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MISC: 1977 COURTHOUSE ANNEX COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARLANE, County Clerk and Recorder James Sanddal, Chairman, Boulder CLERK and RECORDER CARLA MATLACK, Vincent M. Capp, Whitehall Leslie J. (Les) Sodorff, Clancy Boulder, Montana 59632 EvatV July 1, 1977 Mr. Craig Smith, Regional Director Economic Development Administration Rocky Mountain Regional Office 909 17th Street, Suite 505 Denver, Colorado 80202 Dear Mr. Smith: Enclosed, are an original Local Public Works Grant Application Supplement from Jefferson County and two copies. I If you have any questions on this application, please 1110 contact Mr. Tim McCauley by phoning: 406- 442-1552. Sir erely, `(airman, Board of County Commissioners Jefferson County, Montana JS/jm Enc: 2 ` 1 ORM ED-101LP18-5 LOCAL PUBLIC WORKS PROGRAM U.S. DEPARTMENT OF COMMERCE I5-77i APPLICATION SUPPLEMENT ECONOMIC DEVELOPMENT ADMINISTRATION AIIS No. 41-R2964; 43 U.S.C. 6706 r,pproval Expires 9/78 No Assistance Shall be Approve until a Completed Application has been Received OMB Approval No. 29-R0218 FEDERAL ASSISTANCE 2. Appli- a. Number 3. State a. SA1 Number cant's applice- 1. Type of cation 6. Date Yr. mo. day Identifier b. Date Yr. mo. day - action (D Application 19 77- 7 - 1 , (SAI) Assigned 19 5. Federal employer Identification no. JrFFFRSON CNTY OF 81-5001377W COUNTY COMMISSIONER$ 6. a. Number?' 11111011 [01�l Far 115 Program . R01lLfFR MT 596'82 6. T tle Local Public Works LCN!L-MT-0086-1 Federal Capital Development and Catalog) Investment Program • 7. Title and description of applicant's project 8. Type of applicant/reel•lent Title: Jefferson County Office Building Project '-State . 3-Indian Tribe Description: Construction of a new office building D-county E-City adjacent to County Courthouse for cur- F-School District rent ly overcrowded County Agencies. G-Special Purpose District (Enter appropriate letter) 11)1 9. Type of assistance A-Basic grant inifSSu I.gran[ rs--I (Enter appropriate let ter(e) Qlpl 10. Area of project impact (Name of chigoe, countries. 11. Estimated number 12. Type of application NA stereo. etc.) of persons A-New C-Revision E-Augmentation benefiting N A NA B-Renewal 0-Continuation appropriate letter) 15. Type of Change (For 12C or 12E)NA 13. PROPOSED FUNDING 14. CONGRESSIONAL DISTRICTS OF: A-Increase dollars F-Other (Specify) �: Federal $ .00 a. Applicant b. Project B-Decrease dollars 128,000 . C-Increase duration Applicant .00 County D-Decrease duration c. State .00 16. Project Stdrt Dote 17. Project Duration E-Cancellation d. Local 15,000 .00 19 Tyr._ rpo._ 11 dgy Months Nine (Enter appropriateletter(e) 000 e. Other .00 18. GO Yr. mo. day 19. Existing Federal identl(icafion number Estimated date to be L Total 5143, 000 •.00 submitted to Fed. Agency 19 NA L-MT-0086-1 20. Federal Agency to receive request (Name. City, State, ZIP Code) 21. Remarks added (See sec.1V) •Rrnnnmi DPVPlnpment Admini Rtra n e tirs Denvr. Cnlnrpdn 0 Yes IA] No 22. I • To the best of my knowled a and belief. b. If required by OMB Circular A-)5 this application was No Response data in this application submitted, pursuant to ulna-tenons tons therein, to appro- Response Attached The are true and correct, the document has priate clearinghouses and all responses are attached: Appl i. been duly authorized by the governing (I)(See remarks -Sec. IV it more than 3 clearinghouses) O ini cant body of the applicant and the applicant (2) NA E: -ED will comply with the attached assur certifies: antes if the assistance is approved. 131 . 0 0 23. a. Typed name and title 6. Si nature c. Date signed Certifying James Sanddal Yr. mo. day represen- tative Commission Chairman '" ft/aldiall 1977 - 7 - 1 24. Agency name 25. Yr. mo. day Application received 19 26. Organizational unit 27. Administrative office 28. F I li D L - ad° i-r 29. Address 30. Federal grant ID 31. Action taken 32. FUNDING 33. Action Year month day 34. Starting Yr. mo. day 1]a• Awarded o. Federal S .00 date 19 date 19 =b. Rejected b. Applicant .00 35. Contact for additional information 36. Ending Yr. me, day Denied elpe. Returned e. Slate .00 (Name end telephone number) date 19 for Amend- d. Local .00 37. Remarks added (See Sec. mein !V) Q d. Deferred e. Other .00 n Yes Q N o 0e. Withdrawn f. Total $ .00 38. a. In taking above action, any comments received from clearing- 6. Federal Agency A-95 Official Federal Agency houses were considered. If agency response is due under pron.. (Name and telephone no.) A-95 Action stuns of Part I , 0\I0 Circular A-55, a has been or is being made. 1 SF•424 110-751 uscOMM-DC 659.16-P77 LOCATOR NUMBER L — m-1O086I -I Part II Other Required Information and Exhibits TICE: Companion Form EC-101LPW is amended as follows: P.L. 94-369 shall read, "42 USC 6701 et. seq." and Sec. 107, P.L.94-369 shall read, "42 USC 6706." roject location: FOR E A USE NO' _ 3) City or other municipality Boulder PJP (a) )) County or equivalent Jefferson County PFC (b) :) State Mnn rang PST (u irpose of this submission:(Check one) Applicant Address Code t)Reconsideration of previous application(per above locator number) X 1 ' AFS 41 :) Submission of new application (Form ED-101 LPW is attached) 2 RPA PCC 4e If new application attach as Exhibit 541-2 Narrative Statement PCY 4d of Reasons ZIP 4L SCY 'riority assigned to project: Fl rst X PPN SCC this Application endorsed by any other applicant(s)? SST Please check one Yes I No X 9 SBA SP$ • the project area a community or neighborhood(pocket of Poverty)within an ISA 3 i:herwise ineligible city in accord with Sec. 108(e)? Please check one Yes No X PSA • CGA `YES," enter the unemployment rate or the area from J;xhibit 811-5 e % PUN CGP :roes the operation and utility of this project depend on the completion of any other WKT (7) I I rroject(s)not yet fully operational? Yes No TYP (8) X PSD (),6) M M D ' D I Y V '! "YES," attach as Exhibit 5-11-6 a narrative description of the other eject or projects and a report on the status of each. PDU (11) MOS. RII (25) M M D I D I Y I Y I CCC (IV)J1=Yes 9=No LP$ (IV) • TP$ (IV) ENG (IV) PRG I I • • APP 4a ORG 4b • ADR 4c :'a EO.101LPW-5 (5-771 3 USCOMM-DC 63945-P77 • LOCATOR NUMBER L — pm - I r Nfl -N 7. Indicate status of project clearance by A-95 Clearinghouse and State Historic Preservation Officer(SHPO): (Check all Appropriate) • [j a.This project is being submitted to EDA for reconsideration and no significant changes have been made in the size or scope of the project, and I(1) A-95 Clearinghouse comments are attached as Exhibit S-II-la. j 1(2) SHPO comments are attached as;Exhibit S-II-7b. fjj(3) A-95 Clearinghouse comments were not received. xl(4) SHPO comments were not received HR. This project is being submitted to EDA for reconsideration and one or more significant changes have been made in the size or scope of the project, and ❑(1)The project has been re-submitted to the appropriate A-95 Clearinghouse(s)for comments I I(2)The project has been re-submitted to SHPO for comments c.This project is a new or substitute project now being submitted to EDA for the first time, and Form ED-101LPW is attached, and • I I(1) The project has been submitted to the appropriate A-95 Clearinghouse(s) for comment I I(2)The project has been submitted to SHP0 for comment f�d. A copy of this applicant's individual or joint listing of Submitted and Endorsed Applications has been forwarded to the appropriate A-95 Clearinghouse(s) and SHPO for information. 8. Energy conservation measures associated with the projecL Check all of the statements which apply to this project. [XJ a.The project has been designed in conformity to all applicable American Society of Heating, Refrigerating and Air Conditioning Engineers, Inc, and to state standards for the area in which it is located. lb.The project involves redesign and retrofit of an existing facility for increased energy conservation c. The project makes use of one or more alternative sources of energy (solar, geothermal, etc.) • FORM ERIOILP W-5(6'17) 4 USCOMM-DC 63448 P77 LOCATOR NUMBER L - 1M T1-10 0 8 6I-r. • a Pt IV. PROJECT BUDGET INFORMATION Section A—CALCULATION OF LPW GRANT BUDGET CO ST CLASSIFICATION PREVIOUS ESTIMATE PRESENT ESTIMATE EDA USE (a) (b) (c) ONLY 1. Administration Expenses $ 0 S 1,000 LAD 2. Architectural/Engineering 7,600 7,600 3. Other Architectural/Engineering Fees LAE 4. Project Inspection Fees 3,900 3,900 5. Relocation Expenses 6. Relocation Payments to Individuals and Businesses 7. Demolition and Removal a. Labor LDI4 b.Non-labor • B. Construction and Project Improvement a. Labor 45,250 59,750 LCL b. Non-labor 45,250 59,750 9. Equipment LPE 10. TOTAL(Lines l thru 9) $ 100,000 S 132,000 • 11. Add: Contingencies 10,000 10,000 LPC 12. TOTAL LPW Project Amount(eligible costs only) $ $ 13. Federal Share Requested of Line 12(LPW) 110,000 142,000 LP$ 14. Other Shares(State, Local, Federal) a. State b. Other Local/Federal(identify under "Remarks" below) 15. TOTAL Project(Lines 13 +14a and b) TP$ Includes ineligible costs if arty $ 110,000 $ 142,000 Section B— REMARKS •Total additional cost for energy conservation revisions $ 1,000 BUDGET CHANGES Item Number: 1. Administrative cost - $1,000 4. Project Inspection Fees a. Cost of Project Coordinator - $2,000 (one-forth time for nine months) 8. Construction and Project Improvement - $29,000 a. 10% increase in cost of materials and labor, insulation costs and enlargement of building Note: Federal Management Circular 74-7. Exhibit M-4 (modified) FORM ED-101 LP W•S 16.771 6 USCOMM-DC 639 4P-P77 LOCATOR NUMBER L- 1M THO 0 8 6I'f1 10 Part IV. PROJECT BUDGET INFORMATION Section A—CALCULATOR OF LPW GRANT BUDGET COST CLASSIFICATION PREVIOUS ESTIMATE PRESENT ESTIMATE EDA USE (a) • (b) (c) ONLY 1. Administration Expenses $ 0 S 1,000 LAD 2. Architectural/Engineering 7.600 7.600 3. Other Architectural/Engineering Fees _ _ LAE 4. Project Inspection Fees 1.900 3,900 _ 5. Relocation Expenses LPR 6. Relocation Payments to Individuals and Businesses 7. Demolition and Removal LDL _ a. Labor b.Non-labor 8. Construction and Project Improvement LCL a. Labor 45,250 52,750 - (&CIASL b.Non-labor 45,250 52.750 6 oi.20 9. Equipment LPE 10. TOTAL(Lines 1 dm 9) $ i nr_nnn $ ii a nnn t/33.47.77 11. Add: Contingencies 10.000 10,000 • /0, 02) LPC ili 12. TOTAL LPW Project Amount(eligible costs on $ $ a 110,000 128.000 - /N ,� 13. Federal Share Requested of Line 12(LPW) LP$ 14.Other Shares(State, Local, Federal) a. State - b. Other Local/Federal(Identify under"Remarks" below) 15,000 15. TOTAL Project(Lines 13 +l a aid 6) Includes ineligible costs it aey $ $ 143.000 TP$ Section B— REMARKS Total additional cost for energy conservation revisions $ 1,000 Budget Changes Item Number 1. Administrative Cost - $1,000 4. Project Inspection Fees a) Cost of Project Coordinator - $2,000 1 time for nine months 8. Construction and Project Improvement - $15,000 a) 10% increase in materials and labor, insulation costs and enlargement of building 14. b. Local - Federal - Local government contribution - $15,000 a) Cost of basement I. - Note: Federal Management Circular 74-7. Exhibit M-4 (modified) FORM E0•I0 1 LP W-S 1e-77) 6 U sCOMM-OC 53940-P77 LOCATOR NUMBER L — IM IT I —F01-011-1—I 1 Part V. CIVIL RIGHTS INFORMATION ow many definable minority group persons(as defined in 28 CFR 42.402(e))reside within the jurisdiction served by the applicant? a. 64 b. 1 97 (Number) (Percentage of total population of applicant's jurisdiction.) c. Source of above data 1970 Census the proposed facility displacing or causing the relocation of those persons identified in Question 1? Li Yes []No ANSWER THE FOLLOWING QUESTION ONLY IF THE ANSWER TO QUESTION 21S"YES" What action is being taken to ensure that these persons will be displaced or relocated on a nondiscriminatory basis? • • ANSWER QUESTIONS 4 AND 5 ONLY IF THE PERCENTAGE GIVEN IN ANSWER TO QUESTION 11S 5%OR LARGER �1at percentage of the definable minority-group persons identified Question I will be served by the proposed project? Are the proposed project site and/or services readily accessible to the minority population identified in Question 1? I Yes ❑No ANSWER QUESTION 6 ONLY IF THE ANSWER TO QUESTION 5 IS"NO" What action has the applicant taken or what action does it plan to take to ensure that the minority population receives services on a nondiscriminatory basis? Pursuant to the instructions for Part IV, each applicant must attach as Exhibit S-V-7 one of the following documents, displaying data for me year 1976: Ix I A Form ED-612 1 !Form EEO-4 in its entirety, including a summary total sheet [7i A partial Form EEO-4, including the summary total sheet and detailed data only on the specific department applying I IForm EEO-5 Li Form EEO-6 1'd ED-1011PW-S (SO)) 7 USCOMM-DC 65948-P77 PART VI: ASSURANCES Lora"Number The applicant hereby assures and certifies that it shall comply with the regulations, policies, guidelines and require- ments, including Office of Management and Budget Circular No.A-95, and Federal Management Circulars 74-4 and 74-7, as they relate to the application, acceptance and use of Federal funds for this federally assisted project. Also, the applicant gives assurance and certifies with respect to the grant that: 1. It shall require the facility to be designed in accordance with the provisions of 41 CFR Subpart 101-19.6 "Accomodations for the Physically Handicapped." The applicant shall be responsible for continuing inspections to insure compliance with this requirement by the contractor. 2. No contract will be awarded in connection with the project to any bidder who will employ any alien in the United States in violation of the Immigration and Nationality Act or any other law, convention, or treaty of the United States relating to the immigration, exclusion, deportation, or expulsion of aliens. 3. The project will be constructed from raw materials mined or produced in the United States and from United States manufactures substantially made from materials mined, produced or manufactured in the United States, unless the Assistant Secretary determines that this requirement is not applicable to the applicant's project. 4. At least 10 per centum of the amount of each grant shall be expended for minority business enterprises, unless the Assistant Secretary determines that this requirement is not applicable to the applicant's project. For the purpose of this paragraph, the term "minority business enterprise" means a business at least 50 per centum of which is owned by minority group members or, in case of a publicly owned business, at least 51 per centum of the stock of which is owned by minority group members. For the purposes of the preceding sentence, minority group members are citizens of the United States who are Negroes, Spanish-speaking, Orientals, Indians, Eskimos, and Aleuts. 5. Special consideration, consistent with existing applicable collective bargaining agreements and practices, shall • be given to the employment on the project of qualified disabled veterans as defined in 38 USC 2011 (I), and to qualified Vietnam-era veterans, as defined at 38 USC 2011 (2)(A). 6. If the grant is made under the provisions of Section 108(e)of the Act (Pocket of Poverty), employment engendered by the project will be offered preferentially to the residents of the neighborhood or community that defines the project area. Further, the project will be located physically within the project area as defined in Exhibit S-II-5, previously submitted to EDA. 7. No part of the construction (including demolition and other site preparation activities), renovation, repair or other improvement of the project shall be performed directly by any department, agency, or instrumentality of any State or local government. Construction of the project shall be performed by contract awarded by competitive bidding, unless the Assistant Secretary determines that some other method of bidding is in the public interest. 8. The applicant will comply with assurances made previously in connection with any earlier application submitted on Form ED-101LPW for financial assistance for the project herein described if assistance for the project is approved. • FORM ED-1O1LPW-S (5-77) USCOMM-DC 58045-P77 8 LOCATOR NUMBER L - m-1r r6-FT LIST OF EXHIBITS Number Attached? EDA of Description of Exhibit USE Exhibit Yes No ONLY ED-101 LPW LPW Application(for new projects) X 5-11-2 Narrative statement concerning reasons for submitting new application X S-II-3a List of Submitted and/or Endorsed LPW Applications in Order of Priority X S-II-3b Local GovemmenVSchool District List of Submitted and/or Endorsed LPW Applications in Order of X Jointly-Assigned Priority S-I1-4 Certificate of Project Endorsement X 5.11-5 Definition of Community or Neighborhood(Pocket of Poverty) within an Otherwise Ineligible City, X and Statement of Average Unemployment Rate 5-11-6 Statement concerning dependence of this project on other projects and status of each X S-II-7a Comment from A-95 Clearinghouse X S-II.7b Comment from SHPO X S-III.1 Updated architect/engineer(WE) report g 5-111-2 Continuation Sheet- Detailed Statement of changes in Application Data( pages) X S-V-7 Civil Rights documentation, Form En - 612 X (Applicant: Enter Identifying Number) S-VI-3 Request for waiver of"buy American" requirement X • S-VI-4 Request for waiver of 10%minority business enterprise requirement X S-IV-7 Request for waiver of competitive bidding requirement X • FORM ED-101LPW-5 (5-77) 9 USCOMM•DC 65048•P77 LOCAT NUMBER U � (� L— IM IT1- nl OIRI l-li LIST OF EXHIBITS(CONT'D) (If Needed) Number Attached? EDA of Description of Exhibit USE Exhibit Yes No ONLY Applicant: In the space below of this form, describe any additional Exhibits, identifying them by the Part and Item numbers of the Application Supplement to which they pertain. None • • FORM ED-101LP W-S 15-771 10 USCOMM-DC 63940-R77 LOCATOR NUMBER L— I MI TI_- O 0 B 6 —I 1 EXHIBIT S-II-3a • LIST OF SUBMITTED OR ENDORSED LPW APPLICATIONS IN ORDER OF PRIORITY 31 Name of Applicant Street/P.O. Box Jefferson County, Montana Box 115 City ggulder i iizational Unit County County Commissioner's Office Jefferson Y State ZIP Code MnnEmma 54601. :ITE: SCHFOL DISTRICTS MUST IDENTIFY THE CITY (OR CITIES AND COUNTY)PRINCIPALLY TO BE SERVED BY EACH PROJECT. Type of Applicant and Relationship to School District As defined in the Instruction to Part I.1 of the LPW Application Supplement, I I The Applicant is neither a city, a county,nor a school district. Ixl The applicant is a city or a county, and there is no school district with authority under law to apply for LPW funds for school projects principally to serve the city or county. ❑The applicant is a city or a county, and no school district with authority to apply for EDA funds for school projects principally to serve the local jurisdiction has applied or will apply for such assistance. ❑The applicant is a city, a county or a school district authorized to apply for LPW funds for school projects principally to serve a city or a county and wishes EDA to select among the Local Government's and school district's applications. • rity EDA Locator Name of Applicant and Description of Project LPW Funds Number Requested cat NAME: Jefferson County, Montana • I MT-0086-1 DESCRIPTION: $ 128,000 Construction of new office building adjacent to County Courthouse for existing County Agencies 2 $ • •3 $ ED-1011-P101-3 (5.77) 11 USCOMM-DC 83948-P77 LOCATOR NUMBER I L — IM TUMI—t0 018 ! 6 1 -I1�- Priority EDA Locator Name of Applicant and LPW Funds • Number Description of Project Requested 4 $ 5 $ • G $ 1 $ 8 $ 9 $ • 10 $ 11 $ 12 $ 13 $ 14 $ i • 15 $ FORM ED-lOILP W5 (5-77) 12 USCOMM•DC 03948-✓77 • S-111-1 41111/1 -A/E REPORT- 1. Detailed description of changes in the project. Proposed Project changes are: 1. an increase in the size of the building from 2,425 sq. ft. to 2,575 sg. feet to allow for more office space and 2. the con- struction of an unfinished daylight basement of 2,575 sq. feet. This basement area will be utilized immediately for storage space for County agencies. The proposed changes will result in the employment of two additional persons on the project. 2. Summary of changes made in project for energy conservation and total cost of changes. To make the building more energy efficient, insulation will be increased from a R-13 value to a R-19 value in the walls and from a R-19 to a. R-30 in the ceiling. The increase in cost will be $1,000. 3. Current status and final plans. Except for the above mentioned changes the status of the plans for the project remains the same as the original application. All A/E drawings and specifica- tions will be completed within 60 days of the acceptance of the proposal, allowing the proposed building to be under construction in 90 days. 4. Seasonal delays in start or completion of project. If the proposed project is approved by E.D.A. before September construction could commence this fall. However, due to the early arrival of winters in Montana, a waiver for a seasonal delay in the project might be required as it is difficult to commence construction after November in the project area. S. COMMISSIONERS: JEFFERSON COUNTY ' County Clerk end Recorder James Senddal, Chairman, Boulder CLERK and RECORDER CARLA MATLACK, Vincent M. Capp, Whitehall Deputy Lane J. (Les) Sodortf, Clancy Boulder, Montana 59632 July 1, 1977 Tom Crosser A-95 Clearinghouse Governor's Office of Budget and Planning Capitol Station Helena, Montana Dear Tom: Jefferson County is submitting an E.D.A. Local Public Works Project Application Supplement. Since there are no significant changes in the project from the original application on record in your office, the A-95 Review Process was not re-initiated. If you have any questions on this project, please contact Tim McCauley at 442-1552. - "Sin.erely, Or / � � �✓ --- airman, Board of County Commissioners, Jefferson County JS/jm COMMISSIONERS: JEFFERSON COUNTY JOANNE P. and RLANE, County Clark and Recorder Janes Sanddal, Chairmen, Boulder CLERK and RECORDER CARLA MATLACK, Vincent M. Capp, Whitehall WIN J, (Lae) Sodorff, Clancy Boulder, Montana 59632 OeWtY July 1, 1977 Mr. Craig Smith, Regional Director Economic Development Administration Rocky Mountain Regional Office 909 17th Street, Suite 505 Denver, Colorado 80202 Dear Mr. Smith: Due to the small number of minorities residing in Jefferson County and in the adjacent counties (Lewis and Clark - 1.4%, Silver Bow - .8%, and Broadwater - .8%) where purchases will most likely be made for materials used in construction of the project and firms • involved in construction of the proposed project, the Jefferson County Commissioners request that Assurance #4, 10% Minority Business Enterprise Requirement, be waived. Si erely, w airman, Board of County Commissioners, Jefferson County Montana JS/jm S July 12, 1977 Mr. George Robertson Rocky Mountain Regional Office Economic Development Administration Tital Building - Suite 505 905 17th Street Denver, Colorado 80202 RE: EDA Application MT-0086-1 Dear Mr. Robertson: • Please be advised that the local matching contribution of fifteen thousand dollars ($15,000) for Jefferson County's EDA grant will be derived from the County's general fund. Thank you for your interest in the grant proposal. Sr (41 James Sandell, Chairman Jefferson County Commission JS/bc • • S July 6, 1977 Mr. Al Thompson State Historic Preservation Office Montana Historical Society Capitol Station Helena, Montana 59601 Dear Al: • Enclosed are the preliminary plans for the E.D.A. grant Jefferson County is submitting for a new office building. ' If you need any addi- tional information on the project, please contact me or Eugene Vogl, Johnson, Graham and Associate, 644 Grand Ave., Billings, Montana. He will be the architect on the project if the proposal is funded by E.D.A. Sincerely, Tim McCauley Director of Community Affairs TM/bc Enclosures Ilk LOCATOR NUMBER L - IM I r T 1 - [)m2 16 1 -It Part III. CHANGES IN THE PROJECT NOTE: This Part of the Application Supplement is to be completed only for previously submitted applications submitted fir reconsideration. tt is not applicable for new applications. 1. Summary description of changes in the project(except changes in cost). There are two proposed changes in the project. They are: 1) an increase in the size of the building from 2,425 square feet to 2,575 square feet to allow for more office space and 2) the construction of an unfinished daylight basement. The basement area would be utilized immediately as a storage area for county agencies. These changes will provide for the employment of two additional persons during construction of the building. 2. Detailed statement of changes required in application data to reflect changes in the project(except changes in cost). Reference Description Part Section Item Page See original L.P.W. application - Exhibit II - B-3 411 II-B-3 A Increase in size of office building from 2,425 square feet to and 2,575 square feet. C Construction of a daylight basement of 2,575 square feet. I . j Continuation sheet attached • FORM ED•101LR W-515•'1']1 5 US COMM-DC 55048.1.77 --s 1 • . I.fa i \i. , ;( Ii)iiic a Ka ;h ti i 5 71110 U2 )040/id; u 19 4. 4 t y �o m , o6 = ,, i 0 AF® � ® ' NVlt 3115 0 s . Q GIL \. 34( 011M011.51%3 ono ° 0 : : * k- 0 0 y Oki t dti 61+2 - N01114411 MAN • 0 0' 0 4 GO ° 00 AU Ow COUNTY ATTORNEY , WELFARE OFF1&Ph 111771E1 C 1 �— MECHANICAL _, % 160 5F OFFICE orFIGE oFFIGE ;� loo 5F loo W loo 5F 11', i �- I60 5F • �;,D 1 i 1IW!M .3 � / OFFICE 1 1�5F } . . . 10o4F WAITIN WAITINN _ Ll- 2 hf 170 360 ®m OFFICE r rie : OFFICE KWEPrION ° ' . `� KEGEPnION TO' .r "r' a i • EHTSY `1a:q: ' a ;o - l 160 5F I` ` , i • I3 5F • • • FLOCK PLAN . 2429 (RUARE FEET . i / b, a � II_ oil fröPcçv 1 figrnytH �� �' ` &Q 't� f�jC/ V V VaV" pay COMMISSIONERS: JEFFERSON COUNT/ end e JOANNE P. RLANE, 7/ RECORDER County Clerk end Recorder James Sanddel, Chairmen, Boulder CLERK and RECORDER CAR LA MAT LACK, Vincent M. Capp, Whitehall - DePr+ty Leslie J. (Les) Sodort(, Clancy Boulder, Montana 59632 October 4, 1978 Hamlin Construction Gruber Estates Clancy, Montana 59634 Dear Jerry: This is to inform you that the request for extension for completion of the Court House Building Annex has been granted by the Board. Completion date to be October 31, 1978. Sincerely, B oard of County Commissioners Jefferson County, Montana By kmf C airman ofi'the Board JWS/jm (r.„,..R LeyttA..1.1 aki.:04 1 V t - 1 9 2 V tgt;;4 0 PAYMENT VOUCHER ON LETTER CREDIT i 2 414 8 8 9 6 TERM 1000 (TO BE COLLECTED AS A NON-CASH ITEM) The drawer's bank shall be the agent of the drawer for the collection of this SERIAL NO. •>,' instrument and each subsequent collecting commercial bank shall be the sub- s .. agent of the drawer. SYMBOL 17-865 v 0 VOUCHER NO. LETTER OF CREDIT NO. AGENCY STATION SYMBOL DATE VOUCHER DRAWN AMOUNT in 3 7 ,rye c 0 C NAME AND ADDRESS OF DRAWER NAME AND ADDRESS OF DRAWER'S BANK FEDERAL RESERVE BANK OR BRACH cti 5) k- 5.) in NAME AND ADDRESS OF U. S. AGENCY I certify that this payment voucher has been drawn in accordance with the vi� f.q OF _, terms and conditions of the letter of credit cited and that the amount for which ',.5 MTI>w� OF ~s; drawn is properly for credit to the account of the drawer at the drawer's bank. LLI > ^sv a ;,-.h'hi :s:ki IV.!'M nor... .74i U J WASANG '.41,U ot»t (Signature) (Title) a D CC / (Countersignature) (Title) Per authorization of Fiscal Assistant Secretary, Department of the FOR FEDERAL RESERVE BANK USE ONLY O' Treasury, debit the general account of the U. S. Treasury and pay to • the presenting bank the amount shown above. (Date Debited) (Authorized Signature) TFS FORM 5401 FORMERLY Tl1S FORM 5401, DEPARTMENT OF THE TREASURY - FISCAL SERVICE 5-75 REV. 12-67, WHICH MAY BE USED. BUREAU OF GOVERNMENT FINANCIAL OPERATIONS PAYMENT VOUCHER ON LETTER CREDIT c-------t 2 414 8 8 c-------t 6 TFRM 1000 (TO BE COLLECTED AS A NON-CASH ITEM) The drawer's hank shall be the agent of the drawer for the collection of this SERIAL NO. ?-� instrument and each subsequent collecting commercial hank shall be the sub- 0. • agent of the drawer. SYMBOL 17-865 � VOUCHER NO. LETTER OF CREDIT NO. AGENCY STATION SYMBOL DATE VOUCHER DRAWN AMOUNT in 13-^ ,..-:.'!;.3--::- .,;. ; 3-9-78 $ 30,000.00 _C NAME AND ADDRESS OF DRAWER NAME AND ADDRESS OF DRAWER'S BANK` FEDERAL RESERVE BANK OR BRANCH ctl Jefferson County First Boulder Valley Bank Minneapolis, Minn. Boulder, Montana Boulder, Montana Helena Branch 3 #3564-13001-9 T NAME AND ADDRESS OF U. S. AGENCY I certify that this payment voucher has been drawn in accordance with the #�+:_x 2x4"',3T.:Tlf T f"/ae : terms and conditions of the letter of credit cited and that the amount for which x fit. ;s a .. W AAviyR# f2..N1 yQa = i�.i�y A , drawnls properly for credit to the account of Ch.e.drIrd.r abt re drAwer�s .• Q A .,4}.i"IQ Y3 ,..-.1-, , -.--:::,,,m,1% .ii::' 141 i' �I OL! T 1 . lr J1.x.}it.,c'ii'.izi '4 ¶).C. r'.t ? (Signature) (Title) I D County Clerk s, Recorde o 05-51-26274 (Countersignature) (Title) D Per authorization of Fiscal Assistant Secretary, Department of the FOR FEDERAL RESERVE BANK USE ONLY O' Treasury, debit the general account of the U. S. Treasury and pay to the presenting bank the amount shown above. (Date Debited) (Authorized Signature) FORM FORMERLY TUS FORM 5401, DEPARTMENT OF THE TREASURY — FISCAL SERVICE TFS 501 401 REV. 12-67, WHICH MAY BE USED. BUREAU OF GOVERNMENT FINANCIAL OPERATIONS PAYMENT VOUCHER ON LETTER CREDIT 2 /� 1 /� Q Q /� 6 FRM 1000 (TO BE COLLECTED AS A NON-CASH ITEM) `t �+ V v `t • The drawer's bank shall be the agent of the drawer for the collection of this SERIAL NO. a instrument and each subsequent collecting commercial hank shall be the Sub- SYMBOL 17 865 O agent of the drawer. U VOUCHER NO. LETTER OF CREDIT NO. AGENCY STATION SYMBOL DATE VOUCHER DRAWN AM N ® r,/V to 0049 Y 1:.1°3 :�:•{i: gas _. 2-15--78 n C NAME AND ADDRESS OF DRAWER NAME AND ADDRESS OF DRAWER'S BANK FEDERAL RESERVE BANK OR BRANCH Jefferson County First Boulder Valley Bank Mineeapolis, r'inn. — Box 115 _ Boulder, Montana 59632 Helena Branch Boulder, Montana j 59632#3564-131101-9 rO NAME AND ADDRESS OF U. 5. AGENCY I certify that this payment voucher has been drawn in accordance with the 6 t ;! '4r' .�T-�' 'S {2f''. terms and conditions of the letter of credit cited and that the amount for which ( � a.'! l OF _ R+� ��q�— ] y�l� 3y �.yyx Y 7 yx Si.y� !q- drawn is properly for credit to the account of the drawer at the drawer's bank. Q ?-,,C.: -;�11�. ]J� `CYity F7iy $;741 Co. Clerk !. Recorder J gQNs' 79�• r r. d'F.'. (Signature) rtl ChairmaN, ed of Co. Commissioners CC PN� 05-51-26274 (Countersignature) (Title) Q D Per authorization of Fiscal Assistant Secretary, Department of the FOR FEDERAL RESERVE BANK USE ONLY 0' Treasury, debit the general account of the U. S. Treasury and pay to the presenting bank the amount shown above. (Date Debited) (Authorized Signature) TFS FORM S401 FORMERLY TUS FORM 5401, DEPARTMENT OF THE TREASURY — FISCAL SERVICE 5-75 REV. 12-67, WHICH MAY BE USED. BUREAU OF GOVERNMENT FINANCIAL OPERATIONS `4 3°' I PAYMENT VOUCHER ON LETTER CREDIT 2 414 8 8 5 6 TERM 1000 (TO BE COLLECTED AS A NON-CASH ITEM) The drawer's bank shall be the agent of the drawer for the collection of this S RI 'L •• >, instrument and each subsequent collecting commercial bank shall he the sub- Ll.o agent of the drawer. SYMBOL 17-865 U VOUCHER NO. LETTER OF CREDIT NO. AGENCY STATION SYMBOL DATE VOUCHER DRAWN AMOUNT Le E 4 t . -' a 7-7-78 s 50,000.00 • NAME AND ADDRESS OF DRAWER NAME AND ADDRESS OF DRAWER'S BANK FEDERAL RESERVE BANK OR BRANCH tO 1' Jefferson County First Boulder Valley BAnk Minneapolis, Minn. Box 115 Boulder, Montana 59632 Helena Branch Boulder, Montana 59632 (3554-13991-9 3 CZ NAME AND ADDRESS OF U. S. AGENCY I certify that this y payment voucher has been drawn in accordance with the +d+ $•+„rP +.;• )- .q,13I oY terms and conditions of the letter of credit cited and that the amount for.which •f;y •' 1 �;,'� `�•t� drawn is properly for credit to the account at r ank. W F,aNOP.i» .)E.114-.}.' 4, K1 +��: A`4,ii 3 j -1i.:lp P P y h i an, �� Q , r= '',Ut r,t: are V ttii 0i4, 1+ 14)7 County Commissioners o . T4E,s "` J v,,:.A:I. .:;3 (Signature) (Title) D �y ry A County Clerk & Recorde 0 74.- ,er;k, 05-51-26274 1.26274 (Countersignature) (Title) D Per authorization of Fiscal Assistant Secretary, Department of the FOR FEDERAL RESERVE BANK LISE ONLY 0' Treasury, debit the general account of the U. S. Treasury and pay to • the presenting bank the amount shown above. (Date Debited) (Authorized Signature) TFS FORM 5401 FORMERLY TUS FORM 5401, DEPARTMENT OF THE TREASURY — FISCAL SERVICE 5-75 REV. 12-67, WHICH MAY BE USED. BUREAU OF GOVERNMENT FINANCIAL OPERATIONS IIIIIPF PAYMENT VOUCHER ON LETTER CREDIT 2 414 8 8 6 6 TERM 1000 (TO EE COLLECTED A5 A NON-CASH ITEM) s The drawer's bank shall be the agent of the drawer for the collection of this SERIAL NO. r, . R instrument and each subsequent collecting commercial bank shall be the sub- agent of the drawer. SYMBOL 17-865 0 L) VOUCHER NO. LETTER OF CREDIT NO. AGENCY STATION SYMBOL DATE VOUCHER DRAWN AMOUNT' Ui y L ' kw :: ; .:.._ S V a 21,000.00 S NAME ANO ADDRESS OF DRAWER NAME AND ADDRESS OF DRAWER'S BANK FEDERAL RESERVE BANK OR BRANCH tO Jefferson County First Boulder Valley Bank Minneapolis. Minn P.O. Box 115 Boulder, Mon Lana 59632 Helena Branch 43 Boulder, Montana 59632 (3564-130U1-9 m SHAME AND ADDRESS Of U. S. AGENCY I certify that this payment voucher has been drawn in accordance with the Q �"T"/'sE terms and conditions of the letter of credit cited and that the amount for which I ""' � s.,, drawn is properly for credit to the acco t of the drawer the a er's bank. w � � :.� ►_' < Chairman, Bd. o `Co. Comm .4 Afaktittinua �y p3`l4 , 741 Jefferson Count, Montana J ��ry b.C. (Signature) (Title) • 0. ec Co. Clerk Recorder ec 4-d,.-10 05-51-26274 (Countersignature) (Title) D Per authorization of Fiscal Assistant Secretary, Department of the FOR FEDERAL RESERVE BANK USE ONLY Treasury, debit the general account of the U. S. Treasury and pay to the presenting bank the amount shown above. /J '] (Date Debited) (Authorized Signature) TFS FORM 5401 FORMERLY TUS FORM 5401, /�( �// ( DEPARTMENT OF THE TREASURY — FISCAL SERVICE 5-75 REV. 12-67, WHICH MAY BE USED. BUREAU OF GOVERNMENT FINANCIAL OPERATIONS n C {v T c/,>, r t4 ) X a V ao tio_o%„04,ra, (4mxP" MARVIN R.SCHUTT MARKETING DIRECTOR COLONI� 1529 Missoula 410 pV+aa/L II Helena,Mt 59501 LIFE A ACCIDENT INSURANCE c Nv Bus.Tel.:442-4107 Bus.Tel.:443-3558 O TRUCT/ , • Jerry Hamlin President -__ • --- x§91%;44x Octixcv. xhfgx ESC 5 ? 1429 Aspen ; 3 Helena, MT 59601 443-1340 40�. NCr. FIOPMENT CO October 2, 1978 Board of County Commissioners Jefferson County Boulder, SIT. 59632 Gentlemen; I respectfully request another time extension on the completion date of the Boulder Office project. The delay this time is a direct result of the BN Railway strike and non—shipment from Billings of the hardware to hang the interior doors. This material was ordered (as you can see from the enclosed letter) 1-6-78 and fabrication was to have begun on [larch 13, 1978 (see letter). I have been in contact with this supplier by phone this morning and he has promised delivery by 10-6-78. I have also enclosed a letter sent by my lawyer to my M8E, Ron Paul Construction, asking him to reply in 15 days. As of yet I have not heard from him. Also, I have contacted LaSalle Construction, another qualified MBE, to furnish my insulation. He is currently trying to arrange this. Considering these problems and anticipating shipment of my hardware by 10-6-78, I respectfully ask that you consider granting an extension for completion of the project to 10-31-78. This would in no way imply that I would not finish sooner if my materials arrive in time. Very Truly, Hamlin Construction and Development Co.,Inc. President 3RH:kls . PC .CHASE R ,• • . HAMLIN CONSTRUCTION No. ', ' ..'-_.� AND DEVELOPMENT CO., INC. DATE 1-6-78 DATE REQUIRED SOX 64 SR CLANCY MT. 39634 . !HONE 933.3639 • SHIP VIA • F.O.B. TERMS . • TO • SHIP TO Boulder Court House • Building Specialities Boulder, Montana i • P.C. J✓ox 1376 '• Billings, Fiontana 59102 . REQ. NO./FOR. • • 1 QUANTITY 4 STOCK NUMBER/DESCRIPTION _~ PRICE PER • We wish to order the hollow metal doors and frames and finish hardware for the Boulder Office Project as per your quotes Base Bid: . . . Hollow Patel iJOors and Frames 5 U714,3L Finish hardware— Sec. BD 1 53E.dC Total , vi2,112."0 Please provide shop drawings as soon as possible. Shipment won't be needed until approximately Ftny 19'S. • :,• I . INVO!CES PASSED FOP, F:.YMENT LIIEH — • • —T W1L•ON JON(•.COMPANY'•..-)1461 4 PAWRI rGgxVMI "SNAP-A-WAY"FORM 44-131 a-PARTS DUPLICATE. r _a.; scar.-:w"^_ , �,,`"a�__. r �:�--��_'4ta+:�_ ..tu°..i•.�...adx....... '.� �. "`'•. ..,- ..,..u`a.:-'�I��...::.us.� :,..:t,�w.__.a_:.-.. _.. . y •' 5rtd Lette' •• • From HAMLIN CONSTRUCTION - • AND DEVELOPMENT CO., INC. • 5-03 7)-4 r-Ct›- c 5 BOX 64 SR CLANCY NM 19634 P. 0.. /.3,60 • • aLo PHONE 933-5639• Sublect - - 10 FOLO • Message 4,1 CA-nAn, a 4LZ4& . •. Dr 0,4- 4-- • ' . C' 9-u■.) BateL2& ined.' • Rork.- • - U Foul NO.10 FOLD flfE WilsonJones vA.,,,•..0%..~ WAX 4 aft PPIr°9 Ut Ill. • • • • • i , 8eptembr 13, 3.97$_ . PaulConscruction P.O. Sox 597 file :t.; Browning, Montana 59417 Res' Hamlin Construction 'T)e a r Mr. Nlul . . This letter is to advise you tht I have been retained by Mr., Hamlin to represent him in the above 3r,att;r.- On Deeember -18 , 1977 , You and Mr. Hamlin entered into a Sub- contract •Agreement , a copy of which is enclosed, in which bC tain " ►vices were specified on page one. r ursuant to your letter of January 5, 1977 , a copy of which is attached , ybu•. acknowledged the Order for the Bou1-dper Office Project and signed the enclosed contract . At this point , it is important for you to be atrare that Mr. Hamlin: at no t9.mc aer?ed to the provision added by you, after Mr. Hamlin signed,the December 1P, , 1)77 contract, which stated "prices subiect to change after 10 lays" . Since this was not a part of the Agreement which he signed, it is not binding on him aed you are bound by the terms contained ire page one of the Subcontract. Furthermore, the materials for the boulder . Office Project were ordered by Mr. Hamlin prior to any thirty day period, which, is evidenced by your letter of May 24 , 1978, a copy of which is also enclosed. To date, Mr. Hamlin has paid you the amount specified in the contract for the it Le has received. In addition, , he has also purchased the overage shipped by you even though this was not a part of the original contract . Throughout the course of his dealings with you, Mr. Hamlin' has made every effort to cooperate with you in this matter. At this present nolnt in time, your refusal to shin the last two items of the subcontract, to wit • 42 rolls (70 eq ft) 3 l" x 15' batt wall in- sulation R-13 29110 6" batt ceiling insulation R-19 24" 48 )0 has resulted in delaying the completion Of the;+ Rouldeer t t.ver a t Project for two months . As you are aware , in order to complete this project , immediate shipment of the above items is necessary . This letter is to advise you that Mr. Hamlin is hereby making formal demand for the above items at the stated contract price. Said items must be .shipned within fifteen ( 15) days from the date of this letter, in order to prevent a bench of contract on your part. Kindly guide yourself accordingly. Very truly yours , Ann L. Smoyer Attorney at Law ALS/kfj Enclosures cc: ''.r. Jerry Hatr,3 in to 1 ti ' x i -+t•.va Jet a H-:4* ....�..f a P, i `�, �♦., . 1 �c.rt vV•'$�4 JyAw� s;..�, r y, ..r? _ Cr=(r, ,► f .• . � 4 t�y • M'+ t t [1 1 !k ,•T'�C" ‘ .. t n "'"' JEFFERSON CLJNTY Boulder, MT 5 \ ! �� ` \ G All claims must be submitted on or before the 25th day of each month or will not be allowed in that month's business. Separate claims must be submitted for each fund. ! r) ~ — CLAIMANT: Hamlin ConstructiDn & Deus Co" Inc. — ADDRESS: DO NOT POST THIS SPACE 1429 Aspen #3 ACCOUNTING USE ONLY CITY: Helena, Montana 59601 DATE DESCRIPTION AMOUNT F:_t',C ! 4-:-.C.'"):. :' NO — - AAnp NT~ 7/20/78 See attached invoice .22 .:• — I • --- -- 5 1 c70 .. 9.2 MI 1 J TOTAL ;edify that this claim is correct and just in all respects and that payment or credit has not Fi en received. - — -- AIMANT SIGNATURE 24-... 'W.. DATE 7/29/1)8 --- ----- 4 - OFFICIAL USE ONLY FILED 3/ , 197( ALLOWED ❑ f ± , cip,._..,e_ ED KylcdAL/4,t, AMOUNT $ego?. to89. 3/ - 4 COUNTY CLERK I4 , 4 DEPUTY APPROVED 19/ o DISALLOWED ❑ — H W C....J., -___,..""- . Y AMOUNT $ Z22 �� CHAIRMAN 3 I —These claim blank are furnished by the county clerk. 6` �,ZCGcJJ 7 _'l_____1 �ICATION FOR R� (MENT ilk 5 y t r �. Date 2-17-78 For the period June 21, 1978 Eo July 20, 1978 inclusive. PROJECT Office Building for Jefferson County, Boulder, Flt. OWNER Board of County Commissioners Invoice #78-73 Address Jefferson County Courthouse, Boulder, Montana 59632 CONTRACTOR Hamlin Construction and Development Co., Inc. Address Box 64 S. R. Clancy, Mt. 59634 JOHNSON - GRAHAM Cr ASSOCIATES Architects and Engineers ITEM TOTAL THIS % COMPLETED NO. DESCRIPTION COST APPLICATION COMPLETE TO DATE 1) Move one layout & job setup $ 2,046.00 100 2,0466 00 2) Bonds, insurance & permits 2,966.00 100 2,966.00 3) Excavation, backfill & final grade 4,935.00 740.00 95 4,688.00 4) Concrete walls, slabs, sidewalks 15,352.00 922.00 90 13,817.00 5) Structural steel # reinforcing 1,981.00 100 1,981.00 6) Framing floors, walls, & roof & interior partitions 18,486.00 924000 100 18,486.00. 7) Sheeting walls & roof, soffits & facia 6,095.00 305.00 100 6,095.00 8) Manzard & shingles 11,202.00 5,937.00 98 10,978.00 9) Insulation, gyp. board 11,525.00 5,186.00 45 5,186,00 10) Taping & Painting 7,676.00 1,535.00 20 1,535.00 11) Gloss—glazing & aluminum doors & frames 9,733.00 12) , Masonry 11,690.00 13) Doors, frames, finish hard— I ware, toilet partitions 4,013.00 1,605.00 40 1,605.00 + 14) Ocoustical ceilings 2,043.00 15) Mechahical 25,220.00 5,548.00 62 15,636,00 16) Electrical 10,2x1.00 40 4,112.00 17) Carpet & Vinyl 4,479.00 S�8►es 18) Finish carpentry, millwork & specialty items 5,870.00 19) Job cleanup, supervision & equipment rental 1,766.00 44200 75 1,325.00 • TOTALS 26� 157,359.OD �� 57% 90,456.00 CONTRACT RECAPITULATION ORIGINAL CONTRACT SUM . . . $ 157,35_9.00 CHANGE ORDERS TOTAL ADDITIONS $ SUB TOTAL TOTAL DEDUCTIONS $• TOTAL CONTRACT TO DATE . . . __ APPLICATION IS MADE FOR PAYMENT, AS HEREINAFTER SHOWN, IN CONNECTION WITH THE SUBJECT CONTRACT : TOTAL COMPLETED TO DATE _S90,456,00 STORED MATERIALS PER ATTACHED LIST --5,023.00_ TOTAL COMPLETED &- STORED 95!479.00 LESS 10 % RETAINAGE 9 547.90 TOTAL EARNED LESS RETAINAGE 85,93100 LESS PREVIOUS PAYMENTS 63012.60 SUBTOTAL 221918,50 CURRENT PAYMENT DUE LESS 1% TAX L ,229:19 4 This is to certify that the work as listed above has been completed in accordance with the contract docu- ments, that all items are paid for which previous certificates for payment were issued and payments received, and that the current payment is now due. Hamlin Construction and CONTRACTOR Development Co., Inc. t By 1 ARCHITECT'S CERTIFICATION We certify that this Application for Payment, to the best of our knowledge • and belief, is a true and correct statement of work, performed and materials supplied by the contractor, and the contractor's statement of account and amount due him is correct and just, and all work and material included in this Application for Payment has been performed and is in full. accordance with terms and conditions of corresponding construction contract documents and authorized changes thereto. JOHNSfu N - GRAN . - ASSOCIATES • By _.-4 Date , • 0 STRUCTtv Jerry Hamlin President • Y Box 64 SR Clancy, MT. 59634 933-5639 tea. `EOPMENT c0•' 1t, MATERIALS STORED BOULDER OFFICE PROJECT July 20, 1978 Total materials delivered $12,279.00 f Less materials installed 7256.00 Total materials stored 5,023.00 Materials consist mainly of dimensional lumber, brick, gyp bd., and insulation. • t K •. • 1 V iU.A-IOC JOHNSON AA ORVAL H GRAHAM AIA PE VVILUAM J.OTTEM,JR.AIA CHARLES W SUMNER AA EUGENE VOGL JOHNSON-GRAHAM ASSOCIATES ARCHITECTS/ENGINEERS/PLANNERS 644 GRAND AVENUE, BILLINGS. MT 59101 (4063 245-6363 28 July 1978 Board of County Commissioners Jefferson County Courthouse Boulder, MT 59632 Re: Jefferson Co. Office Bldg, Gentlemen: Enclosed herewith is Application for Payment #5 in the total amount of $22 , 918. 50 . The 1% Tax due the State Dept. of Revenue is $229 . 19 and the amount remaining due the Contractor is $22 , 689 . 31. Mr. Vogl has checked and certified this application for payment. Very truly yours, JOHNSON-GRAHAM ASSOCIATES Sue F. Blom sb enc. 1 Hi i IIIIII1 IIIIIIIIVdIIIIIIII b At i 69-4435 PUBLIC HEALTH AND SAFETY • (f) the county and judicial district where the action is filed; (g) the date of judgment and the party � History: En- Sec. 74, Oh. 197, L. 1967. P which was granted it. 69-4436, Duty to furnish information. Section 69-4501. Dete t of the fact shall furnish information he possesses about anbirth,knowledge" 69 4502. Gene 69-4503- Fede -i fetal death,marriage or divorce upon demand of the state registrar, 6s-4594. Com History: En. Sec. 75, Ch. 197, L. 1967. �}`;.x'._ 69-4505. City m 69-4435, False statements or information contained in or mntilab _ 69 4507. Dist �` 69 4507. Dint ! of reports, records, or certificates relating to vital statistics__penalty. 69.4510- Loc person shall be fined not more than one thousand dollars 69-4519. Fon {9l prisoned not more than one (1) ($1,000), • ' 77-4510. Loc. ( ) year, or both,if: s9-4511. Loe. (1) he willfuIIy and knowingly makes any false statement in a repo,s� :? 69-4512, vie' record, or certificate required to be filed by law, or in an application for ..;:, _ ss 4513. He. II' amendment thereof, or willfully and knowingly supplies false informed. 69-4514. Cas . intending that such information be used in gthe preparation of any suds 69.4515. Sm: 1 ,. report,record, or certificate, or amendment; 69-4516. Die Ob o ill (2) without lawful authority and with the intent to deceive, he mak •'.J 69-4517. Be e !` alters, amends, or mutilates any report, record, or certificate required t0%�r ':. 69-4519- De „i., be filed under law or a certified copy of the report, record, or certificat4„:; 69-4519. Pe. 1I (3) he willfully and knowingly uses or attempts to use, or f. ■ to another for use, for any purpose of deception, any certificate, reco 4 69.460 De report, or certified copy made, altered,amended, or mutilated• P clearly indicates o (4) with the intention to deceive, he willfully uses or attempts r (1) "Local b 11.4 use any birth certificate or certified copy of a birth record knowing board of health• such certificate or certified copy was issued upon a record which is (2) "Local h in whole or in part or which relates to the birth of another person, trict health officer (5) he willfully and knowingly furnishes a birth certificate or c (3) in this i. /` copy of a birth record with the intention that it be used by a person of `3 -y medicine in this s 1, than the person to whom the birth record relates- ,-x�(r` story: En. sea f History: En. Sec. 76, Oh. 197, L. 1967. 39 C.S.S. Health §§29-35 a ' Collateral References 39 Am. Jur- 2d 374, Health?;}7 :'`-N"%" 68-4502. Gen: I IIealthQ37-43. , approval of the general supervise, I. 69-4437. Handling and disposing of dead body without 01y° En, Se to give information—neglect or refusal to perform duties imposed Collateral Refer . statistics law penalty. A person shall be fined not less than,t -�f Eealtha=2.g• dollars ($25) nor more than one hundred dollars ($100), imp , - not more than thirty (30) days, or both,if: , 69-460$, Fed (1) he knowingly transports or accepts for transportation, state board, the or other disposition a dead body without an accompanying `� . ;,', accept funds for provided by law; p8°�a aR* or from any oche (2) he refuses to provide information required by law; 3�� �BLp`Y° En•er (3) he willfully neglects or violates any of the provisi", refuses to perform any of the duties imposed upon him by law.': 89-4504 Co History: En. Sec. 77, Ch. 197, L. 1967. 39 CAR. Health beard Of health i h= Collateral References 39 Am. Jur. 2d 37�,�: ''� }-c• (l) the eo Healuh4 87.43. the County cam (2) five (5) 810 -, t 1. Federal Agency and Organizational Element REPORT OF FEDERAL CASH TRANSACTIONS U.S. Dept Commerce (EDA) 2. Name of Grantee Organization I. Report Period (Month, Day, Year) FROM TO Jefferson County 11 I 1 177 I 7 I 1 178 4. Federal Grant Number or other S. Grantee's Account No. or Identifying No. Identifying No. 6, Federal Share of Net Disbursements a. For the Period b. Cumulative 05-51-26274 - 13-20-9701 11-1-78 /7-1-78 - di. Warrant #1 12-8-77 The Boulder Monitor) 42.00 42.00 .B. Warrant # 2 113/78 The Boulder Monitor) 36.00 78.00 .B. Warrant #3 1/3/78 Johnson, Graham, etc) 10,640.00 10,718.00 ' .B. Warrant # 4 Wapiti Co) 3/1/78 90.00 10,808.00 .B. Warrant # 5 3/1/78 St. Dept Revenue) 46.98 10,854.98 .B. Warrant # 6 3/1/78 Hamlin Construction) 4,651.02 15,506.00 .B. Warrant # 7 4/3/78 Johnson , Graham, etc) 1,408.90 16,914.90 .B. Warrant # 8 5/1/78 Rocky Mtn. Dev. ) 994.65 17,909.55 '.8. Warrant # 9 5/1/78 St. Dept. Revenue) 196.95 18,106.50 .B. Warrant # 10 5/1/78 Hamlin Construction) 19,498.65 37,605. 15 .B. Warrant # 11 5/1/78 Johnson, Graham, etc) 1,088.22 38,693.37 .B. Warrant # 12 6/1/78 St. Bd. Revenue) 178.53 38,871.90 .B. Warrant # 13 6/1/78 Hamlin Construction) 17,674.77 56,546.67 .B. Warrant # 14 6/1/78 Johnson, Graham, etc) 328.88 56,875.55 .B. Warrant # 15 7/1/78 St. Bd. of Revenue) 207.68 57,083.23 ' .B. Warrant # 16 7/1/78 Hamlin Construction) 20,558.04 77,641.27 7. TOTALS 77,641.27 77,641.27 FORM CD-286 (REV. 9-76) USCOMM-DC 16 P•76 FORM CD-�g6 U.S. DEPARTMENT OF COMMERCE OMB Approval No. 80-80182 'EPRESC. BY ECONOMIC DEVELOPMENT ADM'N!STR AT!ON L Federal Agency and Organizational Element OMB CSR. A-102 REPORT OF FEDERAL CASH TRANSACTIONS U.S. Dept. of Commerce (E.D.A. ) 2. Name of Grantee Organization 4. Federal Grant No. or other 5. Grantee's Account No. or Jefferson County Proatitycg05 51-26274 Idgrltifyirag 13°701 STREET NO. AND NAME 6. Letter or Credit No. 7, La1stt Payment Voucher No. P.O. Box 115 13-20-5288 (3) 2414884 CITY STATE ZIP CODE 8. Number of Payment Vouchers 9. No. of Treasury Checks Received Boulder Montana 59632 3 3 3. Federal Employer Identification No. 10. Report Period (Month, Day, Year) 81-6001377W FIj M 11 _1 77 TO 7 I 1 I 78 11.STATUS OF FEDERAL CASH a. Cash on hand beginning of period County. Portion $ 40,000.00 b. Letter of credit withdrawals $ 71 .000.00 c. Treasury check payments $ 71,000.00 d. Total receipts (Sum of Lines b and c) $ 142,000.00 e. Total cash available (Sum of Lines a and d) $ 182,000.00 1. Gross disbursements $ 77,641.27 g. Federal share of program income $ 142,000.00 h. Net disbursements (Line f minus Line g) • $ I. Adjustments of prior periods $ N. 1. Cash on hand end of period $ 1n4,ncR 73 12. The amount In Item 11j represents cash requirements for the ensuing days. 13. OTHER INFORMATION a. Interest income $ none b. Advances to subgrantees $ none 14. REMARKS (Attach additional sheets if necessary) - Original project was for $142,000.00 Federal Grant and $40,000.00 County monies Co received 71,000.00 Federal Treasury check and paid 77,641.27 to accounts on building. Of this amount, 71,000.00 was Federal monies and 6,641.27 was County monies 15. CERTIFICATION — I certify that to the best of my knowledge and belief this report is true in all respects and that all disbursements have been made for the purposes and conditions of the grant. Name Title TELEPHONE Joanne P. McFarlane County Clerk and Recorder Area Code Number 406 1225-3332 Extension Signature of Authorized Official Date Report is Submitted 8/22/78 FOR AGENCY USE ONLY DSCOMM•OC 18716 P-76 , • _ I I .; NAME ACCOUNT NUMBER CITY/COUNTY OF FUND—_ /P4 191d I/ iv I r 61,4_17-44.41-4,--,-- DEPARTMENT �1 - FUNCTION. .�'-GZs v esLe-U`.r4-tl-in I I :iV APPROPRIATION-EXPENDITURE LEDGER ACTIVITY Q ' % 1--- ALA y`' I' l 1P' SUB-ACTIVITY .- -n .- -40 _, 14'L-'JJ APPROPRIATION S /4 0 O e , r i T J OBJECT ,_.' r _. ay. l l9I a t C / LEDGER CARD NO / OF _ ., " ". N, >r .. g .; - .;,, ...",* onarthYURE9"'S, ,. ,;N,,,. uRCfiks En , C; . � , . x,"x�+-°.: ��° .. u.ir, ''n-_____:_.;,Fer , i ,, ri' ' ,„ly r , a ,'ti.r v,r 'S: 14)F111:-• f z ' ' � %FENDED � � NEXPENDEQ i' ORDER � W.+i', tiro,' `4 � UNENCUMIEREq� ' n _ 21111FROMEM -%: 1 ‘, --- . te' i• A•I s'' 1 ' arriffilaill _ _ . M11111.111101 1. 111 11111111.11111 ,___ 1 1 I IrlIMMII ,-, . 1 . 1 en .' .._ I.: Irlinillertlial I ' 11111.1110= ! Minn_ i ��� Wii I t I. �� ' ' ��, _: rte. . r ..A.4"'� i 1 i . 11111111111,11 /z Mi / Via, !, _ ' . sit ��l H, 1111S111 •mom % ass' ____ Min 1 Milingillinl - . -, . - • N la , MI i NI • . �_- I t, 31 1 r. ••Y f .i;e'aL �.. 4.A'eTi a 7dih1:- L— _H — _-. CONTRACT FOR SERVICES THIS CONTRACT, made and entered into this 1st day of October, 1977, by and between Jefferson County, Montana, hereinafter referred to as the "CONTRACTOR" and the Rocky Mountain Development Council, Helena, Montana, hereinafter referred to as the "PROVIDER", for assistance in the carrying out of Jefferson County' s responsibilities as a grantee of a Local Public • Works Project funded by the Economic Development Administration, U. S. Department of Commerce. 1. Service To Be Performed The PROVIDER agrees to assist the CONTRACTOR in carrying out its responsibilities as an E.D.A. Local Public Works grantee by assigning an employee to work .-n hours per month as a pro- ject coordinator, beginning October 1, 1977 and ending September 30, 1978. 2. Amount of Payment Ve CONTRACTOR agrees to reimburse the PROVIDER at a rate of $ 7 s dollars per hour and to cover transportation expenses for two round trips per month between Helena and Boulder , Montana, at a rate of $. 15 cents per mile. 3. Method of Payment Upon documentation that the PROVIDER has performed the above mentioned service, the CONTRACTOR will make two (2) payments to the PROVIDER. The first payment will be made upon completion of the first six (6) months of this Contract, April 1, 1978 and the second at the completion of the Contract, September 30, 1978. 4. Contract Period This Contract is effective as of the date first written above and will terminate on September 30, 1978. CONT R: PROVIDER: By: .... ✓ By: ek t-/ Title: Title: Gota°'/ Witness ��.j`li ir Witness: G % /%'L ,)//11" COUNTY CLERK'S SHEET NO. - FISCAL YEAR J97,- 79 STATE EXAM iNER'S FORM C B. NO s ------------"`■,, f - 1- • CLAIM 33/4"ela I MONTH all NO. BUDGET ALLOWANCE_ mg, ,, Do .... lt 1 iol as 03/ 1 i ciA41.. 1,1 sio 1 d-la /7 ) Y 94' . Pigoa /0z87- /1 ./ / i i , ) 49q,goo (4 1 , /05,799 39 . . - ft/5Y/ /47 za 41 1 .:„.5,1-25 , -;,- _ ivitY A0,53'4 ,67 ;40 Azt. 40,qt 3 la i ?licit 39 , -0, - ..., /5/I .61- z554- 6f /a-et-44 ... /5/76 / 7g, SVI 2--5 . /- )5/90 /0 745 .06 ."-e-V Aerl---, 4,0,is-4 AO 6,7,,84r 80 , . .. _. _ Air& /Ali° - 91/ 90 ---e--12-7 W1., ; ' ,- l 7 /5vys 3 / 43 61- - i 5 qv _5 3Z If/.87 Apletr4t."-- 991.299 10 I Alto i 0 I . r . • - ..... - - • /012C./ /5706 n - 9 cb...L. Agi-E., acfi I , I 5 70-0 7, 6.2 ge.„....41 & , --76; . .. 7,2 , ......" , , '9347 9-7 . 03 , , . „ ' 4 .i-,,------ I ;I. 1 1 [ 1 i - I I ...*, a I I . . 4. c 1 . ..__ .),* •1211 0 t'- '- , .„.... . 41 ,,.. ..._ --- -- , 1 . 4t- . . ,.. .,-.. 1 . i . . . . , 1 I 1 1 1 JEFFERSON COUNTY OFFICE BUILDING OF BOULDER, MONTANA 1 ECONOMIC DEVELOPMENT ADMINISTRATION LOCAL PUBLIC WORKS PROJECT NO. 05-51-26274 ' Financial Statements and Schedules For the Period July 1, 1977 to January 9, 1979 1 • 1 1 I ' ROBERT JIMENEZ & ASSOCIATES. P.C. CERTIFIED PUBLIC ACCOUNTANTS STAR PROFESSIONAL BLDG. 11505 BILLINGS,MONTANA'59102 Associate Firm: Rodriguez &Associates,P.C., Denver,Colorado AVENUE D,SUITE 201 TELEPHONE (406) 248-3106 1 ROBERT J. JIMENEZ & ASSOCIATES --- — Professional Corporation ------_ _ 201 STAR PROFESSIONAL BLDG. 1505 AVENUE D BILLINGS,MONTANA 59102 TELEPHONE (406)248-3106 February 14 1e 79 Clerk and Recorder Jefferson County Boulder, Montana 59632 Professional services rendered: Audit Jefferson County Office Building of Boulder, MT Economic Development Administration Local Public Works Project No. 05-51-26274 . . . . $ 1,109.00 ROBERT J. JIMENEZ & ASSOCIATES Professional Corporation 201 STAR PROFESSIONAL BLDG. 1505 AVENUE D BILLINGS,MONTANA 59102 TELEPHONE (406)248-3106 January 25, 1979 Mr. Vincent M. Capp County Office Bldg. Project P.O. Box 115 Boulder, Montana 59632 Dear Mr. Capp: We have pleasure in sending you herewith three copies of our report on examination of the statement of costs claimed of the Jefferson County Office Building of Boulder, Montana, Economic Development Administration, Local Public Works grant No. 05-51-26274 from July 1, 1977 to January 9, 1979. As the primary purpose of the examination was to enable us to form an opinion as to the financial position of the Project and the re- sults of its operations and as a detailed check of the day-to-day transactions was not made, you will appreciate that you must rely on adequate methods of internal check and control as your princi- ple safeguard against irregularities which our test examination may not have disclosed. We shall appreciate your acknowledging receipt of the enclosures by signing the duplicate of this letter and returning it to us. Very truly yours, ROBERT J. JIMENEZ & ASSOCIATES, P.C. *74--- i Robert J. Jimenez President CC: (3) Tim McCauley (4) U.S. Department of Commerce (4) Southwest Regional Office 1 1 Boulder, Montana Project Number 05-51-26274 II January 9, 1979 1 This report is to present the results of our final audit of the Jefferson County Office Building of Boulder, Montana, as 1 required by the U.S. Department of Commerce, Economic Development Administration (EDA) , Office of Public Works for LPW Grant No. 05- 51- 26274. This grant requires the grantee to assist in water 1 distribution and hook up. The grant provides for reimbursement of costs incurred in an estimated amount not to exceed $ 142,000.00. The objectives of our examination were to (i) review, test II and report upon the costs incurred under the grant, and (ii) review, test and report on compliance with grant terms, conditions and EDA requirements. Accordingly, we have performed an examination of the I costs incurred by the grantee and reviewed its method of complying with the LPW grant requirements for the period from July 1, 1977 through January 9, 1979. Our work did not constitute an audit of 1 financial statements prepared by the organization, other than the Statement of 'Project Costs Claimed from July 1, 1977 through January 9, 1979. (Exhibit B) 1 Details concerning the scope of audits, the results of audit and the discussion of audit results with grantee officials for each of the areas described below, are presented in the referenced attach- ' ments. Financial Activities - Attachment 1 IAccountant's Report Exhibit A - Statement of Project Costs Claimed from July 1, I 1977 through January 9, 1979 and Comparison of Accepted Project Costs with Estimated Project Costs I Exhibit B - Statement of Status of Grant Fund Payments as of January 9, 1979 Compliance with Grant Terms and Conditions and Other EDA LPW IIRequirements - Attachment 2 Results of Discussion of Audit Findings and Conclusions with IGrantee Officials - Attachment 3 This report is intended for use in connection with the grant to IIwhich it refers and should not be used for any other purpose. II 1 I .1 1 In accordance with the "Audit Instructions for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977", we have sent four (4) copies of this report and attachments to the Department of Commerce, Robert Godfrey, Audit Manager. 1 Very truly yours, ROBERT J. JIMENEZ & ASSOCIATES, P.C. 1r. • 1 Robert J. Jimenez President 1 1 1 1 1 1 1 1 1 1 1 11 - 2 - ATTACHMENT 1 Boulder, Montana Project Number 05-51-26274 FINANCIAL ACTIVITIES We have examined Boulder, Montana's Statements of Project Costs ' Claimed and Status of Grant Fund Payments as of and for the period ended January 9, 1979, and tested financial transactions, accounts, reports and related supporting documentation. Our examination was ' made in accordance with generally accepted auditing standards and the standards for audit of financial transactions, accounts, and reports, as set forth in the auditing standards for governmental activities published by the Comptroller General of the United States, ' and accordingly included such tests of the accounting records and such other auditing procedures as we considered necessary in the circumstances, including those set forth in the Department of Com- merce's Audit Instructions for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977. 1 In our opinion, the accompanying statements of grant costs presents fairly the budgeted costs, costs claimed, cost questioned and the sta- tus of grant funds for Grant No. 05-51-26274 as of January 9, 1979 in conformity with generally accepted accounting principles, the Depart- ' ment of Commerce's audit instructions referred to above and the speci- fic financial terms of the grant agreement. 1 1 1 1 i 1 1 - 3 - I • MN IMII • MO MI NM MI MN V MI IIIIIIII I MI INIII MI MI MI Boulder, Montana Project No. 05-51-26274 STATEMENT OF PROJECT COSTS CLAIMED FROM JULY 1, 1977 THROUGH JANUARY 9, 1979, AND COMPARISON OF ACCEPTED PROJECT COSTS WITH ESTIMATED PROJECT COSTS Costs Audit Recommendations Cost Claimed Per Questioned Accepted Estimates Overrun RefercrIcc Cost Classification ED-113A Costs _ Costs Per Grant (Underrun) ':ctcs (Note A) (Note B) (Note C) 1. Administrative Expenses $ 1,277 $ - 0 - $ 1,277 $ 1,000 $ 277 2. Basic A/E Fees Updating and/or Completion of Plans and Specifications 16,708 - 0 - 16,708 7,600 9,108 3. Other A/E Fees - 0 - - 0 - - 0 - - 0 - - 0 - I 4. Project Inspection Fees Including Audit 1,977 - 0 - 1,977 3,900 (1,923) 5. Construction & Project Improvements 159,691 - 0 - 159,691 119,500 40,191 6. Contingencies - 0 - - 0 - - 0 - 10,000 (10,000) Totals for Project $ 179,653 $ - 0 - $ 179,653 $ 142,000 $ 37,653 ?4 EXHIBIT B Boulder, Montana Project No. 05-51-26274 STATEMENT OF STATUS OF GRANT FUND PAYMENTS AS OF JANUARY 9, 1979 1 Total authorized costs per grant budget $ 142,000 ' Project costs (per ED-113A) 179,653 Less: Questioned costs - 0 - 1 Total acceptable project costs $ 179,653 Amount of LPW grant payable - 100% of above acceptable costs ($179,653) or $179,653 whichever is smaller $ 179,653 Less payments made: ' A..:thorized by Grant No. 05-51-26274 $ 142,000 Total letter of credit authorized - Federal ' (.:ote B) 142,000 Total letter of credit authorized - County (?;ote C) 37,653 ' Less: Payment vouchers process by the First Boulder Valley Bank, Boulder, Montana 179,653 $ 179,653 Available balance - Letter of credit $ - 0 - Project balance at January 9, 1979 due to EDA $ - 0 - t I 1 - 5 - r ' Boulder, Montana Project No. 05-51-26274 NOTES TO FINANCIAL STATEMENTS A. Financial Statement Presentation and Summary of Significant Accounting Policies: 1. The financial statements presented are prepared from only the accounts and financial transactions of the Local Public Works Project No. 05-51-26274 of Boulder, Montana. Accordingly, they fairly present the finan- cial position or the results of operations of Boulder, . Montana. 11 2. The financial transactions of the project are recorded in accordance with the terms and conditions of the grant, which are not inconsistent with generally ac- cepted accounting principles. B. The total approved budget consists of: Budget as approved on Form Ed-101LPW-5 for Grant No. 05-51-26274 $ 142,000 Total LPW funds available for Grant Project Number 05-51-26274 $ 142,000 C. The approved budget was over-spent, but the county of Jefferson, Boulder, Montana reimbursed the project the difference owed. $ 37,653 D. Inasmuch as the purpose of the contingency item of the approved budget (ED-508LPW) is to cover possible overruns on the other ' cost classifications, costs for this item was claimed on the ED-113A as Basic Architectural and Engineering Fees. 1 1 I 6 ATTACHMENT 2 In connection with our examination of the financial statements as reported in Attachment 1, we have reviewed the terms and conditions ' of the grant and EDA/LPW instructions and have performed tests of Boulder, Montana's operations and records applicable to the compliance requirements set forth in Parts II A and B of the audit program in the Department of Commerce Audit Instructions for Local Public Works Under ' Title I of the Public Works Employment Acts of 1976 and 1977. In our opinion, for the items tested, the Grantee complied in all 11 material respects with the applicable compliance matters contained in mart II A of the audit program referred to above. Further, based upon procedures performed in accordance with Part II B, nothing came to our ' attention to indicate that the Grantee had not complied in all material respects with all applicable items listed in Part II B of the audit program referred to above. 4 . • • 1 i 1 7 ATTACHMENT 3 1 Evert Stevens, representing Robert J. Jimenez & Associates, P.C., on January 10, 1979, discussed the audit findings and conclusions with the Grantee's representative, Mr. Tim McCauley, Project Director. The Grantee's representative listened attentively to the items discussed and stated that they were looking forward to the audit . report. This report is intended for use in connection with the administra- tion of the EDA/LPW grant to which it refers and should not be used , ' for any other purposes. • 1 1 1 1 1 1 • i 1 1 1 1 1 - 8 - • FINAL PUNCH LIST JEFFERSON COUNTY OFFICE BUILDING 26 OCTOBER 1978 LIBRARY RM 101 1 . Two ceiling light fixtures missing - need to be installed. 2. Install cover plate on telephone outlet. 3. Need double weatherstripping on windows. 4. 114 shelves on the job. Need 120 shelves to have 5 for each opening - also shelves should be installed to verify them fitting. `). Seal tops and bottoms of all doors. 6. Restain and finish edge of door 101 . 7. Reset bottom edge of jamb at door 104 with proper clearance. 8. Touch up painting on east wall . 9. Clean all shelving. 10. Set all hinge pins. 11 . Fill nail holes in door jambs (mainly door stop) . OFFICE #102 f. 1 . Touch up painting needed on north wall and west wall , and above door on south wall . 2. Remove bridging exposed inside of joist space at return air grille. 3. Need cover plate for telephone outlet. 4. Fill nail holes in door jambs and stop. 5. Seal top and bottoms of all doors. 6. Need double weather stripping windows. ROOM #103 (Office) 1 . Need double weather stripping on windows. 2. Need cover plate for telephone outlet. 3. Clean dust, dirt and debris out of all floor supply and return registers. 4. Touch up painting on east wall and north wall and south wall . 5. Need new window stop at fixed sash of west window. RECEPTION AREA #104 1 . Supply grille at window is too small for pipe opening. 2. Reset window screen to miss window hardware. 3. Need double weather stripping on window. 4. Need outlet cover for telephone. 5. Touch up paint on all walls. 6. Need window stop on relite window by door. 7. Install door lock to door #106. FINAL PZlnlr" 17rT JEFFERSON ,TY OFFICE BUILDING 26 OCTOBER 1 7II - page 2 8. Install center door hinge. 9. Need to repair bottom of hollow metal frame at relite. 10. Door #106 is cut too small for opening. Replace with new door. 11 . Seal top and bottom of all doors. 12. Reset rubber base outside corner tight to wall and clean base at both outside corners. 13. Need rubber bumpers on hollow metal door frame. STAIRS #105 1 . Repaint walls as needed. 2. Repair wall and ceiling joint above stairs. 3. Repair metal wall angle at lower ceiling where it hangs down. 4. Retape and paint wall around lower stairway door. 5. Intall missing hinge. 6. Need rubber bumpers on hollow metal door frame. 7. Door cut too small for opening at lower stair door. HENS TOILET #106 I 1 . Reset privacy screen between sink and urinal for more space at .sink. 2. Repaint blue wall at ceiling. 3. Clean glue off of wall behind door. • 4. Install rubber bumpers in hollow metal door frame. 5. ;peal top and bottom of door. 6. Repaint east wall where it is rough from foreign objects in paint. 7. Clean protective strip off of chrome on mirror. WOMENS TOILET #107 1 . Repaint blue wall . 2. Need outside corner on base. 3. Clean glue off of wall behind door and behind stool - also reglue where loose at top edge. 4. Remove protective strip off of chrome on mirror. 5. Door cut too small for frame opening at top. 6. Closer doesn't always close door tightly. LOBBY #108 1 . Need outside rubber base corners. 2. Repaint outside corner where chipped and touch up wall (north) and south wall above door closure. 3. Need trim strip at top of exterior door and relite on outside. FINAL PUNCH LIST JEFFERSON COUNTY OFFICE BUILDING 26 OCTOBER 1978 - page 3 • 4. Clean and reset rubber stop on relite where crooked. 5. Front door need to be reset with proper clearance. 6. Need door sweep on outside door. REAR STAIRS #109 1 . Repaint walls as needed. Note popped nail by ceiling. 2. Repair and repaint edge of gyp bd at correction to lower ceiling. 3. Install missing hinge at lower stair door. 4. Repair and repaint around lower stair door. HALL #110 1 . Repaint walls as needed. Note popped nails at ceiling. 2. Need trim strip at top of exterior door and clean tape off of door and need bottom door sweep. 3 / ,Q A 1 o ,. ¢ door CONFERENCE #111 1 . Need cold air return grille. 2. Need cover for telephone outlet. 3. Repair bottom of door where hinge bound. 4. Repair center of wall on east wall . WAITING #112 & RECEPTION #114 1 . Need to install rubber bumpers on hollow metal frame. 2. Need new return grille. 3. Need outlet cover for telephone. 4. Double weather stripping on windows. 5. Touch up painting on all walls as needed. 6. Door #116 fits too close to jamb. 7. Bad outlet on east walls. 8. Seal top and bottoms of all doors . OFFICE #113 & #115 1 . Repair cracked corner in gyp board at east window. 2. Install covers on telephone outlets. 3. Double weather stripping on windows. 4. Touch up paint as needed. 5. Repair wall at outlet on west wall . 6. Check bottom of base where it is loose and reset. FINAL . LIST JEFFERSON COUNTY OFFICE BUILDING 26 OCTOBER 1978 page 4 OFFICE #116 1 . Paint inside of cold air return block. 2. Bad outlet on west wall and north wall . 3. Need cover plate on telephone outlet. 4. Need hardware for extra door-including changing hinges to match reset of doors. 5. Reset bottom window stop on fixed glass. 6. Touch up paint as needed. 7. Replace door casing on extra door where spliced. OFFICE #117 1 . Repair taping at sill on east window. 2. Need outlet cover for telephone. FURNACE ROOM 1 . Need clip to hold plug in from sewage ejector in securely. 2. Fix rattle in furnace #2. 3. Need to tie in water flow valve in sprinkler system to exterior bell to work properly 4. Need fire marshall approval on sprinkler system. 5. Check furnaces for proper zoning with thermostats. BASEMENT AREA 1 . Need to secure return air joist space bottom panel properly and seal joints. 2. Paint hollow metal doors to vaults. 3. Need rubber bumpers on hollow metal frames. 4. Need hardware to vault doors. 5. Need to have a drain on the firehose connection side of check valve to drain line if ever activated. OUTSIDE 1 . Need wood trim at brick and soffit. 2. Straighten up fresh air grilles to lay flat against soffit. 3. Need cap on fire hose connection. 4. The topsoil is too high on the foundation. This should be about 3' -4" below brick line. 5. Remove all large stones from top soil ; specs say anything larger than 1" . 6. Paint soffit vents to match soffit. 7. Replace gravel at service entrance to new sidewalk. • r; t " k.k' A a _._._. !1E;%—&115 S . .7u .!-t 6�iiK a'?!a( -._ .8.o4 _ Q,"3) 9. R ,_,, iasSQ �Q s - }�✓i-C4—CA7\ (-19-78. 3 0 . . 8.cs _Of//.5•4?) .9-n. . _' .Y3sA: Crsa0t i- i8-7$ 7n S 1f-1�- 3�yd D.4s�.�.93�3� -,r_pt.9a.(.l461S. G / 9 8, oc 058,14) tei '`a.2.4 etigp.0.e4 v �. �.- Of w .- 2- 769_ - -_hi,cAvt_inew - 0 1[ `I;- /O,aS 4/ /0,P0 , !W S - .7 6- e,-S' -Caofas, 9S0 = `3ishds7(2al 7 P -. as- ers = `ao,.ac) 44.11.-14;Ci3 1ts -4 -....1,14..4.1- c1ir-ej. - a S•sA t. sa 1a f 31,.a s /a St G9 r P_ _ — . ` - 36.as -A. Y3saf 34"aa = ' /ts_,a7 -- ' _ -_ a_7.3 i!.. _ _ r 4 „ 4 : , 4 . ,. .� } .. . D.M.B. No. 41R-2946 Expires December 31, 1979 • FORM,ED-746 6CONOMFc oevDEPARTMENT MirmS COMMERCE PLEASE READ ACCOMPANYING INSTRUCTIONS This report is •arh6.i,.a by low, P.L. 94-369, Seas.103, ter, BEFORE COMPLETING ANY PART OF THIS FORA 6„a 105; P.L. 94.447, T, 1. I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Name c Project Location:(City, or Town, County, State) (.. f� PLEASE WRITE NUMBERS LIKE THIS: c.. tit<,-rte . :_, . .. c � � 1, � 123 '+ 5678q0• GOVT. USE ONLY Federal Project No. Employer's IRS No. Pay Period Ended J Payroll Number Last Payroll Q •PRINT WITH BALL POINT PEN OR TYPE. Mo. Dy. Yr. I I I 1 I l 'islslll l� l:kHI? I / � �I l �'lpl l / I le I � 7f,g I I 47 Enter "L" if your Last PAGE / OF PAGES Payroll " ihis project - , 7 re 27 33. 36 Otherwise LEAVE BLANK - - . Gross amount = n Gross amount Weeks ag OCCUpa- Pay Actual earned on a Occupa• Pay Actual earned on e.� Social Security (jOn Period Worked this project ug kq 2_ Weeks y� a Social Security a prey. c x Number ¢ e-' Number lion period hours this project unem- LS?' °-c code Code Worked for period unem- �L y code Code worked for period '' 10 ed °E E pay period Z n ',toyed Ie i S zip z ii pay period mo B p y s7 2• –I 37 46 4e 51 54 60 .. 61 62 65 66 1- 33 46 49 sr 54 60 61 62 65 66 I ti,o 9 / o' o' o Y r . Y m 1 16 - - I �- 2 J 7 Y-H S'4.7 i<_t CC�' G.• i6 0.. 1S" r '3 /. C y , 17 3 5_ / L -S a-.i ? o b �`i & S E u' -5 3 -7'S O Y 18 - I 4 - _ 19 i 5 t - I 4 20 . e 6 21 7 I t �` 22 —# 8 23 - 10 — ' ; 25 ti + 26 - 12 , 1 `y 27 - • 14 29 ` r _ 15 j 30 a, Month Day Year •Employees listed above are employed by 1/ l�v // DATE PREPARED: 4 _ I ,� I 7 Q (Check one) Name F kZ ve�4cv3.. (4"Yt47.t-. -/)_a'^-` Cc; !1`— MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report [12-ro,r,Ktef - Economic Development Administration ppp Street Address / }, / L<,�._,.[:�,,�-� U.S. Department of Commerce "�'A f-dc-'c.MnC`/mil Subcontractor Identified at right -jilt r , Room Bb15,Main Commerce Bldg. Are Code Number City,State, ZIP Fiy�1-�,» . � &•f ( 14th St.and Constitution Avenue,N.N. i�Grantee S Telephone f, y < Washington, D.C. M230 TELEPHONE: (VC'Cr) q q j - / 3 etc phone No.of Contact Area Code `/L (L, ) Number Y 3—/,3 1U USCOMM•OC 6•6455-4•77 e 06.13. No. 41R-2946 Expires December 31, 1979 This report is authorised by law. P.L. 94-369, Sec.. 103, 104, `riRe:(0-746 6co,+oMic oE'v DEPARTMENT ts ocieFrrCOMA•COMMERCE PLEASE READ ACCOMPANYING INSTRUCTIONS and 105; P.L. 94-447, Tole I, Ch. 1. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FORM Project Name: , - Project Location: (City, or Town,County, State) C, c_,4 t- (i ,ivy„-6( i PLEASE WRITE NUMBERS LIKE THIS: i. r �m �� ��tit .:� 12 3 9 5 6 .7 8 61 0 X �� f -tea{ y I • J 1 GOVT. USE ONLY Federal Project No. Employer's IRS No. Pay Peeled Ended Payroll Number Last4'ayroll .PRINT WITH BALL POINT PEN OR TYPE, /y Mo. Dy. Yr. 1 I 1 1 1 ( H.5-1 H i 1 . 1 e 1.-4 11Y '71/ id 31‘,19131 / H lc t I 1? I Enter rrL.. i f this is your Last 7 roc 27 j 3 7 33. 5^ Pa roll le� thEi;l7 LAN PAGE / OF / PAGES I Otherwise LEAYE BLANK 36 Gross amount = c P. i Gross amount Social Security ()coupe- Pay Actual earned on to E weeks of w Occupa- Pay Actual earned on g Weeks a3� a vl 8 Number Lion Period hours this project �_ c_., prey. c Social umberrity lion project 1 unem- -- p J period hours this E code Coda Worked for this > unem- code code worked for this _ E3 z pay Period m y ployed gv pay period o5 +'o Ployed 5'u s • dT(.:.hY Aa_Q 1 l E LL 4< 3 W l - -4 37 46 49 51 54 60 ? 61 62 65 166 J 37 44 49 51 54 60 61 63 65 66 I - t �t'iR 38G1� �. 5cc- li0 �3� ?�S GO Y ,� 16 I _ t 2 .5 /i7 q ? 6 ) Ec,- 3 .y 3 5 3. c_ 3 Y 17 L r 3 I! , L V1 G Q' F_ t‘ .37 3 `l 6' 7 .c Y 18 - - 4 11111 y Q. 5r u. `! .S7 C. .510 H Y 019 - '4 { — 20 — 4 7 22 22 - 8 I jI 23 ' A 1 I , I 111 + _ , to 4 a z5 7------ - r, — �--, 13 y r tr 28 29 15 ( —e , 30 - ■ ` a • Month Day Year Employees listed above are employed by DATE PREPARED: 5-- I / Q 7 y (Check one) Name -),./..=... n ..".-L (ery...Q, 't -c i1.Cn - 0-E Cc ; 1-4.. MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report. 1111 ., Economic Development Administration I�_ 1--` °"t"`t"r Street Address /`/ .A / C�1'`.l'..F-Y\ .3 U.S. Dep rtment of Commerce u- f�v vti _ _ ri Subcontractor Identified at right City, State,ZIP _l!,° MAX' . s Y(o U( Room B-615,Main Commerce Bldg. Area Code Number r 14th 5t. and Constitution Avenue,N.W. TELEPHONE: C'CL' ) c/43 — . jL: I--.1 Grantee Telephone No. of Contact. Area Code ('>'E)C,) Numberq'L(,3— /34/(.1 Washington, D.C. 20130 USCOMM.CC 53617-P77 O.M.B. No. 41P-2946 Expires December 31, 1979 TORN ED-746 u.5. DEPARTMENT O. COMMERCE This ..van is authorised by lam, P.L. 9/.769, S.c..103, 10/, " 76 ECONOMIC DEVELOPMENT ADMINISTRATION PLEASE READ ACCOMPANYING INSTRUCTIONS BEFORE COMPLETING ANY PART OF THIS FORM and 105; P.L. 94-447, Title 1, Ch. 1. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Mn.:. ' Project Location:(City, or Town,County, State) PLEASE WRITE NUMBERS LIKE THIS: :« sti. .� � �,, � � m I 2345678q0 L l '.R;n l.,--, vet;_, 1474_,: :.c-,,, ci5-LL GOVT. USE(ONLY Federal Project No. Employer's IRS No. Pay Period Ended Payroll Number Lail Payroll .PRINT WITH BALL POINT PEN OR TYPE, Ma. Cry. T. MI l I l 11 1 I�I l l kkI %IY ul I I I ?HI l � � l I° l l E if is your Lost E 3 G Z 1 7 y Payroll for this project — PAGE / OF / PAGES 1 7 1e 27 33 36 Otherwis.LEAVE BLANK 9 Gross amount c °—a Gross amount = �e° Occupa- Pay Actual earned on a E Weeks Occupa- Pay Actual earned on n -' E Weeks 6a� Social Security non Perin hours this project u_.:: 'c,_ Pre v, vo $ Social Security non Mf'"I prev. Na - Period P I period hours this project IL Number code Code Worked for flux cczet:. unem- d o o Number rcZ unem- y- a n code code worked roreris z pay period 4, ... do ployed Fdn i% z pay period i8 i.e. played §.7. i u c dY ;`fit LAG ii a i- b Y 11-4C 3w -1 37 46 49 51 5• 6.O�.js 61 62 65 66 J 37 46 49 51 - i4 1 60 61 62 65 66 IH I -1-, ;. '- ? ,,,4c-, I `117 E 0: i'3 r:1( 3 5 a. z ( Y 16 - u , 2 C r, G y • C S c; �' sI y ) _ 17 MSS tI 3 2; 7 • ie n C) . S E. tu 5 ' c C C t U , a S ai.3 1i ? S N, Y Y 1 -.3 1 19 lint' 5 11!!1 ENNUI 11111 Ht " 22 23 ii ---1-1 i I.9 11111 _ 24 . 10 M�III 25 111n ■, ' 12 lull � 1111 ■1 14 111 29 1111 1 I1 15 11111 r 1 30 1111 I1 ■ 4 - - ' Month I Day Year Employees listed above are employed by /� Si ATE PREPARED: S 1 ` +'� I ?'7 (Check one) Name _'a .Y.j ,v. „1-71/11:- - 1:a ; CC - c^X-1,-x-. • MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report. LE:litentractor P Q . ._ (9 A 7 iZ4r:12,-Yx_ ' 3 Economic Department Development Administration Street Address U.S.Department of Commerce .v...', 4-A,-,.,-j,�s.,, /'p ,t 7 Room BiIS,Main Commerce Bldg. 1 Ei Subcontractor Identified at right City, State, ZIP eki. G VN1t7 -Thi/L ,, .5 ! 6 0 Area code Number 14th St.and Constitution Avenue,N.M. TELEPHONE: (ii C 4.') tf m .3 — /.� `7(.` ET Grantee Telephone No.of Contact: Area Code �vC'(') Number Y'13—l.3 y!) Washington,D.C. 20230 uscomm.oc 63659-P77 P 0, L lf.aw..//ijj.0 �r Gtn..6v ?0 ,'�er^te`^�" *6� • WI,\A( J1 i, �n S _... ._:.rt,44, 4x-vL't1- :._. - - _- _- _ a.`�, a. ..... _8.C).S . �/97.2.7�..1.•Sn +--�!�t��I S� �N� ��n y- r a-7 Q rif -7 8 Qy„ a 4"Al v 9,50 ,Z,fs•; iA . P . 5--rg-78 3o scs _(ayi,roj' .9s4. . _-4! • FORM ED-746 ECONOMIC OEVEELOPMENTNAOMINISTRARON PLEASE READ ACCOMPANYING INSTRUCTIONS d . This report Is euthenist'by law, P.L. 94-369, Secs.103, 104, and 105;P.L. 94.447, Title I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FORM Project Name: Project Location:(City,or Town, County, State) PLEASE WRITE NUMBERS LIKE THIS: I23H- 56781Q GOVT. USE ONLY Federal Project No. Employer's IRS No. Pay Period Ended Payroll Number Last Payroll 1 11111mPRINT WITH BALL POINT PEN OR TYPE, Mo. 11 1. I 1 I 1 1 1 1 I 1 I I I 1 1 I I 1 I I Iy I Ir. I I Enter "L" if this is your Last T Payroll for this project - PAGE OF PACES I 7 to 27 33 36 Otherwise LEAVE BLANK Gross amount BJ Occupa- Pay Actual earned on ° Gross amount S' Weeks n Weeks erF h Social Security g �� "s Social Security Occupa- Pay Actual earned on g, m $ Number lion Period hours this project _ prey u 5$ Iron period hours this project m _ prey. m° �8 E code Code Worked for this une m- B Number co unem- N o a .5,, code code worked for this •_' pay period -rt played p f`E 5 pay period u played go i m I t-ti+ l"[s s ! A. 11-4i s t i -3 at _. ea 4e st se 00 :_ �u 05 ee J. 37 46 45 r51 54 60 II 62 55 as 1S 2 1111111 II I. 17 1111 3 LSSS S SS S t8 IEEE _ 19 11111111 5 •Sur 11131111119111 7 S _ SS -MISS.. ._ SSSS• ■ !S Sr X1111 + g SSSS�S IN 24• 12 nil 1 N r' :S 27 ens a°� �;MIME 14 ���� I' . 29 �S11S I 15 f` 30 Year Employees listed above are employed by ,,. _. DATE PREPARED: i I , I (Cheek one) Name MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report: CD Contractor Street Address U.S.Eonomic Development a p t Administration Subcontractor Identified at right Room 8415,Main Commerce Bldg. 0 City,State,ZIP 14th St.and Constitution Avenue,N.W. Area Code Number TELEPHONE: ( ) — 0 Grantee Telephone No.of Contact Area Code ( ) Number - Washington,on,D.C.20230 uscoMM-oc 03659-P77�/ r s e e .,--- 0.M.8.No.41R-2946 Expires December 31, 1979, FORM ED-746 El PLEASE READ ACCOMPANYING INSTRUCTIONS mien is°Inherited by low, P.L. 94469, Sees.103, 104, 111-7.1 end 105;P.L.94-447, Title I,Cl.. EFORE COMPLETING ANY PART OF THIS FORM. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Nap Project Locallen:(City,sr Tom Canny, State) PLEASE WRITE NUMBERS LIKE THIS: 1 2 3 LI- 5 6 7 8 CØ GOVT.USE ONLY Pseral Protect Na. Emutpor's IRS Its. Pp Podia Ended Payroll Naas Last Payroll PRINT WITII BALL POINT PEN OR TYPE411t_ Mo. . Yr. Hill I I I 1 I I I I I i Ilmili 11111 1 1 , , pito.1;14;ittMlis is yew Lost PAGE DP PAGES 1 7 IS u. IS 02;mis•LONE gittAla - - - v Gross amount Gross amount . •-- Oaks 412 e . °carpi Pay Actual sand on . - Weeks .4# ° arn- Pay Actual earned am is 25 i Pilaf Parity PPP Ilso Ported boors COP Gads Worked thl:wpor we,. a" --, - ., mem- Ot Social Seamity Illoollaw Ps • PI Basra Cede cede wrecked tItireocertrt --: -. ups- it 21 pay 5.91011 • (11 Ineyed II .... Pei Ported al_A -b pins §2 le .1 - . a sy 411 4, s 4 64 SO - 111 52 65 SS Sr in is Sr Os so St 62 sa Or 111511111111111101111111111111111111111 - MI ',- Ar. : a s. P _ 2 IIIIIIIIIIIIIIIMIIIIIII . III y oci 0 17 111111111111 „ 111 11111111111111111111111111 III 11 4 111111111111111111111111111111111111111111 • III it. EMU II 11111111111111111111111111111111 • . , 1111111111111111111111111111111111111 MI .:. 20 1111 11111111111mam ..,„ 21 v. , r . 11011111111 . . !II i 22 if IIII 11111 II ... ... 9 11111111111111111111111 1111 it.; 24 01111111111111 OEN II • III . . N 1111111111111111111111111111S11111111111111111 SIIIIIIIE11111111111111 1111111111111111111•11111111111 . n1111111111111111111111111111111111111 11111 a IIIIIIIIIIIIII ION II III , . 1111111111110111111111111 • 11111 . 27 13 111111111111111111111111111111 111•111111 a 14 1111111111111111111111111111111 _fl , T . is ■ mono I one I Yew EmPiteemes Hated above at employed by DATE PREPARED: (area en) Name ,. - MASS.TO: Chief,blenestion Syslems aid Services Division Name of Perm Pawing Repast 0Ceekeetet Street Address ECMOIMC Development Admilistratios U.S.Ds*&seat of Cosa -, 0 Sebastreeke identified M fir city,stamp zip .. - Ron B415,Bairn Camera Blds. Area Cada Number - 14th St.ad Constitution Avenue,Mt Tsunami: (t ) • .. Dais Telephone No.of Clattact: Mee Code ( ) liwidew - Illasbiestm,D.C.20233 u.no.....pc (1311511-P77 • r W.1N.V.nv.'t ,\-[iw ,.n rrov vc ter •-' I vortM ED-746 ECONOMIC DEVELOPMENT NADMICOMMERCE•TIO PLEASE READ ACCOMPANYING INSTRUCTRCI S This pagan is.uth.ris.d by low, P.L.91-369, Sees.103, 101, �^-Tam FOR sod 105; P.L.94-147,TIM*1,C6, I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF ma Preleet Name: Pralatt Location:(City,or Tea,County, Slate) PLEASE WRITE NUMBERS LIKE THIS: • 123 '+ 56 -78 '10 GOVT.USE ONLY Fraeral Project No. I Emplaye?s IRS N . Pq Pried tied Payroll Mauer Lad Payroll .PRMT WITH HALL POt11T PEN OR TYPE 1 1 1 1 1 I' lit ! ! 1 1 1 1 L 1 I 1 1 1 1 1 1 i. 1 1. 1 'r. 1 Enter "L" If this is your Lost vryrytoif fo titVE/ect — PAGE / OF / PAGES I 7 IS 27 3f. - IS OThersrl»LEAVE BLANK Gross amount E Gross amount weeks St .. I Social Swwity Oewpa- Pay Actual earned an Weeks •� m Oewpa- Pay Actual earn*as mE lion Peal houts tlnif prot�ect prey, �B` ,M Socifl Sewrlty lion period hours this project prey. we o_ Naernt sole Cade NerkoO for tlnis 1 units- i tt Number Cobh court weAUea for Ou f ..- imam- o t fri pay period E ploy+e F PAY Defied L w, � Dlorea•ti fsT a: r as p . n w a► at rs6 no et E: ea p ©11�i111111111111•11111■ a. awr■11�111•1n1■ • ll�■1111 l!1l !lllllllllllllllllll 1. ; ; I 1111111111 • i , 111 x1111111••••11•11•111•. c/1111O11111111■111111■ Ilf;)° 1811111111 - 1111 . . t11111S11111111111a1111 p, C11111111•1111111111•11■ ■ a ; 1M11111111 111111111•11■ ©1111•n111111■■1111•■1■ ■ , i©111s1111-1III 111111111•11•1•1111111• 11,,. On 1111111111111111111 I III Ellllllllllllli1Illllil lc MI1NIII1M111l1111IIIIIINI1_11■ C•11111111•1111011•1•111 Inn • allIII1E3111.1111 • l01111111111 Er 11•11111111111innings ■ w1■11r11111111 ■w1■1•1■ . E11=11111111.11.11.1.11 ■ 1©11111111 I 111 =° ci■11111•1•1111•11•1•1■ • 111w1D11iii•1101 1I. 4 E 1111111i1111■11111111■ ■ 1J11111111 i III L1111111111i1111111111• ■ MNCIIiiiill ■ III MMNr oy Year Ewptyea listed abovn an mnptoped W DATE PRE►ARElk I 1 (Chou eea► Marne - MIL To m Division Eon*Devoiopeont Na or Pinar Plepabq Repeat p,u..+e*r Stmt Address U.L DpN4Nlt of COMM* 0 sweasuadw waMiRa at right city,stain,2SP Roes 11i15,USe Conosrce BN& Area Code nose, ISM SL and Constitution Avenue,N.t. TELEPHONE: C ) — _ 0 SnaMn TeWplww NO it Canted-. Area Code ( ) Number — WSgton,D.C.28230 uscow4OC•a•EnPTT - -- 4 "" ,/ O.M.B.No.41R-2946 Expires December 31, 1979 ronm ED-746 U.S. DEPARTMENT OF COMMERCE 111•7E1 ECONOMIC C D EV EL oPmEN T ADMIN I ST RA 11014 PLEASE READ ACCOMPANYING INSTRUCTIONS This vows is euthodzed by kw, P.L. 94-369, Secs.103, 104, BEFORE COMPLETING ANY PART OF THIS FOR and 105;P.L. 94-447, Title I,Cl.. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Its: Project Location:(City,or Tems, Corey, Slate) PLEASE WRITE NUNDERS LIRE THIS: I 2 3 4 5 7 8 q 0 GOVT. USE ONLY IFedSt&4 Prefect Ns. Employees IRS No. Pay Ported EMS Payroll Number lag Payroll PRINT WITH BALL POINT PEN OR TYPE ilI 1 I WHIM ' Mo. . Yr. Mill ' 11711 I I Enter "L" if this Is your Lost szon/4 4,a:rat —K PAGE OF PAGES 1 I is as. 36 .,,- Gross amount Gross amount . ' Weeks a 40aSS laarrity Or , Pay Agrr: earned on this prefect . ,r- Weeks tie: Social Security Ottawa- Pay Actual earned on pm. T.S. 6' Deo • led beers Dols pro cods Cede Worked for this N.-- Efft: Arcl1/4. in; if ! .st t" ' I Code code worked tor Usls on Period pay Period i- h' 'N Plead • 1 . . II $4 .:.., no • 40 al all SCHEN" I a, , 44 46 SI 44 4 a• 60 it 6i Si 66 111111111A1111111111111111111111111111111111111111111 1111 ' MIS I OINIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIII s , E1111111111111111111111111111 MEN IIII - III I 17 11111111111111111111111 IOU ti „.„ IIIMPIP,O1111111111111111111111 Illn II a , r u 11/11111111111111111111111111111111111111 , T1111111PAINP.1111111111111111111111111111 111 11111111111111111111111111111111111111111111111111111111111M F11111111111111111111111111 in II; 'II ' 11 la1111111111111111111111 III REIM 1111111111111111111111111111111 Ell II . J,1111111111111111 n 11711111111111111111111 MIMI eli 1111111111111111111111111111111111 III 11 * 'II .1111 22 1111111111111111111111111111111111111 11C11111111111111111111111111111111 WEI , ,_ Ilk a II 23 t1111111111111111111111111 1111111111 .-. LIIIIIIIIIIIIIIII1111111111111 MINI it'll all n IIIIIIIIIIHIIIIIIIII WI sun EIIIIIIJIIIIIIIIIIIIIIIIIIUIIIII III . II I I a MIII/MMIIIIIIIIIIIIIIIIIINIMM111 .. . nilliallaillininille 1111111 III IIIIIIIIIIIII a 31 111111111111111 Mai MI in i CIII1111111111101111111111111 MEI II 1111111111111111 27 1111111111111111111111111 iii C1111111111111111111111111111111111111 an II 111/11111111111 n 111111111111111111111111 11111111 ' a IT,110111111111111111111111111111111111 III 11 II I a 11110111111111.1111 II IMR• 47. IS ss Mai i Day Year En;oyees listed above are employed by , DATE PREPARED: I (Mork nee) Name , MAIL.TO: OS Sanitation Systems al Services Division Name of Person Preparing Newt Demdracter Street Address . Eamomk Development Administration U.S.Department al COMIlera ID Seater identified at fiat city,matt zip A Roes 13415,Main Goan Bid& Area Code Nary 14th St.sod Constitutive Mn.,N.M. 0 grantee Washington,D.G.ma TELEPHONE: C . ) ., Telephone No.of Contact: Area Code ( ) Number A — 1.1.GO...4-DC OOOOO•P'77 I . I , .. O.M.B.No.41R-2946 Expires December 31, 1979 FORM ED-746 U.S. DEPARTMENT OF COMMERCE PLEASE READ •,-.........,,,..m.,, •wn.e.n..n.nam. ECONOMIC DEVELOPMENT ADMINISTRATION A TION VI...GAOL Atilt,171.A.AllIlr AM EMU INSTRUCTIONS Miff a This report I. authorized by la., P.L.94-369, Secs.103, 104. (11-7.1 BEFORE COMPLETING ANY PART OF TIM FORM aid 105; P.L. 94-447, Title I,Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Mar Project Location: (City,w Town,Casty,Sate) PLEASE WRITE NUMBERS LIKE THIS: 1 2 31+ 5 6 7 8 9 0 GOVT.USE ONLY Federal Project No. Colilleyer's IRS No. Pay Perko*UMW Pavel!Nosesor Last Payroll PRINT WITH BALL POINT PEN OR TYPE411 II II WHIM I S. I D . Yr. IIIIIIII I ( 1 I I I Enrol,'IL" If this Is your Low gre:istiLtgletfta:11( PAGE OF PAGES i 7 IS 33 is - Gross amoont Gross amount - . wens lie: ri Rectal Sactority Ocala- pPeragy Actual: anted on - I Inks rai Social Sootily Occupa- Pay Actual earned on - prey. oo _ ISOMMOr coda Cads Worked this project for this ,,ff. L.,,,. "Paz: lig Iti Minds lion riOd hours COS Cod* worked this poled for this -- mew Nt gs on Period N 0 In•4 NZ . on wan n.st.n, Is Plefola li fil J 37 a m el 64 60 62 is 1141 eel 37 es 4a s 1 ,114 60 ' 1$1 62 65 66 131111111111111111111111 I - OM A i . li , I 111E111111111nlial I —ISIS ,. 17 Pe _ IMIIIIIIIIIIIIINNIL 1111111.111111111111 , , . . is ILIIIINONATI0,111111111111111111111111111111 . , ti!, I 1. 111111111111111111111.1 111 II tid1111111111111111111111111111101111111IIII :: II ' a IMMMMIIIIIIIIIIIIII NI C11111111111111111111111 • On ... I n Minn. II II .-.i. 11,11111111111111111111IIIII MEI • 22 11111111110111111111111111MM11 E111111111111111101111111111111 IBM • till n 1111111111111111111111111111 t111111111111111111111111. 111111111111111111111 2. 1 21 1111111111111 IIIIIIIIIIIIIINII -. C1111111111111111111111 111.1111111111111111 a MIIIIIIIIIII 111 1111 IIII1111111111111110111111111111111111111111 I 3 11111/111111111 MEIN oi E111111111111111111111011111 IIIIIIII I . I as; ' E 1111111111111111111111 III NUE 2:: 1111111M I IIII t!11111111111111111111111 II DIE rot, 131111111111111111111111 OSMIUM II 38 1111111111111111 . II 111 Day Year Craeloyees 11t5 above are IIMPlerld by DATE PIREPARDO: ' L I (Clerk en) Name ItAIL TO: Chief,Information Systems and Services Division NUM of Peso Pooderied Iltemort 0CW:este Street Address Economic Development Administration U.S.Department ot COMMIS 0 Iebeeetreeter Identified at Hot City.state.zip Room B41S,thin Commerce B . Anve Code Oltiaber 14th St.and Constitution Avenue,N.N. 0 ma * lashinelon,D.C.20230 TeLtPswert: C ) Telephone No.of Contact: Ana Coda ( ) Number — USCOmm-DC 03650-P77 e \ I O.M.B.No. 41 R-29%Expires December 31, 1979 - FORM Ep-716 ECONOMIC DEVELOPMENT ADMINISTRATION PLEASE READ ACCOMPANYING INSTRUCTIONS This report .eerhe1sed by low, P.L.94-369, Secs.103. 10A Ittnsl end 105;P.L.91447, Tide I, Ch.I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FORM Project Rams: Project Localism:(City,or Ten,Comity, State) PLEASE WRITE NUMBERS LIKE THIS: I 2 3 4 567880 GOVT. USE ONLY fSNral Prefect No. Employer's s IRS Ne. Pay Pe riodEnded r Payroll Nmbe Last Payroll 'PRINT WITH BALL POINT PEN OR TYPE �� I I I ( I I I ( - 1 1 1 1 1 1 1 1 I I ! I I Pr ' if this is your Last Payroll for this project - PAGE OF PAGES I 9 is n u ea Otherwise LEAVE BLANK il . p Gross amount Necks alit- Grou amount ?+ Weeks die. Sochi Security pecepa• Pay Actrral anted w g „� Social Security Oceupa- Pay Actual famed w prey. "+0 s I Nassmsr Den Put•• beura this propeet _ Nev. tlw period hours this protect _ eeM Code Worked for this carom- Number cod* cod* worked for Period lnm- ■&� agg MY period �.. i•g ployed [a WP ported r 'B Welled eE s I j� * 4 r Ind sun 4 1) • • al M w -'- 61 Si ' ee ee .T • 'eaa 51 ea w , Cl 02 ee ee 1 011117/1111111119111111111111 • ! n 96 iiii �I ": 1 2ilillZiliil➢i®®n ■ 17 1111111 n �.f S111111111111111111111111111■:'mss lrilimlili! I —. siienlnaliliili i ln■�■l■ tt NE 1 — 7 iihnlniinllnli l II 22 sliillsliiliiii_! h t ins lain I 1 II 11 11 II lIS�snliiliili-� '-'r�i 24 — ssnniiisntiiiili ! $ - Din i n11111111111111111111111111 II :4 ■!is 1 Is■lliiliiiiliili ! 14■ililnilianili n ■ ss lain 1 15 . mkwe+ Dry Year t Employees Listed stow ars employed by a DATE PNEPAIKO I I (Chock gee) Name -• MAIL TO: Chid,Wormatiee Systems mad Services Division Name of Pena;Primaries Report []CaatreeW Street Address commIDSpatDevelopment tl ol CaccaI ion p sesaatreehr Wernited at nett Gib,site,zip Roam B415,Mahn Commerce Bldg. ` Area(lose Number 14th St.and Coest rilon Avenue,N.B. TELEPHONE: C ) - _. - _ ❑Orman Telephone No.of Contact: Area Code ( - ) Nmeoer - - MS�tiS,D.C.202 USCOMM•DC 33333*PT) V FORM ED-746 ECONOMIC DEVELOPMENT £DMIMtsT RA NON PLEASE READ ACCOMPANYING INSTRUCTIONS l "'-'°' BEFORE COMPLETING ANY PART OF THIS FORM This report is authorised b7 low, P.L- 91.769, Secs.103, 104, I. and 105; P.L. 94447, Tide I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Name: r Project Location: (City, or Town,County,State) PLEASE WRITE NUMBERS LIKE THIS: �F� le �� 1.3t�1t �}n<<> r; << 1.i 6 r , - I2345678g0 se -lie r s C''/) ( ?" (li _ J e_��- a- .r r7• et LL-t"t ►PRIRT WITH BALL POINT PEN OR TYPE, GOVT. USE ONLY ttederal Protect Ne. q Employer's IRS No. Pay Period Ended Q Payroll Number Last Payroll i I I 1115151 42_2IiI1 £I1 /I5It-IS' 5I/ �• 15 ' 1c �i�r° I I ° Enter if this is your Lost / Payroll for this project - PAGE / OF / PAGES 33 Otherwise LEAVE BLANK I 19 27 — - o Gross amount t r Weeks ,F c Gross amount o re Weeks M Occupa- Pay Actual earned on : w 7V/is o S Social Security Occupa• Pa Actual earned ec " e ,e d Social Security bon Period hours this pro ect 8 Prey- c y bon period hours this project a r unem- or- 9g Number coda Code Worked for this 1 'z unem- + e E Number code code worked pay ,: U J4i.U. nu. A...-.J.0 c*Wwa vecemuet u, ury J 4) FORM ED-746 U.S. DEPARTMENT OF COMMERCE This —p--s euthorlsed by le., P.L. 94-369, Sec., 103, 102, ''1'°' ECONOMIC DEVELOPMENT ADMIN,9TRATION PLEASE READ ACCOMPANYING INSTRUCTIONS hi and 105; P.L. 92.227, Title I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FORM Project Naar: (Y L 1 C Project Location:(City,or Town, County,State) PLEASE WRITE NUMBERS LIKE THIS: z [�('1L7� Ils'C� JE �eha�°n �C�iill � C,: �IId6r-/ n), ii-fAna f --4-frerThc-n 0 fity 123 567Sq GOVT. USE ONLY -Federal Protect No. /� Employer's IRS No. �j Pay Period Ended p Payroll Number Last Payroll PRINT WITH BALL POINT PEN OR TYPE, 1 I I I I 'eI I. c5I5) IAEHHH-iI l � �a'I�I� I�s'I' I' I' 15� � [71 1 I -Y - Enter ..L.. if this is your Last l ,� Payroll for this project - PAGE OF J PAGES 1 7 1e 27 33. 36 Otherwise LEAVE BLANK d ° Gross amount 3 .n Gross amount r Occupa- Pay Actual earned on d E Weeks . n '�E° Weeks o Social Security (ion Period hours this project ., E Pre.. 0000��rr _� Social Security Occupa- Pay Actual earned on $ �^ prey. O c: Number P i — code period worked this project - ` u code Code Worked for this �� unem- S?" g Number rcr .?�L unem- d og z pay period i- ie ployed ° P3 i� '�8 Ployed E: °E e gi x I = pay period e°\; oe s K I .2 37 46 ee 51 54 60 �d 61 62 h 65 66 J D 46 45 51 54 60 . 61 62 65 66 15 l-i' lX19n1 . 9r Le 3z 3 21� , ' Yme 16 r . . - 2 % / 1-1/7-l796y 14- 5Fii" a.5 2 i , i - y Ai Y4i � 17 - - . 3`g7y4-I/-7Q1AW Q LLFlo/ 2S I9 %fl it/ N is - - 4 "J jr-5 2-3 10 le ( tCL It/ ,, :;" 9 7'2 3 r7 Iv y .x,19 - - , 5 - 20 _ . iA .. - r 21 - - 7, - - - 1 22 _ 9 - . I 24 - - 11 — e I iI• 26 - 1 1 12 - - 1 27 - - ' —4 13 - 1 28 - - L 14 - - , 29 Y5 month Day HYeagp Employees listed above are employed by /A , 7 !/l - CO DATE PREPARED: 1j I 12 l /V (Check o� Name 71ti' Lk�ln 1 ez ic41i O'�/,€iLe i✓. C r 2-'22N MAIL TO: Chief,Information Systems and Services Division Name of Person Preparing Report: ontraetor -1 y J j� 2 p Economic Development Administration / Street Address LA- (G ! �l� fL %%��,, U.S.Department of Commerce ieraI n ??rc d, iC'U Q sacestractor Identified at right city. C a 2 .25 Room 8615,Main Commerce Bldg. ea Code T3,72)Number � ry, State,ZIP r.C.(/ /((/L//!! \\ �j 14th SL and Constitution Avenue,N.M- TELEPNCNE: C;r, ) — .�t)lit( ❑Grantee Telephone No.of Contact: Areal Code A 2I�'L- J Number /-33—5(13 9 Washington,D.C.202% l USCOMM•OC 03e50-P77 �.�s. _ •Wei gy' -t a r ly , s r 6. fr ,.t "� •> x.0 ;..wF.^k '2 , ielee ! ' d: I 0 f '; .0 `4 •rj avya _8vs (in ors;,(1 , 'C3ss4 v . . P.^c4-e h s �$,. 2$-_ 3Q' _ Pos _(�ytrs) S- !g-7 - s os(a.saa irfatta Cyr.? S3./5), r r< Z .<-w- ��i- ///� �/�/��/(fy /�/p„ (J����/ � �(��j/��/y�/�� � y -•�-4-Q.s * t '_a3:- ✓ ' `19_ : /o,01s 41/p,p p : ., it a _ ____� ,.— — _ _ _—, S �O-S-�noiaS,� _._9a-?� •�` 3.�r�3rs'k,'�9"� T P _ a __. ?vs = Lac/,a:s) ?6 a• - C . — :3E>Sa3tJ- fl-f 3L,3S = _ `1 d a .'e - -*s - 14.,T. y, it Eq r _ r � d f s � ' t l� i , !^ �>r.f' S f ( g/.1S n q v s{ I SY } 4/1/'/ rfi ' A; ro �, ) �v•. ^T " . r >w ' is ," ;4we. O.M.B. No.41R-2946 Expires December 31, 1979 FO=s ED-746 rCONOMicuoeve DEPARTMENT EH rN�o vrCOtxq Tp ON PLEASE READ ACCOMPANYING INSTRUCTIONS This report authorized by la-. P.L. 94-369, s..•. 10 3, 104, BEFORE COMPLETING ANY PART OF THIS FORM and 105; P.L. 94447, Title I, Cl,. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Pro)ect Nano. , , Project Location: (City, or Town,County, State) t' .ct,_,-�.. y� PLEASE WRITE'SUNDERS LINE THIS: C ../r-cc L'�-"-t Y at,t,,cc4 ,17 -ntcn, t^,K. &. �f-... (.E..,....-r.,. .. ;. ;� 12 3 4- 5 6 7 8 g 0 J ,- P .-PRINT WITH BALL POINT PEN OR TYPE, GOVT. USE IONLY Federal Protect No. q y1�/ Emptoye7r/'�a IRS No. 1 1 Pay Period Ended Payroll Number Last ayroll 1 I I 1 I I 1Y I I I 1 ' 1 I QI /1 1 I 1 f""I' 1 1 13 I 1 I c I 1 I 7k I 1 Enter L•• it this is your Lost 5 S l S7 / 3 C' 3 / .S r 3 7 -5 Payroll for this Project - PAGE i OF J PAGES I ] is 27 33. 36 Otherwise LEAVE BLANK Gross amount V °- Gross amount 8 Weeks oil Occu Pd- Pay Actual earned on E Week4 _• XX Social Secunt y project g T d_ Occupa- period hours) this project a g xy lion Period hours this roect r,,. i?"� prey. P .E 1-.1 a Number this "- unem- P It Number cone Codn Worked for this >, '?s unem- S" code code worked for to Z' Pay period 'o yo PloYed _ pay Deriod PloYed �'u c 4} .. !W g W J 37 46 49 51 54 60 61 52 m 66 J 37 46 49 51 54 60 p,,,, 61 62 65 66 1 it 7 5l i 174 � 4ti1 ,_ L- Y 'I` I `l t c , 3 5 ■ 5 .3ic -3 >-. �. 3 e■ c4L — t.- a >= �� - 3 S Y ■■■ 18 ■■■ ■��■i II4 ! ' t " III_i.L0 A fl N O 19 �I■_ ■ 20 IlL —■■ —J' ,11111111111111110111111 Ell 4,- B■■■ 1__t_ ■ — ■■■ 23 ■ ■� ■■ 9 ± -- - ' ■■ 24 ■ ■■ �■■ - - 1 EMI _ 10■ 1 � I ■■■ 25 ■■■■ III " 11111111nEMIll WI , 1.11. �. Nil= -t ■■■ 2t ■ ■___■ r ■■■ 29 �■ ■.11D ■■■ 30 .1111111111111111111.0=111. Month Day Year Employees listed above are employed by DATE PREPARED: 51 / ? j 7 y (Check one) Name — c\.\. ( 's. 1.4 et....-,At-r1 - Oil-- Cc S v-c- MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report; Economic Development Administration C9nhxtor l/ Street Address / .r `i 4�.LeL v3 U-S. Department of Commerce '`ti^ f: o,,.n.0{,vim. S Room B-615,Main Commerce Bldg. - I Subcontractor Identified at right City, State, ZIP 7 ?Vr-vat 111/CAL .�.- ?�O l 14th St-and Constitution AvenueeN.W- Area Code Number _ 7 �,C� / l C ) </.j .5 - i V& L 1 Grants. Telephone No.of Contact. Area Code 7 L't'/ Numbert/t/,3- / 3 YC — Washington, D.C. 20230 TELEPHONE: 'JCL '� � ,c Po �/n.eee PO USC OMM.DC 1136]9.n]] 0.M.B. No. 41R-2946 Expires December 31, 1979 `11,70 ED 746 ECONOMIC DEVELOPMENT 1 TADMINISTRATION PLEASE READ ACCOMPANYING INSTRUCTIONS This report I. authorized by law, P.L. 94-369, Sec..103, 104, BEFORE COMPLETING ANY PART OF THIS FORM and 105; P.L. 94-447, Tid. I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM Project Name: /- Project Location: (City, or Town, County, State) PLEASE WRITE NUMBERS LIKE THIS: ( 4 4.^,c ,, IJ-c-._.��_-C� �',MX 0�4�., .7r_ cl � 23 '� S67ggQS ` " 'j971 L -rte �� GOVT. USE ONLY 7Federal Project Me. Employer's IRS No. Pay Period Ended Payroll Number Last Payroll ►PRINT WITH BALL POINT PEN OR TYPE, [ WI I �� � d / 1:��E-.�:A� %� � � l � � �� '� �� � � 1 �y I �r Enter ..L., if p is your Lost PAGE / 01 / PAGES 9 3 / _2 G k 7 6: P r n re.if protect - 1 7 16 27 33. 36 Orher..I.e LEAVE BLANK r _ - Gross amount . J J . Gross amount t. '. • Weeks g� Occupa- Pay Actual earned on s . ,1 E Weeks n r^ Social Security Occupa- Pay Actual earned on m prev n e0fi of Social umbSecurity lion Period hours this project �..i �--, prey• u �5 Number y lion period hours this project code Code Worked pay this unem- ii. cods code worked for this �i played En 'E a: pay period r -. ,1:8 ployep gu =+I, pay period 't. E, ou ri K c LLY 6 u.< 3 W g 1r Y-� 3 W J 37 46 40 6l 54 60 ;.161 61 65 66 J 37 46 49 51 Si M `IA 61 63 65 66 1 .5-17 7 y ? ( '/ C yi lc: S C ____4f CJ Y ! O. i'10 1_,,,„, _16� 2 Y 7 V 6 '7 4 7 CO C7' C .:� E w 3 5.- 3 7r .5-"C, b - 17 , . , 3 3-, r 6'S 1--3 B o C. 0 6 S c u a c -A 3 -7i.3- O r 18 - _ I � 4 } - - 19 - r 111411111111 T - r 6 _ _ I —. 21 - - , 1 { 22 r _- 8 - - . i 23 - - _�. I 9 } 24 - - 10 - f _r 25 - - 111 �... A 1 11 k"*` 24 12 + 27 13 T r * 28 - - I 14 - I 29 - 15 I - f - 30 - . Month Day Year Employees listed above are employed by // / { . C.C.DATE PREPARED: 4' [ Si I 7 t4 (Check one) Name tiel W it.v- C C)•^=` —�xl C-` C is C MAIL TO: Chief, Inlormation Systems and Services Division Name of Person Preparing Report: I`✓?'Ceetraelor Economic Development Administration Street Address i 4 'Act (_i+',vnp i U.S. Department of Commlerce -�n�.: .rv..n. A- f r-- �) Room 8�t5,Maio Commerce Bldg. lY LI Sobconsrada Identified at right City, State, ZIP t' rQs'--.1."-C\ MAIL, ., 1 6•e r 11 ( 14111 St.gad Constitution Avenue, N.M. Aref Code Number \ _ TELEPHONE: Cy1.'4•) '-�c{ .3 - / 3y() �&antee J Telephone No.of Contact: Area Code (Y;,'(' ) Numbery'( 3-/ 3516) Washington, D.C. 20233 4 usCOMM•DC 63650-P77 P.L. 94 a9, 5.<. 107, 704, iQ. QED-71s s - U.m.n. no.e1N-29eo Expires December 31,1979 U.S, OFP ARTMEHT OF COMMERCE D ^^d r�S°p'i is •r ECONOMIC acv F�ozTr .oMiNisTes TioH PLEASE READ ACCOMPANYING INSTRUCTIONS ir °�• v ,���„+•d yY r LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF This FORM • l,•~" L • T"r C(r,P - 94-269 Pro)oet Lrxetieo:(City, w Timm, Ceunry, Rste) ' j•es. PLEASE WRITE MUMMERS LIKE TNIS: ra, I23456 '78g0 ,.4. F� it,sot (;''a Ebgd6 °-moor)Lest Payroll .PRINT WITN BALL POINT PEN OR TYPE.I En>e, ..L.. it this is Yom Lasf LOCAL PU8 ^"y'sPel"' ' PAGE OP PAGES Pr I LIC 'D ALANK y o NUS. La1'atroe:ICrb, RKS PAYROLL O TINn ,�c cs DEOa ENr 1 MywLtj. •/Rf No, own, lY � I REP RTING RO vie ztke omoNzt,., C� P 'a r^ArRO£ O-N.B. No. IR_ ©O� ct spa. Ps y Ae Mo.Pen OY.E W B 'ARE R$'9D.1C�19 Ex •i A COele boy �MP(ATIl © ! © W `key Una ounl #1 Lay INC C 7' PA e.1! 111 1 St. 's ProlI.ue k' Payroll 7h.EASE N pear ty u" j' SN IDS a •� ,� ®. .. Pjia Y e. I+J r.. �li.wirsie� (. J211 �O or.e-- EA O :a PI1 Tll 4 ! ii 11. ®! y°eN re L�AVF%K/ 'Con MT �L ro�9L �` OF® .; �� W Social Secure Oceape. e „m, .. 3= Number b c.tis.siir�iii�ietitie ! lea Wars Pay - 41.11141 i4.411.1 i!.....all,• •! i 4= lfaa lar code c'o aR uto41 °to v on oddt 1# for t ! .. ;.. .. ��. .�� worked th�a aroleot i� e.Y Penoo R fe l ••! !a! ii! lle.��•i iaeaeia aieeaiieiratte ft I® ASO• ere mm��ss����i��4�il���%�e�%��i �! i1��tiilQjttSi;�il�ir�lrjr�Ilj� © gym 4 1tri iii i!. tt t t heel ldia titarriaraaftari � ia ff i ®.ir'!lii.,.ileii..ea uwW*t en ia•iiiamit.11 - iitjr atet f i :.r is�l alai i!!l��ii li�l** .411111141118.141.1118.11111.41111811111 iaeeeaitaii arl � i/'' �..E sii�.i�i�iil�i►t�� . i miiiii rYir N ° "ke' "�� iiiliiiliiptira le181110 riaartisriiiiaeiifarrrtirir i}*ir .,r.�P ii . ilt aei ii iii tint �PArni,%Om 0 ii lit r i iiiiHale �iae ji�ijj�iO NI i it ,ELE 4.4 Year ...� a • are fSlag Sift is iii r t s s� i aiwag slip ��wise alma 'rail iii ei reatct�: gal� ` ei .t itei . life after f L ir - 0, 4 �°io"°� eiiii4tt e�itals a��i rfr�itiesii f:,aft New e�iti�����a�iiiiii�� r 'NP',, iltiiiimmiatabin..._ r- ar„„e No, of Calt�ct MA/ i " iit� Area Cove L T0; Nei �+G N E.t°°" Doty' Number ..S '' '' &met; rW. O.M.B. No.41R-2946 Expires December 31, 1979 11.70/ •746 ECONOMICDEVELOPMENTNADMINIS ADMINISTRATION PLEASE READ ACCOMPANYING INSTRUCTIONS This report Is authorized by law, P.L.94.369, Sbes.103, 104, and 103; P.L. 94447,Title 1,Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FO E iect Name: Project Location:(Ciq,or Town,County,State) / PLEASE WRITE NUMBERS LIKE THIS: are tote rs°N PQ u/J i V cc e- t ,QC'—. ,&41/r/6't/ ?. ' in hiA/ ken, n �/ 12 3 �- S 6 -7 8 A 0 GOVT. USE ONLY Federal Project No. Employer's IRS No. Pay Porlod Ended Payroll Number Last Payroll / - IIIMPRINT WITH BALL POINT PEN OR TYPE, I S.7 / 2 6 2 7 7 s-{ Enter roll or this r i project Last 1 7 16 27 33. 36 ( Otherwise LEAVE BLANK PAGE Of PAGES Gross amount S h a Gross amount 1 a Weeks et= m Occupa- Pay Actual earned on Weeks At: mn OMNI- Pay Actual earned on r Social Security lion Period hours this project Cl 8 c_ Prev. ^o e 8 Social Security w prey. «B c.5 p j lion period hours this project E Number code Code Worked for this CC unem• & 3?" 8 Number this car unem• y1. a period >`: , >`o ployatl w code code worked for th s �,.. ployed z pay P xa B' pay period c �c 11 It -' 37 46 49 SI 54 60 t . 61 62 65 66 37 46 49 61 54 60 61 62 65 66 2S / iiill - G 24Sfw 32 .7y Al' *6- 'I ' H Al ) i6 _ = i u 3 •fli ' T____~ 18 - I 5 III! 20 — 6 11,11' 21 8 RIME 9 Min 24 - - 10 111111111 25 - 11 1111 26 - 12 OMNI • t 27 - 1 13 inn 28 - - il 14 !!!1 29 - !s. _ 30 - - Month Day Year Employees listed above are employed by n / ,I L��Q / t/ DATE PREPARED: C I /6 I ?? (Check one) Name `• � �� Lund ,^T//f*�€ l-1/21-6'. MAIL TO: Chief,Information Systems and Services Division Name of Person Preparing Report: El.Contractor Street Address ?cc ///�' ///CM/' /j["r Economic Department Development Commerce Administration �� U.S. Deputment of Commerce / // 1 / Room 0415,Main Commerce Bldg. , // �C/�!J F/I beontraeler identified at right city,stab, zip�l�/�/7�J1 �0/// J�Gi4 14th St. and Constitution Avenue,N.W. Area Code Number Grantee (4.4)6 Washington,D.C.20238 TELEPHONE: C yk) Lfz4.7_ g1 sre Telephone No.of Contact: Area Code ) Numbs/W..2,j/� USCOMM•DC 41445-P77 1 O.M.B.No.41R-2946 Expires December 31, 1979 F 701ED•71a ECONOMIC oa'VELOPMwETNI C wuTNATION PLEASE READ ACCOMPANYING INSTRUCTIONS 11 I This report Is authorised by law, P.L.94-369, Sees.103, 101, BEFORE COMPLETING ANY PART OP THIS FO• ad 105;P.L.94447,Title I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM rr ,..surroject Name: Project Location:(City,er Town,Canty, State) PLEASE WRITE NUMBERS LIKE THIS: -a d - I'fe� • a . , i�., tit 1 23 '+ 5678 ' 9 USE - • I C • .Q P SO I a I r PRINT WITH BALL POINT PEN OR TYPE VT. OSE ONLY Fedora!Prof ct No. Employer's IRS N . Pay Parlod Ended Last Payroll ( � , .�1 6 C I-0 .J'7 —) Entot"L„ if this is your Last PAGE OF PAGES J.� P.A. -Al'' /v / i / I ill Pryrymfl !or this mL•ct — 1 n 33, x Otherwise LEAVE BLANK Gross amount cV • - Gross amount I - Weeks . • Occupa- Pay Actual earned on f'M; ' Ya ' Pay Actual eamed on rev. no c fi • Social Security w — - __ y lion Period hours this project a L,.; E S period hours this pro�ect �. p Number code Code Worked for this ".• M. code worked for th a not_ n z pay period - , 2 pay period S >- •B played Qty 3:Cµ J • ], K ra SI 54 x01 61 62 IM 6e 37 es 49 51 54 60 81 62 i 65 66 1_3.39-2RB997 Z 4i icJ 30 327'61 i I, rrilJfG?m fs■l.uff..I.. I 251 7-1:3k-57:3 eo / JOEui 14 8443 N '© 351 &-SO-zz. 7 7 9 7E� 1(47 8 ��.6'o �11111�iili���l������! 5 _ _ ■1111 _HhIII1111111 I - - ■■■■a1_■51111111i■fuu•■f ! - 111111111 111111111111111111111111 • 8 - - ___Noir 111111n■■■■nu•i ! ■■IIf® 11S■1111■11f111■■f ! 10 — — ■■■■® iifl■■■iii■■■ I �fmf■ 2c �•5muuifumf■f■ 1 11 — — 12 — INN__ms1i1 ■imuim111rI 13 — — �■■N■D ifif■■f■u■■�� i + ' 15 — — 30 _ Monthh Day Year Employees listed above are employed by • DATE PREPARED: /JJ� I �� I 73 (Cheek one) Name , //' .1/ /' I , d MAIL TO: Chief, Information Systems and Servicis,Division N o Person Prep 1 Report: Cnntracter Economic Development Administration (�r�sa1 /(� dl� Q Street Address �S/zl/n �IlU,SP/ U.S.Department of Commerce /r / �5ubcoettactor ) Identified at right City, State,ZIP 9UPL P CM," ,1 qbl/ Room 8-615,Main Commerce Bldg, iii 1 rI2 ��//// 14th St.and Constitution Avenue,N.W. TELEPHONE: Are e_ Num r — 4/.t 0/ 0 Grantee Telephone No of Contact Area Code (•Y9N .) Number- l.�/Sd Washington,D.C.2023) /1 U•COMM-DC 5555.4'77 O.M.B. No.41R-2946 Expires December 31, I97911Y.• 11-)61 ED 746 ECONOMIC DCVSLOPMENTNADDMINISTRE TON PLEASE READ ACCIDMPAIFYING INSTRUCTIONS This repast is 4therized by low, P.L.94.369, See O.103, 104, BEFORE COMPLETING ANY PART OF THIS FORA 9 end 105;P.L.94-447,Title I,w Ch- 1. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM "~ •.44'.Projeet Name: , �n . . . 0�/ Project Location:(City,cc Town,County, State) PLEASE WRITE NUMBERS LIKE TN vfl//^, ( JrC1[c cx�wiu� ��� ebant.y 12 345 6 7 8 C0 GOVT. USE ONLY Federal Project No. Employer's IRS No. Pay Period Ended Payroll Number Last Payroll ligisPRINT WITH BALL POINT PEN OR TYPE, 1 1 1 1 1 I I 1511 I&I roI aI719 s l 4ei131‘1i 1311 la I I Iy I Ir 17 Enter "L" If this is your Lost l0 15 % / s-� P6 0ll for EAVEBLAN PAGE / OF / PAGES I 7 18 27 55. 36 ( Otherwise LEAVE BLANK Gross amount `.a Gross amount & ? - Weeks eh » Occupa- Pay Actual earned on e Weeks r» Occupa- Pay Actual earned on g r Social Security tion Period hours this ro1'ect 8 t=r prey. »o B Social Security „ ¢ pray. Ms e 5 A Number code Code Worked fm this 'i unem- i Mon period hours this protect •Number coda code worked for this ¢< unem• LE z pay period .t. :. '.io ployed Em, �I z - = paY Dariod i• - o *Yak @@ 0 d 5 s 7 u.� ilia I ;Y u.tC •3 W c J 37 46 69 51 54 60 s C 61 62 66 66 J 37 44 49 51 54 60 ',q 61 62 66 66 1 5 16-7 4-5,7 a 9 010 S E W 30 8 o'a 5 Y 16 25I 1-1i 8-6 9 to / ato 5 Ew £} 0 111 o, vo Y 17 - - • 317h-6y-76000105 EW YO 28oioo Y 18 - . 45 16-52-,38U1o1610SEW lit 3 ? boo Y 19 • - 5 _ - 20 _ . 6 - - 21 - 7 - - 422 - - 8 - - 23 - - 4 9 - - I 0 24 - - - 10 - - 25 - 11 - - 26 - - 12 - - l 27 - - a 13 - 4 28 - - lill 14 - n 29 - - ■ 15_ - 30 - ' 4 si Month Day Year Employees listed above are employed by ���,,, // DATE PREPARED: Le 1 is I 7 8 (Check one) \ Name y c"'!" �L ���r �—t J��• MAIL TO: Chief,Information Systems and Services Division Name of Person Preparin Reg_port: [(Contractor /'' -# 3 Economic Development Administration Street Address 9 Q-�- • U.S. Department of Commerce ❑Subcontractor Identified at right City,State, ZIP /lC� i/YLsC.. -'1/Z_.74 5//.0 of Room Department Main Commerce Bldg. rea�lCode Number Grantee ( lw) $43- /3 y V Washington, D.C.st232X Avenue,N.W. TELEPHONE: C "7�(n) 7 3 - /3 Telephone No.of Contact Area Code /6 Number USCOMM-DC e366e-PTT voaM ED-746 O.M.B. No. 41R-2946 Expires December 31, 1979 Ti.n. open is eethe.iaed by la.-, P.L. 94-369, Secs.103, 104, 111 RM ECONOMIC OEVELOPMENTN60MFNCa McMEROH PLEASE READ ACCOMPANYING INSTRUCTIONS end 105; P.L. 94-447, Title 1,ch. I. BEFORE COMPLETING MY PART OF THIS FORM LOCAL PUBLIC WORKS PAYROLL REPORTING FORM •I Prefect Name: Project Location:(City, or Ton,County, Stab) PLEASE WRITE NUMBERS LIRE THIS: t , col., Q Q GOVT, USE ONLY federal Project Ni. I V 1 Employer's IRS Ni. Pay Period Ended Payroll Number Last Payroll I I l l l F l l HUH ! I l i l i l l I I y I Yr. .PRINT WITH BALL POINT PEN OR TYPE, 7 I I Enter "L" if this is your Lest + _ +e t Poylo)) for this project _ PAGE PAGES b 3s/ sa Otherwise LEAVE BLANK OF n7 - _ _ _ la • Cross amount r9` - - - Social Security Occupa- Pay Actual earned on , €0€ Weeks it « Gross amount I* - Number tioa Period hours this protect f3 8� prev, wo e_fi Social Security OCCYDA Pay Actual tamed on _ weeks ei= = cede Code Worked for this - - unem- ..13. I Number lion period hours this prolIsct prev. -we a_fi Pay period >- oo ployed a code code worked for Nia - uses- g '� ."> y, _ pay period 'N Dloyed e. i J 37 iW kQ.i! it-6 46 • 81 s6 e0 s+ 62 as GS er ea N at s I . 111111$111111$ 1 6 I _ 61 62 65 66 1 ' ' 17 1111 1S a 11111111 1 1111 ;� 2n 2 1111 I..r .� a Isis zs INNS ! �. 10 iii! a 24 isii ! � ; NESS 11 • x 111 NENN 12 13 =7 NEON 6 i 14 ZS till 1 l 15 * 29 NION ... N DATE PREPARED: Mon* I Day Year Employees listed above arc employed by — ; " (Check one) Name Name of Person Preparing Report: MAIL TO: Chief, Information. - Cervices Division D.Ceemacter Ecomm�ic Der Street Address �f' 0+�- _ o 0 Sebceetractar Identified at riN+t U , � ' d' o Area Code Number City,State.21P R. I TELEPHONE: (r) .. 0 Grantee ( : a g ,ems Telephone No.of Contact: Area Code ( ) Number W ` .�.8, r�� l �� � a 7 r - - '--'— U.M.D.no.a1tt-1946 Expires December M,1979 4 1 101.70) 715 U.a. DEPARTMENT OF COMMERCE This report is authorized by law, P.L. 94-369, Se<e.103, 101, ecoNDMlc DEVELOPMENT 1DMINISTRATION PLEASE READ ACCOMPANYING INSTRUCT IONS and 105; P.L. 94-117, Title I, Ch. I. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF TN/S FORM r Pre)ect Near: Project Location:(City,et Tam, County, State) PLEASE WRITE NUMBERS LIKE THIS: • ' I23H- 567880 GOVT. USE ONLY –Federal Prefect No. I Employer's IRS No. Pay Period Ended Payroll Number Last Payroll NPRINT WITH BALL POINT PEN OR TYPE. ► 1 I I Mil 1 ► ► I I y I I I I I I I I-I ir. I I Enter 'IL" if this is your Last i y _ Payroll for this project – le 7 33. >e Otherwise LEAVE BLANK PAGE Of PAGES Gross amount o Social Security OccuDe- Pay Actual earned on t E Weeks ! w Gross amount Number lion Period hours this Droiect 8 E prey. eo Social Security Occupa- Pay Actual earned on peeks m^ code Code parked for this – unem- o– Number lion period hours this pro+Ibet Drev, wo c_5 •z ¢¢� Ti code coda worked for this r union- �1- y Day period >O o Played u-t ;mot pay period > .•B Dloyed el 2 M lk st, iJ ex of Y e/ a/ 110 {I {i {! M J 37 M b !/ 51 f0 61 ei ea 64 • I 2 a. 1 , f I�1$i 312 17 3 ; _ 18 4 - t! 5 _ - 4_. 20 , • 7 , - i T' . , i Y I .1 2 212 a . 8 23 - • ! - 24 • - ° I' . 25 12 - - 21 13 - 11 - - I 2! - - IS r - - 30 DATE R R R 0: Month I Day Year Employees listed above are employed by - _ • _ _ _ _ - - - - - . I (Check one) Name Name of Person Preparing Report: MAIL TO: Chief, Information Systems and Services Division Street Address Ecolbmic Development Administration U.S.Department of COEMetce Area Cods Number sseeeetracter Identified at right City,State,ZIP Room 8415,Main Commerce Bldg. TELEPHONE: ) – Q Grantee Was St.and Constitution Avenue,N.M. Telephone No.of Contact Area Code ( ) Number – Washington, D.C. 21230 USCOMM-DC•30511-P77 ::........a. �' FORM ED-746 U.S. DEPARTMENT OF COMMERCE 1 This report is authorized by low, P.L.94769, Sect.103, 104, III'yer ECONOMIC DEVELOPMENT ADMINISTR•TION PLEASE READ ACCOMPANYING INSTRUCTIONS eed IDS:P.L.94-447,Title 1,Ch.1. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF THIS FORK f Prefect Name: Prefect Location:(City,a Tema,Cemty, State) PLEASE WRITE NUMBERS LIKE THIS: v '_ I23H- 567890 • GOVT.USE ONLY Federal Prefect Ne. Employer's IRS No. Pay Period Ended Payroll Atwitter Last Payroll ►PRINT WITH BALL POINT PEN OR TYPE, 1 l - I i °' Yr. Enter "L" II this is your Lost I 7 II 27 n. >s Payroll for This project – PAGE OF PAGES Otherwise LEAVE BLANK Gross amount e Gross amount Social Security 0c cope- Pay Actual earned on 8 ate; a weeks ?� c. Occupa- Pay Actual earned on g weeks aif » lion Period hours this project r , .g p ev. fi 8 Social Numbly $ Prev. ere e 5 Number code Code Worked for this - " – anew- & S! lion period Hours this protect = pay period > - iB ployed _ code code worked for this -lc! anew- $Es s \ z pay period - . E played 2W i ! aeW g _ 3a� J�A a 40 at N e0 1 42 Sala J 37 • M {3 fa 40 N�{3 Y S{ 1 _ — _ 1 . . 1 . i 16 – . _ - 1 2 . �,. 11 • • 3 – – 1 tV46 18 – – A 4 – – 19 - - S – – • 20 – - g – - . ! 21 I 7 – – 1 - 22 – 1 - - 23 - 9 – - 1 21 - – n 10 – – 1 I 25 – - • II — — 1 25 – – r f 12 - 21 – – 13 - – 21 - – 14 - - • 2! - - 15 – – 4 30 — – -Meath Day Year Employees listed above are employed by DATE PR D: 1 (Check eat) Name - NAIL TO: Chief,Information Systems aad Services Division Name of Person Papering Report: D,Ceettecta U o Administration Street Address « 0 Saceabaeter Identified at right City,State,ZIP Room Commerce-515,Alain Commerce Bldg. Ana Code Number 1101 St.and Constitution Avenue, N.N. TELEPHONE: C - ) – 0 Grade. Telephone No.of Contact Area Code ( Number – Washington, D.C. 2)230 USCOMe-DC ea•lo•PTT K O.M.B.No. 41P-2946 Expires December 31, 1979 FORM ED-746 ECONOMIC U.S. DEPARTMENT LEN ADMINCSTR T'ON PLEASE READ ACCOMPANYING INSTRUCTIONS This reppn is coko!ls.d by low, P.L. 94-369, Sees.103, 104, end 105: P.L. 94447, 'rifle I, Ch. 1. LOCAL PUBLIC WORKS PAYROLL REPORTING FORM BEFORE COMPLETING ANY PART OF Tiffs FORM Project Namr Project Location:(City,or Town, County, Slats) EA- / -,c. PLEASE WRITE NUMBERS LIKE THIS: �a..+:.c �d 1..,-� k,-,-(,),, EA-,-,-(lvlr I. I h0 "-:MR^i`.(C. 11�� ?((++II//�� 41 / { 1 ��IJ 1234567880 l` I GOVT. USE ONLY Federal Project No. Employes IRS No. Pay Period Ended Payroll Number Laet Payroll .PRINT WITH BALL POINT PEN DR TYPE I I l l I ill I ' ! I 1 l i I I La I ! I; I 19c Mo.��,ly I- 11 Enter rh fh`5 '` your Last / S. k= 1 �' I Payroll for this project r PAGE / OF PAGES I 7 IS 27 33, 36 t Orherw•se LEAVE BLANK . _ _ Gross amount = u Gross amount m rt Weeks ne? Social Security Occupa- Pay Actual earned on a E Weeks --. O1 Occupa- Pay Actual earned on °� y ,n6 ae lion Perio• hours this project 4'',., $„_ Prev. zE E $ SOUal Security tion period hours this project m_.- ,c_ Prev, m < o Number o=. - unem- it. Number o:� unem- pr- o code Code Worked for this code code worked for this pay period 72: tlo played g= r _ • pay period as do played od s u c° _f° y Swat 3 W r2 2� u,4 34.4 J 37 46 49 Si 54 SO 1'' ' 61 62 65 66 J 37 46 49 51 54 , 60 6/ 621 65 66 I!iIIUiIiiUL'1IIIti 17 s e®®®® .... LV Y Y 2-I' . _ _ . 5 ....n.l n...l ..fl _ e 20 _ ...‘.na g rni:mn:niiiiin - 21 7 22 - _�_,annumuilnia: r 21 n -10 uunsinn.0 ___,., 25 1z �n 111111111111111111111� _ •� 27 - 13 .. ia.. n n u. . 20 - = , i - _ y 14 illll..lnl.lh■ ■1..1. . _ - 1 15 30 . Month Day Year Employees listed above are employed by _ + DATE PREPARED: •q I I „i. 1 1F (Check one) Name t k,Vv.'wv. ( r TVA' - - �7-k-` c - di v'- MAIL TO: Chief, Information Systems and Services Division Name of Person Preparing Report. 1 1E-'Contractor 1 Street Address P. C' . ' Cl 1 ,e_-- . Economic Development Administration �,.,.. U.S. Department of Commerce 'y i4c-i—v,..l'�-� [j Subcontractor Identified at right , % Room B415,Main Commerce Bldg. Area City, State, ZIP 1t 5 •7�` C Area Code Number ( 14th St.and Constitution Avenue,N.W. 'sLEPNONE: C`{C 1,7) <j c� ig - 1, cit " iJ Gran(« Telephone No,of Contact. Area Code (` CC) Number`j'/.3-i i VG' Washington,D.C. 0230 i (/5 C 0/.0M-DC 63p]1,3•P77 4 Qa`Yt,c,C/ toz-044 • THE AMERICAN INSTITUTE OF ARCHITECTS i* AIA Document 8141 Standard Form of Agreement Between Owner and Architect THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES; CONSULTATION WITH AN ATTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION AGREEMENT made this 5th day of November in the year of Nineteen Hundred and Seventy-six BETWEEN the Owner: Board of County Commissioners Jefferson County, Montana and the Architect: Johnson-Graham Associates Architects-Engineers-Planners 644 Grand Avenue Billings, Montana For the following Project: (Include detailed description of Project location and scope) An Addition to Jefferson County Courthouse Boulder, Montana The Owner and the Architect agree as set forth below. AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIA® • ©1974 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 1 PERCENTAGE OF CONSTRUCTION COST I. THE ARCHITECT shall provide professional services for the Project in accordance with the Terms and Conditions of this Agreement. II. THE OWNER shall compensate the Architect, in accordance with the Terms and Conditions of this Agreement. A. FOR BASIC SERVICES, as described in Paragraph 1.1, Basic Compensation shall be computed on the basis of one of the following PERCENTAGES OF CONSTRUCTION COST, as defined in Article 3, for portions of the Project to be awarded under A Single Stipulated Sum Construction Contract Nine and One-half percent (9 5%) Separate Stipulated Sum Construction Contracts percent ( %) A Single Cost Plus Fee Construction Contract percent ( %) Separate Cost Plus Fee Construction Contracts percent ( %) B. FOR ADDITIONAL SERVICES, as described in Paragraph 1.3, compensation computed as follows: 1. Principals' time at the fixed rate of Twenty-eight_ _ _ _ dollars ($ 28. per hour. For the purpose of this Agreement, the Principals are: Willard D. Johnson Orval Graham Wm. J. Ottem, Jr. Charles W. Sumner 2. Employees' time (other than Principals) at a multiple of two and one-half ( 21/2 ) times the employees' Direct Personnel Expense as defined in Article 4. 3. Services of Professional consultants at a multiple of one and one-half 1 z ) times the amount billed to the Architect for such services. C. AN INITIAL PAYMENT of dollars ($ -0- shall be made upon the execution of this Agreement and credited to the Owner's account. D. FOR REIMBURSABLE EXPENSES, amounts expended as defined in Article S. III. THE OWNER AND ARCHITECT agree in accordance with the Terms and Conditions of this Agree- ment that: A. IF SCOPE of the Project is changed materially, compensation shall be subject to renegotiation. B. IF THE SERVICES covered by this Agreement have not been completed within twent -four 24 ) months of the date hereof, the amounts of compensation, rates and multiples set forth in Paragraph II shall be subject to renegotiation. AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIA® • ©1974 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 2 • TERMS AND CONDITIONS OF AGREEMENT BETWEEN OWNER AND ARCHITECT ARTICLE 1 of Probable Construction Cost, shall assist the Owner in obtaining bids or negotiated proposals, and in awarding ARCHITECT'S SERVICES and preparing construction contracts. 1.1 BASIC SERVICES CONSTRUCTION PHASE—ADMINISTRATION OF THE CONSTRUCTION CONTRACT The Architect's Basic Services consist of the five phases described below and include normal struc- 11.10 The Construction Phase will commence with the tural, mechanical and electrical engineering services award of the Construction Contract and will terminate and any other services included in Article 14 as when the final Certificate for Payment is issued to the Basic Services. Owner. SCHEMATIC DESIGN PHASE 1.1.11 The Architect shall provide Administration of the 1.1.1 The Architect shall review the program furnished Construction Contract as set forth in AIA Document by the Owner to ascertain the requirements of the Project A201, General Conditions of the Contract for Construc- and shall confirm such requirements to the Owner, tion, and the extent of his duties and responsibilities and the limitations of his authority as assigned thereunder 1.1.2 Based on the mutually agreed upon program, the shall not be modified without his written consent. Architect shall prepare Schematic Design Studies consist- ng of drawings and other documents illustrating the 1.1.12 The Architect, as the representative of the Owner scale and relationship of Project components for ap- during the Construction Phase, shall advise and consult proval by the Owner. with the Owner and all of the Owner's instructions to the Contractor shall be issued through the Architect. The 1.1.3 The Architect shall submit to the Owner a State- Architect shall have authority to act on behalf of the ment of Probable Construction Cost based on current Owner to the extent provided in the General Conditions area, volume or other unit costs. unless otherwise modified in writing. DESIGN DEVELOPMENT PHASE 1.1.13 The Architect shall at all times have access to 1.1.4 The Architect shall prepare from the approved the Work wherever it is in preparation or progress. Schematic Design Studies, for approval by the Owner, the 1.1.14 The Architect shall make periodic visits to the Design Development Documents consisting of drawings site to familiarize himself generally with the progress and and other documents to fix and describe the size and quality of the Work and to determine in general if the character of the entire Project as to structural, mechani- Work is proceeding in accordance with the Contract cal and electrical systems, materials and such other essen- Documents. On the basis of his on-site observations as tials as may be appropriate. an architect, he shall endeavor to guard the Owner 11.5 The Architect shall submit to the Owner a further against defects and deficiencies in the Work of the Con- Statement of Probable Construction Cost. tractor. The Architect shall not be required to make exhaustive or continuous on-site inspections to check the CONSTRUCTION DOCUMENTS PHASE quality or quantity of the Work. The Architect shall not be responsible for construction means, methods, tech- 1.1.6 The Architect shall prepare from the approved Design Development Documents, for approval by the piques, sequences or procedures, or for safety precautions Owner, Drawings and Specifications setting forth in and programs in connection with the Work, and he shall detail the requirements for the construction of the entire not be responsible for the Contractor's failure to carry out Project including the necessary bidding information, and the Work in accordance with the Contract Documents. shall assist in the preparation of bidding forms, the Con- 1.1.15 Based on such observations at the site and on ditions of the Contract, and the form of Agreement the Contractor's Applications for Payment, the Architect between the Owner and the Contractor. shall determine the amount owing to the Contractor and 1.1.7 The Architect shall advise the Owner of any shall issue Certificates for Payment in such amounts. The adjustments to previous Statements of Probable Con- representation of a Certificate for Payment shall constitute a struction Cost indicated by changes in requirements or representation by the Architect to the Owner, based on general market conditions. the Architect's observations at the site as provided in Subparagraph 1.1.14 and the data comprising the Appli- 1.1.8 The Architect shall assist the Owner in filing the cation for Payment, that the Work has progressed to the required documents for the approval of governmental point indicated; that to the best of the Architect's knowl- authorities having jurisdiction over the Project. edge, information and belief, the quality of the Work is BIDDING OR NEGOTIATION PHASE in accordance with the Contract Documents (subject to an evaluation of the Work for conformance with the 1.1.9 The Architect, following the Owner's approval of Contract Documents upon Substantial Completion, to the the Construction Documents and of the latest Statement results of any subsequent tests required by the Contract AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIA® • ©1974 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 3 Documents, to minor deviations from the Contract Docu- 1.2.4 Through the on-site observations by Full-Time ments correctable prior to completion, and to any specific Project Representatives of the Work in progress, the Ar- qualifications stated in the Certificate for Payment); and chitect shall endeavor to provide further protection for that the Contractor is entitled to payment in the amount the Owner against defects in the Work, but the furnish- certified. By issuing a Certificate for Payment, the Archi- ing of such project representation shall not make the tect shall not be deemed to represent that he has made Architect responsible for construction means, methods, any examination to ascertain how and for what purpose techniques, sequences or procedures, or for safety pre- the Contractor has used the moneys paid on account of cautions and programs, or for the Contractor's failure to the Contract Sum. perform the Work in accordance with the Contract 1.1.16 The Architect shall be, in the first instance, the Documents. interpreter of the requirements of the Contract Docu- 1.3 ADDITIONAL SERVICES ments and the impartial judge of the performance there- under by both the Owner and Contractor. The Architect The following Services shall be provided when au- shall make decisions on all claims of the Owner or Con- thorized in writing by the Owner, and they shall be tractor relating to the execution and progress of the Work paid for by the Owner as hereinbefore provided. and on all other matters or questions related thereto. 1.3.1 Providing analyses of the Owner's needs, and pro- The Architect's decisions in matters relating to artistic gramming the requirements of the Project. effect shall be final if consistent with the intent of the Contract Documents. 1.3.2 Providing financial feasibility or other special studies. 1.1.17 The Architect shall have authority to reject Work which does not conform to the Contract Documents. 1.3.3 Providing planning surveys, site evaluations, envi- Whenever, in his reasonable opinion, he considers it nec- ronmental studies or comparative studies of prospective essary or advisable to insure the proper implementation sites. of the intent of the Contract Documents, he will have 1.3.4 Providing design services relative to future facili- authority to require special inspection or testing of any ties, systems and equipment which are not intended to Work in accordance with the provisions of the Contract be constructed as part of the Project. Documents whether or not such Work be then fabricated, installed or completed. 1.3.5 Providing services to investigate existing condi- 1.1.18 The Architect shall review and approve shop tions or facilities or to make measured drawings thereof, drawings, samples, and other submissions of the Contrac- or to verify the accuracy of drawings or other informa- tor only for conformance with the design concept of the lion furnished by the Owner. Project and for compliance with the information given 1.3.6 Preparing documents for alternate bids or out-of- in the Contract Documents. sequence services requested by the Owner. 1.1.19 The Architect shall prepare Change Orders. 1.3.7 Providing Detailed Estimates of Construction Cost 1.1.20 The Architect shall conduct inspections to de- or detailed quantity surveys or inventories of material, termine the Dates of Substantial Completion and final equipment and labor. completion, shall receive and review written guarantees 1.3.8 Providing interior design and other services re- and related documents assembled by the Contractor, and quired for or in connection with the selection of furni- shall issue a final Certificate for Payment. ture and furnishings. 11.21 The Architect shall not be responsible for the 1.3.9 Providing services for planning tenant or rental acts or omissions of the Contractor, or any Subcontrac- spaces. tors, or any of the Contractor's or Subcontractors' agents or employees, or any other persons performing any of 1.3.10 Making revisions in Drawings, Specifications or the Work. other documents when such revisions are inconsistent with written approvals or instructions previously given 1.2 PROJECT REPRESENTATION BEYOND BASIC SERVICES and are due to causes beyond the control of the Archi- 1.2.1 If more extensive representation at the site than tect. is described under Subparagraphs 1.1.10 through 1.1.21 1.3.11 Preparing supporting data and other services in inclusive is required, and if the Owner and Architect connection with Change Orders if the change in the agree, the Architect shall provide one or more Full-Time Basic Compensation resulting from the adjusted Contract Project Representatives to assist the Architect. Sum is not commensurate with the services required of 1.2.2 Such Full-Time Project Representatives shall be the Architect. selected, employed and directed by the Architect, and the 1.3.12 Making investigations involving detailed apprais- Architect shall be compensated therefor as mutually als and valuations of existing facilities, and surveys or agreed between the Owner and the Architect as set forth inventories required in connection with construction in an exhibit appended to this Agreement. performed by the Owner. 1.2.3 The duties, responsibilities and limitations of au- 1.3.13 Providing consultation concerning replacement thority of such Full-Time Project Representatives shall be of any Work damaged by fire or other cause during con- set forth in an exhibit appended to this Agreement. struction, and furnishing professional services of the type AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIA® • ©1974 4 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 set forth in Paragraph 1.1 as may be required in connec- 2.5 The Owner shall furnish structural, mechanical, tion with the replacement of such Work. chemical and other laboratory tests, inspections and re- ports Providing professional services made necessary Ports as required by law or the Contract Documents. by the default of the Contractor or by major defects in 2.6 The Owner shall furnish such legal, accounting, and the Work of the Contractor in the performance of the insurance counseling services as may be necessary for the Construction Contract. Project, and such auditing services as he may require to 1.3.15 Preparing a set of reproducible record ascertain how or for what purposes the Contractor has p g p prints of used the moneys paid to him under the Construction drawings showing significant changes in the Work made Contract. during the construction process, based on marked-up prints, drawings and other data furnished by the Contrac- 2.7 The services, information, surveys and reports re- tor to the Architect. quired by Paragraphs 2.3 through 2.6 inclusive shall be 1.3.16 Providing extensive assistance in the utilization furnished at the Owner's expense, and the Architect shall be entitled to rely upon the accuracy and completeness of any equipment or system such as initial start-up or thereof. testing, adjusting and balancing, preparation of operation and maintenance manuals, training personnel for opera- 2.8 If the Owner becomes aware of any fault or defect tion and maintenance, and consultation during operation. in the Project or non-conformance with the Contract 1.3.17 Providing services after issuance to the Owner of Documents, he shall give prompt written notice thereof the final Certificate for Payment. to the Architect. 2.9 The Owner shall furnish information required of him 1.3.18 Preparing to serve or serving as an expert witness as expeditiously as necessary for the orderly progress of in connection with any public hearing, arbitration pro- the Work. ceeding or legal proceeding. 1.3.19 Providing services of professional consultants for ARTICLE 3 other than the normal structural, mechanical and electri- CONSTRUCTION COST cal engineering services for the Project. 3.1 If the Construction Cost is to be used as the basis 1.3.20 Providing any other services not otherwise in- for determining the Architect's Compensation for Basic cluded in this Agreement or not customarily furnished in Services, it shall be the total cost or estimated cost to accordance with generally accepted architectural practice. the Owner of all Work designed or specified by the ARTICLE 2 Architect. The Construction Cost shall be determined as follows, with precedence in the order listed: THE OWNER'S RESPONSIBILITIES 3.1.1 For completed construction, the cost of all such 2.1 The Owner shall provide full information, including Work, including costs of managing construction; a complete program, regarding his requirements for the 31.2 For Work not constructed, (1) the lowest bona fide Project bid received from a qualified bidder for any or all of such 2.2 The Owner shall designate, when necessary, a rep- Work, or (2) if the Work is not bid, the bona fide nego- resentative authorized to act in his behalf with respect to tiated proposal submitted for any or all of such Work; or the Project. The Owner shall examine documents sub- 3.1.3 For Work for which no such bid or proposal is muted by the Architect and shall render decisions per- received, (1) the latest Detailed Estimate of Construction taining thereto promptly, to avoid unreasonable delay in Cost if one is available, or (2) the latest Statement of the progress of the Architect's services. Probable Construction Cost. 2.3 The Owner shall furnish a certified land survey of 3.2 Construction Cost does not include the compensa- the site giving, as applicable, grades and lines of streets, tion of the Architect and his consultants, the cost of the alleys, pavements and adjoining property; rights-of-way, land, rights-of-way, or other costs which are the responsi- restrictions, easements, encroachments, zoning, deed re- bility of the Owner as provided in Paragraphs 2.3 through strictions, boundaries and contours of the site; locations, 2.6 inclusive. dimensions and complete data pertaining to existing buildings, other improvements and trees; and full infor- 3.3 The cost of labor, materials and equipment furnished mation concerning available service and utility lines both by the Owner for the Project shall be included in the public and private, above and below grade, including Construction Cost at current market rates including a inverts and depths. reasonable allowance for overhead and profit. 2.4 The Owner shall furnish the services of a soils engi- 3.4 Statements of Probable Construction Cost and De- neer or other consultant when such services are deemed tailed Cost Estimates prepared by the Architect represent necessary by the Architect, including reports, test borings, his best judgment as a design professional familiar with test pits, soil bearing values, percolation tests, air and the construction industry. It is recognized, however, that water pollution tests, ground corrosion and resistivity neither the Architect nor the Owner has any control over tests and other necessary operations for determining sub- the cost of labor, materials or equipment, over the con- soil, air and water conditions, with appropriate profes- tractors' methods of determining bid prices, or over com- sional recommendations. petitive bidding or market conditions. Accordingly, the AR DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIA® • ©1974 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 5 Architect cannot and does not guarantee that bids will ees, or his professional consultants in the interest of the not vary from any Statement of Probable Construction Project for the expenses listed in the following Subpara- Cost or other cost estimate prepared by him. graphs: 3.5 When a fixed limit of Construction Cost is estab- 5.1.1 Expense of transportation and living when travel- lished as a condition of this Agreement, it shall be in ing in connection with the Project; long distance calls writing signed by the parties and shall include a bidding and telegrams; and fees paid for securing approval of contingency of ten percent unless another amount is authorities having jurisdiction over the Project. agreed upon in writing. When such a fixed limit is estab- 5.1.2 Expense of reproductions, postage and handling lished, the Architect shall be permitted to determine what of Drawings and Specifications excluding duplicate sets materials, equipment, component systems and types of at the completion of each Phase for the Owner's review construction are to be included in the Contract Docu- ments, and to make reasonable adjustments in the scope and approval. of the Project to bring it within the fixed limit. The archi- 5.1.3 If authorized in advance by the Owner, expense tect may also include in the Contract Documents alter- of overtime work requiring higher than regular rates and nate bids to adjust the Construction Cost to the fixed expense of renderings or models for the Owner's use. limit. 5.1.4 Expense of computer time for professional services 3.5.1 If the Bidding or Negotiating Phase has not com- when included in Paragraph II. menced within six months after the Architect submits the Construction Documents to the Owner, any fixed limit 5.1.5 Expense of computer time when used in connec- of Construction Cost established as a condition of this tion with Additional Services. Agreement shall be adjusted to reflect any change in the general level of prices which may have occurred in the ARTICLE 6 construction industry for the area in which the Project is PAYMENTS TO THE ARCHITECT located. The adjustment shall reflect changes between the date of submission of the Construction Documents 6.1 Payments on account of the Architect's Basic Serv- to the Owner and the date on which proposals are ices shall be made as follows: sought. 6.1.1 An initial payment as set forth in Paragraph II is 3.5.2 When a fixed limit of Construction Cost, including the minimum payment under this Agreement. the Bidding contingency (adjusted as provided in Sub- paragraph 3.5.1, if applicable), is established as a condi- 6.1.2 Subsequent payments for Basic Services shall be tion of this Agreement and is exceeded by the lowest made monthly in proportion to services performed so bona fide bid or negotiated proposal, the Detailed Esti- that the compensation at the completion of each Phase, mate of Construction Cost or the Statement of Probable except when the compensation is on the basis of a Mul- Construction cost, the Owner shall (1) give written ap- tiple of Direct Personnel Expense, shall equal the follow- proval of an increase in such fixed limit, (2) authorize re- ing percentages of the total Basic Compensation: bidding the Project within a reasonable time, or (3) co- Schematic Design Phase 15% operate in revising the Project scope and quality as re- Design Development Phase 35% quired to reduce the Probable Construction Cost. In the Construction Documents Phase . 75% case of (3) the Architect, without additional charge, shall Bidding or Negotiation Phase 80% modify the Drawings and Specifications as necessary to Construction Phase 100% bring the Construction Cost within the fixed limit. The providing of such service shall be the limit of the Archi- 6.1.3 If the Contract Time initially established in the tect's responsibility in this regard, and having done so, Construction Contract is exceeded by more than thirty the Architect shall be entitled to compensation in accord- days through no fault of the Architect, compensation for ante with this Agreement. Basic Services performed by Principals, employees and professional consultants required to complete the Ad- ARTICLE 4 ministration of the Construction Contract beyond the DIRECT PERSONNEL EXPENSE thirtieth day shall be computed as set forth in Para- graph II for Additional Services. Direct Personnel Expense is defined as the salaries of professional, technical and clerical employees engaged 6.2 Payments for Additional Services of the Architect as on the Project by the Architect, and the cost of their defined in Paragraph 1.3, and for Reimbursable Expenses mandatory and customary benefits such as statutory em- as defined in Article 5, shall be made monthly upon ployee benefits, insurance, sick leave, holidays, vacations, presentation of the Architect's statement of services ren- pensions and similar benefits. dered. ARTICLE 5 6.3 No deductions shall be made from the Architect's compensation on account of penalty, liquidated dam- REIMBURSABLE EXPENSES ages, or other sums withheld from payments to con- 5.1 Reimbursable Expenses are in addition to the Com- tractors. pensation for Basic and Additional Services and include 6.4 If the Project is suspended for more than three actual expenditures made by the Architect, his employ- months or abandoned in whole or in part, the Architect AlA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIAO^ • ©1974 6 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 • 1 shall be paid his compensation for services performed the other party to this Agreement and to the partners, prior to receipt of written notice from the Owner of such successors, assigns and legal representatives of such other suspension or abandonment, together with Reimbursable party with respect to all covenants of this Agreement. Expenses then due and all termination expenses as de- Neither the Owner nor the Architect shall assign, sublet fined in Paragraph 8.3 resulting from such suspension or or transfer his interest in this Agreement without the abandonment. If the Project is resumed after being sus- written consent of the other. pended for more than three months, the Architect's compensation shall be subject to renegotiation. ARTICLE 11 6.5 Payments due the Architect under this Agreement shall bear interest at the legal rate commencing sixty ARBITRATION days after the date of billing. 11.1 All claims, disputes and other matters in question ARTICLE 7 between the parties to this Agreement, arising out of, or relating to this Agreement or the breach thereof, shall be ARCHITECT'S ACCOUNTING RECORDS decided by arbitration in accordance with the Construc- tion Industry Arbitration Rules of the American Arbitra- Records of Reimbursable Expenses and expenses pertain- tion Association then obtaining unless the parties mutually ing to Additional Services on the Project and for services agree otherwise. No arbitration, arising out of, or relating performed on the basis of a Multiple of Direct Personnel to this Agreement, shall include, by consolidation, joinder Expense shall be kept on a generally recognized account- or in any other manner, any additional party not a party ing basis and shall be available to the Owner or his to this Agreement except by written consent containing a authorized representative at mutually convenient times. specific reference to this Agreement and signed by all the parties hereto. Any consent to arbitration involving an ARTICLE 8 additional party or parties shall not constitute consent to TERMINATION OF AGREEMENT arbitration of any dispute not described therein or with any party not named or described therein. This Agreement 8.1 This Agreement may be terminated by either party to arbitrate and any agreement to arbitrate with an addi- upon seven days' written notice should the other party tional party or parties duly consented to by the parties fail substantially to perform in accordance with its terms hereto shall be specifically enforceable under the pre- through no fault of the party initiating the termination. vailing arbitration law. 8.2 In the event of termination due to the fault of par- 11.2 Notice of the demand for arbitration shall be filed ties other than the Architect, the Architect shall be paid in writing with the other party to this Agreement and his compensation for services performed to termination with the American Arbitration Association. The demand date, including Reimbursable Expenses then due and all shall be made within a reasonable time after the claim, termination expenses. dispute or other matter in question has arisen. In no event shall the demand for arbitration be made after the 8.3 Termination Expenses are defined as Reimbursable date when institution of legal or equitable proceedings Expenses directly attributable to termination, plus an based on such claim, dispute or other matter in question amount computed as a percentage of the total compen- would be barred by the applicable statute of limitations. sation earned to the time of termination, as follows: 20 percent if termination occurs during the Schematic 11.3 The award rendered by the arbitrators shall be fi- Design Phase; or nal, and judgment may be entered upon it in accordance 10 percent if termination occurs during the Design De- with applicable law in any court having jurisdiction velopment Phase; or thereof. 5 percent if termination occurs during any subse- quent phase. ARTICLE 12 ARTICLE 9 EXTENT OF AGREEMENT OWNERSHIP OF DOCUMENTS This Agreement represents the entire and integrated agreement between the Owner and the Architect and Drawings and Specifications as instruments of service are supersedes all prior negotiations, representations or and shall remain the property of the Architect whether agreements, either written -Or oral. This Agreement may the Project for which they are made is executed or not. be amended only by-Written instrument signed by both They are not to be used by the Owner on other projects Owner and Architect v or extensions to this Project except by agreement in writ- . ing and with appropriate compensation to the Architect. - --- ARTICLE 13 ARTICLE 10 GOVERNING LAW - SUCCESSORS AND ASSIGNS Unless otherwise spec-iced, thtsAgreement stlafl-Se goy- _-4 Owner and the Architect each binds himself, his erned by the law of the j3rjn2lpel, e of busig ss of the partners, successors, assigns and legal representatives to Architect. AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • IANUARY 1974 EDITION • AIAO• • 51974 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 7 to ARTICLE 14 OTHER CONDITIONS OR SERVICES This Agreement executed the day and year first written above. OWNER BOARD OF COUNTY COMMISSIONERS ARCHITECT JOHNSON-GRAHAM SSOCIATES JEFFERSON COUNTY, MONTANA /hair n Willard D. Johnson, AIA Attest: County Clerk & Recorder AIA DOCUMENT B141 • OWNER-ARCHITECT AGREEMENT • JANUARY 1974 EDITION • AIAOO • ©1974 8 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 C R 974: 1. Federal Agency and Organizational Element REPORT OF FEDERAL CASH TRANSACTIONS • 2. Name of Grantee Organization 3. Report Period (Month, Day, Year) FROM I TO l I l 4. Federal Grant Number or other 5. Grantee's Account No. or Identifying No. Identifying No. 6. Federal Share of Net Disbursements a. For the Period b. Cumulative I 7. TOTALS FORM CD-286 (REV. 9-76) uSCOMM•DC 18710 AL ens es I I It UNITED STATES DEPARTMENT OF COMMERCE ' Economic Development Administration Washington, D.C. 20230 v 141g79 -U *r' Letter of Credit:/5 zo J2b 1�F� Project Number: oar--S/-2677Y - [211,,Laelt ‘1"-td-4 le 9 . 11 9X//3 59632 , , 3� 5� � ��(L.F' )L We have not received your "Report of Federal Cash Transactions" , (Form CD-286) for the quarter ended March 31 , 1979 which was due by April 24, 1979 This report, which is required by Office of Manage- ment and Budget Circular A-102 and by EDA letter of credit procedures as outlined in the "Engineering and Construction Guidelines" and in the "Financial Management Guidelines" for the Local Public Works Development and Investment Program, is due in the Accounting Division of EDA no later than 15 working days after the close of every calendar quarter. Please remember that failure to submit this report on a timely basis can result in the termination of your letter of credit. We have enclosed two copies of the report form (CD-286) including appropriate instructions. Please complete this report and return it within three weeks of the date of this letter to: Dennis J. Polivka, Chief, Accounting Division, Economic Development Administration, Department of Commerce, Room 7417 , Washington, D. C. 20230. If you need additional copies or have any questions concerning this report, please contact the finance officer in the EDA. Regional Office servicing your area. Sincerely yours , rr `�KliAlitl pI,Dennis J. Polivka Chief Accounting Division ' Enclosure • I r,, ri 4', r L c. L" ..J1.tat 4 Date __26 JULY 1978 Change Order No. 1 PROJECT JEFFERSON COUNTY OFFICE BUILDING OWNER BOARD OF COUNTY COMMISSIONERS Address BOULDER. MT 59632 CONTRACTOR HAMLIN CONSTRUCTION CO. Address BOX 64SR CLANCY, MT 59634 JOHNSON - GRAHAM & ASSOCIATES Architects and Engineers Following Changes to Subject Contract are Hereby Authorized: 1 ) Add door between offices 116 and 117 $ 285.00 2) Change wall at future probation officers room 75. 00 3) Install new 5' wide sidewalk on the north and west side of the new building from the service drive on the north side to and including the west entrance walk to the existing courthouse. 1 ,972.00 i t Contract will be(increased)(d ,,Axgd)by the Sum o4: $2,332.00 CONTRACT RECAPITULATION: ORIGINAL CONTRACT SUM . . . $ 157,359.00 Previous Changes $ SUB TOTAL $ 157,359.00 THIS CHANGE ORDER $ 2,332.00 TOTAL CONTRACT TO DATE . . , $ 159,691 .00 CONTRACTOR'S ACCEPTANCE: OWNER'S APPROVAL: ARCHITECT: HAMLIN CONST. CO. BOARD OF CO. COMMISSIONERS JOHNSO - PANAMA', A SOC. BY: -2 h1p�'..n'7L'-q� g d� - �. / / BY: 'ATE: 7 /-a 0 — / 6 : - Z — 7 r DATE: ' • `e • ,. No. 1. 39 724 • HECEIPTFOR CERT;?IED MAIL NO INSURAV:L COVERAGE PROVIDED- un" WR INTERNATIONAL MAIL (See Reverse) I SENT TO U.S. Dept. of Commerce STREET AND NO gss 'tSec. for Economic DPJ. PO `I ATE AND ZIP CODE Washington, D.C. 20230 POSTAGE W CERDFIED FEE C W 1 f)0._DELIV RV C L6 0 ^HI RIOTED DELIVER• C WN ,-_.� _.. W W `N -'OH E 10 WHOM ANG FF ¢ LATE DE.VEERI < W W r_ �A i rn m now-OWHDM.EA F INN TOIRESSDE R 6 z` E R C 0 2 S DEG-O WHOM AND IAII Nj J E E IELIVEED WITH RESTRICTED C N 0 22 i DELETE RD CC 2 = HON.TO WHOM.DATE AND o E O 2' ADDRESS OF DELIVERY WITH C I RESTRICTED DELIVERY TOTAL POSTAGE AND FEES 1$Pf 0+ POSTMARK OR DATE �i ce 6. r .• F� Tai 1 0. h I • STICK POSTAGE STAMPS TO ARTICLE TCl CIA EP riFtJ: ' CERTIRED MAIL FEE,AND CHARGES FOR ANY SELECTED OP Platdr Sr: i1 If you want this receipt postmarked,stick the gummed stuh nn e r" "the article,leaving the receipt attached,and present the artmhe hand it to your rural carrier.(no extra charge) 2, It you du not want this receipt postmarked,stink the gun • side of the article,date,detach and retain the coca'rpt.dud o 3. If yai want a return receipt,write the certified-mail number and your r t i el c receipt card,Form 3811,and attach it to the front of the stele by me the Fn=te permits.Otherwise,afix to back of article.Endorse front ot a rc e fET ai r Et°r " adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized eg i t u aI -t endorse RESTRICTED DELIVERY on the front of the article. 6. Enter fees for the services requested in the a[ nett r le receipt is requested,check the applicable blocks Ito F. 1 6. Save this receipt and present it if you make inquiry. Jeri . *.r A� 11 7 a \ • iMM:tit ., . �. etrtm.rer. 7 RETURN TO JEFFERSON COUNTY COMMISSIONERS (Name of Sander) P.O. Box 115 (Street or P.O. Haar) Boulder, Montana 59632 fi (City. State,and ZIP Code) a • SENDER: tonket ilm3 t.2.and V. Ada yew address is the "8ITIVEN TO" apace M IORtlt. I .I The filming service.is requested (check ewe)0 Show to when and date delivered 154 0 show to whom,ate,t address of delivery354 2 : 0 RESTRICTED DELIVERY. Show to whoa and date delivered. 650 RESTRICTED DELIVERY. • Show to whom,date,and address of delivery 850 2. ARTICLE ADO1AWtD Toe E. ARTICLE ORSCRIPtsott: REGISTERED NO. cRat lib NO. INSURED NO. 1139324 t os grielopr.lit 41011,110111110 er soft I have received the article described NONATURE 0 Addressee itk.nsed agent • S. ADORMIg IONNO mMIY TIONe.bQ.. 4 _.C. .: . .t L .TO CONN .tGaaC /Wail • J V C lit UNITED STATES DEPARTMENT OF COMMERCE r . The Assistant Secretary for Economic Development Washington, D.C. 20230 In reply refer to : W 12 S7 Project No. : 05-51-26274 Mr. James Sanddal Chairman, Jefferson County G Board of Commissioners 5 ,v p� K P .0. Box 115 7`l i` Boulder, Montana 59632 tese Dear Mr. Sanddal : We are pleased to enclose two signed copies of an Offer of Grant issued pursuant to your application for Federal assistance under the provisions of the Local Public Works Capital Development and Investment Act of 1976 , as amended by the Public Works Employment Act of 1977. The total project cost is based on the line item estimates contained in Attachment No. 1 hereto. Your acceptance of the Offer of Grant shall be indicated by the signature of your principal official on one of the signed copies. The official ' s signature shall be certified by an authorized official other than your principal official. Send the accepted d- 4+-iii copy to the Di ector, Rockv Mountain Regional Office, Suite 505, h Title Building, 909 17th Street, Denver, Colorado 80202 - Also, enclosed are two copies each of Form ED-1004 , "Designation of Depositary for Direct Deposit of Grant and/or Loan Funds , " and Form SF-1194 , "Authorized Signature Card for Payment Vouchers on Letter of Credit, " which must be completed and forwarded to the Regional Office in order for you to be issued a letter of credit. (The issuance of a letter of credit may not be necessary if you have an existing letter of credit from this agency, or if your total grant funding under this legislation is less than $120 ,000 ; in such cases please contact the LPW Letter of Credit Designee at the Regional Office before completing these forms . ) You are cautioned not to make any commitments in reliance on this grant, nor to enter into negotiations relative hereto, until you have carefully reviewed the terms and conditions and have deter- mined that you are in compliance or that you can comply therewith. Any commitments or undertakings entered into prior to obtaining the approval of the Government in accordance with its terms and conditions will be at your own risk. FORM ED•1028RM (REV. 6/771 USCOMM-DC 08044-P77 - 2 - We would like to remind you that on-site labor must commence within 90 days of the date of your receipt of this Offer of Grant. Sincerely, Assistant Secretary for Economic Development Enclosure FORM ED-1026RM (REV. 6/77) USCOMM-DC 64044-P77 SManeIwo EOlm I 19 Letter of Credit Number e Tyusury FRM 1000 AUTHORIZED SIGNATURE CARD 13-20- Bur.ouolAcc FOR PAYMENT VOUCHERS Bureau uu«wnn Federal Reserve Bank ON LETTER OF CREDIT Letter of Credit Issued in Favor of(Recipient) Issued by (Federal Agency) U.S. Department of Commerce . Economic Development Administration Accounting Division - Room 7417 Washington, D.C. 20230 SIGNATURES OF INDIVIDUALS AUTHORIZED ❑ ONLY ONE SIGNATURE REQUIRED ON PAYMENT VOUCHERS or TO DRAW ON THE CITED LETTER OF CREDIT © ANY TWO SIGNATURES REQUIRED TO SIGN OR COUNTERSIGN Typed Name and Signature Geed Name and Si ure rd.mes W. al Typed Name and Signature i ,-d Name and Signature .'oanne P. McFarlane I CERTIFY THAT THE SIG - RES ABOVE 'E •F THE IND . IS AUTHOR- APPROVED: FOR GOVERNMENT USE ONLY IZED TO D: • 'AYMENT V' 9 ERS •' CI •, 7, - -- -- R'.. . E . a , r t F I or,' •ATE AND SIGNATURE 4•R OFF!,IAL Med/mall DATE AND SIGNATURE OF AGENCY CERTIFYING OFFICER 1194-101 G -c z . ,cwt«-tj_ (7-rtr—nee i 7%cat tX.," c-(I f. - / , // . 7; • FOiM EDJOO4 (REV. 11-161 U.S. DEPARTMENT OF COMMERCE ECONOMIC DEVELOPMENT ADMINISTRATION DESIGNATION OF DEPOSITARY FOR DIRECT DEPOSIT OF GRANT AND/OR LOAN FUNDS SECTION I (To be completed by Grantee and/or Borrower) Name and Address of Grantee and/or Borrower Jefferson County, Boulder, Montana 59632 The First Boulder Valley Bank, Bouldes,a aortac na de 59632 has been designated as the depositary for all funds to be received directly from the U.S. Treasury Department resulting from for deposit to (Account Name and/or Number) EDA project number L — MT—OOSX—/ executed with the Economic Development Administration. Names at persons authorized to make disbursements: STATEMENT OF GRANTEE AND/OR BORROWER Joanne P. McFarlane I (We) understand that disbursements from the account may be made only for authorized costs of the projects. 9/19/77 (Signature of Aut t ed Reprosen[a ve) (Date) Chairman, Board of County Commissioners (Title of Authorized Representative) SECTION II (To be completed by the Depositary) The account identified re Section f has wh which will legally enable this depositary to receive U.S. Government G vernment checks including a power of attorney (where necessary), // directly from the U.S. Treasury Department for deposit to �/e n c.+/ ezarry (Account Natde and/or Number) without the payee's endorsement has been received and is in this depositary's custody. This bank is a member of the Federal Deposit Insurance Corporation. FIRST BOULDER VALLEY 9 :;',(—BOULDER, MONTANA SS6,31 NFL r°.td �e ZIP Code where checks should be mailed) (Name of Bank) r.7uw Name and Address of the Local Federal Reserve Bank FEDERAL RESERVE BANK ,7, OF MINNEAPOLIS Y notify li£L�ttAt4+k` B 1•t when a deposit is made in the The Depositary hereby agrees to immediate) no[if �NA �� above account. LAUREL nt &McATEE S��a2� Vice-President & Cashier `�� �9 � (Signature of Aut onzed Bank I./Ulcer) ate (Tide of Authorized Bank � finer This report is authorized by law, 42 U.S.C. 4212, 34 C.F.A. Part 256, App. A. 12 U.S.C. 265 as amended. Failure to comply can result in legal action by the United States Government to recover the balance of the deposit. uSe OMM•DC 63643•P)] • • •.a 1" • • • • ire 1' UNITED STATES DEPARTMENT OF COMMERCE The Assistant Secretary for Economic Development :z.,jf y Washington, O.C. 20230 . Project No. : 05-51-26274 Offer Date: UP 12 1877 OFFER OF GRANT Pursuant to its authority under the Local Public Works Capital Development and Investment Act of 1976 , as amended by the Public Works Employment Act of 1977 and subject to the Special Conditions (Exhibit "A" ) and the Standard Terms and Conditions (Exhibit "B- LPW" ) which are herein incorporated by reference, the Economic Development Administration, U. S. Department of Commerce (Government) offers a Grant not to exceed $ 142,000 to Jefferson County, Boulder, Montana, (Grantee) to provide financial assistance for the construction of County Office building, (Project ) presently estimated to cost $ 142,000. This Offer, the Acceptance, the Special Conditions, and the Standard Terms and Conditions shall constitute the Grant Agree- ment. Acceptance of this Offer must be returned to the Economic Development Administration prior to SEP 27 1977 ECONOMIC D LOPMENT ADMINISTRATION By: 3 ice'''. -. Assistant Secretary . for Economic Development The above Offer of Grant is hereby accepted. Date: 9/19/77 JEFFERSON COUNTY Legal Name of Grantee / B • _-_Aa■ 4—i ../`_ / Chairman, Board of County Commissioners C RTSignatur - •nd Printed Name Title of Accepting Official IFICATION (by authorized Official other than Accepting Official) The person signing this acceptance was so authorized by the r5-/ v rning Body or Board of the Recipient. ai , ft 91) c drafrticc- Clerk & Recorder 1 Signature Title of Certifying Official Joanne P. McFarlane 9/19/77 . Printed Name Date FORM ED-1029(REV. 0-77) USCOMM-DC 04210-P77 •• -:-g ADDITIONAL WORK AUTHORIZATION .Jts 15( fr81aPMENT .114C. Phone: 933-5639 Box 64 SR • Clancy, Montana 59634 OWNER'S Jefferson County Commisioners PHONE: DATE: NAME; Boulder Office Job 7-6-78 STREET JOB NAME: r108 NUMBER Boulder Office 78-10 CITY STATE STREET Boulder Montana EXISTING CONTRACT NO. DATE Of EXISTING CONTRACT CITY STATE You are hereby authorized fo perform the following specifically described additional work: I Original contract amount $157,359.00 1) We propose to add 1— 2870 left hand door with jamb and casing between Offices 117 and 116 for the sum of $285.00 2) Cost of material and labor to change wall l future probation officers room (moved approximately 4') 75.00 360.00 Revised contract price with this change order $157,719.00 If desired, the following costs to replace sidewalks not included in original price: Total number of feet included in original bid: 170 LF Total number of feet to be replaced: 420 LF Amount extra: 250 LF To demolish, haul away and replace approximately 250 LF of sidewalk 5' wide — price includes forming, pouring, stripping, and itfl finishing sidewalk with 5' cuts and W0' control joints, no wire mesh and using existing fill under slab. Total price to remote and replace approximately 250 LF — 5t wide $1,972.00 ADDITIONAL CHARGE FOR ABOVE WORK IS: $ 360.00 PAYMENT WILL BE MADE AS FOLLOWS: Same as original contract. ABOVE ADDITIONAL WORK TO BE PERFORMED UN DAME CONDITIONS AS SP`' IFIED IN ORIGINAL CONTRACT UNLESS OTHERWISE STIPULATED. / Dote 1—(9 19 7 8 Authorized Signatu =.„7,-4 - el_______....—C (OWNER SIGNS NlelE) WE HEREBY AGREE TO FURNISH LABOR AND T• 'IALS - COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS, AT ABOVE STATED PRICE. I ' Authorized Signature_ Date 1 — 1972 Ck. R ROR SIGNS XEIEI THIS IS CHANGE ORDER NO.. i NOTE:This Revision became,port of,and in conformance with,the existing contract. COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARLANE, County Clerk and Recorder James Sanddet, Chairmen, Boulder CLERK and RECORDER Vincent M. Capp, Whitehall CARLA MATLACK, Leslie J. (1,.I Sodorft, Clancy Bolide; Montana 59632 Deputy October 24, 1978 Mr. Willard Johnson Johnson, Graham & Associates 644 Grand Ave. Billings, Montana 59101 Dear Mr. Johnson: As of October 15, 1978, our records indicate that your firm has billed us and that we have paid you $16,112.00 for architectual services on the • Jefferson County Office Building project. Your contract with us is for 9.5% of the project construction cost. On the original project construc- tion contract of $157,359.00, your services would amount to $14,949.00. A construction change order on the project has increased the project con- struction cost to $159,691.00. An equivalent increase in your services according to our contract would increase your total service cost to $15,171.00. Based on this information, I would appreciate it if you could clarify for us the difference in the amounts in our contract and the amount you have billed us to date. Since final payment is not due until 100% com- pletion of the project I would also like to know if you anticipate send- ing any additional claims for your services on this project. I would appreciate it if you could respond to this request as soon as possible. Sincerely, P James Sanddal, Chariman Jefferson County Ornttission JS/kk PRESS RELEASE: November 14, 1977 RE: New County Office Building FROM: Jefferson County Commissioners CONTACT PERSON: Tim McCauley - 442-1552 Bid openings for a new County office building are scheduled for November 22, 1977, at the Jefferson County Courthouse. The new office building will be located in the southwest corner of the courthouse lot adjacent to the existing courthouse building. County offices to be housed in the new building include county attorney's office and county welfare offices. The building includes an unfinished basement which will be used for storage at the present time. Construction of the building was made possible by a $142,000 federal Lo- cal Public Works grant Jefferson County received from the Economic Development Administration, U. S. Department of Commerce. Jefferson County was eligible for the grant due to the high level of unemployment in the County. Due to grant provision requiring the construction to start as soon as pos- sible, ground breaking ceremonies will occur shortly after the selection of the contractor. Construction of the building should be completed before the end of next summer. • Jerry Hamlin }II o\ President— / • �1 1 J J t ) t /rT�y Box 64 SE Clancy, MT. 59634 9335639 O �FI �PMEhl7 GD" `NG August 2, 1978 Board of County Commissioners Jefferson County Courthouse Boulder, Montana 59632 RE: Office Building Construction Gentlemen; As you are aware, the completion date for the above project was July 31, 1978. I would like to request an extension of time on the project due to unavailability of materials. Specifically, the delay on completion can be tied to the following delays: I ' 1 ) 2i weeks lost because truss manufacturer sent wrong size trusses and had to rebuild. 2) Installation of glass — We have been waiting 4 weeks for the glass now and finally have received a delivery date of 8-18-78. If we get the windows on the 18th, it will take 1 additional week to install them, Then we can do the brickwork and finish sheet— rock and taping on the inside. 3) We still have not received our 6" blanket insulation from our MBE — Paul Construction. I have contacted him numerous times and have received a promise of delivery soon — 3 weeks have now elapsed since I first ordered this material. I have now purchased the wall insulation from another supplier and will do the same on the ceiling insula- tion , if necessary. However, Paul Construction must sell me the approximately $14,000.00 worth of material or I can't meet my MBE requirement for this project. He wants more money for the material than our contract calls for and I won't pay more. We are still negotiating this issue. ii I hope this explains the delay we have had. I also respectfully ask for a 2 month ex- tension on the project, and feel I can complete the structure in that time frame if the olass gets in this month. Respectfully yours, Ii Hamlin Construction and Development Co., Inc. k Jerry Hamlin, President cc—Johnson—Graham STANDARD FORM 1193 MAY 1973 6 TREASURY FRM 2000 ISSUING AGENCY LETTER LETTER OF CREDIT NUMBER • i .tisanes OF k rr�� A isfralaaa CREDIT 133)— 5288 g DIY° Re.7417 Auth:TREASURY DEPARTMENT ,D.C. NM CIRCULAR No. 1075. Revised AMENDMENT NUMBER AGENCY STATION SYMBOL (FOR AGENCY USE) EFFECTIVE DATE 23— -91 � 05-51-26271. 1-26-78 TO: The Federal Reserve Bank, BRANCH BANK AT Minneapolis, MN Helena Br. In accordance with the authorization of the Fiscal Assistant Secretary, Treasury Department, there is hereby authorized for the account and responsibility of the issuing agency a letter of credit: IN FAVOR OF FOR DEPOSIT ONLY TO Y `- a� . Jefferson County First Boulder Valley Ban, Boulder, Montana 59632 Boulder, Montana 59632 gJS6tP*13001-9 ACCOUNT AMOUNT AUTHORIZED ,EACH MONTH PRIOR AUTHORIZATION -THIS CHANGE Increase 0 EACH QUARTER $ 71,000.00 S - 0 .. S 71,000,00 ( WITHOUT TIME LIMIT Decrease ❑ — $ The unpaid balance of this letter of credit will remain available until you are advised in writing by the Treasury Department ttlfft this letter has been revoked.* OR 0 The unpaid balance of this letter of credit is revoked at the end of each period indicated and the full amount reestablished at the beginning of the following period until you are advised in writing by the Treasury Department that this letter has been revoked.* The amount of this letter of credit is hereby certified to be drawn against, upon presentation to you of Form TUS 5401, Payment Voucher on Letter of Credit, by the official(s) of the recipient organization whose signature(s) appear(s) on the Standard Form 1194, Authorized Signature Card for Payment Vouchers on Letter of Credit, attached hereto or previously or subsequently fur- nished you through the Treasury Department. The amount of each payment voucher paid by a Federal Reserve Bank or branch to a designated commercial bank for credit to the account of the recipient organization shall constitute payment to the recipient organization by the United States. I certify to the Treasury Department that the payments authorized herein are correct and proper for payment from the appropriations or funds legally committed and available for the purpose,when paid in accordance with the terms and conditions cited above. *This letter of credit is irrevocable to the extent the recipient organization has obligated funds in good faith thereunder in executing the authorized Federal program in accordance with the grant,contract,or other agreement. •C t� r `„At: to DATE CERTIFIED 1-12-78 `�-' '.$AUTHORIZED C r a j... ..OFFICER '„\ LL-2259 Joseph Burney Operati eg Accountant TYPED NAME AND TITLE 1193-103 r STANDARD F'dltM 1193 MAY 1973 6 TREASURY FRM 2000 ISSUING AGENCY LETTER LETTER OF CREDIT NUMBER li.i.Dasteed+0 Core...-pit OF tate Asaf t Si .7;;t 3-20-s/as `,+ a$C f e` CREDIT REDIT _, Auth: TREASURY DEPARTMENT. 1 ' •+ CIRCULAR No. 1075, Revised AMENDMENT NUMBER AGENCY STATION SYMBOL (FOR AGENCY USE) - EFFECTIVE DATE fl-2( M ESA 05-51-26274 6-14-78 TO: The Federal Reserve Bank, BRANCH BANK AT Minneapolis, ltd Helena, M! • In accordance with the authorization of the Fiscal Assistant Secretary,Treasury Department, there is hereby authorized for the account and responsibility of the issuing agency a letter of credit: IN FAVOR OF FOR DEPOSIT ONLY TO Jefferson tasty First Imam Valley Hank Boulder, MT 59632 eoalder, 11Y' 59632 83564-13001-9 ACCOUNT AMOUNT AUTHORIZED EACH MONTH PRIOR AUTHORIZATION THIS CHANGE Increase O EACH QUARTER $ 142,000.00 $ 71.000.00 $71,000.00 • WITHOUT TIME LIMIT Decrease ❑ $ R The unpaid balance of this letter of credit will remain available until you are advised in writing by the Treasury Department twat this letter has been revoked.* OR El The unpaid balance of this letter of credit is revoked at the end of each period indicated and the full amount reestablished at the beginning of the following period until you are advised in writing by the Treasury Department that this letter has been revoked.* The amount of this letter of credit is hereby certified to be drawn against, upon preitentation to you of Form TUS 5401, Payment Voucher on Letter of Credit, fly the official(s) of the recipient organization whose signature(s) appear(s) on the Standard Form 1194, Authorized Signature Card for Payment Vouchers on Letter of Credit, attached hereto or previously or subsequently fur- nished you through the Treasury Department. The amount of each payment voucher paid by a Federal Reserve Bank or branch to a designated commercial bank for credit to the account of the recipient organization shall constitute payment to the recipient organization by the United States. I certify to the Treasury Department that the payments authorized herein are correct and proper for payment from the appropriations or funds legally committed and available for the purpose, when paid in accordance with the terms and conditions cited above. *This letter of credit is irrevocable to the extent the recipient organization:hat.obligated funds in good faith thereunder in executing the authorized Federal program in accordance with the grant,contracC or other agreement. /f f��^, t. DATE CERTIFIED 6-7-78 1 %' / • J 11I � �s -"�'-i' Ats �fw ZED CERTI- ING • . ER LL-6707 --Andrew tali- r. , Op ccoantitat ..`TYPED NAME AND TITLE 1193-103 . U.S. DEPARTMENT OF COMMERCE Economic Development Administration 3 D ROCKY MOUNTAIN REGIONAL OFFICE ,,,, e Suite 505-Title Building • 909 17th St. Denver, Colorado 80202 October 19, 1977 GRANTEE RE: Round II - Local Public Works Act Ladies and Gentlemen: The Public Works Division of the Rocky Mountain Regional Office has the responsibility for monitoring, on behalf of the Government, the construction of your project. In order to better facilitate this responsibility, it is imperative that close liaison be maintained between the representatives of this office, you or your authorized representatives, and your Architect/Engineer. Please be sure to refer to the Project Number for your LPWProject when communicating with this office, whether by correspondence or telephone. The project engineer responsible for monitoring and assisting you in the construction of your project is: , Drew Bodnar 1531 Stout Street Room 333 Phone: (303) 837 -5441 Denver, CO 80202 Enclosed is a flow chart to assist you and your Architect/Engineer in the planning and construction of your approved project. Within the next few days your project engineer will be in contact with you to discuss EDA procedures and any problem areas requiring resolution. Sincerely, C 1�-Cl c �1 • William . Roberts, Chief Pub1i orks Division Enclosure FLOW CHART MILESTONE 1 MILESTONE 2 I Submit to EOA Copy or Bid Adv. Retteed Budget Recommendation for Bid Award Certified Minutes of tile Bid Opening I Letter of Certificate:Bid R epealed u - Sig.eCar cis CERTIFIED BID TAB SHEET COMPLETE BID FORM OF RIODER ED-120 Equal Employment Op portenity - OepOSItory ED-024 Clean AT Certification Ban E0.530 Part A Cnosnpnetcoc o tno I Statement D I %.'t U WWeekly Payroll Records Establish SC Project Bid if Allan Of RajCCtlOn of Low Ig Construction Ble l(gp pitta ale O _ Account Z ` Install Sign 2 4 E tl W 0 A,ce P to nco- Prep.FMYRN — Nonce to V_, Construction Grant Con fe Yence specs 6ntS gtiva ru se I Oe BAIe $tart Offer pxumyl6 br Blas r pening wdrtl proceed Conti mctlon U rogress $1 IF a W T' F Request for List Of -3 c Ctl ad9e Oetef mF ProbOMci Proposed Change -T' 1lo Sub-COntmctors 0 Order with Request for 1 Project Changes 1 a CERTIFY START OF CONSTRUCTION F I.CERTIFICATION FROM GRANTEE Et SUBMIT 2.CERTIFIED COPY OF CONTRACTOR'S Fl Montty Progreos ED-]O FIRST WEEKS PAYROLL Reports QUARTERLY REPORT NARRATIVE& CO 286 I •• I STATE OF MONTANA Office of the Governor Tkc.-a: L. Judge Gu\i°'nor Budget and Program Planning " ``'e1 G 6:"`ngs • Capitol Building - Helena, Montana 59601 PROJECT NOTIFICATION AND REVIEW SIGNOFF State Clearinghouse File Number 77-07-26 Date July 13, 1977 PROJECT TITLE: LW II Jefferson County Office Building Project APPLICANT AGENCY: Jefferson County Board of County Commissioners AGENCY ADDRESS: P.O. Box- 115, Boulder, Montana 59632 FEDERAL PROGRAM TITLE, AGENCY, & CATALOG NUMBER: Dept. of Commerce, EDA-LPW; 11.310 AMOUNT OF FEDERAL FUNDS REQUESTED: $128,000 PROJECT DESCRIPTION: Construction of new office building adjacent Sn County Courthouse for currently overcrowded county agencies. • CONTACT PERSON: _ James W. Sanddal The State Clearinghouse makes the following disposition concerning this application: x No unresolved problems were identified in the review process. The application may be submitted as received by the State Clearinghouse with this form attached. (BLOCK 1) Comments with completed application. The application must include this form plus the attached comments. (BLOCK 2) Jeane V. Richardson, Manager Montana State Clearinghouse PLEASE RETURN THIS PORTION OF FORM TO: Clearinghouse File No. 77-07-26 Montana State Clearinghouse Office of Budget and Program Planning Room 221, Capitol Building Helena, Montana 59601 • APPLICATION OFFICIALLY SUBMITTED TO ON (Federal Agency) (Date) SUBMPIED BY _ (Agency) (Signature) (Please inform this office of application approval or denial by the funding agency.) , ROBERT J. JIMENEZ& ASSOCIATES P.C. 1SpR CERTIFIED PUBLIC ACCOUNTANT OLIVtR L 2 • 01 STAR PROFESSIONAL BLDG. HOLMES 9 ', 1505 AVENUE D BILLINGS,MONTANA 59102 - „, Jim Sanddal, Chairman County Office Bldg. Project P.O. Box 115 Boulder, Montana 59632 ROBERT J. JIMENEZ & ASSOCIATES Professional Corporation 201 STAR PROFESSIONAL BLDG. 1505 AVENUE D BILLINGS.MONTANA 59102 TELEPHONE (406) 248-3106 / September 11, 1978 r/' ,i. 4 Audit Proposal teCJ -1;) Location: Boulder, MT ` Jim Sanddal, Chairman County Office Bldg. Project P.O. Box 115 Boulder, Montana 59632 Dear Mr. Sanddal: In accordance with your request for a proposal to perform a final audit of LPW Grant No. 055126274, we submit the following proposal: I am an "Independent Public Accountant" as defined in Section IV, Part B2 of the Department of Commerce "Audit Instructions for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977." I am a certified public accountant licensed on February 6, 1975 by the regulatory authority of the State of Montana. 1. I will comply with guidelines in the Department of Commerce "Audit Instructions for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977." The Scope of the audit and the resulting report will be sufficient to meet the requirements of these instructions. 2. Classification of accountants: a. CPA owner through staff; $20.00 per hour or $160.00 per (8) hour day. 3. I estimate that 6 man-days will be required to perform the audit. 4. I estimate the out-of-pocket costs to be $149.00. 5. The estimated maximum fee based on conditions present at the time of the job survey, and out-of-pocket costs to be charged for the audit, will not exceed $1,109.00. 6. Please notify us by return mail estimated date to begin the EDA audit so that we can confirm a date to begin the audit and deliver the report. 7. I agree that all the working papers prepared in connection with this audit shall be retained for a period of three years and that these working papers will be made available for examin- ation, if requested, by duly authorized representatives fo the Department of Commerce, Office of Audits, - 2 - 8. I will comply with Section IV I of the Department of Commerce's DOC "Audit Instructions for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977", in that I will promptly notify DOC's Regional Audit Manager if irregularities involving LPW grant funds as contemplated by this section of the Guide are encountered. 9. In accordance with the requirements of Section IV H of the Audit Guide any written communications by us to you regarding material weak- nesses in internal accounting control would also be furnished to appropriate DOC Regional Audit Managers. 10. By acceptance of this proposal, you are authorizing me to comply with Sections 7, 8 and 9 of this letter. Respectfully submitted, RobeEl P'J. Jimenez President If the terms of this engagement, as set forth in this letter are acceptable to you, you may so indicate by signing in the appropriate place designated below. Accepted: Name Title Date I O I O ; N ! ; 1 O I 0 O ' ' b I \ O 4f] • b + O � b 1 0 O I O O O I ° ° p I o ' c ' o Af 1 ill ' ! IMIIMINI 1 — -so- 'II 1n 3 -I-- _-_-__-4-1--_--, __- 4 i -- 1 {I i -_a f --1- - -- ' -f 1 7 — z� _ �{- r I� -1 ----1__ , =f I 1 -- ` i -- 3 - -_ I I 1 i L. r- _ - - -_1 r--t ; �� I 1` !as! -t- } - } __it { - -- - I - F - —�1 -I _ - I S 1 s _ - -1--1- F L _ r - -�-- - - �� i- - T—i r - H I- ! r— - - - -- rH. t f ��a -- �� �{� I_ _ I I —I -+- 5- 1 --- J l I } I- -it I t- -1- -I +- I -r — 1 —I I l -- -f---i ---- ��__ _--- - r=r _ - -- --- I- r 1 mar.. __4_ ,t - j —: -r ' - t _ 1 i- 1 i- T 1 - 7 - i t I--{ + ' iP',I :ii --I I --s I 1 1 I I _� l T �j- - I I c I I Y I 1 -HLthTh i i - i �- fir -?' _F-__1-_-_T -- - - - MI r - -- _-J 4 --7 — 4 - I I $ { _ -I i � � 1 III I � _ ,, 1 � I -t 1 j J ; I 1 1 - -t—_i I - - _ � I __1 , I C _ _t_ + ' a -L - ` i I 1 J 1 { r- � � I I 1 1 1 I 1 1 ( I Ill ` r -- — i __.___.___-.4=-./_ =i= _ _ { I f I- ; i - I- 1 - -- i- -t y F- LL±2HtiffLt _H- tl : 44v I r ( � - I , r i r _I__ i •MN a tL - --- -----1--- C, I I I f 1 j _ f I_ - 1 .t_, - � - —' - I i W I N �W O w b N 0 N N ON v.N J A N : L--0 v N , N O 1O.- I N I a w ti , r O ,O m ti i P I w _I , 6!ir 1 1 - — I i t —1, 1 # 4— r+� _4 I I ' I ' 4 , 7—b 7 H— � __ _ _ �� -�_ - ___ ,I ( _ - i , � - } _ - -- ` SAIL— �-- — — �, �� "as st 11 1;Il__ -_- I 1L ��!�!� 11 I� S bT"77o(T �i�-� ZI -�l l 8 __ g —�b Z --- E, _- —� � of C 6l O C -11 -a d el • . . •• ♦ ---- --- -- r �y►CI7I(l9 3D1 jj0 30700y I j 1 /I' 4'Tarr ar�`4 U.S. DEPARTMENT OF COMMERCE Economic Development Administration ROCKY MOUNTAIN REGIONAL OFFICE \'\ ,,� 1531 Stout Street,Room 333 '��^'6 O` Denver,Colorado 80202 March 20, 1978 MEMORANDUM FOR: LOCAL PUBLIC WORKS GRANTEE Dear Grantee: Federal Register of Wednesday, excerpt from the be reim- bursed is an clarifying eligible administrative costs related to February 22, The following in-house efforts may in-house/grantee efforts. from grant funds: Accounting: Normal bookkeeping efforts required to maintain 1' accounting records. adequate and accurate legal counsel which are ce- de by eligible. These are y, Legal administration r: En of the grant are elig fort discharge of the attorney's general responsi- bilities be solely ly for dis of required the b oothey for ee ndcanno the g the grantee. to grantee and cannot involve services re acquisition of land or in lawsuits involving with pre- paring 3• Procurement and Contracting: Efforts associated ue bids, should and i administering contracts would be eligible. engineer E) normally handles the bulk of these efforts• efforts should be minimal since the contracted architect/ engineer (A/ performed by the cognizant Final audits may be p allowing a 4, Auditing: Caution should be exercised in exists local to ptrf audit if any close relat s for fists State or organs the public auditor to Porganization. Refer to the audit guide with the grantee's information. Normal associated Management Activities: disbursing grant 5, Other br charges TLeasuty Division for es by grantee es by Charges also costs would be charg of checks or functions would funds n the processing Eg personnel performing Evaluation Rep eligible grant cost. Attention is called to the fact that against reimburse- be an elig prohibition ag effort (unless plans and specifications were in wta e s submitted) and inspection still pent for at he time e t application the charges for the above administrative process at the time the aPP remains. In all cases, time and attendance records and comply services must be supported by • / •vim J Y . 1'27 jam?, �? R •C Rocky Mountain Development Council 3..N 4. "Mr � i NO P. O. BOX 721 S I.U. 9 '4 �1r _. HELENA, MONTANA 59601 1979 " I'S2ost09e , 8960\ ""`, r.. "- -'rte ,y � ' `I c, c J �. .z+-2-CC.Y �,( 1.w�4 (ctt._ C,,rcf 6tn nt“,t1t bk 7)-cy /i5 j6. 3 November 6, 1978 Mr. Reg Gant Local Public Works Division Economic Development Administration 1531 Stout Street Denver, Colorado 80294 RE: L.P.W. Project #05-51-26274 Dear Reg: As a result of our telephone conversation on November 2, 1978, I am writing to clarify the status of the MBE requirements on Jefferson County's LPW project. As I explained over the telephone, Mr. Jerry Hamlin, owner of Hamlin Con- struction Co. and prime contractor on the project, listed Paul Construction of Browning, Montana, a certified MBE, on his bid documents as a supplier of construction materials. On December 18, 1977, Hamlin Construction entered into a contract with Paul Construction to supply $14,343.27 worth of construction materials. This figure is slightly over the 10% MBE re- quirement on the project which amounts to $14,200. In August 1978, Mr. Hamlin informed the County that he had paid Paul Con- struction $12,871.62 for materials, a figure equivalent to 9.06% of the EDA funds allocated to the project. However, due to a contract dispute over an increase in prices, Paul Construction would not send him the re- maining materials he had ordered. In response to his request for a time extension on the project and after conferring with the EDA project engineer about the problem, I sent him a letter on September 11, 1978, explaining the County's position as an EDA grantee (see Attachment A) . On October 2, 1978, in a letter to the County requesting an additional time extension on the project, Mr. Hamlin ex- plained the steps he had taken to comply with the MBE requirements. He also enclosed a copy of the letter his attorney sent to Paul Construction explaining the contract dispute. Paul Construction did not respond to his attorney's letter (see Attachment B and C) . On October 16, 1978, in an- other letter to the County, Mr. Hamlin stated his belief that he had made a special effort to comply with the MBE requirements, but that his efforts were futile. In order to complete the project by the extended deadline, Mr. Hamlin used construction materials he had available from other build- ings his firm has under construction. A . November 6, 1978 Mr. Reg Gant Page 2 Following up on our discussion of utilizing a MBE accounting firm to audit this project, I contacted Mr. Robert J. Jimenez in Billings, Montana. Although not listed as a MBE on the Montana Contractors Association or the Montana Department of liguways lists, Mr. Jimenez is listed as a MBE by the Small Business Administration. This was verified by Mr. John Cronholm, Deputy Director of the SBA office in Montana. Mr. Jimenez estimated his audit costs for this project would not exceed $1.109. In a telephone con- versation with him, he stated that he did not wish to re-negotiate this estimate; however, he did say that if the audit time was shorter than the estimated six days, he would reduce his charges. There were three audit estimates requested by the County on the project. One was slightly higher than Mr. Jimenez's and one was approximately $700 lower. If the County accepted Mr. Jimenez's audit estimate at $1.109, the County's MBE requirement would be at 9.84% of the IDA funds on the project. Consequently, the Jefferson County Commissioners are requesting a waiver of the 10% MBE requirement. The final percentage would be between 9.06% and 9.84%, depending on whether the County accepts Mr. Jimenez's audit estimate. To assist the County in this matter, they would like to know if your office could respond to the following questions: 1. What is an average audit cost on this type and size of project? 2. If the average costs are substantially lower than Mr. Jimenez's estimate, would your office try to re-negotiate the audit estinate cost with him? In the line item expenditure cost estimates on the project, the County had estimated administrative expenses to be $1,000. Audit costs were esti- mated to be approximately two-thirds, or $666, of the administrative ex- penses. The Commissioners would appreciate your response to this letter as soon as possible as they would like to take the necessary steps to close out the project now that construction is complete. Thank you for your assistance. Sincerely, Tim McCauley Project Coordinator Jefferson Co. L.P.W. Project TM/kw cc: Jefferson County Commissioners IMPORTANT REMINDER QUARTERLY REPORTS ARE REQUIRED AND DUE FOR THE QUARTER ENDING SEPTEMBER 30, 1977 ON ALL LOCAL PUBLIC WORKS PROJECTS. THE NARRATIVE PORTION OF THE REPORT MUST BE COMPLETED EVEN IF NO FISCAL TRANSACTIONS HAVE OCCURED. A LETTER REPORT MAY BE USED FOR THE OCTOBER REPORT. DISTRIBUTION OF QUARTERLY REPORT FORM ED-286, "REPORT OF FEDERAL CASH TRANSACTIONS" WILL BE MADE BEFORE THE JANUARY REPORT IS DUE. FOR INSTRUCTIONS CONCERNING INFORMATION TO BE COVERED IN THE QUARTERLY REPORT NARRATIVE, SEE pp. 7, Sect. 12. OF "ENGINEERING & CONSTRUCTION GUIDELINES". (Green Cover Booklet) COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARLANE Vicent M.Capp.Chairman.Whitehall County Clerk and Recorder Leslie .S dortII,Clancyn CLERK and RECORDER Cep ty MATLACK Delbert Boulder, Montana 59632 March 13 , 1979 • • Director Economic Development Administration 1531 Stout Street Denver, Colorado 80202 I Re: LPW Project #05-51-26274 I Dear Sir: The Jefferson County Commissioners respectfully request a waiver of the ten (10) percent minority business requirement on the construction of a new county office building funded primarily through .a $142,000. 00 E.D.A. - LPW grant. Due to a contract dispute between a general contractor and the minority business involved as a sub-contractor, the final M.B.E. dollar amount was 9. 85% of the EDA-LPW funds allocated to the project. Please refer to a November 6 , 1978 letter sent to Mr. Reg. Gant by the project • coordinator, Mr. Tim McCauley, for a more complete ex- planation of this request. Si erely, Chairman, Board of Co. Commissioners, Jefferson County, Montana VMC/jm • -ar, COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARLANE, County Clerk and Recorder Jamas Sanddal, Chairman, Boulder CLERK and RECORDER CARLA MATLACK, Vincent M. Capp, Whitehall Leslie J. (Lad Sodorff, Clancy Boulder, Montana 59632 Deputy .' August 3, 1978 Jerry Hamlin Hamlin Development Co. , Inc. Box 64 S.R. Clancy, Montana 59634 Dear Jerry: This is in regard to your request for an extension of completion date in regard to the courthouse addition. We recognize the problems that you have been confronted with and we are extending the completion date to October 1, 1978. We hope you will get the work completed as rapidly as possible. Sincerely, airman, Board of County Commissioners, Jefferson County, Montana JWS/jm Copies: Johnson Graham & Asso. Tim McCauley, EDA 4 el \ \\?, vb? V 1 \,,, ,,,, Nt, k C" � i ,' • , 1 ' \ t! )1 : i , iii',\ ' . ' N 1 1 i 1 I H ; , i : I 'i ! s st, • 'a a CI w v \ ;•\ ° P \ v. \ ti \ I\ 4 \ N7' \ Sr in \I LI Nz N 1%. Q - M : %., . • CERTIFICATE OF OWNER ❑ ARCHITECT ❑ SUBSTANTIAL CONTRACTOR ❑ • COMPLETION FIELD ❑ ``� AlA DOCUMENT C704 PROJECT: OFFICE BUILDING FOR ARCHITECT: JOHNSON-GRAHAM ASSOL (name, address) JEFFERSON COUNTY BOULDER, MT ARCHITECT'S PROJECT NUMBER: 7746 • TO (Owner) (� CONTRACTOR: HAMLIN CONST. CO. CONTRACT FOR: GENERAL CONSTRUCTION JEFFERSON COUNTY COMMISSIONERS JEFFERSON COUNTY COURTHOUSE BOULDER, MT 59632 J CONTRACT DATE: DECEMBER 8, 1977 DATE OF ISSUANCE: 26 OCTOBER 1978 PROJECT OR DESIGNATED AREA SHALL INCLUDE: OFFICE BUILDING FOR JEFFERSON COUNTY The Work performed under this Contract has been reviewed and found to be substantially complete. The Date of SI stantial Completion is hereby established as 26 OCTOBER 1978 which is also the date of commencement of all warranties and guarantees required by the Contract Documei DEFINITION OF DATE OF SUBSTANTIAL COMPLETION The Date of Substantial Completion of the Work or designated portion thereof is the Date certified by the Architect wl construction is sufficiently complete, in accordance with the Contract Documents, so the Owner may occupy the Work designated portion thereof for the use for which it is intended, A list of items to be completed or corrected, prepared by the Co tractor and verified and amended by the Arc! appended hereto. The failure to include any items on such list o s not alter responsibility of the Contractor plete all Work in accordance with the Contract Documents. JOHNSON-GRAHAM ASSOCIATES ARCHITECT BY DATE The Contractor will complete or correct the Work on the list of items appended hereto within from the above Date of Substantial Completion. HAMLIN CONSTRUCTION COMPANY r • DA'DA CONTRACTOR BY � The Owner accepts the Work or designated portion thereof a substantially complete and will assume full posso at (time) of BOARD OF COUNTY COMMISSIONERS _ // OWNER DA The responsibilities of the Owner and the Contract. •r maintenance, heat, utilities and insurance shall E (NOTE—Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage Owner shall assume all responsibility for this building. i AIA DOCUMENT G704 • CERTIFICATE OF SUBSTANTIAL COMPLETION • APRIL 1970 EDITION • AIA® Cs'1970•THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW, WASHINGTON, D.C. 20006 s;« "people`-.ping people" '4411fr, 1111111111 Montana International Insurance Offices in Helena and Bozeman October 24, 1978 Johnson-Graham Associates Architects-Engineers-Planners 644 Grand Ave. Billings, MT 59101 RE: Construction of office building for Jefferson County Dear Sirs: Please consider this letter as consent of the Surety, Aetna Life and Casualty, to the release of final payment and retainage on the cap- tion p oject to Hamlin Construction and Development Co. , Inc. / 74474 R.A. Hill Attorney-in-fact Aetna Life and Casualty David R.Bruck Thomas J.Downey Audrey L. Fiske Richard A.Hill Charles J.Holland now' r Patrick S.McCutcheon FVWM(P IRGENT Alvin C.Feller 1200 North Montana Avenue•P.O.Box 1164,Helena,Montana 59601 •Telephone 108/442-5380 m° THE /ETNA CASUALTY AND SURETY COMPANY LIM Hartford, Connecticut 06715 LIFE&CASUALTY POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL MEN BY THESE PRESENTS, THAT THE /ETNA CASUALTY AND SURETY COMPANY, a corporation duly organized under the laws of the State of Connecticut, and having its principal office in the City of Hartford, County of Hartford, State of Connecticut, path made. constituted and appointed, and does by these presents make, constitute and appoint David R. Bruck, Patrick S. McCutcheon, Charles J. Holland, Audrey L. Fiske or R. A. Hill - - of Helena, Montana , its true and lawful Attorneys-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States. or. if the following line be filled in, within the area there designated the following instrumentlsl: by his sole signature and act, any and all bonds,recognizances,contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance. or con- ditional undertaking, and any and all consents incident thereto not exceeding the sum of SEVEN HUNDRED FIFTY THOUSAND ($750,000.00) DOLLARS - and to bind THE.ETNA CASUALTY AND SURETY COMPANY, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of THE ETNA CASUALTY AND SURETY COMPANY, and all the acts of said Attorneys-in-Fact,pursuant to the authority herein given,are hereby ratified and con- firmed This appointment is made under and by authority of the following Standing Resolutions of said Company which Resolutions are now in full force and effect, VOTED. That each of the following officers: Cbairmen, Vice Chairman. President. Any Executive Vice President. Any Senior Vice President, Any Vice President, Any Assistant Vice President, Any Secretary. Any Assistant Secretary. may from time to time appoint Resident Nees Presidents, Resident Assistant Secretaries, Attorneys-in-Fact, and Agents to act for and on behalf of the Company and may give any such appointee such authority as his certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds. recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors may at any time remove any such appointee and revoke the power and authority given him. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the Chairman, the Vice Chairman, the President. an Executive Vice President, a Senior Vice President, a Vice President, an Assistant Vice President or by a Resident Vice President, pursuant to the power prescribed in thu certificate of authority of such Resident Vice President, and duly attested and sealed with the Company's seal oy a Secretary or Assistant Secretary or by a Resident Assistant Secretary. pursuant to the power prescribed in the certificate of authority of such Resident Assistant Secretary; or lb)duly executed (under seal, if required)by one or more Attorneys-in-Fact pur- suant to the power prescribed in his or their certificate or certificates of authority,. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile under and by authority of the following Standing Resolution voted by the Board of Directors of THE E7NA CASUALTY AND SURETY COMPANY which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: Chairman, Vice Chairman, President. Any Executive Vice President, Any Senior Vice President, Any Vice President, Any Assistant Vice President, Any Secretary, Any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such fac- simile signature or facsimile seat shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and fac- simile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. • IN WITNESS WHEREOF, THE ETNA CASUALTY AND SURETY COMPANY has caused this instrument to be signed by its Secretary , and its corporate seal to be hereto affixed this 20th day of September , 1978 :;✓"'"°.E•: THE 1' A CASUALTY AND SURET C P Y M{xTiORD. fi net, By State of Connecticut Secretary ss. Hartford County of Hartford On this 20th day of September 1978 , before me personally came VINCENT A. WALSH to me known, who, being by me duly swan, did depose and say: that he is Secretary of THE ETNA CASUALTY AND SURETY COMPANY, the corporation described in and which executed the above instrument; that he knows the seal of said cor- - -.peration: that-the-seal affixed to the said instrument is such corporate-seal;and that he executed the said instrumanlonebebalf of he!nrpnration by authority of $h office under the Standing Resolutions thereof. µCs tir t 9a V yi 4 9'roao My commission frl� :rch 31, 19 ?e Notary Public CERTIFICATE I7 I, the undersigned, Assistant Secretary of THE ETNA CASUALTY AND SURETY COMPANY, a stock corpaation.of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked. and furthermore, that the Standing Resolutions of the Board of Directors. as set forth in the Certificate of Authority, are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hanford, State of Connecticut Dated this 24th aay o! October , 19 78 \r\r s corn % / fly/�AC4 i2- Assistant Secretary .15-1922.01 1Mt 12-i2 PRINTED :N U S A y j mimeo.JOHNSON/VA ORVAL M GRAHAM NAPE WRiJAMJ.OTTEM.JR.NA 4 r' - GyiARIESW.SIMNER.JA , EUGENE J.VOGLNA —, HAM Assails !„ ,,TS/ENGINEERS/PLANNERS 644 GRAND AVENUE, BUNGS,MT 59101[ 245-6363 u. 25 October 1978 James Sanddal, Chrm. Jefferson County Commissioners ' Jefferson County Courthouse JK ,K Boulder, MT 59632k Gentlemen: TUB The following is a breakdown of paymen, ived from you for the Architectural FeCkof the J -n County Office Building Project per your lette �"- .uiry of 24 October 1978. The Construction Cost $ x A/E Fee @ 9.5% Payments received on Contract _ , le _Expenses per '" of "Contract $10,640.00 '.;_, 25 1,408.90 t : 47 298.97 . -7.26 328.88 .- ..: .26 ,, 986.64 try 1,022.17 4"-‘4.0.24 s $14,685.56 The total amount left on the Construction e., l ct A/E Fee is $485.44 unless there would be another ; .,-ii,:::: r to the con- tract. A mistake on the statement dated -. . -r 1978 in- advertently added the toll call and travel-,., so there is a credit on the reimbursible expenses of $ ' , The reimburs- ible expenses are in addition to the A/E , „ ' _ -scribed in 5 Article 5 of the contract. I hope this. answers your questions but if f - y g '{ further we can help with, please-lit' us „�. an thin a V 4 Sin rely' F JO. /N-G' r' AS OCZATES X ■ ta E ge ogi 'AIA , l �( I W P t SET TAB STOPS AT ARROWS • Certificates oLJnsurant e ' ...— " ' ccocci THIS CERTIFICATE IS ISSUED AS A MATTER OF H ALTEATL.', COO AND CONFERS "cB RIGHTS UPON THE erc BELOW. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAWE"M60RP.E.V BY THE POI CC.; LISTED BELOW. NAME AND ADDRESS OF AGENCY AY p f , IJ COMPANIES AFFORDING COVERAGES 3054 MT INTL Idh �T COMPANY A £TNA C & S LETTER COMPANY B LETTER NAME AND ADDRESS OF INSURED COMPANY LETTER HAMLIN CONST & DEVELOPMENT CO., INC COMPANY D LETTER COMPANY C - LETTER G This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. COMPANY POLICY Limits of Liability in Thousands(00W LETTER TYPEOF INSURANCE POLICY NUMBER EXPIRATION DATE EACH OCCURRENCE AGGREGATE — - - - GENERAL LIABILITY 1000 1000 BODILY INJU�4r $ $ ©COMI/RRHLNSYE ICBM PREMISES—OPERATIONS I PROPERTY DAMAGE $ 500 $ 500 EXPLOSION ANC COLLAPSE HAZARD FAUNDERGROUND HAZARD PRODUCT S/COMPLETED 55AB202202CMA 6/6/79 ' K (� OPERAS IONS HAZARD BODILY INJURY AND LAJ CON TRACTLIAL INSURANCE PROPERTY DAMAGE $ $ n BROAD FORM PROPERTY COMBINED DAMAGE ®�INDEPENDENT CONTRACTORS t' PERSONAL INJURY PERSONAL LYJURY $ AUTOMOBILE LIABILITY BODILY INJURY I $500 (EACH PERSON © COMPREHENSIVE FORM BODILY INJURY $ (TANNED (EACH OCCURRENCE) 1DDD 1,RED PROPERTY DAMAGE $ 500 11 H BODILY INJURY AND X N,,N oNNED PROPERTY DAMAGE $ COMBINED EXCESS LIABILITY BODILY INJURY AND UMBRELLA FORM PROPERTY DAMAGE $ $ ❑ OTHER THAN UMBRELLA COMBINED ■ FORM WORKERS'COMPENSATION STATUTORY and --- EMPLOYERS'LIABILITY I s ,E•HAcaorro, OTHER SCRIPTION OF OPERATIONSiLOCATIONS^lEWCLES JOB AT CONSTRUCTION OF AN OFFICE BUILDING FOR JEFFERSON COUNTY, BOULDER, MT Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OFCERTIFICATE HOLDER ,.� BOARD OF COUNTY COMMISSIONERS IssueD i JEFFERSON COUNTY COURTHOUSE 040DATE ��� "" BOULDER, MT 59632 � A , -1". R PRESENTA E Ln To S:e..e Boar1 of _. ._c .-. r. 1. Contract awarded by Jefferson County Box 115, Boulder, Montana 59632 (P._.. ) (Address) —i- 2. Contract number/official designation Court House Annex Building 3. Date contract was awarded December 8, 1977 4. Location of work to be performed County Courthouse Lot 5. Brief description of work to be performed_ Construction of 2,575 sq. ft county office building 6. Contractor or subcontractor to whose account the 1% payment is to be credited _ Hamlin Construction , Box 64 Star Route, Clancy, Montana 59634 Mont. Contr 4-'3785-A (Name) (Address) 7. Gross sum of increment due contractor or subcontractor at time of this report (Including any amounts withheld until completion of job.) . . Hone` 8. Gross sum of increment due contractor or subcontractor at time of this report (Excluding any amounts withheld until completion of job). . . . none 9. Amount transmitted to state board of equalization with this report (1% of line 8) 1596.93 Net amount paid contractor or subcontractor at time of this report (Line 9 subtracted from line 8) 159,691.00 Amount transmitted to state board of equalization upon completion of job (1% of any moneys withheld until completion and approval of job) 1596.93 "his report submitted by Joanne P. McFarlane (Authorized Representative) rnnnt Ti rtle)lark and P rnrder ,January 10, 1 79 Dat e) Hamlin rnnctrurtinn any Aa ctClanry, y, 34 _ (Prime contractor) Address) (Subcontractor) (Address) (Awarding Agency) .44', 14, , 11 1.1 Lal 511. , $ 2 E7 13 n t. Total $ WILL PAY TO State Department_o_f_ReYtnue or order - -(),Y. . • ' IHI I t DOLLARS FOR Hamlin construction 4 % Out of any Money in the Treasury belonging to the COUNTY BUILDING .FUND. Presented for Payment - Not Paid for Want of Funds. Chairman"3:dot County COminIssforieri ,, , ,, County Treasurer. County Clerk. 1:0 9 2 Liii0 L 11-0: COMB. 1.72 40517 TRIBUNE I OCT 5 1978 #23 BOULDER, MONTANA, , 19 The Treasurer of JEFFERSON COUNTY, MONTANA $ 1_78.84 Int Total$ WILL PAY TO _State_Board sj_Resenge_ or order arEFFC'P dirk I 7 8 an-o18 14 n't.t. .DOLLARS FOR i = HantLLnConstructJ em Out of any Money in the Treasury belonging to the N siOsia.TY BUILDING F D. Presented for Payment , 19 Not Paid for Want of Funds. AIM Charlideif Count Commissio ers. County Treasurer. 0i County Clerk. ':oq 2 11101 114: . , • 350 COMB. 2.71 40517 TRIBUKE s NO I/ • , #2 7 BOULDER, MONTANA,. icon The Treasurer of JEFFERSON COUNTY, MONTANA $_3_81-63 Int Total$— State Department of Revenue WILL PAY TO_ or order I /14 E 6 3 ea LS c1 f_if r n an 91;se DOLLARS FOR Haml in Construction on New County Building Out of any Money in the Treasury belonging to the.______CPIATY___PP I Presented for Payment__ _ 19 Not Paid for Want of Funds. / I Chairmay3o4l of County Commissioners. County Treasurer, L.,/ CountstClerk.---- 1:0 9 2 11,101 ILI: 1i 3e irecs.6rer o'i Irit:.'uk I i I , ft:"ti1:41!1141.1 178. 53 1,,t . Total $_.. ---- -. __ _ State Board of Revenue WILL PAN" TO -_---- - _ -T or order _ ___ -- ----- I . , a- I - ti,--CLtj r! /'' -,'} - ':----_ ----_DOLLARS FOR_. .__. __._-__1% contractors 'tax (Hamlin....Construction) .—_ Out of any Money in the Treasury belonging to the CO filly l!IL_DING FU "I Presented for Payment_----_._.._._—___.._-__._ , 19___ _ __5.-/__' _-_ -__ Not Paid for Want of Funds. ! Chairman Board of County Co _Commissioners. -- - County Treasurer. � Count_ Clerk. 1:09 2 L..01141s 350 COMB, 2.72 40517 TRIBUNE 0, 1 JUL 3 1978 15 BOULDER, MONTANA,`l — 'J_-.___-__,19__-__ The Treasurer of JEFFERSON COUNTY, MONTANA zo7 68 Int. ----------- Total$------------------- WILL PAY TO----- State Board of Revenue .or order �:.�TF: - mil . .Vt s. !- .2 ,, c s } : 1 DOLLARS FOR _sSate._ li tax (_Hamlin _Cms_t ruction) _________ Out of any Money in the Treasury belonging to the . C9 -TY _Bi�11,DIN&_-_ FUND. - i din --"c. Presented for Payment--------- 19 �{i Cha .oardof,o, n •Com issloners. Not Paid for Went of Fends. r ,_A dear _ ________--.__-_— -- / County Clerk. County Treasurer. 1:092L1110L114: 350 COMB. 2.72 40517 TRIBUNE 0 1 AUG BOULDER, MONTANA, U -- 7178---._,19.__--_ kt8 t The Treasurer of JEFFERSON COUNTY, MONTANA $222._19_____- Int. Total$—-----_- ---- WILL PAY TO SjA De i. FMLttLQ -13EY€NiJ ___..__ or order t9 ..- ,z, :.k'x 2 9 t -- (✓w 1 r L,�f��:'s-- � �-� -���(LW-CIS---- DOLLARS 114 Hamlin-_Cons.true-tion_huiLdi.ng_project FOR - -----Out of any Money in the Treasury belonging to the t-COUNTY---BU I-LD I NG `___FUN�r /' � Presented for Payment. ..-----------------, 19__ \i-=_(f iic. " - Not Paid for Want of Funds. 1 Cha and f county dinniala;I;E:r r_.._ ,� : <... -_ - —_ County Treasurer. County Clerk. 1:092 Line 1L41: 1. I kik;.:4 I,ei isi I •L,Lie IC i:11 1.4116;iii 61 It 14,4 V11.1 1 7.0 0 Int Total$ State Department of Revenue WILL PAY TO or order tilL --6;1.11-0-15.:E"-- DOLLARS FOR Earn] Cdns tr tan At__ out of any Money in the Treasury belonging to the COUNTY BUILDING _FUND. Presented for Payment • 19 _ -7 2 Not Paid for Want of Funds. Chairmanpoard of County Commissioners. - 1/' . County Treasurer. County Clerk. 1: 9 2 LII.0 1 L14: nso come 2.72 40517 TRIBUNE 0 I #5 BOULDER, MONTANA, ,19 The Treasurer of JEFFESON COUNTY, MONTANA 46.98 Int. Total$ State Department of Revenue 9 WILL PAY TO __or order citt, E_BAEL ,-8 DOLLARS FOR 1% - Hamlin Conttructliin & Development - New County Building Out of any Money in the Treasury belonging to the NEW BUILDING _FUND. Presented for Payment , 19 /".-Th • - Not Paid for Want of Funds. Chairm-4-Board of _ County Treasurer. County Clerk_ 1:0 9 2 /1110 I Ito: ,•.-, . 350 CONS. 2-72 40517 TRIBUNE ,..AL,3* I BOULDER, MONTANA, MAY aza ,19 The Treasurer of JEFFERSON COUNTY, MONTANA 196.95 Int. Total$._ WILL PAY TO State Department of Revenue _or order t'titttittr-Cr..,--T,Tri • .142.:Lesia s_' 157. :11; DOLLARS FOR state 1%- (Hamlin Construction) Out of any Money in the Treasury belonging to the COUNTY-BUILDING ________ Presented for Payment , 19 -- Not Paid for Want of Funds. Chattunan Board of County Commissioners. • • 1.-Jr County Treasurer. County 2-/1:09 2 1..0 L • 1-111 IIT 5^1�'1 •• ii. '_If r=9salt`, c_ BLAP1 4. ' TRUCT! . A — 3V1?41 %$ 1429 Aspen #3 Helena, PIT 59601 433-1340 ,FEEL O P M E N T CO , LNG • November 2, 1978 County Commissioners Jefferson County Boulder, PIT 59632 Gentlemen; I am enclosing two copies of my final billing for the Boulder Office Project. I have ordered but have not receivedbthe hardware for the basement doors; the double weatherstripping at the windows and the rubber door bumpers on the metal doors. I have contacted all parties concerned and hope to have all punch list items completed within one week. Very Truly, Hamlin Construction and Development Co.,Inc. U U President kls 1. Federal Agency and Organizational Element REPORT OF FEDERAL CASH TRANSACTIONS 2. Name of Grantee Organization 3. Report Period (Month, Day, Year) FROM I I I TO 4. Federal Grant Number or other 5. Grantee's Account No. or Identifying No. Identifying No. 6. Federal Share of Net Disbursements a. For the Period b. Cumulative 7. TOTALS FORM CO-266 (REV. 8g61 USCOMM-0C 18716 P'76 (TEAR OFF BEFORE FORWARDING) INSTRUCTIONS FOR PREPARING PAGE 2 OF THE REPORT OF FEDERAL CASH TRANSACTIONS Use this page only when the Report of Federal Cash Item 5—Space is reserved for the grantee to show its account Transactions covers more than one grant. or other identification numbers. Item Item 6a— Show the net disbursements (gross disbursements tem 1 — Enter the name of the Federal grantor agency and less program income received) made from Federal cash during organizational element to which this report is submitted. the reporting period for each p g p grant or line item shown under Item 4. Item 2—Enter only the name of the grantee as shown on Item 2 of page 1. Item 6b—Show the cumulative net disbursements made for each grant or line item under Item 4. Item 3—Enter the reporting period covered by this report as Item 7 — Enter the totals for Columns 6a and 6b.The total of shown in Item 10 of page 1. Column 6 should be the same as the total on Line 11h on Page 1. Also,the total in Column 6b should be the same as the sum Item 4—Enter the Federal grant number for each grant listed. of this period's disbursement (Column 6a), the adjustments Provide a subdivision by other identifying numbers if required shown on Line 11i on Page 1, and the cumulative disburse- by the Federal grantor agency. ments in the last report.Explain any differences. n)a 4.4 11F1 TY "' `� `I ' i-1 ' r' 7 ' - 1, 1 «--, L ,, , x" , / 'a , 1*atilp ,OA k t � os/ I oSi _ � + 1 oL I�6/ ,__ + oor \ 6 ' see b y SYZ' i ` osr osr , _sir s' b1 sir oo g 1. std osj Jig cob ILI ' ✓f µ$/ .s! Alai,-;r Ali/ +s! / ts/ ,,S/ .r/ puS/ $1 u3/ Jill r3/ ,:/ gJ1 a ' usi .:/ y e Alit $1 N + -nq Aviv d.3 41q1 70` %o Arta 7411/ yvw 9 u fib?, f RM DC Public Community Action agency serving Broadwater, Jefferson and Lewis and Clark counties ,1.11110"r 74 © aY MCAMAIPI AD N lN? MUNCJ 0 P. O. Box 721 • 201 South Last Chance Gulch • Helena, Montana 59601 • (406) 442-1552 1?,. s t z Council Programs include Head Start •• VISTA •• Community Action •• Helena Indian • Alliance • Family planning • Youth Conservation Corps • SPEDY • In-School Youth Program • RSVP • Senior Center • Area IV Council on Aging • Foster Grandparents •Daily Dinner Club CERE IRONER r._ ".Clot s l Y July 21, 1977 `8 G o-c Mr. George Robertson Economic Development Administration 909 17th Street - Suite 505 Denver, Colorado 80202 RE: L.P.W. Project #L-MT-0086-1 Dear Mr. Robertson: As a result of our telephone conversation of July 21, 1977, I am sub- mitting on behalf of the Jefferson County, Montana Commissioners a revised budget sheet for their L.P.W. grant. The total budget for the project now totals one hundred forty-two thousand dollars ($142,000). This amount corresponds to the revised E.D.A. planning target allocation for the County. The local govern- ment contribution, which was submitted as part of the application for Round II funding, has been eliminated. The budget sheet reflects in the previous estimate column the amount of funds requested for Round I funding. Also, enclosed are two copies of the revised budget. If you have any questions on this project, please contact me or Mr. Milo Westburg by telephoning 442-1552. Sincerely, A. ./6. C / ( _ Cc GC (#4"- Tim McCauley, Director --_j Community Development TM/kw Enclosure December 1, 1977 Mr. Bill Roberts Local Public Works Division Economic Development Administration 1531 Stout Street, Room 333 Denver, Colorado 80202 RE: Jefferson County, Montana,.L.P.W. Project Project number 055126274 Dear Mr. Roberts: Due to the rebidding of our Local Public Works Project, Jefferson County requests a waiver of the ninety day start of construction re- quirement. The request for a waiver is based upon the necessity to rebid the project. Originally the project was advertised for bids on November 3, 10 and 17, 1977. Bids were to be opened on November 22, 1977. On November 21, 1977 the lack of interest in the project by a general con- tractor required the County to cancel the bid openings. The project is being readvertised for bids on November 24, December 1 and December 8, 1977. Bids are scheduled to be opened on December 8, 1977. Although we will attempt to have on-site construction started prior to the ninety day expiration date, December 13, 1977, we anticipate that it will be difficult for a contractor to start prior to the expiration date. Consequently, the request for a waiver. We do believe, weather permitting, that construction could begin within fifteen days of the expiration date or no later than December 28, 1977. . We would appreciate it if you could respond to our request as soon as possible. If you need any additional information concerning this request on the project, please contact Tim McCauley, Project Coordinator, by tele- phoning (406) 442-1552. Sincerely, JiM Sandell Chairman, Board of Commissioners Jefferson County JS/bc • iwiI611 IV 'i I u� WNW' 1 i -at—• thin NAME AND ADDRESS OF AGENCY International ins. ., Iac� COMPANIES AFFORDING COVERAGES Mama. _ t. 04 Max 116 COMPANY A _—.-- Oslaaa, Xt. 59601 Aetna Casaalty s Surety Cannon, COMPANY B LETTER • NAME AND ADDRESS OF INSURED LETTER C Manila Construct ion s Dsw A a lop nt Co. • Sac. COMPANY D tog µ' Star louts LETTER Clancy, At. 5963' COMPANY E • ��KK LETTER This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. COMPANY POLICY Limits of Liability in Thousands(006) LETTER TYPE O°INSURANCE POI ICY NUMBER EXPIRATION DATE EACH AGGREGATE OCCURRENCE GENERAL LIABILITY BODILY'NJURY g 7� $ I MO ®COMPREHENSIVE FORM �•W�I ❑PREMISES-OPERATIONS PROPERTY DAMAGE $ 500 $ 500 EXPLOSION AND COLLAPSE 500 HAZARD ❑ UNDERGROUND HAZARD 5 PRODUCTS/COMPLETED O HAZARD SS x 206355 cca 6-6-3 BODILY INJURY AND rfh CONTRACTUAL INSURANCE PROPERTY DAMAGE $ $ A r I BROAD FORM PROPERTY I COMBINED A (�i DAMAGE L INDEPENDENT CONTRACTORS • PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY BODILY INJURY _ (EACH PERSON) b El COMPREHENSIVE FORM BODILY INJURY • 1,000 A I - A ® OWNED (EACH OCCURRENCE) ® HIRED 55 AL 20 leer 6-6-7$ PROPERTY DAMAGE g 500 A BODILY INJURY AND /• ® NON-OWNED PROPERTY DAMAGE $ COMBINED EXCESS LIABILITY BODILY INJURY AND • UMBRELI A FORM PROPERTY DAMAGE $ $ • OTHER THAN UMBRELLA COMBINED FORM WORKERS'COMPENSATION. STATUTORY and EMPLOYERS'LIABILITY $ I=cTicTmrno OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES For Job: Canaral Construction of an Office Mulidlag for &efforts Casty, Moulder Notts Cancellation: Should any of the above described policies he cancelled before the expiration date thereof. the issuing com- pany will endeavor to mail O days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERT IFICATE HOLDER �r� DATE ISSUED: s a^a° 200. 1971 board of County tMalssienaals Jefferson Carty Courthouse Moulder. Mt. 5963/ ' AUTHORIZED REPRESENTATIVE, 'ion „ .cn A]li curt arse � U.S. DEPARTMENT OF COMMERCE Economic Development Administration t ROCKY MOUNTAIN REGIONAL OFFICE \.,o,? Suite 505-Title Building 909 17th St. Denver, Colorado 80202 Date: July 7, 1977 Mr. Tim McCauley Jefferson County Box 115 Boulder, Montana 59632 Dear Applicant: This is to acknowledge that on July 7, 1977 the (Date) Economic Development Administration received your application for a grant of $ 128,000.00 for a County office building project (Project Description) in Boulder, (Location) Montana EDA has begun to process your application for consideration under the Local Public Works Capital Development and Investment Act of 1976, as amended by the Public Works Employment Act of 1977. The Project locator number assigned to your application is No. MT-0086-1 and should be used as a reference in future correspondence. Sincerely, Regional Director FORM ED-1029 RM I R EV. 5-77) USCOMM-DC 63994-R77 4 V t U.S. DEPARTMENT OF COMMERCE 7 ' Economic Development Administration \; ROCKY MOUNTAIN REGIONAL OFFICE ,,,,,.✓ Suite 505-Title Building 909 17th St. December 12, 1977 Denver, Colorado 80202 Mr. Tim McCauley Jefferson County County Courthouse Box 115 Boulder, Montana 59632 Subject : LPW Project No . MT-0086, Courthouse Construction Historical Coordination Condition Clearance Dear Applicant : This office has received advice from the State Historical Preservation Officer (SHPO) that having review plans and specifications for the subject project , he is satisfied the Historical Coordination Condition placed on the project as part of the Grant Award has been met . Accordingly, you are authorized to proceed with the advertising for construction bids with the understanding you will utilize the plans and specifications approved by the SHPO. Any deviation from the approved plans and specification will be permitted only on further authorization from the SHPO and concurrence from this office . It is recommended , in the event that any historical , archeo- logical , or other cultural artifacts , vestiges , or remains are found prior to , during , or after any earth disturbance or construction in the proposed project area, that the State His- toric Preservation Officer will be notified immediately and the site and the materials will be protected from further dis- turbance until a professional examination of them can be made or until some other form of clearance to proceed is authorized by the State Historic Preservation Officer or his designated representative . cerely 7 d /raig M. Smith Regional Director cc : State Historic Preservation Officer Advisory Council on Historic Preservation Special Assistant for the Environment , EDA RECD JUL 271977 III MONTANA HISTORICAL SOCIETY I� 4 ,4 225 NORTH ROBERTS STREET • (406) 449-2694 • HELENA, MONTANA 59601 ;Rrmk .04 July 26, 1977 Mr. Tim McCauley Director of Community Affairs Rocky Mountain Development Council P. 0. Box 721 _____ Helena, Montana 59601 Re: EDA Project Jefferson County Construction of New Office Building Dear Mr. McCauley: Pursuant to the request from your office, we wish to make the following • comments: Based on the information provided, and on the preliminary plans, we foresee no adverse impact to historic and/or archaeologic resources from the above referenced proposed development. • If the project is funded, however, we request the opportunity to review the final plans in order that we may make the full assessment before construction begins. We are aware of the need to expedite the review process and we will make every effort to keep the procedures moving forward in order that the project not be delayed. Thank you for contacting us. Yo r ly f K:n K'rt: S ate storic Preservation Officer KK:AT:vk CC: Eugene Vogel • Johnson, Graham and Associates, Billings Dr. John DeHaas, Bozeman s 3t '"C'rFfl WLSDC 343 mATELETYPE CENTER 2 17 RAAUIJA7 RUWLRDJ0019 3362011-UUUU--RUWLSDG. 03PM ' :HELENA.MT. CEDA 'M WILLIAM J ROBERTS CHIEF PUELIC WORKS DIV USDOC KVA DENVER CO TO TIM MCCAULEY JEFFERSON COUNTY BOARD OF COMMISSIONERS COUNTY COURTHOUSE BOULDER MT 59632 PT 1,° SUBJECT: NINETY-DAY CONSTRUCTION START OUR RECORDS INDICATE THAT YOUR GRANT OFFER WAS RECEIVED ON SEPT EMBER 15, 1977, FOR YOUR PROJECT NO. 05-51-26274 WHICH CONSTITUTES THE 90-DAY TIME REQUIREMENT FOP THE START OF CONSTRIJCTI'ON . THIS TELEGRAM IS YOUR FINAL NOTIFICATION THAT YOUR PROJECT MUST BE UNDER CONSTRUCTION BY DECEMBER 13, 1977. FAILURE Tfl MEET THIS REQUIREMENT, PER GRANT AGREEMENT ASSURANCES, MAY RESULT IPJ PROJECT TERMINATION. YOUR IMMEDIATE RESPONSE IS REQUESTED REGARDING PROJECT STATUS AND SCHEDULING FOR COMPLYING WITH THE 9E-DAY CONSTRUCTION START REQUIRE MENT . IF YOU SHOULD HAVE ANY QUESTIONS PLEASE CONTACT DREW BODNAR AT ( 303) 837-5441 . BT CONE _ MATION COPY' TM 9 DI 0019499SMION OF A MESSAGE TELEPHONED e ' J ,3 3cA TO � .. ON1°) .-.&-' .77 AT -3•'O7/1M GENERAIt.ypiERV10ES AQM?P:ISTRATION ,,,MT-158.5-5240 (FTS) - ;--- J - 448-5240 (COM'L) NNNN t 71148 4.LSL6e :: "C�Y�•z ' :2-•1;C• • , • • • • • • • • • • • h ` 71', }, 1r5Yfia ..la .. .�..seals_ .. e ,... P -� r•"#<ipC / U.S. DEPARTMENT OF COMMERCE Economic Development Administration 1), 4, ROCKY MOUNTAIN REGIONAL OFFICE ,,,,,,� Suite 505-Title Building 909 17th St. Denver, Colorado 80202 December' 7 , . 1977 Mr. James Sanddal Jefferson County Board of Commissioners Boulder, MT 59632 Re: LPW Project No. 05-51-26274 Dear Grantee: This is in response to your request of December 1, 1977 . Your request for the indicated waiver is hereby granted: /Sue a. 90-day start of construction deadline extended by 15 days. construction to start no later than December 28, 1977 . / /- b. 10 Percent MBE Requirement: A full waiver / /; or, the requirement is reduced to percent / /. / /- l:. Waiver ui euLLLpeciLive bidding requirement. (never to FMC 74-7, Attachment 0, Section 3c(6) , last paragraph, page 4; and MBE Technical Bulletin, October 11, 1977, III, Section 3, last paragraph, page 7. / / d. Other. Remarks: An extension is needed to allow grantee to overcome a lack of interest by general contractors. Sincerely, Craig M SSmith � 1t Regional Director 1L • • w,r.wcp� c. U.S. DEPARTMENT OF COMMERCE • of • Economic Development Administration ti ROCKY MOUNTAIN REGIONAL OFFICE >4a,oi Suite 505-Title Building 909 17tH St. Denver, Colorado 60202 July 14, 1977 Jefferson County Commissioners Project Locator No. MT-0086-1 Post Office Box 115 Boulder, Montana 59632 Dear Applicant: Your request for modification of the. 10% Minority Business Enterprise requirement appended to the application supple- ment as Exhibit S-VI-4 will be held by this office in abeyance until after the mailing of the grant offer package. Within the grant offer package will be full instructions concerning modifications to the 10% requirement as well as the five day report form to be given to the prime contractor upon award of the contract. On said form, the prime con- tractor will list the minority firms he intends to use during the construction phase of the project. Also enclosed in the grant offer package will be a directory of Office of Minority Business Enterprise funded organizations that will be of use in contacting minority firms in your trade area. The appli- cant should contact said OMBE funded organizations upon receipt of the grant offer package. Please keep in mind that under our guidelines, justifications for modifications of the 10% requirement will be based partly on sufficient good faith effort in the locating and utilization of minority firms in your trade area. Also, please note that fulfillment of the 10% minority business requirement is not limited to prime and subcontractors. Such endeavors as minority accounting, minority supplies, as well as minority architectural and engineering consultantships may be included as partial fulfillment of the 10% requirement. If you have any questions regarding the 10% requirement, you are encouraged to call Mr. Jon Roybal at (303) 837-5441 for assistance and information. Sincerely, 0. ' 'eland, Chief Civil Rights Division E.D.A. PUBLIC WORKS PROJECT GUIDELINES A. Special Conditions: 1. Must be met before construction starts. B. Budget Expenditures: 1. E.D.A. approval required on: a. Major line item expenditures. b. Major change orders. 2. E.D.A. should be contacted on: a. Use of contingency. b. Use of under-run funds. c. Over-run costs must be borne by grantee. 3. Eligible Expenditures: a. Administrative costs include; travel, legal advertising, tele- phone calls, paper, etc. b. Project inspection costs include; architect inspection, project coordinator (must not be an employee of the grantee - needs to be a contract), audit expenses (state audits are allowable). C. Special Bid Requirements 1. Davis-Bacon wage scale: a. E.D.A. will send scale to grantee. b. Bids must include decision number, date and location. c. Grantee is responsible for maintaining weekly pay roll sheets for construction employees. 2. Veterans benefits. 3. Buy - American clause - open to audit challenge. 4. Local labor. 5. Contractor E. 0. Certification (Form E.D.-120). 6. Clean Air Certification (Form E.D.-524). 7. 10% Minority Business Clauses. tD. Letter of Credit 1. Establishment of account at local bank (funds cannot be transferred into general fund account). 2. Fifty percent of the funds will be transferred at the start of con- struction. 3. Fifty percent will be transferred when 40% of the project is complete. E. Bidding Requirements and 10% Minority Business Enterprise Clause (M.B.E.) 1. Open Competitive Responsive bidding. 2. Determination of number of potential M.B.E. 's to work on project prior to bidding (dollar amount). 3. Responsive bidding - construction firm which is closest to meeting Minority Business Requirements could be accepted bidder even though the firm might not be the lowest bidder on the project. 4. Grantee is required to make extensive effort (Good Faith) to involve M.B.E. in their project. Waivers will be allowed, but they must be docu- mented. F. Pre-bid Conference - (Items to be covered) 1. Standard Construction Requirement 2. 10% M.B.E. Requirement 3. 90 Day start of construction 4. Any possible change orders or line item expenditure changes 5. Sub-contractors (Performance bonds) 6. Weekly payroll forms 7. Project signs G. Other Requirements 1. Upon opening of bids - bid tabulation sheet must be sent to E.D.A. 2. M.S.E. involvement (form 530) must be sent to E.D.A. 3. E.D.A. requires also a. Quarterly Construction Report (Form 286) b. Quarterly..M.B.E. Depart (Form 530b) c. Notification - 7 days before final inspection of project d. Signs erect at site e. (2) Project photos (color) 1 IYY ylli/ "A ' k WILIAmD JOHNSON AA . t 3. ,r ORVALN GRAHAM AAPE�Y.- WUW J O7EM JA AA CHARLES W SUMNERMA..- EUGENEJ.VOGL JOHNSON-GRAHAM NGINEERS/P ANNERS 844 GRAND AVENUE.&LUNGS.MT 59101 (406)245$363 L r T 29 December 1977 Board of County Commissioners Jefferson County Courthouse , Boulder, Montana 59632 Re: Construction Contract for Courthouse • Gentlemen: £ It does appear now that Hamlin. Cqnstruction ' " L is having difficulty proceeding with the construction;-,: new County Office Building. a. . Due to the inclement weather and the ground that has been encountered, we certainly deef it advisable --441t time to stop construction until more favorable excavat #tions are available. We have a serious concern that could the - , be completed and left open for the winter., someone , g_ tf ured seriously by falling in the hole. Even i 'construction. -continue and they finished the footings and foundations, our. . is also a matter of freezing under the foundations' causing _ ' damage to the structures of the building. Therefore, we have sent the attached .- `.., in Constr-uction- Company and to Tim McCauley so. that EDA • '#:- be informed of the construction stoppage. if this • . r eet with your approval, please let us know i ediatei � .mCertain that Hamlin Construction will start const tion once st as soon as weather conditions are favorable. Sincerely, #A JOHNSON-GRAHAM • Oft( S RL1& 7, 10' �,, f. Willard D. Johnson, AIA ca encl. -' cc: Jerry Hamlin Tim McCauley COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARI ONE, County Clerk end Re'"'dar James Senddel, Chairman, Boulder CLERK and RECORDER Vincent M. Capp, Whitehall CARLA MATLACK, Leslie J. (Les) Sodorff, Clancy Boulder, Montana 59632 Deputy December 19, 1977 • 1 Mr. Rick Hill 1 Montana International Insurance 1500 North Montana Avenue Helena, Montana 59601 Re: Bonding of Hamlin Construction Company Dear Mr. Hill : The Board of County Commissioners of Jefferson County have examined Hamlin Construction Company's utilization of Paul Paul Construction of Browning, Montana as a Minority Business Enterprise involved in the County's Local Public Works project funded by the Economic Development Administration. Based on our investigation, we believe Pual Construction meets E.D.A. 's guidelines as a legitimate minority business enterprise involved in the supply of construction materials. If for reasons unknown to us at this time, Paul Construction is ruled to not be in compliance with E.D.A. guidelines as a supplier, we will re-negotiate the contract price with Hamlin Construction if it is necessary for him to involve another minority business on this project. i If you have any questions on this matter, please contact me. Sincerely, Boar of County Commissioners defter on County, Mon na/ � By et s wef „ hairm/ Board t an t e B JWS/jm I 1 WILLARU O JOHNSON AIA ORVAL H GRAHAM AIA PE WYLLIAM J OTTEM,JR.AIA CHARLES W SUMNER AIA EUGENEJ VOGL JOHNSON-GRAHAM ASSOCIATES ARCHITECTS/ENGINEERS/PLANNERS 644 GRAND AVENUE, BILLINGS, MT 59101 [406)245-6363 29 December 1977 Jerry Hamlin, President Hamlin Construction Company P 0 Box 64, SR Clancy, MT 59634 Re: Jefferson County Office Building Dear Mr. Hamlin: We are attaching a copy of a letter sent to the Board of County Commissioners and EDA Offices indicating that it is not favorable conditions to proceed with construction and therefore, ask that you stop construction on this project until such time as weather conditions will permit you to complete the excavation, the footings and foundations and backfill without the concern of frost. Please advise in receipt of this letter in what your intentions might be to proceed construction in the future. Sincerely, JOHNSON-GRAHAM ASSOCIATES Willard D. Johnson, AIA ca encl cc: Board of County Commissioners Tim McCauley COMMISSIONERS. JEFFERSON COUNTY JOANNE P V FARLANE• V -enl V Capp.C'a:eman Wrdehal; COUOn CIPIk end R= :. Le � ;; C CLERK and RECORDER C.L.0 MATLFC� Boulder, Montana 59632 January 9, 1979 REPRESENTATION LETTER Robert J. Jimenez & Associates 201 Star Professional Bldg. 1505 Ave. D Billings, Nbntana 59102 Gentlemen: In connection with your examination of the (1) Statements of Project Costs Claimed from August 1, 1977 through October 31, 1978 and Status of Grant Fund Payments as of October 31, 1978 for the Jefferson County Office Building Project of Boulder, Montana, Economic Development Administration Local Public Works Project No. 0551-26274 for the purpose of expressing an opinion as to whether these statements present fairly project costs claimed and status of grants funds in conformity with generally accepted accounting principles, and (2) compliance with the Department of Conmerece's "Audit Instruction for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977", we confirm to the best of our knowledge and belief, the following representations made to you during your examination on matters pertaining to the project being audited. 1. We are responsible for the fair presentation in the Statements of Project Costs Claimed and Status of Grant Fund Payments in conformity with generally accepted accounting principles. We believe that all costs claimed are eligible for reimbursement under the terms of the grant agreement. In this regard, our response to costs questioned by you are set forth as an appendix to this letter. 2. We have made available to you all: a. Financial records and related data. b. Minutes of the meetings Of the Jefferson County Office Building Project for Boulder, Montana or summaries of actions of recent meetings. c. Background information set forth in Section IV E of the "Audit Instruction for Local Public Works Grants Under Title I of the Public Works Employment Acts of 1976 and 1977" thereafter referred to as the Audit Guide. 3. There have been no: COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFAR ANE Viceni M Cape na�-rtar VJh te .C ba Cou^i� Cier�.arG R.c,.o, s ," ar CLERK and RECORDER CAF.F °Ch c■ 5s,r. Dep. . Boulder, Montana 59632 a. Irregularities involving management or employees who have significant roles in the system of internal accounting control. b. Irregularities involving other employees that could have a material effect on the Statements of Project Costs Claimed and Status of Grant Fund Payments. c. Communications from regulatory agencies concerning noncompliance with, or deficiencies in, financial reporting practices that could have a material effect on the Statements of Project Costs Claimed and Status of Grant Fund Payments. 4. Related party transactions and related amounts receivable or payable, including revenues, expenditures, loans, transfers, leasing arrangements and guarantees have been properly recorded or disclosed in the Statements of project Costs Claimed and Status of Grant Fund Payments. There have been no bribes or kickbacks. 5. There are no: a. Natters of noncompliance with grant contract terms or requirements set forth in the Audit Guide whose effects should be considered for disclosure or questioning costs in the Statement of Project Costs Claimed and Status of Grant Fund Payments or as a basis for recording a loss contingency. b. Other materials liabilities or gain or loss contingencies that are required to be accured or disclosed by Statement of Financial Accounting Standards No. 5. 6. There are no unasserted claims or assessments that our attorney has advised us are probable of assertion and must be disclosed in accordance with Statement of Financial Accounting Standards No. 5. 7. There are no material transactions that have not been prop- erly recorded in the accounting records underlying th Statements of Project Costs Claimed and Status of Grant Fund Payments. All liabilities with respect to EDA funds have been recorded in the proper records. 8. The Co: has satisfactory title or a non-cancelable long- term lease to all real property relevant to the project, and there are no leins or encumbrances on such assets nor has any of these assets been pledged. COMMISSIONERS: JEFFERSON COUNTY JOANNE P. McFARLANE V.cent M Cap:.Chairman Vin Ieha�' County Crerk and R:=co�tler CLERK and RECORDER CAPS. MATLACK Boulder, Montana 69632 9. Purchase commitments have. not teen rti e for inventory quanities in excess of normal requirements or at prices in excess of the prevailing market prices. 10. We have complied with all aspects of contractural ayreerrents that would have a material effect on the Statements of Project Costs Claimed and Status of Grant Fund Payments in the event of noncompliance. 11. No events have occured subsequent to date of the financial statements that would require adjustment to, or disclosure in the Statements of Project Costs Claimed and Status of Grant Fund Payments. it!p d kk4p, Chairman/ / hi 9r^" County Office Building Project :inuary 9, 1979 D.S. D parent of Cc-r:- -ce Eoonsnic Develop-Tent istration Acco_Lnting Division, n 7417 '..:as=:9ncton, D.C. 20230 'ear Sirs: Rol-,e-rt J. Jimenez, 201 Star Professional Bldg. , 1505 Ave. D, Billings, Lntana 59102, is ^a'kinz an examination of the Jefferson County Office Building Project - :=soucjer, ?,Dntana and we shall be obliged therefore, j'o'u will kindly c: f_ -m to him the below listed information in relation to Project =05-51-26274 as of the close of business on Le.__,ber 31, 1978. According to our reoords the funds approved and received were as follo:•:s: 1. mount Authorized: Federal letter Credit 1/26/78 $71,000 Letter Credit 6/14/78 $71,000 $142,000 2. Funds Received: 2/3/78 $15,000 2/15/78 $26,000 3/9/78 $30,000 7/7/78 $50,000 12/5/78 $21,000 $142,000 3. Funds Due: -0- Very truly yours Vinc'T7lf M. Capp, Chairman/ / 1 County Office Building Project The in formation shown above is correct except as noted: Name Title Date COMMISSIONERS: JEFFERSON COUNTY JOANNE P McFARLANE V:cent M Cap; C^a�unar K'I'.tehnin Coun•� Qerk and Rg�!:r�p LESl,F J s°-i CLERK and RECORDER PAATLAC r. Boulder, Montana 59632 January 9, 1979 U.S. Department of Commerce Economic Development Administration Accounting Division, Rom 7417 Washington, D.C. 20230 Dear Sirs: Roinrt J. Jimenez, 201 Star Professional Bldg. , 1505 Ave. D, Billings, Montana 59102, is making an examination of the Jefferson County Office Building Project - Boulder, Ybntana and we shall be obliged therefore, if you will kindly confirm to him the below listed information in relation to Project #05-51-26274 as of the close of business on December 31, 1978. According to our records the funds approved and received were as follows: 1. Amount Authorized: Federal Letter Credit 1/26/78 $71,000 Letter Credit 6/14/78 $71,000 $142,000 2. Funds Received: 2/3/78 $15,000 2/15/78 $26,000 3/9/78 $30,000 7/7/78 $50,000 12/5/78 $21,000 $142,000 3. Funds Due: -0- Very truly yours, V CMC/,rjr rr? - y eR . Capp, Chairman' County Office Building Project The in formation shown above is correct except as noted: Name Title Date ewee, I It •t UNITED STATES DEPARTMENT OF COMMERCE Economic Development Administration 1%0 Washington, O.C. 20230 Letter of Credit: j3.-074-.Sad' QUG 15 IBM Project Number: as_ 51- ,2 74 t arivat, Cei-u-nrt C6 ' '1 efien,a-w-, cap �/ tutcW M7 5963 . We have not received your "Report of Federal Cash Transactions" , (Form CD-286) for the quarter ended June 30, 1978, which was due by July 24 , 1978. This report, which is required by Office of Manage- ment and Budget Circular A-102 and by EDA letter of credit procedures as outlined in the "Engineering and Construction Guidelines" and in the "Financial Management Guidelines" for the Local Public Works Development and Investment Program, is due in the Accounting Division of EDA no later than 15 working days after the close of every calendar quarter. Please remember that failure to submit this report on a timely basis can result in the termination of your letter of credit. We have enclosed two copies of the report form (CD-286) including appropriate instructions. Please complete this report and return it within three weeks of the date of this letter to: Dennis J. Polivka, Chief, Accounting Division, Economic Development Administration, Department of Commerce, Room 7417 , Washington, D. C. 20230. If you need additional copies or have any questions concerning this report, please contact the finance officer in the EDA Regional Office servicing your area. Sincerely yours, - 4ennis J. Polivka y Chief Accounting Division Enclosure APPLICATION FOR PAYMENT No 1 Date 24.17•46 For the period _ to 2 —I7-70 incIuslY�, ;;;�. iy PROJECT Office Building for Jefferson County,•Boulder, Mt. OWNER Board of County Commissioners rs Address Jefferson County Courthouse, Boulder, Montana 59632 CONTRACTOR_ Hamlin Construction and Development Co„ Inc. w Address Box 64 S. R. Clancy, Mt. 59634 %"A JOHNSON - GRAHAM & ASSOCIATES Architects and Engineers ITEM TOTAL THIS % COMPLETED "r NO. DESCRIPTION COST APPLICATION COMPLETE TO DATE 1) Move on, layout & job setup $ 2,046.00 $ 616.00 40% $ 818.00:.. — 2) Bonds, insurance & permits 2,966.00 2,966.00 100% 2,966,00 ' ' 3) Excavation, backfill & final f. grade 4,935.00 247.00 5% . 247.00 • 4) Concrete walls, slabs, -- „` sidewalks 15,352.00. 5) Structural steel 0 reinforcinc 1,981,00' 9'606$4* -1 j . -lam-. 6) Framing floors, walls, & roof & interior partitions 18,486.00 7) Sheeting walls & roof, soffits & facia 6,095.00 B) Manzard & shingles 11,202.00 9) Insulation, gyp. board 11,525.00 10) Taping & Partitions 7,676.00 11) Glass-glazing & aluminum doors & frames 9,733.00 12) , . Masonry 11,690.00 13) Doors, frames, finish hard- ware, toilet partitions 4,013,00 14) Ocoustical ceilings 2,043.00 ,, 15) Mechahical 25,220.00 ,, " 16) Electrical 10,281.00 17) Carpet & Vinyl 4,479.00 18) Finish carpentry, millwork & specialty'iteme ' 5,870.00 19) Job cleanup, supervision & equipment rental ". 71;766.06 1 .' i C. 2'6'W.- . ;r • ',.'-3 ',' --$ . Ir TO y157,`f59,nn I t' i +-s "0 ;• l !I ± . . nf. • CONTRACT RECAPITULATION "'" t` i • a ORIGINAL CONTRACT SUM $ 15703S9.00________ CHANGE ORDERS TOTAL ADDITIONS SUB TOTAL • TOTAL DEDUCTIONS . . . . $ — e TOTAL CONTRACT TO DATE . . . $ 157,356.9D— „t x C!f APPLICATIQN IS MADE, FOR PAYMENT, AS HEREINAFTER SHOWN, IN CONNECTION WITH THE SUBJECT CONTRACT : TOTAL COMPLETED TO DATE $41p31 .110 STORED MATERIALS PER ATTACHED LIST TOTAL COMPLETED & STORED_ 5'a?•2Q;Il0__ LESS 10% RETAINAGE —^ 22.b0 TOTAL EARNED LESS RETAINAGE LESS PREVIOUS PAYMENTS CURRENT PAYMENT DUE $4• • /of £7Jt?' ) % rte. 1l -*• This is to certify that the work as listed above has , ? -Dke. 1t A' - been completed in accordance with the contract dots '6• 74,,. itt ments, that all items are paid for which previous certificates for payment were issued and payments %�'?: Z$ { feceived, and that the current payment is now due ` .. , Hamlin Construction and CONTRACTOR i ." Development Co.,—Inc. — R` By ARCHITECT'S CERTIFICATION We certify that this Application for Payment, to the best of our knowledge and belief, is a true and correct statement of work, performed and materials supplied by the. contractor,_end the.contractor's statement of account and amount due him is correct and just, and all work and material included in ;•,'S this Application for Payment has been;performed and is in full, accordance • with terms and conditions of corresponding construction contract documents and authorized changes thereto -• '..�,r:..+ -� 1I ,rS,• At A JOHNSQN - RAHAM ASSOCIATES y r sy ✓ V 3 Date /oaf 2' --f7p '& t '. PERIODIC ESTIMATE FOR PARTIAL PAYMENT -- MATERIALS ON SITE . -- PROJECT NAHE g)f'Fia & nLDlN1 ?Cr J&F# tSOA/ Qo I Proj . No. NAME OF CONTRACTOR 0 -•,441 4 0 t/� ADDRESS (p4 S• Q. - �• i "M 431 Periodic Estimate No. - / for period ending 2 -17- Item Material Delivered Material In Place — Material On Site /, / J Item Material Delivered Material In Place Material On Site Item 3. Material Delivered Material In Place . Material On Site _ - = Item _ Material Delivered Material In Place Material On Site ._ Item Material Delivered Material In Place Material. On Site Item Material Delivered Material In Place Material On Site Item Material Delivered Material In Place Material On Site • Item Material Delivered Material In Place Material On Site Nit UNITED STATES DEPARTMENT OF COMMERCE Economic Development Administration a AI,, MEMORANDUM FOR: Local Public Works Grantee Subject : Clarification of LPW Project Evaluation Requirements and the Payroll Reporting Form (WH-347) There seems to be some confusion on the part of Grantees concerning the evaluation requirements and the related forms that are applicable to their LPW projects , particularly the Forms ED-746, ED-747 and WH-347 . To help clarify the situation and hopefully minimize the confusion, we have developed, in the following paragraphs, a composite statement of the require- ments for LPW Projects that have been selected for evaluation, a definitive statement about the Payroll Reporting Form WH-347 and its use, and a brief look at two new surveys which will be initiated in the near future . I. Requirements for LPW Projects Included in the Evaluation Sample (65% sample) Upon notification of inclusion in the sample, the Grantee must appoint an LPW Evaluation Representative (LPW Evaluation Coordinator in Round I) to serve as EDA' s contact for matters pertaining to EDA' s requirements for the collection of evaluation data. Specific responsibilities of the LPW Evaluation Representative or Coordinator are: (1) to inform EDA Washington (on Form ED-747) of each Contractor and Subcontractor to perform on-site construction work on the Grantee s LPW project; (2) to establish a mechanism insuring that each Contractor and Subcontractor performing on-site construction work submits payroll data (on Form ED-746) to EDA Washington (with a copy to the Grantee) for each pay period; Details of the Employee Characteristics Survey will be disseminated when negotiations between EDA/PAD and Census are complete. IV. Field Surveys PAD is preparing to contract for on-site data collection in support of the LPW evaluation. This contract will involve surveys of local officials in approximately 100 jurisdictions as well as contractors and major suppliers to about 250 projects . Details of these surveys will be disseminated when finalized . t�crRe Regional Director g -4- II . Form WH-347, "Payroll Reporting Form" Davis-Bacon Act Reporting Requirements All Grantees will require each contractor and subcontractor to submit, in compliance with the Davis-Bacon Act, a weekly payroll record (WH-347 or its equivalent) . These records are to be retained by the Grantee for a period of three years from the date of completion of the contract in a manner reasonably accessible to EDA, the agency which retains responsibility for examining these records to assure compliance with the Davis-Bacon Act . The Grantee should file these records by contract number. If the grantee wishes to use another system for maintaining these records, the EDA Regional Office should be consulted to avoid any violations of the Privacy Act . The Grantee should check the submitted payroll records to assure they contain the following: (1) A properly completed Department of Labor Form WH-347 , or (2) if another form is used, all the information required by WH-347, including the name, address , correct classification, rate of pay, daily and weekly numbers of hours worked, deductions made and actual wages paid for all employees , and the weekly Statement of Compliance Form ED-162 or equivalent, properly completed. Department of Labor Form WH-347 , "Payroll Reporting Form" contains all of the information requirements in II(2) above including the "Certification. " Copies are available from any U.S . Government Printing Office at a price of $3 . 95 per pad of 100 (Stock Number 029-005-00014-1) , Catalog Number L22, Form WH-347 . All violations of the Davis-Bacon Act will be reported to the EDA Regional Office . III . LPW Employee Characteristics Survey It is anticipated that the Bureau of the Census, under contract to EDA, will be conducting personal interviews with LPW employees during the summer of 1978 . This survey is expected to involve approximately 8 , 500 employees working on approximately 1 , 200 projects . Each interview will require about 15 minutes . The process of selecting employees to be interviewed will require contact with, grantees, and the contractors or subcontractors . -3- (3) to monitor submitted payroll data and to take appropriate action to insure that each Contractor and Subcontractor submits a properly completed payroll reporting form for each pay period; and (4) to satisfactorily respond to all of EDA' s requests for assistance pertaining to evaluation data matters . Form ED-747 -- "Identification of LPW Evaluation Repre- sentative, Contractors , and Subcontractors" (to be referred to as the LPW Identification Form) enables each Grantee organization to record and submit data identifying the Evaluation Representative as well as the various contractors and subcontractors (or grantee agencies as allowed in Round I) which are or will be working on the site of the LPW project . Additional form(s) must be submitted, as required to identify: (1) any new Evaluation Representative who is a replace- ment for the individual identified on a previously submitted form: (2) Any additional Organizations and Firms, as soon as they become known, that are to perform on-site work; (3) any Organization or Firm previously reported as scheduled to work on the project but which will actually not perform any work. A copy of each completed form should be retained by the Grantee and the original shall be submitted to EDA. Form ED-746 -- "Local Public Works Payroll Reporting Form" (referred to as the LPW Payroll Form) is required of each contractor and subcontractor working on each LPW project selected for evaluation by EDA. Starting with the first on-site payroll, each contractor and subcontractor must complete and submit to EDA an LPW Payroll Form that identifies and provides payroll data for each employee having worked on the project during the pay period, regardless of whether the individual was paid with EDA funds or with project funds from any other source . For Round I projects, the Grantee must also submit forms if there are Grantee construction payrolls associated with the project . The original of each completed ED-746 Form is to be sub- mitted to EDA Washington. The first copy of the form is to be retained by the Grantee, contractor or subcontractor which prepared the form, and the second copy is to be submitted to the Grantee which received LPW funds for the project . -2-