3.07 3.7
FINANCIAL\2020\Proposal-Dow Electric-Roof at Water-Piggybacking with Gordian-Fund Balance Transfer to Capital Project-1 1-2
RESOLUTION AUTHORIZING PROPOSAL OF ENVIRONMENTAL &
FUELING SYSTEMS FOR UNDERGROUND STORAGE FUEL TANK
REPLACEMENT AT WATER DEPARTMENT
RESOLUTION NO.: ,2020
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, by Resolution No.: 282,2020, the Queensbury Town Board authorized
establishment of Water Treatment Plant Campus Improvements Capital Project No. 232 in the
amount of$150,426.48 to establish funding for expenses related to the repairs and improvements
at the Water Treatment Plant Facility/Campus, and
WHEREAS, the Town Water Superintendent has recommended that the Town Board
authorize replacement of an underground storage fuel tank at the Town Water Department(Project)
as the present tank is nearing the end of its 30 year old warranty period and the Town would incur
significant expense to upgrade the tank to meet current EPA regulations,and
WHEREAS, New York State Office of General Services (OGS) awarded a Contractor's
Proposal to Environmental & Fueling Systems (EFS) for Design and Construction work related
to OGS Project No.: 45531C - Fuel Tank Modification and Environmental Remediation Program
- which the Town Purchasing Agent and Town Counsel have determined meets the requirements
of New York State General Municipal Law and the Town's Purchasing Policy (hereinafter called
the OGS Agreement), and
WHEREAS, the OGS Agreement program includes the Northern Region, a geographical
area in the State of New York containing Warren County and the OGS Agreement provides that
EFS may propose for design and construction projects within the Northern Region 8, and
WHEREAS, the New York State Legislature adopted legislation allowing any political
subdivision in New York State to "piggyback" off an existing County/State Bid and therefore, due
to the agreeable and advantageous terms represented by OGS in this instance, the Town of
Queensbury wishes to piggyback with the OGS Agreement, and
WHEREAS, the Town of Queensbury will adhere to all New York State bidding
requirements, and
WHEREAS, EFS has submitted a Contractor's Proposal dated 12/14/20 for the Project in
the amount of $181,067 and the Water Superintendent has requested Town Board approval to
accept the Proposal, and
WHEREAS, the Town Board wishes to authorize such Project, with funding to be from
Water Capital Reserve No.: 65,and
WHEREAS, in accordance with New York State General Municipal Law §6(c), the Town
Board is authorized to withdraw and expend funds from Water Capital Reserve No.: 65 subject to
permissive referendum, and
WHEREAS, the Water Superintendent has advised the Town Board that there are times
when Change Orders may become necessary for the Project and has requested that the Town
Board also authorize him to approve and sign certain Change Orders up to a 10% contingency for
Change Orders that he deems necessary or appropriate,
NOW,THEREFORE,BE IT
RESOLVED, that the Queensbury Town Board hereby authorizes Environmental &Fueling
Systems' 12/14/20 Contractor's Proposal in the amount of $181,067 substantially in the form
presented at this meeting and in accordance with NYS OGS Project No. 45531-C to be paid from
Capital Expense Account No.: 232-8130-2899, and
BE IT FURTHER,
RESOLVED, that the Town Board hereby authorizes the Town Water Superintendent to
approve and sign Change Orders pertaining to the Contract up to a 10% contingency or in the
total amount not exceeding $18,108 that he deems necessary or appropriate, and
BE IT FURTHER,
RESOLVED, that the Town Board hereby finds that the withdrawal and expenditure for this
Project is an expenditure for a specific capital project and/or certain maintenance project for which
the Water Capital Reserve Account No.: 65 was established, and
BE IT FURTHER,
RESOLVED, that the Town Board hereby authorizes the Town Budget Officer to take all
actions necessary to amend the Town Budget and effectuate the transfer from Water Capital
Reserve No.: 65 in the amount of$199,175 to Capital Expense Account No.: 232-8130-2899 to
fund such purchase, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs an increase in funding in
the Capital Project by transferring $199,175 from Capital Reserve No. 65 to the Capital Project
as follows:
• 040-9950-9030-0065 Transfer to Capital Project - $199,175
• 232-0000-55031 Interfund Transfers - $199,175
0 232-8310-2899 Capital Construction - $199,175
and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Budget
Officer to amend the Town Budget, make any adjustments, budget amendments, transfers or
prepare any documentation necessary to establish such appropriations and estimated revenues,
and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
execute the Proposal, any other needed Agreement and/or documentation between the Town and
EFS in form acceptable to the Town Supervisor, Water Superintendent, Town Budget Officer
and/or Town Counsel, and the Town Supervisor, Water Superintendent, Town Budget Officer
and/or Town Counsel to take any and all actions necessary to effectuate the terms of this
Resolution and
BE IT FURTHER,
RESOLVED, that this Resolution is subject to a permissive referendum in accordance with
the provisions of Town Law Article 7 and the Town Board hereby authorizes and directs the Town
Clerk to publish and post such notices and take such other actions as may be required by law.
Duly adopted this 2 1"day of December, 2020, by the following vote:
AYES
NOES
ABSENT:
,P NEWYORK ��� �� � Design and Construction
SUITE OF AN ISO 500 t:2008 CERTIFIED ORGANIZATION
OPPORTUNITY. General
�l >�°ervices Dvi;IonaeIsm .Ron,y7µFbm,Ganng Plaza
�.,r �ffi Services�'H the Governor Flelsan A Rockefeller Empue State Plaza
Albany,New Yak 12242
Pbone:(W)474A331
CONTRACTOR'S PROPOSAL Project No. 45531 C
Contractor Name: Environmental&Fueling Systems Date: 12/14/20
Address: 20 Gurley Ave S Number:
Troy,NY 12182 Work Order Number:
Telephone No.: 518-272-8142 Modification:
SECTION A: CONTRACTOR WORK OGS REVISIONS
1. Total Contractor Labor (from BDC 1234M $6,698.18
2. Total Contractor Material (from BDC 123tM $11,781.95
3. Total Contractor Equipment (from BDC f24K9 $4,750.00
4. Not Used
5. SUBTOTAL (Total lines 1 fhru 4.) $23,230.13
6. Contractor's Override Combined O and P (f 5/of line 5.) $3,484.52
7. CONTRACTOR TOTAL (Total lines 5 and 6.) $26,714.65
SECTION B: SUBCONTRACTOR WORK (From BDC 122W-Use a separate form for each Subcontractor)
8. Names of Subcontractors.
A. Richard sears Tree Service $1,739.16
B.
C.
D.
9. TOTAL SUBCONTRACTORS'PROPOSALS (Total lines A thru 0.) $1,739.16 --�
10. Contractor's Override on Subs'Proposals:
10a. 10%of first$10,000 of line 9 ($1,o00 maximum) $173.92
10b. 5%of next$90,000 of line 9 ($4,500 maximum)
10c. 3%of sum in excess of$100,000 of line 9
11. SUBCONTRACTOR TOTAL $1 913.07
SECTION C: UNIT PRICE COSTS
12a.Total Contract Unit Price Costs (from BDC 126W) $152,439.00
12b.Total Supplemental 1 Negotiated Unit Price Costs (from BDC 126W.1)
12, UNIT PRICE TOTAL $152,439.00
SECTION D: CONTRACTOR'S REQUESTED TOTAL Round Totals to Nearest Dollar
13. AMOUNT REQUESTED (total tines 7,if,and 12.) �— $i81,067,
Contra ors Signature�77" Date
Print Name of Authorized Representative Print name of Cbritact Person(ifdifffirenf)
Print Title Phone No.(f different from above)
SECTION. : FIELD OFFICER'S REVIEW
I h e reviewed the material quantities,labor hours and equipment and
no exceptions are taken to the Proposal. ❑ Other:
❑ see comments noted on proposal.
❑ Field Report dated attached.
By. ` �', �-p-a-t-e--f�2
-0v Phone No.
SECTION F: REVIEW AND CERTIFICATION C70 t '
I hereby certify that the above proposal has bee heckled that the amounts allowed have been verified,and I
recommend approval in the amount of -�yi,,Mgnt
Reviewer: —T lisom
Date
BDC 121W RevOl E-FILE:V:\DesignAndConstr%Project Folder150_Construction Phase\54 COFOslnlernal
Design and Construction ,
NEWYORK
Office of
fTr
OFAN ISO 9001:2008 CERTIFIED ORGANIZATION
aRTUNITY•. ��� � 0 Division of Construction,341"Floor,Corning Tower
General I! Services�a a The Governor Nelson A.Rockefeller Empire State Plaza
Albany,New York 12242
Phone:(610)474-0331
SUBCONTRACTOR'S PROPOSAL (A.) Project No. 45531 C
Subcontractor Name: Richard sears Tree Service Date: 12/09/20
Address: S Number:
Work Order Number:
Telephone No.: Modification:
A. LABOR FOR OGS USE ONLY
Total Rate
Work Description Trade Hours from BDC 125,Line Total Labor Cost OGS Revisions OGS Field Comments
D
Tree Removal Laborer 11 $67.89 $746.79
Tree Removal Operator 8 $95.69 $765.52
(Total from BDC 123W,if required.)
TOTAL SUBCONTRACTOR LABOR —$1,512.31
B. MATERIAL
Material Description Quantity Unit Unit Cost Material Cost
(Total from BDC 123W,if required.)
TOTAL SUBCONTRACTOR MATERIAL 11
C. EQUIPMENT
TOTAL SUBCONTRACTOR EQUIPMENT(From BDC 124W.1)
D. SUMMARY
Total Labor, Material, Equipment (A+B+C) $1,512.31
Subcontractor's Override(15%of line 1) $226.851
TOTAL SUBCONTRACTOR PROPOSAL(to BDC 121W Section B) $1,739.16
Subcontractor's Signature ame(Please type or print.) Date
BDC 122W Rev02 E-FILE:V:\DesignAndConstr\Project Folder\50_Construction Phase\54_COFOslnternal
ce ofG�EIUYOIIK Desig u and Construction
STATE OF AN ISO 9001:2008 CERTIFIED ORGANIZATION
OPPORTUNITY. � � Services
�A i� � Division of Construction,34"Floor,Corning Tot+er
The Governor Nelson A.Rockefeller Empire State Plaza
✓�� Albany,New York 12242
Phone:(618)474-0331
LABOR AND MATERIAL WORKSHEET Project No. 45531 C
Contractor Name: Environmental&Fueling Systems Date: 12/11/20
Address: 20 Gurley Ave S Number:
Troy, NY 12182 Work Order Number:
Telephone No.: 518-272-8142 Modification:
A. LABOR FOR OGS USE ONLY
Mal Kate
Work Description Trade Hours from BDC 125,Line Total Labor Cost OGS Revisions OGS Field Comments
Jack Hammer existing island Laborer 16.00 $67.89 $1,086.24
Remove Existing dispenser/sump Plumber 16.00 $89.44 $1,431.04
Install new sump&ext dispenser Plumber 16.00 $89.44 $1,431.04
Install Fill Rite Pump on Temp tank Plumber 4.00 $89.44 $357.76
Filter fuel during transfer Laborer 6.00 $67.89 $407.34
Install deadman Laborer 12.00 $67.89 $814.68
Remove existing underground diesel pipe Laborer 12.00 $67.89 $814.68
R &R existing dispenser Electrician 4.00 $88.85 $355.40
(Total from BDC 123W 1,if required.)
TOTAL LABOR �- $6,698.18
B. MATERIAL
Material Description Quantity Unit Unit Cost Material Cost
Up Grade from 4,000 to 5,000 gallon tank 1.00 ea $2,000.00 $2,000.00
Deadman 2.00 ea $1,373.30 $2,746.60
Dispenser sump 1.00 ea $506.00 $506.00
Omntec 4-20 it amp Board 1.00 ea $723.25 $723.25
Add FilRite Pump to temp tank 1.00 ea $300.00 $300.00
Filter Bags&canisters 1.00 grp $450.00 $450.00
Brine up-grade 1.00 ea $776.10 $776.10
Soil Samples 6.00 ea $480.00 $2,880.00
Closure report 1.00 ea $800.00 $800.00
Dumpster 1.00 ea $600.00 $600.00
(Total from BDC 123W.2,if required.)
TOTAL MATERIAL $11,781.95
BDC 123W Rev02 E-FILE:V:\DesignAndConstr\Project Folder\50_Construction Phase\54_COFOs Internal
Design and Construction
TATE OF
TAB ®�� ffic of AN ISO 9001:2008 CERTIFIED ORGANIZATION
S
OPPORTUNITY � �� ����� Division of Construction.3411 Floor,Coming Tower
The Governor Nelson A.Rockefeller Empire State Piaza
Albany,New York,2242
Phone:(518)474-0331
EQUIPMENT EXPENSE PROPOSAL Project No. 45531 C
Contractor Name: Environmental&Fueling Systems Page Number: 1 of 1 Date: 12✓14/20
Address: 20 Gurley Ave S Number:
Troy,NY 12182 Work Order Number:
Telephone Number: 518-272-8142 Modification:
1. For self-owned equipment calculate rate In column 6 or column 7. Comments:
2. Rented equipment will be paid for at actual cost.Complete columns 1,3,4 and 12.
include a copy of the rental invoice or quote verired with the signature of the OGS E/C.
3. Operating cost includes fuel and lubricants but does not Include operator's wages.
4. Minor equipment and hand tools are considered overhead costs and cannot be claimed.
1 2 3 4 5 6 7 8 9 10 11 12
Indicate Refer- Complete Equipment Hours Monthly Used Less Used 5 Days Equipment Actual Hourly Total Total
if once Description Required Rate Than 5 Days or More Expense Operating Operating Operating Equipment
Owned Page on Hours Cost Cost Cost
or from Year,Make,Complete Model No., Site Hourly Rate Billing Rate Column 7 Sum of
Rented Blue Size,Capacity,H.P.,GWV, Column 5 Column 5 or Column 4 Rate from Column 9 Column 8 and Column rr
Book Fuel Type used or other Information to divided by multiplied by multiplied by Blue Book muftplied by or
completely describe the equipment used. 176 Hrs✓Nonth 45% Column 6 Column 10 Total Rental Cost
Filtration trailer 6 $750.00
Hydro-vac excavator/opertor 16 $4,000.0
TOTAL CONTRACTOR EQUIPMENT EXPENSE Carry forward to BDC 121W. $4,750.00
BDC 124W Rev02 E-FILE:V:iDesignAndConstriProjeet Folder150_Construction Phase154_COFOslntemat
UNIT PRICES SPECIFIED IN THE CONTRACT DOCUMENTS Project No. 45531 C
[EAddress:
Environmental&Fueling Systems Date: 12/11/20
20 Gurley Ave S Number: 0
Troy,NY 12182 Work Order Number: 0
er: 518-272-8142 Modification:
Fule Description
p Quantity Unif Unit Cost Tota!Cost
Removal&Transporting of First 200 Gallons of Existing Fuel 1.00 per site $600.00 $ 600.00 Removal&Transporting of Existing Fuel Over 200 Gallons 1600.00 per gallon $1.25 $ 2,000.00
26500.07 Remove&Dispose of First 500 Gallons of Contaminated Fuel 1.00 per site $1,600.00 $ 1,600.00
26500.08 Remove&Dispose of Contaminated Fuel Over 500 Gallons 500.00 per gallon $1.80 $ 900.0
26500.11 Remove and Dispose of 2,001-6,000 Gal Tank-UST 1.00 per tank $4,000.00 $ 4,000.0
33001.01 Cast In Place Concrete 6.00 per cu yd $685.00 $ 4,110.0
33001.02 Cast In Place Concrete Misc 7.00 per cu yd $450.00 $ 3,150.00
231100.02 2 inch FR Pipe 35.00 per lin ft $31.00 $ 1,085.00
231100,05 4 inch containment pipe 210.00 per lin ft $35.00 $ 7,350.00
231100.08 1"Black pipe 10.00 per lin ft $31.00 $ 310.00
231100.09 1 1/2"Black pipe 10.00 per lin ft $33.00 $ 330.00
231100.10 2 inch Black Steel Pipe 12.00 per lin ft $38.00 $ 456.00
231100.13 1 inch Flexible Prfmary Piping 140.00 per lin ft $25.00 $ 3,500.00
231100.14 1-1/2 inch Flexible Primary Piping 140.00 per lin ft $26.00 $ 3,640.00
231100.15 2 inch Flexible Primary Piping per fin ft $27.00 $
231100.16 Transition Assembly 2.00 1 per assembly $1,400.00 $ 2,800.0
231100.17 Sump Wall Seal 2'to 4" 5.00 per seal $250.00 $ 11250.00
231100.18 Sump Wall Seal 1"&3/4"to4" 5.00 per seal $250.00 $ 1,250.00
231100.19 Sump Wall Seal 1"&3/4"to4" per seal $250.00 $
231100.20 1/4 inch Type K Copper Tubing 60.00 per lin ft $21.00 $ 1,260.00
231100.23 314 inch Type K Copper Tubing 50.00 per lin ft $24.00 $ 11200.0
231313.09 4,000 Gallon Fiberglass 1.00 per tank $23,500.00 $ 23,500.0
231313.14 Diesel Tank Installation Package 1.00 per package $1,900.00 $ 1,900.0
231313.15 Diesel(Generator)&Fuel Oil Tank Accessories Package 1.00 per package $2,800.00 $ 2,800.00
231313.16 Instrumentation Package 1.00 per package $10,000.00 $ 10,000.0
231313.19 Flush mount watertight Access lid assembly 1.00 per assembly $1,800.00 $ 1,800.0
231315.03 Temporary Skid Tank(2000 Gallon)(Fuel Oil) 3.00 1 per month $350.00 $ 1,050.0
231315.08 Mob/demob Temporary Skid Tank(2000 Gallon)(Fuel Oil) 1.00 per tank $3,600.00 $ 3,600.00
231323.16 Non Discriminating Leak sensor 2.00 per sensor $400.00 $ 800.00
260532.01 3/4"Conduit 360.00 per lin ft $18.00 $ 6,480.00
262726.02 Indoor receptacle 1.00 pre recep $200.00 $ 200.00
262726.03 Device surge 1.00 per surge $250.00 $ 250.00
310000.01 General Excavation of first 100cy 1.00 per site $5,900.00 $ 5,900.00
310000.02 General Excavation 200.00 per cu yd $17.00 $ 3,400.00
310000.03 Trenching 70.00 per cu yd $25.00 $ 1,750.00
310000.04 Hand Excavation 5.00 per cu yd $150.00 $ 750.00
310000.05 Saw Cutting Pavement %00 per lin ff $12.00 $ 120.00
310000.06 Removal of Asphalt Conc. Pavement or Conc.Sidewalk 6.00 per cu yd $65.00 $ 390.00
310000.07 Removal of Conc. Pads 6.00 cu per d p y $390.00 $ 2,340.00
310000.09 Removal of construction debris 12.00 per cu yd $90.00 $ 1,080.00
310000.10 Disposal of Unsuitable Excavated Material per cu yd $45.00 $
310000.11 Subbase Course Type 2 30.00 per ton $55.00 $ 1,650.00
310000.12 Pea Gravel 450.00 per ton $50.00 $ 22,500.00
310000.16 Filter Fabric 664.00 per sq yd $12.00 $ 7,968.00
310000.17 Lawn Restoration 160.00 per s d p q y $15.00 $ 2,400.00
310000.18 Remove and Stockpile Topsoil 30.00 per cu yd $59.00 $ 1,770.00
310000.20 Moving&Stockpiling Unsuitable soil on site 200.00 per sq yds $30.00 $ 6,000,00
310000.23 Reuse Excavated Material classified as suitable material 50.00 per cu yds $25.00 $ 1,250.00
112 A.TOTAL CONTRACT UNIT PRICE COSTS Carry forward to BDC 121W Section C. $ 152,439.00
BDC 126W
NEWYORK �� � Design and Construction
STATE QF AN ISO 9001:2008 CERTIFIED ORGANIZATION
OPPORTt,NITY.. General Services Division N Construction,34°l Floor,CorningState Plaer
za
,� The Governor Nilson A.Rockefeller Empire Sato Plaza
Albany,New York 12242
Phone:f5i8)4740331
LABOR RATE WORKSHEET Project No. 45531 C
Contractor Name: Environmental&Fueling Systems County: Warren Date: 12/11/20
Address: 20 Gurley Ave ❑ Work Order Modification No.:
Troy,NY 12182 ❑ Feld Order No.: ❑ Time and Material No.:
Telephone Number:518-272-8142 ❑ Change Order Control No.:
LABOR RATE BREAKDOWN(For T&M only.Use a separate worksheet for each employee.) Trade: Operator
{T&M Only)Item No.:
(T&M Only)Employee Name: REGULAR PREMIUM TIME
(T&M Only)Social Security No.: BASE RATE BASE RATE
A. WAGE RATE PER HOUR $46.27
BENEFITS f` Identifies benefits paid directly to the Employee * %per hour $per hour
Vacation and Holiday
Health and Welfare
Pension
Annuity
Education/Apprentice Training * $1.00
Supplemental Unemployment
Security Fund
Suplemental Benefits paid in cash
Suplemental Benefits paid in cash ' $28.45
B. TOTAL BENEFITS PER HOUR $29.45 $29.45
PAYROLL TAXES AND INSURANCE
F.LC.A./Social Security (up to the maximum required by law) 6.20 %
Medicare 1.45 %
Federal Unemployment (up to a ma)dmum of$56.00 per employee per year) 0.60 %
State Unemployment (up to 1st s8,500 of base salary paid per employee per year) 9.55
Workers'Compensation Code: 6217 8.57 %
Disability %
C. TOTAL TAXES AND INSURANCE PER HOUR
❑ All benefits are paid directly to Employee.
Q Only benefits identified by*are paid directly to Employee. $75.72 x 26.37 %_ $19.97
D. TOTAL LABOR RATE (A+B+C)_ $95.69
E. CONTRACTOR'S CERTIFICATION
I certify that the labor rates,insurance enumerations,tabor fringe enumerations and expenses are correct and in accordance with actual and true
cost incurred.
Swore before me this day
Signature
of 20
Print Name of Authorized Representative
Print Title Notary Public
RDC 125 ReY02 E-FtLE:V:\DesignAndConstr\Project Folder\50 Construction Phase\54_COFOslntemal
Design and Construction� Y® K Office
STATE OF AN ISO 9001:2008 CERTIFIED ORGANIZATION
OPPORTUNITY. Ulsion of Construction,34e1 Floor.Corning Te.er
General
Services� ces The GoaeirorNelson:,Rockefellar Empire State Plan
Albany,Near York 12242
Phone:(512)474-0331
LABOR RATE WORKSHEET Project No. 45531 C
Contractor Name: Environmental&Fueling Systems County:Warren Date: 12/11/20
Address: 20 Gurley Ave ❑ Work Order Modification No.:
Troy,NY 12182 ❑ Feld Order No.: ❑ Time and Material No.:
Telephone Number:518-272-8142 ❑ Change Order Control No.:
LABOR RATE BREAKDOWN(For T&M only.Use a separate worksheet for each employee.) Trade: Plumber
tT&M Only)Item No.:
{T&M Only)Employee Name: REGULAR PREMIUM TIME
(T&M Only)Social Security No.: BASE RATE BASE RATE
A. WAGE RATE PER HOUR
BENEFITS(- Identifies benefits paid directly to the Employee * %per hour $per hour
Vacation and Holiday
Health and Welfare
Pension
Annuity
Education/Apprentice Training ' $1.00
Supplemental Unemployment
Security Fund
Suplemental Benefits paid in cash # $10.63
Suplemental Benefits paid in cash * $20.85
B. TOTAL BENEFITS PER HOUR $32.48 $32.48
PAYROLL TAXES AND INSURANCE
F.I.C.A./Social Security (up to the maximum required by law) 6.20 %
Medicare 1.45 %
Federal unemployment (up to a maximum of$55.00 per employee per year) 0.60 %
State Unemployment (up to 1st$8,500 of base salary paid per employee per year) 9.55 %
Workers'Compensation Code: 6217 8.57 %
Disability aka
C. TOTAL TAXES AND INSURANCE PER HOUR
❑ All benefits are paid directly to Employee.
Q Only benefits identified by*are paid directly to Employee. $70.78 x 26.37 %_ $18.66
D. TOTAL LABOR RATE (A+B+C)—]F $89.44
E. CONTRACTOR'S CERTIFICATION
I certify that the labor rates,insurance enumerations,labor fringe enumerations and expenses are correct and in accordance with actual and true
cost incurred.
Sworn before me this day
Signature
Of 20
Print Name of Authorized Representative
Print Title Notary Public
BDC 126 Rev02 E-FILE:VADesignAndConstf%Project Folderr50 Construction Phase154 COFOslnternal
�9EWYORK m�� ® Design and Construction
STATE OF AN ISO 9001:2008 CERTIFIED ORGANIZATION
OPPORTUNITY. General Services Givisionof Construction,31'^Floor,coming Toeer
�? The Governor Nelson A.Rockefeller Empire State Plaza
Albany,New York 12242
Phone:(518)474-0331
LABOR RATE WORKSHEET Project No. 45531 C
Contractor Name: Environmental&Fueling Systems County: Warren Date: 12/11/20
Address: 20 Gurley Ave ❑ Work Order Modification No.:
Troy,NY 12182 ❑ Field Order No.: ❑ Time and Material No.:
Telephone Number:518-272-8142 ❑ Change Order Control No.:
LABOR RATE BREAKDOWN(For T&M only.Use a separate worksheet for each employee.) Trade: Laborer HH
{T&M Only}Item No.:
{T&M Only)Employee Name: REGULAR PREMIUM TIME
{r&M Only)Social Security No.: BASE RATE BASE RATE
A. WAGE RATE PER HOUR $26.87�
BENEFITS(` Identifies benefits paid directly to the Employee * %per hour $per hour
Vacation and Holiday
Health and Welfare
Pension
Annuity
Education/Apprentice Training " $1.00
Supplemental Unemployment
Security Fund
Suplemental Benefits paid in cash
Suplemental Benefits paid in cash * $25.85
B. TOTAL BENEFITS PER HOUR $26.85 $26.85
PAYROLL TAXES AND INSURANCE
F.I.C.A./Social Security (up to the maximum required by law) 6.20 %
Medicare 1.45 %
Federal Unemployment (up to a maximum of$56,00 per employee per year) 0.60 %
State Unemployment (up to 1 at$8,500 of base salary paid per employee per year) 9.55 %
Workers'Compensation Code: 6217 8.57 %
Disability
C. TOTAL TAXES AND INSURANCE PER HOUR
❑ All benefits are paid directly to Employee.
Only benefits identified by*are paid directly to Employee. $53.72 x 26.37 %_ $14.17
D. TOTAL LABOR RATE (A+B+C)= $67.89
E. CONTRACTOR'S CERTIFICATION
I certify that the labor rates,insurance enumerations,labor fringe enumerations and expenses are correct and in accordance with actual and true
cost incurred.
Swom before me this day
Signature
Of 20
Print Name of Authorized Representative
Print Title Notary Public
BDC 125 Rev02 E-FILE:VADesignAndConstrlProject FoldeM0_Construction Phase%54_COFOslnternal