HomeMy WebLinkAboutDAQ-2024-007659Request For Payment from
VW EVSE
Division of Air Quality
Department of Environmental Quality
State of Utah
195 North 1950 West
Salt Lake City, UT 84116
PAYABLE TO:
SLC, UT 84114
TAX ID:
CHARGE TO: Fund Agency Approp Unit Function Prog Object or BS
2158 480 2158 2113 2VWUDOT 7512
DATE DESCRIPTION TOTAL
1/5/2023 $158,719.46
$158,719.46
Reviewed and Approved By: Date:
Mat Carlile
Andrea Riddle
Project completed: October 1, 2020
Please note that this payment was part of a larger project and that request
is for a portion of the overall cost of the project.
Payment to UDOT for reimbursement for purchase, installation, warranty, and
networking costs for two DC Fast Chargers($158,718.46) at 455 W Main St.
Bluff, UT 84512. As per the State Cooperative Agreement with Verdek
shipping costs will not be reimbursed on this payment. This payment comes
from the Contract 201217 for UDOT through the VW Settlement funds.
Transaction Id:______________________
UDOT #VC0000179400
4501 South 2700 West
Awardee Name: _UDOT-Bluff ___
Award Amount (verify that the requested amount does not exceed total amount reimbursed to UDOT
pursuant to the Volkswagen Eligible Mitigation Action Agreement Between State of Utah, Department of
Transportation and State of Utah, Department of Environmental Quality, #201217, effective December
18, 2019, as amended March 23, 2022): $_1,047,6231
Project Summary
Proposed number of EVSEs (type and quantity of each) Two DC Fast Chargers
Actual number of EVSEs (type and quantity of each) Two DC Fast Chargers
Proposed address of EVSE location(s): 455 W Main St. Bluff, UT 84512
Actual address of EVSE location(s): 455 W Main St. Bluff, UT 84512
Bid amount: $146,672.84
Invoice amount $158,719.46.47 The original bid amount for the install at this location was
$146,672.84. That amount was made up of $13,400 in power upgrades and $133,272.84 in Verdek
install costs. The actual costs to install the EV Chargers at this location was $158,719.46 for an
increase in cost of $12,046.62. Additional costs associated with the power upgrades accounted for
$17,646.62. These additional costs were associated with the additional supply costs and costs due to
the COVID-19 Pandemic. Reduction in cost associated with Verdek actual installation costs accounted
for $4,000. Costs associated with Verdek related improvement/repairs, increased by $857.31, due to
by $4,857.97, due to profit percentage not being taken from cost of charging
equipment & cloud/warranty service.
Checklist of required documents (Provide a description of any modifications from the original, proposed
project).
A site map showing the location of the EVSE funded by this funding assistance;
Installation start date of the EVSE project April 1, 2020 (See Bluff Session Data) ;
The date the EVSE was placed into October 10, 2020 (See Bluff Session Data)
A photo of the EVSE funded by this funding assistance and placed into service;
The estimated hours per day and days per year the EVSE funded by this funding assistance
will be used: 1 hours a day 236 days a year (See Bluff Session Data).
A final purchase invoice for each EVSE, installation, maintenance, and other itemized actual
costs from the Funding Assistance Application. The invoice shall include:
a. the invoice date;
b. the itemized purchase cost for each item or service listed in the competitive bid; and
c. the applicant as the purchaser;
If costs are higher than the original bid, are the increased costs reasonable? The original bid
amount for the install at this location was $146,672.84. That amount was made up of $13,400 in
power upgrades and $133,272.84 in Verdek install costs. The actual costs to install the EV Chargers at
this location was $158,719.46 for an increase in cost of $12,046.62. Additional costs associated with
the power upgrades accounted for $17,646.62. These additional costs were associated with the
additional supply costs and costs due to the COVID-19 Pandemic. Reduction in cost associated with
Verdek actual installation costs accounted for $4,000. Costs associated with Verdek related
1 Please note that this payment was part of a larger project and that request is for a portion of the overall cost of
the project.
improvement/re
terrain. Reduction of Verdeck profit cost decreased by $4,857.97, due to profit percentage not being
taken from cost of charging
equipment & cloud/warranty service.
If items purchased are different from competitive bid did entity document that they meet
procurement rules for changed items (see Terms and Conditions section II B.); and
Proof of payment.
Did the applicant use the State Cooperative Agreement? Yes
o If yes, did the invoice include shipping? Yes, however, VW funds will not reimburse for
shipping costs because UDOT used the Verdek State Cooperative Agreements where
shipping costs are not allowed.
Amount authorized for reimbursement: =$158,719.46
With this authorized amount, the total amount reimbursed to UDOT to date =$593,142.24
Reviewed by
Mat Carlile _______________
Becky Close________________
Andrea Riddle_______________
Locations Vendors Attachment B-
Bid Item
Application Bid
$
VW $ UDOT $ Finial Invoice Items Contract List
Price
Final Invoice $ VW $ UDOT $ Invoice #
455 W Main St. Bluff,
UT 84512
CPE250-
ChargePoint
Express 250
$60,850.00 $60,850.00 $0.00 CPE250C-625-CCS1-CDH $74,256.00 $60,850.00 $60,850.00 $0.00 84708
Shipping $1,600.00 $1,600.00 Shipping $1,600.00 $1,600.00 84708
5 Year Warranty
(Assure Plan)/
Network Plan
$34,710.00 $34,710.00 $0.00 CPCLD-ENTERPRISE-DC-5 5yr
Prepaid Enterprise Cloud Plan
$7,424.00 $6,810.00 $6,810.00 $0.00 84708
$0.00 $0.00 EXPRESS-ASSURE5 Express
CPE 250 5-yr Prepaid Assure
Plan (per module - 2 modules
per station)
$29,140.00 $27,900.00 $27,900.00 $0.00 84708
Mobilzation $3,598.00 $3,598.00 $0.00 MOBILIZATION $3,598.00 $3,598.00 $0.00 84708
Design/
Equipment
$2,959.00 $2,959.00 $0.00 DESIGN EQUIPMENT $2,956.00 $2,956.00 $0.00 84708
Related
Improvements/R
epairs
$12,219.00 $12,219.00 $0.00 RELATED
IMPROVEMENTS/REPAIRS
$13,076.31 $13,076.31 $0.00 84708
Electrical
Materials
$6,206.00 $6,206.00 $0.00 ELECTRICAL MATERIALS $6,206.00 $6,206.00 $0.00 84708
Commissioning
System
$432.00 $432.00 $0.00 COMMISSIONING SYSTEM $432.00 $432.00 $0.00 84708
Overhead $4,573.88 $4,573.88 $0.00 OVERHEAD $4,573.98 $4,573.98 $0.00 84708
Profit $6,128.52 $6,128.52 $0.00 PROFIT $1,270.55 $1,270.55 $0.00 84708
Subtotal (Verdek) $133,276.40 $133,276.40 $0.00 Subtotal (Verdek) $129,272.84 $127,672.84 $1,600.00
Rocky Mountain
Power
Provide 3 phase
power 277/480
to EV charging
station for
udot at455 W
Main St. Bluff,
$13,400.00 $13,400.00 $0.00 Provide 3 phase power
277/480 to EV charging
station for
udot at 455 W Main St. Bluff,
UT 84512
$13,962.62 $13,962.62 $0.00 6686602
Subtotal Upgrades $13,400.00 $13,400.00 $0.00 Rocky Mountain Power -
Additional Power Install Costs
$1,470.00 $1,470.00 6850987
Estimated Grand
Total
$146,676.40 $146,676.40 $0.00 Subtotal Upgrades $13,962.62 $15,432.62 $0.00
Kilgore - 1/2 Inch HMA Paving
at Site
$9,902.80 $9,902.80 2600162-4
Kilgore - Retention for 1/2
Inch HMA Paving at Site
$521.20 $521.20 2600162-4R
Lyle Northern Electric -
Electrical Install/Hookup
$4,990.00 $4,990.00 1018
Lyle Northern Electric - Final
Inspection
$200.00 $200.00 1171
Contructon Subtotal $15,614.00 $15,614.00
Upgrade Total $29,576.62 $31,046.62 $0.00
$158,719.46Grand Total Payment amount for Project
Original Bid Final Invoice Amount
Verdek
UPGRADES UPGRADES
STATEMENT
Utah Department of Transportation
4501 S. 2700 W./ BOX 141510
801-965-2494 (for Accts. Receivables)
DATE:
STATEMENT # 201217-
Department of Environmental Quality
195 N 1950 W
Salt Lake City UT 84116
Customer ID: DEQ-VWGRANT
COMMENTS: Per VW Eligible Mitigation
Action Grant Agreement
#201217 - is
to be reimbursed
DATE DESCRIPTION AMOUNT BALANCE
//20
CURRENT 1-30 DAYS
PAST DUE
31-60 DAYS
PAST DUE
61-90 DAYS
PAST DUE
OVER 90 DAYS
PAST DUE AMOUNT DUE
$ $
REMITTANCE
Statement # 201217-
Date
Amount Due
Amount Enclosed
Make all checks payable to Utah Department of
Transportation. Please include the UDOT coding
block:
Unit
Appr XE
Program 73261
Phase
$ $
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 4 10-28-2020
lbarker October 28, 2020
lbarker
$129,272.84
Roll Document from 2020 to 2021
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
123 Rolling Meadow Rd
Check
true
10/28/20VC219254
Verdek LLC $129,272.84
Madison, CT 06443 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:
2 25170
Vehicle components & systems including safety & security
129272.84000 EA $129,272.84
84708 1 10-05-2020
$1.00 1
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1 2021
PartialDO 2002209759810 1 2 1
2800 6816810 7203 XED 73261 10U UDOT
AR2842 - BLUFF MAINTENANCE STATION
AP01 $129,272.84
Name Date 7/13/2020
Request # 6850987
Address WO # 6850987
City SLC State UT ZIP 84114 Acct # 56412930 002
Site ID # 125930787 006
Email Employee: p10009
Qty Unit Price TOTAL
1.0 $1,470.00 $1,470.00
TOTAL $1,470.00
Invoice costs are valid for only 90 days from invoice date!
Please remit payment to address at top of invoice.
Canyonlands
UDOT Strategic Investments
320 North 100 West
Moab, Utah 84532-2305
Attention: Lyle McMillan
4501 S 2700 W # 143600
Description
install span guy, 35' span guy pole, anchor
this material added to work order #6686602 due to customer
adding driveway in location of anchor needed
Office Use Only
PRO FORMA INVOICE
Customer
uCalc - Invoice Version 14May20
Request #6850987
56412930 002
7/13/20207/13/2020
$1,470.00
Page:of1 1
CREATION DATE:
STATE OF UTAH GENERAL ACCOUNTING EXPENDITURE
DOCUMENT TOTAL:
PRINT DATE: FY:
DOCUMENT DESCRIPTION:
VENDOR LINES:
ENTERED BY:
LAST USER:
BFY:
DOCUMENT NAME:
PERIOD:
07-20-2020
2021 1 1 July 20, 2020
lbarker
lbarker
$1,470.00
ALIAS/DBA:
VNDR LN: VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
SNGL CHK FL:
PYMT DT:
DISB TYPE:
AMOUNT:
HDLG CD:
1
320 N 100 W
true
07/20/20
Check
02408CK
Moab, UT 84532-2305 US
$1,470.00ROCKY MOUNTAIN POWER & LIGHT CANYONLAND OPE
ACCT LINE DESC:
ACCT LN:
VNDR INV LN:VNDR INV DT:
REF ACTG LN:
BFY:
REF VNDR LN:
PERIOD:FY:
VNDR INV #:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSADEPT
REF DOC:
1 $1,470.00
2800 6816810 7203 XED 73261 10U UDOT
Acct # 56412930 002
AP01
6850987 1 07-13-2020
Name Date 4/28/2020
Request # 6686602
Address WO # 6686602
City SLC State UT ZIP 84114 Acct # 56412930 002
Site ID # 125930787 006
Email Employee: p10009
Qty Unit Price TOTAL
1.0 $13,962.62 $13,962.62
TOTAL $13,962.62
Invoice costs are valid for only 90 days from invoice date!
Please remit payment to address at top of invoice.
Office Use Only
Moab, Utah 84532-2305
Description
Provide 3 phase power 277/480 to EV charging station for
UDOT at 350 W. Main, Bluff, UT.
Canyonlands
320 North 100 West
UDOT Strategic Investments
Attention: Lyle McMillan
4501 S 2700 W # 143600
PRO FORMA INVOICE
Customer
uCalc - Invoice Version 28Apr20
1 of 6
(UT May2019 - NoAdvRfnd) Estimator; Gary Lawley
Account #:56412930 002 C/C: 11406
Service ID #:125930787 006 Request #: 6686602
Monthly Contract #:
GENERAL SERVICE CONTRACT
(1000 KVA OR LESS)
between
ROCKY MOUNTAIN POWER
and
UDOT STRATEGIC INVESTMENTS
UDOT STRATEGIC
INVESTMENTS
at or near 450 W MAIN ST, BLUFF, Utah.
from time to time, regulate this Contract and are incorporated in this Contract. In the event of
any conflict between this Contract and the Electric Service Schedules or the Electric Service
request.
1. Delivery of Power. Company will provide 277/480 volt, three-phase electric service to
the Customer facilities.
2. Contract Demand. The demand in kVA that Customer requires to meet its load
requirement and Company agrees to supply and have available for delivery to
Customer, shall be 135 kVA (diversified, based on Customer's submitted load prior to
After 36 months of service the Company may reduce Contract Demand to the
maximum recorded and billed demand in the previous 36 months. The reduction in
Contract Demand shall become effective thirty (30) days after the Company provides
notice.
Demand, Company shall advise Customer in writing whether the additional power and
energy is currently available, or if not currently available, initiate the processes to
determine the costs to make it available.
3. Extension Costs.
Customer agrees to pay Company the estimated construction costs in excess of the
Customer has paid $0.00 for engineering, design, or other advance payment for
The balance due is $13,962.62.
2 of 6
provided for Company lines and equipment, may be subject to refund as calculated
using Company standard costs. As per tariff the refund will be 20% of the calculated
cost for shared facilities. This extension has no potential TCVR refunds.
4. Contract Minimum Billing. Customer agrees to pay a contract minimum billing (the
Company is ready to supply service. The Contract Minimum Billing shall be the greater
of: (1) the ; or, (2) $0.00 (the monthly facilities charge) plus
eighty percent (80%) of the . Billings will be based on Rate
Schedule No. 6 and superseding schedules.
5. Effective. This Contract will expire unless Customer signs and returns an original of this
Contract along with any required payment to Company within ninety (90) days of the
Contract date shown on page 1 of this Contract.
6. Contract Minimum Billing Term. This Contract becomes binding when both
Company and Customer have signed it, and will remain in effect for five (5) years
In the event Customer terminates service or defaults (which results in termination of
service) within the first five (5) years of this Contract, Customer shall be responsible for
paying the Contract Minimum Billing for the remainder of the Term.
If Customer is not ready to receive service from Company within one-hundred fifty (150)
days of the date Customer signs this Contract, then Company may terminate this
r
design, permitting and other associated Contract costs. However, if Company has
installed Improvements so that Company is ready to supply service, but Customer is
not ready to receive service from Company within such one-hundred fifty (150) day
period, then the failure of Customer to receive service may be treated as a Customer
default, and Customer shall be responsible for paying the Contract Minimum Billing for
remainder of the Term.
7. Customer Obligations. Customer agrees to:
a) Provide legal rights-of-way to Company, at no cost to Company, using Co
st
adjoining property and any permits, fees, etc. required to cross public lands;
ions;
c) Install all Customer provided trench, conduit, equipment foundations, or
excavations for equipment foundations within the legal rights-of-ways; and,
d)
8. Special Provisions: 1 meter (200 amp); customer has chosen contract buyout @
$13,400.48;
3 of 6
9. Underground Facilities. If service is provided by an underground line extension,
enching
and backfilling, imported backfill material, conduit and duct, and furnish and install all
equipment foundations, as designed by Company. Company may abandon in place
any underground cables installed under this Contract that are no longer useful to
Company.
Customer warrants that all Customer provided trench and excavations for equipment
foundations, and Customer installed conduit and equipment foundations are installed
Service Requirements Manual, and other specifications as otherwise provided by
Company. In the event Customer fails to comply with the foregoing, Customer shall be
liable for the cost to Company for relocating the facilities within a legal right-of-way,
acquiring right-of-way for Company facilities, repair or replacement of improperly
installed conduit or foundations, and paying costs for damages that may arise to any
third party as a result of Company facilities being located outside of a legal right-of-way.
The provisions of this paragraph 9 shall survive the termination of this Contract.
10. Design, Construction, Ownership and Operation. Company shall design, construct,
inst .
Com
facilities that serve or will serve Customer. Construction of the Improvements shall not
begin until (1) both Company and Customer have executed (signed) this Contract, and
(2) all other requirements prior to construction have been fulfilled, such as permits,
payments received, inspection, etc. Any delays by the Customer concerning site
preparation and right-of-way acquisition or trenching, inspection, permits, etc. may
correspondingly delay completion of the Improvements.
Company warrants that its work in constructing and maintaining the Improvements shall
be consistent with prudent utility practices. COMPANY DISCLAIMS ALL OTHER
WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE
WARRANTY OF MERCHANTABILITY, FITNESS FOR PARTICULAR PURPOSE,
AND SIMILAR WARRANTIES.
the Improvements, or installation of the Improvements shall be limited to repair or
replacement of any non-operating or defective portion of the Improvements or
liable for other economic losses, including but not limited to consequential damages.
Company shall not be subject to any liability or damages for inability to provide service
to the extent that such failure shall be due to causes beyond the reasonable control of
Company.
No other party, including Customer, shall have the right to operate or maintain
Improvements.
11. Payments. All bills shall be paid by the date specified on the bill, and late charges
shall be imposed upon any delinquent amounts. Company reserves the right to require
4 of 6
customer payments be sent by EDI or wire transfer. If Customer disputes any portion
of Customer's bill, Customer shall pay the total bill and shall designate the disputed
portion. Company shall decide the dispute within sixty (60) days after Customer's notice
of dispute. Any refund Company determines Customer is due shall bear interest at the
rate then specified by the Commission or, if no rate is specified, the then effective prime
rate as quoted in The Wall Street Journal.
Company may request deposits from Customer to the extent permitted under the
applicable Electric Service Regulations and the applicable Electric Service Schedule.
In the event of a default by Customer in any of its obligations, Company may exercise
any or all of its rights and remedies with respect to any such deposits.
12. Furnishing Information and Deposits. Customer represents that all information it has
furnished or shall furnish to Company in connection with this Contract shall be accurate
and complete in all material respects. Company will base its decision with respect to
credit, deposits, allowances or any other material matter on information furnished under
this section by Customer. Should such information be inaccurate or incomplete,
Company shall have the right to revoke or modify this Contract and/or its decision to
reflect the determination Company would have made had Company received accurate
and complete information. Company may request deposits, for the purpose of
guaranteeing payment of electric service b
Electric Service Regulation No. 9.
13. Governing Law; Venue. All provisions of this Contract and the rights and obligations
of the parties hereto shall in all cases be governed by and construed in accordance with
the laws of the State of Utah applicable to contracts executed in and to be wholly
performed in Utah by persons domiciled in the State of Utah. Each party hereto agrees
that any suit, action or proceeding in connection with this Contract may only be brought
before the Commission, the Federal courts located within the State of Utah, or state
courts of the State of Utah, and each party hereby consents to the exclusive jurisdiction
of such forums (and of the appellate courts therefrom) in any such suit, action or
proceeding.
14.Assignment. The obligations under this Contract are obligations at all times of
Any such assignment also shall be subject
applicable Electric Service Schedule, and (ii) such successor being bound by this
Contract and assuming the obligation of Customer from the date of assignment, which
may be evidenced by written agreement of such successor or other means acceptable
to Company. Company may condition this assignment by the posting by the successor
of a deposit as permitted under the applicable Electric Service Regulations and the
applicable Electric Service Schedule.
Company may at any time assign its rights and delegate its obligations under this
Contract to any: affiliate; successor in interest; corporation; or any other business entity
in conjunction with a merger, consolidation or other business reorganization to which
Company is a party.
5 of 6
15. Remedies; Waiver. Either party may exercise any or all of its rights and remedies
under this Contract, the applicable Electric Service Regulations, the applicable Electric
Service Schedule and under any applicable laws, rules and regulations. No provision
of this Contract, the Electric Service Regulations, or the applicable Electric Service
Schedule shall be deemed to have been waived unless such waiver is expressly stated
in writing and signed by the waiving party.
If any suit or action arising out of or related to this Contract is brought
by any party, the prevailing party or parties shall be entitled to recover the costs and
fees (including, without limitation, reasonable attorneys' fees, the fees and costs of
experts and consultants, copying, courier and telecommunication costs, and deposition
costs and all other costs of discovery) incurred by such party or parties in such suit or
action, including, without limitation, any post-trial or appellate proceeding, or in the
collection or enforcement of any judgment or award entered or made in such suit or
action.
17. Waiver of Jury Trial. TO THE FULLEST EXTENT PERMITTED BY LAW, EACH OF
THE PARTIES HERETO WAIVES ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY
IN RESPECT OF LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF,
UNDER OR IN CONNECTION WITH THIS CONTRACT. EACH PARTY FURTHER
WAIVES ANY RIGHT TO CONSOLIDATE ANY ACTION IN WHICH A JURY TRIAL
HAS BEEN WAIVED WITH ANY OTHER ACTION IN WHICH A JURY TRIAL
CANNOT BE OR HAS NOT BEEN WAIVED.
18. Entire Agreement. This Contract contains the entire agreement of the parties with
respect to the subject matter, and replaces and supersedes in their entirety all prior
agreements between the parties related to the same subject matter. This Contract
may be modified only by a subsequent written amendment or agreement
executed by both parties.
UDOT STRATEGIC INVESTMENTS
By
signature
Lyle McMillan Dir, Strategic Inv
NAME (type or print legibly) TITLE
DATE
ROCKY MOUNTAIN POWER
By
signature
Dan Vink manager
NAME (type or print legibly) TITLE
DATE
6 of 6
Contract
ATTENTION OF
ADDRESS
CITY, STATE, ZIP
EMAIL ADDRESS
for Executed Contract
320 N 100 W
ADDRESS
Moab, UT 84532
CITY, STATE, ZIP
c/o Amber Wiggins
EMAIL ADDRESS
Page:of1 1
CREATION DATE:
STATE OF UTAH GENERAL ACCOUNTING EXPENDITURE
DOCUMENT TOTAL:
PRINT DATE: FY:
DOCUMENT DESCRIPTION:
VENDOR LINES:
ENTERED BY:
LAST USER:
BFY:
DOCUMENT NAME:
PERIOD:
05-06-2020
1 May 06, 2020
rvanallen
rvanallen
$13,962.62
ALIAS/DBA:
VNDR LN: VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
SNGL CHK FL:
PYMT DT:
DISB TYPE:
AMOUNT:
HDLG CD:
1
320 N 100 W
false
05/06/20
Check
02408CK
Moab, UT 84532-2305 US
$13,962.62ROCKY MOUNTAIN POWER & LIGHT CANYONLAND OPE
ACCT LINE DESC:
ACCT LN:
VNDR INV LN:VNDR INV DT:
REF ACTG LN:
BFY:
REF VNDR LN:
PERIOD:FY:
VNDR INV #:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSADEPT
REF DOC:
1 $13,962.62
2800 6816810 7203 XED 73261 10U UDOT
ACCT# 56412930 002
AP01
6686602 1 04-28-2020
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2020 12 06-12-2020
lbarker June 12, 2020
lbarker
$9,902.80
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
P O Box 869
Check
true
06/12/20VC0000157045
Kilgore Companies $9,902.80
Magna, UT 84044 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:MA 810 169807
1 74512150160
Hot plant bituminous 12.5 (1/2") delivered pg grade 64-34
1.00000 EA $9,902.80
2600162-4 1 12-16-2019
$9,902.80 1
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1
Partial00
2800 6816810 7203 XED 73261 10U UDOT
169807 - HMA - 1/2 inch - Electrical Charging Stations
AP01 $9,902.80
Mth
08/20
Plus Sales Tax 0.00
Less Retainage 0.00
Total Due This Invoice 521.20
Retention Owed for Electrical Charging Station 2600162- 0 521.20
Total To Date 521.20
Description Contract Contract Item Unit Price Quantity Total
Terms
7906 Electrical Charging Station 2600162-4R 08/11/20 9/10/2020 Net 30 Days
Invoice
Bill to: UDOT Region #4
708 South 100 West
Richfield, UT 84701
Ship to:UDOT Region #4
708 South 100 West
Richfield, UT 84701
Cust # Customer Ref Invoice # Invoice Date Due Date
521.20
2600162-4R 08/11/20
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 4 11-02-2020
lbarker November 02, 2020
lbarker
$521.20
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
P O Box 869
Check
true
11/02/20VC0000157045
Kilgore Companies $521.20
Magna, UT 84044 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:MA 810 169807
1 74512150100
Hot plant bituminous 9.5 (3/8") delivered pg grade 58-22
1.00000 EA $521.20
2600162-4R 1 08-11-2020
$521.20 1
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1
Partial00
2800 6816810 7203 XED 73261 10U UDOT
#169807 - Cusomer 7906 - Retention for EVSE
AP01 $521.20
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 1 07-23-2020
lbarker July 23, 2020
lbarker
$4,990.00
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
61 W 300 N 19-10
Check
true
07/23/2014319H
LYLE NORTHERN ELECTRIC INC $4,990.00
BLANDING, UT 84511 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:
1 96435
Electricians
4990.00000 JOB $4,990.00
1018 1 07-20-2020
$1.00 3
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1 2021
FinalDO 2006264437810 1 1 1
2800 6816810 7203 XED 73261 10U UDOT
EVSE infrastructure
AP01 $4,990.00
STATE OF UTAH CONTRACT AMENDMENT
AMENDMENT #: 1 CONTRACT #: 199716
Utah Department of Transportation Contact Person:Denise Johnson
(Referred to as STATE)Phone Number:435-678-2415
And the following entity:Fax Number:
Lyle Northern Electric Email Address:denise@lnelectric.net
Vendor Code:14319H
BOTH PARTIES AGREE TO AMEND THE CONTRACT AS FOLLOWS:
The CONTRACT PERIOD is amended: The TOTAL CONTRACT AMOUNT is amended:
Original Starting Date: 06/29/2018 Current Contract Amount:
Original Expiration Date 10/28/2019 Amount Added by Amendment:
Current Expiration Date:
(if different from original)-New Contract Total Amount:
Amended Expiration Date:4/28/2021
X This is a requirements contract.
Effective Date of Amendment:10/11/2019
The purpose of this amendment is to extend the master contract for the AVL as the vendor has re-certified their ability to perform the
scope for 18 months.
Other changes to the contract include:
All other terms and conditions of the contract, including those previously modified, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties sign and cause this contract to be executed.
CONTRACTOR STATE OF UTAH
Signature Date UDOT Procurement Manager Date
Director of Operations Date
Title (Print) Contract Administrator Date
Purchasing Agent Phone # e-mail
Kai Turner 801-965-4071 kaiturner@utah.gov
Mailing Address: UDOT Procurement, P.O. Box 148260, Salt Lake City, UT 84114-8260
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 3 09-08-2020
lbarker September 08, 2020
lbarker
$200.00
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
61 W 300 N 19-10
Check
true
09/08/2014319H
LYLE NORTHERN ELECTRIC INC $200.00
BLANDING, UT 84511 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:MA 810 199716
1 96435
Electricians
1.00000 EA $200.00
1171 1 09-01-2020
$200.00 3
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1
Partial00
2800 6816810 7203 XED 73261 10U UDOT
Contract 199716 - Electrical Inspection
AP01 $200.00
STATE OF UTAH CONTRACT AMENDMENT
AMENDMENT #: 1 CONTRACT #: 199716
Utah Department of Transportation Contact Person:Denise Johnson
(Referred to as STATE)Phone Number:435-678-2415
And the following entity:Fax Number:
Lyle Northern Electric Email Address:denise@lnelectric.net
Vendor Code:14319H
BOTH PARTIES AGREE TO AMEND THE CONTRACT AS FOLLOWS:
The CONTRACT PERIOD is amended: The TOTAL CONTRACT AMOUNT is amended:
Original Starting Date: 06/29/2018 Current Contract Amount:
Original Expiration Date 10/28/2019 Amount Added by Amendment:
Current Expiration Date:
(if different from original)-New Contract Total Amount:
Amended Expiration Date:4/28/2021
X This is a requirements contract.
Effective Date of Amendment:10/11/2019
The purpose of this amendment is to extend the master contract for the AVL as the vendor has re-certified their ability to perform the
scope for 18 months.
Other changes to the contract include:
All other terms and conditions of the contract, including those previously modified, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties sign and cause this contract to be executed.
CONTRACTOR STATE OF UTAH
Signature Date UDOT Procurement Manager Date
Director of Operations Date
Title (Print) Contract Administrator Date
Purchasing Agent Phone # e-mail
Kai Turner 801-965-4071 kaiturner@utah.gov
Mailing Address: UDOT Procurement, P.O. Box 148260, Salt Lake City, UT 84114-8260
199716
14319H
CONTRACT #:
Bluff Station – West 1
Bluff Station – East 2