Loading...
HomeMy WebLinkAbout17-128 - Road Construction Northwest - Baker Boulevard Non-Motorized Improvement Project17-128 Council Approval 7/17/17 Agreement Form C-1 AGREEMENT FORM CONTRACT NO. 11— J 2-5 THIS AGREEMENT is made and entered into on this „?J -day of 31t- 1 `+' , 20 17, by and between the City of Tukwila, Washington ("Owner") and Road Construction Northwest, Inc. ("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 BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS PROJECT, Project No. 9160409, 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 TUKW (Owner) By:41. WASHI T rowor Attest: This 5—day of 0"—iA-'1 City Clerk Approved as to Form: City Attorney Road Construction Northwest, Inc. (Contract By: Title: effre, ,T. Kanyer / President Attest: This 7th day of July , 2017 Contractor's License No. RCNW*CN978L6 Address for giving notices: Address for giving notices: City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 PO BOX 2228 Renton, WA 98056 15+ ©4 2 ('n , n0 -td Rev. 6-15-10 June 2017 Performance & Payment Bond C-2 PAYMENT AND PERFORMANCE BOND Bond to City of Tukwila, Washington Bond No. S442616 We, Road Construction Northwest, Inc. , and Employers Mutual Casualty Company, (Principal) (Surety) a Iowa 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 Seven Hundred Ninety -Nine Thousand One Hundred Forty -Three and 00/100 Dollars ($ 799,143.00 ), 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 X14-1 `1 aS , 20 /? , between Principal and Owner for a project entitled BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS PROJECT, Contract No. 11-12-- ("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. This bond shall remain in effect for one (1) year after Final Acceptance of the Contract at ten percent (10%) of the Total Bid Price, including sales tax, to insure against all defects and corrections needed in the material provided or workmanship performed. 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Performance & Payment Bond C-3 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. This Payment and Performance Bond shall be governed and construed by the laws of the State of Washington, and venue shall be in King County, Washington. IN WITNESS WHEREOF, the parties have executed this instrument in two (2) identical counterparts this 6th day of July , 2017 Rod Construction Northwest, Inc. Employers Mutual Casualty Company "7 Principal Gig t re oft uthorized Official Jeffrey M. Kanyer / President urety Signature of Authorized Official By Heather L. Allen, Attorney -in -Fact Title Attorney in Fact (Attach Power of Attorney) Name and address of local office of Propel Insurance agent and/or Surety Company: PO Box 2940 Tacoma, WA 98401 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 /EMC INSURANCE THE FACE AND REVERSE OF THIS DOCUMENT HAVE A COLORED FLAG ON WHITE PAPER P.O. Box 712 • Des Moines, IA 50306-0712 No. C03067 CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY-IN-FACT KNOW ALL MEN BY THESE PRESENTS, that: 1. Employers Mutual Casualty Company, an Iowa Corporation 2. EMCASCO Insurance Company, an Iowa Corporation 3. Union Insurance Company of Providence, an Iowa Corporation 4. Illinois EMCASCO Insurance Company, an Iowa Corporation hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint: KAREN C. SWANSON, JAMIE DIEMER, BRENT E. HEILESEN, PETER J. COMFORT, JULIE R TRUITT, CHRISTOPHER KINYON, CARLEY ESPIRITU, KYLE JOSEPH HOWAT, ANNELIES M. RICHIE, MARY S. NORRELL, HEATHER L. ALLEN 5. Dakota Fire Insurance Company, a North Dakota Corporation 6. EMC Property & Casualty Company, an Iowa Corporation 7. Hamilton Mutual Insurance Company, an Iowa Corporation its true and lawful attorney-in-fact, with full power and authority conferred to sign, seal, and execute its lawful bonds, undertakings, and other obligatory instruments of a similar nature as follows: ANY AND ALL BONDS and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all of the acts of said attomey pursuant to the authority hereby given are hereby ratified and confirmed. AUTHORITY FOR POWER OF ATTORNEY This Power-of-Attomey is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at a regularly scheduled meeting of each company duly called and held in 1999: RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have power and authority to (1) appoint attomeys-in-fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attomey-in-fact at any time and revoke the power and authority given to him or her. Attomeys-in-fact shall have power and authority, subject to the terms and limitations of the power-of-attorney issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and any such instrument executed by any such attomey-in-fact shall be fully and in all respects binding upon the Company. Certification as to the validity of any power-of-attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power-of-attomey of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this 1st day of JUNE , 2017 , p,PT y„g, C'R,r'', ` PPOR '. G O 1953 KATHY LOVERIDGE • Commission Number 780769 :' my October 10,�2019 ruce G. Kelley, Gfiairman of Companies 2, 3, 4, 5 & :; President of Company 1; Vice Chairman and CEO of Company 7 Todd Strother Vice President On this 1st day of JUNE AD 2017 before me a Notary Public in and for the State of Iowa, personally appeared Bruce G. Kelley and Todd Strother, who, being by me duly swom, did say that they are, and are known to me to be the Chairman, President, Vice Chairman and CEO, and/or Vice President, respectively, of each of The Companies above; that the seals affixed to this instrument are the seals of said corporations; that said instrument was signed and sealed on behalf of each of the Companies by authority of their respective Boards of Directors; and that the said Bruce G. Kelley and Todd Strother, as such officers, acknowledged the execution of said instrument to be the voluntary act and deed of each of the Companies. My Commission Expires October 10, 2019. CERTIFICATE Notary Public in and for the State of IdNa ;r I, James D. Clough, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and this Power of Attorney issued pursuant thereto on JUNE 1, 2017 on behalf of: KAREN C. SWANSON, JAMIE DIEMER, BRENT E. HEILESEN, PETER J. COMFORT, JULIE R TRUITT, CHRISTOPHER KINYON, CARLEY ESPIRITU, KYLE JOSEPH HOWAT, ANNELIES M. RICHIE, MARY S. NORRELL, HEATHER L. ALLEN are true and correct and are still in full force and effect. In Testimony Whereof have subscribed my nam and affixed the facsimile s�` each Company this (p day of -/�� 7832 (12-16) "For verification of the authenticity of the Power of Attorney you rti4loall1(5"15) 345-2689." Vice President lient#: 105477 MCCACONS2 CORDT. CERTIFICATE OF LIABILITY INSURANCE A7/06/2017 DAT06/20D/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Propel Insurance Seattle Commercial Insurance 925 4th Ave, Suite 3200 Seattle, WA 98104 CONTACT Debbi Hodges -Creed PHONE 800 499-0933 Fax 866 577-1326 (A/C, No, Ext): (AIC, No): E-MAIL s: debbi.hodges-creed@propelinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: The Phoenix Insurance Company 25623 INSURED McCann Construction Enterprises, Inc. Road Construction Northwest, Inc. PO Box 3211 Renton, WA 98056 INSURER B : Travelers Property Casualty Coo 25674 INSURER C : Homeland Insurance Company of N 34452 INSURER 0: Hartford Fire Insurance Company 19682 INSURER E : Travelers Indemnity Co of Conne 25682 INSURER F : COVERAGES CERTIFICATE NUMBER: 17/18 MAIN 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. ILTR TYPE OF INSURANCE INSRL SUBR WVD POLICY NUMBER (MM/DD//YY EYYY) (MMIDD//YYY YY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X DTC0527D334717 05/15/2017 05/15/2018 EACH OCCURRENCE $1,000,000 PREMISES (Eaoccurrence)$300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 X PD Ded:5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES PR - JECOT PER: LOC PRODUCTS-COMP/OPAGG $2,000,000 $ E AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ X1:41(31 _ SCHEDULED AUTOS -OWNED AUTOS X X DT810527D334717 05/15/2017 05/15/2018 j aBclldeotSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X DTSMCUP527D334717 05/15/2017 05/15/2018 EACH OCCURRENCE $6,000,000 AGGREGATE $6,000,000 $ DED X RETENTION $10000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A DTC0527D334717 WA STOP GAP ONLY 05/15/2017 05/15/2018 STATUTE x ETH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C D Pollution Liab.* *Claims Made Install. Floater 7930033390001 52UUMJH8997 05/15/2016 05/15/2017 05/15/2018 05/15/2018 $3,000,000 Each & Agg. Deduct.$5,000 $25,000 & $1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Project #91610409 / Baker Boulevard Non -motorized Improvements. The City of Tukwila and its officers, elected officials, employees, agents, and volunteers; King County, its officers officials, employees, and agents; KPFF; and KPG, Inc. are included as additional insureds per the attached. CERTIFICATE HOLDER CANCELLATION City of Tukwila Attn: Cyndy Knighton 6300 Southcenter Boulevard #100 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 ACORD 25 (2014/01) 1 of 1 #S2771225/M2704894 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALWOO Proposal P-1 PROPOSAL (unit price) Contractor's NameRoad Construction Northwest, Inc. Contractor's State License No. RCNW*CN978L6 City of Tukwila Project No. 91610409 To the Mayor and City Council 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 BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS, which project includes but is not limited to Construction of approximately 500 feet of new curb, gutter, and decorative sidewalk, including associated storm drainage, illumination, landscaping; removal and replacement of existing pavement, curb and gutter, sidewalk, and curb ramps; adjustments of utility structures to grade, installation of slip resistant coating on utility and manhole covers; construction of new pavement marking for bicycle facilities along approximately 1,500 feet of roadway; installation of APS pushbutton system, replacement of pedestrian signal head modules and junction boxes, and other minor items of work including providing all necessary traffic control labor and devices, providing temporary erosion/water pollution control, and other work necessary to complete the Work as specified and shown in 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) 0 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 80 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 calendar 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No, 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Schedule P-2 BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS - SCHEDULE A Project No. 91610409 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. Include applicable Sales Tax in the various Unit and Lump Sum prices. Bid Item No. Bid Item Description Quantity Unit Unit Price Amount ROADWAY 1 MOBILIZATION 1 LS 75;60.00 157000 .°° 2 RESOLUTION OF UTILITY CONFLICTS 1 EST $ 7,500 $ 7,500 3 TRAFFIC CONTROL LABOR, MIN. BID $ 35 PER HOUR 640 HR on 7d ea Lia ,goo 4 PROJECT TEMPORARY TRAFFIC CONTROL 1 LS 74104040;4 ,000, °° 5 UNEXPECTED SITE CHANGES 1 EST $ 20,000 $ 20,000 6 ROADWAY SURVEYING 1 LS 10,000.°" 101000.°e 7 SPCC PLAN 1 LS t ‘-y,pp.o° l,/ O a , ") 8 CLEARING AND GRUBBING 1 LS G, 6‘)°." !o 000. ea 9 REMOVAL OF STRUCTURE AND OBSTRUCTION 1 LS S Oo 0. °° S os.xs 10 ROADWAY EXCAVATION INCL. HAUL 1 LS 37, rm." 37, ,rb0." 11 GRAVEL BORROW INCL. HAUL 170 TON ,r).5; 00 4/ WO • °o 12 CRUSHED SURFACING BASE COURSE 125 TON (QO,' -7, Coo, 'O 13 CRUSHED SURFACING TOP COURSE 60 TON co.,. 3, God •.• 14 HMA Cl. 1/2 In. PG 64-22 120 TON l qp " 1)..7.1V00 ." 15 INLET PROTECTION 25 EA las' 'a '1, t mss- °o 16 EROSIONNVATER POLLUTION CONTROL 1 LS S[it3 ." 3 $"00 °' 17 CEMENT CONC. TRAFFIC CURB AND GUTTER 900 LF r 35:vr / 3t, roc) O° 18 CEMENT CONC. PEDESTRIAN CURB 295 LF 31." to f o30." 19 ADJUST CATCH BASIN/MANHOLE 8 EA 75-1,0° 00D moo° 20 ADJUST EXISTING UTILITY TO GRADE 2 EA 700 °o 1( I00 °° SIDEWALK 21 CEMENT CONC. DRIVEWAY ENTRANCE 45 SY 66). o° 2l q TD." 22 CEMENT CONC. SIDEWALK 670 SY 5"?..°4 34 td4.16,°° 23 DECORATIVE CEMENT CONCRETE FINISH TYPE 2 6 SY 33s ' 1 21 D f 1� o0 24 CEMENT CONC. CURB RAMP 12 EA V? 5-0.'" /3,066." 25 INSTALL OWNER -PROVIDED BIKE RACK 2 EA i , TM, ° ••3r OW.°O 26 NON-SKID SURFACE TREATMENT 1 12 LS LF 'ice.° ° /00.4" L ooO. •• Sr (9pa, °° 27 PAVEMENT EDGE GUIDE TRAFFIC CONTROL DEVICES 28 REMOVING PAVEMENT MARKINGS 1 LS 3, 3 pp.'O 3, 3oO. °' City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Schedule P-3 29 PLASTIC LINE 2,400 LF 30 PLASTIC 6 IN LINE 650 SF 31 PLASTIC GREEN LINE 4,400 SF 32 PLASTIC CROSSWALK LINE 410 SF 33 PLASTIC STOP LINE 130 LF 34 PLASTIC BICYCLE LANE SYMBOL 23 EA 35 PLASTIC TRAFFIC ARROW 16 EA 36 PLASTIC TRAFFIC LETTER 7 EA 37 RAISED PAVEMENT MARKER TYPE 1 9 HUND 38 RAISED PAVEMENT MARKER TYPE 2 2 HUND 39 PERMANENT SIGNING 1 LS ROADSIDE DEVELOPMENT 40 PROPERTY RESTORATION 1 EST $5,000 $5,000 41 TOPSOIL TYPE A 90 CY 42 BARK OR WOOD CHIP MULCH 25 43 SEEDED LAWN INSTALLATION 55 SY PSIPE Fraxinus Iatifolia/ Oregon Ash; 2.5" Cal., 12'-14' Ht. . 7 EA 45 PSIPE Vaccinium ovatum Thunderbird'/ Thunderbird Evergreen Huckleberry; 18" Ht. & Sp. 1 EA 46 PSIPE Spiraea betulifola Tor/ Tor Birchleaf Spirea; 24" Ht. & Sp.. 31 EA 47 PSIPE Cornus sericea ssp. sericea 'Kelseyi'/ Kelseyi Red Twig Dogwood; 2 Gal. Cont. 37 EA 48 PSIPE Gaultheria shallon/ Salal; 2 Gal. Co . 33 EA 49 PSIPE Mahonia nervosa/ Cascade Ore. on Grape; 2 Gal. Cont. 81 EA 50 PSIPE Polystichum munitum/ Swor. ern; 2 Gal. Cont. 95 EA 51 PSIPE Iris tenax; 1 Gal. Cont. 35 EA 52 PSIPE Asarum caudatum/ d Ginger; 1 Gal. Cont. 65 EA 53 PSIPE Arctostaphylos --ursi/ Kinnikinnick; 1 Gal. Cont. 35 EA PSIPE Fragaria Chi .ensis/ Beach Strawberry; 154 Gal. Cont. 325 EA 55 AUTOMATIC 1 ''IGATION SYSTEM, COMPLETE 1 LS 56 WAYFINDIrG SIGNS 1 LS STORM DRAINAGE 57 REMr ING DRAINAGE STRUCTURE 2 EA 58 T' NCH SAFETY SYSTEMS 1 LS 59 /CATCH BASIN TYPE 1 9 EA 60/ SOLID COVER 2 EA C7 �+ DUCTILE IRON STORM SEWER PIPE 8 N. DIAM. 10 LF City of Tukwila Baker Boulevard Non -Motorized Improvements Project No, 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Date of Issue: Bid Submittal Date: Date of Opening: ADDENDUM NO. 1 City of Tukwila Baker Boulevard Non -Motorized Project City Project No. 91610409 June 15, 2017 June 20, 2017 9:30 AM June 20, 2017 10:00 AM Notice to All Planholders: This Addendum No. 1, containing the following revisions additions, deletions, and/or clarifications, is hereby made 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. PROPOSAL] Page P-3 1. BID SCHEDULE — Replace, Modify & Supplement Delete and REPLACE with the attached Modified Pages The Bid Schedule is modified to include additional units under Bid Item 32. All other Bid Items in the Bid Schedule and numbering remains the same. CONTRACT`PLANS' 1. Sheet Numbers 24 - Replace Delete and REPLACE with attached Revised Sheet. See clouded area for revisions. ALL OTHER REQUIREMENTS OF THE CONTRACT DOCUMENTS REMAIN IN EFFECT. All 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 acknowledge receipt of the Addendum may be considered as an irregularity in the Bid Proposal and the City reserves the right to determine whether the bid will be disqualified. Sincerely, J444Ah Robin Tischmak, P.E. City Engineer Receipt acknowledged and cond�s.agreed to this 19:1-1- day of Jo A e. , 20J7 . Bidder: Sig tiSre Addendum No. 1 Project No. 91610409 June 15, 2017 Page 1 of 1 Provided to Builders Exchange of WA, Inc.. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Schedule P-3 29 PLASTIC LINE 2,400 LF 41,5 ) 0I gd 0 , o0 30 PLASTIC 6 IN LINE 650 SF 6.71i 4r 3Ql • SO 31 PLASTIC GREEN LINE 4,400 SF 11. }D t1 f f 2•To. ae 32 PLASTIC CROSSWALK LINE 850 SF 41.76- ". 2$1 . Sd 33 PLASTIC STOP LINE 130 LF 1 —t, •e 1 'PO .o I 34 PLASTIC BICYCLE LANE SYMBOL 23 EA 3 Xs".-" 71 915":" 35 PLASTIC TRAFFIC ARROW 16 EA 300. a o IIrt0D.66 36 PLASTIC TRAFFIC LETTER 7 EA ) 7,57- ins. - 37 RAISED PAVEMENT MARKER TYPE 1 9 HUND 35"0.0*, 3, 1Sp,aa 38 RAISED PAVEMENT MARKER TYPE 2 2 HUND OS."' $r( • +e 39 PERMANENT SIGNING 1 LS `I"rODO•ao tS'ic,c ,e° ROADSIDE DEVELOPMENT 40 PROPERTY RESTORATION 1 EST $5,000 $5,000 41 TOPSOIL TYPE A 90 CY 417 00 111 9.30 -va 42 BARK OR WOOD CHIP MULCH 25 CY 573. Y Y 11 27.101 gru 43 SEEDED LAWN INSTALLATION 55 SY 1." 10. co PSIPE Fraxinus latifolia/ Oregon Ash; 2.5" Cal., 12'-14' Ht.. 7 EA 400.' 2t c.00 eo 45 PSIPE Vaccinium ovatum'Thunderbird/ Thunderbird Evergreen Huckleberry; 18" Ht. & Sp. 17 EA L 311,ue p� 7 7l.oe 46Spirea; PSIPE Spiraea betulifola'Tor'I Tor Birchleaf 24" Ht. & Sp.. 31 EA 31, SD q 1(0. So 47 PSIPE Comus sericea ssp. sericea'Kelseyi'/ Kelseyi Red Twig Dogwood; 2 Gal. Cont. 37 EA 1).2 , SD 831. so 48 PSIPE Gaultheria shailon/ Salal; 2 Gal. Cont. 33 EA ');a,so 7411.so 49 PSIPE Mahonia nervosa/ Cascade Oregon Grape; 2 Gal. Cont. 81 EA �1 F6.oe 2, t bL .•o 50 PSIPE Polystichum munitum/ Sword Fem; 2 Gal. Cont. 95 EA ')7• Sa 2 113 1 . t 51 PSIPE Iris tenax; 1 Gal. Cont. 35 EA 1(0- " SLO. •• 52 PSIPE Asarum caudatum/ Wild Ginger; 1 Gal. Cont. 65 EA 1r."1 iio ++ 53 PSIPE Arctostaphylos uva-ursi/ Kinnikinnick; 1 Gal. Cont. 35 EA 1 3,C.6 kza •;o PSIPE Fragaria Chiloensis/ Beach Strawberry; 154 Gal. Cont. 325 EA ) 3,7. a L(+ 3n, �D 55 AUTOMATIC IRRIGATION SYSTEM, COMPLETE 1 LS 1,0e..°* 12l000 uv 56 WAYFINDING SIGNS 1 LS 4,1000"6 1J 000,10 STORM DRAINAGE 57 REMOVING DRAINAGE STRUCTURE 2 EA gSO.•' 1 r 400,cb 58 TRENCH SAFETY SYSTEMS 1 LS So6.°° Sr'�ii u+ 59 CATCH BASIN TYPE 1 9 EA 1r 35-1),00 1 ral t 5i -• 60 SOLID COVER 2 EA 6019, o• 1,00.'7'. 61 DUCTILE IRON STORM SEWER PIPE 8 IN. DIAM. 10 LF ^^� !O5'o n 2, -).s -b. ee City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Schedule P-4 62 SCHEDULE A STORM SEWER PIPE 12 IN. DIAM. 130 LFo 14f, " 911 OSe) .66 63 CONTROLLED DENSITY FILL 45 CY lsdy !0 6f 70.'0 64 CONNECTION TO DRAINAGE STRUCTURE 3 EA � i Ooo ° 3�oa's 65 ROTATE MANHOLE ACCESS 1 EA f If s-pD.aa ts00oe WATER. 66 ADJUST VALVE BOX 5 EA 5'51).°O 2t 7SD. o0 67 REMOVE HYDRANT ASSEMBLY 1 EA 111000." 1(DOO00 68 HYDRANT ASSEMBLY 1 EA G ')•00 o+ Gi 700 e• 69 SERVICE CONNECTION 3/4 IN. DIAM. 1 EA 3e000.4. 3r po 0 •"' 70 DUCTILE IRON PIPE FOR WATERMAIN 6 IN. DIAM. 8 !F 100." 3a 700.'1. 71 DUCTILE IRON PIPE FOR WATERMAIN 8 IN. DIAM. 16 LF /�ye� 3CO.p. ti /g•O0 00 ILLUMINATION AND SIGNAL SYSTEM 72 ILLUMINATION MODIFICATIONS at CHRISTENSEN RD, COMPLETE 1 LS (%ipt„At, vo (").6 15 ti 000.4d Q�' 73 SIGNAL MODIFICATIONS at BAKER BLVD ANDOVER PK E, COMPLETE 1LS -7/, l �,t4 c147/, l tW t (o Q� d p Bid Total $ -7tit? 1(3 ,00 *Sales tax shall be included in the various unit prices, per Standard Specification section 1-07.2(1) and WAC 458-20-171. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Proposal Signature Sheet P-5 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 long 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 (Total) 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 on 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 from 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 quantiti-s-shown on the Bid form then totaling all of the extended amounts. Signed: Title: Vice President t Date: 6/19/2017 By signing below, Bidder acknowledges receipt and understanding of the following Addenda to the Bid Documents: Addendum No. 1 2 Date of Receipt Addendum No. 6/15/17 3 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Proposal Signature Sheet P-6 The Surety Company which will furnish the required Payment and Performance Bond is Employers Mutual Casualty Company Bidder: (Name) of PO Box 712, Des Moines, IA 50306 Road Construction Northwest,I c. (Address) Signature of Authorized Official: Otk)f v Printed Name and Title: Matthew Wagester, Vice President Address: PO Box 2228, Renton, WA 98056 Circle One: Individual / Partnership / State of Incorporation: WA Joint Venture / Corporation Phone No.: 425-254-9999 Date: 6/19/17 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Security P-7 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, Road Construction Northwest, Inc. (Principal), and Employers Mutual Casualty Company (Surety), are held and firmly bound unto the City of Tukwila (Owner) in the penal sum of Five PArrent (5%) of Rid Amntint dollars ($ 5% of Rid Amount ), 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 BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS, Project No. 9160409, 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 20th day of June ,2017 Road Construction Northwest, Inc. Employers Mutual Casualty Company Principal Surety Si natde of Authorized Official V: Le Vre_s;at - Title Name and address of local office of agent and/or Surety Company:. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Attorney in Fact (Attach Power of Attorney) Heather L. Allen Propel Insurance PO Box 2940 Tacoma, WA 98401 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Bid Security P-8 Surety companies executing bonds must appear on the current Authorized Insurance List in the State of Washington per Section 1-027 of the Standard Specifications. City of Tukwila Baker Boulevard Non -Motorized. I rnprovements Project No. 91610409 Rev: 6 15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal ti • /EMC INSURANCE THE FACE AND REVERSE OF THIS DOCUMENT HAVE A COLORED FLAG ON WHITE PAPER P.O. Box 712 • Des Moines, IA 50306-0712 No. C03039 CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY-IN-FACT KNOW ALL MEN BY THESE PRESENTS, that: 1. Employers Mutual Casualty Company, an Iowa Corporation 2. EMCASCO Insurance Company, an Iowa Corporation 3. Union Insurance Company of Providence, an Iowa Corporation 4. Illinois EMCASCO Insurance Company, an Iowa Corporation hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint: KAREN C. SWANSON, JAMIE DIEMER, BRENT E. HEILESEN, PETER J. COMFORT, JULIE R TRUITT, CHRISTOPHER KINYON, CARLEY ESPIRITU, KYLE JOSEPH HOWAT, ANNELIES M. RICHIE, MARY S. NORRELL, HEATHER L. ALLEN 5. Dakota Fire Insurance Company, a North Dakota Corporation 6. EMC Property & Casualty Company, an Iowa Corporation 7. Hamilton Mutual Insurance Company, an Iowa Corporation its true and lawful attorney-in-fact, with full power and authority conferred to sign, seal, and execute its lawful bonds, undertakings, and other obligatory instruments of a similar nature as follows: ANY AND ALL BONDS and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all of the acts of said attomey pursuant to the authority hereby given are hereby ratified and confirmed. AUTHORITY FOR POWER OF ATTORNEY This Power -of -Attorney is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at a regularly scheduled meeting of each company duly called and held in 1999: RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attomey-in-fact at any time and revoke the power and authority given to him or her. Attomeys-in-fact shall have power and authority, subject to the terms and limitations of the power-of-attorney issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and any such instrument executed by any such attomey-in-fact shall be fully and in all respects binding upon the Company. Certification as to the validity of any power-of-attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power-of-attomey of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this 1st day of JUNE , 2017 Seals TU MU,4 �o�MUTUq'Ls�9 oa6P`O Pox r,,,, 1953 fr * ,IOWA *,,0‘ `‘0U7UA; C''. SEAL KATHY LOVERIDOE Commission Number 780769 Oommission ctober 10, 2019 ruce G. Kelley, Qfiairman of Companies 2, 3, 4, 5 & :; President of Company 1; Vice Chairman and CEO of Company 7 Todd Strother Vice President On this 1st day of JUNE AD 2017 before me a Notary Public in and for the State of Iowa, personally appeared Bruce G. Kelley and Todd Strother, who, being by me duly swom, did say that they are, and are known to me to be the Chairman, President, Vice Chairman and CEO, and/or Vice President, respectively, of each of The Companies above; that the seals affixed to this instrument are the seals of said corporations; that said instrument was signed and sealed on behalf of each of the Companies by authority of their respective Boards of Directors; and that the said Bruce G. Kelley and Todd Strother, as such officers, acknowledged the execution of said instrument to be the voluntary act and deed of each of the Companies. My Commission Expires October 10, 2019. ?' Z 1J�ffilliliti Rs,�A� .oma Notary P lic in and for the State of Idiva 'NEs,' CERTIFICATE I, James D. Clough, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and this Power of Attorney issued pursuant thereto on JUNE 1, 2017 on behalf of: KAREN C. SWANSON, JAMIE DIEMER, BRENT E. HEILESEN, PETER J. COMFORT, JULIE R TRUITT, CHRISTOPHER KINYON, CARLEY ESPIRITU, KYLE JOSEPH HOWAT, ANNELIES M. RICHIE, MARY S. NORRELL, HEATHER L. ALLEN C-1 are true and correct and are still in full force and effect. In Testimony Whereof ave subscribed y name and affixed the facsimile seal of each Company this p20— day of �� / , 7832 (12-16) "For verification of the authenticity of the Power of Attorney ` ery, ayrcall'(; 15)°$45-2689." Vice President Non -Collusion Declaration P-9 NON -COLLUSION DECLARATION STATE OF WASHINGTON ) ) ss. COUNTY OF KING The undersigned, being first duly sworn, on oath states that the person, firm, association, partnership, joint venture, or corporation named in the Bid Proposal has (have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the City of Tukwila project named BAKER BOULEVARD NON -MOTORIZED IMPROVEMENTS, Project No. 9160409. Road Construction Northwest, Inc. Signed and svporn to be e me c$n this Signature of Notary Public in and for a State of Washington, residing at C,V`efOW Name of Firm Vice President Title —^ day of 31ne- ,20[ . My appointment expires: 11, l0 - (ci 01111111111111111111111111111111111111111111110 E Notary Public = SEAL State of Washington E SCOTT P. VAAGEN MYCOMMISSION NO EMBER 02,2 19ES _ NOTICE TO ALL BIDDERS IDI I IIHihtI111I I I I 111 If II I I11I I II I I I I I II I I I I I IO To report bid rigging activities call: 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. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Responsible Bidder Determination Form P-10 RESPONSIBLE BIDDER DETERMINATION FORM Attach additional sheets as necessary to fully provide the information required. Road Construction Northwest, Inc. Name of Bidder: Address of Bidder: PO Box 2228 Renton WA 98056 City State Zip Code Contractor's License No. RCNW*CN978L6 WA State UBI No. 602-286-010 Dept. of L&I License Bond Registration No. Worker's Comp. Acct. No. 044,215-03 Bidder is a(n): 0 Individual 0 Partnership 0 Joint Venture incorporated in the state of List business names used by Bidder during the past 10 years if different than above: N/A WA Bidder has been in business continuously from 2003 Bank Reference Banner Bank Dave Jensen Year (425) 739 1009 Bank No. of regular full-time employees: 50+ Account Officer Officer's Phone No. Number of projects in the past 10 years completed: _ ahead of schedule 100+ on schedule behind schedule Bidder has had experience in work comparable to that required for this Project: As a prime contractor for 14 years. Asa subcontractor for 14 years. 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 Gordon Lee Brian Menard Jeff Stern City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Project Manager 12 years Superintendent 14 years Foreman 14 years Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Responsible Bidder Determination Form P-11 Name the Surveyor to be used on this Project, who will directly supervise all surveying activities. Attach a resume outlining the experience and quali 'cations of the Surveyor. Is the Surveyor licensed in the State of Washington (a PLS)? Yes ❑ No Surveyor's Name: American Surevey and Envrionmental, LLC 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 Project Name Completed Amount Owner/Reference Name and Phone See Attached 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: Name of Client and Proiect N/A Total Claims Amount of Contract Arbitrated Settlement Amount or Litigated of Claims Hyl Bidder, or any representative or partner thereof, ever failed to complete a contract? Q No 0 Yes If yes, give details: _lips Bidder ever had any Payment/Performance Bonds called as a result of its work? 'YI No 0 Yes If yes, please state: Project Name City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Contracting Party Bond Amount Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Responsible Bidder Determination Form P-12 H1s Bidder ever been found guilty of violating any State or Federal employment laws? No 0 Yes If yes, give details: Has Bidder everfil d for protection under any provision of the federal bankruptcy laws or state insolvency laws? VANo 0 Yes If yes, give details: Has any adverse legal judgment been rendered against Bidder in the past 5 years? ONo 0 Yes If yes, give details: Has Bidder or any of its employees filed any claims with Washington State Workman's Compensation or other ' surance company for accidents resulting in fatal injury or dismemberment in the past 5 years? ' 'No 0 Yes If yes, please state: Date Type of Injury Agency Receiving Claim The undersigned warrants under penalty of Perjury that the foregoing information is true and accurate to the best of his/her knowledge. The undersigned authorizes the City of Tukwila to verify all information contained herein. Signature of Bidder Oeb7'"v�v Title: Vice President City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 Date: 6/19/17 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Proposed Equipment and Labor Schedule P-13 PROPOSED EQUIPMENT AND LABOR SCHEDULE (Use additional sheets if required) Equipment to be used: DESCRIPTION/TYPE YEAR CONDITION OWN/RENT Roler; Dyna Pac Good Owned Truck; Kenworth Good Owned Excavator; Caterpillar Good Owned Backhoe; John Deere Good Owned Wheel Loader; john Deere Good Owned Labor to be used: Operators, Laborers, Pipe Layers, Operating Foreman, flaggers, truck driver Road Construction Northwest, Inc. Name of Bidder Signa e of Authorized Official Vice President Title City of Tukwila Baker Boulevard Non -Motorized Improvements' Project No. 91610409 Rev. 6-15-10 June 2017 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Proposed Subcontractors P-14 PROPOSED SUBCONTRACTORS Name of Bidder Road Construction Northwest, Inc. 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, if awarded. the contract, will subcontract for performance of the work of: HVAC (heating, ventilation, and air conditioning) 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 mustindicate 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 itself to perform such work or the naming of two or more subcontractors to perform the same work shall render the prime contract bidders bid nonresponsive and, therefore, void. The successful Bidder must have thewritten permission of the Owner to make any change to this list: Percent of total bid to beperformed by Bidder Schedule/Bid Item Numbers % of Name Subcontractor will perform Total Bid Rohr' iC n.l 't fJl t 0^% oriAnwept in . Rna'nf+1 ktV44.6.1 4v111-0-%w?liIr�t. City of Tukwila Baker Boulevard Non -Motorized Improvements Project No. 91610409 HO( % ki/A ( i ? 101,.4,`,,.] ! N/A ripoe 1 16.1141. 417 .w 4-73 1K7o Rev. 6-15-10 June 2017 Provided to Builders Exchange. of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal