071-20 - Express Septic Tank Cleaning - Supplement / Change Order 1CITY OF PORT ORCHARDLI
Authorization for Change Order No. 1
Date: 10/27/2020 Contractor: Express Septic Tank Cleaning _
Project: Sidney Glen Elementary School PO Box 1938
Annual Pumping Port Orchard, WA 98366
Contract / Job # C071-20
This Change Order authorizes the additional offsite removal of 1500 gallons of sewerage from the
Sidney Glen Elementary Annual Pumping contract. Contracted amount of 2000 gallons was an
estimated amount based on previous years invoiced totals. Total removal for this year was 3500
gallons.
Contract History
Amount Sales Tax Total Date Appvd b
Original Contract
$2�358.00
$212.22
$2,570.22
27-Au -20
PW DIRECTOR
'Change Order 1
$680.08
$61.12
$741.20
10-Nov-20
COUNCIL
Total Contract $3,038.08 $273.34 $3�311.42
I have reviewed the Change Order information above and certify that to the best of my knowledge descriptions and
costs are true and accurate.
�— --
ContractorApproval Signature Public Works ()ir_nr�Cl I"er:tgiheer
Delpha Oxier Vice President
Printed Name & Title
Change Orders that do not exceed 10%, with a maximum of
$50,000, of either legally authorized budget limit or contract Appl
amount established by City Council can be approved by the Public
Works Director.
Change Orders that do not exceed 10%, with a maximum of Atte
$1.00,000.. of either legally authorized budget Iimit or rontrart
tPmount established by City Countil are to he approved by the
jxvc
Change Orders over $100,000 or exceed a total of 10% req� AGO
Council Action.
.1 SEAL .
_MARK R. DORSEY, P.E.
Printed Name
I ,,, c, ic fauh ('Iraitiu,t
N) Itr)X 10,18
l"m ih-ch,trd, 11;A 98"W,
Invoice
l Dam �InYeicu
9/30/2020 11457
City Of Port Orchard
2 16 Prospect Si
Pots Orchard WA 98366
P.O. Number Due Date
Sidney Glen Elementry
500 Birch Rd 98367
AFFIDAVIT STATUS APPROVED
AFFIDAVIT ID 975415
'i ank is 6 feet deep hom top of tank to fluor of tanl� plus '10 feet of
risers foi a total of 18 feet from grade to bottom of tank 2 trips to
City sewer I IaUled away 3500 gallons for disposal at Bio
Recycling Pumped extra grater clue to vactoi truck onsde rinsing
tank with water
muck Time Truck Time $784 00 pei load to off load to City sewer designates 15`3UM-f
site per City of Port Orchard
2 loads to city seuver 4000 GALLONS PIER LOAD
Septic Pumping Septic Pumping L 42y Per Gallan to haul offsite to Bio Recycling 1 •+ 0 001
Actu-1-.11y gallons hauled off 3500 Gallons
(F_S IMAI E WAS BASED ON 2000-GALLONS FROM 2018)
Sales Tax '-' 42
Total $3,3'11-42
Payments/Credits �,r ;hr
Phone# (l1ri:.r.ti,c(uiCseryice'CO 1l-mail Balance Due ' 3,31IJ
360-895-5412 cttm