HomeMy WebLinkAbout09112026Change Order 2 (003)CHANGE ORDER REQUEST
Cle Elum Transfer Station
Change Order Request No.: CO-02
Date: May 27, 2026
Project: Cle Elum Transfer Station
Owner: Kittitas County
Contractor: Gibson & Son Road Building, Inc.
Requested By: Jack Jensen
Description of Change
During Road Excavation, a sewer manhole was found below subgrade depth on the new
entrance road. We will need to add 2’ of risers to this manhole to get it to asphalt finish
grade. This will require setting risers to gravel subgrade, paving over them, and then saw
cutting new asphalt, setting lid and patching the asphalt.
Additional Work Performed
Additional services required include:
• Digging and removing manhole lid
• Adding risers to match gravel subgrade
• Grouting
• Saw cutting after asphalt
• Setting lid and risers plus grouting
• Patching asphalt
Cost Breakdown
Description Amount
Contractor PM / Administrative
Coordination (5 Hours @
$100.00/hr)
$500.00
Riser Rings + Delivery $1,850.00
Expose Manhole and remove Lid
Set Rings and Lid to Gravel Subgrade
Grout and labor
Saw cut Asphalt
Jack and Raise Lid
Patch Asphalt
$900.00
$900.00
$550.00
$800.00
$900.00
$3,450.00
Total Requested Change Order $9,850.00
Supporting documentation attached.
Schedule Impact
This will set us back 2 working days due to an unforeseen condition. We request to allow
working day extension if needed
Requested Adjustment
Gibson & Son Road Building, Inc. respectfully requests approval of this Change Order
Request in the amount of:
$9,850
for additional survey control recovery, coordination, and project management efforts
required prior to commencement of construction activities.
Submitted By: Jack Jensen (Project Manager)
Jack Jensen
Gibson & Son Road Building, Inc.
Date: _____5/27/2026__________
Owner Acceptance
Approved By:
Kittitas County Representative
Title: ____________________________
Date: _____________________________
Attachments
1. Layout area of manhole
Gre c e ional Landfill Reprint
191 Ticket# 1048926
Wena e ® Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier GIBS GIBSON & SON ROAD BUILDING
Ticket Date 06/22/2026
Vehicle# 67
Payment Type Credit Account
Container
Manual Ticket#
Driver
Route
Check#
Hauling Ticket#
Billing# 0508597
Destination
Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale
Operator Inbound
Gross
81400 lb
In 06/22/2026 10:23:48 Inbound
dmille39
Tare
42080 lb
Out 06/22/2026 10:39:42 Outbound
dmille39
Net
39320 lb
Tons
19.66
Comments REPLACEMENT TICKET FOR TICKET Nbr 1048910- autho letter on file
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 19.66 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre c e Tonal Landfill Reprint
191 Ticket# 1048966
Wena e e Ph: (509) 884-2802
Customer Name KITTITAS COUNTY
SOLID WA Carrier
Ticket Date 06/22/2026
Vehicle#
Payment Type Credit Account
Container
Manual Ticket#
Driver
Route
Check#
Hauling Ticket#
Billing#
Destination
Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale Operator
In 06/22/2026 14:54:29 Inbound Janelle
Out 06/22/2026 15:07:08 Outbound Janelle
Comments
GIBS GIBSON & SON ROAD BUILDING
67
0508597
Inbound Gross 96500 lb
Tare 41760 lb
Net 54740 lb
Tons 27.37
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 27.37 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature ��
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre c e Tonal Landfill Reprint
191 Ticket# 1048967
Wen, e Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier
Ticket Date 06/22/2026
Vehicle#
Payment Type Credit Account
Container
Manual Ticket#
Driver
Route
Check#
Hauling Ticket#
Billing#
Destination
Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale Operator
In 06/22/2026 15:08:05 Inbound Janelle
Out 06/22/2026 15:24:12 Outbound Janelle
Comments
GIBS GIBSON & SON ROAD BUILDING
66
0508597
Inbound Gross 99520 lb
Tare 41540 lb
Net 57980 lb
Tons 28.99
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 28.99 Tons KITTITAS
Total Tax/Fees
Total Ticket
Drivers Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre onal Landfill
Reprint
191
WRZO
Ticket#
1049385
Wena
Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier
GIBSON
Ticket Date 06/25/2026
Vehicle#
67
Payment Type Credit Account
Container
Manual Ticket#
Driver
Route
Check#
Hauling Ticket#
Billing#
0508597
Destination
Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale
Operator
Inbound
Gross
93700 lb
In 06/25/2026 13:54:56 Inbound
dmille39
Tare
42420 lb
Out 06/25/2026 14:14:50 Inbound
dmille39
Net
51280 lb
Tons
25.64
Comments REPLACEMENT TICKET FOR TICKET Nbr 1049333
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 25.64 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre c e ional Landfill Reprint
191 Ticket# 1049315
Wena e ® Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier
Ticket Date 06/25/2026
Vehicle#
Payment Type Credit Account
Container
Manual Ticket#
Driver
Route
Check#
Hauling Ticket#
Billing#
Destination
Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale Operator
In 06/25/2026 12:49:13 Inbound Janelle
Out 06/25/2026 13:03:19 Inbound Janelle
Comments
GIBS GIBSON & SON ROAD BUILDING
66
0508597
Inbound Gross 100780 lb
Tare 42340 lb
Net 58440 lb
Tons 29.22
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 29.22 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre c e Tonal Landfill Reprint
191 Ticket# 1049384
Wen a eWJ\10MO Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier GIBSON
Ticket Date 06/25/2026 Vehicle# 66
Payment Type Credit Account Container
Manual Ticket# Driver
Route Check#
Hauling Ticket# Billing# 0508597
Destination Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale Operator
In 06/25/2026 08:56:17 Inbound dmille39
Out 06/25/2026 09:10:58 Inbound dmille39
Inbound Gross 105180 lb
Tare 42360 lb
Net 62820 lb
Tons 31.41
Comments REPLACEMENT TICKET FOR TICKET Nbr 1049258
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 31.41 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.
Gre c e Tonal Landfill Reprint
191 Ticket# 1049383
Wen, e ® Ph: (509) 884-2802
Customer Name KITTITAS COUNTY SOLID WA Carrier GIBSON
Ticket Date 06/25/2026 Vehicle# 67
Payment Type Credit Account Container
Manual Ticket# Driver
Route Check#
Hauling Ticket# Billing# 0508597
Destination Grid
Manifest
Profile ()
Generator
PO# CLE ELUM
Time Scale Operator
In 06/25/2026 08:36:33 Inbound dmille39
Out 06/25/2026 08:53:39 Inbound dmille39
Inbound Gross 98900 lb
Tare 42380 lb
Net 56520 lb
Tons 28.26
Comments REPLACEMENT TICKET FOR TICKET Nbr 1049254
Product LD% Qty UOM Rate Tax/Fee Amount Origin
----------------------------------------------------------------------------------------
1 MSWTCLE-Trash - Mixed 100 28.26 Tons KITTITAS
Total Tax/Fees
Total Ticket
Driver's Signature
The total amount includes fees and taxes that may not all be listed on this ticket due to technic
limitation.