� Titie: � Date: r � , only when sig�ed by both parties: City of Fede y � + � Signed: � Title: a S Date: Z t (Please sign and retum one copy) 3581 7-04 PUGET SOUND ENERGY Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary oT PUGET ENERGY � RETURN TO: �_.:,� � � EXT: � `Zv L__-- CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. �RIGINATING DEPT/DIV: PUBLIC WORKS / �� t� e� 1��, 2. ORIGINATING STAFF PERSON: T I Gl L� �'( O k7 N r� C EXT: Z-? � 3 3. DATE IZEQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, IZFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT o MAINTENANCEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT O HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACTAMENDMENT �AG#�: C7 � � ❑ INTERLO AL ❑ OTHER C L�a�a P C�,rr,� ��^ # l S` Pua e� 5ou �c� � �l � rn.� � 5. PROJECT NAME: 6. NAME OF ADDRESS: SIGNATURE TELEPHONE: 'crS3� 3�1.5-��7 TITLE:MuN;u�va� L� �usOh t�jr,ccec�)�'. -- 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION a INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES � PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , E�• � �_ 8. TERM: COMMENCEMENT DATE: COMPLET�ION DATE:�� � � ` SO�� 3 6 q �-- 9. TOTAL COMPENSATION: $ 5��� ��{ 3 ^� � 3.1 ?�l _(INCLUDE EXPBNSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - P:1 SCHE LES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ C1TY ❑ PURCHASING: PLEASE CHARGE TO: �11� '" ��� � (S� � �/� ~ ��� �� lO. DOCUMENT / CONTRACT REVIEW �ROJECT MANAGER Tln�m*l+�rA�e enno DEPUTY DIRECTOR MQ �- L .� n T e�x� �r r 11. COUNCILAPPROVAL (IF APPLICABLE� �,� ' se� . ' ■ �y�r COMMITTEE APPROVAL DATE: N �'1' 12. CONTRACT SIGNATLIRE ROUTING x ❑ SENT TO VENDOR/CONTRACTOR ��� ATE ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS "^CrGi`TY�'T�LTT - � SIGNATORY (MAYOR O DIRECTOR)� ITY CLERK --�'' : � ASSIGNED AG # SIGNED COPY RETURNED � � {�RETURN ONE ORIGWAL COMMENTS: �� INITIAL / DATE SIGNED Z � AG# �o-o"'�.�a O DATE SENT: _ INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'D: 1/ PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 Description of work: Date: 10/21 /2011 Project Number: 101046016 Project Manager: BIII Thwing Credit for Inspector time not needed. I tem Amount Comments Company Labor Materials Service Provider Outside Services $ (8,419) includes sales tax Operating Rights $ - Overhead $ (1,516) Company Total S (9,935) Government Entity Labor $ - Operating Rights $ - Govemment Entity Total S - Change Order Total $ (9,935) Allocation of Cfiange Order Total Company 60% $ (5,961) Govemment Entity 40% $ (3,974) Change Order Total S (9,935) Note: This change order will be Puget Sound E �rgy � ^ �. Signed: Title: Date: � -� CHANGE ORDER Number # 15 only when signed by both parties: City of Fede ay r Signed: � � � Title: \I' c� S Date: (Pleaae sign and return one copy) 9 PUGET SOUND ENERGY sse� �-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary oT PUGET ENERGY �j RETURN TO: � �' (� � EXT: �"�� �'�---- � ._ CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / �'j r� r' C� 2. ORIGINATING STAFF PERSON: T i GL 1, J I� o k9 P �'�` C EXT: 'c,..�- 7�� 3. DATE REQ. BY: 4. TYPE OF DOCU�tENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODSANDSERVICEAGREEMENT ❑ REALESTATEDOCUMENT ❑ ORDINANCE �CONTR ❑ OTHER S. PROJECT 6. NAMEOFCONTRACTOR: t.�Vt ADDRESS: 5 � � 7 TELEPHONE: �-$�3 �- 3�iS-�Slo 7 E-MAIL: � vr t c'. , t+-� FAX: SIGNATURENA � [� u.d �` �rin TITLE:Muu�ci�Da� L�arso�, !►7auas�e+ 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , E�• � � 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: /�C� ss� � ` s�o, 3� � °r' 9. TOTAL COMPENSATION: $ S�(J, � �J ���(�c `— (INCLUDE EXP$NSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - TACH HEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES O NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: JUG .'/ { lX,i �� S 1'�Gc�' 3� ��` lO. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER DEPUTY DIRECTOR �(� r - ��� � � Fr--. .-+ T �c�c°i - 11. COUNCILAPPROVAL(IFAPPLICABLE� INI L / DAT VIEWED �t r� --� — 2 �2-t 11 COMMITTEE APPROVAL DATE: IY � 12. CONTRACT SIG(VATURE ROUTING � '� ❑ SENT TO VENDOR/CONTRACTOR c ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS .. T • .r Trn�r . �SIGNATORY �MAYOR O DIRECTOR��� �CITY CLERK ----'" � AsstGNED AG # SIGNED COPY RETURNED y� RETURN ONE ORIGINAL COMMENTS: � �� �.�n� r rrr. "�"!ln Tr� mr � r c INITIAL / DATE SIGNED � � � � AG# IO -��� N DATE SENT: _ INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'I): 1 �� O SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ RESOLUTION PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 CHANGE ORDER Number # 14 Date: 9/27/2011 Project Number: 107046016 Project Manager: Bill Thwing Description of work: The original design was to install a second single phase transformer (V07A) at the north property line of the RST Plaza to serve the building with 720/240 three phase power. The Customer decided to convert their service voltage to 120/208 three phase. To accommodate this, new transformer V07A is no longer needed and can be deleted and a new secondary hand hole (H02A) fed from the existing H02 will need to be installed. This Change Order includes the deletion of V07A (credit) and the addition of H02A. This Change Order is billed at 60/40 split as a change to the standard conversion. Item Amount Comments Company Labor Materials $ (597) Service Provider Outside Services $ 331 includes sales tax Operating Rights $ - - Overhead $ (48) Company Total $ (314) Government Entity Labor $ - Operating Rights $ - Govemment Entity Total $ - Change Order Total $ (314) Allocation of Change Order Total Company 60% $ (189) Govemment Entity 40% $ (126) Change Order Total S (314) Note: This change order will be effective only when signed by both parties: Puget Sound E�erg� �� City of Fede y n I� Signed: Title: Date: (Please slgn and return one copy) Signed: / - ` G � - Title: Date: PUGET SOUND ENERGY sss� �-oa Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY '� RETURN TO: 1 Y� � EXT: '�� '� C � �-�„ i CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. �RIGINATING DEPT/DIV: PUBLIC WORKS / �� f�� 2. ORIGINATING STAFF PERSON: Q T IGl tc� �� D k� E r� � EXT: Z-7 �� 3. DATE REQ. BY: � TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT o MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACT AMENDMENT (AG#):� CJ Z� ❑ INTERLO AL ❑ OTHER C�t A ua r (Y�� f f �-F- t 3 �G1Q e� �o u K� � ut N fCP �-1 _ 5. PROJECT N (. NAME OF ADDRESS: 7. TELEPHONE: �? S�'� �f.5-�� 7 FAx: TITLE:/�u�ict�d�cl L rGtr9oh e 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: /�C �.�' � � =,� S�O�C 6nR ��NSES AND SALES TAX, IF ANY� 9. TOTAL COMPENSATION: $� (� � ± � S� y �-( �Z '— � (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: � YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: � CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: �rI � � " � ����!��� ' ��� S" 3� �� �^� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER °C�i�' ��' DEPUTY DIRECTOR �� � t sTU L � �� Tlno s 11 . COUNCILAPPROVAL(IFAPPLICABLE� INI L/ DAT R VIEWED _ / COMMITTEE APPROVAL DATE: /Y � 12. CONTRACT SIGNATURE ROUTING n ' ❑ SENT TO VENDOR/CONTRACTOR � ATE SENT: ❑ ATTACH: SIGNATURE AUTHOR[TY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'D: -^Q- nr i=r- - = �SIGNATORY (MAYOR O D[RECTOR� \':� 2 " � �CITY CLERK —.------�'"'� � ASSIGNEDAG# AG# 1�� SIGNED COPY RETURNED DATE SENT: �ETURN ONE ORIGINAL . COMMENTS: EXECUTE "�;� ORIGINALS 1/ EXHIBITS AND ATTACHMENTS: O SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / /_ PUGET SOUND ENERGY CHANGE ORDER Number # 13 To: Attn: City of Federal Way 33325 8th Avenue S Federal Way, Wa 98063-9718 Brian Roberts, P.E. Street Systems Project Engineer Project: Hwy 99 Phase 4, 310th to 18th Description of work: Date: 10/19/2011 Project Number: 101046016 Project Manager: Biil Thwing the J04 575 Vautt J07 575 Vault J17 575 Vault PV02 5106 Vault PVO4 5106 Vault and 2 pull vault lids set too high by replacing lids or risers with shorter Item Amount Comments Company Labor Materials $ 3,810 Service ProviderOutside Services $ 806 includes sales tax Operating Rights $ - Overhead $ 831 Company Total S 5,447 Govemment Entity Labor $ - Operating Rights $ - Govemment Entity Total $ - Change Order Total S 5,447 Allocation of Change Order Total Company $ - Government Entity 100% $ 5,447 Change Order Total a 5 ��� Note: This change order will be effective only when signed by both parties: Puget Sound E ergy � . Signed: ,....,. Title: t Date: (Please slgn and return one copy) City of Fed I Way Si ned. � G � 9 Title: � Date: PUGET SOUND ENERGY 35s� �-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY L RETURN TO: '"� EXT: � � � � d CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / ��/ CF'� � 2. ORIGINATING STAFF PERSON: � T 1Gt � I� D�i N ��� EXT: c?.7 � 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENI' ❑ GOODS AND SERVICEAGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� O ORDINANCE � RESOLUTION �CONTRACT AMENDMENT (AG#):�� C'7 ,�,- � o INTERLO_C .s O OTHER C � t r.t uGi l �� P f" -(-� � 2 --- pU Q e. - T �C� u �t� [ ty f� �( 5. PROJECT NAME: 6. NAME OF CONTRACTOR: V v ADDRESS: S� � �I �7 TELEPHONE: 'c��'3' 3�I.S-�K� 7 E � c' a+-r Ea�c: SIGNATUREN t,� TITLE:/ LrcttSOa lYlaccu�: � 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES O COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI #� � E�• � � 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:� /� � � f 32} _ .� ���4zZ 9. TOTAL COMPENSATION: $�('� � -�— (INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXRv1UM DOLLAR AMOUNT: $ IS SALES TAX OWED: O YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: �3(7�" N�D� � I��� �✓ i�J� �� ��r � 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER n..,.�.,,�r r,r., ro _ DEPUTYDIRECTOR ���-��� T e�.a-�::�°-,"r-- �t , •i e � - r �%� . � . - !�r - 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: �� 12. CONTRACT SIGNATURE ROUTING � ❑ SENT TO VF.NDOR/CONTRACTOR � t ATE SENT: � ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED INITIAL / DATE APPROVED COUNCILAPPROVALDATE: N DATE REC'D: -^r.r Ti-�ci '�ii-i-^= �'SIGNATORY (MAYOR O DIRECTOR)� w �� �Z- �CITY CLERK `�''ASSIGNED AG # AG# fo--UZ� 1.- `�SIGNED COPY RETURNED DATE SENT: � � �RETURN ONE ORIGINAL COMMENTS: EXECUTE "G�' ,`� ORIGINALS 1/ PUGET SOUND ENERGY To: City of Federal Way 33325 8th Avenue S Federal Way, Wa 98063-9718 CHANGE ORDER Number # 12 Date: 3/24/2011 Project Number: 101046016 Attn: Brian Roberts, P.E. Project Manager: Bill Thwing Street Systems Project Engineer Project: SR-99 Sch 74 Relocation Phase 4 - �vcl+¢1� w�,a� vl Description of woMc: Temporarily relocate service pole, P28A, on 3/30/11 to make way fo�'�'ire-hydrent installation. I Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 2,804 includes sales tax Operating Rights $ - Overhead $ 505 - Company Total S 3,308 Government Entity Labor $ - Operating Rights $ - Govemment Entity Total S - Change Order Total a 3,308 Allocation of Change OMer Total Company 60% $ 1,985 Govemment Entity 40% $ 1,323 Change Order Total 3 3,308 Note: This change order will be effective only when signed by both parties: Puget Sound E erg ,' Signed: Title: � Date: (Please sign and retum one eopy) City of Fede Way Si ned: /"� � �"� 9 Title: .� f S Date: PUGET SOUND ENERGY �9� �� Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary M PUGET ENERGY � RETURN TO: � EXT: � ��b�,. CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / ��/�P}` 2. ORIGINATING STAEF PERSON: � T I GL 1:�� I�( O 4� f� r`�� EXT: 'C_.� -� Z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT � GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE �CONTR ❑ OTHER S. PROJECT 6. NAME OF CONTRACTOR: v ADDRESS: � � �( `�J' TELEPHONE: �? � � '- 3qS- � S(o 7 E-MAIL: ' h < [' t�f FAX: SIGNATURE NA � D�u.d C� P �( �.r TITLE:Muwr'ct���t� L rctis0�+ lYjorKa�+ 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES O COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE 0 ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBj # � E�• � � 8. TERM: COMMENCEMENT DATE: �/-�-� C DATE: /� /i� — r'V�j�"C � —T 9. TOTAL COMPENSATION: $ F�FS, 3I3 �`I .�� S��� � (INCLUDE EXP�NSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOiJNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, PAID BY: ❑ CONTRACTOR ❑ CITY O PURCHASING: PLEASE CHARGE TO: JL� "���' !� ��15 c,'� � 10. DOCUMENT / CONTRACT REV[EW �PROJECT MANAGER �a-z ='rioiv"�xi�zirn=, DEPUTY DIRECTOR M�„� �-��� L.� �- , n T e ��-Tr- 11 . COUNCIL APPROVAL (IF APPLICABLE� INI L/ DAT i VIE D INITIAL / DATE APPROVED /ti z 2�i lZ ��� � COMMITTEE APPROVAL DATE: /� �t' 12. CONTRACT SIGNATURE ROUTING x o SENT TO VENDOR/CONTRACTOR � ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIB(TS INITIAL / DATE SIGNED COUNCIL APPROVAL DATE:�/-�_ DATE REC'D: v�ci.�v�ii-i — �SIGNATORY (MAYOR O DIRECTOR� �� �� �— �CITY CLERK --�`' � ASSIGNED AG # AG# IproZ. �j K SIGNED COPY RETURNED DATE SENT: t�RETURN ONE ORIGWAL COMMENTS � � EXECUTE ° G�'} ORIGINALS 11/ ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� � RESOLUTION PUGET SOUND ENERGY CHANGE ORDER Number # 11 To: City of Federal Way PO Box 9718 Federal Way, WA 98063 Attn: Brian Roberts Project: Hwy 99 Phase 4, 310th to 18th Date: 3/3/2017 Project Number: 101046016 Project Manager: Bili Thwing Description of work: The construction pricing was originally provided in November 2009. The pricing was updated to reflect 2070 labor rates by Change Order # 2 in June of 2010. As of 2/1/2011, new labor rates for 2071 went into effect. At this date, the project was estimated to be 21% compiete. This Change Ordsr applies the 2017 labor rates to the remaining 79°k of the project. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 32,597 includes sales tax Operating Rights $ - Overhead $ 5,868 Company Total 38,465 Government Entity Labor Operating Rights Change Order Total 38,465 Allocation of Change Order Total Company 60% Govemment Entity 40% 23,079 15,386 Change Order Total $ 38,465 Note: This change order will be effective only when signed by both parties: Puget Sound ergy City of Federal Way � Signed: � � Signed: Title: �, L, /�.� TiUe: � _ Date: �Z,/Z,/t i Date: �� ('Z (Please sign and retum one copy) $ - $ - Government Entity Totat S - PUGET 80UND ENERC,Y �e� i.oa Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY � RETURN TO: �ti-� � EXT: �,""1� �. - CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLICWORKS/ � 1 ► 2. ORIGINATING STAFF PERSON: �, T i ct � I� o k� H r�" ;; EXT: c�- ��- 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT ❑ GOODS AND SERVICEAGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE O RESOLUTION �CONTRACTAMENDMENT (AG#�: �'7 . � . � ❑ INTERLO o OTxER _ C L�aua � C''� rY.! ��^ � lC� f�ua e`i� �ou �c� � K�r�P N 5. PROJECT NAME: 6. NAME OF CO! ADDRESS: $ E-MAIL:� SIGNATURE N TELEPHONE: 'c? f 3 3�JS- � 8� 7 Fax: TITLE:/'�uur"c�� L narsoy �?u��e. 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXH[BITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31 / UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:�� �{ g �� 3 i,�� 9. TOTAL COMPENSATION: $ u S y$(� '�" 3 � 3� ` (INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MA?CIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR � CITY ❑ PURCHASING: PLEASE CHARGE TO: �`�-/�� '!✓ �' ��5� �� lP 3S 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER '-,_r�n.,�—,.� Aa , ,,-�o DEPUTY DIRECTOR �(��-�� �.� � ��,� �f��f� S INI L/ DAT VIEWE INITIAL / DATE APPROVED z �`l�L 2 '2=", � 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: /� � _ 12. CONTRACT SIGNATURE ROUT[NG x ❑ SENTTO VENDOR/CONTRACTOR�� ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, L[CENSES, EXHIBITS m — �'SIGNATORY (MAYOR O DIRECTOR) � �CITY CLERK �'' � ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIG[NAL INITIAL / DATE SIGNED _� � AG# 1q 5 7 DATE SENT: _ COUNCIL APPROVAL DATE: /� DATE REC'D: COMMENTS: EXECUTE "G� ORIGINALS I1/ PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts CHANGE ORDER Number # 10 Project: SR-99 Sch 74 Relocation Phase 4 Date: 3/29/2011 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Hold poles P24 & P25 on 1/18/11 and 1/19/11 for city contractor to dig joint trench close to the poles. Also hold poles P02 & P12A on 2/8/11 and 2114/11. �tero Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 8,121 includes sales tax Operating Rights $ - Overhead $ 1,462 Company Total S 9,582 Government Entity Labor $ - Operating Rights $ - Government Entity Total $ - Change Order Total $ 9,582 Allocation of Change Order Total Company 60% $ 5,749 Govemment Entity 40% $ 3,833 Change Order Total S 9,582 Note: This change order will be effective only when signed by both parties: Puget Sound E ergy Signed: � r Title: Da4e: y- (Please sign and return one copy) City of Signed: � � Title: S Date: 2 PUGET SOUND ENERGY ass� �-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY �TU� To: �h���n.� EXT: z�D � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DN: PUBLIC WORKS / �� l e P`�� 2. ORIGINATING STAFF PERSON: T 1 Gt L7 I� O�9 E? f'�� EXT: � 7 Z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT o SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACT AMENDMENT AG# :� C� Z� o INTERLO AL t � � ❑ OTHER C�i GZ ua r � P 1^ �- G Pt.LQ N.� Jc? u �c� Lt fC'/ �l _ 5. PROJECT 6. NAME OF ADDRESS: SIGNATURE TELEPHONE: '4S3' 39S-�S(o � FAx: TITLE:/�luNic��Va� � na�SOti !Y(�csc�r --� a+-r 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION O INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES O PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI #� , EXP. _/ /_ 8. TERM: COMMENCEMENT DATE: COMPLETIO�I DATE:� �' �, = �f �S�-!� H � �. 9. TOTAL COMPENSATION: $�, �f � ��"{ � 3� S�D �INCLUDE EXP$NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: � YES ❑ NO IF YES, MAXIMUM DOLLARAMOUNT: $ IS SALES TAX OWED: ❑ YES o NO IF YES, PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: ��'� ��'�] '� � LS� � � Y �S 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER c v r'vivivit' z i r"cen� "`�DEPUTYDIRECTOR MQf-�� . � .^ T��DL'n� T Al r� � �� �• 'o � , �r�e �� ��, iI � 1 �►✓ - 11. COUNCILAPPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: IY 12. CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR � � AT SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS --o�' ir"' ovi£:i�r - �SIGNATORY (MAYOR O DIRECTOR� �CITY CLERK � ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED �'" _.�_�_- AG# d-n�r-, I DATE SENT: INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'D: COMMENTS: EXECUTE " �� ORIGINALS 11/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, WA 98063 Attn: BMan Roberts Project: Hwy 99, Phase 4, 310th to 18th CHANGE ORDER Number # 9 Date: 6/22/2011 Project Number: 1 07 04601 6 Project Manager: Bill Thwing Description of work: Hold the following poles for city contractor to trench by. (1 day each); � ^ P17, ' �EG�'Grct,� �'_2r'�"iTt� ��r� `I P23, NW Corner of Hwy 99 & 308th; and P28, 30747 Hwy 99 in front of appartments. Dates: 1/11/11, 1/72/11, 1/13/11. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 7,501 includes sales tax OperaUng Rights $ - Overhead $ 1,350 Company Total a 8,851 Government Entity Labor $ - Operating Rights $ - Government Entity Total a - Change Order Totai S 8,857 Allocation of Change Order Total Company 60% $ 5,311 Govemment Entity 40% $ 3,540 Change Order Total S 8,851 Note: This change order will be effective only when signed by both parties: Puget Sound E ergy City of Federal ay 1 Signed: - Signed: � Title: ! �� � Title: S Date: Date: Z (Please slgn and retum one copy) PUGET SOUND ENERGY ssa� �-04 Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY RETURN TO: S� EXT: � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / �� r�P'�� 2. ORIGINATING STAFF PERSON: T' IGL � I� o k9 ( f''�` EXT: 2-7 �_3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT O HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT �E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACT AMENDMENT (AG#�: • Z � ❑ INTERLO AL ❑ OTHER C_�i Gt� �_ _ `-� g Pu a e: � �O u t�t� � K L' f�I W 5. PROJECT NAME: 6. NAME OF ADDRESS: SIGNATURE N TELEPHONE: Z.S3 3�1S-�S(o 7 Fax: TITLE:/yuuiet�0a� � �+�SOH l�GCUSecip+^ 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES O COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS � PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , E�P• � � 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:� 9. TOTAL COMPENSATION: $ � �� � ��/ � '�" - � �� � � � �INCLUDE EXP�NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, PAID BY: O CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: ��XO" 4��` ��� ` S� S 3 � `(p 3� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER .=Tl,.�r v»iTiTw.,i��cn. DEPUTY DIRECTOR M��-�Ua 1� r, T e�i�-.s,- x�r..-�nre- 11. COUNCILAPPROVAL�IFAPPLICABLE� INI L/DAT VIEWED ( 8 Lt COMMITTEE APPROVAL DATE: Iv �'T' 12. CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR � ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ,-, T . .rTlrnm �SIGNATORY (MAYOR O DIRECTOR� �CITY CLERK � A5SIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED ��— AG# �o-o�.su DATE SENT: INIT[AL / DATE AFPROVED COUNCIL APPROVAL DATE: N DATE REC'D: COMMENTS: EXECUTE ��G�;=ORIGINALS � an l P s Es` C..�+.�"� 1/9 PUGET SOUND EIVERGY CHANGE ORDER Number #8 To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 Date: 1 /20/2011 Project Number: 101046016 Project Manager: Bill Thwing Description of work: This Change Order is to cover the cost of removing and reinstalling two area lights that are rented to the property owned. This cost is based on utilizing the existing supply wiring and does not include the cost of new wire or trenching. This Change Order was to be billed at 100°� City cost because the existing lights are not in the preexisting Right of Way. Intolight decided not to charge city due to deteriorating poles discovered when removing. These charges for Project Management coordination only. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 408 includes sales tax Operating Rights $ - Overhead $ 61 Company Total $ 469 Government Entity Labor Operating Rights Change Order Totai 469 AllocaUon of Change Order Totai Company 100% Govemment Entity O�o 469 Change Order Total S 469 �lote: This change order will be effective only when signed by both parties: Puget Sound E ergy Signed: � ` Title: � — �- � Date: (Please slgn and retum one copy) $ - $ - Govemment Entity Total $ - City of Fede Way Signed: / � � Y � ` Title: � C Date: PUGET SOUND ENERGY sse� i�w Puget Sound Energy PO Boz 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY �TU� To: s� a�n,� EXT: Z �� � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / � I { eP`k� 2. ORIGINATING STAFF PERSON: T iGl1.� �� O k� N f'�S, EXT: C..'�-7 Z- 3 3. DATE REQ. BY: � TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT o PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICEAGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION 5. 6. ,� 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES O COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS � PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / / H. TERM: COMMENCEMENT DATE: COMPLETION DATE:� 2o ve '"' ����y�� 9. TOTAL COMPENSATION: $�{�� I g7 "I" ��S3 � � (INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, ❑ PURCHASING: PLEASE CHARGE TO: 3 �0` ��� ""� S�I" S�I S lO. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER � $�i'Pioivi�rir"tiir"cvi,•a� DEPUTYDIRECTOR M��-�v ��r1 �. �. . . : � ►«rr�e� 1� `��� �! � _ � �- 11. COUNCILAPPROVAL �IF APPLICABLE� COMMITTEE APPROVAL DATE: !�r /T 12. CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR � ATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED PAID BY: � CONTRACTOR � CITY INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'D: �'O lTCYtL'L7'T . �SIGNATORY (MAYOR O D[RECTOR� Z ��L �CITY CLERK `�'ASSIGNED AG # AG# �(7�UZGj C�s �SIGNED COPY RETURNED DATE SENT: � � �I RETURN ONE OR[GINAL COMMENTS: EXECUTE "G�;` ORIGINALS 11/9 PUGET SOUND ENERGY CHANGE ORDER Number # 7 To: City of Federal Way PO Box 9718 � Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 Date: 3/29/2011 Project Number: 107046016 Project Manager: Bili Thwing Description of work: We were requested to hold 2 poles on December 8, 2010. Hold Pole P23 on corner of Hwy 99 & 308th and pole P28A at'30820', Great Floors to support City contractor to dig trench. There was no notification to us of the change in plans so the crew showed up. Standby until released. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 1,595 includes sales tax Operating Rights $ - Overhead $ 287 " Company Total S 1,882 Government Entity Labor Operating Rights Change Order Total 1,882 Allocation of Change Order Total Company 60% Government Entity 40% 1,129 753 Change Order Total 5 ' 1,882 Note: This change order will be effective only when signed by both parties: Puget Sound ergy City of Federa�y �, � . � � Signed: Signed: Title: ' � y — �Z Title: ♦ Date: � Date: Z (Pleaae sign and retum one copy) $ - $ - Govemment Entity Total $ - PUGET SOUND ENERGY 3591 7-04 Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY RETURN TO: ���� � ) n� EXT: �.��� Uv � � � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / � f rC� P`�t - 2. ORIGINATING STAFF PERSON: T IGi L� 1'( D�9 P f`�`C EXT: �7 Z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT O SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT O MAINTENANCE AGREEMENT ❑ GOODS AND SERVICEAGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACTAMENDMENT(AG#�:�� C'7 ❑ ❑ OTHER C�i Gt uq � �/� �(` � l� 5. PROJECT N 6. NAME OF ADDRESS: SIGNATURE N wt TELEPHONE: 'crS3" 39S-6S(o 7 Fax: TITLE:Muuiet�al L �QISOH r 7. EXHIBTTS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION O INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / /_ 8. TERM: COMMENCEMENT DATE: COMP DATE:� ov crp = � �� � �7 9. TOTAL COMPENSATION: $ y 7S �$�$ - ( - ��I� �� `� �INCLUDE EXP$NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLARAMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: 3 �- � �'I Q��S� ` S�I S'�D"Cp 3S� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER �av T �� DEPUTYDIRECTOR ��t-�J T e�,a—aR::�°rr- _, �. ..� � �r�er� �� ��► � ` i�L ��-- �� 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: � 12. CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR �� S �� �� � TE SENT: 0 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS .-. T • .. TrnT SIGNATORY �MAYOR O D[RECTOR� '� ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIG[NAL INITIAL / DATE SIGNED � AG# 1 �.A2�i � DATE SENT: Q'�LD• I � INITIAL / DATE APPROVED COUNCILAPPROVALDATE: N DATE REC'D: COMMENTS: EXECUTE ��G�' ," ORIGINALS 11/9 PUGET SOUND ENERGY CONSTRUCTION CHANGE ORDER Number # 6 To: City of Federal Way PO Box 9718 Federal Way, WA 98063 Attn: Brian Roberts Project: Hwy 99, Phase 4, S 310th to 18th Underground Conversion Date: 10/21 /2010 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Temporarily relocate P28 due to new Storm Sewer going directly under it and interferes with water line to firehydrant. Materials have not been included because the pole is temporary and materials will be returned to stores. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 9,128 includes sales tax Operating Rights $ - Overhead $ 1, 369 Company Total $ 10,498 Government Entity Labor Operating Rights Change Order Total $ - $ - Govemment Entity Total $ - $ 10,498 Allocation of Change Order Total Company 60% $ 6,299 Government Entity 40% $ 4,199 Change Order Total S 10,488 Note: This change order will be effective only when signed by both parties: Puget Sound Energy Signed: Title: �,,, .- p Date: ' / �i (Please sign and return one copy) City of Fede ay � Signed: / - ` . Title: � Date: �,/ � Z,� �� PUGET SOUND ENERGY sss� �-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY RETURN TO: �,/���� 1 y� /,� EXT: ��3 � ivvv v i l,{/ \. CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. �RIGINATING DEPT/DIV: PUBLIC WORKS / �� 1� G� P'�,� 2. ORIGINATING STAFF PERSON: Y' 1 Gt L7 I� D�� f' r�c, EXT: Z? Z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTR ❑ OTHER 5. PROJECT 6. NAME OF CONTRACTOR: ADDRESS: 5SD � M E-MAIL: rQ s� SIGNATURENA : D�i TELEPHONE: 'c�S3' 3�1S-�S� 7 FAx: TITLE:Mu+�ict�/�atl � /q�SOH �GCCts�s1�E+^ 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS � PROOF OF AUTHORITY TO SIGN O REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBl # , EXP. / / 8. TERM: COMMENCEMENT DATE: /' CO�MPLETION DATE:� pp � �i 7S l �� i 9. TOTAL COMPENSATION: $� 7 S�os Z.Z � (INCLUDE EXP$NSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLARAMOUNT: $ IS SALES TAX OWED: O YES 0 NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY O PURCHASING: PLEASE CHARGE TO: 3D rc — � - f LF� -" ��q" �Z S- � O 3S 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER .-. Tl.c�rn.. DEPUTY DIRECTOR MQ �-�� � Pr--�+ ��D[ 11. COUNCILAPPROVAL (IF APPLICABLE� INI L/DAT VIEWED [ � � 11 COMMITTEE APPROVAL DATE: � �"T' 12. CONTRACT SIGNATURE ROUTING x 1 ❑ SENT TO VENDOR/CONTRACTOR �� S �� �� llA E SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS �17 1��V1"��T . � (MAYOR O D[RECTOR� A� � IC AG # �SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED 1�\'Pr� F1 t 1 AG# 10 - 02�j E DATE SENT: q• ZO• � � INIT[AL / DATE APPROVED COUNCIL APPROVAL DATE: N DATE REC'D: COMMENTS: EXECUTE "��� ORIGINALS 1/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, WA 98063 Attn: Brian Roberts CONSTRUCTION CHANGE ORDER Number # 5 Project: Hwy 99, Phase 4, S 310th to 18th Underground Conversion Date: 10/21 /2010 Project Number: 101046016 Project Manager: Bill Thwing Description of work: Overtime differential compensation for inspector to work on Saturday, 10/23/10, to support city contractor to maintain schedule at wall #15 relative to weekend installation of joint utility trench. To accommodate 6" gas line. ��m Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 485 includes sales tax Operating Rights $ - Overhead $ 73 Company Total S 558 Govemment Entity Labor $ - Operating Rights $ - Govemment Entity Total $ - Change Order Total Allocation of Change Order Total Company 60% Government Entity 40% , $ 558 $ 335 $ 223 Change Order Total S 558 Note: This change order will be effective only when signed by both parties: Puget Sound nergy City of Fed y . , y�,� Signed: � Signed: , v ` � Title: Title: � Date: Date: (Please slgn and retum one copy) PUGET SOUND ENERGY ssai �-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY RETiJRN TO: ���� � EXT: ���� CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / �� f��� 2. ORIGINATING STAFF PERSON: � T I GL 1.� �� D�� (° r+�� EXT: Z?�_3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICEAGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT � SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE � RESOLUTION �CONTRACT AMENDMENT (AG#�:� ('7 Z ��� ❑ INTERLO AL �+ O OTHER C Ist Gt ud t C� IY� P f �-[-^ ^t Pf.� Q e.-� JO u t-c� � Lt E" f(.� W 5. PROJECT NAME: 6. NAME OF CONTRACTOR: �,l ADDRESS: �. �I 7 TELEPHONE: 'c�S3 3�fS-�S(�? E-MAIL: C �+-i FAX: SIGNATURE NA : Dpu.0 F, P 1 v� _ TITLE: MuNic��Val L.. �t�SOH lYlau�J�er 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES o COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES o PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / / 8. TERM: COMMENCEMENT DATE: COMPLETIO�N DATE:� g� � a{ 7 S, ?� S 9. TOTAL COMPENSATION: $�{ Z3��( (� � g� (INCLUDE EXP$NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, PAID BY: O CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: 3D(o �� OZ� - I�VI -� S� �' �l� "��3 S� 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER DEPUTYDIRECTOR M���,v r, T e��x' Tl� � . ��e ' 1�� d� � INITIAL / DATE APPROVED 11 . COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: ��T' 12. CONTRACT SIGNATURE ROUTING '� ❑ SENT TO VENDOR/CONTRACTOR �� � �� � � �A E SENT: ❑ ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS --crnrc "rr�iT-- . �'SIGNATORY (MAYOR O DIRECTOR) � C�K NED AG # �SIGNED COPY RETURNED � � ❑ RETURN ONE ORIGINAL COMMENTS: ^-----�_u.�-�u.-._____.__ T/_ „ ' —-� COUNCIL APPROVAL DATE: N DATE REC'D: INITIAL / DATE SIGNED AG# � n . �� DATE SENT: � •ZO • � � O� T�l� �/ f I1/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 971 S Federal Way, WA 98063 Attn: Brian Roberts CONSTRUCTION CHANGE ORDER Number # 4 Date: 12/3/2010 Project Number: 101046016 Project Manager: Bill Thwing Project: SR-99 Sch 74 Relocation Phase 4 Description of work: This Change Order is to cover the cost of installing and removing line barriers at the billboard at 304th.To be billed to third party (J.R. Hayes) I tem Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 1,609 includes sales tau Operating Rights $ - Overhead $ 241 Company Total S 1,850 Govemment Entity Labor $ - Operating Rights $ - Govemment Entity Total S - Change Order Total $ 1,850 Allocation of Change Order Total Company 0% $ - Govemment Entity 100% $ 1,850 Change Order Total S 1,850 Note: This change order will be effective only when signed by both parties: Puget Sound er y Signed: f Title: Date: (Please sign and return one copy) City of `/� Signed: � � � Title: Date: � _� , .* ( . � PUGET SOUND ENERGY �sa> >� Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary oi PUGET ENERGY xETU�trr To: S� �,�' b� � ExT: �70 3 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / � 1 r�C�'�S 2. ORIGINATING STAFF PERSON: T IGl (,a I� o�9 N r�C EXT: 2-7 �� 3. DATE REQ. BY: 4. TYPE OF DQCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT � MAINTENANCEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� O ORDINANCE ❑ RESOLUTION �CONTRACTAMENDMENT AG# :� C7Z� ❑ t I - N�TERLO AL �+ s ❑ �THER C�st Gt ud t � P 1`� =FF- � 1 [.LL7 �� JO t.� K� C �� fC.� �l 5. PROJECT NAME: 6. NAME OF ADDRESS: SIGNATURE TELEPHONE: ZS3 � 3�IS-6S(v 7 F�: TITLE:/�luNic��da� L_ na�soy l�cu�e+^ 7. EXHIBITS AND ATTACHMENTS: � SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSiJRANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. _/ / 8. TERM: COMMENCEMENT DATE: COMPLETION DATE:� O�' �2. 9. TOTAL COMPENSATION: $�'{ C��, 7� 7� �GI , I Gs g� ' � 7 3 � � t S (�CLUDE EXP6NSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOUR Y LABOR CHARGE � ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: o YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: ���o"��IC� -f S S�I S 3�'�0 3S lO. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER � T zn' ^ - 'rioivi:r'�rn" i'zivi-i� �' DEPUTYDIRECTOR M�crevav� T� r, T e c +� r- �crr- . �• �� •' � �r�e �� '.►��7���A 11 . COUNCILAPPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: Iv 12. CONTRACT SIGNATURE ROUTING '� 1 ❑ SENT TO VENDOR/CONTRACTOR �� S �� � S llA E SENT: ❑ ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS vLrr"' T �tc-T - . �'SIGNATORY (MAYOR O DIRECTOR� �.'LY�LE'RK � ASSIGNED AG # �SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED _____�� � � AG# IU •�2�? C, DATE SENT: �I • �• L� INITIAL / DATE APPROVED COUNCILAPPROVALDATE: N DATE REC'D: COMMENTS: EXECUTE "��� ORIGINALS 11/9 PUGET SOUND ENERGY To: City of Federal Way PO Box 9718 Federal Way, Wa 98063 Attn: Brian Roberts Project: SR-99 Sch 74 Relocation Phase 4 CONSTRUCTION CHANGE ORDER Number # 3 Date: 12/3/2010 Project Number: 101046016 Project Manager: Bill Thwing Description of work: This Change Order is to cover the cost of "holding" two poles at the City's request due to excavation takes place next to the poles to install the storm sewer. The work took 4 different days, at the intersection of SR-99 and 308th. One at the northeast corner and one at the northwest corner of the intersection. Item Amount Comments Company Labor Materials $ - Service Provider Outside Services $ 9,060 includes sales tax Operating Rights $ - Overhead $ 1,359 Company Total S 10,419 Government Entity Labor $ - Operating Rights $ - Govemment Entity Total $ - Change Order Total $ 70,419 a Ailocation of Change Order Total Company 60% Govemment Entity 40% 6,252 4,168 Change Order Total S 70,419 Note: This change order will be effective only when signed by both parties: Puget Sound ergy Signed: , Title: _ L,,,,� _ ..- S � Date: � (Please slgn and retum one copy) City of / Si ned: � � � 9 • Title: � t Date: PUGET SOUND ENERGY ssa> >-a Puget Sound Energy PO Box 90868 Bellevue, WA 98009-0868 a subsidiary of PUGET ENERGY RETURN TO: �������/ � ✓I���� EXT: ��C�� /4 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLIC WORKS / �}('� S 2. �RIGINATING STAFF PERSON: � f' tc( v1 � o b� r�s EXT: � 7 2. 3 3. DATE REQ. BY:, 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G, RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LINIITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT o HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECUffiTY DOCUMENT �E.G. BOND RELATED DOCUMENTS� � ORDINANCE ❑ RESOLUTION � CONTRACTAMENDMENT �AG#�: rO �Or-' `� � INTERLOCAL �THER �f� t(C-{_ � �u c �CLf.t'c�u.'t 7"1 5. PROJECT NAME: ��t C ( � 6. NAME OF CONTRACTOR: �ti ADDRESS: Sc'�c;��7 !'`l(�i u.'1t E-MAIL: cl vot s. • - i� SIGNATURENA : 1�o t.c� C TELEPHONE: �? 5 3•- 3°l 5~� 3G, 7 F.aY: TITLE: /�ac� i cc�Pa � L r a r sati, /��+t G��� �tizf�s �Ui 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE O ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL , EXP. 12/31/ UBI # , EXP. � � 8. TERM: COMMENCEMENT DAT£s: ' COMPLETION DATE: � Y��� 00 9. TOTAL COMPENSATION: $ �I � 3 � / �? � ''-� .} j(�,� (ry �( � _ �d (��f� 1 �{ '7 "'— �INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX O WED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: .3C` (e - �1 e-f�G' -• j S � - � �� ,S- 3Q - [,-� 3 � 10. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER ( �'� I`� (� �DEPUTY DIRECTOR _� �� 11 . COUNCILAPPROVAL �IF APPLICABLE� I IAL/DAT REVIEWED INITIAL/DATEAPPROVED az �� r 'L 2 �� COMMITTEEAPPROVALDATE: �;4 COUNCILAPPROVALDATE: J�Ya 12. CONTRACT SIGNATURE ROUTING ��SENTTOVENDOR/CONTRACTOR C `�� s��"`s ( �: �i�irividz � ��'7,?'01C �SIGNATORY �r b��r�e:� -�\�p � CITY CLERK � AssiGrrED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL DATE SENT: � f � I✓ DATE REC'D: ? �� n��� � I lu�.� .: � INITIAL / DATE SIGNED W �--�----' AG# — DATE SENT: - COMMENT C r I � EXECUTE "G„`� ORIGINALS L t�, S i� vt S 7 i f"S� s I Gt t S i S I� S� S't'P w D! atT f � C t.+c9r �� p,� 'tu P v� ` � / 1/9 C:\Documents and SettingslbrianhrlLocal Settings\Temporary Internet FileslContent.0utlook\U07KCQ36\PW Routing Form.doc � • PUGET 50tJND ENER�Y CONSTRUCTlON CHANGE ORDER Number #2 To: City of Feds�F Cify af Federal Way Date: 1?13l2010 PO Box 9718 PO Bcx 9T1$ Federal Way, Federai Way, Wa 98083 P'roject Number: 101046016 Attn: Marwan $alloum Project: SR-89 Phase 4 Canversion Project Manager: Bill Thwing Descriptian of work: Ths original pricing for this project was developed and provided in November 2009. The ProJect Pian states thffi ali labor provided in 201Q ts subject to 2010 labor rates. Thts changa order covers the cost of the increase in PSE labor rates from 20d9 to 2Qi0. kem pm�M Comments Company Latyor Materia{s $ - Servfce Provider Outside Services $ 36,178 includes sales tax dPe���9 �9hts $ - Overhead $ 5�427 Company Totai � 41,805 Govemment Entity Labor $ - Operdti►�g Rights � - Govemment Enttty Total 3 - Change Order Totai 41,645 Atlocatton of Change Order Totai Company 64%, Govemment Entity 4U% 24,863 �s,saz Change Order Totai S 41,608 �z� Note: This ahange order wiil be effectiwe oniy when slgned by both parties: Puget Saun Ene y City of Fede y �� Signed: � Signed: / `� � Title: Tide: p� � r c ��ks. Put�l�G --r'-- Date: 1�_./ .._ Date: �7 /'}/( ,.�.��f. (Plsase aign and retum one aopy) �� � �••��� PUGET SOrlNO ENEROY Puget Sound Erre�gy PO Box 90868 Belle�n�e, WA 88W&0888 a su6sidiary � PUQET ENERGY u�TU�r To: �i, l� � k� 1--�" ��tS-1-�' ExT: �-.� ( CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLIC WORKS/ ��I'e�C'�� 2. ORIGINATING STAFF PERSON: lJ f �Ct L'� �p I� �(TS EXT: � 7�� 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G, RFB, RFP, RFQ� o PusLic Woxics CorrTitacT ❑ SMALI, OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AC3REEMENT o HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT �E. G BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION �CONTRACTAMENDMENT�AG#�: ��`D�� 1 ❑ INTERLOCAL OTHER Pt,�a� Soa �KErdc1 Sc1�ec4„��.P ��'�' _� 5. PROJECT NAME: 0. G v v ��t S 6i r � 6. NAME OF CONTRACTOR: +�.2 ADDRESS: � � u, 0. K ��I �S 7'ELEPHONE: ? S�3 — S�'! �—�n��{ �o E-M.�L: -F��w� s��r �H(d cse c,ou.� F�: SIGNATURE NAME: �(+j wt (s� ct ct t� TITLE: rn; M a 7. EXHIBTTS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. � � 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: /�/% t 9. TOTAL COMPENSATION: $�S� ZO S f' L I � 7� Cl �=�� S��I D S� �INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: O CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: ���o' y �FO� �� 5� S S' 3 �(0 3� 1 O. DOCUMENT / CONTRACT REVIEW �PROJECT MANAGER �� �(��ip �DEPUTYDIRECTOR /�IarwaH I ( � lp ,�IRECTOR Cctr � RISK MANAGE�NT (IF APPLICABLE� ❑ LaW D�r 11. • i� rc k� � j , �, ... � � �• �• � ��[�7 � , ,!iL=�R�1 ' �.� . - - /�� i�u COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING � SENT TO VENDOR/CONTRACTOR DATE SENT: �.I I�' I � ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ L,Aw DEr�r �` ����D �[SIGNATORY �CM OR DIRECTOR� C(�;1 /.I,1 � � CITY CI,ERK J �ASSIdNED AG # �SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COM �� . , ,„�,; � /'� '� ��. r,.'ti l� 1 U S�Q b'l S INIT7AL / DATE SIGNED �� AG# �� - a DATE SENT: ' D �S ?SE� COUNCILAPPROVALDATE: I Q� Da� REC'n: PS E wr l( r�u�� .aa. � ��1W. �� � v ��V 11/9 C:\Documents and Settings\brianhr�Local Settings\Temporary Intemet Files\Content.0utlook\U07KCQ361PW Routing Form.doe PUGET SOUND ENERGY CONSTRUCTION CHANGE ORDER Number # 1 To: City of Feder City of Federai Way Date: 4114/2010 PO Box 9718 PO Box 9718 Federal Way, Federal Way, Wa 98063 Project Number: 101046016 Attn: Marvvan Salloum Project: SR-99 Phase 4 Conversion Project Manager: Jeff Zittertch Description of work: This Change Order is at the City's request to transfer the existing distribution lines to the new transmission poles between stations 27 and 38. This Change Odrder will be billed at 100°�6 City because the City has requested that the lines be transferred prior to the conversion. Wo�lc to be completed prior to the construction of the retaining wall. After the distribution lines are transferred, they can be de- energized at the City's request with the understanding that PSE, at its option, may re-energize the Ilnes due to weather conditions or other unforseen circumstances. If necessary, PSE will give the City 24 hours notice of this need. Item Amount Comments Company Labor Materials $ 3,444 Service Provider Outside Services $ 27,169 includes sales tax Operating Rights $ - Overhead $ 4,592 Company Total �� Govemment Entity Labor $ - Operating Rights $ - Govemment Entity Total S - Change Order Total 35,205 Allocation of Change Order Total Company 0% Govemment Entity 100°h 35,205 Change Order Total S 35.205 Note: This change order will be effective only when signed by both parties: Puget Sound nergy City of Federal `� Signed: Gti--� ��✓ `---- Signed: � Title: TiUe: s c,J 1."� Date: i Date: o (Please sign and retum one copy) PUGET SOUND ENERGY ase� �� Puget Sound Energy PO Box 90868 Bellewe, WA 98009-0868 a subaidiary of PUGET ENERGY RETURN TO: �va- CITY OF FEDERAL WAY LAW DEPARTMENT FOR CONTRACT PREPARATION/DOCUMENT REVIEWISIGNATURE ROUTING SLIP l. ORIGINATING DEPT./DIV: P� / S��'f.�'�S 2. ORIGINATING STAFF PERSON: C� t� tGC v► �O � Q� i S EXT: Z� 23 3. DATE REQ. BY: 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) � PUBLIC WORKS CONTRACT ❑ SMALL PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT � GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG � REAL ESTATE DOCUMENT � ORDINANCE � SECURITY DOCUMENT �E.G. BOND RELATED DOCUMENTS) � RESOLUTION O C�NTRACTAMENDMENT(AG#): ,,�OTHER pu.qP�� Soc,�tio� �VCPf4 N � 2 u�-,e �7'� 5. PROJECT NAME: Pct G c�i c N Sa �D U G rx H�'S � Gtct s e ZIZ' 6. NAME OF CONTRACTOR: P -F ,S ct. ADDRESS: �t S, Z S H v(/ 32 TELEPHONE PS3 SIGNATURENAME: po � C,��� �`� TITLE MuK�ci�i -L.,�ai5dti Md►caoef 7. EXHIBITS AND ATTACHMENTS;� WORK OR SERVICES O COMPENSAT[ON O[NSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBCfS PROOF OF AU'i'HORTCY TO S[GN ❑ REQUIRED LICENS£S 0 PRIOR CON'fRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: ' COMPLETION DATE: /�/i4 � �. TOTAL COMPENSATION $ I 7��I � (tNCLtrDE E7crENSES AND Sa[.ES T�c, ►� ,�wY) (IF CALCULATED ON HOURLY LABOR C{-IARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOL[DAY RATES) REIMBURSABLE EXPENSE: � YES � tvo IF YES, IWIAXIIvtUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO [F YES, $_ ___ PAtD BY_ O CONTRACTOR � CffY ❑ PURCHASING: PLEASE CHARGE TO: ,3G2'v Q� 1 SR- S�'S� 3 D�- � 3S� 10. CONTRACT REVIEW � PROJECT MANAGER '�I `t �bIRECTOIt/M�kRwA� - ��(SIGNATORY(E�A6�4 Dt[tECro CEiRY - • �(��'�.Aw (Revie� �I-'S�n�.� Z- �'-1 t 1. CQNTRACT SIGNATURE ROUTIN �-+� C'� J�ENi' TO VENDORJCONTRACTOR DATE SENT: 2 � �-/ �'e r, ATTACH: SIGNATURE AUTH INSURANCE CERTIFICATE, LiCEN ES, EXHY ITS e./� SIqHf � � . GO S�/ttC�l loH �. V DATE REC' D: pZ I(o (� �{� r �,� ITIAL / DATE SIGNED � �LAW DEPEIR T Z' ' O � SIGNATORY C , ACM OR IRECTOR p.(o% d S�auJa v Rees�ar�� P r�d tct P1 � �n �3 8 ��� CITY CLERK(LkST, Proj er�- ,�ASSIGNED AG# PIa,K.. AG# � p- D2 � COPY R�TURNED .__. � 0 t� t q 1�1'� c� � �ES C�mn� 24� DATE S�FNT: 2• � 7• � 4/9 SCHEDULE 74 UNDERGROUND CONVERSION Project Construction Agreement Project Name: City of Federal Way — Paci�c Hwy Phase 4 Project Number: 101046016 �' N THIS Agreement, dated as of this i Z�day of ��=�i Z v� a.Y , 20� is made by and between the City of Federal Way, a Municipal Corporation (the "Government Entit�'), and PUGET SOUND ENERGY, Inc., a Washington Corporation (the "Company"). RECITALS A. The Company is a public service company engaged in the sale and distribution of electric energy, and pursuant to its franchise or other rights from the Government Entity, currently locates its electric distribution facilities within the jurisdictional boundaries of the Government Entity. B. The Govemment Entity has determined that it is necessary to replace the existing overhead electric distribution system within the area specified in the Project Plan (as defined below) (the "Conversion Area") with a comparable underground electric distribution system, all as more specifically described in the Project Plan (the "Conversion Project"). C. The Government Entity and the Company have previously entered into a Project Design Agreement dated as of December 12, 2006 (the "Design Agreement"), pursuant to which the parties completed certain engineering design, cost assessment, operating rights planning and other preliminary . work relating to the Conversion Project and, in connection with that effort, developed the Project Plan. D. The Government Entity and the Company wish to execute this written contract in acxordance with Schedule 74 of the Company's Electric Tariff G("Schedule 74") to govern the completion of the Conversion Project, which both parties intend shalf'qualify as airunderground conversion under the terms of Schedule 74. AGREEMENT The Government Entity and the Company therefore agree as follows: 1. Definitions (a) Unless specifically defined otherwise herein, all terms defined in Schedule 74 shall have the same meanings when used in this Agreement, including, without limitation, the following: i) Cost of Conversion; ii) Public Thoroughfare; iii) Temporary Service; iv) Trenching and Restoration; v) Underground Distribution System; and vi) Underground Service Lines. (b) "Company-Initiated Upgrade" shall mean �ny feature of'the Underground Dist�ibution System which is required by the Company and is not reasonably required to make the Underground Distribution System comparable to the overhead distribution system being replaced. For purposes of the foregoing, a"comparable" system shall include, unless the Parties otherwise agree, the number of empty ducts (not to exceed finro (2), typically having a diameter of 6" or less) Construction Agreement, Attachment "B° to Schedule 74, Page 1 City of Federal Way — Pacific Hwy Phase 4 of such diameter and number as may be specified and agreed upon in the Project Plan necessary to replicate the load-carrying capacity (system amperage ciass) of the overhead system being replaced. (c) "Estimated Reimbursable Private Conversion Costs" shall mean the Company's good faith estimate of the Reimbursable Private Conversion Costs, as specified in the Project Plan and as changed and adjusted from time to time in accordance with Section 6, below. (d) "Estimated Reimbursable Temporary Service Costs° shall mean the Companys good faith estimate of the Reimbursable Temporary Service Costs, as specified in the Project Plan and as changed and adjusted from time to time in accordance with Section 6, below. (e) "Estimated Reimbursable Upgrade Costs" shall mean the Companys good faith estimate of the Reimbursable Upgrade Costs, as specified in the Project Plan and as changed and adjusted from time to time in accordance with Section 6, below. -;;:. (fl "Estimated Shared Company Costs" shall mean the Cotrmpany's good faith estimate of the Shared Company Costs, as specified in the Project Plan and as changed and adjusted from time to time in accordance with Section 6, below. (g) "Estimated Shared Government Costs" shall mean the �Government Entity's good faith estimate of the Shared Government Costs, as specified in the Project Plan and as changed and adjusted from time to time in accordance with Section 6, below. (h) "Government-Requested Upgrade" shall mean any feature of the Underground Distribution � System which is requested by the Government Entity and is not reasonably required to make the Underground Distribution System comparable to the overhead distribution system being replaced. For purposes of the foregoing, any empty ducts installed at the request of the Government Entity shall be a Government-Requested Upgrade. (i) "Part�' shall mean either the Company, the Government Entity, or both. (j) "Private Property Conversion" shall mean :that portion,;ff any, of the Conversion Project for which the existing overhead electric distribution system is located, as of the date determined in accordance with Schedule 74, (i) outside of the Public Thoroughfare, or (ii) pursuant to rights not derived from a franchise previously granted by the Government Entity or pursuant to rights not , otheiwise previously granted by the Government Entity: (k) "Project Plan" shall mean the project plan developed by Parties under the Design Agreement and attached hereto as Exhibit A, as the same may be changed and amended from time to time in accordance with Section 6, below. The P�`oject Plan includes, among other things, (i) a detailed description of the Work that is required to be perFormed by each Party and any third party, (ii) the applicable requirements and specifications for the Work, (iii) a description of the Operating Rights that are required to be obtained by each Party for the Conversion Project (and the requirements and specifications with respect thereto), (iv) an itemization and summary of the Estimated Shared Company Costs, Estimated Shared Government Costs, Estimated Reimbursable Private Conversion Costs (if any), Estimated Reimbursable Temporary Service Costs (if any) and Estimated Reimbursable Upgrade Costs (if any), and (v) the Work Schedule. (I) "Operating Rights° shall mean sufficient space and legal rights for the construction, operation, repair, and maintenance of the Underground Distribution System. (m) "Reimbursable Private Conversion Costs" shall mean (i) all Costs of Conversion, if any, inc:un�ed by the Company which are attributable to a Private Property Conversion, less (ii) the distribution pole replacement costs (if any) that would be avoided by the Company on account of such Private Property Conversion, as determined consistent with the applicable Company distribution facilities Construction Agreement, Attachment °B" to Schedule 74, Page 2 City of Federal Way — Pac�c Hwy Phase 4 replacement program, plus (iii) just compensation as provided by law for the Company's interests in real property on which such existing overhead distribution system was located prior to conversion; provided that the portion of the Reimbursable Private Conversion Costs attributable to the Costs of Conversion under subparagraph (i) of this paragraph shall not exceed the Estimated Reimbursable Private Conversion Costs without the prior written authorization of the Government : Entity. � � � (n) "Reimbursable Temporary Service Costs";shall mean all costs incurred by the Company which are attributable to (i) any facilities installed as part of the.Conversion Project to provide Temporary Service, as provided for in Schedule 74, and (ii) the removal of any facilities installed to provide Temporary Service (less salvage value of removed equipment); provided that the Reimbursable Temporary Service Costs shall not exceed the Estimated Reimbursable Temporary Service Costs without the prior written authorization of the Government Entity. (o) "Reimbursable Upgrade Costs" shall mean all Costs of Conversion incurred by the Company which are attributable to any Government-Requested Upgrade; provided that the Reimbursable Upgrade Costs shall not exceed the Estimated Reimbursable Upgrade Costs without the prior written authorization of the Government Entity. (p) "Shared Company Costs" shall mean all Costs of Conversion (other than Reimbursable Upgrade Costs, Reimbursable Private Conversion Costs and Reimbursable Temporary Service Costs) incurred by the Company in connection with the Conversion Project; provided, however, that the Shared Company Costs shall not exceed the Estimated Shared Company Costs without the prior written authorization of the Government Entity. For the avoidance of doubt, the "Shared Company Costs" shall, as and to the extent specified�in the Design Agreement, include the actual, reasonable costs to the Company for the "Design Work" performed by the Company under the Design Agreement. (q) °Shared Government Costs" shall mean �II Costs of Conversion incurred by the Government Entity in connection with (i) any duct and vault installation Work which the Parties have spec�ed in the Project Plan is to be performed by the Government Entity as part of the Govemment Work, and (ii) the acquisition of any Operating Rights which the Parties have, by mutual agreement, specified in the Projec�'':Plan are to be obtained by the Government Entity for the Conversion Project, but only to the extent attributable to that portion-�of such Operating Rights which is necessary to accommodate the facilities of the Company; provided, however, that the Shared Government Costs shall not exceed the Estimated Shared Government Costs without the prior written authorization of the Company. (r) °Total Shared Costs" shall mean the sum of the Shared Company Costs and the Shared Government Costs. For the avoidance of doubt, the Total Shared Costs shall not include, without limitation, (i) costs to the Government Entity for Trenching and Restoration, or (ii) costs associated with any joint use of trenches by other utilities as permitted under Section 3(b). (s) "Work° shall mean all work to be pertormed in connection with the Conversion Project, as more specifically described in the Project Plan, including, without limitation, the Company Work (as defined in Section 2(a), below) and the Government Work (as defined in Section 3(a), below). (t) "Work Schedule° shall mean the schedule specified in the Project Plan which sets forth the milestones for completing the Work, as the same may be changed and amended from time to time in accordance with Section 6, below. ` 2. Obliaations of the Com�anv. . ;: (a) Subject to the terms and conditions of this��Agreement, the Company shall do the foHowing as ' spec�ed in, and in accordance with the design and construction spec�cations and other requirements set forth in, the Project Plan (the "Company Work"): �.. � �; . . . ... . - ,.(.+: ' � Construction Agreement, Attachment "B" to Schedule 74, Page 3 City of Federal Way —Pac�c Hwy Phase 4 i) furnish and install an Underground Distribution System within the Conversion Area (excluding any duct and vault installation or other Work which the Parties have specified in the Project Plan is to be performed by the Government Entity); ii) provide a Company inspectoron-site at the times specified in the Work Schedule to inspect the performance of any duct and vault installation Work which the Parties have specified in the Project Plan is to be performed by the Government Entity; and iii) upon connection of those persons or entities to be served by the Underground Distribution System and removal of facilities of any other utilities that are connected to the poles of the overhead system, remove the existing overhead system (including associated wires and Company-owned poles) of 15,000 volts or less within the Conversion Area except for Temporary Services. (b) Upon request of the Government Entity, the Company shall provide periodic reports of the progress of the Company Work identifying;(i) the Company Work completed to date, (ii) the Company Work yet to be completed, and (iii) an estimate regarding whether the Conversion Project is on target with respect to the Estimated Shared Company Costs, the Estimated Reimbursable Private Conversion Costs (if any), the Estimated Reimbursable Temporary Service Costs (if any), the Estimated Reimbursable Upgrade Costs (ff any) and the Work Schedule. (c) Except as otherwise provided in the Companys Electric Tariff G, the Company shall own, operate and maintain all electrical facilities installed pursuant to fhis Agreement including, but not limited to, the Underground Distribution System and Underground Service Lines. (d) Subject to the terms and conditions of this Agreement, the Company shall perform ail Company Work in accordance with the Project Plan, the Work Schedule and this Agreement. 3. Obliaations of the Government Entifir. (a) Subject to the terms and conditions of this Agreement, the Government Entity shall do the following as specified in, and in accordance with the design and construction specifications and other requirements set forth in, the Project Plan (the "Government Work"): i) provide the Trenching and Restoration; ii) perform the surveying for alignment and grades for ducts and vaults; and iii) perform any duct and vault installation and other Work which the Parties have specified in the Project Plan is to be performed by the Government Entity. (b) Other utilities may be permitted by the Government Entity to use the trenches provided by the Government Entity for fhe installation of their facilities so long as such facilities or the installation thereof do not interFere (as determined pursuant to the Company's electrical standards) with the Underground Distribution System or the installation or maintenance thereof. Any such use af the trenches by other utilities shall be done subject to and in accordance with the joint trench design specifications and installation drawings set forth or otherwise ident�ed in the Project Plan, and the Government Entity shall be responsible for'the coordination of the design and installation of the facilities of the other utilities to ensure compliance with such specifications and drawings. :,, (c) Upon request of the Company, the Government Entity shall provide periodic reports of the progress of the Government Work idenfifying (i) the Government Work completed to date, (ii) the Government Work yet to be completed, and (iii) an estimate regarding whether the Conversion Project is on target with respect to the Estimated Shared Government Costs and the Work Schedule. (d) The Govemment Entity shall be responsible for coordinating all work to be performed in connection with the street improvement program within the Conversion Area. Construction Agreement, Attachment "B" to Schedule 74, Page 4 City of Federal Way — Pacific Hwy Phase 4 ____ (e) Subject to the terms and conditions of this Agreement, the Government Entity shall perform all Government Work in accordance with the Project Plan, the Work Schedule and this Agreement. 4. Work Schedule (a) The Government Entity and the Company„have agreed �upon the Work Schedule as set forth in the Project Plan. Changes to the Work Schedule shall ;6e made only in accordance with Section 6, below. }' (b) Promptly following the �execution of this Agreement, and,upon completion by the Govemment Entity of any necessary preliminary work, the Government Entity shall hold a pre-construction meeting involving all participants in the Conversion Project to review project design, coordination requirements, work sequencing and related pre-mobilization requirements. Following the pre- construction meeting, the Government Entity shall give the Company written notice to proceed with the Work at least ten (10) business days prior to the commencement date specified in the Work Schedule. (c) Subject to the terms and conditions of this Agreement, each Party shall perform the Work assigned to it under this Agreement in accordance with the Work Schedule. So long as the Company performs the Company Work in accordance with the Work Schedule, the Company shall not be liable to the Government Entity (or its agents, servants, employees, contractors, subcontractors, or representatives) for any claims, actions, damages, or liability asserted or arising out of delays in the Work Schedule. 5. Location of Facilities All facilities of the Company installed within the Conversion Area pursuant to this Agreement shall be located, and all related Operating Rights shaU be obtained, in the manner set forth in the applicable provisions of Schedule 74, as spec�ed by the Parties in the Project Plan. 6. Chanpes. � (a) Either Party may, at any time, by written notice thereof to the other Party, request changes in the Work within the general scope of this Agreement (a "Reguest for Change"), including, but not limited to: (i) changes in, substitutions for, additions to or deletions of any Work; (ii) changes in the specifications, drawings and other requirements in the Project Plan, (iii) changes in the Work ` Schedule, and (iv) changes in the location, alignment, dimensions or design of items included in the Work. No Request for Change shall be effective and binding upon the Parties unless signed by an authorized representative of each Party. (b) If any change included in an approved Request for Change would cause a change in the cost of, or the time required for, the performance of any part of the Work, an equitable adjustment shall be made in the Estimated Shared Company Costs, the Estimated Shared Govemment Costs, the Estimated Reimbursable Private Conversion Costs (if any), the Estimated Reimbursabie Temporary Service Costs (if any), the Estimated Reimbursable Upgrade Costs (if any) and/or the Work Schedule to reflect such change. The Parties shall negotiate in good faith with the objective of agreeing in writing on a mutually acceptable equitable adjustment. If the Parties are unable to agree upon the terms of the equitable adjustment, either Party may submit the matter for P resolution pursuant to the dispute resolution provisions in Section 10, below. (c) The Work Schedule, the Estimated Shared Company Costs, the Estimated Shared Gaverrtt�nent Costs, the Estimated Reimbursable Private Conversion Costs, the Estimated Reimbursable ' Temporary Service Costs and/or the Estimated Reimbursable Upgrade Costs shall be further equitably adjusted from time to time to reflect any change in the costs or time required to perform the Work to the extent such change is caused by: (i) any Force Majeure Event under Section 11, below, (ii) the discovery of any condition within the Conversion Area which affects the scope, cost, . �# ._. �;i{ � � � . . .. . i '�i♦ Construction Agreement, Attachment "B" to Schedule 74, Page 5 City of Federal Way — Pacific Hwy Phase 4 ' schedule or other aspect of the Work and was not known by or disclosed to the affected Party ` prior to the date of this Agreement, or (iii) any change or inaccuracy in any assumptions regarding the scope, cost, schedule or other aspect of the Work which are expressly identified by the Parties in the Project Plan. Upon the request of either Party, the Parties will negotiate in good faith with the objective of agreeing in writing on a mutually acceptable equitable adjustment. If, at any time thereafter, the Parties are unable to agree upon the terms of the equitable adjustment, either Party may submit the matter for resolution pursuant to the dispute resolution provisions in Section 10, below. (d) Notwithstanding any dispute or delay in reaching agreement or arriving at a mutualiy acceptable equitable adjustment, each Party shall, if requested by the other Party, proceed with the Work in accordance with any approved Request for Change. Any request to proceed hereunder must be accompanied by a written statement setting forth the requesting Party's reasons for rejecting the proposed equitable adjustment of the other Party. 7. Comnensation and Payment. (a) Subject to and in accordance with the terms and condifions of this Agreement��(including, without limitation, the payment procedures set forth in this Section 7), payment in connection with the Conversion Project and this Agreement shall be as follows: i) The Total Shared Costs shall be allocated fo the Parties in the following percentages: (A) sixty percent (60%) to the Company, an�! (B) forty percent (40%) to the Government Entity. ii) The Government Entity shall pay one hundred percent (100%) of all Reimbursable Private Conversion Costs, if any. iii) The Government Entity shall pay one hundred percent (100%) of all Reimbursable Upgrade Costs, if any. iv) The Government Entity shall pay one hundred percent (100%) of all Reimbu�able Temporary Service Costs, if any. v) The Government Entity shall pay one hundred percent (100%) of the costs it incurs to perform that portion of the Government Work spec�ed in Section 3(a)(i) and (ii) (i.e., Trenching and Restoration and surveying).. vi) The Company shall pay one hundred percent (100%) of the costs it incurs to design, provide and construct any Company-Initiated Upgrade. vii) The Company shall pay one hundred percent (100%) of the costs it incurs to obtain- Operating Rights outside the Public Thoroughfare. (b) Based on the allocation of responsibilities set forth in Section 7(a), above, the Parties shall determine the net amount payable by the Government Entity or the Company, as applicable, to the other Party under this Agreement (the "Net Amount"). The Net Amount shall be determined by using the amount of the Total Shared Gosts allocated to the Government Entity under Section 7(a)(i), and adjusting such amount as follows: ' i) ii) iii) .;, Subtracting (as a credit to the Government Entity) the amount of the Shared _ Governme�t Costs. - Adding (a� a credit to the Com�pany) the amount of all Reimbursable Private Conversion Costs, Reimbursable Upgrade Costs and Reimbursable Temporary Service Costs. Subtracting (as a credit to the Government Entity) any payments previously made to : the Company by the Government Entity under the Design Agreement which, under the terms of the Design Agreement, are to be credited to the Government Entity under this Agreement. The Net Amount, as so calculated, (A) will be an amount payable to the Company if it is a positive number, and (B) shall be an amount payable to the Government Entity if it is a negative number. Construction Agreement, Attachment "B" to Schedule 74, Page 6 City of Federal Way — Pacific Hwy Phase 4 " (c) Within sixty (60) business days of completion of the Conversion Project, the Government Entity shall provide the Company with an itemization of the Shared Government Costs (the "Govemment Itemization"), together with such documentation and information as the Company may reasonably- request to verify the Government Itemization. The Government Itemization shall, at a minimum, break down the Shared Government Costs by the following categories, as applicable: (i) property and related costs incurred and/o� paid by the Government Entity, including any costs of obtaining Operating Rights, and (ii) construction costs incurred and/or paid by the Government Entity, including and listing separately inspection,'labor, mater'ials and equipment, overhead and all costs charged by any agent, contractor or subcontractor of the Government Entity. �: (d) Within thirty (30) business days after the Company's receipt of the Government Itemization and requested documentation and information, the Company shall provide the Government Entity a written statement (the "Company Statement") showing (i) an itemization of the Shared Company Costs, (ii) the Parties' relative share of the Total Shared Costs based on the Company's itemization of the Shared Company Costs and the Government Entity's itemization of the Shared Government Costs set forth in the Government Itemization, (iii) any Reimbursable Private Conversion Costs, (iv) any Reimbursable Upgrade Costs, (v) any Reimbursable Temporary Service Costs, (vi) any credits to the Government Entity for payments previously made to the Company by the Government Entity under the Design Agreement which, under the terms of the Design Agreement, are to be credited to the Government Entity under this Agreement, and (vii) the Net Amount, as determined in accordance with Section 7(b), above, together with such documentation and information as the Government Entity may reasonably request to verify the Company Statement. The itemization of the Shared Company Costs included in the Company - Statement shall, at a minimum, break down the Shared Company Costs by the foltowing categories, as applicable: (i) design and engineering costs, and (ii) construction costs, including and listing separately inspection, labor, materials and equipment, overhead and all costs c�arged _ by any agent, contractor or subcontractor of the Company. (e) Within thirty (30) business days after the Government Entity's receipt of the Company Statement and requested documentation and inform�tion, the Net`Amount shall be paid`by the owing Party to the other Party, as specified in the Compahy Statement. ; 8. Indemnification. { �' (a) The Govemment Entity releases and shall defend, indemnify and hold the Company harmless - from all claims, losses, harm, liabilities, damages, costs and expenses (including, but not limited to, reasonable attorneys' fees) caused by or arising out of any negligent act or omission orwiltful misconduct of the Government Entity in its performance under this Agreement. During the performance of such activities the Government Entity's employees or contractors shall at all tirr►�s remain employees or contractors, respectively, of the Govemment Entity. (b) The Company releases and shall defend, indemnify and hold the Govemment Entity harmless from all claims, losses, harm, liabilities, damages, costs and expenses (including, but not timited to, reasonable attorneys' fees) caused by or arising out of any negligent act or omission or willful misconduct of the Company in its performance under this Agreement. During the performance of such activities the Company's employees or contractors shall at all times remain employees or contractors, respectively, of the Company. ` (c) Solely for purposes of enforcing the indemnification obligations of a Party under this Section`8, each Party expressly waives its immunity under Title 51 of the Revised Code of Washingtoni t4� Industrial Insurance Act, and agrees that the obligation to indemnify, defend and hold harmless provided for in this Section 8 extends to any such claim brought against the indemnified Party by or on behalf of any employee of the indemnifying Party: �'The foregoing waiver-shall not in any wray preclude the indemnifying Party from raisir�'g such immunity as a defense against any claim brought against the indemnifying Party by any of its employees. Construction Agreement, Attachment °B" to Schedule 74, Page 7 City of Federal Way - Pacific Hwy Phase 4 `� 9. Conversion of Service to Customers within Conversion Area. (a) Upon commencement of the Work, the Government Entity shall notify all persons and entities within the Conversion Area that service lines to such customers must be converted from overhead to underground service within the applicable statutory period following written notice from the Government Entity that service from underground facilities are available in accordance with RCW 35.96.050. Upon the request of any customer, other than a single family residential customer, within the Conversion Area, the Company shall remove the overhead system and connect such persons' and entities' Underground Service Lines to the Underground Distribution System. . (b) The Parties acknowledge that single family residences within the Conversion Area must (i) provide a service trench and conduit, in accordance with the Company's specifications, from the underground meter base to the point of service provided during the conversion, and (ii) pay for the secondary service conductors as defined in Schedule 85 of the Companys Electric Tariff G. The Government Entity shall exercise its authority to order disconnection and removal of overhead facilities with respect to owners failing to convert service lines from overheadto underground within the timelines provided in RCW 35.96.050. - 10. Dispute Resolution. (a) Any dispute, disagreement or claim arising out of or concerning this Agreement must first be presented to and considered by the Parties. A Party who wishes dispute resolution shall notify the other Party in writing as to the nature of the dispute. Each Party shall appoint a representative who shall be responsible for representing the Party's interests. The representatives shall exercise good faith efforts to resolve the dispute. Any dispute that is not resolved within ten (10) business days of the date the disagreement was first raised by written notice shall be refened by the Parties' representatives in writing to the senior management of the Parties for resotution. In the event the senior management are unable to resolve the dispute within twenty (20) business days (or such other period as the Parties may agree upon), each Party may pursue resolution of the dispute through other legal means consistent with the terms of this Agreement. All negotiations pursuant to these procedures for the resolution of disputes shall be confidential and shall be' treated as compromise and settlement negotiations for purposes of the state and federal rules t�f evidence. (b) Any claim or dispute arising hereunder which relates to any Request for Change or any equitable adjustment under Section 6, above, or the`compensation payable by or to either Party under Section 7, above, and which is not resolved by senior management within the time permitted under Section 10(a), a6ove, shall be resolved by arbitration in Seattle, Washington, under #he Construction Industry Arbitration Rules of the American'Arbitration Association� then in effect. The decision(s) of the arbitrator(s) shall be final; conclusive`and binding upon the Parties. All other disputes shall be resolved by litigation in a�y�court or gbvernmental agency, as applicabie, having jurisdiction over the Parties and the dispute. (c) In connection with any arbitration under this Section 10, costs of the arbitrator(s), hearing rooms and other common costs shall be divided equally amo�g the Parties. Each Party shall bear the cost and expense of preparing and presenting its own case (including, but not limited to, its aim � attorneys' fees); provided, that, in any arbitration, the arbitrator(s) may require, as part of his'or her decision, reimbursement of all or a portion of the prevailing Party's costs and expens� (including, but not limited to, reasonable attorneys' fees) by the other Party. (d) Unless otherwise agreed by the Parties in writing, the Parties shall continue to perform their respective obligations under this Agreement during the pendency of any dispute. Construction Agreement, Attachment °B" to Schedule 74, Page 8 City of Federal Way — Paci�c Hwy Phase 4 11. Uncontrollable Forces. In the event that either Party is prevented or delayed in the performance of any of its obligations under this Agreement by reason beyond its reasonable control (a "Force Majeure Event"), then that Party's performance shall be excused during the Force Majeure Event. Force Majeure E�ents shall include, without limitation, war; civil disturbance; flood„'earthquake or other Act of God; storm, earthquake or other condition which necessitates the mobilization of the personnel of a Party or its contractors to restore utility service to customers; laws, regulations, rules or orders of any governmental agency; sabotage; strikes or similar labor disputes involving personnel of a Party, its contractors or a third party; or any failure or delay in the performance by the othec Party, or a third party who is not an employee, agent or contractor of the Party claiming a Force Majeure Event, in connection with the Work or this Agreement. Upon removal or termination of the Force Majeure Event, the Party claiming a Force Majeure Event shall promptly perform the affected obligations in an orderly and expedited manner under this Agreement or procure a substitute for such obligation. The Parties shall use all commercially reasonable efforts to eliminate or minimize any delay caused by a Force Majeure Event. 12. insurance. (a) PSE shall, and shall require each of its contractors to, secure and maintain in force throughout the duration of the Conversion Project (or, if sooner, until termination of this Agreement) comprehensive general liability insurances, with a minimum coverage of $2,000,000 per occurrence and $2,000,000 aggregate for personal injury; and $2,000,000 per occurrence/ aggregate for property damages, and professional liability insurance in the amount of $2,000,000. (b) The Government Entity shall ensure that each of its contractors performing any Govemment Work secures and maintains in force throughout the duration of the Conversion Project (or, if sooner, until termination of this Agreement) insurance policies having the same coverage, amounts and "" limits as spec�ed Section 12(a), above. � � (c) In lieu of the insurance requirements set forth in Section 12(a), above, the Company may self- insure against such risks in such amounts� as are consistent with good utility practice. Upon the Government Entity's request, the Company shall provide the Government Entity with reasonable written evidence that the Company is maintaining such self-insurance. ti; 13. Other. (a) Aareement Subiect To Tariff. This Agreement is subject to the General Rules and Provisions set forth in Tariff Schedule 80 of the Company's electrical Tariff G and to Schedule 74 of suctrTariff as approved by the Washington Utilities and Transportation Commission and in effect as of ffie '` date of this Agreement. (b) Termination. The Government Entity reserves the right to terminate the Conversion Project and this Agreement upon written notice to the Company. In the event that the Government Entity terminates the Conversion Project and this Agreement, the Government Entity shall reimburse the Company for all costs reasonably incurred by the Company in connection with the Work performed prior to the effective date of termination. In such event, the costs reimbursable to the Company (i) shail not be reduced by any Shared Government Costs or other costs incurred' by'the Government Entity, and (ii) shall be paid within thirty (30) days after the receipt of the Company's invoice therefor. Sections 1, 5, 7, 8, 9, 10, 11 and 13 shall survive any termination of the` Conversion Project and/or this Agreement. • (c) Facilities Greater Than 15.000 Volts. Nothing in this Agreement shall in any way affect the rights or obligations of the Company under any previous agreements pertaining to the existing or future facilities of greater than 15,000 Volts within the Conversion Area. _ �:. iz. .- � Construction Agreement, Attachment "B" to Schedule 74, Page 9 City of Federal Way — Pacific Hwy Phase 4 (d) Compliance With Law. The Parties shall, in performing the Work under this Agreement, comply with all applicable federal, state, and local laws, ordinances, and regulations. (e) No Discrimination. The Company, with regard to the Work performed by the Company under this Agreement, shall comply with all applicable laws relating to discrimination on the basis race, color, national origin, religion, creed, age, sex, or the presence of any physical or sensory handicap in the selection and retention of employees or procurement of materials or supplies. (fl �9) Independent Contractor. The Company and the Government Entity agree that the Company is an independent contractor with respect to the Work and this Agreement. The Company is acting to preserve and protect its facilities and is not acting for the Government Entity in performing the Work. Nothing in this A. greement shall be considered to create the relationship of employer and employee befinreen the Parties. Neither the Company nor any employee of the Company shall be entitled to any benefits accorded employees of the Government Entity by virtue of the Work or this Agreement. The Government Entity shall not be responsible for withholding or othervvise deducting federal income tax or social security or contributing to the State Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the Company, or any employee of the Company. Nonwaiver of Risahts or Remedies. No failure or delay of either Party to insist upon or enforce strict performance by the other Party of any provision of this Agreement or to exercise any other right under this Agreement, and no course of dealing or: performance with respect thereto, shall, except to the extent provided in this Agreement, be construed as a waiver or, or choice of, or relinquishment of any right under any provision of this Agreement or any right at law or equity not othervvise provided for herein. The express waiver by either Party of any right or remedy under this Agreement or at law or equity in a particular instance or circumstance shall not constitute a waiver thereof in any other instance or circumstance. (h) No Third Party Beneficiaries. There are no third-party beneficiaries of this Agreement. Nothing contained in this Agreement is intended to confer any right or interest on anyone other than the Parties, their respective successors, assigns and legal representatives. (i) Governmental Authoritv. This Agreement is subject to the rules, regulations, orders and other �_�' requirements, now or hereafter in effect, of all governmental regulatory authorities and courts having jurisdiction over this Agreement, the Parties or either of them. All laws; ordinances, n�les, regulations, orders and other requirements, now or hereafter in effect, of governmental regulatory authorities and courts that are required to be incorporated into agreements of this characterare by this reference incorporated in this Agreement. (i) (k) No Partnershi�. This Agreement shall not' be interpreted or construed to create an association, joint venture or partnership befinreen the Parties or to impose any partnership obligations or liability upon either Party. Further, neither Party shall have any right, power or authority to enter into any agreement or undertaking for or on behalf of, to act as or be an agent or representative of, or to otherwise bind the other Party. .' Severabilitv. In the event that any provision of this Agreement or the application of any such provision shall be held°invalid as to either Party or any �ircumstance by any court having jurisdiction, such provision shall remain in force and effect to the maximum extent provided by � law, and alt other provisions of this Agreement and their application shall not be affeated thereby but shall remain in force and effect unless a court or arbitrator holds they are not severabt� from the invalid provisions. Construction Agreement, Attachment "B° to Schedule 74, Page 10 City of Federal Way — Pacific Hwy Phase 4 � (I) Notice. Any notice under this Agreement shall be in writing and shall be faxed (with a copy followed by mail or hand delivery), delivered in person, or mailed, properly addressed and stamped with the required postage, to the intended recipient as follows: If to the Government Entitv: City of Federal Way P.O. Box 9718 - Federal Way, WA 98063-9718 Attn: Brian Roberts ��: k Fax: 2�3-835-2709 If to the Com�anv: Puget Sound Energy, Inc. 6905 South 228th Street Kent, WA 98032 Attn: Doug Corbin Fax: 253-395-6882 Any Party may change its address specified in this Section 13(I) by giving the other Party notice of such change in accordance with this Section 13(I). �' (m) A�alicable Law. This Agreement shall in all respects be interpreted, construed and enforced in accordance with the laws of the State of Washington (without reference to rules goveming conflict of laws), except to the extent such laws may be preempted by the laws of the United States of America. (n) Entire Aareement. This Agreement constitutes the entire agreement of the Parties with respect to the subject matter hereof and all other agreements and understandings of the Parties, whether written or oral, with respect to the subject matter of this'Agreement are hereby superseded in their entireties; provided, however, that except as expressly set forth in this Agreement, nothing herein is intended to or shall alter, amend or supersede the Design Agreement and the same shall remain in full force and effect in accordance with its terms. (o) Successors and Assiarls. This Agreement shall be binding upon and inure to the benefit of the respective successors, assigns, purchasers, and transferees of the Parties, including but not limited to, any entity to which the rights or obligations of a Party are assigned, delegated, or transferred in any corporate reorganization, change of organization, or purchase or transfer of assets by or to another corporation, partnership, association, or other business organization or division thereof. Government Entity: City of Federai Way BY ��"_ ` rian i s ITS City Man er/Police Chief Date Signed d/�9�,�.�/a Appro as to form: Patricia A. Richardson, City At�omey . ,�r ,.: , Construction Agreement, Attachment °B" to Schedule 74, Page 11 City of Federal Way — Paeific Hwy Phase 4 Company: PUGET SOUND ENERGY, INC. . BY ITS Municipal Liaison Manager Date Signed ?��'L �� 0 <�` r PUGET SOUND ENER�`Y Ezhibit "A" Project Plan Schedule 74 Underground Conversion City of Federal Way — SR 99 Phase 4 Conversion PSE Project Number: 101046016 December 2, 2009 Pursuant to Puget Sound Energy ("PSE") Rate Schedule 74 and as describ� in this Project Plan, PSE will convert its existing overhead electrical distribution system of 15,000 volts or less to an equivalent Underground Distribution System. `This Project Plan describes work to be performed by PSE and the City of Federal Way (the "City") for the conversion of certain PSE electrical distribution system facilities as described herein (the "Conversion Project"). Construction of this Conversion Project is contingent upon and sha:ll not commence prior to both written acceptance of this Project Plan and written execution of a Schedule 74 Construction Agreement by the City and PSE. . This Project Plan includes �d consists of: ' • Detailed description of the Construction Work to be performed • Applicable requirements, drawings and specifications for the work (previously provided) • Operating Rights to be obtained for the Conversion Project (attached) • Construction Work Schedule • Construction Costs Estimate Summary (attached) Revisions to this Project Plan must be mutuallv approvedbv the Citv and PSE. Scone of Work This Conversion Project will replace PSE's existing overhea.d electrical distribution system with an Underground Distribution System within the following area (the "Conversion Area"): Both sides of SR-99 (Pacific Highway South) from � S 310�' to 18� Ave S. The Conversion Proj ect is approximately 4,950 feet in length, including laterals and'road crossings. ; The Conversion Project includes modification}or replacement of all existing services lines within the Conversion Area to connect to the Underground Distribution System and removal of PSE's existing overhead electric distribution facilitiea (including PSE distribution poles and pole mounted street lights) from��.the Conversion Area. Costs associated with the installation of new underground services will be billed to the party placing the new service order per Electric Rate Schedule 85. PSE initiated upgrades included in this project consist of: One additional6" conduit beyond the one sparetwo conduits allowed for a total of 3-6" conduits throughout the project. City requested upgrades included in this project consist of None. City of Fedeisl Way Pacific Highway south HOV Lanes Phase IV Underground Conversion Page 1 Temporary Service included in this project consists of: None. The following portions of PSE's existing facilities to be converted are located outside of Public Thoroughfaze: Existing V02A is located on an Easement. In conjunction with the Conversion Project, PSE will remove its existing street lighting system , within the Conversion Area.. Provision of a new street lighting system within the Conversion Area under terms of applicable PSE Tariff Schedules will be addressed on a separate work order and work sketch. Additional costs will apply and will be quoted separately. Responsibilities of Parties Citv Resaonsibilities a) Provide written notice to customers wifihin the Conversion Area in advance of Conversion Project Construction Work start. The notice will include contact information for both the City and'"PSE, the expected Conversiori Project schedule, anticipation of service interruptions and work required to be performed by customers. b) Coordinate other utility conversion, removal and relocation from PSE's poles. c) Provide a11 surveying for equipment placement, locations, and establish a11 grade elevations for the Underground Distribution System within the Conversion Area. d) Provide all necessary excavation, bedding, backfill, off-site disposal, site restoration and coordination for installation of the Underground Distribution System. This includes trenching, backfill, and restoration for cut-over and transfer of existing underground system and service lines from the existing overhead distribution system to the new Underground Distrib�ution System. e) Coordinate private property trenching, excavation and restoration activity with private property owners affected by this Conversion Project. fl Provide flagging and �raffic control as fequired for a11 work performed by the City. g) Install and proof a11 ducts and vaults for the Underground Distribution System (excluding work in ducts or vaults containing energized cables or equipment — see PSE Responsibilities) in accordance with PSE standards and specifications using ducts and vaults provided by PSE. "Proofing" as used herein:is defined as verification using a mandrel that the duct and vault system is free and cleaz of damage, installed to the proper grade and at the proper location and contains a pulling line. h) Provide PSE at least ten (10) business days notice prior to the start of trenching activity to a11ow for delivery of PSE materials to the job site and scheduling of PSE's on-site Inspector. Provide at least two (2) business days notice for schedulal delivery of vaults from the manufacturer. i) Provide secure staging and storage area.(s) for duct and vault materials pmvided by PSE. The City sha11 be responsible for the security and condition of these materials unt�7 they are installed and accepted by PSE or retumed to PSE's custody. City of Fedeial Way Pacific Highway south HOV Lanes Phase N Undergou� Conversion Page 2 j) Provide labor and equipment for the off-loading of PSE duct and vault materials delivered to the job site. k) Promptly following notice from PSE that the Underground Distribution System has been energized, provide notice to customers within the Conversion Area. informing them of their obligation and responsibility to convert their overhead service lines to underground service lines as provided by state law o'r to modify existing underground service lines for connection to the Uniierground Distribution System. Affected service lines are listed in the Service Lines section of this Project Plan. 1) Facilitate weekly (or as otherwise agreed by the City and PSE) construction coordination meetings to include all relevant parties participating in the conversion including PSE and it's contractor(s), the City and it's contractor(s), and other utilities. m) Provide any necessary operating rights for the installation of PSE's facilities in accordance with PSE's Schedule 74 Section 3 and as mutually agreed by the PSE and the City. Operating rights are further addressed in the Operating Rights section of this Project Plan. n) Modify, reroute or replace service lines to City owned facilities to connect to the Underground Distribution System. o) Following notification from PSE that Construction Work is complete, provide to PSE any Shared Government Costs as provided for in the Construction Agreement. Puget Sound Energv Resaonsibilities a) Provide a11 duct and vault materials, cables, electrical equipment and components necessary for installa�ion of the Underground Distr�bution System. b) Following notice from the City, deliver or cause to be delivered all duct and vault materials to the designated staging/storage area(s). Acknowledge delivered quantities and condition of duct and vault materials by signing shipping manifests. c) Following notice from the City, provide inspection services needed for overseeing the proper installation of ducts and vaults by the City. d) Accept delivery of the completed duct and vault system once the new system has been proofed.(as described above) by the City. PSE will provide a mandrel to the City to be used in proofing of the duct and vault system. e) Provide PSE electrical workers to complete duct ins�allation and proofing when such work is performed at or in any energized vault containing energized cables or equipment. fl Install (except for ducts and vaults insxalled by the City) and energize the Underground Distribution System. Provide written notice to the City when the Underground Distribution System is energized. g) Perform cut-over and transfer of existing Underground Distribution System and existing underground service �lines from the overhead distribution system to the new Underground Distribution System �vhere applicable (see City Responsibility item "d" concerning trenching responsibility). PSE will notify the City for excavation and the affected customers at Ieast two (2) business days prior to installation, transfer, and connection of City of Fadeial Way Pacific Highway sonth HOV Lanes Phase N Undergound Conversion Page 3 underground service lines. Affected service lines are listed in the Service Lines section of this Project Plan. h) Install and connect replacement underground service lines to single family residences and connect replacement non-residential underground service lines provided by customers within the Conversion Area pursuant to PSE TarifF Schedule 85. Costs associated with the installation of new underground services will be billed to the party placing the new service order per Electric Rate Schedule 85. Affected service lines are listed in the Service Lines section of this Project Plan. i) Remove the existing overhead electric �distribution system including, conductors, equipment, down guys, anchors and poles after all service lines to customers within the Conversion Area are connected to the Underground Distribution System and a11 other utilities have been removed from PSE's poles. Holes left following removal of poles will be filled with crushed rock and compacted in accordance with applicable City standards or specifications. j) Provide flagging and traffic control as required for all work performed by PSE (except as may otheiwise be reasonably provided by the City during installation of ducts and vaults in conjunction with City performed trenching, excavation, back-fill and restoration). k) Attend weekly (or as otheiwise agreed by the City and PSE) construction coordination meetings facilitated by the City and its contractor during duct and vault installation and while line crews are actively working the project. Operating Rights The Underground Distribution System will be located within Public Thoroughfaze except as described in the Operating Rights Attachment. The Construction Work will not be released by PSE for construction until i) all operating rights necessary for the installation of PSE's facilities have been obtained and have been verified by'PSE, or ii) the City otherwise signs an agreement releasing PSE from any and all financial obligations associated with the location or relocation of PSE facilities resulting from commencement of construction prior to acquisition of a11 identified necessary operating rights. � ` ; Construction Work Schedule The work will be performed in accordance with the following Work Schedule, unless this schedule is revised by mutual agreement of the City and PSE or circumstances beyond the reasonable control of the City andlor PSE preclude such performance. Installation of ducts and vaults: 124 working days. Begin May 2010, end December 2010. Installation and ener�ization of the Underground Distribution Svstem: Approximately 45 working days. Removal of overhead facilities: Approximately 20 days City of Federal Way Pacific Highway south HOV Lanes Phase N Undergound Conversion ' Fa�e 4 Work Schedule Restrictions: Except in the case of emergency or unless otherwise approved by the City, the normal straight time working hours sha11 be between 7:00 AM and 3:30 PM with a 5-day work week. If PSE desires to perform work on holidays, Saturdays, Sundays, or before 7:00 AM or after 3:30 PM on any day, PSE sha11 apply in writing to the City for permission to work such times. Such requests shall be submitted to the City no later than three (3) working days prior to the day for which PSE is requesting permission to work. : Permission to work 3:30 PM to 8:00 PM Monday through Friday and 9:00 AM to 8:00 PM on Saturdays may be granted by the Public Works Director. For pernussion to work 8:00 PM to 7:00 AM Monday through Saturday, or 7:00 AM to 8:00 PM on Sundays or Holida.ys, PSE must apply for a noise variance from the Director of Community Development. Approval to continue to work during these hours may be revoked at any time PSE exceeds the City's noise control regulations, or complaints are received from the public or adjoining property owners regazding the noise from PSE's operations. Permission to work Saturdays, Sundays, holidays or other than the agreed upon normal straight time working hours Mondaythrough Friday may be given subject to certain other conditions set forth by the City. Construction Cost Estimate The estimated costs to perform the Construction Work and the allocation of costs between the parties are presented in the attached Constructi'on Costs Estimate Summary. These estimated costs are valid for 90 days from the date on the Construction Costs Estimate Suxnxnary page. If this Project Plan and the Construction Agreement aze not fully executed within 90 days, the estimated cost is subject to revision. Proiect Assumntions The project design, construction plans and cost estimates are based on and reflect the following assumptions. Construction conditions that are not consistent with these assumptions may result in a request for change or an equitable adjushnent to project compensation under Section 6 of the Construction Agreement. , Cost Assumutions 1. The Construction Work will be performed in accordance with the Construction Work Schedule. � 2. PSE's Project Manager will accept or reject (with written justification) :the duct and vault installation work performed by the City within five (5) business days riotice of completion from the City. In the event PSE rejects{any of the ducts or vaults (with reasonable written justification), the City will perform the necessary remedial work. The City will then re-not�fy PSE and PSE sha11 have five (5) business days to accept or reject the remedial work. City of Fedeial Way Pacific Highway south HOV Ianes Phase N Underground Conversion Page 5 3. All PSE cables can be pulled through the ducts and vaults system to be used for the Conversion Project utilizing normal cable pulling techniques. �.�_::, ; __ ;� , City Street Use permit is the only permit necessary for PSE to perform its work for this Conversion Project and will be issued within two (2) weeks of PSE submitting a complete permit application (including any supporting documentation reasonably required by the City). Provided that PSE works solely between the hours of 7:00 AM to 8:00 PM Monday through Friday and 9:00 AM through 8:00 PM Saturday. Work performed outside those hours will require a noise variance issued by the Director of Community Development. PSE will pay the customary permit fees. 5. The daily productivity rate for PSE duct and vault installation is bas�l on the City's contractor opening a minimum of 40 feet of trench per working day. The daily productivity rate is used to calculate the number of days a PSE provided inspector will be required. During construction, the Inspector will be scheduled in full day increments and in one continuous efFort. Changes to a continuous Schedule are requiredtla minim� of five days in advance. `� �: 6. This proposal assumes the use of two flaggers, basic signage and simple channelization. Additional trai�c control measures aze not included. 7. Work to be performed by PSE does not include installation andlor removal of Temporary Service facilities at the request of others during construction. 8. All cut-over and transfer work will be completed during regular working hours. 9. Installation of protective bollards may be necessary at some locations and maynot be included in the project design. In the event unplanned bollards are required, the associated installation cost will be a shared cost. 10. Where notal on the plans, existing ducts, either empty or currently used, are to be utilized for new cables. The Construction Costs Estimate assumes that such duets are in place and available for use to pull in new cables using the same equipment and effort as newly installed ducts. 11. The Construction Costs Estimate assumes that guy anchors are installed prior to the installation of the ducts in the area. Installation of guy anchors in the same area as newly installed conduits may be subject to Change Order. 12. The labor rate assumption used in the Cost Estimate is based on 2009 rates. Any work performed on this project during 2010 is subject to Change Order based on 20101abor rates. >•� 13. PSE will likely be asked to transfer the existing distribution lines to the new transmission poles between station 28+00 and 39+00. If this becomes necessary, the cost to complete this work will be covered by Change Order and will be 100% City cost. Schedule 1. There will be a total of two (2) PSE crew mobilizations as follows: i) one mobilization of an underground line crew for installation of underground conductors and equipment; and ii) one mobilization of an overhead line crew for removal of the existing overhead facilities. Onc�.. City of Fedeml Way Pacific Highway south HOV Lanes Phase IV Underground Conversion Page 6 mobilized PSE crews will have continuous productive work until all PSE Construction Work is complete. 2. All PSE Construction Work will be performed during regular working hours from 7:00 AM to 3:30 PM excluding holidays. In the event that lane closures are necessary for performance of work, PSE sha11 be limited to working between the hours of 9:00 AM to 3:30 PM on northbound Pacific Highway South, and 7;00 AM to 3:00 PM on southbound Pacific Highway South. PSE will provide a weekly construction schedule during the weekly meeting. Once approved, PSE crews will be allowed to complete the work as scheduled, without changes and work stoppages caused by other construction activities. 3. Work requiring scheduled interruption of electric service (cut-overs and transfers) will be performed during the working hours specified in Schedule Assumption #2 above, and will be scheduled with at least two (2) business days notice. PSE will notify customers of scheduled service interruptions. Additional Considerations Service Lines Service lines within the Conversion Area must be replaced or modified to provide underground service from the Underground Distribution System as described in the attached Service Lines Replacement & Modification Requirements List. PSE Tariff Schedule 85 and it's associated chazges, will apply to performance of this work. The individual addresses to be converted are: Service Relocations and Conversions Name and Address New Lumber and Hardware, 30854 P Demers 8 Granger, 30640 PHS Zaren Sayer and Assoc, 30504. PHS Sharon Christian Books, 30406 PHS AI Holz Auto Repair, 30402 PHS Norman Kim CPA, 30390 PHS Smart Start Day Care Billboard, #30313 Federal Way Used Cars, 30423 PHS Jiffv Lube. 30509 PHS Cleaners, 30833 PHS hop NW, 30845 PHS Dental Location � Point Delivery ew Point ` Delivery roof - South side of buildi On roof north side On support pole Southwest corner Northwest corner On suoaort pole center of roof , center of roof roof north side City of Federal Way Pacific Highway south HOV Lanes Phase N Undergound Conversion 3: ¢ s � P14 P14 P14 P27 • T. V15 V15 V17 V13/HH13 V13 V13 V07 �y , Page 7 �. Cut-overs and Transfers PSB customers within the Conversion Area will experience interruption of electric service during performance of the Construction Work when transferring system and customer: loads from the overhead distribution system to the Underground Distribution System. PSE will notify customers at least two (2) business days in advance of expected service interruptions. Customers may request that cut-over and transfer work affeeting their service be performed outside the regulaz working hours listed above subject to the customer's written agreement to reimburse PSE for the additional cost (at overtime ratesJ to perform such work outside the regulaz working hours. New Service Connection of new or increased load for City facilities (such as new traffic signals) under terms of PSE Tariff Schedule 85 will be addressed on a sepazate work order and work sketch. Additional costs may apply and will be quoted separately. PSE Desi�n & Construction Standards This Conversion Project has been designed and will be constructed in accordance with PSE design and construc�ion sta�dards in effect as of the date o€ this Pr-oje.c�-�'lan. FS� staa�a�ds - applicable to Construction Work to be performed by the City have been provided to the City in PSE's "Electric Distribution Trench/DuctlVault Construction Standards, 2007". All relevant PSE standard described above aze atta.ched to this Project Plan by this reference. Temaorarv Suoaort Bolding) of PSE Poles Whenever any pole(s) are required to be temporarily supported due to excavation in proximity to such poles, the City will coordinate with PSE to provide such support. The need to temporarily support such poles shall be determined by PSE, and if required, such support shall be provided by PSE. As us� herein, "temporary support" means supporting one or more poles for a continuous working period of ten hours or less. Accentance of Fi•oiect Plan The City and PSE mutually agree to and accept this Project Plan as of the date indicated below: For the ' - By: � Cary M. R , P.E. Its: Director of Parks, Public Works and Emergency Management Date: � /� /� ° ��=� - City of Federal Way Pacific Highway south HOV Lanes Phase N Undergvund Conversion For P : B o-..--+� , D ugl L. Corbin Its: Municipal Liaison Mai�ager Date: Z-- ► z- � O �g Pacific Highway South Phase 4 Project # 101046106 Operating Rights Attachment Vault # Business Name Address Station * Easement Parcel # Description Size V03 Bucke s Muffler 30924 PHS 5+58 R 10 x 10 North 10' of the West 10' North 14' of the East 5'. May require relocation V02 "� H undai Oriental Market 309?? PHS g+43 L 14 x 5 of an existin as service line. oca e eas ex s ng on e o 0 V07A Hair Sho NW 30845 PHS 9+30 L 10 x 16 the East 10' V05 Great Floors 7+60 R 10 x 10 North 10' of the West 10' of Southern Parcel V09 Care Plus Med Ctr 30800 PHS 9+74 R 10 x 10 South 10' of the west 7'. Need low flam Tfr. 1' back of sidewalk vault centered at end of SW01 Oriental Garden Center 30650 PHS 17+70 R 16' x 1T sidewalk V10 --. - Demers � Ga ner 30640 PHS : 15+7 R.. �10 x 10 North 10' of the west 10' Elevate.to SW Level V11 Zaren and Assoc 30504 PHS 19+05 R 10 x 10 North 10' of the south 40' of the west 10' P16 View of the Lake rtments 30602 PHS 16+58 R 10 x 15 South 10' of the west 15'. South 20' of the north 25' of the west 10' Need V12 Bld south of Barri a Llena 304?? PHS 20+98 R 10' x 20 low flam Tfr -- V14 & V14A Sharon Ch�istian Books 80406 PHS 23+47 R 10 x 15 North 15 of the west 10' Elevate to SW level Approximately 10' East of the Southwest V15 Nonnan .S. Kim CPA 30380 PHS 24+80 R 10 x 10 corner Elevate to SW Isvel "`'SV1102 :,"` � F ';�IfcJ` , �usino ' ��`�:803�:PH5 `"",, � 2�b t�: 4".��"�1� � the west 76' of the east 47' of the south 16' 1/8/201011:02AM 1 Operating rights list.xis V13 J Lube 30509 PHS 31+36 L 10 x 10 North 10' of the east 10' V17 Smart Start Da Care 29928 PHS In RW behind SW NOTE: in all areas where the sidewalk is to be used as the working space, the vault needs to be set at an elevation within 1' of the sidewalk. � 1/8/201011:02 AM ,�. _ _- - , .,.s:� ���� � �.�. :. . . 2 , Operating rights list.xls . P5F ' � � , Date: Project Title: Federal Way SR�9 Phase 4 Conversion Project Description: Convert the existing overhead distribution system along SR�99 from the south boundary of Phase 3(18th Ave Rate Schedule: 74 Project Manager / Phone #: Tom Quann 253-606�'i598 Project Engineer / Phone #: Tom Quann 253�06-5598 Municipal Liaison Mgr / Phone #: Doug Corbin 206-604-3137 Project #: 101046016 Revision #• Revision Date: Construction Costs Estimate Summarv �'� � . •; :.. Inspection Service Provider Outside Services Operating Rights Overhead Govemment Entity 3 I Private I Gov Req Shared Costs Conversion Uo�rade $ 3,000 $ - $ - $ $ 394,700 $ 3,700 $ - $ $ - $ - $ - $ $ 1,1.3,000 $ - $ - $ $ 295,800 $ � 2,800 $ - $ $ - $ - $ - $ $ 125,500 $ 1.100 $ - $ I $ 93,700 � $ h'n� Ri hts $ - $ Constructlon Cos� Totals g 1,025,700 $ :ted allocation of Estimated Construction Costs at any $ 615,400 rnnerrt Entitv $ 410.300 Prior Total 100% GE Temporary Corn/Reloc Reimbursable 1�% PSE Construction 3ervices Within 5 Years Costs Costs Costs Totals Estimate Estimate Estimate Estimate Estimate - $ - $ - $ - $ 3,000 - $ - $ 3,700 $ 36,500 $ 434,900 - $ - $ - $ - $ - - $ - $ - ,$ - $ 113,000 - $ - $ 2,800 $ - $ 298,600 - $ - $ - $ - $ - - S - $ 1.100 $ 5,800 $ 132.400 -�$ - $ - S �$ - $ - $ 7,600 $ - $ - $ pletion of Constructfon Work - $ - $ - $ - $ - $ 7,600 $ 7 Notes: � E�imate prepared in acoordance with Sections 6 811 of Schedule 74 Design AereemeM and Section 7 of Schedule 74 Construction /�reement. ' AN amouMs shown in this estimate are rounded up to the next $100 ' Shared Costs are allocated 40% to the Govemment Entlty and 60% to the Company if the Conversion Project is completed 4 Total Costs exdudes Govemment EMity � of trenching, rostoration, and surveying , Construction EsUmate 37,600 $ 131,300 - $ - 79,900 $ 1,113,200 695�300 417.900 Printed 1/8/2010 10:56 AM