pay request e-mail 2-4-04 001
Page 1 of I
Shelly Badger
From: "Shelly Badger" <shellyb@ci.yelm.wa.us>
To: <garyc@ci.yelm.wa.us>
Sent: Wednesday, February 04, 2004 118 PM
Subject: Re: Pay request
Supplemental Condition 5.04 states that they must be approved Intents to pay
Prevailing Wages for both the contractor and all subcontractors. So, let's
do this, tell Jim I will process Payment #1 (and #2 if it comes in on time
as we discussed), but if he could check with his subs to ensure that they
have the forms submitted so we can have as many approved ones as possible
when it comes time to pay each pay request. Thanks Gary, Shelly
Shelly Badger
Yelm City Administrator
P O. Box 479, Yelm, WA 98597
360-458-8405
shelly(a,yelmtel com
Original Message
From: "Gary Carlson" <garyc(k.ci velm.wa.us>
To: "Shelly Badger" eshellvblruci.yetru wa us
Cc: "Grantb(ri,Ci. Yelm. Wa. Us" < ramb a/ci.yelm.wa.us>
Sent: Wednesday, February 04, 2004 11:53 AM
Subject: Pay request
> Shelly,
> I passed on to Jim that we needed an approved form for his subs.. He said
most jurisdictions pay on the form submitted because it takes L& I so long
to process the paper work. How do I answer him?
Thanks
Gary Carlson
> Building Official
24,2004
a'an o(40or ud 4~AUV i. 1 0 .71 Al G.
P- `111 Vl ll~l l l l~ x a v
aw)pm s u PAY PREVAILING WAGES
w....ka.-.x••M.wmrt`•w Public works Convect
• nut ram Man be types or Rmaa in mt MOD Rltrm Fee Maul
or..
• Pill i. W Wmks«fam will u Me mi fm oeoeoco. (majaw. 4611 imp
• Pima albw a mWmmo of 10 w«kisl d4'{ fa pn.crx*. x.wua •^I+.1
4am¢urMcmp~paey.oeyrma.darrx dq, n..el Z1P. a .4
P• O. 6ok ~rS nyl.a.raye.
:50 mes l 1. ~Q-Wl4S CDM~Y~..
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woken I mpby M IN. WWb Wedu AojM *IN M pW ro
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e}i( udom:a staw.imafR: D.pemmer Leo.m
a.pnWm rmIw. 6•.a~..
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APPROVED: DeOVmnmoflab« and hmaria 1, sl.'
f '
By
flOCOD-000 wrwrri.maw0.l p¢wll~ •LL.1 16«
Mf
_
Department of Leber and Industries; iv STATEMENT OF INTENT TO
Prevailing Wage PAY PREVAILING WAGES
(360) 903-5375 PRblk Works Contract
www.Ini.wa.goWpmailing wage
$25.00 Filing Fee Required
• ILie fpm most be typed or printed in ink. Meats
• Fill in all blanks or form will be returned for correction (Us-back).
eu ae..i aM•ewl
• Please allow a minimum of 1 0 working days f o r processing. ` Aaedi.e r i a amen
~rKK
APPROVED FORM WILL W MAILED TOTIDS ADDRG48 .l)
COIIhaCIM, cons my or agency name, address, city, slate & ZIP+4 (11( LI
see
A, Zuc ~PIw
11
e
91 5911
911 aemiwdmsay Ni., ta•m.a
P, o. X31»
~aY4
9 Lt) 1 ~3^ ` ca hmw rs e c „ .vas my e
y BNbe des IwM') Oaw.mnuwukd Iw )
Iz 03 h 03
Prmc mwaear0•ea concoct wiW me Wbla alencY) C.ewsctor oea Y,aeebw-laEOOee.ebn'r Go ElytmdpsRpuuweR
aIw c IWQ1L epmmmObb Ells Y. do E BI
CnR/Inde and acemptllaa IN msYr list sircre es) Rmco( usueofpwrly eetimadm
Ileody ply R Lmefite ofwmtkrr
NHS oNS~s~ c5w I~af Iv ~r~~~~ I
i
stems, cit, area fJW4 Indicme mW dollar mount
s
)<e p ~s 0_»ry of aant d
I hereby earthly Wm the above infe i is conact end dut all
-mil f'u r-e Si workers I employ on this Public Works Project will be paid no
qc~ hen than the Prevailing Wage Eeta(e) as determined by the
Industrial Seetimician of W ~epatWUnt of labor and laduatrice.
1 O 5C
teems
tle
Nlc6~NF 701 S,566-31- T1
Fmul.aa.. NJ 1 Ii ~D -O Clvl R~maen. 'Aw.ec U•
a
APPROVED: Department of labor and lrldushies tamed 9r'
1 ~ ~ iri ~ naueT' ,/,~s•(q;~' yg/,~I.earrbAamnearamw
~rrl`- MY•
Department of Labor and Industries STATEMENT OF INTENT TO
Prcvaiing Wage PAY PREVAILING WAGES
) 902-5335
W,v Public Works Contract
www.lni.wa.gov/prevailingwage
25.00 Filing Fee Required
• This form must be typed or printed in ink. Pmim Nerve _ caamnr_
• Fill in all blanks or form will be returned for correction ( see bgc). r-' L, ~t q ~l~l ( H^I 1 r' I•V/„
• Please allow a minimum of 10 working days for processing. C~,.Awardnrerr6W,ua1a1icasar aw rmerat arPn..a)
APPROVED FORM WILL BE MAILED TO THIS ADDRESS ^ndT .I 1.
Contractor, company m agency name, address, city, state & ZIP +4 r .0 _ 'j,
CD Cay s ZtP+a
y Il V ~-r f'J AwaNa,e Agency Pmlea Sm Pmm Phortea
h')`1J7
C' I /171 Ll cwmr wnrsa wo mxtpran cvr wher= wen oc ryrrannm
161q ae (raW/y) DaremrW -arded IMNy)
Prime mmrecror(h.. mmnet with the own, Conuauor Regisrnlion No. Da -re,d ,.jubeaa.,rs noy yund pone
va nl9 N° mv9 a
ST.-
Craft/trade and occupation (Do NOTtinaWremices) Rneof Rawofhoufly Enimawdn,
heady Pay fringe bOrefrs of woracr
(lti)'v+f l o'~>rhlof i
-r
1
t
i
I
Cwna y am addwo, c 1y new, ZIP+4 Indicate mtal dollar mount r
of our contract $ J O'er v
I hereby ccnify twat the above information is correct and that all
workers I employ on this Public Works Project will be paid no
less than the Prevailing Wage Rate(s) as determined by the
y, w 1. Ji a 5°Ir) Industrial Sutistician of the Department o bor and bade tries.
canaaiLrRegls aon No. Urn y Tide p Signowne
I V / I.. F~ fJ ~ ~ v (J (
Email address Plwne nasnber For L&1 Onl
(3~>>(i 3yr (I%
For "I nee Only C1wa Nwnbv: ?525 or $
APPROVED: Department of Labor and Industries lssued Ry'
By
ausWal suunician
crrnme.rcn..,r..,,.m d:nr.m m.o-+ere.vAlno w.vra 10-02 _ AftmAPERQYAL-MaC-hhLM"AgAw-aEdWZAlwrwg~
HILL4TR01, 253 375 09901 02;5'04 i't: §1 A9;lelfsX 41^t:,0, - _
lwlement of Intent to Pay Prevailing Wages P4ge I of I
Prevailing Wage Section
Department of Labor 8
_ Statement of Intent to Pay Industries
Prevailing Wage PO Box 44540
Olympia, WA 911504-4540
(360) 902-5335
Received: Intent Id: status:
v">.52004 25406 Approved on C2/2512U[M
COMPANY
L ompany HILLSTROM CABINETS INC
. dormatlon: HILLSCI151KF
600 551 757
18504 CANYON RD E
PUYALLUP, WA 89375
Payment Type: Elecronic
-mpany Electronic
ugnaturer
PROJECT
YELM, CITY OF
Public Agency: PO BOX 479
YELM. WA 98597
aunty: THURSTON Multiple Ccuntlas7 No
Yekn
,yeat Name: Yelm City Hail Improvements
cntract Number:
:IIU Due fate: 12!062003
Award Oate: 12/31/2003
,ne Contractor: A M JAMES COMPANY INC
Narx Yes
,nconlraatad7
,contrector$? Yes
,+puiantlces7 No
mount. $19,82600 Time and Materials No
l'ia by PAULINE OSLIN
WAGES
^vmberof0weers0
Journey Lave! Tradesloccupations
hay s://transact. wa.gov/LNt-P W IA/lntent/IntenLPrint.asp?ID=25406 1'25'2,004
HILLSTRW 253 375 09991 02125104 10:52AU;Jetiea @121;Page 3;4
Statement of Intent to Pay Prwailing Wages Page I of I
Prevailing Wage Section
Department of Labor &
Statement of Intent to Pay Industries
Prsvalling Wage Po Box 44640
Olympia, WA 886044540
(360) 902-5335
Necenred: Intent Id: Status:
_25/2004 25411 Approved on 02/2512004
COMPANY
=:ompany STARR INST 8 CABINETRY INC
,formation: STARR0004KR
601 997 647
16917 99TH AVE CT E
PUYALLUP, WA 98375
ayment Type: Electronic
ompany Electronic
."Nature:
PROJECT
YELM, CITY OF
-tic Agency: PO BOX 479
YELM. WA 98597
-ntyr THURSTON Multiple Counties? No
+y: Yeirn
r yoct Name: Yatn City Hag Improvements
...:.,tract Number
.J,JPug Oate: 120/2003
i...rd Date: 12/31/2003
- :re Contractor: A M JAMES COMPANY INC
:cork
.:wcontrac[ed' No
.~nncontractors? No
.:pprenbcee? No
a Amount: $2,800.00 Time and Materiels No
. ilad by, PAULINE OSLIN
WAGES
Number of owner' 1
Journey Level Tredes/Occupations
County Trade Occupation Wage Fringe
Workers
THURSTON CARPENTERS CARPENTER 59333 5000 i
:ps://treUSact.wa.govlLNl-P W f AllntenVlntenlPrint.asp7lD-25411 ?i ! 5;,~,pp4
mpanment of moor ands, mdusmes - -
Prevailing Wage PAY PREVAILING WAGES
(360) 902-5335 Public Works Contract
www.hu wa.go4/psevailingwage
25.00 Filin Fee Re wired
• This form must be typed or printed in ink. e/m~mrN. cm,ad• i
• Fill in all blanks or form will be returned for conviction ( s~-back /'c° 0 l A dy
• Pleme allow a minimum of 10 working days for Processing. Co. Afea:g w sue r- mat-' tn:r.~)
APPROVED FORM WILL BE MAILED TO THIS ADDRESS Addm p,
Contractor, company or a envy name, address, city. state & ZIP+4
Amy Ag~'Pa'mr nd testis Plmrc?
coozy will cuyPk.~va eee~rma~
q /jf JZJ aiEmsdsm away) neat . j. (mwy)
/z 0-5 0T it 03
Prime mnmmor swnvaa with the public agenry) Cmuacmr Reg's((oati Do ama subemancwnx Do bawd mud~ x
tC ~C/DuYl UYa mEd No 3Y.
CG l- Rue of Rate of hourly pmimted no.
Craft/trade and Occupation (Do NOT list apprvnices) heady pay fringe bu.cfin of wukcrs
-3-7-070
I
i
Company none. add... city, dues ZIP•4 Ldicate toW dollar emmmt
oI otn connect
P I hereby certify h the shove information is career and that all
x't./l-Td n1 I Nsuls+'c`o N ~o /IAjf' workers I employ w this Public Works Project wig be paid no
less than the Prevailing Wage Rate(s) u determined by the
"230) ( ST 1 Ideas trial Statistician of~pa indusaies.
Coamcor Regismtioo N. Out Tide
Bch c~ oLAC3b 0C) $3(0 `'R%S
Email addreas Phonenvnber rarlatnv Oat
(.?53 A6-2,7 I O 1Nwtr. ?$25 or S
Par L&I U..O.d
APPROVED: Department of Labor and Industries laud By_
By
Inasstdd Swidi<im
F7MO29-000 rmmmemofinrentw,YPrevailing wages la-M A PPROVA d hit A rdl Aaencv
Co., copy - L&I
Ikfwrunem of labor eM lednaeks STATEMENT OF INTENT TO
(360)902- Wagc
(360) 902-5335 PAY PREVAILING WAGES
ww .Ni wagw/prceailingwage Public Works Contr4et
25.00 Ellin Fee Re wired
• This form must be typed or printed in int. 7-w w e Lm 1; A25
y a cwr..w.
• Fill in all blanks tw form will be Mouned for correction (5{4 back). Improvements
• Pleas: allow a minimum of 10 working days for processing. Ceuta Aw.a„w At-, tP'tlle 3(301 ro, fwl .w.l
Cie. of Yelm
APPROVED FORM WILL BE MAILEDTO THIS ADDRESS Adep•
Unmr.mr. oompMy m agency none. addmss, city. state & ZIP t 4 P.O. Box 479
Cur sw yA.a
A.M. James Company, Inc. Yelm Wa. 98597
P.O. Box 815 A-udaw A• P mc4n.,. n.•„ PMnta
Gig Harbor, Wa. 98335 hell Badger 060)458-13444
ce3arwM wed edaeaum`uu.r cdYwape weu.~ah
Thurston Yelm
But maaa (Mdy) D•w mmuas..dN 1•dmel
12 S 03 12 31 03
Prime eDnuatur @eaeemranInc. wnh NepuNAteMTJAM ree99lC1066RB
Cenuurer Retlnnuen Ne. X~Y~ w0 e.ee.r oM~ a amdw M.sl.waw.t
A.M. James Co. 'I
CnNtrdeandaccupatbm (Do NOTlin•pge.A-t) Ruo of Rue ofhwrly 6uinurd no
coed on,
roy. haufin a wet..3.
Soft floor overina-All work
~I
cereWrynnu'adduaa• ody' •zupi Indicate total dollar wnoom
Campbell-COX Floor Coveri UInc. of tat S M 6 M
1002 S. 30th St. _ I bemby certify dun the above iummaaon a eorrat ane fin ad
workers I employ on dda Public Works Project will be paid
Ina than the Pmvailing Wage Rate(s) dc".'oncd by the
Tacoma, Wa. 99409 Industrial Said a'iur of she Dcparvnont
C6ntsanor ReaiAnaoe No. UeI TO,
CAMPBCP174JB 500 473 873 President y I'i
powlMMn Pmmeuaber dr oN'..
(253)272-4799 r
uao. a.a Nm~ Os2s errS
h.uee ar.
APPROVED'. Department of Labor and Industries
i
By
m, - t stole' ~N
t706e19.000 awunem of inmm to pay pmvailint w.gu le02 An APPyO_
II
Department of Labor and industries STATEMENT OF INTENT TO
Prevailing WageY ~y"• PAY PREVAILING WAGES
(360) 902-5335 Public Works Contract
www.Irr.wrrgov/prev ailing wage $25.0_0 Filing Fee Required
• This form must be typed or printed in ink.
. C.Lj~! y,~G~ y+»~$OdE liS
• Fill in all blanks or form will be returned for eonce6nn (rc LaSk), YEA24
• Pleascellow aminimum of 10working days for prraesaing mr~,~n~..mmans<ncy tww,<s<n<r na r<d<N a.Pnr.ml
APPROVED FORM WILL RE MAILED TO THIS ADDRESS ^'ktT" i
Contracrnq cntnpany w agency name. mbiress, city. 51aw & ZIP , 4 -PQ • 80 X ,4Z.7 A M' 3A m s Co..rn/C• 0" nl< LP„
PC, P ~7'0A $/5 "^-~pA~ NOrW Cnmxl Penan /f~A PtmaeB
G'r6 111V,Q,6oR, u/.0. 983,x; s"~. . y,IB-o - ep.nn o,.inep o a 1s!
foamy wh<n wM ~.1.I
~m/N>I Mrtc ~r NN (MNY)
t o3
Primecommetm.(arts u,ntred_ with the public agcnryl Commcto. Pegtstraoon No WQ lmmM )z no dte as<Bnrawclon+ DoOIYn auermnntkaP
4. 44v'jv 5 m
rm.
Craftnrade and occupation (Do NOT list appremrcal Rate or Rid efhoody Entreated
Romly Pny rnrlge bmnrta ar-ark.
Comp.ny name,Wdr<n, city,.,me, Ltw, Indicate total dollaramount $ ~j Q (7
Yl/oi2THERn1 AGOJSrLi;Rh $ZjI of nur contract 7
I hereby certify that the above information is mid that all
workers I employ on Ibis Public Works project ct will ill be paid no
no
less than the Prevailing Wage Rate(,) as determined by the
Indantrlal SlmuYiclan of the Department of Labor and Industries.
con or Regmntlnn
alaffie No ,Y U91 line G uR o0-a? ] C!
Emadaddrresa Phoncnumhc, F.,UIU,,Oat
i2s3 )Ssl76 CY3= Mock N-kr _ Amorm. -
For t61 Ure Only
NOIITH(RN RCOUSTICRL
SYSTEMS R COMPRNY, INC. 16001
Iesn Pola.d
P.O. BOI 358 953,047.W5
- D5mp50
GRARRK WA 98338 20D
PAV TO THE
10, 1
w
/,rl fZe} .~,IC DOLLARS f)
i iuar r> nand na iFi o11 esana.l. "I, "I NNaNIN(1N[ binAA
Department of Labor and Industries STATEMENT OF INTENT TO
Prevailing Wage PAY PREVAILING WAGES
(160) 902-5335
www.lniwa.govtprevai ling wage Public Works Contract
$25.00 Filing Fee Rectuired
• This form must be typed or printed in ink. rmta'vm^ r.~amd n
• Fill in all blanks or form will be rammed for correction (see back). _ 1'{ IO1 .-h m~fC ~P VMP n fS
• Please allow a minimum of 10 working days for processing. cnmr Awudr^F An<n,~ asnbbr ail<nry nm t<a<ml nr pn.mn
C•+~~,E `!rlw•
APPROVED FORM WILL BE MAILED TO THIS ADDRESS Aaa ^
- H
Contractor, company or agency name. address, oily, state & ZIP +4 I 'BU ~ _ -
riw, 1 State ZIr-4y
~jauv es co '-\C /e ~0A ~JO Iss9 /
I d n8 Agomr r^fi' I C am Filson Phone ft
C 4 0v, c~S 15 SLCII ('e r oz) 15ry
0-
iCnoNrwM1rn kwill bpcr@med t'iry where orY wal berertormetl
OG' NOrD~J W 98335 ud5 O,r h y\ I e- and ana aam rm aq~ Dn-I~ro,rlaward<a meaty'
O3 fr'/ 31 / 03
Prim tractor (ha' n true' with the public Reny R tr for Reg'st aro t Yo >u v - tl " n ."c" nrn.mrs' po you tl I use appreni ces'
A M ~Q4Y PS v ~qnc .1 M oG ~P tl~rt
Craft/trade and occupation irnthrfhs'aMnentieevl Reaeof Raleofhourly Estimatedno.
Hourly Pay base benefits nfwnrkers
37n 90 -
,'-cXV if \F
Cnm anyname, shares, airy, scam, ]IPM Indicate Iota' dollar am wart ount $ I LI C~ r ~l
U V
~QVV\ 1 Cy.:... fC of our a', ca
rs Ux 1 C I hereby certify that the ahuve inf'om'ation is correct and that all
C) .Xk~1 5 workers I employ on this Public Works Project will be paid no
I p less than the Prevailing Wage Rants) as determined by the
G I ~~{V-1r )OY w 0 3 Industrial Statistician of the Department of Labor and Industries,
ContracmrR sbation No. UBI Title Sign
AMiAtiic,c ~rvb 001 a lSU ~(G UVPV
Email address Phone number < / For U I Ua O I
(3°l 2i) 85 1_5556~ CM1cck Number Amoanr
F 1.&I Uw Only
APPROVED: Department oft shot and Industries Issued By.
pr~
INIIJSTRIi1L STFT .JAH 15'04
By
Indavmal Statistician
F700-029-OUO St2lement of intent to pay prevailing wager: 202 After APPRA_ d h' A dI qA
Canary ropy - L&I
Department of Labor and Industries STATEMENT OF INTENT TO
Prevailing Wage PAY PREVAILING WAGES
(360) 902-5335 Public Works Contract
www.ini.wa.gov/prevailing wage
$25.00 Filing Fee Required
• This form must be typed or printed in vile. vml-e{n rvzme ( l ~ coanvu e -
1 W D-( T eL pl T i-L c I J v ro K7-05
• Fill in all blanks or fomr will be returned for correction (see b ck). C177'
• Please allow a minimum of 10 working days for processing. Conan Awarding Agency (public agency - not reaeal o. 1.1.1e)
C_iz - IL a L
APPROVED FORM WILL RE MAILED TO THIS ADDRESS .Add-
Contractor, company orE5ency name, address, city, state et ZIP +4
A. . ~ -n ~n~s ~I.~, Sip vie ZlF,4
`tllo-1
r• Awaeding Agency Pmiecl Con4<I Purace pIwl,#
1!\~ fLA ~ l f l l y &d P r 6i ) 32M
rI Y~/1rU~t GJ?l 1nD3.L County wMrc work-111 e Rrfnrme Citywhere rct4 x•JiMPeRnemed
r6 1r1iu ~t IF
s,a ace Bale Im~myl Dam vnnvao awarded ta:a'r)
_ a S o L`~
Pr~~\<c aacror((hes contractwNthe public agency) C tractor Regisva/t~ion N/OQ(~ onE! and io N Onuanors? WL)iyes lz~pNpurtmm<a^
Ll- ~ t ~-H ~l'~'~ l D LUL ~~kn ~~C ~V6btIW
Crafrlt andpecupation fW NOT listapprenticvo Ram of Rateofhourly Eatimated no.
yJ ^ll Hourly Pay hin, behis cfworkos
LL) ~4p
I
C.om ryme, ado, rty, smt ZIP+4 Indicate total dollar amount $
par r( of nor conttact
- / J 1 hereby certify that the above information is correct and that all
i
V~J j/~0.P~ W g~ workers I employ on this Public Works Project will be paid no
J less than the prevailing Wa a Rate(s) as determined by the
Industrial Statistician of d, a dement of abor a dusiries
Co vactor Re rs no. U_BI Si more
Email addreav Phonenumber Fort IUx ONy
For L&f Ux Ody ) Chuck Number'. An,.-c
APPROVED: Department of Labor and Industries 1ssvice By:-- - -
Dy InJUSlrial SWnatician _
: _ A1TIb')1QY1t-L.d4p1w111CS9P'L4nS1vE[d)SLCCn1'~
s,epanmenr m tanor an. mammas - - -
02-Wage
(360) PAY PREVAILING WAGES
www.W.w&g.wag oV/prevailingwage public Works Contract
ww
25.00 Filing Fee Require
tl
• This form must be typed or printed in ink. Rsi r N- G
• Fill in all blanks or form will be returned for correction ( see back). Cy /J l 6 l Z V ~y,
Awnd"v,{A blic
•Please 8110w4 minimum of 10 working days for processing. Cm ar-,oaf pdw¢)
o~~e A
APPROVED. FORM WILD BE MAILED TO THIS ADDRESS A- &0 ~
Convactorrr,, eompany or~agency namF address, city, state & 2IP+4 Q(
17• !F^l ~p-r ~.J..~"'c ~J~PL,~ ZtJi1 s es'
2S~'1
i! Av~yBA 'm bn FEem ` PMaU
<i ~P ` )~yv
WTL ~O Cousywn d:wal mined Ciq wMe wrd wiabepetfamrd F
ffUUJJ'""'"~" J ~F2
aiddacdale (Wtlly) W¢mmavwerNd (m/WYI
/z 3 t a3 /Z f
Rime muvnctor alas wnua/n wide Ue puNic agairy) Cw/ntec/dar Regis(aado Taa uxmd uum-•
CO aC /'"I l-~OU3 ~Ye [.(No C) Yes KNpewm?
Cm6/trade and occupation (Do NOT lisuMreraices) Ramof Rateofhoofly Imiesaw no.
h-rly rey fringe benenn of workers
Ir~SUt~..-,off f~Pr~clcp`.:s2 ?7~~CJ0 '
i
i
i
I
C-m Y name, address, city, state, 2I 4 Indicate total dollar amount
P....._.
~ULTdrJ I NSVL,T.p rA ~p r 1 hereby certify that the above information is coned and that all
I_,__._...__......~. workers I employ on this Poblie Works Project wiH be paid no
less than the Prevailing Wage Rate(s) as determined by the
~~d I ST 1 g-c-.-i•42~ w'f' P-2`1 a-f Industrial Statistician of the Department of Isbor d Indusvies.
CeetotMr Regisuadon No. UBI Tide
~`pcJL-S-t ot-13b c7c7S ~Sylo p12;c) xV.a~s.`
Bmail address P oenumher ror(ArtLe Onl
(Zrje3 )67.7 1 p N-n , ? $25 or $
Fwldl Ure Onl
APPROVED: Department of Labor and Industries hs-f By`
By
IndustdalSmixician
P0n029-WO suvmcn -f imcmbpay prevailing wages 1602 ABarAPVROVAI. send wM1lte mnv to Awardlpe Aeencv
Canary copy - L&I
Feb 13 04 03:33p Raymond Moreau
- - 253-473-4012 P.2
Dcpanmenrof Lahm and Industries STATEMENT OF INTENT TO
Prevailing Wage PAY PREVAILING WAGES
(360) 902-5333
ww.m;.wa.sov,,n,vailingwage Public Works Contract
25.00 Filin Fee Required
•This form must be typed or printed in ink. >'mi=. Nacre coati.««
• Fill in all blanks or form will be returned for correction ( stsLpRCk). City Hall Ire rovements Yelm-
• Plezse allow a minimum of 10 working days for processing, cona.anwwme Aamcy (wat+=s>+cr-notrm=:avrr^•,ml
_ it of Y-1-
APPROVED FORM HILL BE MAILED TO THISADDRESS Add a
Contractor, company or agency name, address, city. state &ZIP+4 105 Yelm Ave. West
Gry swe ZIP+4
Apple Electric Yelm WA 98597
Awarding AF^=y Pmlm[ cmt,G Peova ph..4
P.O. Box 1252
Puyallup, WA 98371 Sally Badaer (360)458-3244
- CwmY +haa wck wJl bcPmfa~mm City whaewM will6c PUfomim
'hurston Yelm _
&dau. d.m (NNr) da momn>w.mm (m/mr)
12 05 03 12 12 03
poreem.d tbasmntranwiththepublie,are,) Conuactor Regiornien No. D. Immdmuumern-sce, 0. rw..droacapprnd=a?
-,Alit JAMES CO. * . YA ® No (:I Yn ®No
CraPlRradP arM accuparlnn (Ib NOTlm apprcndccs) Rare of Rasothcerly Hosoned no.
boorly joy fringe landits or-fion
Foreman Electrician _
i
I
Company name, addteas, city, mart. LIP+4 Indicate meal dollar amount
Apple Electric-.. of tom cemtract X22400.00
I hereby ecrafy that tlw abwe information is correct and that all
P.O. BOX 1252 worlus I employ oa this Public works project will be paid no
lass than the Prevailing Wage Rate(s) as determinW by the
Puyallup, WA 98371 Indusnial Statistician of the Department of Labor and Industries.
Connaeor Regjntation No. IIoI Tile SI'r
APPLEECO 5BR 60 59 Preciden? %
Fimit address Phonemmnear Frclhr x
a leelect i 2~m nn~ X2,3 caert teas- ?sxs ors )a
r,. aaf u... oat
APPROVED: Department of Labor and Industries Issum Ry:
IlairmIR STAT FEB 30'04
sy
6rdnnnal5tnieic
F'00.029-OOO satvnenr of innrn to WYPrerading wages ]0.02 Canary eap-L&I ntlwhl A- A
Page I of 1
Shelly Badger
From: "Gary Carlson" <garyc@ci.yelmma.us>
To: 'Shelly Badger"<shellyb@ci.yeirnma.us>
Sent: Wednesday, February 11, 2004 1203 PM
Subject: Insulation C O
Shelly,
The break down works like this:
$900 in labor-4 guys 6 hrs each
$1353 in material R-38 blow and R-21 Batt in knee walls.
$ 16° o contractor mark up. Jim charged 20%, 1 think it should bel6%
per our specs.
$95.00 for increased bond amount coverage
Total $ 2708.48
I think this is close enough for approval
Gary Carlson
Building Official
2 16!2004