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Mn/DOT - 9 (1 -93) STATE OF MINNESOTA - D.. ARTMENT OF TRANSPORTATION SUMMARY OF DAILY FORCE ACCOUNT WORK ORDER No. 1 Sheet 1 of 1 S.P. No. 02- 090-01 Fed Proj No. Contract No. 2010 -0601 Contractor / Sub. Veit Construction For Period from 5/29/2011 to 6/4/2011 Location CRT Segment E (7216 Mill Rd) Engineer Stantec Consulting Inc. — LABOR MATERIAL EQUIPMENT RENTAL # of Men Position Title Hrs OT/Hr Pay Rate Amount No. Kind of Material Rate Amount No. Description Total Hrs Rate Amount 1 Foreman 1 0 $ 32.27 $ 32.27 4 1 1/2" Rock $ 20.90 $ 83.60 1 Laborer 1 0 $ 28.32 $ 28.32 N . 1... SALES TAX $ 5. u6 SUB-TOTAL $ 89.56 Total Overtime PLUS 15% $ 13.43 SUB TOTAL (Taxable Wat es) $ 60.59 TOTAL OF MATERIAL $ 102.99 i PLUS of Taxable Wale $ 37.57 1904 (7) SPECIALTY CONTRACTOR SUB -TOTAL X16 Invoice Cost Specialty Contractor $ - SUB -TOTAL $ - Other Labor - related cost chargeable (A) $ - @5% = $ - PLUS Q� $ - to This Supplemental Agreement / Work Order (13) $ - @2% = $ - ' TOTAL OF EQUIPMENT $ Health and Welfare $ 14.25 TOTAL SPECIALTY CONTR. $ - COMPUTATION OF PRIME CONTRACTOR , Pension Fund $ 13.52 1904(4) MISC COMPENSATION ALLOWANCE Other Fringe Benefits $ 1.76 ype: i.e. dump fees, permits, etc. (A) No Sub @ 14z = f $ _ Travel (B) No Sub @ 2% = $ Subsistence TOTAL ALLOWANCE (A +B) $ TOTAL OF LABOR $ 127.69 TOTAL MISC. COMP. .$ [GRAND TOTAL J $ . . { Send original and two copies to Central Office with Final Estimate The above report includes only items chargeable to Work Order No. 1 All coppies must be signed by the engineer, and the Contractor or their Authorized Agent. i Note: When material is billed on this sheet, receipted Engineer S . tec C.nsultin Inc. Contractor — invoices must accompany same. f / See Const. Manual 5- 591.484 for instructions in preperation. By ilk/ Af