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HomeMy WebLinkAbout000967 Amendment City of Port Angeles VOR),� City y of Port Angeles Record # 000967 Public Works&Utilities Dept. Engineering 321 E.5"Street LIMITED PUBLIC WORKS PROCESS Port Angeles,WA 98362 11(; Tel: 360-417-4541 Fax: 360-417-4709 ❑ Request for Quotation ® Contract Contract Title: Cla-Val Valves Repair and Maintenance Project Number: CON15-25 THIS CONTRACT is entered into the date last below written between the CITY OF PORT ANGELES, WASHINGTON ("CITY") AND CASCADE WATER SYTEMS CORP, OREGON ("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 10 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 10 calendar days after notice to proceed and ends (90 days thereafter or after contract award). 3. PAYMENT A. The City shall pay the Contractor for the work performed under this contract (check one): ❑ Force Account -Time and material, not to exceed: $ ❑ Force Account- Time and actual expenses incurred, not to exceed: $ ❑ Force Account- 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: $ 13,008.00 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 CON 15-25 Page 1 Rev.4/8/2015 NA 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 and finish the work by whatever methods it may deem expedient, by giving 10 days written notice to the Project CON 15-25 Page 2 Rev.4/8/2015 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. INDEMINIFICATION / HOLD HARMLESS A. 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. B. 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 Project CON 15-25 Page 3 Rev.4/8/2015 waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. 11. INSURANCE The Contractor shall maintain insurance as set forth in Attachment B. 12. PREVAILING WAGE This Contract is subject to Chapters 39.12 and 49.28 RCW, amendments thereto and regulations issued thereunder, relating to prevailing wages, benefits and other requirements. Workers shall receive no less than the prevailing rate of wage. Bidders shall examine and be familiar with such requirements. No claim for additional compensation will be allowed which is based upon a lack of knowledge or a misunderstanding of any such requirements by the Bidder or a failure to include in Bidder's price adequate increases in such wages during the performance of this Contract. The Contractor is advised to consult the Washington State Department of Labor and Industries to determine the prevailing wages that must be paid. This public works project is being done in Clallam County. Washington State wage determinations for Clallam County Journeymen and Apprentices can be found at: https://fortress.wa.gov/Ini/wagelookup/prvWagelookup.aspx https://fortress.wa.gov/Ini/wagelookup/ApprenticeWa eLookup.aspx The applicable wage determinations to use have an effective on the bid due date. A copy of the applicable wage rates is available for viewing at the Port Angeles Public Works and Utilities Contracts Office. In addition, this agency will mail a hard copy of the applicable wage rates upon request. For a contract award 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 to 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. 16. SUBLETTING OR ASSIGNING OF CONTRACTS Project COM 5-25 Page 4 Rev.4/8/2015 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. 19. SUBCONTRACTOR RESPONSIBILITY A. 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. B. 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: • Industrial insurance coverage for the subcontractor's employees working in Washington as required in Title 51 RCW; • An employment security department number as required in Tile 50 RCW; and • A state excise tax registration number as required in Tile 82 RCW; • An electrical contractor license, if required by Chapter 19.28 RCW; • 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 CON15-25 Page 5 Rev.4/8/2015 IN WITNESS WHEREOF, the parties have executed this Contract as of C)EZ6 WI 2015. CASCADE WATER SYSTEMS CORP CITY OF PORT ANGELES By. By: A— Printed Name: 6(-v-1 6)c/k Printed Name: Title: 21-ve-c Title: A(.+f1,--\ APIVI % J J Address: 6-24 st (tom , J city: OR 97 1 17 Tax ID #: Phone Number: t L4 5-56, Project CON 15-25 Page 6 Rev.4/8/2015 City of Port Angeles ATTACHMENT "A" Engineering Office WORK BY CONTRACTOR Public Works and Utilities Department 360-417-4541 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. Site Point of Contact: James Burke at 360-417-4855. Work Hours and Schedule: The contractor will be allowed to work from 7 AM to 3:30 PM, Monday through Friday. Work outside of these hours may be requested from and is at the discretion of the City Engineer. Permits: None 1.0 Project Description Bid Item 1: Annual Servicing General Description: Inspection of Cla-Val Valves. Specifications: Servicing shall consist of cleaning all strainers in the main valve, exercising the valves, and checking the calibration to insure Cla-Val valves are properly functioning per the manufacture's specifications. The City shall supply all equipment, two City staff members with knowledge of the water system, and complete any documentation required for confined space entry. Additionally, the City shall provide any necessary traffic control revisions for work in the right-of-way. Servicing Parts and Locations: Below is a list of Cla-Val valves requiring inspection services: 2"model # 90G-01AS 6"model # 90G-01A6 Viewcrest&Peabody 2"model # 90G-01AS 6"model # 90G-01AB Craig &Porter 3"model # 90G-01AS Del Guzzi @ Motel 8 (S. of Hwy 101) 8"model # 90G-01AB 3"model # 90G-01AS 8"model #690G-01A6 Highland Hills Community 2"model #90G-01ABCSKC 6"model #90G-01BCSYKC 4"model #692G-01BCKCO Fairmount Pump Station 8"model #92DG-07BCSYKCO 6"model #90G-01BCSY 2"model #90G-01BCSY 3"model #50A-01B Campbell &Wabash 1"model #124G-01 3"model #90-01AS Golf Course Road 6"model #90G01AB Golf Course Road 16"model #92G-01B Jones Street Reservoir 12"model #60-08BY Ranney Well 8"model #52-01-60E Ranne y Well 10"model #80-OBEY Water Treatment Plant Project CON 15-25 Page 7 Rev.4/8/2015 10"model #80-013BY Water Treatment Plant 16"model #60-08-114K Water Treatment Plant 16"model #60-08-114K Water Treatment Plant Bid Item 2: Complete Rebuild General Description: Complete Rebuild and Maintenance of Cla-Val Valves Specifications: Complete rebuild/replacement of all rubber parts in the main valve and pilot systems with factory repair kits. Cleaning of cover and seating chambers, cleaning of all screens, filters, all speed controls, and cleaning of restriction fittings. Repair has to be in accordance with manufacture's original specifications. The City shall supply the Cla-Val factory repair kits. Service Parts and Locations: Perform complete rebuild, which shall consist of replacement of all rubber parts in main valve and pilot systems with factory repair kits, cleaning of cover and seating chambers, cleaning of all screens, filters, all speed controls, and cleaning of restriction fittings, on the following: 3"model # 90G-01AS Del Guzzi &Lindberg Rd 8"model #90G-01AB 12"model #208 E Street Reservoir Project CON 15-25 Page 8 Rev.4/8/2015 City of Port Angeles ATTACHMENT "B" Engineering Office Public Works and Utilities Department INSURANCE 360-417-4541 INSURANCE 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. 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 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: Project CON15-25 Page 9 Rev.4/8/2015 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. H. 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 CON 15-25 Page 10 Rev.4/8/2015 .--� CASCWAT-01 ROBIN ACORC7 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 912/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: tminnville,gan Hamilton Insurance PHONE (503)472-2165 FAX,No Box 847 A/C No Ext OR 97128 A DRIESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Liberty Mutual INSURED INSURER B:SAIF 36196 Cascade Water Systems Corp dba: Ridgeway Supply INSURER C: PO Box 100 INSURER D: Lafayette,OR 97128 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS; EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE D POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE FX] OCCUR X X BKS53744580 05/19/2015 05/19/2016 PREMISES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ] JE� F—] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT cc $ 1,000,000 Ea aident A X ANY AUTO X X BA053744580 05/19/2015 05/19/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS $ NON-OWNED Pe a RT DAMAGE X HIRED AUTOS X AUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE _$ 5,000,000 j _. A X EXCESS LIAR CLAIMS-MADE X X US053744580 05119/2015 05/19/2016 AGGREGATE $ DED X RETENTION$ 10,000 Aggregate $ 5,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y� NIA 919876 07/01/2015 07/01/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Equipment Floater BKS53744580 05/19/2015 05/19/2016 Leased Or Rented 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:PROJECT Number:CON15-25—PROJECT Title:Cla-Val Valves Repair and Maintenance The City of Port Angeles,their agents,representatives and employees are included as an additional insured per policy endorsement form CG8810 04-13 under the General Liability and CA8810 0110 under the Commercial Auto. Coverage is primary and non contributory. General Aggregate Limit Per Project applies per policy endorsement CG8870 12-08. Policy form CG0442 11-03;WA Stop Gap-Employers Liability applies,with an endorsement to follow. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Port Angeles Engineering Office/Public Works AUTHORIZED REPRESENTATIVE and Utilities Department 321 E 5th St Port Angeles,WA 98362 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD -City of Port Angeles ATTACHMENT "C" Engineering Office Public Works and Utilities Department BID RECEIVED 360-417-4541 Attached is the bid submitted by Cascade Water Systems Corp Project CON 15-25 Page 11 Rev.4/8/2015 QUOTATION FORM Project Title: Cla-Val Valves Repair and Mainkenancc Project Number: CON15-25 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. Bid items Bid Item 1-Annual Servicing: Lump Sum: Bid Item 2—Complete Rebuild Lump Sum: $ Subtotal: $ / C C icy Sales Tax (8.4%) $ 1 Cc Total Bid 5. The bidder hereby acknowledges that it has received Addenda No(s). (I e� Enter"N/A" if none were issued) to this Request for Quotation package. 6. 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: Contractor Information: 1. Company Name: 2. Address: CU —01�;� ` iyl t (�{a, t^z C /00 3. City, State, Zip Code: Or Cf-11 4. Phone Number: �vc3 4S Cs7 5. Contractor Registration Number: C.Ai C-AL ) 6. UBI Number: "Yoca 7. WA State Industrial Insurance Account Number: _ C- V-� 8. WA State Employment Security Dept Number: ll ' 9. State Excise Tax Registration Number: 4 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 °/"• I /� Title Printed Name: Date Project:CON15-25 Pate 3 Rev 8/30/2011