HomeMy WebLinkAbout4.376 Original Contract
01-14.24
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ROOF MEMBRANE/SYSTEM GUARANTEE
A member of the Icopal Group
Guarantee No.: 27090
Guarantee Date: August 2, 2004
SIPLAST. has sold materials which have been used in applying a Roof Membrane/System comprised solely of the Siplast Inc. Roof
Membrane, Rigid Roof Insulation designated as Paratherm Polyisocyanurate and/or Siplast Wood Fiberboard, and/or Dens Deck or
Dens Deck Prime as manufactured by Georgia-Pacific and distributed by Siplast, and Para fast Fasteners, and/or Insta-Stik
Professional Roofing Adhesive as manufactured by the Dow Chemical Company and distributed by Siplast to a building owned and
described as follows:
OWNER: City of Port Angeles
ADDRESS OF OWNER: 321 E. 5th Street
Port Angeles, WA 98362
JOB NAME & AREA: Fire Station - Port Angeles
ADDRESS OF BUILDING: 102 E. 5th Street
Port Angeles, WA 98363
USE OF BUILDING: City/County Facilities
SIPLAST HEREBY GUARANTEES TO THE ABOVE
OWNER, subject to the terms, conditions and limitations
stated herein, that the Roof Membrane/System (comprised
solely of the SIPLAST Roof Membrane, Paratherm and/or
Wood Fiberboard, and/or Dens Deck or Dens Deck Prime,
Parafast Fasteners and/or Insta-Stik Professional Roofing
Adhesive) at the above building will remain in a watertight
condition for a period of twenty (20) years, commencing with
the date hereof; or SIPLAST, will repair the Roof
Membrane/System at its own expense.
A. TERMS AND CONDITIONS
This Guarantee shall be subject to the following additional
terms and conditions.
1. SIPLAST shall be liable under this Guarantee only if:
a. The Roof Membrane is installed according to SIPLAST
specifications;
b. The Rigid Roof Insulation is installed according to
SIPLAST specifications;
c. The installation of the Roof MembrClne and Roof
Insulation is by a roofing contractor approved in advance
by SIPLAST;
d. The use of SIPLAST materials has been approved in
advance by SIPLAST.
B. NOTICE OF CLAIM
Any claim hereunder shall be deemed waived unless the
Owner shall have given SIPLAST written notice thereof
within thirty (30) days after a leak is discovered or should by
reasonable diligence have been discovered.
C. EXCLUSIONS FROM COVERAGE
This Guarantee does not cover leaks or failure of the Roof
Membrane/System to perform as guaranteed herein
resulting from occurrences beyol1d the control of SIPLAST
including but not limited to:
1. Damage to the Roof Membrane/System caused by
lightning, windstorm, "'ail, earthquake, tornado,
hurricane, flood, malicIous mischief, vandalism, chemical
or organic deposits or other unusual occurrences.
2. Damage to the Roof Membrane/System caused by (i)
abuse or abnormal 'Use of the roof or Roof
Membrane/System or (ii) any deliberate or negligent act
in maintaining the roof.
3. Damage to the Roof Membrane/System caused by
unauthorized repairs, alteraU::ns or modifications,
ROOF MEMBRANE:
ROOF DECK:
Paradiene 20/Paradiene 30 FR
Plywood
ROOF INSULATION:
Paratherm Polyisocyanurate,
Paratherm Polyisocyanurate,
Perlite
130 Squares
ROOF AREA:
ROOFING CONTRACTOR: Snyder Roofing of WA LLC
COMPLETION DATE: August 2, 2004
or subsequent work on or through the roof done without
prior written approval by SIPLAST of the methods and
materials to be used.
4. Damage to the Roof Membrane/System caused by
structural defects or failures (including, but not limited to,
settling or shifting of the building, and cracking or
movement of girders, beams, partitions or foundations) or
defects or failure of any substrate component, including
defects in application of any substrate component to
which the Membrane/System is installed.
5. Damage to the Roof Membrane/System caused by falling
objects.
6. Damage to the Roof Membrane/System caused by
movement of metal work used in conjunction with the
Roof Membrane/System.
7. Damage to the Roof Membrane/System caused by
installation of a sprinkler system, water or air corlciitioning
equipmel1t, radio or television antel1na, framework for
signs, water tower or other instal:ation on the roof after
the installation of the Roof Membrane without a prior
written approval by SIPLAST of the method::: and
materials to be used.
8. Damage to the Roof Membrane/System resulting from
other than occasional traffic across its surface or from its
use as a storage area or recreational surface or for any
other similar purposes,
9. Damage to the Roof Membrane/System caused by a
change in use of the building without prior written
approval of SIPLAST.
10.Damage to the Roof Membrane/System caused by
ponding of water or other conditions resulting from
improper drainage.
D. LIMITATION OF LIABILITY
SIPL.AST shall be liable only fo! the cost of repair Of such
eXisting Roof Membrane/System by a SIPLAST app;oved
contractor and will not be liable for damages to other
components of the roof assembly or the building or the
contents or for consequential damages, The expense of
removing and replacing traffic surfaces built over the roof
shall be borne by the Owner.
It shall be a condition to the liability of SIPLAST, hereunder
that SIPLAST have access to the roof during business hours
throughout the term of the Guarantee. This Guarantee will
be subject to all costs of installation being paid, including
those of the roofing contractor.
ll1iS tii.js-\F:A.'\r'~;::. 1~''4U t~i:; 5fATE::iYIENi':::\ObLil:iAYh)NS A,,:iJ Rcr;}iEf:EN'fATICNS HEREIN (;QNTAiiliEu, SHI\.lL BE IN
LIEU OF ANY AND ALL OTHER GUARANTEES, EXPRESS OR IMPLIED, II~CLUDING, WITHOUT LIMITATION, ANY IMPLIED
GUARANTEE OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE. SIPLAST SHALL NOT BE LIABLE FOR
ANY DAMAGE TO THE BUILDING OR CONTENTS THEREOF, OR FOR ANY CONSEQUENTIAL, INCJDENTAL, SPECIAL OR
PENAL DAMAGES, SIPLAST AGENTS HAVE NO AUTHORITY TO GIVE GUARANTEES BEYOND THOSE PROVIDED IN THIS
GUARANTEE.
SIPLAST, I~ ..---
By: I +~-k
Gregory T. Faherty, President - /
1000 E. Rochelle Blvd., Irving, Texas 75062 Toll Free 1 8009228800 www.siplast.com
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PUBLIC WORKS
CONTRACT
Fire Hall Apparatus Bay; Drywall Ceiling and Roof Insulation I Vapor Barrier Removal
This Contract is made and entered into in duplicate thiscR.6JA-day of~, dJ{jDI
by and between the City of Port Angeles, a non-charter code city of the State of Washington,
hereinafter referred to as "the City", and Aldergrove Construction Inc., a Washington Corporation
hereinafter referred to as "the Contractor".
WITNESSETH:
Whereas, the City desires to have certain public work performed as hereinafter set forth,
requiring specialized skills and other supportive capabilities; and
Whereas, the Contractor represents that it is qualified and possesses sufficient skills and the
necessary capabilities to perform the services set forth in this Contract.
NOW, THEREFORE, in consideration of the terms, conditions, and agreements contained
herein, the parties hereto agree as follows:
1. Scope of Work.
The Contractor shall do all work and furnish all tools, materials, and equipment in order to
accomplish the project as described in the attached Scope of work, Exhibit A -Bid#l, and included
provlSlons.
The Contractor shall do said work in accordance with and as described in this Contract, which
includes the attached scope of work, performance bond, and the 2000 Standard Specifications for
Road, Bridge, and Municipal Construction prepared by the Washington State Department of
Transportation, including section 1-99APW A supplement, and shall perform any alterations in or
additions to the work provided under this Contract and every part thereof. 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.
2. Time for Performance and Liquidated Damages.
A. Time is ofthe essence in the performance ofthis Contract and in adhering to the time
frames specified herein. The Contractor shall commence work within ten (10)
PublIc Warks Contract - Page 1 of 7
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calendar days after notice to proceed from the City, and said work shall be physically
completed within~ working days after said notice to proceed, unless a different
time frame is expressly provided in writing by the City.
B. Ifsaid work is not completed within the time for physical completion, the Contractor
may be required at the City's sole discretion to pay to the City liquidated damages as
set forth in the WSDOT Standard Specifications, for each and every day said work
remains uncompleted after the expiration of the specified time.
3. Compensation and Method of Payment.
A. The City shall pay the Contractor for work performed under this Contract as detailed
in the attached Exhibit B. Bid item # 1, lump sum cost $5,371.00, shall be the
maximum compensation for the respective bid items. The Equipment item, scissor
lift with operator, is a rental rate and will be paid at $430.00 per day for each day it
is used by the structural engineer for inspections of the underside ofthe apparatus bay
roof.
B. Payments for work provided hereunder shall be made following the performance of
such work, unless otherwise permitted by law and approved in writing by the City.
No payment shall be made for any work rendered by the Contractor except as
identified and set forth in this Contract.
C. Progress payments shall be based on the timely submittal by the Contractor of the
City's standard payment request form.
I
D. Payments for any alterations in or additions to the work provided under this Contract
shall be in accordance with the City's standard design clarification/variation request
(DCVR) form and/or change order process. Following approval ofthe DCVR and/or
change order, the Contractor shall submit the standard payment request formes).
E. The Contractor shall submit payment requests with a completed Application for
Payment form, an example of which is included in the Attachments to this Contract.
This form includes a lien waiver certification and shall be notarized before
submission. Applications for payment not signed or notarized shall be considered
incomplete and ineligible for payment consideration under the Contract provisions.
The City shall initiate authorization for payment after receipt of a satisfactorily
completed payment request form and shall make payment to the Contractor within
approximately thirty (30) days thereafter.
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F. Independent Contractor Relationship.
The relationship created by this Contract is that of independent contracting entities. No
agent, employee, servant, or representative of the Contractor shall be deemed to be an employee,
agent, servant, or representative of the City, and the employees ofthe contractor are not entitled to
any ofthe benefits the City provides for its employees. The Contractor shall be solely and entirely
responsible for its acts and the acts of its agents, employees, servants, subcontractors, or
representatives during the performance of this Contract. The Contractor shall assume full
responsibility for payment of all wages and salaries and all federal, state, and local taxes or
contributions imposed or required, including, but not limited to, unemployment insurance, workers
compensation insurance, social security, and income tax withholding.
4. Prevailing Wage Requirements.
The Contractor shall comply with applicable prevailing wage requirements of the
Washington State Department of Labor & Industries, as set forth in Chapter 39.12 RCW and Chapter
296-127 WAC. The Contractor shall document compliance with said requirements and shall file
with the City appropriate affidavits, certificates, and/or statements of compliance with the State
prevailing wage requirements. The Washington State Prevailing Wage Rates For Public Works
Contracts, Clallam County, incorporated in this Contract have been established by the Department
of Labor & Industries. The Contractor shall also ensure that any subcontractors or agents of the
Contractor shall comply with the prevailing wage and documentation requirements as set forth
herein.
5. Indemnification and Hold Harmless.
A. The Contractor shall defend, indemnify, and hold harmless the City, its officers,
officials, employees, and volunteers against and from any and all claims, injuries,
damages, losses, or lawsuits, including attorney fees, arising out of or in connection
with the performance ofthis Contract, except for injuries and damages caused by the
sole negligence of the City. It is further provided that no liability shall attach to the
City by reason of entering into this Contract, except as expressly provided herein.
B. Should a court of competent jurisdiction determine that this Contract is subject to
RCW 4.24.115, then, in the event ofliability 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
Contractors 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 ofthis section shall survive the expiration or termination ofthis Contract.
PublIc Warks Contract - Page 3 of 7
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6. Insurance.
The Contractor shall procure and maintain for the duration ofthe Contract, 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. Failure by the Contractor to maintain the insurance as required shall constitute a
material breach of contract upon which the City may, after giving five working 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, off set against
funds due the Contractor from the City.
A. Minimum Scope of Insurance
The 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.
11. 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, 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 2503 11 85. 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 11 85 or a substitute endorsement providing equivalent coverage.
111. Workers' Compensation coverage as required by the Industrial Insurance
laws of the State of Washington.
B. Minimum Amounts of Insurance
The Contractor shall maintain the following insurance limits:
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1. Automobile LiabilIty insurance with a minimum combined single limit for
bodily injury and property damage of $1 ,000,000 per accident.
11. Commercial General Liability insurance shall be written with limits no less
than $1,000,000 each occurrence, $2,000,000 general aggregate and a
$2,000,000 products-completed operations aggregate limit.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions for
Automobile Liability and Commercial General Liability insurance.
1. The Contractor's insurance coverage 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.
11. The Contractor's insurance shall be endorsed to state that coverage shall not
be cancelled by either party, except after thirty (30) days prior written notice
by certified mail, return receipt requested, has been given to the City.
D. 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
The 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 include all subcontractors as insureds under its policies or shall furnish
separate certificates and endorsements for each subcontractor. All coverages for
subcontractors shall be subject to all ofthe same insurance requirements as stated herein for
the Contractor.
7. Compliance with Laws.
A. The Contractor shall comply with all applicable federal, state, and local laws,
including regulations for licensing, certification, and operation of facilities and
programs, and accreditation and licensing of individuals, and any other standards or
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criteria as set forth in the project manual.
B. The Contractor shall pay any applicable business and permit fees and taxes which
may be required for the performance of the work.
C. The Contractor shall comply with all legal and permitting requirements as set forth
in the project manual.
8. Non-discrimination. The parties shall conduct their business in a manner which assures fair,
equal and nondiscriminatory treatment of all persons, without respect to race, creed, color, sex,
Vietnam era veteran status, disabled veteran condition, physical or mental handicap, or national
origin, and, in particular:
A. The parties will maintain open hiring and employment practices and will welcome
applications for employment in all positions from qualified individuals who are
members of the above-stated minorities.
B. The parties will comply strictly with all requirements of applicable federal, state or
local laws or regulations issued pursuant thereto, relating to the establishment of
nondiscriminatory requirements in hiring and employment practices and assuring the
service of all patrons and customers without discrimination with respect to the above-
stated minority status.
9. Assignment.
A. The Contractor shall not assign this Contract or any interest herein, nor any money
due to or to become due hereunder, without first obtaining the written consent ofthe
City, nor shall the Contractor subcontract any part of the services to be performed
hereunder without first obtaining the consent ofthe City.
B. The Contractor hereby assigns to the City any and all claims for overcharges resulting
from antitrust violations as to goods and materials purchased in connection with this
Contract, except as to overcharges resulting from antitrust violations commencing
after the date of the bid or other event establishing the price of this Contract. In
addition, the Contractor warrants and represents that each of its suppliers and
subcontractors shall assign any and all such claims for overcharges to the City in
accordance with the terms ofthis provision. The Contractor further agrees to give the
City immediate notice of the existence of any such claim.
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10. Contract Administration.
This Contract shall be administered by 1J4L"Tf~ L 1JJL.L'f~ behalf ofthe Contractor
and by J(tn.../ -:J;;;l~'" StJ-h./ on behalf of the City. Any written notices required by the
terms of this Contract shall be served or mailed to the following addresses:
Contractor:
City:
Aldergrove Const. Inc.
1705 West 12th Street
Port Angeles, W A 98363
City of Port Angeles
P.O. Box 1150
321 East Fifth Street
Port Angeles, W A 98362-0217
11. 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 Clallarn
County, Washington.
IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day
and year first set forth above.
CONTRACTOR:
CITY OF PORT ANGELES:
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By: Na 0 ontrac~or
WA-....~ l. \)A&..~yM1L..f
Title: J. c...c
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Approved as to Form:
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City Attorney
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Attest:
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PublIc Works Contract - Page 7 of 7
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EXHIBIT A
SCOPE OF WORK
Fire Hall Apparatus Bay; Drywall Ceiling and Roof Insulation I Vapor Barrier Removal
Bid #1: Remove the sheetrock ceiling, batt roof insulation I vapor barrier at the two center bays
(there is a total of six bays) of the Apparatus Bay and haul to the Landfill. The City will pay for
all dumping fees related to this project. It is required that the work at these two bays be
completed within 4 consecutive working days. Working days over 8 hours may be worked if
necessary.
Bid #2: Remove the sheetrock ceiling, batt roof insulation I vapor barrier at the remaining four
bays of the Apparatus Bay and haul to the landfill. The City will pay for all dumping fees related
to this project. The remaining 4 bays are to be done "two-at-a-time". It is required that the work
at these four bays be completed within 8 consecutive working days. Working days over 8 hours
may be worked if necessary.
If this work is required, our wishes are to have the contractor perform it nearly immediately after
completing the two above bays in Bid #1, pending the Structural Engineer's inspection
schedule.
The above bids are to include the foJ/owing provisions:
-provide Prevailing Wages per current guidelines.
-Be certain to turn off the vehicle exhaust ventilation system prior to starting any work. The Fire
Dept. will assist you in turning off the proper circuit breakers.
-Provide a full perimeter visqueen curtain from floor to ceiling surrounding each pair of adjacent
bays, including the north & south walls and overhead doors. Tape the visqueen full-length to the
floor and full length at joints for a dust-proof seal. Ok to staple or batten visqueen to ceiling, but
remove staples or fasteners upon completion of demolition work.
-Provide a full-surround dust proof visqueen wrap around ceiling heater elements and turn off
each unit's individual breaker. Remove and dispose of visqueen once the ceiling is removed
and dust is cleaned up and turn all breakers back on.
-Provide a full-surround dust proof visqueen wrap around overhead door motors. Remove and
dispose of visqueen once the ceiling is removed and dust is cleaned up.
-City crews will remove all equipment, loose items, etc., at the bays the contractor is working.
The City will coordinate moving items with the Contractor's schedule. Contractor to take
necessary steps to avoid interference with Fire Dept. daily & emergency operation.
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-Pull all sheetrock nails or screws so bottom chords of roof trusses are smooth. Take
precautions not to tear truss chords. If sheetrock screws were used. back out each screw as
reauired. No Dullina out of screws will be Dermitted.
-Completely remove in a neat fashiofl the existing roof insulation batts, vapor barrier, and
suspension wires holding up insulation and haul debris to the landfill.
-Prior to any demolition work at each pair of bays, unplug and remove light fixtures and ceiling
"Spudnik" speaker and store in Fire Dept. provided area. Re-hang and re-connect fixtures once
ceiling removal work is completed.
-Provide temporary support for existing air hoses and lines, electrical cords, and possibly the
ceiling heaters.
-Contractor is to obtain all necessary building and related permits prior to starting work.
-Be aware of conduits, fire sprinkler lines, etc., underneath the ceiling sheetrock and in the attic
area. The Contractor is responsible for any damage to existing construction, vehicles, or
equipment.
-Clean floors with fine broom to a dust-free condition upon completion of each pair of bays.
-Rolling staging or bucket truck(s) may be used. Contractor may use a dump truck or dumpster
inside visqueened area to dump debris into, but must take steps to eliminate dust tracking to
non-work areas and damaging the floor with the dumpster rollers.
-Provide a cost per day (prevailing wages apply) for a 2-man scissor lift and operator, capable
of reaching the underside of the Apparatus Bay roof.
This lift will be necessary to provide the Structural Engineer a platform to inspect the roof
structure once the ceiling area(s) has I have been removed. It is not known at the present time
how many days this / these inspection(s) may take.
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EXHIBIT B
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,lJ.idergrove Construction, Inc,
1705 West 12th Street
Port Angeles, WA 98363
PROPOSAL
DATE PROPOSAL NO.
360457-2067 P, 360457-6765 F
10/0212001
Bid Item 1
CUSTOMER NAME & ADDRESS:
City of Port Angeles
P.O. Box 1150
Port Angeles, WA 98362
Attn: Kirk Johnson
ITEM DESCRIPTION QTY RATE TOTAL
This Proposal is for Bid Item 1 of the PA Fire Hall Appartatus Bay Inspection.
Demolition Demolition of ceiling in middle two bays. 1 5,371.00 5,371.00
Includes all labor, material and equipment to make trusses and underside of
roof available for inspection.
Equipm... Scissor lift with operator, Per Day 1 430.00 430.00
Alternate to scissor lift.
Rolling staging could be provided at no cost.
Note: Excludes the following:
Washington State Sales Tax
Bond
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SIGNATURE
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TOTAL
$5,801.00 \
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;:.l,ioer5-!rOVe l".OnsrnJL-dOH, ,fiL.
1705 West 12th Street
Port Angeles, WA 98363
PROPOSAL
360457-2067 P, 360457-6765 F
I DATE PROPOSAL NO.
110/0212001 Bid Item 2
CUSTOMER NAME & ADDRESS:
I City of Port Angeles
P.O. Box 1150
Port Angeles, WA 98362
Attn: Kirk Johnson
I !
I ITEM DESCRIPTION QTY RATE TOTAL I
I
,
This Proposal is for Bid Item 2 of the PA Fire Hall Apparatus Bay Inspection.
Demolition Demolition of ceiling in each of the outer two bays. 2 5,000.00 10,000.00
Includes all labor, material and equipment to make trusses and underside of
roof available for inspection.
Equipm.. . Scissor lift with operator, Per Day 2 430.00 860.00
Alternate to scissor lift.
Rolling staging could be provided at no cost.
Note: Excludes the following:
Washington State Sales Tax
Bond
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SIGNATURE
TOTAL
$10,860.00 i
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',.ACORQM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDfYY)
10/16/2001
PRODUCER (425)454-9346 FAX (425)646-4799 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Baldwin Resource Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
RECE~V IE ,_" ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 1848 l:r
Bellevue, WA 98009 INSURERS AFFORDING COVERAGE
~"'.,. - - nftnt
INSURED Al dergrove Construction, Inc. ULl ~ f LUlU INSURER A Underwriters at Lloyds of London
1705 West 12th INSURER B North Pacific Ins. Co.
Port Angeles, WA 98362 INSURER C
INSURER D
I INSURER E
COVERAGES
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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE POLICY NUMBER P~l-+~~~~~8gm~ Pg~!fl/~~~~N LIMITS
LTR
~NERAL LIABILITY 1\01BF110 01/23/2001 01/23/2002 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 50,000
I-:J CLAIMS IvlADE 00 OCCUR MED EXP (Anyone person) $ 5,000
A 7 $2500 ded PD PERSONAL & ADV INJURY $ 1,000,000
I-- .
X Per project aggre GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS" COMP/OP AGG $ 2,000,000
"I nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY 10 11-77-34 01/23/2001 01/23/2002 COMBINED SINGLE LIMIT
- $
X ANY AUTO (Ea aCCident) 1,000,000
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
B X
HIRED AUTOS BODILY INJURY
- $
X NON-OWNED AUTOS (Per aCCident)
-
- PROPERTY DAMAGE $
(Per aCCident)
GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
=:J OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND ~TATUTORY I TORY LIMITS I IOJ~-
EMPLOYERS' L!ABILITY E LEACH <>'CCIDENT $
E L DISEASE - EA EMPLOYEE $
E L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
he City of Port Angeles, its Officers and Employees are additional insureds with respect to liability
arising out of the operations by or on behalf of the named insured
RE: Port Angeles Fire Hall Apparatus Bay Inspection
ANCELS AND REPLACES CERTIFICATE ISSUED 10-12-01 **By Certified rlail
CERTIFICATE HOLDER I I ADDITIONAL INSURED, INSURER LETTER' CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Port Angeles EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~~ MAIL
2L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, **
Dept of Public Works
Attn: Ron Johnson J(OO}OO()(~){K)(~~X)t~16~)@(j~X~XX
P.O. Box 1150 N~nN~~lOOVXJ~~~~)(*~~XXXXXXXX
Port Angeles, WA 98362 AUTHORIZED REPRESEj;IV'
(J ,'~' ' o",p, ~~,.." ;1;1 .d
I,,' of 0 ..- . ~ ~ J
ACORD 25-S (7/97) ... o __ _.- @ACORD'CORPORATION 1988
~._- -~~ , ~
,,~
:
CONTRACTOR'S APPLICATION FOR PAYMENT
TO: City of Port Angeles
Public Works & Utilities Department
P.O. Box 1150
Port Angeles, W A 98362
DATE:
PAYMENT REQUEST NO.
FROM: Aldergrove Construction Inc.
1705 West 12th Street
Port Angeles, WA 98362-0217
PROJECT NAME: Fire Hall Apparatus Bay
PROJECT NUMBER: 21-14
PERIOD From:
to [end of period]:
1 Contract Amount Thru Approved Change Order Noo_ E* $
[Excluding Sales Tax]
2 Work Completed to Date [per attached continuation sheets] J* $
3 Sales Tax (Port Angeles is 8.2% of [2]) $
4 Amount Retained (5% of [2])** $
5 Subtotal ([2]+[3]-[4]) $
6 Total Previously Paid [Deduction] G* $
7 AMOUNT DUE THIS REQUEST ([5]-[6]) $
STATEMENT OF CONTRACT ACCOUNT
*correspond to column letters shown on the continuation sheet.
**Enter zero if a retainage bond has been approved
Page 1 of 2
t
.
CONTRACTOR'S APPLICATION FOR PAYMENT
WAIVER OF CLAIMS FOR EXTRA COST OR TIME: The undersigned Applicant waives and releases, up
through the date hereof, any and all claims for costs or item extensions arising out of or relating to extra or
changed work or delays or acceleration not specifically identified and reserved in the amounts identified
below or previously acknowledged in writing by the City of Port Angeles.
CERTIFICATE OF THE CONTRACTOR: I hereby certify that the work performed and the materials
supplied through the ending period date noted above represents the actual value of accomplishment under
the terms of the contract (and all authorized changes) between the Applicant and the City of Port Angeles,
relating to the above referenced project, and that the remaining contract balance is sufficient to cover all
costs of completing the work in accordance with the contract documents.
I also certify that all lower-tier payments, less applicable retention, have been made by the Applicant for the
periods covered by previous payment received by the Applicant to (1) all lower-tire
subcontractors/suppliers, and (2) for all materials, equipment and labor used or in connection with the
performance of this contract. I further certify that I have complied with all Federal, State and local tax laws,
including Social Security laws and Unemployment Compensation laws and Workmen's Compensation laws,
insofar as applicable to the performance of this work, and have paid all such taxes, premiums and/or
assessments arising out of the performance of the work.
I further certify that, to the best of my knowledge, information and belief, all work for which previous
payment(s) have been received shall be free and clear of liens, claims, security interests and
encumbrances in favor of the Contractor, subcontractors, material suppliers, or other persons or entities
making a claim by reason of having provided labor, materials and equipment relating to the work.
Within seven (7) days of receipt of the payment requested herein, all payments, less applicable retention,
will be made through the period covered by this pay request to all my lower-tier subcontractors/suppliers
and for all materials, equipment, labor, taxes and assessments arising out of the performance of all said
lower-tier work.
DATED:
CONTRACTOR:
SIGNATURE:
PRINTED NAME AND TITLE:
SUBSCRIBED AND SWORN to before me this
day of
Notary Public in and for the State of
residing at
My appointment expires
APPROVAL:
Project Manager
Date
City Engineer
Date
PW-402.13 [rev. 1/01]
Page 2 of 2
1 of 1 Original Counterparts
s
PERFORMANCE and PAYMENT BOND
Bond to the City of Port Angeles
Bond # 103 641 310
KNOW ALL MEN BY THESE PRESENTS:
That we. the undersigned, AJderQrove Construction Inc. as Principal, and Travelers Casualty & Surety
Company of America a ccrporation, organized and exisbng under the laws of the State of CT.
Wasbi~, as a Sllrety corporation. and Qualfied under the laws of the State of Washington to become
surety upon bonds of contractors with munlc:pai corpo~tlons as SlXfJty, are jointly and severally held and
firmly bound to the Cjty of Port Angeles In tne psnal sum of S ** 5,371.00** for the payment at
wnich sum on demand we bind ourse~ and our succeSsors. heirs, admmistrators or personal
reprezenta6ves. as the case may be.
Thi~ obligat!Qn is entered Into pursuant to the statutes of the State of Washington and the ordinances of 1he
City of Port Angeles.
, WashIngton. this.1l. day of
October
.2001 .
Dated at
Seattle
The conditions of the above obligation arc such that:
WHEREAS, the City of Port Angeles has let or is about to let to thasald Aldergrove Construction, Inc.
the above bounded PrtnClpal, a certain contract, tho S:1id c:ontract
being numbered 21-1~--, end providing for Fire Hall Aocaratus B~\I caillnQ, and Insulation rernoYi'L
(which conbact 1$ referred to herein and is made a pan hereof as though attached hereto). and
WHEREAS, tho s~id Principal has accepted. or is about to accept, the S03ld contract, and undertake to
pelform the work therein provided for in the manner and within the time set forth; naN, therefore,
If the said PnnClpal. Aldergrove Construction, Inc. , shajf rarthfully perform aU
of the provisions of said contrnct In the manner and within the time therein set forth. or INlthln such
extensIons of time as may be granted under said contract. and snail pay aU 1abora~. machanic:z.
subcontractors and materialmen, and ail persons who shall supply Goard Principal or iubcontractors with
provisions and supplies for the carrying on of said work. and shall Indemnify and hcki the City of Port
Ar19.eI~ hC'1rmlcss from any damage or expense by reason of failure of performance as spcofied in said
contrad or from defects appeatir'lg or developing rn the material or workmanstllp PrtMdod or performed
under :3Sid contract Within a period af one year after Its acceptance thereof by the City of Port Angeles. then
and illlh....t event, this obligation shall be void: but otherwlse. It shaft be and ramaln In full force and effect.
Signed thi::;.1l... day of October
Travelers Casualty and Surety
Company of Amercia
S~rety/
By. Itl...J+
R.A. F~x,
Attorney in Fact
Tille B.A. Tower - 3850
701 5th Ave
Seattle, WA 98104
5ucc; Address t
K.yle tIowa
(206) 386-5762
Surel)' Coot~ct and Phone Number
2001.
-. -
Inc.
DO NOT REMOVE THIS PAGE FROM PROJECT MAN.UAL
11- 3
.
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY 1/1 #103641310
Hartford. CODDecUcut 06183-9061
. ~ J~~
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT
KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,
corporations duly orgi'm17ed under the laws of the State of Connecticut, and havIng their principal offices in the City of Hartford,
County of Hartford. State of Connecticut, (hereinafter the "Compames") hath made. constituted and appointed. and do by these
presents make, constitute and appomt: Christine V. Felicetty, N. B. Fa. R.A. FIX, of Seattle. Washington, the1l'true and lawful
Attomey(s)-lIl-Fact, with full power and authonty hereby conferred to sign. execute and acknowledge, at any place WIthin the Umted
States, the followmg instrument(s): by hislher sole Signature and act, any and all bonds, recognizances, contracts of indemnIty, and
other wntlngs obligatory m the nature of a bond, recogrnzance, or conditional undertakmg and any and all consents lIlCldent thereto
and to bmd the Compames, thereby as fully and to the same extent as If the same were Signed by the duly authonzed officers of the
Compames, and all the acts of Sald Attomey(s)-m-Fact, pursuant to the authonty herem given. are hereby raofied and confirmed.
This appomtment is made under and by authonty of the follOWIng Standing Resolutions of said Compames, which Resoluuons are
now m full force and effect:
VOTED. That the Chamnan, the President, any Vice ChaIrman, any Execunve Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any AsSistant Treasurer, the Corporate Secretary or any AsSIStant Secretary may appomt Attorneys-in-Fact
and Agents to act for and on behalf of the company and may gIve such appomtee such authonty as !us or her cert1ficate of authonty may prescnbe
to Sign Wlth the Company's name and seal Wlth the Company's seal bonds, recogmzances, contracts of ind.emmty, and other wntmgs obligatory m
the narure of a bond, recogmzance, or conditional undertakmg, and any of said officers or the Board of Directors at any time may remove any such
appomtee and revoke the power gl ven lum or her.
VOTED. That the Chamnan, the PreSident, any Vice Chamnan, any Executive Vice PreSident, any Sernor Vice PreSident or any Vice President
may delegate all or any part of the foregomg authonty to one or more officers or employees of tills Company, proVlded that each such delegation IS
m wntmg and a copy thereof is filed in the office of the Secretary.
VOTED. That any bond, recogmzance, contract of mciemmty, or wntmg obligatory in the nature of a bond, recogmzance, or conditional
undertakmg shall be valid and bmding upon the Company when (a) signed by the PresIdent, any Vice Chauman, any Executive Vice PreSident, any
Semor Vice PreSident or any Vice PreSident, any Second Vice President, the Treasurer, any AsSistant Treasurer, the Corporate Secretary or any
AsSiStant Secretary and duly attested and sealed Wlth the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, 1f
reqmred) by one or more Attomeys-m-Fact and Agents pursuant to the power prescnbed m his or her cert1ficate or thel1" certificates of authonty or
by one or more Company officers pursuant to a wntten delegation of authonty
This Power of Attorney and Certificate of Authority is signed and sealed by facsimile under and by authority of the following
Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and F.AR.l\1INGTON CASUALTY COMPANY, which
Resolution is now in full force and effect:
VOTED. That the signature of each of the following officers: President, any Executive Vice PresIdent, any Sernor Vice President, any Vice
PreSident, any ASSistant Vice President, any Secretary, any AsSiStant Secretary, and the seal of the Company may be affixed by facsmule to any
power of attorney or to any certlficate relanng thereto appomtIng Resident Vice Presidents, Resident AsSiStant Secretanes or Attorneys-m-Fact for
purposes only of executmg and attestmg bonds and undertakIngs and other wntIngs obligatory 111 the nature thereof, and any such power of attorney
or ceruficate beanng such facslIIllle signature or facsmule seal shall be valid and bmdmg upon the Company and any such power so executed and
cernfied by such facsumle Signature and facsimile seal shall be valid and bmding upon the Company m the future Wlth respect to any bond or
undertakmg to wluch It IS attached.
(5-00 Standard)
t
IN WITNESS m~~~, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRA:~:.
CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrumenL to be
signed by their Senior Vice President and their corporate seals to be hereto affixed this 18th day of August, 2000.
STAlE OF CONNECTICUT
} S8. Hartford
COUN1Y OF HARTFORD
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY
~~~~~c
-
By
George W. Thompson
Senior Vice President
On this 18th day of August. 2000 before me personally carne GEORGE W. THOMPSON to me known, who, being by me duly
sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMl'lANY, the
corporatIons described in and wInch executed the above mstrument; that he/she knows the seals of saId corporatIons; that the seals
affixed to the said mstrument are such corporate seals; and that he/she executed the saId instrument on behalf of the corporatIons by
authority ofluslher office under the Standing ResolutIons thereof.
~~
C-~
My commiSSion expires June 30, 2001 Notary PubliC
Marie C. Tetreault
CERTIFICATE
I, the undemgned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,
TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, Slock corporatIons of
the State of ConnectIcut, DO HEREBY CERTIFY that the foregomg and attached Power of Attorney and Cernficate of Authority
remams In full force and bas not been revoked; and furthermore, that the Standing Resolutions of the Boards of DlI'CCtors, as set
forth in the Certificate of Authonty, are now in force.
Signed and Sealed at the Home Office of the Company, In the CIty of Hartford, State of Connecticut. Dated tIns 23rd day of
OCTOBER ,20 01.
~ -/'U- ,-." p? ~
By ~
Kori M. Johanson
Assistant Secretary, Bond