HomeMy WebLinkAbout000542 Original ContractVORT
City of Port Angeles
Public Works Utilities Dept.
Operations Office
1703 South B Street
Port Angeles WA 98362
Tel. 360 417 -4541
Fax: 360-452-4972
Contract Title: PAPD Carnet Replacement
City of Port Angeles
Record #000542
LIMITED PUBLIC WORKS PROCESS
Request for Quotation
Contract
Project Number: PK- 12- 039/PD02 -11
THIS CONTRACT is entered into the date last below written between the CITY OF PORT ANGELES, WASHINGTON
"CITY AND INTEGRITY CONSTRUCTION GROUP "CONTRACTOR
1. WORK BY CONTRACTOR
The Contractor shall perform the work as described in Attachment "A" (Attachment "A" may include Contractor's
Proposal, Scope of Work, Statement of Work, Plans, Specifications, and any other related Contract Documents)
which is attached hereto and by this reference is incorporated herein.
2. TERM OF CONTRACT
All work under this Contract is to be completed as indicated (check one):
All work under this Contract is to be completed by this date:
All work under this Contract is to be completed 30 days from the Notice to Proceed. No work is
to be performed prior to written Notice to Proceed by the City.
The performance period under this Contract commences calendar days after contract
award and ends calendar days after contract award.
3. PAYMENT
A. The City shall pay the Contractor for the work performed under this contract (check one):
n
Time and material, set forth in the Contractor's bid or quote: $28.595.92
Time and actual expenses incurred, not to exceed:
Unit prices set forth in the Contractor's bid or quote, not to exceed:
Firm Fixed Price set forth in Contractor bid or quote in the amount of:
The Contractor shall do all work and furnish all tools, materials, and equipment, in accordance
with and as described in the Attachment "A
The Contractor shall provide and bear the expense of all equipment, work and labor of any sort
whatsoever that may be required for the transfer of materials and for constructing and completing
the work provided for in this contract and every part thereof; except as are mentioned in the
specifications to be furnished by the City of Port Angeles.
B. The Contractor shall maintain time and expense records, which may be requested by the City. The
contractor shall submit invoices to the City for payment for work performed. All invoices must reference the
City's contract number. Invoices shall be in a format acceptable to the City.
C. The City shall pay all invoices from the Contractor by mailing a City warrant within 30 days of receipt of a
properly completed invoice.
D. All records and accounts pertaining to this Contract are to be kept available for inspections by
representatives of the City for a period of three (3) years after final payment. Copies shall be made available
to the City upon request.
Project PK -12 -039 Page 1
E. If during the course of the Contract, the work rendered does not meet the requirements set forth in the
Contract, the Contractor shall correct or modify the required work to comply with the requirements of this
Contract. The City shall have the right to withhold payment for such work until it meets the requirements of
the Contract Documents.
4. RESPONSIBILITY OF CONTRACTOR
A. Safety. Contractor shall take all necessary precautions for the safety of employees on the work site
and shall comply with all applicable provisions of federal, state and local regulations, ordinances and codes.
Contractor shall erect and properly maintain, at all times, as required by the conditions and progress of the
work, all necessary safeguards for the protection of workers and the public and shall post danger signs
warning against known or unusual hazards.
B. Correction of Defects. Contractor shall be responsible for correcting all defects in workmanship and /or
materials discovered within one year after acceptance of this work. When corrections of defects are made,
Contractor shall be responsible for correcting all defects in workmanship and /or materials in the corrected
work for one year after acceptance of the corrections by the City. The Contractor shall start work to
remedy such defects within seven (7) days of mailing notice of discovery thereof by City and shall complete
such work within a reasonable time. In emergencies where damage may result from delay or where loss of
service may result, such corrections may be made by the City, in which case the cost shall be borne by the
Contractor. In the event the Contractor does not accomplish corrections at the time specified, the work will
be otherwise accomplished and the cost of same shall be paid by the Contractor.
C. Warranty. Contractor shall be liable for any costs, losses, expenses or damages including
consequential damages suffered by the City resulting from defects in the Contractors work including, but
not limited to, cost of materials and labor expended by the City in making emergency repairs and cost of
engineering, inspection and supervision by the City. The Contractor shall hold the City harmless from any
and all claims which may be made against the City as a result of any defective work and the Contractor
shall defend any such claims at its own expense. Where materials or procedures are not specified in the
Contract Document, the City will rely on the professional judgment of the Contractor to make appropriate
selections.
D. Nondiscrimination /Affirmative Action. Contractor agrees not to discriminate against any employee or
applicant for employment or any other persons in the performance of this Contract because of race, creed,
color, national origin, marital status, sex, age or handicap, or other circumstances as may be defined by
federal, state or local law or ordinance, except for a bona fide occupational qualification. Contractor agrees
to post in conspicuous places, available to employees and applicants for employment, notices to be
provided by Contractor setting forth the provisions of the nondiscrimination clause.
E. Employment. Any and all employees of the Contractor, while engaged in the performance of any work
or services required by the Contractor under this Contract, shall be considered employees of the Contractor
only and not of the City. Any and all claims that may arise under the Workers Compensation Act on behalf
of said employees, while so engaged, and all claims made by a third party as consequence of any negligent
act or omission on the part of the Contractor's employees, while so engaged on any of the work or services
provided or rendered herein, shall not be the obligation of the City.
5. COMPLIANCE WITH LAWS
The Contractor shall comply with all federal, state and local laws and regulations applicable to the
work done under this Contract. Any violation of the provisions of this paragraph shall be considered a violation of
a material provision of this Contract and shall be grounds for cancellation, termination or suspension of the
Contract by the City, in whole or in part, and may result in ineligibility for further work for the City.
6. TERMINATION OF CONTRACT
A. This Contract shall terminate upon satisfactory completion of the work described in Attachment "A"
and final payment by the City.
B. The City may terminate the Contract and take possession of the premises and all materials thereon
Project PK -12 -039 Page 2
and finish the work by whatever methods it may deem expedient, by giving 10 days written notice to the
Contractor, upon the occurrence of any one or more of the events hereafter specified.
1. The Contractor makes a general assignment for the benefit of its creditors.
2. A receiver is appointed as a result of the insolvency of the Contractor.
3. The Contractor persistently or repeatedly refuses or fails to complete the work required herein.
4. Contractor fails to make prompt payment to subcontractors for material or labor.
5. Contractor persistently disregards federal, state or local regulations and ordinances.
6. Contractor persistently disregards instructions of the Contract Administrator, or otherwise
substantially violates the terms of this Contract.
7. The City determines that sufficient operating funds are not available to fund completion of the work
contracted for.
C. In the event this Contract is terminated by the City, Contractor shall not be entitled to receive any
further amounts due under this Contract until the work specified in Attachment "A" is satisfactorily
completed, as scheduled, up to the date of termination. At such time, if the unpaid balance of the amount
to be paid under this Contract exceeds the expense incurred by the City in finishing the work, and all
damages sustained by the City or which may be sustained by reason of such refusal, neglect, failure or
discontinuance of employment, such excess shall be paid by the City to the Contractor. If the City's
expense and damages exceed the unpaid balance, Contractor and his surety shall be jointly and severally
liable therefore to the City and shall pay such difference to the City. Such expense and damages shall
include all legal costs incurred by the City to protect the rights and interests of the City under the Contract,
provided such legal costs shall be reasonable.
7. OWNERSHIP OF DOCUMENTS
A. On payment to the Contractor by the City of all compensation due under this Contract, all finished or
unfinished documents and material prepared by the Contractor with funds paid by the City under this
Contract shall become the property of the City and shall be forwarded to the City upon its request.
B. Any records, reports, information, data or other documents or materials given to or prepared or
assembled by the Contractor under this Contract will be kept confidential and shall not be made available to
any individual or organization by the Contractor without prior written approval of the City or by court order.
8. CLAIMS
Any claim against the City for damages, expenses, costs or extras arising out of the performance of this
Contract must be made in writing to the City within thirty days after the discovery of such damage, expense
or loss, and in no event later than the time of approval by the City for final payment. Contractor, upon
making application for final payment, shall be deemed to have waived its right to claim for any other
damages for which application has not been made, unless such claim for final payment includes notice of
additional claim and fully describes such claim.
9. GENERAL ADMINISTRATION AND MANAGEMENT
The Director of the Public Works and Utilities Department or his /her designee shall have primary responsibility for
the City under this Contract and shall oversee and approve all work to be performed, coordinate communications,
and review and approve all invoices, under this Contract.
10. HOLD HARMLESS
A. The Contractor shall protect, defend, indemnify and save harmless the City, its officers, employees and
agents from any and all costs, claims, judgments or awards of damages, arising out of or in any way resulting
from the negligent acts or omissions of the Contractor. The Contractor agrees that its obligations under this
subparagraph extend to any claim, demand, and /or cause of action brought by, or on behalf of, any of its
employees or agents. For this purpose, the Contractor, by mutual negotiation, hereby waives, as respects the
City only, any immunity that would otherwise be available against such claims under the industrial insurance
provision of Title 51 RCW. In the event the City obtains any judgment or award, and /or incurs any cost arising
therefrom including attorneys' fees to enforce the provisions of this article, all such fees, expenses, and costs
shall be recoverable form the Contractor.
Project PK -12 -039 Page 3
B.'The City shall protect, defend, indemnify and save harmless the Contractor, its officers, employees and
agents from any and all costs, claims, judgments or awards of damages, arising out of or in any way resulting
from the negligent acts or omissions of the City. The City agrees that its obligations under this subparagraph
extend to any claim, demand, and /or cause of action brought by, or on behalf of, any of its employees or
agents. For this purpose, the City, by mutual negotiation, hereby waives, as respects the Contractor only, any
immunity that would otherwise be available against such claims under the industrial insurance provision of Title
51 RCW. In the event the Contractor obtains any judgment or award, and /or incurs any cost arising therefrom
including attorneys' fees to enforce the provisions of this article, all such fees, expenses, and costs shall be
recoverable form the City.
11. INSURANCE
The Contractor shall maintain insurance as set forth in Attachment B.
12. PREVAILING WAGE
This Contract is subject to the requirements of Chapter 39.12 RCW, and as it may be amended, relating to
prevailing wages. On Public Works projects, funded in part or in whole with Federal funds, Federal wages laws
and regulations shall also be applicable. NO WORKER, LABORER OR MECHANIC EMPLOYED IN THE
PERFORMANCE OF ANY PART OF THIS CONTRACT SHALL BE PAID LESS THAN THE PREVAILING RATE OF WAGE
as determined by the Industrial Statistician of the Department of Labor and Industries for the State of
Washington. The schedule of prevailing wage rates for this Contract is made a part of this contract as though
fully set forth herein.
Prior to making any payment under this Contract, the City must receive an approved copy of the "Statement
of Intent to Pay Prevailing Wages on Public Works Contracts" from the Department of Labor and Industries.
It is the Contractor's responsibility to obtain and file the "Statement of Intent to pay Prevailing Wage". The
Contractor shall be responsible for all filing fees. Each invoice shall include a signed statement that
prevailing wages have been paid by the Contractor and all subcontractors. Following the final acceptance
of services rendered, Contractor shall submit an "Affidavit of Wages Paid
For a contract award or an on -call contract work order under $2,500, and in accordance with RCW 39.12.040(2),
the contractor or subcontractor is authorized to submit a combined Statement Of Intent To Pay Prevailing Wages
Affidavit Of Wages directly to the City of Port Angeles at final invoicing. Submission shall be made on the form
developed by the Washington State Department of Labor and Industries and available from the City of Port
Angeles Public Works and Utilities Department.
In case any dispute arises as to what are the prevailing rates of wages for a specific trade, craft or occupation
and such dispute cannot be adjusted by the parties in interest, including labor and management representatives,
the matter shall be referred for arbitration to the Director of the Department of Labor and Industries, and his
decision shall be final, conclusive, and binding on all parties involved in the dispute.
13. INTERPRETATION AND VENUE
This Contract shall be interpreted and construed in accordance with the laws of the State of Washington. The
venue of any litigation between the parties regarding this Contract shall be Clallam County, Washington.
14. BRANDS OR EQUAL
When a special "brand or equal" is named it shall be construed solely for the purpose of indicating the standards
of quality, performance, or use desired. Brands of equal quality, performance, and use shall be considered,
provided Contractor specifies the brand and model and submits descriptive literature when available. Any bid
containing a brand which is not of equal quality, performance, or use specified must be represented as an
alternate and not as an equal, and failure to do so shall be sufficient reason to disregard the bid.
15. INSPECTION AND REJECTION
All goods, services, work, or materials purchased herein are subject inspection and to approval by the City. Any
rejection of goods, services, work, or materials resulting because of nonconformity to the terms and specifications
of this order, whether held by the City or returned, will be at Contractor's risk and expense.
Project PK -12 -039 Page 4
16. SUBLETTING OR ASSIGNING OF CONTRACTS
Neither the City nor the Contractor shall assign, transfer, or encumber any rights, duties or interest accruing from
this Contract without the express prior written consent of the other.
17. INDEPENDENT CONTRACTOR
The Contractor is and shall be at all times during the term of this Contract an independent contractor and not
an employee of the City.
18. EXTENT OF CONTRACT /MODIFICATION
This Contract, together with the attachments and /or addenda, represents the entire and integrated Contract
between the parties hereto and supersedes all prior negotiations, representations, or agreements, either
written or oral. This contract may be amended, modified or added to only by written instrument properly
signed by both parties hereto.
This Contract, together with the attachments and /or addenda, represents the entire and integrated Contract
between the parties hereto and supersedes all prior negotiations, representations, or agreements, either
written or oral. This contract may be amended, modified or added to only by written instrument properly
signed by both parties hereto.
19. SUBCONTRACTOR RESPONSIBILITY
The Contractor shall include the language of this section in each of its first tier subcontracts, and shall require
each of its subcontractors to include substantially the same language of this section in each of their subcontracts,
adjusting only as necessary the terms used for the contracting parties. The requirements of this section apply to
all subcontractors regardless of tier.
At the time of subcontract execution, the Contractor shall verify that each of its first tier subcontractors
meets the following bidder responsibility criteria:
At the time of subcontract bid submittal, have a certificate of registration in compliance with chapter 18.27
RCW;
Have a current state unified business identifier number;
If applicable, have:
1) Industrial insurance coverage for the subcontractor's employees working in Washington as required in
Title 51 RCW;
2) An employment security department number as required in Tile 50 RCW; and
3) A state excise tax registration number as required in Tile 82 RCW;
4) An electrical contractor license, if required by Chapter 19.28 RCW;
5) An elevator contract license, if required by Chapter 70.87 RCW.
Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065(3).
Project PK -12 -039 Page 5
IN WITNESS WHEREOF, the parties have executed this Contract as of %Col 30 201 2
INTEGRITY CONSTRUCTION GROUP CITY OF PORT ANGELES
By:
6./ L)
Printed Name: ,`cam
By:
Project PK 12 039 Page 6
Printed Name: Oa" re-1 m.ck e"'
Title: Title: CA -'"1 rt ct e'
Address: "10% A '3 4
.j
City: ArCer+7vs1.r f..r9' q 7
Tax ID C 10 �g1°IF51a-
Phone Number: Purchase Order u°` 5 25 `T
City of Port Angeles
Operations Office
Public Works and Utilities Department
360- 417 -4541
ATTACHMENT "A"
WORK BY CONTRACTOR
The contractor shall do all work and furnish all tools, materials, and equipment in order to accomplish the project
described below. Unless otherwise provided for in the Statement of Work, the Contractor will be responsible for
obtaining and paying for any and all permits required for this work.
General Scope: Remove existing carpeting in the Port Angeles Police Department Offices and replace with
Carpet Tiles.
Location: City Hall /Port Angeles Police Department (PAPD), 321 East 5th Street, Port Angeles WA 98362.
Site Point of Contacts: Corey Delikat, Park Superintendent- 360 417 -4566.
Terry Gallagher, Police Chief- 360 417 -4901.
Work Hours: The contractor will be allowed to work at City Hall /Police Department between the hours of 7:00
A.M. to 4:30P.M., Monday through Sunday. The Contractor can request additional hours of operation to better
accommodate PAPD and Contractor Staff and must be approved by the Site Point of Contact. Due to possible
security issues, work outside of these hours may be requested from and is at the discretion of the City's Site Point
of Contacts. Contractor will be notified in advance if such changes need to made.
Site Visit: A pre -bid walk is scheduled for 10:00 A.M., December 4, 2012, at the work site. All bidders are
encouraged to attend.
Work Requirements:
1.0 Project Description
1.) The Contractor shall follow all WISHA safety regulations.
2.) The Contractor shall maintain a clean and safe work area free of excessive debris.
3.) The Contractor shall be responsible for moving all appliances and furniture in the PAPD offices prior to
commencing work and moving them back to the same location after work is completed.
4.) Contractor is required to clean up the work area and properly dispose of any debris. The old flooring
system is the property of the contractor and needs to be disposed properly.
5.) Once flooring is removed, the concrete slab needs prepared for new carpeting. Use trowelable leveling
and patching compounds, according to manufacturer's written instructions, to fill cracks, holes, and
depressions in substrates.
6.) Remove any coatings, including curing compounds, and other substances that are incompatible with
adhesives and that contain soap, wax, oil, or silicone, without using solvents. Use mechanical methods
recommended in writing by following carpet manufacturer.
7.) Install Patcraft "Big Splash" Modular Carpet Tiles or a carpet tile of equal quality throughout PAPD offices.
Color of carpeting will be selected by the Site Point of Contacts.
8.) Direct -Glue -Down Installation must comply with CRI 104, Section 8, "Direct Glue -Down Installation.
Project PK -12 -039 Page 7
9.) Cut and fit carpet to butt tightly to vertical surfaces, permanent fixtures, and built -in furniture including
cabinets, pipes, outlets, edgings, thresholds, and nosings. Bind or seal cut edges as recommended by
carpet manufacturer.
10.) Extend carpet into toe spaces, door reveals, closets, open- bottomed obstructions, removable flanges,
alcoves, and similar openings.
11.) Maintain reference markers, holes, and openings that are in place or marked for future cutting by
repeating on finish flooring as marked on subfloor. Use nonpermanent, non staining marking device.
12.) Install pattern parallel to walls and borders.
13.) Install carpet in recessed inserts on floor mounted electrical box covers.
14.) Remove excess adhesive, seam sealer, and other surface blemishes using cleaner
recommended by carpet manufacturer. Remove yarns that protrude from carpet surface and vacuum
carpet using commercial machine with face beater element.
15.) After installation, the Contractor will install four (4) inch ROPPE Pinnacle Rubber Wall base or a wall
base of equal quality. Color of wall base will be selected by the Site Point of Contact.
16.) The Contractor will use ROPPE Pinnacle Rubber Base or a wall base of equal quality. The
Contractor must prepare floor surface in accordance with manufacturer's installation instructions. Check
slab for acceptable moisture levels to meet or exceed manufacturer's requirements.
17.) The ROPPE Pinnacle Rubber Wall Base will be installed according to manufacturer's written installation
instructions.
18.) Below is the footprint of the PAPD offices and bidders should verify their own measurements onsite
before submitting bid.
Project PK -12 -039 Page 8
Project PK -12 -039
Page 9
City of Port Angeles
Operations Office
Public Works and Utilities Department
360- 417 -4541
INSURANCE INDEMNITY REQUIREMENTS FOR
CONSTRUCTION AND SERVICE CONTRACTS
Includes construction and remodeling, janitorial service, tree maintenance, road maintenance, painting,
electrical work, plumbing, movers, and on site maintenance agreements.
Indemnification Hold Harmless
The Contractor shall defend, indemnify and hold the City, its officers, officials, employees and
volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees,
arising out of or in connection with the performance of this Agreement, except for injuries and damages
caused by the sole negligence of the City.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115.
then, in the event of liability for damages arising out of bodily injury to persons or damages to property
caused by or resulting from the concurrent negligence of the Contractor and the City, its officers,
officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the extent of the
Contractor's negligence. It is further specifically and expressly understood that the indemnification
provided herein constitutes the Contractor's waiver of immunity under Industrial Insurance. Title 51
RCW. solely for the purposes of this indemnification. This waiver has been mutually negotiated by the
parties. The provisions of this section shall survive the expiration or termination of this Agreement.
Insurance
ATTACHMENT B
INSURANCE
The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims
for injuries to persons or damage to property which may arise from or in connection with the
performance of the work hereunder by the Contractor, their agents, representatives, employees or
subcontractors.
No Limitation
Contractor's maintenance of insurance, its scope of coverage and limits as required herein shall not be
construed to limit the liability of the Contractor to the coverage provided by such insurance, or
otherwise limit the City's recourse to any remedy available at law or in equity.
Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non owned, hired and leased vehicles.
Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form
providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide
contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and
shall cover liability arising from premises, operations, independent contractors, products
completed operations, stop gap liability, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General Liability insurance shall be
endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85 or an
equivalent endorsement. There shall be no endorsement or modification of the Commercial
Project PK -12 -039 Page 10
General Liability Insurance for liability arising from explosion, collapse or underground property
damage. The City shall be named as an insured under the Contractor's Commercial General
Liability insurance policy with respect to the work performed for the City using ISO Additional
Insured endorsement CG 20 10 10 01 and Additional Insured Completed Operations
endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of
Washington.
Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident.
2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each
occurrence, $2,000,000 general aggregate and $2,000,000 products completed operations
aggregate limit.
Other Insurance Provision
The Contractor's Automobile Liability and Commercial General Liability insurance policies are to
contain, or be endorsed to contain that they shall be primary insurance as respect the City. Any
insurance, self insurance, or insurance pool coverage maintained by the City shall be excess of the
Contractor's insurance and shall not contribute with it.
Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not less than A: VII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements,
including but not necessarily limited to the additional insured endorsement, evidencing the insurance
requirements of the Contractor before commencement of the work.
F. Subcontractors
The Contractor shall have sole responsibility for determining the insurance coverage and limits required,
if any, to be obtained by subcontractors, which determination shall be made in accordance with
reasonable and prudent business practices.
G. Notice of Cancellation
The Contractor shall provide the City and all Additional Insureds for this work with written notice of
any policy cancellation, within two business days of their receipt of such notice.
Project PK -12 -039 Page 11
II. Failure to Maintain Insurance
Failure on the part of the Contractor to maintain the insurance as required shall constitute a material
breach of contract, upon which the City may, after giving five business days notice to the Contractor to
correct the breach, immediately terminate the contract or, at its discretion, procure or renew such
insurance and pay any and all premiums in connection therewith, with any sums so expended to be
repaid to the City on demand, or at the sole discretion of the City, offset against funds due the
Contractor from the City.
Project PK -12 -039 Page 12
City of Port Angeles
Operations Office
Public Works and Utilities Department
360- 417 -4541
See attached listing:
Project PK -12 -039 Page 13
ATTACHMENT "C"
PREVAILING WAGE RATES
1. Washington State Prevailing Wage Rates For Public Works Contracts Journey Level and Apprentices,
Clallam County, effective 11/8/2012.
2. To access applicable prevailing rate(s) of wages rates for the describe work by trade, use the following Labor
and Industries website link: httn:// www. lni. wa. sov/ TradesLicensina /PrevWaae/WaeeRates /default.asn
3. A copy of the applicable prevailing wage rates can be obtain by contacting Lucy Hanley at 360 417 -4541 or by
email, lhanlevna,citvofna.us. A hard copy is available for viewing in person at 1703 South B Street, Port Angeles,
WA. 98363.
QUOTATION FORM
Project Title: ELPD Cap Re;men# Project Number: PK- I2-039
The bidder hereby bids the following amounts for all work (including labor. equipment, time
and materials) required to perform the work in the Statement of Work and this package.
1. Time Material o
Sales Tax (8.4%) IS °i
Total Bid 5 9 5 99-
Note: Time and material shall not exceed $27,100.00
3 The bidder hereby acknowledges that it has received Addenda No(s).
(Enter `N/A° if none were issued) to this Request for Quotation package.
4. The name of the bidder submitting this bid and its business phone number and address, to which
address all communications concerned with this bid and with the contract shall be sent, are listed
below. Any written notices required by the terms of an awarded contract shall be served or mailed to
the following address:
reciabgetOr InfOn
1. Company Name:
4. 1 2r s le on S At ur. C-3
2. Address: tO5 Nor 4 35 5-krr t
3. City, State, Zip Cade: 11;4 O r 1 7
4. Phone Number: ,953 t9 096-3 (W
5. Contractor Registration Number:
6. UBI Number: Coo 3 10 -119'
7. WA State Industrial Insurance Account Number. 09-8406 10. a
8. WA State Employment Security Dept Number 4g to ct R
9. State Excise Tax Registration Number. (49 t
The bidder represents that it is qualified and possesses sufficient skills and the necessary capabilities
to perform the services set forth in this Contract.
Signed by
Title
Printed Name:
Date 12 v 1 rte)
Project: PK -12 -039 Page 3 Rev 8/311f201 t