Loading...
HomeMy WebLinkAbout17-141 - ICON Materials (dba CPM Development Corporation) - 2017 Overlay and Repair Program17-141 Council Approval 8/7/17 C-1 AGREEMENT FORM r CONTRACT NO. I -1 — I `-4-I THIS AGREEMENT is made and entered into on this ' 1 day of 5LLS1_,, , 20 . j')by and between the City of Tukwila, Washington ("Owner") and (Rn\T e4 Corgi Div; a.ciJ r&A1-E2tM-S ("Contractor"). Now, therefore the parties agree as follows: 1. Project. Contractor shall complete all work and furnish all labor, tools, materials, and equipment for the project entitled 2017 OVERLAY PROGRAM, Project No. 91610401 including all changes to the Work and force account work, in accordance with the Contract Documents, as described in Section 1-04.2 of the Supplemental General Requirements. 2. Payments. Owner shall pay Contractor at the unit and lump sum prices, and by force account as specified in the Proposal according to the Contract Documents as to time, manner, and condition of payment. The payments to Contractor include the costs for all labor, tools, materials and equipment for the Work. 3. Completion Date. Contract time shall commence upon Owner's Notice to Proceed date. The Work under this Agreement shall be completed within the time specified in the Proposal. If the Work under this Agreement is not completed within the time specified, as detailed in the Contract Documents, Contractor shall pay liquidated damages and all engineering inspection and supervision costs to Owner as specified in the Proposal. 4. Attorney's Fees. In the event litigation is commenced to enforce this Agreement, the prevailing party shall be entitled to recover its costs, including reasonable attorney's and expert witness fees. 5. Disclaimer. No liability of Contractor shall attach to Owner by reason of entering into this Agreement, except as expressly provided in this Agreement. 6. Counterparts. This Agreement is executed in two (2) identical counterparts, by the parties, each of which shall for all purposes be deemed an original. CITY OF TUKWILA, WASHINGTON (Owner) By: etNa5 t. M Attes j 14 This ` 1 day of or App . •fid as o Form• CPM Development Corporation DBA ICON Materials (Contra By: Title: enior Project Manager Attest: This 3rd day of August , 20 17 Mark Eichelberger Contractor's License No. £ SgA Ms. y30(40- ICONM**982CF City Attorney Address for giving notices: ( 3ao S \cam �tvL. Sr6, to() wPis ni W 2017 OVERLAY PROGRAM Address for giving notices: 1508 Valentine Ave SE Pacific, WA 98047-2103 5 i (,,°/6/4Vi*-S JUNE 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal PAYMENT AND PERFORMANCE BOND Bond to City of Tukwila, Washington Bond No. 9262707 We CPM Development Corporation dba Icon Materials and Fidelity and Deposit Company of Maryland (Principal) (Surety) a Maryland corporation, and as a surety corporation authorized to become a surety upon Bonds of Contractors with municipal corporations in Washington State, are jointly and severally bound to the City of Tukwila, Washington ("Owner"), in the penal sum of Six Hundred Fifty Nine Thousand Four Hundred Forty One nd 00/100 Dollars ($ 659,441.00 ), the payment of which sum, on demand, we bind ourselves and our successors, heirs, administrators, executors, or personal representatives, as the case may be. This Payment and Performance Bond is provided to secure the performance of Principal in connection with a contract dated August 7 2017 , between Principal and Owner for a project entitled 2017 OVERLAY PROGRAM , Contract No. 91610401 ("Contract"). The initial penal sum shall equal 100% of the Total Bid Price, including sales tax, as specified in the Proposal submitted by Principal. NOW, THEREFORE, this Payment and Performance Bond shall be satisfied and released only upon the condition that Principal: • Faithfully performs all provisions of the Contract and changes authorized by Owner in the manner and within the time specified as may be extended under the Contract; • Pays all laborers. mechanics, subcontractors, lower tier subcontractors, material men, and all other persons or agents who supply labor, equipment, or materials to the Project; • Indemnifies and holds Owner, its officers, and agents harmless from and against all claims, liabilities, causes of action, damages, and costs for such payments for labor, equipment, and materials by satisfying all claims and demands incurred under the Contract, and reimbursing and paying Owner all expenses that Owner may incur in making good any default by Principal; and • Indemnifies and holds Owner harmless from all claims, liabilities, causes of action, damages and costs, including property damages and personal injuries, resulting from any defect appearing or developing in the material provided or workmanship performed under the Contract. The indemnities to Owner shall also inure to the benefit of the Consulting Engineers and other design professionals retained by Owner in connection with the Project. The liability of Surety shall be limited to the penal sum of this Payment and Performance Bond. No change, extension of time, alteration, or addition to the terms of the Contract or to the Work to be performed under the Contract shall in any way affect Surety's obligation on the Payment and Performance Bond. Surety hereby waives notice of any change, extension of time, alteration, or addition to the terms of the Contract or the Work, with the exception that Surety shall be notified if the Contract time is extended by more than twenty percent (20%). If any modification or change increases the total amount to be paid under the Contract, Surety's obligation under this Payment and Performance Bond shall automatically increase in a like amount. Any such increase shall not exceed twenty-five percent (25%) of the original amount of the Payment and Performance Bond without the prior written consent of Surety. 2017 OVERLAY PROGRAM Page 26 Payment and Performance Bond Provided to Builders Exchange of WA, Inc For usage Conditions Agreement see www.bxwa.com - Always Verify Scale JUNE 2017 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by DAVID MCVICKER, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Tina DAVIS, Lisa HALL, Lindsey PLATTNER and Linda NIPPER, all of Salt Lake City, Utah, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of June, A.D. 2017. Assistant Secretary Joshua Lecker ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Vice President David McVicker State of Maryland County of Baltimore On this 15th day of June, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, DAVID MCVICKER, Vice President, and JOSHUA LECKER, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA -F 020-8022W RELEASE OF RETAINAGE BOND Bond Number: 9262708 KNOW ALL MEN BY THESE PRESENTS, that we CPM Development Corporation dba Icon Materials as Principal, (the "Principal"), and Fidelity and Deposit Company of Maryland, a corporation organized under the laws of the State of Maryland as Surety, (the "Surety"), are held and firmly bound unto City of Tukwila as Obligee, (the "Obligee"), in the penal sum of Thirty Two Thousand Nine Hundred Seventy Two and 05/100 Dollars ($32,972.05), which is 5% of the Principal's bid for the payment of which sum well and truly to be made, the Principal and the Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has by written agreement dated August 7, 2017, entered into a Contract (the "Contract") with the Obligee for 2017 Overlay Program - 91610401 which Contract is by reference made a part hereof. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that the Surety is held and bound unto the Obligee in the penal sum of 5% of the final contract cost, which shall include any increases due to change orders, increases in quantities of work or the addition of any new item of work. If the Principal shall indemnify and save harmless the Obligee against loss to which the Obligee may be subject by reason of the Obligee's release of retainage relating to the above described Contract, then this obligation shall be null and void; otherwise to remain in full force and effect. PROVIDED AND SUBJECT TO THE CONDITIONS PRECEDENT: 1. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee named herein or the heirs, executors, administrators or successors of the Obligee. 2. The Surety hereby waives notice of any alternation or extension of time made by the Obligee. 3. The liability of the Surety hereunder shall not exceed 5% of the total amount earned by the Principal if no monies are retained by the Obligee on estimates during the progress of construction. 4. Any claim must be presented in writing to Zurich North America Claims, PO Box 968037, Schaumburg, IL 60196. DATED as of this 7th day of August, 2017. CPM Development Corporation dba Icon Materials Name: Xfxg /i1g! Title: GEm Fidelity and Deposit Co By: !4% (Seal) and (Seal) • , " ttorney-In-Fact ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by DAVID MCVICKER, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Tina DAVIS, Lisa HALL, Lindsey PLATTNER and Linda NIPPER, all of Salt Lake City, Utah, EACH its true and Lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of June, A.D. 2017. Assistant Secretary Joshua Lecker ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Vice President David McVicker State of Maryland County of Baltimore On this 15th day of June, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, DAVID MCVICKER, Vice President, and JOSHUA LECKER, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA -F 020-8022W Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that r ICON Materials (a dba of CPM Development Corporation) 1508 Valentine Ave SE Pacific WA 98047 L NAME AND ADDRESS OF INSURED Ube rty Mutual. INSURANCE is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued. TYPE OF POLICY II FAI EXP DATE CONTINUOUS EXTENDED POLICY TERM POLICY NUMBER LIMIT OF LIABILITY WORKERS COMPENSATION 9/1/2017 WA7-C8D-004095-026 WC7-C81-004095-016 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: A -026: States except OH, ND, A, WY -016: WI EMPLOYERS LIABILITY Bodily In'ury by Accident tt 1 , 000, 000 Each Accident Bodily Injury By Disease $1,000,000 Policy limit Bodily Injury By Disease $1,000.000 Each Person GENERAL F NI COMMERCIAL LIABILITY OCCURRENCE CLAIMS MADE 9/1/2017 TB2-C81-004095-116 -Per Project Aggregate included General Aggregate $2,000,000 Products / Completed Operations Aggregate $2,000,000 Each Occurrence $2,000,000 Personal & Advertising Injury $2,000,000 Per Person / Organization RETRO DATE Other Dama�gge to Premises Rented to You: $250.000 Other Medical Exp: $5,000 IZIOWNED FA El AUTOMOBILE LIABILITY NON -OWNED HIRED 9/1/2017 AS2-C81-004095-126Each Accident—Single Limit $2,000,000 B.I. And P.D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence OTHER -Automobile policy -Excess Workers Compensation and Employer Liability 9/1/2016 - 9/1/2017 9/1/2016 - 9/1/2017 -AS2-C81-054502-526 -EW7-68N-004095-346 (WA) Physical Damage only -$10,000 Comp -$10,000 Coll SIR $250 000 Excess WC -$250,000,000 (includes WA stop gap)/EL-$750,000 Per OCC. ADDITIONAL COMMENTS RE: Project #91610401 - 2017 Overlay Program City of Tukwila, its Officers, Elected Officials, Employees, Agents, and Volunteers, KPG, Inc. P.S. its Officers, Employees, Agents, and Subconsultants are listed as additional insured with regards to the general liability and automobile liability policies, on a primary and non-contributory basis, where required by written contract. Waiver of subrogation is included in favor of the additional insured, where required by written contract, and where applicable by law. If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Project #91610401 - 2017 Overlay Program aL. U [City of Tukwila 6300 Southcenter Blvd Tukwila WA 98188 L Liberty Mutual Insurance Group Valerie Reece Fairfield / 049C AUTHORIZED REPRESENTATIVE 9450 Seward Road Fairfield OH 45014 800-332-3226 8/2/2017 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 37087289 1 LM_44 1 9/16-9/17 - WA 2/2 1 Donna Smitala 1 8/2/2017 12:33:29 PM (CDT) 1 Page 1 of 1 LDI COI 268896 02 11 ACORb® CERTIFICATE OF LIABILITY INSURANCE `..----- DATE(MM/DD/YYYY) 8/1/2017 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(les) must have ADDITIONAL INSURED provisions or 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 Liberty Mutual Insurance Co. National Insurance East Westwood estwood Dr. Wausau, WI 54401 www.LibertyMutual.com NAMEACT Donna Smitala PHONE FAX 715-870-6376 (A/c No): 715-842-6865 E-MAIL ADDRESS: Donna.Smitala @LibertyMutual.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED ICON Materials (a dba of CPM Development Corporation) 1508 Valentine Ave SE Pacific WA 98047 INSURER B : INSURER C : INSURER D : $ 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 LTR TYPE OF INSURANCE ADDL j0ISp SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES JECOT- PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A ,,/ UMBRELLALIAB EXCESS LIAB i OCCUR CLAIMS -MADE i TL2-681-054523-926 9/1/2016 9/1/2017 EACH OCCURRENCE $ $1,000,000 AGGREGATE $ $1,000,000 DED RETENTION $ Products/Completed Ops $ $1,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Project: #91610401 2017 Overlay Program City of Tukwila, its officers, elected officials, employees, agents, and volunteers, KPG, Inc P.S. its Officers, Employees Agents, and Subconsultants is listed as additional insured with regards to the excess liability policy, where required by written contract. CERTIFICATE HOLDER CANCELLATION Project: #91610401 2017 Overlay Program City of Tukwila 6300 Southcenter Blvd Tukwila WA 98188 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Valerie Reece i -tom Zeedc ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 37071909 1 LM_44 1 9/16-9/17 Excess 1 David Menebroeker 1 8/1/2017 3,25:40 PM (CDT) 1 Page 1 of 1 Policy Number: AS2-C81-054502-526 Issued by: Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizzations(s): Any person or organization for which such coverage is required by written contract with the Named Insured Regarding Designated Contract or Project: Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section ll of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contrlution from such insurance. AC 84 23 0811 2010, Liberty Mutual Group of Companies. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 POLICY NUMBER: AS2-C81-054505-526 COMMERCIAL AUTO CA_ 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Informationrequired to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 288201600002200029 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following:. EXCESS LIABILITY POLICY FORM SCHEDULE Name of Person or Organization: As required by written contractor agreement entered into prior to Toss. The following is added to Section 1i - CONDITIONS, Paragraph K. Subrogation: We waive any right of recovery we may have against any person or organization, shown in the Schedule above, with whom you have agreed in writing prior to an "occurrence" to waive your rights because ui Jdyi7ieru5 we make for Injury or damage arising out of .AUr ongoing operations or "your 'work" done under a contract with that person or organization and included in the "products -completed operations hazard TL 24 07 04 09 Page 1 of 1 POLICY NUMBER: TB2-C81-004095-1 16 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury', 'property damage' or 'personal and advertising injury" caused, in whole or in part, by: 1. Your acts or om fissions; or 2. The acts or omissions of those acting on your behalf; In the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the Insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after. 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to is intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional Insureds, the following Is added to Section III— Limits Of Insurance: If coverage provided to the additional insured Is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement or 2. Available under the applicable Limb of Insurance shown in the Declarations; whichever is Tess. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s): Any owner, lessee, or contractor for whom you have agreed in writing prior to a Toss to provide liability insurance Any location listed in such agreement Information required to complete this Schedule, if not shown above, will be shown In the Declarations. CG 2010 0413 ©Insurance Services Office. Inc.. 2012 Page 1 of 1 POLICY NUMBER: TB2-081-004095-116 COIW ERC1AL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. •ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only wlh respect to liability for 'bodily injury" or "property damage° caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Name Of Additional Insured Person(s) Or Organlzatlon(s): Any owner, lessee, or contractor for whom you have agreed in writing prior to a loss to provide tiabifry insurance B. With respect to the insurance afforded to these addkional insureds, the following is added to Section 111— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the addltional insured is the amount of insurance: 1. Required by the contract or agreement or 2. Available under the applicable Limb of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SCHEDULE Location And Description Of Completed Operations Any location listed in such agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 0413 C Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: TB2-C81-004095-116 COMMERCIAL GENERAL LIABILITY CG 24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract wfh that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule below. SCHEDULE Name Of Person Or Organization: As required by wrtten contract or agreement entered into prior to Toss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 24 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER TB2-C87-004095-116 COMMERCIAL GENERAL LIABILITY CG 25030509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section 1— Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C. which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule below 1. A separate Designated Construction Project General Aggregate Limit applies to each des- ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we VIII pay for the sum of all damages under Coverage A, ex- cept xcept damages because of "bodily injury" or "property damage" Included in the 'products - completed operations hazard", and for medi- cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medreal expenses shall reduce the Designated Con- struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag- gregate Limft shown in the Declarations nor shall they reduce any other Designated Con- struction Project General Aggregate Limit for any other designated construction project shown in the Schedule below. 4. The limits shown 'ii the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to the appli- cable Designated Construction Project Gen- eral Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C. which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule below. 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount avalable under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate LIaniL C. When coverage for liability arising out of the "products -completed operations hazard" is prov- ided, any payments for damages because of "bodily injury" or "property damage" Included in the "products -completed operations hazard" will reduce the Products -completed Operations Agg- regate Limit, and not reduce the General Agg- regate Limit nor the Designated Construction Project General Aggregate Lim k. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted. or y the authorized contracting parties deviate from plans. blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25 03 05 09 C insurance Services Office, Inc., 2008 Page 1 of 2 SCHEDULE Designated Construction Project(s): All Projects. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 25 03 05 09 C insurance Services Office, Inc., 2008 Page 2 of 2 Policy Number TB2-C81-004095-116 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: Where required by written contract prior to a loss If you are obligated under a written agreement to provide liability Insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule that Is an additional insured on this policy, this policy will apply solely on the basis required by such written agreement If the applicable written agreement does not specify on what basis the liability insurance will apply, this insurance shall be excess over any other valid and collectible Insurance available to the additional Insured, whether such insurance is on an excess, contingent or primary basis. Condition 4 Other Insurance of Section IV is revised accordingly. LD 2410 0713 02013 Liberty Mutual insurance. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. City of Tukwila Public Works Department CONTRACT PROVISIONS FOR 2017 OVERLAY PROGRAM Project No. 91610401 Bid Document June 2017 Prepared for: CITY OF TUKWILA 6200 Southcenter Boulevard Tukwila, Washington 98188 Prepared by: Interdisciplinary Design 3131 Elliott Avenue Suite 400 Seattle, WA 98121 P1206.286.1640 www.kpg.com CPM Development Corporation DBA ICON Materials Page 1 Cover Page Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale P-1 PROPOSAL CPM Development (unit price) Corporation • Contractor's Name DBA ICON Materials Contractor's State License No. ICONM**982CF City of Tukwila Project No. 91610401 To the Mayor and City Coundl City of Tukwila, Washington The undersigned (Bidder) hereby certifies that he personally examined the location and construction details of Work outlined in the Contract Documents for the City of Tukwila (Owner) project titled 2017 OVERLAY PROGRAM, which project includes but is not limited to Hot Mix Asphalt (HMA) overlay of up to SIX (6) sites, planing bituminous pavement, removing pavement and pavement repairs, installation of concrete curbs, sidewalks, driveways and ramps, adjusting surface utilities to grade, installing new channelization and signage, providing all necessary traffic control labor and devices, providing temporary erosion/water pollution control and other items necessary to complete the Work as shown on the Contract Documents; and has read and thoroughly understands these Documents which govern all Work embraced in this improvement and the methods by which payment will be made for said Work, and thoroughly understands the nature of said Work; and hereby proposes to undertake and complete all Work embraced in this improvement in accordance with these Contract Documents and at the following schedule of rates and prices. The Bidder understands that the quantities mentioned herein are approximate only and are subject to increase or decrease, and hereby proposes to perform all quantities of work as either increased or decreased in accordance with the Contract Documents. As evidence of good faith, (check one) R bid bond or 0 cash, 0 cashier's check, 0 certified check, or 0 postal money order made payable to the City of Tukwila equal to five percent (5%) of the Total Bid Price is attached hereto. Bidder understands that, should this offer be accepted by Owner within ninety (90) calendar days after the day of Bid Opening and the Bidder fails or refuses to enter into an Agreement and furnish the required Payment and Performance Bond and liability insurance within ten (10) calendar days after Notice of Award, the Contract shall be null and void and the Bid Deposit or Bond accompanying this Proposal shall be forfeited and become the property of Owner as liquidated damages, all as provided for in the Bid Documents. Bidder shall attain Physical Completion of all Work in all respects within FORTY (40) working days from the date stated in the written Notice to Proceed. If the work is not completed within this time period, Bidder shall pay liquidated damages to Owner as specified in Section 1-08.9 of the Standard Specifications for every working day work is not Physically Complete after the expiration of the Contract time stated above. In addition, Bidder shall compensate Owner for actual engineering inspection and supervision costs and any. other legal fees incurred by Owner as a result of such delay. 2017 OVERLAY PROGRAM JUNE 2017 Page 9 Proposal Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale Proposal 2017 Overlay Program Project No. 91610401 CPM Development Corporation DBA ICON Materials P-2 Note: Unit prices for all items, all extensions, and the total amount bid must be shown. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shaft be corrected to conform thereto. Refer to Division 10 for definition of pay items. Include applicable sales tax shall be included in the various unit and lump sum prices, per section 1-072(1) and WAC 458-20-171. Item No. Item Description Qty Unit Unit Price Amount I ROADWAY (SCHEDULE A) 1 Unexpected Site Changes 1 FA $ 10,000.00 $ 10,000.00 2 Resolution of Utility Conflicts 1 FA $ 5,000.00 $ 5,000.00 3 4 SPCC Plan Mobilization 1 1 LS LS Z OC10,00 50, 1300.00 S0, 000.00 5 Project Temporary Traffic Control 1 LS 6 Cement Conc. Sidewalk Removal Incl. Haul 110 SY 90,000.00 80, 00D,00 7 Cement Conc. Curb Removal Incl. Haul 190 LF 8 Removal of Structure and Obstruction 1 LS 9 Roadway Excavation Incl. Haul 620 CY 85.00 14 560,00 tt2oo.00 g0.00 10 Unsuitable Foundation Excavation Incl. Haul 40 CY 18.00 4,750.00 1124:0,00 55,8OO' 11 Crushed Surfacing Top Course 710 TON 12 Pavement Repair Excavation Incl. Haul 150 CY 13 HMA Cl. 1/2" PG 64-22 1,510 TON 75.t0o 100,00 3`I2o.b0 3P,46,0.00 14 HMA for Pavement Repair Cl. 1/2" PG 64-22 90 TON 15 Thickened Edge 180 LF 3.50 11,RSO, 00 ,1/000100 czo,aso-0O 30.00 16 Planing Bituminous Pavement 1,160 SY 020 • DO 17 Joint/Crack Sealing 1 FA $ 1,000.00 025,,200,6,9 $ 1,000.00 Page 10 Provided to Builders Exchange of WA, Inc, For usage Conditions Agreement see www.bxwa,com - Always Verify Scale CPM Development Corporation Proposal DBA ICON Materials 2017 Overlay Program Project No. 91610401 Note: Unit prices for ab items, all extensions, and the total amount bid must be shown. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shag prevail, and totals shat be corrected to contorrn thereto. Refer to Division 10 for definition of pay hems. Include applicable sales tax shall be Included in the various unit and lump sum prices, per section 1-07.2(1) end WAC 458.21-171. P-3 Item No. Item Description p . Qty Unit Unit Price Amount 18 Adjust Water Valve 11 EA g00,00 g, X00.00 19 Erosion/Water Pollution Control 1 FA $ 5,000.00 $ 5,000.00 20 Inlet Protection 18 EA 60 -00 ti D R0,00 21 Cement Conc. Traffic Curb and Gutter 190 LF 30.00 5110000 22 Adjust Monument Case and Cover 1 EA SIDEWALK (SCHEDULE A) 23 Cement Conc. Sidewalk 120 SY SO .00 q,600 •Q'S 24 Cement Conc. Curb Ramp 6 EA 3f50O 211000f60 STORM SEWER (SCHEDULE A) 25 Adjust Catch Basin 12 EA !r 000.00 4009.00 26 Storm Drain Marker 11 EA SANITARY SEWER (SECHEDULE A) 27 Adjust Manhole 7 EA 4000xo ,7t0oo'tx) TRAFFIC CONTROL (SCHEDULE A) 28 Raised Pavement Marker Type 1 1 HUND AOd,O0 i{00,00 29 Raised Pavement Marker Type 2 1 HUND ba0.00 600, OCA Page 11 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verity Scale Proposal 2017 Overlay Program Project No. 91610401 CPM Development Corporation DBA ICON Materials P-4 Note: Unit prices for alt items, all extensions, and the total amount bid must be shown. Where conflict occurs between the unit price and the total amount specified for any Item, the unit price shall prevail, and totals shall be corrected to conform thereto. Refer to Division 10 for definition of pay items. Include applicable sates tax shall be Included in the various unit and lump sum prices, per section 1-072(1) and WAG 458-20-171. Item No Item Description Qty Unit Unit Price Amount TRAFFIC ►. CONTROL DEVICES (SCHEDULE A) _ 30 Plastic Stop Line 20 LF X5.00 4 500-00 31 Painted Line, 4 Inch 200 LF 540 , 600.00 ROADSIDE DEVELOPMENT (SCHEDULE A) 32 Edge Restoration 1,370 LF 3.30 33 Property Restoration 1 FA $ 5,000.00 $ 5,000.00 FRANCHISE UTILITY ITEMS (SCHEDULE A) 34 Adjust Franchise Utility ManholeNault 1 EA ai,CO o?,SdD40 35 Adjust Gas Valve 2 EA goo,a) //600.00 Total Schedule A Bid $ S S l j b n. Op Page 12 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale Proposal 2017 Overlay Program Project No. 91610401 CPM Development Corporation DBA ICON Materials P-5 Note: Unit prices for all items, all extensions, and the total amount bid must be shown. Where conflict oxurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shall be corrected to conform thereto. Refer to Division 10 for definition of pay items. Include applicable sales tax shaft be included in the various unit and lump sum prices, per section 1-07.2(1) and WAC 458.20-171. Item No. Item Description Qty Unit Unit Price Amount ROADWAY (SCHEDULE B) 36 Unexpected Site Changes 1 FA $ 500.00 $ 500.00 37 SPCC Plan 1 LS 38 39 40 Mobilization Project Temporary Traffic Control Cement Conc. Sidewalk Removal incl. Haul 1 1 25 LS LS SY D'/AOID. co 000.00 8, 000.00 41 42 43 Cement Conc. Curb Removal Incl. Haul Roadway Excavation Incl. Haul Unsuitable Foundation Excavation Incl. Haul 40 210 20 LF CY CY /a0•,O bs,60 /40.00 7g,ao 3/400,00 8,400,00 //560,410 44 Crushed Surfacing Top Course 10 TON 46.00 6,0 ,040 45 HMA Cl. 1/2" PG 64-22 390 TON /DO.A� 46 Inlet Protection 6 EA d0.00 39,41.90.40 360.00 47 Cement Conc. Traffic Curb and Gutter 40 LF ,30.00 baoOF00 48 Cement Conc. Traffic Curb 190 LF 30.00 49 Cement Conc. Extruded Curb Type 6 130 LF /5; 69 5/700.10 /jQ.sdiGtO Page 13 Provided to Builders Exchange of WA, Inc For usage Conditions Agreement see www.bxwa.com - Always Verify Scale CPM Development Corporation Proposal DBA ICON Materials 2017 Overlay Program Project No. 91610401 Note: Unit prices for all items, all extensions, and the total amount bid must be shown. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shall be corrected to conform thereto. Refer to Division 10 for definition of pay items. Include applicable sales tax shall be Included In the various unit and lump sum prices, per section 1-07.2(1) and WAC 458-20-171. P-6 Item No.Unit . Item Description Unit Price Amount SIDEWALK (SCHEDULE B) 50 Cement Conc. Sidewalk 30 SY so.cn z,a9 51 Cement Conc. Curb Ramp 1 EAj (b 31500.040 STORM SEWER (SCHEDULE 8) 52 Adjust Catch Basin 2 I EI, f/600, 00 TRAFFIC CONTROL (SCHEDULE 8) 53 Plastic Line, 4 Inch 220 LF 7 041400 Total Schedule B Bid Summary: Total Schedule A Bld Total Schedule B Bid $ ‘02i3-10.00 ...$ 551, 071,00 $ lO 437D.00 Total Base Bid (Schedule A + Schedule B) . $ t9591 44 iv 00 Note: Determination of low bidder will be based solely on the 'Total Base Bid'. Page 14 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale Proposal P-7 Bids Submitted on Computer Printouts Bidders, at their option, in lieu of hand writing in the unit prices in figures in ink on the Bid forms above, may submit an original computer printout sheet with their bid, as tong as the following requirements are met: 1. Each sheet of the computer printout must contain the exact same information as shown on the hard- copy bid form — Project Name, Schedule Name, column headings — in the order shown, totals, etc. 2. The computer printout of the Bid Proposal must have the exact certification language shown below, signed by the appropriate officer of the firm. 3. If a computer printout Is used, the bidder must still execute that portion of the unit price Bid form which acknowledges the Bid Guaranty, Time of Completion, and all addenda that may have been issued, etc. If any of these things are missing or out of order, the bid may be rejected by the Owner. The unit and lump sum prices shown on acceptable printouts will be the unit prices used to tabulate the Bid and used in the Contract if awarded by the City. In the event of conflict between the two. unit. Bid prices will prevail over the extended fFotaft prices. If the BId submitted by the bidder contains both the form on these Bid Proposal sheets, and also a computer printout, completed according to the instructions, the unit bid prices shown on the computer printout will be used to determine the bid. Put this certification on the last sheet of the Bid computer printout, and sign: (YOUR FIRM'S NAME) certifies that the unit prices shown an this complete computer print-out for all of the bid items contained in this Proposal are the unit and lump sum prices intended and that its Bid will be tabulated using these unit prices and no other information frorp this print-out. (YOUR FIRM'S NAME) acknowledges and agrees that the total bid amount shown will be read as its total bid and further agrees that the official total Bid amount will be determined by multiplying the unit Bid prices shown In this print-out by the respective estimated quantities shown on the Bid form then totaling all of the extended amounts. Signed: Title. Date: N/A 2017 OVERLAY PROGRAM CPM Development Corporation DBA ICON Materials Page 15 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see vwwv.bxwa.com - Always Verify Scale JUNE 2017 Proposal P-8 By signing below, Bidder acknowledges receipt and understanding of the following Addenda to the Bid Documents: Addendum No. Date of Receipt -7/12] 11 Addendum No. 3 2 4 Date of Receipt NOTE: Failure to acknowledge receipt of Addenda may be considered as an irregularity in the Bid Proposal and Owner reserves the right to determine whether the bid will be disqualified. By signing below, Bidder certifies that Bidder has reviewed the insurance provisions of the Bid Documents and will provide the required coverage. It is understood that Owner may accept or reject all bids. The Surety Company which will furnish the required Payment and Performance Bond is Marsh USA Risk & Insurance Services, Inc of 15 West South Temple, Ste 700 Salt Lake City, UT 84101 (Name) CPM Development (Address) Corporation ON -M Bidder: Signature of Authorized Official: Printed Name and Title: Address: Mark Eichelberger Senior Project Manager 1508 Valentine Ave SE Pacific, WA 98047-2103 Circle One: Individual / Partnership / Joint Venture / Corporation Phone No.: 206 575-3200 State of Incorporation: Washington Date: July 13, 2017 This address and phone number is the one to which all communications regarding this proposal should be sent. NOTES: 1. If the Bidder is a co -partnership, give firm name under which business is transacted; proposal must be executed by a partner. If the Bidder is a corporation, proposal must be executed In the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). 2. A bid must be received on all items. If either a unit price or an extension is left blank (but not both) for a bid item, the Owner will multiply or divide the available entry by the quantity, as applicable, and enter it on the bid form. If there is no unit price or extension for one or more bid item(s), the proposal will be rejected. 2017 OVERLAY PROGRAM JUNE 2017 Page 16 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale ADDENDUM NO. 1 City of Tukwila, Washington 2017 OVERLAY PROGRAM Project No: 91610401 DATE OF ADDENDUM ISSUE: DATE OF BID OPENING: July 12, 2017 July 13, 2017 NOTE TO ALL PLANHOLDERS: This Addendum No. 1, containing the following revisions, additions, deletions, and/or clarifications, is hereby made a part of the Plans and Contract Provisions (Contract Documents) for the above-named project. Bidders shall take this Addendum into consideration when preparing and submitting their bids. Bidders shall acknowledge receipt and acceptance of this Addendum No. 1 in the space provided on the Proposal Signature Sheet or by signing in the space provided below and submitting the signed addendum with the bid package. Failure to provide this written acknowledge may result in disqualification of the Bidder's submittal. CONTRACT PROVISIONS 1.. Special Provisions SP -30: DELETE Page SP -30 and REPLACE with the attached Page SP -30. The attached sheets include the following revisions: • Revised project sites and hours of work ALL OTHER REQUIREMENTS OF THE CONTRACT DOCUMENTS REMAIN IN EFFECT. Bidders shall acknowledge receipt and acceptance of this Addendum No. 1 in the space provided on the Proposal Signature Sheet or by signing in the space provided below and submitting the signed addendum with the bid package. Failure to provide this written acknowledge may result in disqualification of the Bidder's submittal. Sincerely, Robin Tischmak, P.E. City Engineer City of Tukwila Receipt ackn ed, and conditions agreed to this (2.- day of__ , 2017 Bidder 2017 Overlay Program Addendum No.1 Page 1 of 1 Page 1 Addendum #1 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verifv Scale Division 1 SP -3o 4244 Ave S — 8 -hour period between 9:00 a.m. and 6:00 p.m 45th Ave S — 8 -how' period between 7;00 a.m. and 6.00 pin S 128'" St — 8 -hour period between 7:00 a.m. and 600 p.m S 130+" St — 8 -hour period between 7:00 a.m. and 6:00 p.m S 143,d PI — 8 -hour period between 7:00 a.m. and 6:00 p.m Fort Dent Park — 8 -hour period between 8:00 p.m. and 6:00 am (December 8, 2014 APWA GSP) New Except in the case of emergency or unless otherwise approved by the Engineer, the normal working hours for the Contract shall be any consecutive 8 -hour period between 7:00 a.m. and 6:00 p.ni. Monday through Friday, exclusive of a lunch break. if the Contractor desires different than the normal working hours stated above, the request must be submitted in writing prior to the preconstruction conference, subject to the provisions below. The working hours for the Contract shall be established at or prior to the preconstruction conference. All working hours and days are also subject to local permit and ordinance conditions (such as noise ordinances). If the Contractor wishes to deviate from the established working hours, the Contractor shall submit a written request to the Engineer for consideration. This request shall state what hours are being requested, and why. Requests shall be submitted for review no later than 2 working days ,prior to the day(s) the Contractor Is requesting to change the hours. If the Contracting Agency approves such a deviation, such approval may be subject to certain other conditions, which will be detailed in writing. For example: 1. On non -Federal aid projects, requiring the Contractor to reimburse the Contracting Agency for the costs in excess of straight -lime coats for Contracting Agency representatives who worked during such times. (The Engineer may require designated representatives to be present during the work. Representatives who may be deemed necessary by the Engineer include, but are not limited to: survey crews; personnel from the Contracting Agency's material testing lab; inspectors; and other Contracting Agency employees or third party consultants when, in the opinion of the Engineer, such work necessitates their presence.) 2. Considering the work performed on Saturdays, Sundays, and holidays as working days with regard to the contract time. 3. Considering multiple work shifts as multiple working days with respect to contract time even though the multiple shifts occur in a single 24-hour period. 4. If a 4-10 work schedule is requested and approved the non working day for the week will be charged as a working day. 5. If Davis Bacon wage rates apply to this Contract, all requirements must be met and recorded properly on certified payroll 1-08.3 Progress Schedule 1-08.3(1) General Requirements (Special Provision) Replacement For this prosect. a Tune A Progress Schedule is required. Contractor shall sequence and control work activities such that work shall not be performed at more than two sites at anv time during anv shift. A split night/ day shift within the same day shall reduce the above site limitation to one. Weekly construction schedule shall be approved by the Engineer for the upcoming week. City of Tukwila 2017 Overlay Program June 2017 Page 2 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale CPM DEVELOPMENT CORPORATION _CORPORATE OFFICE • 5111 E BROADWAY • SPOKANE VALLEY, WA 99212 P.O. BOX 3366 • SPOKANE, WA 99220-3366 • OFFICE: (509) 534-6221 • FAX: (509) 536-3051 Central Pre -Mix Concrete Co. Central Pre -Mix Prestress Co. 41105 Inland Asphalt Co. a Oldcastle® Materials Interstate Concrete & Asphalt Co. ICON ICON Materials WSG Wenatchee Sand and Gravel Central Washington 'Concrete Eugene Sand & Gravel Viking Reds -Mix Green & White Rock Products 411. Klamath Paelfls Corporation Bandon Concrete & Development River Bend Sand and Grovel Salem Road & Driveway Volley Concrete & Gravel CERTIFICATE OF AUTHORITY Please be advised, that the individuals whose names, titles and signatures appear below are authorized to execute proposals, contracts, bonds, and other documents and/or instruments on behalf of CPM Development Corporation, d/b/a ICON Materials. ICON Materials is a CPM Development Corporation trade name. Name and Title Ric Linares, Regional President Rob Meidinger, General Manager/Vice President Scott Droppelman, Construction Division Manager Mark Eichelberger, Senior Project Manager STATE OF WASHINGTON ) ss. COUNTY OF SPOKANE Signature Respectfully submitted, CPM DEVELOPMENT CORPORATION f5i Susan L. Devaney Northwest Division CFO On this day personally appeared before me Susan L. Devaney, known to me to be the person that executed the foregoing instrument, on behalf of CPM Development Corporation, d/b/a ICON Materials, and acknowledged said instrument to be the free and voluntary act of said corporation, for the uses and purposes therein mentioned. SUBSCRIBED and sworn to before me this c / day of Notary Public State of Washington JEFF L CAVINESS My Appointment Expires Mar 18, 2018 w' E. y W .... / . 2017. S lure ofNotary L CSU /iv S Print or Type Name ofNotary NOTARY PUBLIC in and for the State of Washington Residing at A un.2, My Commission expires on /WA. J & -zto R.. . P-9 BID SECURITY Bid Deposit: The undersigned Principal hereby deposits a Bid Deposit with the City of Tukwila in the form of a cash deposit, certified or cashier's check, or postal money order in the amount of dollars ($ ). -- OR -- Bid Bond: The undersigned, CPM Development Corporation DBA ICON Materials (Principal), and Fidelity and Deposit Company of Maryland (Surety), are held and firmly bound unto the City of Tukwila (Owner) in the penal sum of Five Percent of Total Amount Bid dollars ($ 5% of Amt Bid ), which for the payment of which Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally. The liability of Surety under this Bid Bond shall be limited to the penal sum of this Bid Bond. Conditions: The Bid Deposit or Bid Bond shall be an amount not Tess than five percent (5%) of the total bid, including sales tax and is submitted by Principal to Owner in connection with a Proposal for 2017 OVERLAY PROGRAM, Project No. 91610401, according to the terms of the Proposal and Bid Documents. Now therefore, a. If the Proposal is rejected by Owner, or b. If the Proposal is accepted and Principal shall duly make and enter into an Agreement with Owner in accordance with the terms of the Proposal and shall furnish a bond for the faithful performance of said Project and for the payment of all persons performing labor or furnishing materials in connection therewith, with Surety or Sureties approved by Owner, then this Bid Security shall be released; otherwise it shall remain in full force and effect and Principal shall forfeit the Bid Deposit or Surety shall immediately pay and forfeit to Owner the amount of the Bid Bond, as penalty and liquidated damages. The obligations of Surety and its Bid Bond shall be in no way impaired or affected by any extension of time within which Owner may accept bids; and Surety does hereby waive notice of any such extension. Signed and dated this 13th day of July , 20 17 CPM Development Corporation DBA ICON Materials Fidelity and Deposit Company of Maryland Principal Surety Signature of thorized Official General Manager VP Title Name and address of local office of agent and/or Surety Company: tomey in Fact (A ach PowerofAttorrisy 1400 American Lane, Tower One, �1 Oth Fir ' ' ii Schaumburg, IL 60196 • Surety companies executing bonds must appear on the current Authorized Insurance List in the State of Washington per Section 1-02.7 of the Standard Specifications. 2017 OVERLAY PROGRAM JUNE 2017 Page 17 Bid Security Provided to Builders F change of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Rob D. MEIDINGER, Karen RHINEHART, Susan L. DEVANEY and Scott A. DROPPELMAN, all of Pacific, Washington, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings,Any and all bid bonds issued on behalf of ICON Materials (dba of CPM Development Corporation), Pacific, Washington each in a penalty not to exceed the sum of $1,000,000 and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 27th day of October, A.D. 2015. BY Secretor.? Michael McKibben ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Vice President Thomas O. McClellan State of Maryland County of Baltimore On this 27th day of October, A.D. 2015, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O. MCCLELLAN, Vice President, and MICHAEL MCKIBBEN, Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. J p J} �2 •`��.y%ttiiii %plt ty%%% R1) )lN ` h111IIN, Maria D. Adamski, Notary Public My Commission Expires: July 8, 2019 POA -F 020-80221) P-10 NON -COLLUSION DECLARATION STATE OF WASHINGTON ) )ss. COUNTY OF KING The undersigned, being first duly sworn, on oath states that the person, firm, association, partnership, joint venture, or corporation named in the Bid Proposal has (have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection wJli tllepCity e5 Tumei a project named 2017 OVERLAY PROGRAM, Project No. 91610401. (:PM V lop T Corporation NOr��N N °LAIC •- O •,'01.2021 ,.•'�..► 44 W v,4,.,000%g8H11.4 Signed and swom"ffore me on this 13th day ofJuly 20 17 \. Wendy Hayes Ign of Authorized Official Senior Project Manager Title Signature of Notary Public in and for the State of Washington, residing at Algona My appointment expires: 2/1/2021 SEAL To report bid rigging activities call: NOTICE TO ALL BIDDERS 1-800-424-9071 The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through Friday, 8:00 a.m. to 5:00 p.m., eastern time. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the "hotline" to report such activities. The "hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will be treated confidentially and caller anonymity will be respected. 2017 OVERLAY PROGRAM JUNE 2017 Page 18 Non -Collusion Declaration Provided to Builders Exchange of WA, Inc, For usage Conditions Agreement see www.bxwa.com - Always Verify Scale P-11 RESPONSIBLE BIDDER DETERMINATION FORM Attach additional sheets as nec.pl*lthe information required. Name of Bidder: Corporation titere6 Address of Bidder: 1508 Valentine Ave SE Pacific WA 98047-2103 City State Zip Code Contractor's License No. ICON M"982CF WA State UBI No. 601-006-854 Dept. of L&I License Bond Registration No. 8876949 Worker's Comp. Acct. No. 700,174-00 Bidder is a(n): 0 Individual 0 Partnership ❑ Joint Venture • Incorporated in the state of WA If Out -of -State Corporation, has Bidder complied with WA Corporation laws? 0 YES ❑ NO List business names used by Bidder during the past 10 years if different than above: SEE ATTACHED Bank Reference Bank of America Year Lois Marshall 800 325-6999 Bank Account Officer Officer's Phone No. of regular full-time employees: 135 Number of projects in the past 10 years completed: 10% ahead of schedule 90%on schedule behind schedule Total value of contracts in hand (gross): $ 35+ Mil Bidder has been in business continuously from Bidder has had experience in work comparable to that required for this Project: As a prime contractor for 57 years. As a subcontractor for 57 years. 1960 Describe the general character of work performed by your company: Site Development, Aggregate Sales & Asphalt Paving List major equipment anticipated for this project; state whether Contractor -owned, or if it will be rented or leased from others. SEE ATTACHED 2017 OVERLAY PROGRAM JUNE 2017 Page 19 Responsible Bidder Determination Form Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale ICON M A T E R I A l 5 an Oldcastle Company PAST COMPANY NAMES The current business name, ICON Materials, (dba of CPM Development Corporation) has been in use since January 1, 2002. The company was formed April 1998 to purchase the assets and continue the operations of M.A. Segale, Inc. a Washington Corporation since 1960. ICON Materials, a Division of CPM Development Corporation Jan. 1, 2002 to Present ICON Materials, Inc. June 2000 to Dec 2001 Oldcastle NW, Inc., d/b/a M.A. Segale, Inc. April 1998 to June 2000 M. A. Segale, Inc. Startup 1960 to April 1998 Grading & Paving • Site Development • Heavy Civil Construction • Aggregates & Hot Mix Asphalt ICON Materials Corporate Office • 1508 Valentine Ave SE, Pacific WA 98047-2103 • 206.575.3200 phone • 206.575.3207 facsimile ICONM"982CF An Equal Opportunity Employer ICON Materials (dba of CPM Development Corporation) Major Equipment Detailed List Qty Description Model Model Yr Age Condition 10 3 Axle Pup Trailer Peerless 1991 25 Good Own 4 3 Axle Pup Trailer Transfer Reliance 2007 9 Good Own 4 3 Axle Pup Trailer Transfer Reliance 2006 10 Good Own 2 3 Axle Pup Trailer Transfer Reliance 2005 11 Good Own 2 3 Axle Pup Trailer Transfer Sturdyweld 2012 4 Excellent Own 3 4 Axle Pup Trailer Sturdyweld 2006 10 Good Own 1 Booster w/ Pintle Hitch Superior 2010 6 Excellent Own 1 Detachable Lowboy Trailer Superior 2010 6 Excellent Own 2 4 Axle Flowboys Red River 1998 18 Good Own 1 Bottom Dump Trail King 1995 21 Good Own 1 Bottom Dump Trail King 1994 22 Good Own 1 Bottom Dump Trail King 2007 9 Good Own 2 Side Dumps Trail King 2007 9 Good Own 1 Grove Hyd Crane 40 Ton RT740 1980 36 Good Own 1 Pettibone Hyd Crane 35 Ton RT35 1976 40 Good Own 1 Tymco Sweeper 600BAH 2007 9 Good Own 1 CAT Dozer D9T 2012 4 Excellent Own 1 John Deere Dozer 650JLG 2005 11 Excellent Own 1 John Deere Dozer 450J LGP 2008 8 Excellent Own 1 CAT Loader 972G 2000 16 Good Own 1 JD Backhoe Landscraper 210LE 1998 18 Good Own 2 CAT Off-Hwy Dump Trucks 773B 1993 23 Good Own 1 CAT Off-Hwy Dump Trucks 7738 1990 26 Good Own 1 CAT Off-Hwy Dump Trucks 773B 1981 35 Good Own 1 CAT Off-Hwy Dump Trucks 773E 2003 13 Good Own 1 CAT Grader 140H 2004 12 Excellent Own 1 CAT Grader 14G 1985 31 Good Own 1 Rahco Grader Rahco 2004 12 Excellent Own 1 Hitachi Mini Excavator 5OZTS 2005 11 Very Good Own 70 Maint. & Operation Vehicles Various 2016 Excellent Own 1 Freightliner Dump Truck FLD/TM 2005 11 Good Own 5 Freightliner Dump Truck FLD/TM 2006 10 Good Own 4 Freightliner Dump Truck FLD/TM 2007 9 Good Own 1 Kenworth Dump Truck T800B 1997 19 Good Own 1 Mack Dump Trucks RD688S 1998 18 Good Own 2 Western Star Dump Trucks 49F/TM 2012 4 Excellent Own 2 Western Star Tractors 49S/DS 2007 9 Good Own 2 Western Star Lowboy Tractors 4900SA 2010 6 Excellent Own 2 International Distributors Bearcat 1995 21 Good Own 1 Road Widener Midland 2006 10 Very Good Own 1 CAT Paver AP1005B 2003 13 Good Own Page 1 Major Items Equipment Detailed List 3.14.11 1 CAT Paver AP1005E 2012 4 Excellent Own 1 CAT Paver AP1005D 2008 8 Excellent Own 1 CAT Paver AP555E 2010 6 Excellent Own 2 CAT Grade Rollers CS563C 1995 21 Good Own 1 Hypac Pneumatic Roller C560B 2001 15 Good Own 1 Writgen Milling Machine W1200FT 2001 15 Very Good Own 5 Truck Scales & (2 Portables) 30 to 150 Ton Excellent Own 1 Auburn Asphalt Plant Gencor Very Good Own 1 Seattle Asphalt Plant StanSteel/Gencor Very Good Own 1 Complete Crushing Plant Metso/JCI Excellent Own 1 Cat Excavator 374 2014 2 Excellent Own 1 Cat Excavator 345D 2011 5 Excellent Own 1 1 Cat Excavator 336D 2011 5 Excellent Own 1 Cat Excavator 320D 2011 5 Excellent Own 1 Cat Loader 980K 2014 2 Excellent Lease 1 John Deere Loader 824k 2015 1 Excellent Lease 2 Cat Loader 982M 2015 1 Excellent Lease 4 Cat Loader 982M 2016 0 Excellent Lease 1 Cat Loader 972H 2011 5 Excellent Own 2 CAT AC Rollers 224B 2007 9 Good Own 1 CAT Roller (15 Ton) CB54 2012 4 Good Lease 1 CAT Roller (20 Ton) CB64 2011 5 Excellent OWN 2 CAT Roller (10 Ton) CB434D 2011 5 Excellent Lease 1 CAT Mini Excavator 305E 2013 3 Excellent Own 2 3 Axle Tilt Trailers Dump Trk 1999 17 Good Own 1 2 Axle Lowboy TrIr Trail King 1999 17 Good Own 1 3 Axle Lowboy TrIr TrailKing 1999 17 Good Own Page 2 Major Items Equipment Detailed List 3.14.11 Responsible Bidder Determination Form P-12 List the supervisory personnel to be employed by the Bidder and available for work on this project (Project Manager, Principal Foreman, Superintendents, and Engineers): Name Title How Long With Bidder Scott Droppelman Construction Manager 2 Years Skip Keely General Superintnedent Pat Gailey Ray Babcock Paving Superintnedent Paving Foreman 1 Year 2 Years 21 Years Name the Surveyor to be used on this Project who will directly supervise all surveying activities. Attach a resume outlining the experience and qualifications of the Surveyor. Is the Surveyor licensed in the State of Washington (a PLS)? 0 Yes IfirNo Surveyor's Name: n/a List all other anticipated subcontractors Bidder intends to use on this project. Indicate previous experience working with these firms, if any. Subcontractor '„...........44044:141......a. ` ' `--- iv Scope of Work '"' 146 No of Previous Contracts Worked with Bidder 'TUNtsr 0:wcietelE 4 - f}f/° -A- t -NE .5 -ed Pt At& /0 GRo »'v op 424425 444-Aii/Jar ,o List all those projects of similar nature and size completed by Bidder within the past 10 years. Include a reference for each. Any attached preprinted project listing must include all this information. Bidder must have at least 10 years' experience working on projects of similar nature and size. Year Contract Protect Name Completed Amount Owner/Reference Name and Phone SEE ATTACHED 2017 OVERLAY PROGRAM CPM Development Corporation DBA ICON Materials Page 20 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale JUNE 2017 ICON MATERIALS SAMPLE LISTING ASPHALT PAVING PROJECTS PROJECT NAME OWNER 1 GENERAL CONTRACT AMT CONTACT COMPLETION DATE 401h -42nd Ave South - Phase III Active Construction, Inc $240,500 Ryan Heathers 253 248-1091 EST 11/17 Penny Salsa Pacific Civil & Infrastructure $85,126 Randy Durr 206 735-9265 EST 7/17 Bonney Lake Estates Phase III Johansen Excavating, Inc $180,850 Shane Webley 360 829-8493 EST 11/17 Connel's Prairie Rd 15 NB S 320th St to Duwamish River Br Johansen Excavating, Inc $249,009 Shane Webley 360 829-6493 EST 11/17 Gary Merlin Construction $8,717,258 Steve Simmons 206 255-2619 EST 9/17 North Bend JB Paveover SEACON, LLC $149,394 Mike Michaud 425 283-7337 6/17 NBF Stall Expansion Gary Martino Construction $370,000 James Newhouse 208 719-9113 EST 10/17 SR410, White River Br to SR184 WA State DOT $1,988,350 Timothy LaPorte 253 856-5500 EST 8/17 Prologis Park Tacoma JR Hayes Corporation $359,088 Rick Maurstad 206 423-6636 EST 8/17 Prologls Perk Building B Sierra Construction Co. $901,831 Dave Buckholtz 425 487-5200 EST 8/17 Mente 8075 Aviation Facility Lease Crutcher Lewis $104,465 Grant Howard 206 755-8419 EST 10/17 Gensco, Seattle Donovan Bros. $115,331 Abe Hudson 253 394-5107 6/17 Arbors © Rock creek Phase 3 & 4 RPD, LLC $206,352 Adam Fredericks 253 405-8516 11/16 2016 Arterial Asphalt & Conc - Renton Ave Titan Eartwork, LLC $342,648 Justin Gilsoul 253 266-5998 11/16 Washington Park Arboretum Loop Trail OHNO Construction $225,093 John Falk 206 325-1529 2/17 Transportation Gateway - S 216th St SCI Infrastructure, LLC $235,520 Tyson Lashbrook 208 730-1227 10/16 15 SB S 320th St to Duwamish River Bridge Mid Mountain Contractors $4,686,500 Dave Stumbaugh 206 348-4356 11/16 2016 Asphalt Overlays City of Kent $3,489,530 Jason Bryant 253 261-5863 2/17 NB South 277th St to Green River Bridge WA State DOT $467,579 Mary Ann Redell 425 225-8725 8/15 2015 Ashpalt Overlays City of Kent $1,066,044 Timothy LaPorte 253 856-5500 10/15 2015 Citywide Pavement Patch & Overlay City of Aubum $1,894,842 Jai Carter 253 804-5286 8/16 South 200th Link Extension Johansen Excavating $455,194 Mike Dysert 360 829-6493 11/16 2014 Citywide Pavement Patch & Overlay City of Aubum $1,584,113 Jai Carter 253 804-5286 8/15 Runway 16C/34C Reconstruction Scarsella/Acme JV $5,418,800 Dan Rivera 253 872-7173 9/16 South Park Industrial Terminal SEACON, LLC $2,301,498 Eric Reese 425 837-9720 5/15 Green River Filtration Project MidMountain Contractors $555,566 Greg Lovinger 425 202-3600 2/15 DCT Fife 45 Bldgs A & B Norlhway Construction $201,442 Jason Vandenberg 253 735-8100 3/15 Renwood Apartments Tarragon, LLC $203,657 Dave HenUne 253 863-6200 10/14 2014 Asphalt Overlay Project City of Federal Way $1,508,128 Jeff Huynh 253 835-2526 8/14 Stewart Road/Thornton Ave City of Pacific $2,941,127 James Morgan 253 929-1100 1/16 2014 Asphalt Overlays City of Kent $1,608,003 Timothy LaPorte 253 856-5500 12/14 138th Ave & Valentine Ave SE City of Sumner $12,411,555 Ted Hill 253 299-5703 11/16 South 188th Street Overlay City of SeaTac $730,407 Tori Khlevnoy 206 973-4800 11/13 West Valley Highway Preservation City of Aubum $924,114 Seth Wickstrom 253 804-5034 11/13 East Valley Hwy Resurfacing Phase 2 City of Sumner $594,385 Ted Hill 253 299-5703 10/13 Transportation Gateway Protect SCI Infrastructure, LLC $607,250 Mark Scoccoio 206 242-0633 6/14 "M" Street Grade Separation Scarsella Brothers Inc $617,268 Mike Wilson 253 872-7173 10/13 2012 Overlay Project City of Tukwila $974,259 Robin Tischmak 208 433-0179 9/12 2012 Local Street Pavement Reconstruction SCI Infrastructure, LLC $216,850 Mark Scoccolo 206 242-0633 5/13 East Valley Hwy Resurfacing City of Sumner $1,258,003 Ted Hill 253 299-5703 9/12 Greenwood Ave North Gary Merlin Construction $844,155 Brian Smedley 208-782-9125 03/10 DC/KSP Pavement Rehab The Boeing Company $735,250 Rock Moug 206-999-4139 12/10 Stewart Rd Improvements Goodfellow Brothers $962,534 Mark Kaveny 425-432-2202 09/10 2009 Arterial & Collector Pave City of Aubum $1,387,819 Seth Wickstrom 253-261-2202 6/10 Southcenter Parkway Extension Scarsella Brothers Inc $2,078,828 Bob Scarsella 253-872-7173 7/12 Runway 15/33 Resurfacing City of Renton $3,792,826 Ryan Zulauf 425-430-7471 10/09 Aubum Airport Taxiway City of Aubum $2,461,430 Don Barclay 425-741-3800 09/09 1-40515 to SR -169 Stage 2 Widening 1-405 Corridor Design Bfdrs 02,136,464 Chad Webley 425-496-2021 03/11 SR -181 James St to S 180th St Paving WA State DOT $2,827,036 Joshua Cheatham 253 872-2958 08/08 Rehabilitation of Taxiway Bravo King County $9,567,000 Victor Daggs 206-423-1063 12/08 1st Ave S Improvement Project Frank Colucclo Construction $1,592,334 John Mark 206-793-1070 10/08 2007 Asphalt Overlay City of Kent $1,342,115 Paul Kuehne 253-856-5543 10/07 2007 South County Overlay King County $4,816,110 Robert Lee 206-205-5231 10/07 2007 Aubum Citywide Overlay City of Aubum $990,545 Seth Wickstrom 253-804-5086 12/07 2007 Arterial Asphalt Resurfacing City of Seattle $891,515 Robert Joyner 206-815-1557 10/07 SR509 to 1-5 /1-405 Widening Tri-State Construction $1,463,428 Tim Rayner 425-455-2570 05/09 "C" St NW Road Improv CP0601 City of Aubum $696,960 Mike Kamenzind 253-804-5083 11/06 So. 160th St Loop Ramp Mowat Construction Co $5,000,270 Geno Jorgensen 425-398-0205 01/09 Terminal 7 Redevelopment Port of Tacoma $10,333,500 Doug Saathof 253-383-9456 12/05 Terminal 115 Upland Pavement Repair SCI infrastructure, LLC $1,402,330 Dave Jorgenson 253-218-0444 10/06 2005 Asphalt Overlays City of Kent $692,950 Pete Tenerelli 253-859-5543 09/05 2005 Citywide Asphalt Overlays City of Aubum $647,274 Seth Wickstrom 253-804-5086 11/05 2005 South King County Overlays King County $3,360,452 Paul Moore 206-4231081 11/05 1-182 to Columbia Center UC WA State DOT $30,473,330 Moe Dever( 509-222-2402 08/07 Pierce Cnty Line To Tukwila Stage 4 WA State DOT $35,846,819 Mark Sawyer 425-649-4429 08/07 ICON MATERIALS SAMPLE LISTING ASPHALT PAVING PROJECTS PROJECT NAME OWNER 1 GENERAL CONTRACT AMT CONTACT COMPLETION DATE 1-5 to No. Central Ave WA State DOT $1,769,199 Mark Sawyer 425-649-4429 05/05 Fed Way S 317th Street WA State DOT $22,441.120 John Chi 206-764-6444 01/06 Bremerton Airport Runway Port of Bremerton $3,361,970 Fred Salisbury 360-674-2381 10/05 2004 So County Overlays King County $1,909,088 Robert Lee 206-205-5231 11/04 KCIA Runway 13R/31 L Gary Merlin Construction $1,310,774 Jody Robinson 206-762-9125 09/05 2004 Runway Improvement City of Aubum $728,823 Larry Dahl 253 804-5082 09/04 ICON Materials was famed 04/30/98 to purchase the assets 8 continue the operations of M. A Segale, Inc., a WA corporation since 1980. PrequatiSample List Asphalt Pro) (Rev. 2/17) Responsible Bidder Determination Form P-13 List all projects undertaken in the last 10 years which have resulted in partial or final settlement of the Contract by arbitration or litigation in the courts: Total Claims Amount of Contract Arbitrated Settlement Name of Client and Protect Amount or Litiaated of Claims NONE Has Bidder, or any representative or partner thereof, ever failed to complete a contract? $ No 0 Yes If yes, give details: Has Bidder, or any representative or partner thereof, been assessed with liquidated damages within the past 5 years? fM No 0 Yes If yes, give details: Has Bidder, or any representative or partner thereof, ever been indicted, pled guilty, pled no contest, or been convicted of any offense that has resulted in your firm being barred from bidding or performing work for any State, Local or Federal agency? 0 No 0 Yes If yes, give details: Has Bidder, or any representative or partner thereof, ever been indicted, pled guilty, pled no contest, or been convicted of any illegal restraints of trade, including collusive bidding? 10 No 0 Yes If yes, give details: Has Bidder ever had any Payment/Performance Bonds called as a result of its work? Ij No 0 Yes If yes, please state: Proiect Name Contracting Party Bond Amount Has Bidder ever been found guilty of violating any State or Federal employment laws? 0 No D Yes If yes, give details: CPM Development Corporation DBA ICON Materials 2017 OVERLAY PROGRAM Page 21 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale JUNE 2017 Responsible Bidder Determination Form P-14 Has Bidder ever filed for protection under any provision of the federal bankruptcy laws or state insolvency laws? k No 0 Yes If yes, give details: Does the Bidder owe any delinquent taxes to the Washington State Department of Revenue? allo OYes If yes, does the Bidder have an approved payment plan with the Washington State Department of Revenue? 111 No ❑Yes Has any adverse legal judgment been rendered against Bidder in the past 5 years? No 0 Yes if yes, give details: Has Bidder or any of its employees filed any claims with Washington State Workman's Compensation or other insurance company for accidents resulting in fatal injury or dismemberment in the past 5 years? lig No 0 Yes If yes, please state: Date Type pf Iniury Aaencv Receiving Claim Attach additional sheets as needed. The undersigned warrants under penalty of Perjury that the foregoing information is true and accurate to the best of his/her owledge. The undersigned... • izes the City of Tukwila to verify all information contained he Signature of Bidder Title: Senior Project Manager 2017 OVERLAY PROGRAM D July 13, 2017 CPM Development Corporation DBA ICON Materials Page 22 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale JUNE 2017 P-15 PROPOSED EQUIPMENT AND LABOR SCHEDULE (Use additional sheets if required) Equipment to be used: DESCRIPTION/TYPE YEAR CONDITION OWN/RENT SEE ATTACHED Labor to be used: Paving Superintendent, Paving Foreman, Topside, Screedman, Roller Operators, Rakers, General Laborers, 2017 OVERLAY PROGRAM CPM Development Corporation S'nature of Authorized Senior Project Manager Tale Page 23 Proposed Equipment and Labor Schedule Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale JUNE 2017 ICON Materials (dba of CPM Development Corporation) Major Equipment Detailed List Qty Description Model Model Yr Age Condition 10 3 Axle Pup Trailer Peerless 1991 25 Good Own 4 3 Axle Pup Trailer Transfer Reliance 2007 9 Good Own 4 3 Axle Pup Trailer Transfer Reliance 2006 10 Good Own 2 3 Axle Pup Trailer Transfer Reliance 2005 11 Good Own 2 3 Axle Pup Trailer Transfer Sturdyweld 2012 4 Excellent Own 3 4 Axle Pup Trailer Sturdyweld 2006 10 Good Own 1 Booster w/ Pintle Hitch Superior 2010 6 Excellent Own 1 Detachable Lowboy Trailer Superior 2010 6 Excellent Own 2 4 Axle Flowboys Red River 1998 18 Good Own 1 Bottom Dump Trail King 1995 21 Good Own 1 Bottom Dump Trail King 1994 22 Good Own 1 Bottom Dump Trail King 2007 9 Good Own 2 Side Dumps Trail King 2007 9 Good Own 1 Grove Hyd Crane 40 Ton RT740 1980 36 Good Own 1 Pettibone Hyd Crane 35 Ton RT35 1976 40 Good Own 1 Tymco Sweeper 600BAH 2007 9 Good Own 1 CAT Dozer D9T 2012 4 Excellent Own 1 John Deere Dozer 650JLG 2005 11 Excellent Own 1 John Deere Dozer 4501 LGP — 2008 8 Excellent Own 1 CAT Loader 972G 2000 16 Good Own 1 JD Backhoe Landscraper 210LE 1998 18 Good Own 2 CAT Off-Hwy Dump Trucks 773B 1993 23 Good Own 1 CAT Off-Hwy Dump Trucks 773B 1990 26 Good Own 1 CAT Off-Hwy Dump Trucks 773B 1981 35 Good Own 1 CAT Off-Hwy Dump Trucks 773E 2003 13 Good Own 1 CAT Grader 140H 2004 12 Excellent Own 1 CAT Grader 14G 1985 31 Good Own 1 Rahco Grader Rahco 2004 12 Excellent Own 1 Hitachi Mini Excavator 5OZTS 2005 11 Very Good Own 70 Maint. & Operation Vehicles Various 2016 Excellent Own 1 Freightliner Dump Truck FLD/TM 2005 11 Good Own 5 Freightliner Dump Truck FLD/TM 2006 10 Good Own 4 Freightliner Dump Truck FLD/TM 2007 9 Good Own 1 Kenworth Dump Truck T800B 1997 19 Good Own 1 Mack Dump Trucks RD688S 1998 18 Good Own 2 Western Star Dump Trucks 49F/TM 2012 4 Excellent Own 2 Western Star Tractors 49S/DS 2007 9 Good Own 2 Western Star Lowboy Tractors 4900SA 2010 6 Excellent Own 2 International Distributors Bearcat 1995 21 Good Own 1 Road Widener Midland 2006 10 Very Good Own 1 CAT Paver AP1005B 2003 13 Good Own Page 1 Major Items Equipment Detailed List 3.14.11 1 CAT Paver AP1005E 2012 4 Excellent Own 1 CAT Paver AP1005D 2008 8 Excellent Own 1 CAT Paver AP555E 2010 6 Excellent Own 2 CAT Grade Rollers CS563C 1995 21 Good Own 1 Hypac Pneumatic Roller C560B 2001 15 Good Own 1 Writgen Milling Machine W1200FT 2001 15 Very Good Own 5 Truck Scales & (2 Portables) 30 to 150 Ton Excellent Own 1 Auburn Asphalt Plant Gencor Very Good Own 1 Seattle Asphalt Plant StanStee(/Gencor Very Good Own 1 Complete Crushing Plant Metso/JCI Excellent Own 1 Cat Excavator 374 2014 2 Excellent Own 1 Cat Excavator 345D 2011 5 Excellent Own 1 Cat Excavator 336D 2011 5 Excellent Own 1 Cat Excavator 320D 2011 5 Excellent Own 1 Cat Loader 980K 2014 2 Excellent Lease 1 John Deere Loader 824k 2015 1 Excellent Lease 2 Cat Loader 982M 2015 1 Excellent Lease 4 Cat Loader 982M 2016 0 Excellent Lease 1 Cat Loader 972H 2011 5 Excellent Own 2 CAT AC Rollers 2246 2007 9 Good Own 1 CAT Roller (15 Ton) CB54 2012 4 Good Lease 1 CAT Roller (20 Ton) CB64 2011 5 Excellent OWN 2 CAT Roller (10 Ton) CB434D 2011 5 Excellent Lease 1 CAT Mini Excavator 305E 2013 3 Excellent Own 2 3 Axle Tilt Trailers Dump Trk 1999 17 Good Own 1 2 Axle Lowboy TrIr Trail King 1999 17 Good Own 1 3 Axle Lowboy TrIr TrailKing 1999 17 Good Own Page 2 Major Items Equipment Detailed List 3.14.11 P-16 PROPOSED SUIS®lrAtiltiRS Name of Bidder DBA ICON Materials In accordance with RCW 39.30.060 as amended, every bid that totals $1 million or more shall include below the names of the subcontractors with whom the Bidder, ff awarded the contract, will subcontract for performance of the work of: HVAC (heating, ventilation, and air condifioning); plumbing as described in chapter 18.106 RCW; and electrical as described in chapter 19.28 RCW, or to name itself for the work. The Bidder shall not list more than one subcontractor for each category of work identified, unless subcontractors vary with bid alternates, in which case the Bidder must indicate which subcontractor will be used for which alternate. Failure of the Bidder to submit as part of the bid the names of such subcontractors or to name itset to perform such work or the naming of two or more subcontractors to perform the same work shall render the prime contract bidder's bid nonresponsive and, therefore, void. The successful Bidder must have the written permission nnoof the Owner to make any change to this list. Percent of total bid to be performed by Bidder 1.5 % Schedule/Bid ftem Numbers % of Name Subcontractor will perform Total Bid 2017 OVERLAY PROGRAM JUNE 2017 Page 24 Proposed Subcontractors Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale