Mark two coordinates you wish to measure with the combined grid factor. The factor can only be used to measure two coordinates at a time, so, if you have more than two coordinates to factor, you'll need to do each two points individually before adding them all up for one final distance.
Measure the distance between both points. Since the combined grid factor takes into account scale, make sure to use the same measurement that the grid is scaled into.
Multiply the distance of the two measured points with the combined factor. The results will tell the ellipsoid distance between the two measured points.