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21-089 - Gary Harper Construction, Inc - Tukwila Lift Stations #4 and #12 Retrofits
21-089(a) Council Approval N/A Sheet 1 of 1 CITY OF TUKWILA CONTRACT CHANGE ORDER NO. 1 DATE: October 26, 2021 CONTRACT NO.: 21-089 PROJECT NAME: Tukwila Lift Stations #4 and #12 Retrofits TO: Gary Harper Construction, Inc. You are hereby directed to make the herein described changes to the plans and specifications or do the following described work not included in the plans and specifications on this contract: NOTE: This change order is not effective until approved by the "City" and the "Contractor" CHANGE: We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will perform all ongoing services necessary for the work specified in the original contract, and will accept as full payment therefore the prices shown below. ACCEPTED: Date 101, Original Contract (without tax) Previous Change Order This Change Order (without tax) REV. CONTRACT AMOUNT fi $ 311,000.00 $ 0.00 Date $ 26,102.06 By $ 337,102.06 APPROVED BY THE CITY OF TUKWILA Original Contract Time: 120 Days Additional Contract Time for previous Change Orders: 0 Days Additional Contract Time for this Change Order: 30 Days ORIGINAL: City Clerk (1 of 2) Consultant (2 of 2) PW Project Finance File cc: Finance Department (w/encumbrance) (11/2014) GH WA RIPER 4,:oNs RU( 1 1(.04 14831 223rd Street SE Snohomish, WA 98296-3989 (360) 863-1955 Fax (360) 863-1966 DESIGN CLARIFICATION REQUEST/FIELD QUESTION To: Tukwila LS #4 & LS #12 Attn: Adib Altallal Ref. Dwg E6 Description of (Clarification) (Variation) Request. See Below on MD Marine Electric's RFI Spec Section: RE: Job Tukwila Lift Stations #4 & #12 Retrofits Request No, 6 Job No. 327-21 Fax: Email: Item: Reply Required By. 10/ /2021 Originator: Response: Architect Clarification: JJ Smith -Marquez Engineer Impact Job Schedule: Yes Impact Other Trades: Yes Date of Request: 10/7/2021 Contractor Other X No X VARIATION: Additional Comments: Received by Approval• Approved Disapproved Date: Date: MD Marine Electric 672 E llth St Tacoma, WA (253) 383-9983 www.mdmarineelertnc,com Request For Information 5183 — Tukwila LS 4 and 12 Retrofits (Local 46) RFI Subject : Install conduits through drywell To JJ Smith -Marquez Gary Harper Construction Phone No: 3608631955 Mobile: 2063102271 jj@garyharperconst.com Return To Kevin Held MD Marine Electric kevinh@mdmarineelectric.com RFI Number : 5183-004 RFI Revision Number : 0 RFI Date : 10/7/2021 Type Original RFI Clarification Requested This is a follow up to the previous RFI about sealing the conduits entering the dry well. The caulking will not last over time and will start to leak. A better install would be to core drill the concrete and place link seals around the conduits. Once the conduits are back filled with CFD there will be no chance to leak. This will also enclose the pathway which will keep it secure from being tampered with. Please confirm if core drilling is acceptable. See attach photo for proposed location to drill. ROM would be $1000 dollars or less Details Dravirtirtg Detail Spec E6 Schedule / Cost Impact To mitigate schedule delay, return by the following date 10/12/2021. This problem is impacting our progress This problem is impacting our costs (other than schedule costs) Please provide a written directive on how to proceed. Descriptions of materials and methods should be accompanied by drawings, sketches and specifications if not covered by applicable contract documents. Please re -review relevant submittals referenced above. Signed By: Dated: 10/7/2021 GARY HARPER CONSTRUCTION INC. October 27, 2021 �� 14831 223rd Street SE3oohunni�h. \\\A, 98298-3989 (360) 863-1955 Fax (360) 863-1966 City of Tukwila At n: AdibA|taUa| 63OUSovthcenterBlvd, Ste 101 Tukwila, WA 98188 Re: Tukwila Lift Station 4 and Lift Station 12 Retrofits Change Order No. 1 Cost for bypass pumping due to PSE delay 1 week delay for Link Seals. lncludes sales tax for rentals. Sunbelt Rental Overhead & Profit 21% Total Change Order No. 2 - Revised 1.00 Week 2,695.25 566.00 SIMBEU��� RENTALS INVOICE TO 2308 GARY HARPER CONSTRUCTON 14831223RDSTGE SNOHOMISH WA 98296'3988 VL/It,:t SEND ALL PAYMENTS TO: SUNBELT RENTALS,INC. PO aox 409211 ^rLxwrx, GA 30384-9211 � |V | ! "|�| |"xmY�'"�U'x"U"'Yu�/�`(��"|1N''"1"||U|1|"/1'1 JOe*oonsSn GARY HARPER CONSTRUCTION I8351 CASCADE AVE S TUKWILA, WA 98188 4712 206-310-227I 8007355-0002 wsoo, SMITH, JJ pun��\aso�cs�nc 0/09/21 327-017 18007355 46- GARY HARPER CONS SEATTLE PUMP SOLUTIONS p[1348 I 2102 s 341ST PL FEDERAL WAY, WA 98003 6862 253-620-4947 . QTY EQUIPMENT # min Day' week 1.00 6X6x11 SOLIDS VAC 74HP QF CONTR PUMP 234.80 234.00 570.09 I013555I Make: ATLAS COPC model: PAS 150 SUN CS Ser ;: ITHUUZ HR OUT: 1279.500 HR IN: TOTAL: 12 9.500 ##### backup pump ##### 1.00 8X6X10 CHOPPER VENT QF PUMP 289.00 289.00, 1258.00 10259424 make: PREMIER model: HE6W8 Ser #: 909048 HR OUT: I01I.100 HR IN: 6277-000 TOTAL: 52 5.900 #### 24/7 ##### 1.00 REMOTE MONITOR XR50 4G 12VDC 50.00 50.00) 150.00 10313794 Make; OMNISITE model: xR5OEN12Ser #: 35331 4.0U 6xI0 U( RBR WATER SUC/DIS 10.00 10.00 1.00 10.00 2.00 8X10 ORANGE/CLEAR SUC BAUERHOSE �� 10.00 2,00 8x20 ORANGE/CLEAR SUC BAUER �«n; ' | 10.00 1.00 6" ADAPTOR BAUER F X FNPT 10.00 10.00 Adaptor 1.00 6" ADAPTOR CAMLOCK M X MNPT10.0010.00 20'00 Adaptor 1.00 6x8 INCREASER CONC BAUER m 10.001 '10.00 10.001 10.00 10.00 10-00 10.00 10.00 Q0.mtt��� 10.00 10.00 10.00 min Day 20.00 20.00 20.00 20.00 20.00 2.00 6" 90 -DEG ELB BAUER 1.00 6" 90 -DEG ELB BAUER 2.00 6"45 -DEG ELB BAUER 1.00 6" 45 -DEG ELB BAUER 1.00 6" WYE BAUER F x F X M QTY EQUIPMENT # 2.00 6" CHECK VALVE BG - 10.00 I'00 8x6 REDUCER CONC BAUER F X M 10'00 2.00 8" 90 -DEG ELB BAUER 10'00 2.00 FLOAT SWITCH - DOUBLE I0.00 1.00 6' x 10' CONTAINMENT BERM 35'00 1.00 8' u 10' CONTAINMENT BERM 35'00 Re SALES ITEMS: Qty Item number Vrn7--- prrc�' I ENVIRONMENTAL EA 101.550 10.00 10.00 10.00 10.00 25.00 25.00 al sub -t 0 20.00 20.00 20.00 20.00 20.00 20.00 Week 20.00 20.00 20.00 20.00 75.00 75.00 tal: 4 week Amount 6I5'00 I6I5'00 ]/HVP0 247'00 3247'00 450.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 60.00 4 week 60.00 60.00 60.00 60.00 50.00 50.00 450.00 240.00 60.00 120.00 120.00 60.00 60.00 60.00 120.00 60.00 12O'0O 60.00 60.00 Amount 120.00 60.00 120.00 120.00 150.00 150.00 7172.00 l0I'55 Equipment. Service. Guaranteed. REMIT TO: 6747,0 2o4°5 /72V. SUNBELT RENTALS, INC. NET DUE UPON RECEIPT PO BOX 40921I ATLANTA, GA 30304-92I1 Invoices not paid within 30 days may be subjec SUBTOTAL SALES TAX INVOICE TOTAL SUNBELT RENTALS INVOICE TO 1oz-1965- nos GARY HARPER CONSTRUCTION 14831 223RD ST SE SNOHOMISH WA 98296-3989 JOB ADDRESS GARY HARPER CONSTRUCTION 18351 CASCADE AVE S TUKWILA, WA 98188 4712 206-310-2271 . QTY EQUIPMENT # INVUll:t SEND ALL PAYMENTS TO: SUNBELT RENTALS, INC. Po BOX 409211 ATLANTA, GA 30384-9211 ENVIRONMENTAL/HAZMAT FEE 2133xxx0000 D ERY CHARGE CHAAGt—'• 118007355-0002 SMITH, JJ ,( 0/09/21 2 of 2 118007355 327-017 46- GARY HARPER CONS SEATTLE PUMP SOLUTIONS PC1348 2102 5 341ST PL FEDERAL WAY, WA 98003 6862 253-620-4947 Min Day week 4 week Amount WEEKS 9/22/21 THRU 10/19/21. Equipment. Service. Guaranteed. REMIT TO: SUNBELT RENTALS, INC. PO BOX 409211 ATLANTA, GA 30384-9211 NET DUE UPON RECEIPT Invoices not paid within 30 days may be subject to a 1-1/2% per month charge. SUBTOTAL SALES TAX INVOICE TOTAL 4 WEEK BILL 660.00 660.00 8,593.55 867.96 9,461.51 October 27, 2021 GH GARY HARPER CONS-rRucrioN ' - -_- 48�l 22]nj3�ect5I� �nohurnisb,\VA98296'3�09(360) 863-1955 Fax (360) 863-1966 City of Tukwfla Attn: AdibAkoUa| 63OOSouthcenterBlvd, Ste 101 Tukwila, WA 98188 Re: Tukwila Lift Station 4 and Lift Station 12 Retrofits Change Order No. 1 Cost to provide Vactor Truck to install flow meter in drywell Subcontractor Pro -Vac Overhead & Profit 12% Total Change Order No. 1 1,742.50 209.10 Billing Address Gary Harper Construction, Inc. 14831 223rd Street Southeast Snohomish, WA 98296 USA Pro -Vac PO Box 24351 Seattle, WA 98124 253-435-4328 Description of Work 0 Invoice 126327 Invoice Date 10/26/2021 Completed Date 10/26/2021 Customer PO Job Address Gary Harper Construction #Station #4 18300 Cascade Avenue South Tukwila, WA 98188 USA ET to Clean wet well Task # Description Quantity Your Price Your Total PWOP 10/26-126327 PW - Operator Only 5.50 $235.00 $1,292.50 #400 10/26-126327 Disposal 1.00 $450.00 $450.00 Sub -Total $1,742,50 Tax $0.00 Total Due $1,742.50 Balance Due $1,742.50 Thank you for choosing Pro -Vac I hereby confirm that the work performed by Pro -Vac was of quality and in a timely manner. 10/26/2021 I have inspected all the work performed by Pro -Vac and understand that I have been given the opportunity to address any concerns regarding the work performed. I have found no such concerns, or these concerns were addressed by the Pro -Vac operator to my satisfaction. My signature signifies my full acceptance of all work performed. 10/26/2021 Job #126327 Driver Ticket Customer Name Gary Harper Construction, Inc. Location Address 18300 Cascade Avenue South, Tukwila, WA 98188 USA Technician Name Raring, John No Truck Number Travel Start Time Pv550 630am Arrival Onsite Time Site Departure Time 800am 1130am Dump Out Completed Time Dump Location Name 1200pm P2 How many loads did you dump Summary ET to control sewage in lift station for 1 installation of new line. Decant onsite Location Name Gary Harper Construction #Station #4 Today's Date 10/26/2021 Did you have a laborer? Extra Equipment Used GH wormwormumurimorprommirmt GARY HARPER CONSTRC1 OON ;NC 14831 223rd Street SE Snohomish, WA 98296-3989 (360) 863-1955 Fax (360) 863-1966 Thursday, October 7, 2021 City of Tukwila Attn: Adib Altallal Re: Tukwila Lift Stations No. 12 and No.04 Retro fits Change Order No. 3 Relocate extra light fixture inside the wetwell and add switch in drywell at lift station #12 Labor Equip Operator - Tim Pipelayer - Juan Pipelayer - Patrick Foreman - Derek Dump Truck Driver Laborer - Christian Gary Harper Project Manager Subtotal Overhead & Profit 15% Total Labor Subcontractor & Equipment MD Marine Electric 1 Ton Work Truck Cat 308E Subtotal Overhead & Profit Total Materials & Equipment Subtotal Overhead & Profit 12% Total Change Order No. 03 hrs @ 88.18 hrs @ 70.00 hrs @ 70.00 hrs @ 85.00 hrs @ 76.11 hrs @ 63.18 hrs @ 87.84 hrs @ 57.35 1.00 LS @ 17,758.22 17,758.22 hrs @ 30.00 hrs @ 46.87 17,758.22 17,758.22 17,758.22 2,130.99 $ 19,889.21 MD Marine Electric 672 E iith St Tacoma, WA (253) 383-9983 www,mdmarineelectriccom Change Order Request 5183 — Tukwila LS 4 and 12 Retrofits (Local 46) COR Subject: Install new switch and fixture lift #12 To JJ Smith -Marquez Gary Harper Construction 3608631955 Return To Jeremy Porter MD Marine Electric, Ltd. (253) 341-2051 jporter@mdmarineelectric.com COR Number: 5183-1 COR Revision Number: 1 COR Date: 10/7/2021 Price / Do Not Work Type: Proceed Days Valid: 15 Scope Of Work / Time Extension Request This change order request represents the costs to add conduit and a new switch to the dry well side that will operate the fan and light in the wet well. Remove the existing switch in the wet well install a new led fixture and refeed the exhaust fan and new fixture from the drywell. Details Description Cost / Rate Qty Hrs st CLU 46 Foreman - 21.22 $106.03 15.00 Hrs $1590.45 CLU 46 Journeyman - 21.22 $98.73 15. 00 Hrs $1480.95 Safety Equipment $692.80 1.00 $692.80 Harnesses, Tripod, Sniffer, Planking General Materials $2,394.35 1.00 $2394.35 Quoted Light $598.82 1.00 $598.82 PM $125.00 40.00 $5000.00 General Superintendant $130.00 16.00 $2080.00 Estimator $88.00 4.00 $352.00 Van $1,150.00 1.00 $1150.00 Breakout Labor : $3,071.40 Contractor Markup @ 15%: $460.71 Equipment : Contractor Markup @ 15%: Material : Contractor Markup @ 15%: Overhead : Contractor Markup @ 15%: Other : Contractor Markup @ 15%: Small Tools Cost : $692.80 $103.92 $2,993.17 $448.98 $7,432.00 $1,114.80 $1,150.00 $172.50 $117.94 Total: $17,758.22 Reservation of Rights This COR does not include any amount for impacts such as interference, disruptions, rescheduling, changes in the sequence of work, delays and/or associated acceleration. We expressly reserve the right to submit our request for any of these items. Signed By: Dated: 10/7/2021 CITY OF TUKWILA 21-089 Council Approval 5/3/21 C-1 AGREEMENT FORM CONTRACT NO. 21-089 THIS AGREEMENT is made and entered into on this 12 day of May , 2021 , by and between the City of Tukwila, Washington ("Owner") and Gary Harper Construction, 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 TUKWILA LIFT STATIONS #4 and #12 RETROFITS, Project No. 91440201, 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 Gary Harper Construction, Inc. (Owner) m (Contracto/'� 7 �a By: YbOUJcUoYeel cla,JUG1 By: � Mayor 06/14/2021 Title: President Attest: Attest: This 14th day of June , 20 21 This 1 day of 'y ,rte , 20 21 Key: Uo50,,,,,,c1,1,5,7,035eoSJIoSSOti City Clerk Approved as to Form: ir-e;e. o.9a,/-c�G City Attorney Address for giving notices: 6200 Southcenter Boulevard Tukwila, WA 98188 GARYHCI055LF Contractor's License No. Address for giving notices: 14831 22rd St SE Snohomish, WA 98296 TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 9144020/ MARCH 2021 CITY OF TUKWILA C-3 PAYMENT AND PERFORMANCE BOND Bond to City of Tukwila, Washington Bond No. 023209310 We, Gary Harper Construction, Inc. , and The Ohio Casualty Insurance Company (Principal) (Surety) a New Hampshire 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 Three Hundred Forty Two Thousand Four Hundred Eleven and 00/100 Dollars ($ 342,411.00 ), 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 June 14 , 2021, between Principal and Owner for a project entitled TUKWILA LIFT STATIONS #4 and #12 RETROFITS, Project No. 91440201 ("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. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 CITY OF TUKWILA C-4 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 12th day of May , 20 21 . Gary Harper Construction, Inc. The Ohio Casualty Insurance Company P cipal Surety Sig "attire of Authorizeficial Signature of Authorized Official Gary Harper, President Title Name and address of local office of agent and/or Surety Company: By Holly E. Ulfers Attorney in Fact (Attach Power of Attorney) USI Insurance Services 601 Union Street, Suite 1000 Seattle, WA 98101 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. TUKINILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 CITY OF TUKWILA PROPOSAL TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Circ OF TUKWILA THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Cir OF TUKWILA P-1 Contractor's Name Contractor's State License No. City of Tukwila Project No. To the Mayor and City Council City of Tukwila, Washington PROPOSAL (unit price) (Czr- /)//-/Ar Cai,;)41,471dr 07 14c 0 91440201 The undersigned (Bidder) hereby certifies that they personafly examined the location and construction details of Work outlined in the Contract Documents for the City of Tukwila (Owner) project titled LIFT STATIONS #4 and #12 RETROFITS, Prject No. 91440201, which prject includes, but is not Iimited to: Lift Station No. 4- Electrical Upgrades: Construction of upgrades for Sanitary Sewer Lift Station #4, the scope of which includes the demolition and replacement of the existing Pump Starter Panel, Manual Transfer Switch, Flow Meter, Conduits, Conductors, Meter Base, PSE conductors from the existing transformer, Bypass Pumping, and other work necessary to complete the work as specified and shown in the Contract Documents. Lift Station No. 12-VVetWell Rehabilitation: Construction of upgrades for Sanitary Sewer Lift Station #12, the scope of which includes the deaning, pnepping, and complete coating and lining of the entirety of all four interior walls of the existing wet well. The Work also includes concrete repair within the wet well for a spalling area approximately 50 to 100 square feet by 8 -inch (max) depth as shown on the Contract Plans. Bypass pumping and other miscellaneous work is necessary to complete the Work as specified and shown in the Contract Documents. The undersigned further certifies that they have read and thoroughly understand 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) bid bond or -� cash, E] cashier's check, 111 certified check, or 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 darnaQos, all as provided for in the Bid Documents. Bidder shall attain Physical Completion of all Work in all respects within 120 calendar days from the date stated in the written Notice to Proceed. If the work is not completed within this time TUKWILA LIFT STATTONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see °m,.bxva.cnm Always Verify Scal C/TYopnUKWIm P-2 period, Bidder shall pay liquidated danloQento[vnarasa inSection 1-O8.9ofthe 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. BID SCHEDULES TUKWILA LIFT STATIONS #4 and #12 RETRQFITS Project No. 91440201 Note: Unit prices for all items, all ext*nekons, 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 totais shall be corrected to conform thereto. It is the ntent of the OWNER to award the lowest responsible BIDDER for the total price bid for the project (combined total of Schedules A and B). The OWNER reserves the right to construct one or both bid schedules, depending on funds available for the prject at the time of the Notice to Proceed. SCHEDULE A: LIFT STATION NO. 4 Item No. Item Description Qty Unit Unit Price Amount A-1 Mobilization 1 LS ��6c��o - - ��,����' ~_ A-21 Temporary Pollution/Erosion Control LS � o,o 4,'W�)r7' �~ t/���]�� �rm A-3 Resolution of Utility Conflicts 1 FA $3.000.00 $ 3.000.00 A-4 Project Temporary Traffic Control 1 LS 3 ge..,cre 35c,,e,,c' A-5 Electrical 1 LG^�e-LJ�� la /uu �> 'n�L/67 ' u~~ A-6 Temporary Bypass Pumping 1 LS lJ��/�/{/) /7uu /J/m' /l/ / �t uy' GO A-7 Site Restoration 1 LS�c, ����� cno �����` A-8 SafetyTiench/Exnavatipnv 1 LS c"�� ����_ c,� /c°��_ A-9 Electrical Permits t FA $1.000D0 $ 1.000.00 A-10 Unexpected Site Changes 1 FA $20.000.00 $ 20.000.00 Subtotal Schedule A � �U $ y// ;�av�� ' c/ Mh Sales Tax �B 1O 196 ~~ �/ �� � /\ /4� L/ $ ��// �� // ^ TOTAL BID SCHEDULE �� �/� /�� [) � ^�/L4 `� //' /� " TLJKWILA LIFT STATIONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA. Inc. For usage conaitiooa Agreement see www.bxwa.com Always Verify Scal CITY OF TUKWILA P-3 SCHEDULE B: LIFT STATION NO. 12 Item No. Item Description Qty Unit Unit Price Amount B-1 Mobilization 1 LS B-2 Wet Well Cleaning and Lining 1 LS4 47/4 56b, 00 B-3 Wet Well Concrete Spalling Repair 1 FA >5,'r:, $10,000.00 $ 10,000.00 B-4 Bypass Pumping 1 LS -?0,r,r1c)ca70 B-5 Unforeseen Conditions Contingency 1 FA $5,000.00 $ 5,000.00 Subtotal Schedule B $ /4A M. 0 0 < Sales Tax 10.1% $ 477/ 1/07 1 ' TOTAL BID SCHEDULE B $ TOTAL SCHEDULE A (Incl. Sales Tax) $ 62/O 57 . TOTAL SCHEDULE B (Incl. Sales Tax) $ /35267, V-) - TOTAL AMOUNT BID $ .53(7 h3Y -,, - Total Bid Price in Words: TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY OF TUKWILA P-4 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 esti day ntitiesown on the Bid form then totaling all of the extended amounts. Signed: Title: Date: /2/, /,0/ TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY opnUKWIm P-5 By sining belowBidder acknowledges receipt and understanding of the following Addenda to the Bid Documents: Addendum Addendum No. Date of Receipt No. Date of Recept 1 3 / 2. / 2 4 NOTE: Failure to acknowledge ofAddenda may be considered as an irregularity in the Bid ProposalandOwner reserves the right to determine whether the bid will be disqualified. By signing be|ovv. 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 rject all bids. The Surnish the -7/R7 //, - required Payment and Performance Bond is ff/e 9V,54/ (Address) � � /f^ ,/,/,'d;/W..,4Y/L . _ __ 6�� /^/J�-5/ �����Y/�' �+��~-��/ ��^/i///»/v//�r/L ^~^' ^� El Partnership State of Incorporation: 4x/f�� Bidder: (Name) of Signature of Authorized Official: Printed Name and Title: Address: Check One: El Individual El Joint Venture Phone No.: JKI Corporation Date: This address and phone number is the one to which all communications regarding this proposal should be sent. NOTES: 1. Itthe Bidder is a co -partnership, give firm name under which business is transacted; proposal mus be executed by a partner. |fthe Bidder ioecoq�r�on.pm���|m�be����in�ecor�o� any other corporate officer accompanied by evidence of authority to sign). 2. A bid musbe 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. TUKWILA LIFT STATIONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com Always Verify Scal CITY OF TUKWILA P-6 THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY OF TUKWILA 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, Gary Harper Construction, Inc. (Principal), and The Ohio Casualty Insurance Company (Surety), are held and firmly bound unto the City of Tukwila (Owner) in the penal sum of Five Percent (5%) of the Total Bid Amount dollars ($ 5% ), 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 less than five percent (5%) of the total bid, including sales tax and is submitted by Principal to Owner in connection with a Proposal for TUKWILA LIFT STATIONS #4 and #12 RETROFITS, Project No. 91440201, 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 9th day of April Gary Harper Construction, Inc. ignature of Authorized Title Name and address of local office of agent and/or Surety Company: , 2021 The Ohio Casualty Insurance Company Surety By Roxana Palacios Attorney in Fact (Attach Power of Attorney) USI Insurance Services -NW 601 Union Street, Ste. 1000 Seattle, WA 98101 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. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal vi 0) c c cy) • N o(0 • > a .� ljo 3 mu) z P 5 D as a = U U c 5 9 V Liber Mutual, SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Certificate No: 8203153 - 969224 West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Scott Alderman, Jamie Annfield, Timothy S. Buhite, Amber Engel, Peggy A. Firth, Brandi Heinbaugh, Debbie Lindstrom, Kathleen M. Mitchell, Deanna K. Nakashima, Roxana Palacios, Gail E. Tsuboi, Holly E. Ulfers all of the city of Seattle state of WA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 20th day of February , 2020 . State of PENNSYLVANIA County of MONTGOMERY ss On this 20th day of February , 2020 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company By: David M. Carey, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA Notarial Seal Teresa Pasteila, Notary Public Upper Merion Twp., Montgomery County My Commission Expires March 2e, 2021 Member. Pennsylvania Association of Notaries By: Lvt, eresa Pastella, Notary Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV - OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII - Execution of Contracts: Section 5, Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 9th day of April , 2021 . LMS -12873 LMIC OCIC WAIC Multi Co 12/19 By: Renee C. Llewellyn, Assistant Secretary -o rn 0 0 0 (6 0 _I— o W 0 00 M Q d' 0 coE 0 c6 0- c) u)9 0 a1 > a).<1. _c CV 00 L- CO C CO 00 U N— o t—� CITY OF TuKwu ,a P-8 THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY upTUKWIm NON -COLLUSION DECLARATION STATE OF WASHINGTON ) ) ss. COUNTY (JFKING ) The undersined.beingfirstduk/uvvonn.onoothstateathattheporaon.firrn.ossoc|otion. podnenship, jointventure. or corporation named in the Bid Proposal has (have) not, either directly or indivectk/, entered into any egreenlont, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the City of Tukwila project named Tukwila Lift Stations #4 and #12 Retrofits, Project No. 91440201. `~"~`/ Name of FiUn Ti SEAL ~ - Offici No‘IIIIIIII///41 Signe,d.2 r -: •`R0.~ day 2 i .,` mmrwwp~*• :• e.049 ^ .//2eii, _~~z*c^'/,~ .-._ -uuu" : 4 ,1,^^:...^^iiiiiiiiiino 7r/ 7/. Signature o{Notary Public in and for the State of VVmshington, residing at <5~e.:00/27(M 7.5'>7�0 NOTICE TO ALL BIDDERS To report bid rigging activities caII: 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. TUKWILA LIFT STATIONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MA RC H 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see x^w,bx°a.com Always Verify Scal CITY OF TUKWILA P40 THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Cir,' OF TuKwILA RESPONSIBLE BIDDER DETERMINATION FORM Attach additional sheets as necessa!y to fully provide Name ofBidder' (;/�` /��//����yI/�/ Address of Bidder: ~-- � 71, City Contractor's License No.OVq/kg.:043,7---1 WA State UBI No. /.71:7 State Zip Code Dept. of L&I License Bond Registration No. -5;WPy4/l—� Worker's Comp. Acct. No. Bidder is a(n): 0 Individual 0 Partnership [1] JointVonture ]Et|ncorporated in the state of List business names used by Bidder during the past 10 years if different than above: 32,7-07 Bidder has been in business continuously from Bank Reference 077Bank /// No. of regular full-time e : Account Officer Ed_4 -52750 Officer's Phone No. Number of pjects in the past 10 years completed: /����� ahead p,nachaduha behind schedule Bidder has had experience in work comparable As a prime contractor for ���-- years. As a subcontractor for years. List the supervisory personnel to be employed by the Bidder and available for work on this project (Prject Manager, Principal Foreman, Superintendents, and Engineers): Name Title ~'477__ re L4-7-P�� re, '-e~,=~^���.~,°°^�~°r^*v�c���°�� How Long With Bidder Name the Surveyor to be used on this Project, who will directly supervise all surveyingacUvities. Attach a resume outlining the experience and qualifications of the Surveyor. Is the Surveyor licensed in the State of Washington (a PLS)? Yes 0 No Surveyor's Name: TUKWILA LIFT STATONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Buliders Exchange of WA, Inc. For usage Conditions Agreement see w�.bxwa.mom Always Verify Scal P42 List all those projects,ofsirnUornetureendsize.00moletedbvBiddarwithinthe past 10 years. lnclude a reference for each. Any attached preprinted pjuot|istingnnust|ndudneUthis information. Bidder must have at least 10 years experience working on projects of similar nature and size. Project NameCompleted Amount Year Contract Owner/Reference Name and Phone 7- 5— 67://77,?1 List all projects undertaken in the Iast 10 years which have resulted ted in partial or final settlement ofthe Contract by arbitration or lftigation in the courts: Total Claims Amount of Contract Arbitrated Settlement Name of Client and Project Amount or Litiqated of Claims Has BUdder, or any representative or partner thereofever failed to complete a contract? E No El] Yes If yes, give details: /7/ Has Bidder ever had anyPayment/Performance Bonds called as a result of its work? M No [1] Yes If yes, please state: Project Name //�� Contracting Party Bond Amount Has Bidder ever been found guilty of violating any State or Federal employment laws? No Yes If yes, give details: TIJKWILA LIFT STATIONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com Always Verify Scal C/TYoF TUKWIm P-13 Has Bidder ever filed for protection under any provision of the federal bankruptcy laws or state insolvency laws? 2'No E] Yes If yes, give details: Has dverse legal judgment been rendered against Bidder in the past 5 years? ET No Li Yes If yes, give details: Has Bidder or any of its employees filed any claims with Washington State Workman's Compensation or other insurance comy for accidents resulting in fatal ijury or dismemberment in the past 5 years? jg No 11 Yes If yes, please state: Date Type of Injury Agency Receiving Claim The unde' ned warrants under penalty of Perjury that the foregoiinformation 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 Title: Date: TUKWILA LIFT STATIONS #4 AND #1 2 RETROFETS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com Always Verify acaz CITY OF TUKWILA P-14 THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal C/TYorTUKWIm CERTIFICATE OF COMPLIANCE WITH WAGE PAYMENT STATUTES The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date, April 14.2O21.the bidder ksnot a"vv|Kul"violator, asdefined in RCW 48.48D82. of any provision of Chapters 49.46. 49.48. or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgement entered by a court of limited or general jurisdiction. | certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. /m 71//241:2,1 Bidder's BuSines 8inotu []���r g vecv*u�nn{�-�u —� "— � /l /�/(//r/77 Print Nam ri/(7,-(7),(th Title /4 Dater/ , /!/ '-~ ' Check One: Sole Proprietorship .S-Ayhoia/ City State Partnership EJoint Venture II] Corporation State of Incorporation, or if not a corporation, State where business entity was formed: IeY If a co -partnership, give firm name under which business is transacted: *If 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). If a proposal must be executed by a partner. TumwuxLIFT STATIONS #4AND #i2RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com Always Verify Scal CITY OF TUKWILA P-16 THIS PAGE IS INTENTIONALLY LEFT BLANK. TUKWILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY OF TUKWILA P-17 PROPOSED EQUIPMENT AND LABOR SCHEDULE (Use additional sheets if required) Equipment to be used: DESC RI PTION/TYPE YEAR CONDITION OWN/RENT Cf--;- .4 ?e?,... ?-.:-.74—,---,--,,,,,-- ' I-- •-.1- i' Fa -c-4-,./4--",77/- /e€7,--rfe in( Labor to be used: .M.5c/rAel)/a-, Siature of A th Official Title TUKVVILA LIFT STATIONS #4 AND #12 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal CITY OF TUKWILA P-18 PROPOSED SUBCONTRACTORS NenleofBidder (0444/47:11,2141-C6/Lag «') ---- |naccordance with RCVV3S.3O.O8Oosamended, every bidthat 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: structural steel instoUatiun, rebar insta||atiVn, electrical, heating, ventilation, air conditioning and plumbing as described in RCW 18.106 and electricai as described in RCW 19.28, and, or to name itself for the work. The Bidder shall not Iist more than one subcontractor for each category of work identified, unless subcontractors vary with bid n|tarnoiea, 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 itself 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. Prime Contractor must declare if they intend to perform any of these items. The successful Bidder must have the written permission of the Owner to make any change to this list. Percent of total bid to be performed by Bidder 17 % Schedule/Bid Item Numbers % of Name Subcontractor will perform Total Bid //777 5,2 � WORK TO BE PERFORMED BY PRIME CONTRACTOR �L 4 � TUKWILA LIFT STATIONS #4 AND #1 2 RETROFITS PROJECT NUMBER: 91440201 MARCH 2021 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com Always Verify Scal City of Mercer Island 9611 SE 36th St Mercer Island, WA 98040 Lakehaven W&S District PO Box 4249 Federal Way, WA 98003 City of Kent 400 W. Gowe Kent, WA 98032 Gary Harper Construction, Inc. 14831 223rd St SE, Snohomish, WA 98296-3989 Ph (360) 863-1955, Fax (360) 863-1966 Lic # GARYHCI055LF 2020 Public Works Projects as a General Contractor Name of Contract: Pump Station No. 18 Pump Replacement - Pump Stations No. 13, 17 & 24 Generators Replacement, Project No. 2018-P18G131724 Install owner supplied generators in underground vaults at three pump stations, including new ventilation systems and confined space equipment. Install owner supplied pumps, new piping, valves and ladders at one pump station. Contact: James Moe, Sewer Utility Foreman (206) 960-0602, james.more@mercergov.org JOB COSTS: $573,398.18 Name of Contract: Lakota Liquid Stream Improvements, Phase 1 (19-1449) Mechanical modifications at Lakota WWTP. Install 6 new 10" flow meters and D.I. piping. Install new 4" valves and D.I. piping on 3 WAS pumps. Install new 3" air release piping on existing 10" D.I. pipe. Painting and electrical work. Contact: Molly Du, Project Manager (253) 946-5415, myoung@lakehaven.org JOB COSTS: $528,090.88 Name of Contract: Armstrong Well 2 Pump Replacement, Project No. W20089 Provide and install new turbine pump in existing well building. Contact: Bryan Bond, Engineering Project Coordinator (253) 856-5662, Bbond@kentwa.gov JOB COSTS: $97,783.53 King County Water Dist 90 Name of Contract: Pump Station No. 2 System Improvements, Contract No. 2020-01 15606 SE 128th St Remove one old pump, piping, fittings and control valve. Provide and install new pump, Renton, WA 98059 piping, fittings and control valve. Minor concrete work. Contact: Bryan Wolf, PE - Santec Consulting Services, Inc. (425) 289-7328, brian.wolf@stantec.com JOB COSTS: $78,735.00 Ronald Wastewater Dist PO Box 33490 Shoreline, WA 98133 City of Kirkland 123 5th Ave Kirkland, WA 98033 Name of Contract: 2112 & 2118 N. 155th St Sewer Lateral Repair (211909-9) Replace existing sewer stubs for 2 side sewers. Restore sidewalk and driveway. Contact: Craig Chrisensen, PE - CHS Engineers (425) 637-3693, craigc@chsengineers.com JOB COSTS: $49,225.89 Name of Contract: Rose Point Lift Station Improvements, Job No. 22 -18 -PW Construct a new Sewer Lift Station with controls and generator building. Construct soldier pile wall and concrete retaining wall. The new Sewer Lift Station was built into an existing steep slope. Abandon old Sewer Lift Station. Storm drain work, paving and landscaping. Contact: Hunter Richards, Project Representative JOB COSTS: $2,188.694.64 (425) 587-3244, Hrichards@kirklandwa.gov King County Wastewater Treatment Div 2501 W Jameson St Seattle, WA 98199 City of Bonney Lake PO Box 7380 Bonney Lake, WA 98391 Seattle Public Utilities 700 Fifth Ave Seattle, WA 98124 Seattle Public Utilities 700 Fifth Ave Seattle, WA 98124 City of Bainbridge Island 280 Madison Ave N Bainbridge Island, 98110 City of Redmond 15670 NE 85th St Redmond, WA 98073 Gary Harper Construction, Inc. 14831 223rd St SE, Snohomish, WA 98296-3989 Ph (360) 863-1955, Fax (360) 863-1966 Lic # GARYHCI055LF 2019 Public Works Projects as a General Contractor Name of Contract: WPTP - Dry Polymer Feeder Replacement, Contract No. C01146C17 Replace two existing Dry Polymer Feeders with new units. Replace existing piping to mixing tanks with new stailness steel pipe. Electrical upgrades. Contact: Ken Bergstrom PE, Project Engineer (206) 477-2154 JOB COSTS: $545,336 Name of Contract: Prairie Ridge Booster Pump Station - Supply and install two new pumps, valves and fittings in Booster Pump Station. Install new controls and electrical work. Contact: Doug Budzynski PE, Assistant City Engineer (253) 447-4342 JOB COSTS: $320,327 Name of Contract: Delridge NPDES 99 CSO Gate Retrofit, Contract No. PW#2018-066 Temporary sewer bypass pumping. Remove existing hydrobrake in manhole and install new controlled slide gate. Install adjustable weir plate and pressure transducer in overflow manhole. Install actuator vault and actuator for Slide Gate. Install pulser ultrasonic sensor in existing manhole. Contact: James Barnett PE, Senior Resident Engineer SPU (206) 477-6483 JOB COSTS: $409,860 Name of Contract: South Transfer Station Trackout Control, Contract No. PW#2018-078 Replace catch basins on existing tipping floor. Modifications in existing oil/water separator. Demolish existing tire wash facility. Install new owner supplied settling tank, form and pour new tire wash facility. Contact: Allan Arayata, Associate Civil Engineer (206) 423-2165 JOB COSTS: $606,203 Name of Contract: Old Treatment Plant Pump Station Replacement - Sewer bypass pumping, replace existing pumps, motors and control panels at City's Sewer Pump Station. Remove old generator and building, install a Kohler 40KW generator on new concrete slab. Install new electrical service. Miscellanious site improvements. Contact: Chris Munter, PE, PMP ENV SP (206) 780-3720 JOB COSTS: $415,939 Name of Contract: Wastewater Pump Station No. 2 Rehab, Project No. 20021128 Construct new Sewer Pump Station and demolish old pump station. Dewatering, install 12' diameter Caisson Shoring, install new wet well. Temporary bypass pumping, construct new manholes and electrical controls building. Install new electrical and water service lines. Asphalt and landscape restoration. Contact: Mike Haley PE, Senior Project Manager JOB COSTS: $1,701.538 (425) 556-2843 King County Wastewater Treatment Div 22505 SR9 SE Woodinville, WA 98072 City of Burlington 833 S. Spruce St Burlington, WA 98233 King County Wastewater Treatment Div 22505 SR9 SE Woodinville, WA 98072 Port of Seattle PO Box 68727 SeaTac, WA 98168 City of Issaquah 1775 12th Ave NW Issaquah, WA 98027 City of Issaquah 1775 12th Ave NW Issaquah, WA 98027 City of Federal Way 33328 8th Ave S Federal Way, WA 98003 Gary Harper Construction, Inc. 14831 223rd St SE, Snohomish, WA 98296-3989 Ph (360) 863-1955, Fax (360) 863-1966 Lic # GARYHCI055LF 2018 Public Works Projects as a General Contractor Name of Contract: Brightwater Storm Drain Alternate Flow, Contract No. C01084C16 Temp sewer bypassing. Install new utility vault with two 12" sluice gates. Install 24" sluice gate in existing manhole, install new 48" manhole, 18" SDR35 pipe, 8" SDR 35 pipe, misc. concrete work, HMA pavement and site restoration. Contact: Pierre Larochelle, Project Representative (206) 263-9458 JOB COSTS: $228,899 Name of Contract: Waste Water Pump Station No. 10 Upgrades, G&O Contract No. 17466.00 Temp bypass pumping, partial demolition of existing wet well, install new slab top of wet well, valve vault, meter vault, new pumps, piping, valves, electrical, controls, coatings, concrete work, HMA asphalt, fencing and site restoration. Contact: Don Erickson, Sewer Dept Supervisor (360) 757-4085 JOB COSTS: $707,691 Name of Contract: Hollywood & Woodinville Pump Station Install RSP, Contract No. C01180C17 Removal and modification of six 14" discharge pipes at two pump stations. Install new gate valve assemblies. Also includes plugging sewer lines, testing, coatings and site restoration Contact: Gary Casad, Project Representative (206) 477-6483 JOB COSTS: $154,770 Name of Contract: Signature Lift Station Pump Replacement, Contract No. SW -0319198 Temp bypass pumping. Remove and replace pumps, piping, floats etc. from wet well. Make modifications to electrician and control panel. HMA asphalt, concrete work and site restoration. Contact: Brian Allen, Construction Manager (206) 787-5880 JOB COSTS: $144,870 Name of Contract: Pickering Lift Station Revisions, Contract No. SEWR15001 Upgrades to Lift Station includes new submersible pumps, motor control center, revising pump controls, programming, replace wet well fan and site restoration. Contact: Tony Nguyen, PE - Project Engineer (425) 837-3437 JOB COSTS: $122,567 Name of Contract: Forest Rim Booster Station, Contract No. WATR17004 Construct a new booster pump station with associated site piping and tie ins, remove old booster pump station. Landscaping, HMA asphalt, traffic control and site restoration. Contact: Tony Nguyen, PE - Project Engineer JOB COSTS: $1,002,761 (425) 837-3437 Name of Contract: Lakota Park Stormwater Facility Repair, Contract AG#18-082 Repair a settled earthen berm of a stormwater facility in Lakota Park. Replace 470 LF 18" concrete pipe with 24" CPEP pipe. Install two 48" manholes. Repair and restore running track and other site restoration. Contact: Fei Tang, PE - Project Engineer (253) 835-2751 JOB COSTS: $295,533 Seattle Public Utilities 700 Fifth Ave Seattle, WA 98124 City of Issaquah 1775 12th Ave NW Issaquah, WA 98027 Alderwood Water and Wastewater District 3626 156th St SW Lynnwood, WA 98087 City of Sultan 319 Main St Sultan, WA 98294 Lakehaven Water and Sewer District PO Box 4249 Federal Way, WA 98063 City of Lynnwood PO Box 5008 Lynnwood, WA 98036 City of Tukwila 6300 Southcenter Blvd Tukwila, WA 98188 Gary Harper Construction, Inc. 14831 223rd St SE, Snohomish, WA 98296-3989 Ph (360) 863-1955, Fax (360) 863-1966 Lic # GARYHCI055LF 2017 Public Works Jobs and Major Projects as a General Contractor Type of Work: Pump Station 50 Airlift Replacement - Temp bypass pumping, remove all pipe, compressor and electrical in existing drywell. Remove slab top, install new slab top and convert drywell to a wet well. Install new pumps and piping. Install new mechanical/electrical vault with piping, valves, electrical and controls. Restore site and landscaping. Contact: Bobby Jones, PE - Project Representative (206) 276-1762 JOB COSTS: $847,687 Type of Work: Wildwood Tank Improvements - Upgrade existing 250,000 Gal Water Reservoir. Install new mixing system, new overflow piping, new access hatch, ladders and platforms. Construct new seismic reinforcement ring inside of reservoir. Install new Dechlorination vault and automatic valve vault. Electrical and controls Contact: Tony Nguyen, PE - Project Engineer (425) 837-3437 JOB COSTS: $325,147 Type of Work: Picnic Point WWTF Air Gap Pump Systems - Construct new CMU building with metal roof. Purchase and install two new Air Gap Pump Skid systems with piping, valves electrical and controls. Contact: Josiah Hartom, PE - Project Engineer (425) 741-7969 JOB COSTS: $294,632 Type of Work: Grit Equipment Replacement Project - Remove old grit classifier, cyclone and associated equipment purchase and install new grit classifier, cyclone. New electrical. Contact: Eric Smith, PE - RH2 Engineering (800) 720-8052 JOB COSTS: $72,807 Type of Work: 2017 Lakota Headworks Screens/Compactor Installation & Upgrades - Replace old screens and compactor with owner supplied bar screens and compactor. Install new odor control piping, gratings, electrical and controls. Temp bypass pumping. Install new rock trap on existing 48" RC pipe. Install 24" bypass line, 4 slide gates with actuators and retaining wall. Replace 6 actuators with new actuators in headworks. Contact: Aaron Werner, PE - BHC Consultants (206) 357-9925 JOB COSTS: $967,265 Type of Work: Lift Station 10 Wet Well Modifications - Temp bypass pumping. Remove old grating, piping and slide gates in wet well. Apply Xypex Coatings in wet well. Install new manual operated slide gates, grating and piping. Install new pig port vault, stairs, railing and concrete slab Contact: Alex Fussell, PE - RH2 Engineers (425) 951-5348 JOB COSTS: $427,955 Type of Work: 2016 Andover Park East Sewer Repair - Temp bypass pumping. Replace 435 LF of 12" asbestos pipe with new PVC pipe on Andover Park East. Traffic control, site restoration. Contact: Jeff Faunce, PE - AKANA (206) 768-8500 JOB COSTS: $363,492 Covington Water District 18631 SE 300th Place Kent, WA 98042 King County 401 Fifth Ave Seattle, WA 98104 Hartstene Pointe Water -Sewer District 772 Chesapeake Dr Shelton, WA 98584 Cross Valley Water District 8802 180th St SE Snohomish, WA 98296 Pierce County Public Works 9850 64th St W University Place, WA 98467 Seattle Public Utilities 700 Fifth Ave Seattle, WA 98124 City of Sumner Public Works 1104 Maple St Sumner, WA 98390 Gary Harper Construction, Inc. 14831 223rd St SE, Snohomish, WA 98296-3989 Ph (360) 863-1955, Fax (360) 863-1966 Lic # GARYHCI055LF 2016 Public Works Jobs and Major Projects as a General Contractor Type of Work: 222nd PI SE Wells C&D Improvements - Demolish two existing vaults for for existing wells. Construct two new well buildings. Install new pumps, valves, fittings, piping, electrical & controls. Misc electrical work in 3 other well buildings. Contact: Fred French (253) 631-0565 JOB COSTS: $1,271,349 Type of Work: Vashon Treatment Plant UV Disinfection System #C00963C15 - Construct new U.V. Disinfection system and building. Install new inlet & discharge piping. New electrical and controls for U.V. System. Demolish old U.V. System. Contact: Glen Hiraki, Project Representative (206) 263-1783 JOB COSTS: $610,144 Type of Work: WAS Pump Station Improvements - Remove old pumps & piping. Install two new waste activated sludge pumps, valves, fittings & pipe. Minor electrical work. Contact: Mont Jeffreys, General Manager (360) 427-2413 JOB COSTS: $63,700 Type of Work: Office Site Fueling Station - Install new above ground dual fuel tank. Install oil -water separator. Minor electrical. Restore site. Contact: Curt Brees, General Manager (360) 668-6766, Ext 102 JOB COSTS: $89,700 Type of Work: Warner Pump Station Chopper Pump Installation - Temporary bypass pumping. Remove old pumps, piping and valves. Install new pumps, piping and valves. Electrical upgrades. Contact: Jason Beaver, Civil Engineer (253) 798-3089 JOB COSTS: $109,332 Type of Work: Pump Station 70 Rehab & Forcemain Replacement - Temporary bypass pumping. Remove all electrical controls, mechanical & HVAC from existing lift station. Install new electrical, controls, mechanical & HVAC in existing structure. Install new grating and grating supports. Direction drill new force main. Contact: Rosalind Liston -Riggs, Senior Inspector (206) 423-2576 JOB COSTS: $443,359 Type of Work: Parker Road Pump Station No. 5 - Construct a sewer pump station including temporary bypass, installation of force main, gravity sewer, new standby generator, electrical and controls. Sheet pile shoring & vacuum pump dewatering. Site and street restoration. Contact: Jeff Faunce, PE - Akana (206) 768-8500 JOB COSTS: $1,610,780 GARYHAR-06 NSTAMM ,d►CORO" CERTIFICATE OF LIABILITY INSURANCE (►�--"'� DATD/YYYY) 5//13/213/2021 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 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 Hub International Northwest LLC PO Box 3018 Bothell, WA 98041 CONTACT NAME: PHONE 425 489-4500 FAx 425 485-8489 (AIC, No, Ext): ( ) (A/C, No): ( ) aPDAhss: now.info@hubinternational.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Admiral Insurance Company 24856 INSURED Gary Harper Construction, Inc. 14831 223rd St SE Snohomish, WA 98296 INSURER B: Mutual of Enumclaw Insurance Company 14761 INSURER C : Landmark American Insurance Company 33138 INSURER D : Lloyd's of London 15792 INSURER E : 300000 $ 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X 12/1/2020 12/1/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 300000 $ CLAIMS -MADE X OCCURCA00003673002 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GE X 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES jECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 WA STOP GAP $ 1,000,000 B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY SCHEDULED AUTOS NON-OWNEDUUS X X CPP0025713 12/1/2020 12/1/2021 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per PROPERTY $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE LHA250651 12/1/2020 12/1/2021 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ $ 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 /A CA00003673002 12/1/2020 12/1/2021 PER STATUTE X OTH- ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ D Poll/Prof Liability x x ENP000327202 5/18/2020 5/18/2021 Ded: $5,000 Occ/Agg 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Tukwila Lift Stations #4 and #12 Retrofits, Tukwila Project No. 91440201 City of Tukwila, the Contracting Agency and its officers, elected officials, employees, agents and volunteers, PACE Engineers, Inc., Follett Engineering, PLLC, and Other Construction Management Consultants and Testing Consultants are included as Additional Insureds; coverage is Primary and Non -Contributory and Waiver of Subrogation applies per attached forms/endorsements. CERTIFICATE HOLDER CANCELLATION City of Tukwila Y 6200 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: CA000036730-02 CG20101219 Effective Date: 12/1/2020 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization that is an owner, lessor or man- ager of real property or personal property on which you are performing ongoing operations, or a contractor on whose behalf you are performing ongoing operations, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. All locations at which the Named Insured is performing ongoing operations. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 omissions; 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 insured(s) at the location of the covered operations has been completed; or CG20101219 © Insurance Services Office, Inc., 2018 Page 1 of 2 0 2. That portion of "your work" out of which the injury or damage arises has been put to its 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 limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG20101219 © Insurance Services Office, Inc., 2018 Page 2 of 2 0 Policy Number: CA000036730-02 CG 20 37 12 19 Effective Date: 12/1/2020 THIS ENDORSEMENT CHANGES THE POLICY. 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization that is an owner, lessee or manager of real property or personal property for whom you work or have worked, or a contractor on whose behalf you work or have worked, but only if coverage as an additional insured extending to "bodily injury" or "property damage" included in the "products -completed operations hazard" is required by a written contract or written agreement that is an "insured contract" and provided that the "bodily injury" or "property damage" first occurs subsequent to the execution of the contract or agreement. All locations except locations where "your work" is or was related to a job or project involving single-family dwellings, multi -family dwellings (other than rental apartments in an apartment building: (a) originally constructed and at all times used for such purpose, or (b) converted from a commercial building), condominiums, townhomes, townhouses, time - share units, fractional -ownership units, cooperatives and/or any other structure or space used or intended to be used as a residence. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" 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. B. 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 limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG20371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 0 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage"; (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of "prop- erty damage" arising out of any one "occurrence"; Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. (3) 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 01 04 13) The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. Infounation required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Condi- tions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the per- son or organization shown in the Schedule above. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 8 0 with its permission, 2009, 2012 & 2013. CONTRACTUAL LIABILITY — RAILROADS (Insurance Services Office Endorsement CG 24 17 10 01) SCHEDULE Scheduled Railroad: Any railroad, but only if the following conditions are met: a. You have expressly agreed to indemnify the railroad in a written contract entered into by you; and b. The injury or damage occurs subsequent to the execu- tion of the written contract. Designated Job Site: Any job site covered by this insurance where you are per- founing operations for or affecting a Scheduled Railroad. (If no entry appears above, info ration required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) With respect to operations perfourred for, or affecting, a Scheduled Railroad at a Designated Job Site, the definition of "in- sured contract" in the Definitions section is replaced by the following: 9. "Insured Contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a munici- pality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a munici- pality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liabil- ity that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or dam- age; (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no entry appears above, inforrrration required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 8 0 with its permission, 2009, 2012 & 2013. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction pro- ject, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is $5,000,000 . 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical 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 medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such pay- ments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Des- ignated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can- not be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available 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 Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Desig- nated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if 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 Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to ap- ply as stipulated. IV. ADDITIONAL INSUREDS ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT — AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU (Insurance Services Office Endorsement CG 20 34 04 13) A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agree- ment that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organiza- tion(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent pe fitted by law; and AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 8 0 with its permission, 2009, 2012 & 2013. Policy Number: CPP0025713 COMMERCIAL AUTO EA 9911 0318 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The following changes revise SECTION I — COVERED AUTOS Paragraph C.1. is deleted and replaced with the following: 1. Trailers a. "Trailers" with a load capacity of 2,000 pounds or less designed primarily for travel on public roads; or b. "Trailers" designed primarily for travel on public roads when: (1) Pulled by an owned private passenger auto specifically described in Item Three of the Declarations as a covered "auto" for Liability Coverage under this Coverage Form; and (2) Not used for business, farming or ranching purposes. Private passenger auto means a motor vehicle of the private passenger, station wagon, pickup or van type designed for use on public highways and subject to motor vehicle registration. The following is added: D. Temporary Substitute Autos — Physical Damage If Physical Damage Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. EA 9911 0318 The coverage that applies is the same as the coverage provided for the vehicle being replaced. Physical Damage Coverage is extended to the temporary substitute auto for the lesser of the following number of days: 1. The number of days reasonably required to repair or replace the covered "auto" that is out of service; or 2. 30 days. The following changes revise SECTION 11 — LIABILITY COVERAGE The following is added to ParagraphA.1.: d. Any person or organization that you are required to include as an additional insured on this Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance applies. A person's or organization's status as an additional insured under this endorsement ends when your contract or agreement with such person or organization ends. The Limits of Insurance applicable to the Additional Insured are those specified in the written contract or agreement but not more than the Limits of Insurance specified in the Declarations of this policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the declarations for the Named Insured. This Coverage does not apply to lessors of leased "autos". Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 6 e. Broadened Named Insured Any business entity newly acquired or formed by you during the policy period provided you own 51% or more of the business entity and the business is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity or until the end of the policy period, whichever comes first. f. Employee Hired Auto An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. Paragraphs A.2.a.(2) and A.2.a.(4) are deleted and replaced with the following: 2. Coverage Extensions a. Supplementary Payments (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. Paragraph B.5. is deleted and replaced with the following: 5. Fellow Employee "Bodily Injury" to: a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business. This exclusion does not apply to an "insured" who occupies a position as an officer, manager or supervisor.; or b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of Paragraph a. above. The following changes revise SECTION III — PHYSICAL DAMAGE COVERAGE This coverage applies only for a covered "auto" for which Physical Damage Coverage is provided for on this policy. Paragraph A.2. is deleted and replaced with the following: A. COVERAGE EA 9911 0318 2. Towing We will pay up to $200 for a covered "auto" for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. This coverage is excess over a. any limit shown in the Declarations for towing and labor costs; and b. any other collectible insurance. This coverage applies only for an "auto" covered on this policy for c. Comprehensive or Specified Causes of Loss Coverage; and d. Collision Coverage. The following is added to Paragraph A.3 Glass Repair — Waiver of Deductible No deductible will apply to glass breakage if such glass is repaired in a manner acceptable to us rather than replaced. Paragraph A.4.a. is deleted and replaced with the following: 4. Coverage Extensions a. Limited Rental Reimbursement or Travel Expense We will pay up to $75 per day to a maximum of $2,250 for rental reimbursement expenses for the rental of an "auto" or other transportation expense incurred by you because of "loss" to a covered "auto" which is covered by Comprehensive, Specified Causes of Loss, or Collision coverage under this policy. No deductible applies to this coverage. (1) We will pay only for those expenses incurred as a result of a covered "loss" occurring during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or (b) 30 days. (2) Our payment under this Coverage Extension (4.a.) is limited to the lesser of the necessary and actual expenses incurred or the maximum amount shown, $2,250. Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 6 (3) Coverage under this Coverage Extension (4.a.) does not apply while there are spare or reserve "autos" available to you for your operations. (4) If a covered "auto" is described or designated as a covered "auto" on endorsement EA 99 01, the coverage provided by this extension is excess over coverage provided by endorsement EA 99 01. The following is added to paragraph A.4. c. Tapes, Records and Discs We will pay for "loss" to tapes, records, compact discs, or other similar devices used with audio, visual or data electronic devices. (1) We will pay only if the tapes, records, compact discs, or other similar devices: (a) Are your property or that of a family member; or (b) Are the property of an "employee" using a covered "auto" in your business affairs at the time of the "loss"; and (c) Are in a covered "auto" which sustains other covered "loss" under Comprehensive or Collision coverage at the time of the "loss" to tapes, records, compact discs, or other similar devices. (2) The most we will pay for "loss" under this Coverage Extension (4.c.) is $200. Physical Damage Coverage provisions apply to this coverage, except that any deductible applicable to Comprehensive or Collision coverage does not apply to this Coverage Extension (4.c.). d. Audio, Visual and Data Electronic Equipment (1) Coverage (3) (a) EA 9911 0318 We will pay with respect to a covered "auto" described in the Schedule for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto". (b) We will pay with respect to a covered "auto" described in the Schedule for "loss" to any accessories used with the electronic equipment described in Paragraph (1)(a) above. However, this does not include tapes, records or discs. (2) Exclusions The exclusions that apply to Physical Damage Coverage, except for the exclusion relating to Audio, Visual and Data Electronic Equipment, also apply to coverage provided by this extension. In addition, the following exclusions apply: We will not pay, under this extension, for either any electronic equipment or accessories used with such electronic equipment that is: (3) (a) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system; or (b) An integral part of the same unit housing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered "auto" in the opening of the dash or console normally used by the manufacturer for the installation of a radio. Limit of Insurance With respect to coverage under this extension the Limit of Insurance provision of Physical Damage Coverage is replaced by the following: (a) The most we will pay for all "loss" to audio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: (i) The actual cash value of the damaged or stolen property as of the time of the "loss"; Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 6 (ii) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or (iii) $500. (b) An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the "loss". (c) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) Deductible No deductible applies to this coverage. The insurance provided by this extension is excess over any other collectible insurance. e. Custom Signs and Decorations Physical Damage coverage on a covered "auto" may be extended to "loss" to custom signs and decorations including custom murals, paintings or other decals or graphics. Our limit of liability for loss to custom signs and decorations shall be the least of: (1) Actual cash value of the stolen or damaged property; (2) Amount necessary to repair or replace the property; or (3) $500. f. Personal Effects Coverage (1) Physical Damage Coverage on a covered "auto" may be extended to "loss" to your "personal effects" or, if you are an individual, the "personal effects" of a family member, that are in the covered "auto" at the time of the "loss". (2) "Personal effects" as used in this extension means tangible property that is worn or carried by the "insured". "Personal effects" does not include tools, jewelry, money, securities, radar or laser detectors, or tapes, records, discs or similar audio, visual or data electronic equipment. The most we will pay for any one "loss" under this coverage extension is $500. No deductible applies to this extension. The insurance provided by this extension is excess over any other collectible insurance. (3) EA 9911 0318 g. Camper Bodies In the event of a "loss" to a detached "camper," physical damage coverage will apply as if it were part of the covered "auto" on which it is rated. h. Contents of a Travel Trailer, Camper or Motor Home When a Travel Trailer, "Camper" or Motor Home is a scheduled auto for physical damage coverage, we will pay up to $1,000 for "loss" to personal property belonging to you or a family member that is within the Travel Trailer, "Camper" or Motor Home. We will pay up to $250 for "loss" to personal property belonging to you or a family member that is outside the Travel Trailer, "Camper" or Motor Home. (1) We will not pay for "loss" to: (a) Articles carried or held for sale, storage or repairs, or for later delivery; goods kept to show or sell; or theatrical wardrobes. (b) Business, store of office furniture or equipment. (c) Records or accounts, money, bullion, deeds, contracts, evidences of debt, securities, tokens or tickets, stamps in current use or manuscripts. (d) Animals, private passenger "autos," motorcycles, aircrafts, boats or any other motorized vehicles or their equipment, furnishings or appurtenances. Equipment or accessories while your Travel Trailer, "Camper" or Motor Home is leased or rented to any organization or any person other than you or a family member. (2) The maximum we will pay for "loss" is the lesser of: (a) (e) The actual cash value of the personal property at the time of "loss"; (b) The cost of repairing the damage; or (c) The cost of replacing the damaged personal property with other personal property of like kind, condition, quality and value. Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 4 of 6 i. Vacation Expense Allowance We will pay you $50 per day to a maximum of $500 for extra expenses when a Travel Trailer, "Camper" or Motor Home is a scheduled auto for physical damage coverage, and the Travel Trailer, "Camper" or Motor Home: (1) Is damaged or destroyed and is uninhabitable; and (2) While being used for vacation purposes within the policy period. Extra expenses must by supported by receipts or other valid evidence. The following is added to Paragraph A.: 5. Extra Expense — Broadened Coverage We will pay for the direct expense of returning a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Specified Causes of Loss Coverage. This coverage will only apply to vehicles recovered inside the 48 contiguous United States. This coverage does not apply to an "auto" we deem a total "loss". 6. Auto Loan/Lease Gap Coverage In the event of a covered total "loss" to a covered "auto" described or designated in the Schedule or in the Declarations, we will pay up to $2,000 for any unpaid amount due on the lease or loan for a covered "auto" less: a. The Amount paid under the Physical Damage Coverage section A.1. of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; Security deposits not returned by the Lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and Carry-over balances from previous loans or leases. (3) (5) 7. Hired Auto Physical Damage Coverage EA 9911 0318 If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss or Collision Coverages are provided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire of like kind and use, subject to the following: a. The most we will pay for any one "loss" is $50,000 or the actual cash value or the cost to repair and replace, whichever is less, minus a deductible; b. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage; c. Hired Auto Physical Damage coverage is excess over any other collectible insurance; and d. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. If a limit for Hired Auto Physical Damage is indicated in the Declarations, then that limit replaces, and is not in addition to, the $50,000 limit indicated above. The following is added to Paragraph B.3.a.: Airbag Coverage — Accidental Deployment However, this exclusion does not apply to the unintended inflation of an airbag if the inflation is caused by mechanical or electrical breakdown. The following is added to Paragraph C.2. New Vehicle Replacement Cost If, however, a "loss" occurs to your covered "auto" within 180 days of your purchase of the "auto" and, we deem the covered "auto" to be a total "loss" and it has not been previously titled under the motor vehicle law of any state, we will pay at your option: a. the cost to replace the covered "auto" with a new "auto" of like make, model and year; or b. an amount equal to the original purchase price you paid to acquire the vehicle, including taxes, but excluding any extended warranties and licensing fees. This coverage applies only to a covered "auto" of the private passenger, light truck or medium truck type (20,000 lbs. or less gross vehicle weight). Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 5 of 6 The following changes revise SECTION IV — BUSINESS AUTO CONDITIONS The following is added to ParagraphA.2.a.: Amended Duties in the Event of an Accident, Claim, Lawsuit or Loss However, this duty is only required when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. The following is added to Paragraph A.: 6. We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" because of payments we make for damages under this coverage form. The following is added to Paragraph B.2.: Unintentional Failure to Disclose Hazards Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. Paragraph B.5.b. is deleted and replaced with the following: a. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". d. To the extent required by an "insured contract", this insurance is primary on behalf of the additional insured, and any other insurance maintained by the additional insured is excess and not contributory with this insurance. If the "insured contract" does not require this provision, then Paragraph a. above will apply. EA 9911 0318 The following changes revise SECTION V — DEFINITIONS The following is added: Q. "Camper" means a portable dwelling unit without axles or wheels that has been manufactured for attachment on the bed of a pickup truck to be used for casual travel or camping. Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 6 of 6 Certain Underwriters at Lloyds Unique Market Reference B1776BL2o23ooLoo2 effective date of this endorsement: 05/18/2020 policy number: ENP 0003272-02 Endorsement Number: 02 ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE PART All other terms and conditions of this Policy remain unchanged. SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations Any person(s) or organization(s) where this endorsement is required by contract. All project locations where this endorsement is required by contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 Damages and Claims Expenses caused, in whole or in part, by: 1. Your acts or omissions; 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. CPL271 12/2016 Page 1 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to Damages or Claims Expenses 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 insured(s) 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 its 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. CPL271 12/2016 Page 2 Certain Underwriters at Lloyds Unique Market Reference B1776BL2o23ooLoo2 effective date of this endorsement: policy number: ENP 0003272-02 05/18/2020 Endorsement Number: 03 ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: All other terms and conditions of this Policy remain unchanged. CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Any person(s) or organization(s) where this endorsement is required by contract. All project locations where this endorsement is required by contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 Damages and Claims Expenses 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. CPL275 12/2016 Page 1 Certain Underwriters at Lloyds Unique Market Reference B1776BL2o2300Loo2 effective date of this endorsement: policy number: ENP 0003272-02 05/18/2020 Endorsement Number: 04 OTHER INSURANCE — PRIMARY WITHOUT RIGHT OF CONTRIBUTION This endorsement modifies insurance provided under all coverages applicable to this policy. All other terms and conditions of this Policy remain unchanged. In consideration of the premium charged for the Policy, it is hereby understood and agreed that Clause XIV. OTHER INSURANCE is deleted in its entirety and replaced with the following: XIV. OTHER INSURANCE Subject to Clause VII. and VIII., where other valid and collectible insurance is available to the Insured for any Pollution Condition or Claim, this insurance shall apply as primary insurance versus any other valid and collectable insurance, and the Underwriters will have no right of contribution against any other insurance company providing insurance for a Pollution Condition or a Claim on a primary basis. CPP208 12/2016 Page 1 policy number: ENP 0003272-02 XIX. ACTION AGAINST THE UNDERWRITERS XX. No action shall lie against the Underwriters unless, as a condition precedent thereto, the Insured shall have fully complied with all of the terms of this Policy, nor until the amount of the Insured's obligation to pay shall have been fully and finally determined either by judgment against them or by written agreement between them, the claimant and the Underwriters. Nothing contained herein shall give any person or organization any right to join the Underwriters as a party to any Claim against the Insured to determine their liability, nor shall the Underwriters be impleaded by the Insureds or their legal representative in any Claim. In the event of any payment under this Insurance, the Underwriters shall be subrogated to all the Insureds' rights of recovery therefore against any person or organization, and the Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing to prejudice such rights. The Underwriters agree to waive its rights of recovery against any client of the Named Insured for a Claim which is covered pursuant to Insuring Cause I.A., I.B.i. or 1.6.2. of this Policy to the extent the Named Insured had, prior to such Claim, a written agreement to waive such rights. Any recoveries shall be applied first to subrogation expenses, second to Damages and Claims Expenses paid by the Underwriters, and third to the Each Claim Deductible. Any additional amounts recovered shall be paid to the Named Insured. XXI. ENTIRE AGREEMENT By acceptance oft his Policy, all Insureds a gree that this Policy embodies all agreements existing between them and the Underwriters relating to this Insurance. Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or a change in any part of this Policy or estop the Underwriters from asserting any right under the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by written endorsement issued to form a part of this Policy, signed by the Underwriters. XXII. VALUATION AND CURRENCY AH premiums, limits, deductibles, Damages and other amounts under this Policy are expressed and payable in the currency of the United States. If judgment is rendered, settlement is denominated or another dement of Damages under this Policy is stated in a currency other than United States dollars or if Claims Expenses are paid in a currency other than United States dollars, payment under this Policy shall be made in United States dollars at the rate of exchange CPP111 12-2016 Page 38 of 40 ui N _oz o oa) o� > (13 o aj C w mu) -- 0 .c oc T me >at O Zcoi Liberty 1Viutualw SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8203153 - 969224 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Scott Alderman, Jamie Armfield, Timothy S. Buhite, Amber Engel, Peggy A. Firth, Brandi Heinbaugh, Debbie Lindstrom, Kathleen M. Mitchell, Deanna K. Nakashima, Roxana Palacios, Gail E. Tsuboi, Holly E. Ulfers all of the city of Seattle state of WA each individually if there be more than one named, its true and lawful attomey-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 20th day of February , 2020 . State of PENNSYLVANIA County of MONTGOMERY ss On this 20th day of February , 2020 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. By: Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company David M, Carey, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA Notarial Seal Teresa Pastella. Notary Public Upper Merlon Twp„ Montgomery County My Commission Expires March 28, 2021 Member, Pennsylvania Association of Notaries By: eresa Paslella. Notary Public eresa Pastella, Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV – OFFICERS: Section 12. Power of Attomey. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attomey, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII – Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation – The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization – By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this /r, 1day of � w" : LMS -12873 LMIC OCIC WAIC Multi Co 12119 By: Renee C. Llewellyn, Assistant Secretary >, cri a) o R O _t— cn o W m 0 c `oc) o - N C0 0 c' 0- O e) - O oa) v_ v 'cam >o o EA c°O 00 oco SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Certificate No: 8203153 - 969224 West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Scott Aldennan, Jamie Annfield, Timothy S. Buhite, Amber Engel, Peggy A. Firth, Brandi Heinbaugh, Debbie Lindstrom, Kathleen M. Mitchell, Deanna K. Nakashima, Roxana Palacios, Gail E. Tsuboi, Holly E. Ulfers all of the city of Seattle state of WA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 20th day of February , 2020 . State of PENNSYLVANIA County of MONTGOMERY ss On this 20th day of February , 2020 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. By: Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company David M. Carey, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA Notarial Seal Teresa Paslella, Notary Public Upper Medan Twp., Montgomery County My Commission Expires March 28, 2021 Member. Pennsylvania Association of Notaries By: eresa Paslella. Notary Public eresa Pastella, Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV — OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject 10 the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 9th day of April , 2021 . LMS -12873 LMIC OCIC WAIC Multi Co 12/19 By: Renee C. Llewellyn, Assistant Secretary T as rn rn a) N (0 O _ t— TIS O W 0) d O O a_ -s .o 0) E 0 U GARY HARPER CONSTRUCTION INC Owner or tradesperson Principals HARPER, GARY A, PRESIDENT Doing business as GARY HARPER CONSTRUCTION INC WA UBI No. 601 606 620 14831 223RD ST SE SNOHOMISH, WA 98296-3989 360-863-1955 SNOHOMISH County Business type Corporation License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no. GARYHCI055LF Effective — expiration 06/06/1995— 06/03/2023 Bond DEVELOPERS STY & INDEMNITY CO Bond account no. 334944C Active Meets current requirements. $12,000.00 Received by L&I Effective date 04/29/2008 06/01/2008 Expiration date Until Canceled Insurance Admiral Insurance Co $1,000,000.00 Policy no. CA00003673002 Received by L&I Effective date 11/24/2020 12/01/2020 Expiration date 12/01/2021 lnsuuirance Ihiistoiry Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations Infraction no. PFORK00385 Issue date 07/14/2020 Violation city SNOHOMISH Type of violation PLUMBER INFRACTION Description Contractor employed a person to engage in the trade of plumbing without a current Satisfied RCW/WAC 18.106.020 Violation amount $500.00 journeyman, specialty or trainee certificate, temporary permit or medical gas endorsement as required. Certifications & Endorsements OMWBE Certifications No active certifications exist for this business. Apprentice Training Agent Registered training agent. Check tlheiiir elliigiiblle programs and occupations. Workers' Comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. Account is current. L&I Account ID 838,522-01 Doing business as GARY HARPER CONSTRUCTION INC Estimated workers reported Quarter 1 of Year 2021 "4 to 6 Workers" L&I account contact TO / KARLA BOWMAN (360)902-5535 - Email: BOWK235@Ini.wa.gov Public Works Requirements Verify the contractor is eligible to perform work on public works projects. ... Required ........raiinn— Effective July 1, 2019.�.................. Exempt from this requirement. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace Safety & Health Check for any past safety and health violations found on jobsites this business was responsible for. No inspections during the previous 6 year period.