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HomeMy WebLinkAboutAG 21-098 - PRECISION CONCRETE CUTTINGRETURN TO: PW ADMIN EXT: 2700 ID #: 4163
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS / _
2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 2711 3. DATE REQ. BY: 11 /16/22
.3. TYPE OF DOCUMENT (CHECK ONE):
p CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
0 CONTRACT AMENDMENT (AG#): 21-098 ❑ INTERLOCAL
❑ OTHER
4. PROJECT NAME: Concrete Sidewalk Beveling - Trip Hazard Removal
5. NAME OF CONTRACTOR: Precision Concrete Cutting, Inc.
ADDRESS: 3191 N Canyon Rd Provo UT 84604 TELEPHONE:801-830-4060
E-MAIL: WAAdmin safesidewalks.com FAX:
SIGNATURENAMF: Matt Haney TITLE: President
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES 0 COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / /
7. TERM: COMMENCEMENT DATE: COMPLETION DATE: 12/31 /2024
8. TOTAL COMPENSATION: $ add $100,000 ($350,000 TOTAL) (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: O YES 13 NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR Cl CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
PURCHASING: PLEASE CHARGE T0:
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REV]EWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER
6 DEPUTY DIRECTOR DSW 10/20/22
6 DIRECTORr'
❑ RISK MANAGEMENT (IF APPLICABLE)
8 LAW DEPT TMW 10/25
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: 1111/22 COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: 11/15/22 COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING G -�
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: Off- (p �ac�. DATE REC' D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL / DATE SfGNED
❑ FINANCE DEPARTMENT
8 LAW DEPT
8 SIGNATORY (MAYOR OR DIRECTOR)
CirY CLERK
ASsIGNE➢ AG # A #
SIGNED Copy RETURNED TE.SENT:
I-V %17- -1—
COMMENTS:
EXECL'TF " I "ORIGINALS
1/2020
OW QP CITY HALL
Fede ra I Way 33der J y. WAAvenu03
Federal Way, WA @8043-8325
(263) a35-70ll0
Mxv.CdY0fkhd8MAVW__rnm
AMENDMENT NO.2
TO
PUBLIC WORKS MAINTENANCE AGREEMENT
FOR
CONCRETE SIDEWALK BEVELING —TRIP HAZARD REMOVAL PROJECT
This Amendment ("Amendment No. 2") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Precision Concrete Cutting, Inc,, a Washington Foreign Profit Corporation ("Contractor").
The City and Contractor (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree
to amend the original Agreement for Concrete Sidewalk Beveling — Trip Hazard Removal Project ("Agreemenf)
dated effective June 17, 2021, as amended by Amendment No. 1, as follows:
1. ANWNPED TERM. The term of the Agreement, as referenced by Section 1 of the Agreement and any prior
amendments thereto, shall be amended and shall continue until the completion of the Services, but in any event no
later than December 31, 2024 ("Amended Term").
2. AME�]1 DED COMPENSATION. The amount of compensation, as referenced by Section 4 of the
Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or
method of payment, as delineated in Exhibit B-2, attached hereto and incorporated by this reference. The Contractor
agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the
negotiated rate(s) for the Amended Term. Except as otherwise provided in an attached Exhibit, the Contractor shall
be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance
and payment of this Agreement.
4. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior
amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done
by either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after the
previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been
performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment. The
provisions of Section 13 of the Agreement shall apply to and govern this Amendment. The Parties whose names
appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding
on the parties of this contract.
[Signature page follows]
AMENDMENT - I - 3/2017
QTY of MY HALL
Federal Way Feder V Avenue OM
Federal WA 9BQU3-8325
(253) 835-70M
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CIT
0
W I -
,a "I-, A I 01�
ATTEST:
APP D AS TO RM:
f t, J. yan Call, City Attorn
PRECISION CON CUTTING, INC.:
By.
Printed Name: __sad.✓_ �Crr.�G, /.CrC.
IV
.
Date:'�1���
STATE OF QTF M
) ss.
COUNTY OF -f
On this day personally appeared before me of , to me known to be the
of re t�C, that executed the foregoing
instrument, and acknowledged the said instrument to be the free an volun act and deed of said corporation, for
the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said instrument
and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this 11 4- day of —6 6U Idle f , 20&
Notary's signature
Notary's printed nam
5
Notary ublic in and for the State of Washington.
My commission expires
AMENDMENT - 2 - 3/2017
a" OF CITY FiP► I
Federal Way � o Sm"'
Frei wn 0003-W25
try
wwr�darraw►+
EXHIBIT B-2
ADDITIONAL COMPENSATION
1. Total Compensation: In return for the Services, the City shall pay the Contractor an additional amount not to
exceed One Hundred Thousand and 00/100 Dollars ($100,000.00). The total amount payable to Contractor pursuant
to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed Three
Hundred Fifty Thousand and 00/100 Dollars ($350,000.00).
2. Method of Compensation:
unit -price
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount,
calculated on the basis of the updated unit bid prices as follows:
Item #
Description
Unit of
Measurement
Unit Price
1
Sidewalk Repairs X" to X"
Inch Feet
$50.65
2
Sidewalk Re airs to 2"
Inch Feet
$50.65
IAUT 0Z)1)&i0z
10/24/22, 8:23 AM Washington State Department of Revenue
Washington State Department of Revenue
< Business Lookup
License Information:
New search
Back to results
Entity name: PRECISION CONCRETE CUTTING, INC.
Business name: PRECISION CONCRETE CUTTING
Entity type: Profit Corporation
UBI #: 603-026-241
Business ID: 001
Location ID: 0003
Location: Active
Location address: 3191 N CANYON RD
PROVO UT 84604-3916
Mailing address: 3191 N CANYON RD
PROVO UT 84604-3916
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endorsements held at this loc License # Count Details
Status
Expiration dat
First issuance
Burien General Business - 09496
Active
Jan-31-2023
Mar-01-2012
Non -Resident
Colville General Business - 027935.0
Active
Jan-31-2023
Dec-14-2015
Non -Resident
Federal Way General
Active
Jan-31-2023
Sep-02-2020
Business - Non -Resident
Sumner General Business -
Active
Jan-31-2023
Apr-15-2021
Non -Resident
Governing People May include governing people not registered with Secretary o(State
Governing people Title
v
https://secure.dor.wa.gov/gteunauth/—/#3 1/2
10/24/22, 8:23 AM
Washington State Department of Revenue
Governing people
HANEY, MATT
OLLIVIER, AARON
Registered Trade Names
Title
Registered trade names Status First issued
PRECISION CONCRETE CUTTING Active Sep-15-2017
View Additional Locations
The Business Lookup information is updated nightly. Search date and time: 10/24/2022
8:22:38 AM
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10/24/22, 8:24 AM Corporations and Charities System
iri.�5Mrw ris—and Charities Filing System
BUSINESS INFORMATION
Business Name:
PRECISION CONCRETE CUTTING, INC.
UBI Number:
603 026 241
Business Type:
FOREIGN PROFIT CORPORATION
BUslnass Status-
ACTI VE
Principal Office Street Address:
5624128TH ST E, PUYALLUP, WA, 98373-5160, UNITED STATES
Principal Office Mailing Address:
3191 N CANYON RD, PROVO, UT, 84604-3916, UNITED STATES
Expiration Date:
01/31/2023
JurlsdIcdon:
UNITED STATES, UTAH
Formation/ Registration Date:
01/24/2019
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
OTHER SERVICES
REGISTERED AGENT INFORMATION
JARED EATON
5624128TH ST E, PUYALLUP, WA, 98373-5160, UNITED STATES
Registered Agent Name:
Street Address:
Mailing Address:
GOVERNORS
Title Governors Type Entity Name First Name Last Name
hftps:]/ccfs.sos.wa.gov/#/BusinessSearrh[Businessinformation
112
10/24/22, 8:24 AM Corporations and Charities System
Title Governors Type Entity Name First Name Last Name
GOVERNOR INDIVIDUAL MATT HANEY
GOVERNOR INDIVIDUAL AARON OLLIVIER
Back
Filing History Name History Print � Return to Business Search
https://ccfs.sos.wa.gov/#/BusinessSearch/Businesslnformation 212
RETURN TO: PW ADMIN EXT: 2700 ID #: 4064
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIv: PUBLIC WORKS /
2. ORIGINATING STAFF PERSON:
Desiree Winkler EXT: 2711 3. DATE REQ. BY: 3/2/22
3. TYPE OF DOCUMENT (CHECK ONE):
n- CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
0 CONTRACT AMENDMENT (AG#): 21-098 ❑ INTERLOCAL
❑ OTHER
a. PROJECT NAME: Concrete Sidewalk Beveling - Trip Hazard Removal Services
5. NAMEOFCONTRACTOR: Precision Concrete Cutting, Inc.
ADDRESS: TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME: TITLE:
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES 0 COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACTIAMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # 603026241 , EXP.
7. TERM: COMMENCEMENT DATE: 6/17/2021 COMPLETION DATE: 12/31 /2022
8. TOTAL COMPENSATION: $ add $150,000 new total $250,000.00 .. (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: d YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES 0 NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO: amend existing PO #
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER
A DEPUTY DIRECTOR DSW 2/22/22
11 DIRECTOR _ -
❑ RISK MANAGEMENT (IF APPLICABLE)
11 LAW DEPT 2.25.22 MP
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: 2m22
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 2n5122
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 2/28/22 DATE REC, D: Z
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL 1S NEEDED.)
INITIAL / DATE SIGNET]
❑ FINANCE DEPARTMENT
II LAW DEPT o/-Zots
A SIGNATORY (MAYOR OR DIRECTOR)
A CITY CLERK
ASSIGNED AG # A i
'IN tf DATE SENT: ] �-
COMMENTS:
ExECUTE " 'ORIGINALS
to Law: This is a PW Maintenance contract amendment The PW Maintenance contract does not have any language or attachment for a Change Order I have historically utilized the Amendment Form to amend these agreements in the past -DSW
to DSW - we are working on the new templates as we speak and will continue to do what were doing until the official change is made. Thanks for the info. Also, are you taking this to council? MP
1/2020
CirY OF CITY HALL
Fe d e ra I Way33325 8th Avenue South
4! Federal Way, WA 98003-6325
(253) 835-7000
www cl"ffederahvay com
AMENDMENT NO. 1
TO
PUBLIC WORKS MAINTENANCE AGREEMENT
FOR
CONCRETE SIDEWALK BEVELING — TRIP HAZARD REMOVAL PROJECT
This Amendment ("Amendment No. I") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Precision Concrete Cutting, Inc., a Washington Foreign Profit Corporation ("Contractor").
The City and Contractor (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree
to amend the original Agreement for Concrete Sidewalk Beveling — Trip Hazard Removal Project ("Agreement")
dated effective June 17, 2021, as follows:
1. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the
Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or
method of payment, as delineated in Exhibit 13-1, attached hereto and incorporated by this reference. The Contractor
agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the
negotiated rate(s) for the Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be solely
responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and
payment of this Agreement.
2. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior
amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done
by either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after the
previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been
performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment. The
provisions of Section 13 of the Agreement shall apply to and govern this Amendment. The Parties whose names
appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding
on the parties of this contract.
[Signature page follows]
AMENDMENT - 1 - 3/2017
CITY OF CITY HALL
Fe d e ra Way8th Avenue South
Feder
Federal Way, WA 98003-6325
(253) 835-7000
www.utyoffedem)"y com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
By.
_ (
rim ell, ayor
DATE: 1
PRECISION CONCRETE CUTTI'NG, INC.:
B
Y•
Printed Name: t, ci l
Title:
Date: ZZZg?� Z-
V��
STATE OF W*C+TT4
ATl3TlZh7
) ss.
COUNTY OF tIAYM )
ATTEST:
SWhdnie Courtney, CMC, t
Clerk
APPROVED AS TO FORM:
// / � 1 —4 —,�
. Ryan Call City ity Atto
(ln tbic dqv nerennnlly nnnaarPrl hefnre me. makvi La►o6 to me knnwn in he the
VFW- S. (xT of • r„ .G, Gviw, , �hr, that executed the foregoing
instrument, and acknowledged the said instrument to be the free and oluntary act and deed of said corporation, for
the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said instrument
and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this 2 Way of r�Nll�r- , 20 8 Zr
Notary's signature
� KYLE S H A N K L I N Notary's printed name
.m "nZ`s!, -
"~ NOTARY PUBLIC STATE OFUTAH Notary Public in and for the State of Wash4tt6 ..
'-'COMMISSION# 703019 My commission expires to /z N `?07 z
u T
COMM. EXP, 10-24-2022
AMENDMENT - 2 - 3/2017
CITY OF CITY HALL
Federal Way Feder 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederatway. com
EXHIBIT B-1
ADDITIONAL COMPENSATION
1. Total Compensation: In return for the Services, the City shall pay the Contractor an additional amount not to
exceed One Hundred Fifty Thousand and 00/100 Dollars ($150,000.00). The total amount payable to Contractor
pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to
exceed Two Hundred Fifty Thousand and 00/100 Dollars ($250,000.00).
2. Method of Compensation:
i Jnit Price
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount,
calculated on the basis of the original unit bid prices.
Reimbursable Expenses
The actual customary and incidental incurred by Contractor in performing the Services including traffic control and
other reasonable costs; provided, however, that such costs shall be deemed reasonable in the City's sole discretion
and shall not exceed Five Thousand and 00/100 Dollars ($5,000.00).
AMENDMENT - 3 - 3/2017
P.�ECISI9N
CINC�Eif CUi11N6
March 10, 2022
To Whom It May Concern:
3191 N. Canyon Road Provo, UT 84604
P: (801) 224-0025 F: (801) 224-0062
www.SafeSidewalks.com
Mike Lamb is an authorized signer for Precision Concrete Cutting. His position with
PCC is VP of a Sales.
Chief Executive Officer
Aaron 011ivier
Filed
�. W A S H I N G T O N
Secretary of State
Secretary of State
State of Washington
Date Filed: 03/10/2022
a Corporations & Charities Division
Effective Date: 03/10/2022
UBI #: 603 026 241
EXPRESS ANNUAL REPORT WITH CHANGES
BUSINESS INFORMATION
Business Name:
PRECISION CONCRETE CUTTING, INC.
UBI Number:
603 026 241
Business Type:
FOREIGN PROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
5624 128TH ST E, PUYALLUP, WA, 98373-5160, UNITED STATES
Principal Office Mailing Address:
3191 N CANYON RD, PROVO, UT, 84604-3916, UNITED STATES
Expiration Date:
01/31/2023
Jurisdiction:
UNITED STATES, UTAH
Formation/Registration Date:
01/24/2019
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
OTHER SERVICES
REGISTERED AGENT RCW 23.95.410
Registered Agent Name
JARED EATON
PRINCIPAL OFFICE
Phone:
8013736060
Street Address
5624 128TH ST E, PUYALLUP, WA, 98373-5160, USA
Email:
AC COUNTING@SAFE SIDE WALKS.0 OM
Street Address:
Mailing Address
This document is a public record. For more information visit www.sos.wa.jZov/corj3s Work Order #: 2022031000167133 - 1
Received Date: 03/10/2022
Amount Received: $85.00
5624 128TH ST E, PUYALLUP, WA, 98373-5160, USA
Mailing Address:
3191 N CANYON RD, PROVO, UT, 84604-3916, USA
GOVERNORS
Title Type Entity Name First Name Last Name
GOVERNOR INDIVIDUAL MATT HANEY
GOVERNOR INDIVIDUAL AARON OLLIVIER
NATURE OF BUSINESS
. OTHER SERVICES
EFFECTIVE DATE
Effective Date:
03/10/2022
CONTROLLING INTEREST
1. Does this entity own (hold title) real property in Washington, such as land or buildings, including leasehold improvements?
NO
2. In the past 12 months, has there been a transfer of at least 16-2/3 percent of the ownership, stock, or other financial interest in
the entity?
NO
a. If "Yes", in the past 36 months, has there been a transfer of controlling interest (50 percent or greater) of the ownership,
stock, or other financial interest in the entity?
NO
3. If you answered "Yes" to question 2a, has a controlling interest transfer return been filed with the Department of Revenue?
NO
You must submit a Controlling Interest Transfer Return form if you answered "yes" to questions 1 and 2a.
Failure to report a Controlling Interest Transfer is subject to penalty provisions of RCW 82.45.220.
For more information on Controlling Interest, visit www.dor.wa.gov/REET,
RETURN ADDRESS FOR THIS FILING
Attention:
MIKE LAMB
Email:
MIKEL@SAFESIDEWALKS.COM
Address:
3191 N CANYON RD, PROVO, UT, 84604-3916, USA
AUTHORIZED PERSON
Person Type:
INDIVIDUAL
This document is a public record. For more information visit www.sos.wa.gov/corns Work Order #: 2022031000167133 - 1
Received Date: 03/10/2022
Amount Received: $85.00
First Name:
MIKE
Last Name:
LAMB
Title:
VP OF SALES
Q' This document is hereby executed under penalty of law and is to the best of my knowledge, true and correct.
This document is a public record. For more information visit www.sos.wa.Povlcorps Work Order #: 2022031000167133 -1
Received Date: 03/10/2022
Amount Received: $85.00
2/23/22, 7:50 AM Washington State Department of Revenue
\Alashington State of Revenue
< Business Lookup
License Information:
Entity name: PRECISION CONCRETE CUTTING, INC.
Business PRECISION CONCRETE CUTTING
name:
Entity type: Profit Corporation
UBI #:
603-026-241
Business ID:
001
Location ID:
0003
Location:
Active
Location address:
Mailing address:
3191 N CANYON RD
PROVO UT 84604-3916
3191 N CANYON RD
PROVO UT 84604-3916
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endorsements held a License # Count C
New search Back to results
__ s Expiratioi First issua
https //secure.dor.wa gov/gteunauth/_/#3 1/3
2/23/22, 7:50 AM
Washington State Department of Revenue
Endorsements held a License # Count
Details Status
Expiratioi First issua
Burien General 09496
Active
Jan-31-2C Mar-01-2
Business - Non -
Resident
Colville General 027935.0
Active
Jan-31-2C Dec-14-2i
Business - Non -
Resident
Federal Way
Active
Jan-31-2C Sep-02-21
General Business -
Non -Resident
Sumner General
Active
Apr-30-2( Apr-15-2(
Business - Non -
Resident
Governing People May include governing people not registered with Secretary of State
Governing people Title
HANEY; MATT
OLLIVIER, AARON
Registered Trade Names
Registered trade names Status
PRECISION CONCRETE Active
CUTTING
First issued
Sep-15-2017
View Additional Locations
The Business Lookup information is updated
nightly. Search date and time: 2/23/2022 7:49:55
AIVi�
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2/23/22, 7:50 AM
Washington State Department of Revenue
Contact us
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Take our survey!
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PRECCON-31 VEGOE T
CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDMW)
619/2021
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 ofsueh endorsements).
PRODUCER MET Jason Gardner
InflniTeam Insurance Ai°cNN .Ext: (801) 748--2825
39 West 9000 S
Sandy, UT 84070 _Mfrs Jason arE6rnkers.com
INSURED
Precision Concrete Cutting, Inc
Matthew Haney
3191 N. Canyon Rd.
Provo, UT 84604
Travelers Property Cos
The Travelers Indemnit
INSURERE;
MUIRFR F -
lid of Amarlics
of Connecticut
OVERAGES CERTIFICATE NUM EIS: REVISION NUMBER: _
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT NTH RESPECTTO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
E]CCLUSIONSAND CONDITIONS OF F SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADDL 5USH s'OLICY FSF POLICY EXP
5_S TYPE OFIHSURANCE :ry;p yn�, POLICY NUMBER Iryltvlfg0 LIMITS
A X COMMERCIAL GENERAL LIABILITY_ J�GIi OCCURfiENCE i 1,000,0
:AMAGE TO RENTED 300,0
CLAIMS -MADE X OCCUR X CO-9K038046 5/21/2021 5/21/2022 ;gij sasu a
l _. 10,0
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space is required)
I Re: 2021 /2022 Contract
City of Federal Way is Blanket general liability additional Insured on ongoing and completed operations form CGD246 applies. Coverage subject to terms and
conditions of policy. Forms attached.
CERTIFICATE HOLDER _CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Federal Way ACCORDANCE WITH THE POLICY PROVISIONS.
33325 8th Ave S
Federal Way, WA 98003
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(includes Products -Completed Operations If Required By Contract)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION 11— WHO IS AN
INSURED:
Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. with respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury' caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part d the contract or
agreement is in effed; and
b. If, and only to the extent that, such injury or
damage is caused by acts cr omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent ads or omissions of such
person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limas. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limns d any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providirg,
or failure to provide, any professional
architectural, engineering cr surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by ')lour work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires _you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following dudes:
(1) Give us written notice as soon as practicable
d an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence'
or offense took place;
(b) The names and addresses of any injured
persons and witnesses and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
b. The insurance provided to such additional (2) If a claim is made or "suit' is brought against
insured does not apply to: the additional insured:
CG D2 46 0419 0 2018 The Travelers indemnity Company. All rights reserved, Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "sulf' and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or'suir as soon as practicable.
(3) Imtnedlately send us copies of all legal
papers received In connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
Insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
Insured is primary to other insurance
available to such additional insured whirr
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
Page 2 of 2 0 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 0419
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical e)penses described in any of the provisions d this endorsement may be excluded or
limited by anather endorsement to this Coverage Par, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an emforsemeri.. The following listing is a general
coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to
determine rights, dudes, and what is and is not covered.
A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations
PROVISIONS
A. WHO IS AN INSURED — UNNAMED
SUBSIDIARIES
The following is added to SECTION 11— WHO IS
AN INSURED:
Any of your subsidiaries, other than a partnership,
joint vulture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sale owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.
No such subsidiary is an insured for "bodily injury'
or "property damage" that occurred, cr "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.
For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as:
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust
as indicated in its name or the documents that
govern Its structure.
B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR
AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION H — WHO IS
AN INSURED:
Any governmental entty that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily
injury". "property damage" or "personal and
advertising injury" arising out of such operations.
The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury'. "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity; or
b. Any "bodily injury' or "property damage"
included in the "products -completed
operations hazard".
CG D3 16 02 19 0 2017 The Travelers Indermlty Company. All rights reserved. Page 1 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
COMMERCIAL GENERAL LIABILITY
C. IWADENTAL MEDICAL MALPRACTICE
1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
b. An act or omission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samarkan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.
2. The following replaces the last paragraph of
Paragraph 2.&(1) of SECTION II — WHO IS
AN INSURED:
Unless yeu are in the business ❑r occupation
of providing professional health care services,
Paragraphs (1)(a). (b). (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) Frst aid or 'Good Samaritan services" by
ary of your "employees" or 'volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
sevices" during their work hours for you
will be deemed to be acting wkhin the
scope of their employment by you or
performing duties related to the conduct
of your business
3. The following replaces the last sentence of
Paragraph 5. of SECTION III - LIMITS OF
INSURANCE:
For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".
pharmaceuticals committed by, or with the
knowledge or consent of, the insured.
5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
Instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDRIONS:
This Insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other bags, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical servioEe'
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.
D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily iryury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
4. The following exclusion is added to subsequent to the execution of the contract or
Paragraph 2., Exclusions, ct SECTION 1 — agreement.
COVERAGES - COVERAGE A - BODILY E. CONTRACTUAL LIABILITY - RAILROADS
INJURY AND PROPERTY DAMAGE
LIABILITY: 1. The following replaces Paragraph C. of the
Sale Of Pharmaceuticals definition of "insured contract" in the
"Bodily injury' or "property damage" arising DEFINITIONS Section:
out of the violation of a penal statute or c. Any easement or license agreement;
ordinance relating to the sale of
Page 2 of 3 c 2017 The Travelers Indemnity Company. All rlghts reserved. CG D3 16 02 19
Includes copyrighted material of Insurance Services Office, Inc., with its permissim.
COMMERCIAL GENERAL LIABILITY
2. Paragraph ftl) of the definition of "insured a. Any premises while rented to you or
contract" in the DEFINITIONS Section Is temporarily occupied by you with perrnisson
deleted, of the owner, or
F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such
The following replaces the deumition of "premises premier is rented to you, if you rent such
damage' in theOi=i FiNiTiOIdS Section: premises for a period of seven or fewer
consecutive days.
"Premises damage means "property damage" to:
CG 0316 0219 0 2017 The Travelers In im.. by Comparry. All rVft reserved. Page 3 of 3
Inchrdes copyrighted material of Insurance Services Ofllce, Inc., with Its permission.
POLICY NUMBER: 4T-CO-9K038046-PHX-19
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 05-23-19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
DESIGNATED PROJECT(S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Project(s):
EACH `PROJECT° FOR WHICH YOU HAVE AGREED, IN
A WRITTEN CONTRACT WHICH IS IN EFFECT DURING
THIS POLICY PERIOD, TO PROVIDE A SEPARATE
GENERAL AGGREGATE LINITI PROVIDED THAT, THE
CONTRACT IS SIGNED BY YOU
BEFORE THE "BODILY INJURY° OR 'PROPERTY
DANAGR� OCCURS.
A. For aN sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION 9, and
for all medical expenses caused by accidents un-
der COVERAGE C (SECTION 1), which can be
attributed only to operations at a single desig-
nated "project" shown in the Schedule above:
1. A separate Designated Project General Ag-
gregate Limit applies to each designated "pro-
ject', and that limit is equal to the amount of
the General Aggregate Limit shown in the
Declarations, unless separate Designated
Project General Aggregate(s) are sched-
uled above.
2. The Designated 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 "prop-
erty damage" included in the "products -
completed operations hazard", and for medi-
cal expenses under COVERAGE C, regard-
less of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations maldng claims
or bringing "suits".
Designated Project
General Aggregate(s):
GENERAL AGGREGATE
UNIT SHOWN ON THE
DECLARATIONS.
3. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the Desig-
nated Project General Aggregate Limit for
that designated "project". Such payments
shall not reduce the General Aggregate Limit
shown in the Declarations nor shall they re-
duce any other Designated Project General
Aggregate Limit for any other designated
"project" shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented
To You and Medical Expense continue to
apply. However, instead of bang subject to
the General Aggregate Limit shown in the
Declarations, such limits will be subject to the
applicable Designated Project General Ag-
gregate Limit
B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION Q, and
for all medical expenses caused by accidents un-
der COVERAGE C. (SECTION q, which cannot
be attributed only to operations at a single desig-
nated 'project" shown in the Schedule above:
CG D2 1101 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2
COMMERCIAL GENERAL LIABILITY
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 Ag-
gregate Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Project General Aggregate Limit..'. ..z'
C. Part 2. of SECTION 11— LIMITS OF INSURANCE
is deleted and replaced by the following:
2. The General Aggregate Limit is the most we
will pay for the sum of:
a. Damages under Coverage B; and
b. Damages from "occurrences" under
COVERAGE A (SECTION Q and for all
medical expenses caused by accidents
under COVERAGE C (SECTION 9 which
cannot be attributed only to operations at
a single designated 'project" shown in the
SCHEDULE above.
D. When coverage for liability arising out of the
'products -completed operations hazard' is pro-
vided, any payments for damages because of
"bodily injury" or "property damage" included in
the "products -completed operations hazard" will
reduce the Products -Completed Operations Ag-
gregate Limit, and not reduce the General Aggre-
gate Limit nor the Designated Project General
Aggregate Limit
E. For the purposes of this endorsement the Defrni-
ti0ns Section is amended by the addition of the
following definition:
"Project" means an area away from premises
owned by or rented to you at which you are per-
forming operations pursuant to a contract or
agreement. For the purposes of determining the
applicable aggregate limit of insurance, each
"project" that includes premises invohdng the
same or connecting lots, or premises whose con-
nection is interrupted only by a street, roadway,
waterway or right-of-way of a railroad shall be
considered a single "project".
F. The provisions of SECTION III — LIMITS OF
INSURANCE not otherwise modified by this en-
dorsement shall continue to apply as stipulated.
Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
S. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION li — COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury' or
'property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
1. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION 11 — COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.
2. The following replaces Paragraph b. in B.S.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "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
an "employee's" name, with your
CA T3 S3 0215 0 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4
Includes copyrighted material or Insurance Services Office. Inc. with its permission.
COMMERCIAL AUTO
permission, while performing duties
(a) With respect to any claim made or "suit'
related to the conduct of your busi-
brought outside the United States of
ness.
America, the territories and possessions
However, any "auto"that is leased, hired,
of the United States of America, Puerto
rented or borrowed with a driver is not a
Rico and Canada:
covered "auto".
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
D. EMPLOYEES AS INSURED
tle any such claim or "suit" and keep
The following is added to Paragraph A.1., Who Is
us advised of all proceedings and ac-
An Insured, of SECTION 11— COVERED AUTOS
tions.
LIABILITY COVERAGE:
(ii) Neither you nor any other involved
Any "employee" of yours is an "insured' while us-
"insured" will make any settlement
ing a covered "auto" you don't own. hire or borrow
without our consent
in your business or your personal affairs.
(iii) We may, at our discretion, participate
E. SUPPLEMENTARY PAYMENTS — INCREASED
in defending the "insured" against, or
LIMITS
in the settlement of, any claim or
1. The following replaces Paragraph A.2.a.(2),
"suit".
of SECTION II — COVERED AUTOS UABIL-
(iv) We will reimburse the "insured" for
iTY COVERAGE:
sums that the "insured" legally must
(2) Up to $3.000 for cost of bail bonds (in-
pay as damages because of "bodily
cluding bonds for related traffic law viola-
injury" or "property damage" to which
tions) required because of an "accident
this insurance applies, that the "in -
we cover. We do not have to fumish
sured" pays with our consent, but
these bonds.
only up to the limit described in Para-
2. The following replaces Paragraph A.2.a.(4),
graph C., Limits Of Insurance, of
SECTION 11 — COVERED AUTOS
of SECTION II — COVERED AUTOS LIABIL-
LIABILITY COVERAGE.
tTY COVERAGE:
(4) All reasonable expenses incurred by the
(v) We will reimburse the "insured" for
the reasonable expenses incurred
"insured" at our request, including actual
with our consent for your investiga-
loss of earnings up to $500 a day be-
tion of such claims and your defense
cause of time off from work.
of the "insured" against any such
F. HIRED AUTO — LIMITED WORLDWIDE COV-
"suit", but only up to and included
ERAGE — INDEMNITY BASIS
within the limit described in Para -
The following replaces Subparagraph (5) in Para-
graph C.. Limits Of Insurance, of
graph B.7., Policy Period, Coverage Territory,
SECTION II — COVERED AUTOS
of SECTION IV — BUSINESS AUTO CONDI-
LIABILITY COVERAGE, and not in
TIONS:
addition to such limit. Our duty to
make such payments ends when we
(5) Anywhere in the world, except any country or
have used up the applicable limit of
jurisdiction while any trade sanction, em-
insurance in payments for damages,
bargo. or similar regulation imposed by the
settlements or defense expenses.
United States of America applies to and pro-
hibits the transaction of business with or
(b) This insurance is excess over any valid
within such country or jurisdiction, for Cov-
and collectible other insurance available
ered Autos Liability Coverage for any covered
to the "insured" whether primary, excess,
"auto" that you lease, hire, rent or borrow
contingent or on any other basis.
without a driver for a period of 30 days or less
(c) This insurance is not a substitute for re -
and that is not an "auto" you lease, hire, rent
quired or compulsory insurance in any
or borrow from any of your "employees%
country outside the United States, its ter -
partners (iyou are a partnership), members
ritories and possessions, Puerto Rico and
(if you are a limited liability company) or
Canada.
members of their households.
Page 2 of 4 0 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
The following is added to Paragraph AA.. Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
Personal Property
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(1) Owned by an "insured"; and
COMMERCIAL AUTO
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2a.. of
SECTION IV — BUSINESS AUTO CONDITIONS:
Your duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
S. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex-
tent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
CA T3 53 0215 a 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
such contract. The waiver applies only to the
person or organization designated in such
contract.
N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-
oeshnarrt. Misrepreserrt don, Or Fraud; -of
SECTION N —(BUSINESS AUTO CONDITIONS:
The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How-
ever this provision does not affect our right to col-
lect additional premium or exercise our right of
cancellation or non -renewal.
Page 4 of 4 0 2015 The Travelers Indemnhy Compa ny. All rights reserved. CA T3 53 02 15
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
T>R A �`�+ �8�� WORKERS COMPENSATION
i# 11 fe ii AND
OM SQUARE LIABILITY POLICY
HARTFORD CT 06183 ENDORSEMENT WC 43 03 OS (00) - 002
POLICY NUMBER: UB-8R743862-18-26-0
UTAH WAIVER OF SUBROGATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A.of the
Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to beneft anyone not named in the Schedule. Our waiver of
rights does not release your employees' rights against third parties and does not release our authority as trustee
of claims against third parties.
Schedule
Designated Person:
Designated Organization:
RHY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS
WAIVER.
INCLUDING:
DATE OF ISSUE: 05-23-18 STASSIGN: PAGE 1 OF
TRAVELERSAM WORKERS COMPENSATION
AND
ONE TOWER 90'OARE EMPLOYERS LIABILITY POLICY
RARTlORD Cr 06183
ENDORSEMENT WC 00 0313 (00) - 001
POLICY NUMBER: vE-SX743e62-16-26-0
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
ANY PERSON OR ORMNIZATION FOR WIHICH THE INSURED ERR ACM=
BY WWRITTEN CONTRACT MMCOTED PRIOR TO LOSS TO FURNISH THIS
WAIVER.
DATE OF ISSUE: 05-23-18 ST ASSIGN: PAGE i OF
A t.�+ r��'�k WORKERS COMPENSATION
TR NCI LE AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 99 03 76 ( A) - 001
POLICY NUMBER: UB-8R743862-18-26-G
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule.
The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre-
mium.
Schedule
Person or Organization Job Description
ANY PERSON OR ORGANIZATION FOR
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED
PRIOR TO LOSS TO FURNISH THIS
WAIVER.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise
stated.
(The Information below is required only when this endorsement is issued subsequent to preparation of
the policy.)
Endorsement Effective
Insured
Insurance Company
Policy No.
Countersigned by
Endorsement No.
Premium
DATE OF ISSUE: 05-23-18 ST ASSIGN: Page 1 of 1
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract)
This endorsement modes insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:
Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
irrjury' caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent ads or omissions of such
person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or facing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury' or "property damage"
caused by "yur owork" and included in the
"products -completed operations hazard'
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence'
or offense.
b. The insurance provided to such additional (2) If a claim is made or "suiC is brought against
insured does not apply to: the additional insured:
CG D2 46 0419 0 2018 The Travelers indemnity Company. An rights reserved. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) Immediately record the speciflcs of the
claim or "wit' and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit' as soon as practicable.
(3) Wynedlately send us copies of all legal
papers received in connection with the claim
or 'suit', cooperate with us in the
investigation or settlement of the claim or
defense against the 'suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
insured for a lass we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other Insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
Page 2 d 2 0 2018 The Travelers Indemnity Comparry. All rights reserved. CG 02 46 0419
RETURN TO: PW ADMIN EXT: 2700 ID #: 3855 / 3919
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS /
2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 3. DATE REQ. Bv:
3. TYPE OF DOCUMENT (CHECK ONE):
® CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
® PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
❑ OTHER
4. PROJECT NAME: Concrete Beveling Service - Trip Hazard Repair
5. NAME OF CONTRACTOR: Precision Concrete Cutting
ADDRESS: 5624 128TH ST E. PUYALLUP. WA, 98373-5160 TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME.- Matt Haney TITLE: President
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / /
7. TERM: COMMENCEMENT DATE: TBD COMPLETION DATE: 4 12/31 /22
8. TOTAL COMPENSATION: $ 35-,t6e-00- 100,000 (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES d NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: .i RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
n PURCHASING: PLEASE CHARGE TO: 101-4400-240-542-50-480
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER
d DEPUTY DIRECTOR DSW 2/16/21 DSW 5/13121
4 DIRECTOR EJW 31912021 EJW 5/1912021
❑ RISK MANAGEMENT (IF APPLICABLE)
8 LAW DEPT ER 2123/21; ER 3/2/21 ER 5/1912021
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: 5/3121 COMMITTEE APPROVAL DATE: 5//3//221
SCHEDULED COUNCIL DATE: 5/18/21 COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
lNrUAL I DATE SIGNED
❑ FINANCE DEPARTMENT
/LAW DEPT
SIGNATORY (MAYOR OR DIRECTOR) 17t
CITY CLERK
SSIGNED AG # AG#
e'f SIGNED COPY RETURNED DATE SENT:
COMMENTS:
EXECUTE, "ORIGINALS
1/2020
RETURN TO: PW ADMIN EXT: 2700 ID #: 3855 / 3919
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS /
2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 3. DATE REQ. BY:
3. TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
0 PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
❑ OTHER
4. PROJECT NAME: Concrete Beveling Service - Trip Hazard Repair
5. NAME OF CONTRACTOR: Precision Concrete Cutting
ADDRESS: 5624 128TH ST E PUYALLUP WA 98373-5160 TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME: Matt Haney TITLE: President
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL EXP. 12/31/ UBI # , EXP.
7. TERM: COMMENCEMENT DATE: TBD COMPLETION DATE: 12/31 /21
8. TOTAL COMPENSATION: $ 35,000.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES d NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: - RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
O PURCHASING: PLEASE CHARGE TO: 101-4400-240-542-50-480
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER
d DEPUTY DIRECTOR DSW 2/16/21 DSW 5/13121
6 DIRECTOR EJW 319/2021 EJW 5/19/2021
❑ RISK MANAGEMENT (IF APPLICABLE)
8 LAW DEPT ER 2/23/21; ER 3/2/21 ER 5/19/2021
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: 5/3121 COMMITTEE APPROVAL DATE: 5//3//221 I n
SCHEDULED COUNCIL DATE: 5/18/21 COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC' D.
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
IN L / DATE SIGNED
❑ FINANCE DEPARTMENT
r/LAW DEPT SIGNATORY (MAYOR OR DIRECTOR)
y`�'CITY CLERK r �SSIGNED AG # ;A10
IGNED COPY RETURNED DATE SENT:
COMMENTS:
EXECUTE, "ORIGINALS
1/2020
RETURN TO: PW ADMIN EXT: 2700 ID #: 3855 / 3919
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS /
2. ORIGINATING STAFF Pk:R50N: Desiree Winkler EXT: 3. DATE REQ. BV-
3. TYPE OF DOCUMENT (CHECK ONE):
In CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
0 PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
❑ OTHER
4. PROJECT NAME: Concrete Beveling Service - Trip Hazard Repair
5. NAME OF CONTRACTDR: Precision Concrete Cutting
ADDRESS; 5624 128TH ST E. PUYALLUP, WA, 98373-5160 TELEPHONE:
E-MAIL: FAX-
SIGNATURENAME: Matt HaneV TITLE: President
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP.
7. TERM: COMMENCEMENT DATE: TBD COMPLETION DATE: 12/31 /21
8. TOTAL COMPENSATION: $ 35,000.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES d NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: q RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
O PURCHASING: PLEASE CHARGE TO: 101-4400-240-542-50-480
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER
d DEPUTY DIRECTOR DSW 2/16/21 DSW 5/13/21
A DIRECTOR EJW 319/2021 EJW 5/19/2021
❑ RISK MANAGEMENT (IF APPLICABLE)
8 LAW DEPT ER 2/23/21; ER 3/2/21 ER 5/1912021
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: 5/3121 COMMITTEE APPROVAL DATE: 5//3//221 I /J
SCHEDULED COUNCIL DATE: 5/18/21 COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC' D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INFUAL I DATE SIGNED
❑ FINANCE DEPARTMENT
/LAW DEPT
X SIGNATORY (MAYOR OR DIRECTOR)
/CITY CLERK 74— j s�
SIIGNED AG # AG#
SIGNED COPY RETURNED DATE SENT:
COMMENTS:
EXECUTE" " ORIGINALS
1/2020
41k
CITY Federal of
Way
RID AND CONTRACT DOCUMENTS
AND
SPECIFICA TIONS
FOR
CONCRETE SIDEWALK BEVELING —TRIP HAZARD REMOVAL
RFR # 21-004
City of Federal Way
Public Works Department
33325 Eighth A venue South
Federal Way, WA 98003
BID AND CONTRACT DOCUMENTS AND SPECIFICATIONS
FOR
CONCRETE SIDEWALK BEVELING — TRIP HAZARD REMOVAL
RFB # 21-004
Quotes Accepted Until 2:00 p.m., April 15, 2021
Prepared By:
Public Works Department
CITY OF FEDERAL WAY, WASHINGTON
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 2 2021
RFB ver. 9-18
TABLE OF CONTENTS
PAGE
NOTICETO CONTRACTORS.......................................................................................... 4
BIDDER'S CHECKLIST................................................................................................. 6
SECTION 1: INSTRUCTIONS TO BIDDERS.................................................................. 8
SECTION 2: GENERAL CONTRACTUAL TERMS AND CONDITIONS ............................. 15
NO BID RESPONSE FORM (Attachment A).................................................................
21
BIDFORM (Attachment B).........................................................................................
22
BIDSIGNATURE PAGE (Attachment D)....................................................................
25
SUBCONTRACTOR LIST (Attachment F)...................................................................
27
COMBINED AFFIDAVIT AND CERTIFICATION FORM (Attachment G).......................
28
CONTRACTOR'S COMPLIANCE STATEMENT (Attachment H).....................................
30
CONTRACTOR CERTIFICATION — WAGE LAW COMPLIANCE (Attachment I) .............31
PUBLIC WORKS MAINTENANCE AGREEMENT (Attachment 3).................................
32
(with Exhibits A-F and Appendixes as attached)
Exhibit A Services
Exhibit B Compensation
Exhibit C Performance/Payment/Retainage Bond
Exhibit D Insurance Certificate
Exhibit E Prevailing Wages
Exhibit F Title VI Assurances
APPENDIX A Scope and Specifications................................................... WHITE PAGES
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 3 2021
RFB ver. 9-18
NOTICE TO CONTRACTORS
CONCRETE SIDEWALK BEVELING — TRIP HAZARD REMOVAL RFB # 21-004
The City of Federal Way extends this invitation to bid to selected contractors listed with the MRSC
Small Works Roster. This protect is a small public works protect and will be awarded under the small
works roster process.
PURPOSE: The City of Federal Way ("City") is requesting quotes for the Concrete Sidewalk Beveling — Trip
hazard Removal contract. Quotes will be received via email only to PW_Bids@cityoffederalway.com on
April 15, 2021 at 2:00 P.M. PST. Quotes received after that time and date will not be considered.
DESCRIPTION OF WORK:
This project shall consist of:
Concrete sidewalk beveling to remove trip hazards on sidewalks throughout the city right-of-way
and city -owned property. This will be a public works maintenance contract anticipated to be
between $35,000 and $100,000 annually.
The Contractor shall complete all work within 30 working days after issued a Task
Order.
The bidder is urged to check the plans and contract provisions carefully.
All bid proposals shall be in accordance with the Instructions to Bidders and all other contract
documents. Any questions concerning the description of the work contained in the contract
documents must be directed to Desiree Winkler, Deputy Public Works Director, by email at
desiree.winkler@cityoffederalway.com. The questions must be received by the City on or before
Tuesday, April 13, 2021 to allow a written reply to reach all prospective Bidders before the
submission of their bids.
BIDDING DOCUMENTS:
Free -of -charge access to project bid documents (specifications, addenda, and Bidders List) is
provided to Prime Bidders that are invited to bid on this project.
The City, in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d
to 2000d-4 and Title 49 C.F.R., Department of Transportation, Subtitle A, Office of the Secretary,
Part 21, Nondiscrimination in Federally -assisted programs of the Department of Transportation
issued pursuant to such Act, hereby notifies all bidders that it will affirmatively ensure that in any
contract entered into pursuant to this advertisement, disadvantaged business enterprises as
defined at 49 CFR Part 23 will be afforded full opportunity to submit bids in response to this
invitation and will not be discriminated against on the grounds of race, color, national origin, or sex
in consideration for an award. The City encourages minority and women -owned firms to submit
bids consistent with the City's policy to ensure that such firms are afforded the maximum
practicable opportunity to compete for and obtain public contracts.
The Contractor will be required to comply with all local, State, and Federal laws and regulations
pertaining to equal employment opportunities.
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 4 2021
RFB ver. 9-18
The City anticipates awarding this project to the successful bidder and intends to give Notice to
Proceed as soon as the Contract and all required associated documents are executed in full.
Regardless of the date of award, or Notice to Proceed the Contractor must complete all work under
this project by December 31, 2021.
RESERVATION OF RIGHTS:
The City,of Federal Way reserves the right to reject any and all bids, waive any informalities or
minor irregularities in the bidding, and determine which bid or bidder meets the criteria set forth in
the bid documents. No bidder may withdraw his bid after the hour set for the opening thereof
unless the award is delayed for a period exceeding thirty (30) days.
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BIDDER'S CHECKLIST
The bidder's attention is especially called to the following forms, which must be executed in full as
required and submitted as part of the bid. Failure to comply shall result in rejection of any bid not
so complying.
Bid Form (Attachment B)
The Bid Form shall be completed and fully executed, including filling in the total bid amount.
Bid Schedule (Attachment C)
Not Used
Bid Signature Pa a (Attachment D)
The Bid Signature Page shall be filled in and fully executed by the bidder.
Subcontractor List (Attachment F)
The Subcontractor List shall be filled in by the bidder. (This section may/may not apply)
Combined Affidavit and Certification Form (Attachment G)
This form must be subscribed to and sworn before a Notary Public and notarized.
1�( Contractor's Compliance Statement (Attachment H)
The Contractor's Compliance Statement shall be filled in and fully executed by the bidder.
CONTRACTOR CERTIFICATION — WAGE LAW COMPLIANCE (Attachment I)
This form must be filled in and fully executed by the bidder.
d Contractoes Certificate of Rem—
ration
The bidder shall provide a copy of Contractor's current registration with the State of
Washington.
C.ontractWA State Identification Number
The bidder shall provide a copy of Contractor's current state unified business identifier
number and, as applicable, an employment security department number and state excise
tax registration number.
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SUCCESSFUL BIDDER'S CHECKLIST
The following documents are to be executed and delivered to the City within ten (10) calendar days
after the Bid is awarded:
❑ Public Works Maintenance A reement (Attachment J)
The successful bidder will fully execute and deliver to the City the Public Works Maintenance
Agreement for Concrete Sidewalk Beveling — Trip Hazard Removal Project ("Contract'l from
these Bid Documents.
❑ Performance Payment Retaina a Bond (Exhibit C)
The successful bidder will provide a bond on form provided.
❑ Certificate of Insurance (Exhibit D)
The successful bidder will provide a Certificate of Insurance evidencing the insurance
requirement set forth in the Contract.
❑ Business License
The successful bidder will provide a copy of a current Business License with the City of
Federal Way.
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SECTION 1: INSTRUCTIONS TO BIDDERS
1-1 Time and Place for Submission of Bids
The City of Federal Way ("City") is requesting quotes for the Concrete Beveling — Trip Hazard
Removal Project. Quotes will be received via email only to PW_Bids@cityoffederalway.com on
April 15, 2021 at 2:00 PM (PST). Quotes received after that time and date will not be considered.
If, after reviewing this document the bidder chooses not to submit a bid, the bidder may
complete and return the "No Bid Response Form" provided as Attachment "A" by the date
and time indicated above.
1-2 Bid Form
Bids shall be made on the "Bid Form," Attachment "B" issued by the City as part of these
contract documents, without reservation or amendment. Bids must be typewritten or printed
in ink. Upon completion, the Bid Form and the bid bond or certified check and any
requested information shall be placed in a sealed envelope. On the outside of the envelope,
place the bid name, bid number and the time bids are due.
1-3 Bid Signature
All bids shall give the total bid price and shall be signed in ink by the bidder or their
authorized representative, with the address. If the bid is made by an individual, the name,
signature, and address must be shown. If the bid is made by a firm or partnership, the
name and address of the firm or partnership and the signature of at least one of the general
partners must be shown. If the bid is made by a corporation, the bid shall show the title of
the person authorized to sign on behalf of the corporation, his or her title and the address.
The City reserves the right to request documentation showing the authority of the individual
signing the bid to execute contracts on behalf of anyone, or any entity, other than
himself/herself. Refusal to provide such information upon request may cause the bid to be
rejected as nonresponsive.
1-4 Bid Withdrawal Due to Error
Bids may not be withdrawn due to a claim of error in a bid unless written notice of such
claim and supporting evidence for such claim including cost breakdown sheets are delivered
to the City within forty-eight (48) hours prior to the opening of bids.
1-5 Modification of Bid
A modification of a bid already received will be considered only if the modification is
received prior to the time announced for bid opening. All modifications shall be made in
writing, executed and submitted in the same form and manner as the original bid.
1-6 Examination of Bid and Contract Documents — Bidder Responsibilities
The submission of a bid shall constitute an acknowledgment upon which the City may rely
that the bidder has thoroughly examined and is familiar with the bid and contract
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documents and has reviewed and inspected all applicable federal, state and local statutes,
regulations, ordinances and resolutions dealing with or related to the equipment and/or
services to be provided herein. The failure or neglect of a bidder to examine such
documents, statutes, regulations, ordinances or resolutions shall in no way relieve the
bidder from any obligations with respect to the bidder's bid or the contract documents. No
claim for additional compensation will be allowed which is based upon a lack of knowledge
of any contract documents, statutes, regulations, ordinances or resolutions. Bidders shall
visit delivery and service locations(s) as required. Bidders shall become familiar with and
verify any environmental factors, which may impact current or future prices for this
requirement.
1-7 Interpretation of Bid and Contract Documents
No oral interpretations will be made to any bidder as to the meaning of the bid or contract
documents and no oral communications will be binding upon the City. Any questions
concerning the description of the work contained in the contract documents must be
directed to Desiree Winkler, Deputy Public Works Director, by email at
desiree.winkler@cityoffederalway.com. The questions must be received by the City on or
before Tuesday, April 13, 2021 to allow a written reply to reach all prospective Bidders
before the submission of their bids. Any interpretation deemed necessary by the City will be
in the form of an addendum to the bid documents and when issued will be sent as promptly
as is practical to all parties to whom the bid documents have been issued. All such addenda
shall become part of the bid.
1-8 Addenda
Each bid shall include acknowledgment of receipt and review of all addenda issued during
the bidding period on the Bid Form.
1-9 Bid Price
The bid price shall include everything necessary for the completion of the contract including,
but not limited to, furnishing all materials, equipment, tools, freight charges, facilities and all
management, superintendence, labor and service, except as may be provided otherwise in
the contract documents. All Washington State sales tax and all other government
taxes, assessments and charges shall be included in the various Bid item prices
as required by law. The offer shall remain in effect ninety (90) days after the bid opening.
In the event of a discrepancy between a unit price and an extended amount and/or the total
price, the unit price will govern and the extended amount and/or total price will be
corrected accordingly. However, downward correction of a bid, which would displace the
apparent low bidder, will only be permitted if the error made and the intended bid price can
be determined solely from the bid documents.
1-10 Postponement of Bid Opening
The City reserves the right to postpone the date and time for the opening of bids by
announcing such postponement at any time prior to the date and time announced in these
documents.
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1-11 Rejection of Bids
A. The City reserves the right to reject any bid for any reason including, but not limited to,
the following: any bid which is incomplete, obscure, irregular or lacking necessary detail
and specificity; any bid which omits a price on any one or more items on the Bid Form
and Bid Schedule; any bid in which prices are unbalanced in the opinion of the City; any
bid accompanied by insufficient or irregular bid bond; any bid from bidders who (in the
sole judgment of the City) lack the qualifications and/or responsibility necessary to
perform the work after considering the elements in Section 1-14.B; any bid for which a
bidder fails or neglects to complete and submit any qualifications information within the
time specified by the City and as may be otherwise required herein; and, any bid
submitted by a bidder who is not registered or licensed as may be required by the laws
of the State of Washington.
B. The city further reserves the right to reject any portion of any bid and/or to reject all
bids. In consideration for the City's review and evaluation of its bid, the bidder waives
and releases any claims against the City arising from any rejection of any or all bids.
1-12 Alterations to Documents Prohibited
Any addition, limitation or provision attached to the bid may render it informal or
nonresponsive and cause its rejection. Alteration by erasure or interlineations must be
explained or noted in the bid form over the signature of the bidder. No oral, telegraphic or
telephonic bids or modifications will be considered.
1-13 Disqualification of Bidder
If, in the opinion of the City, there is reason to believe that collusion exists among bidders,
none of the bids of the participants in such collusion will be considered. All bidders are
required to submit the Affidavit of Non -Collusion (Attachment G) with their bids.
1-14 Evaluation of Bids
It is the intent of City to award a contract to the lowest responsive bid by a responsible
bidder as evaluated by the City. The bidder may be required by the City to submit
documentation demonstrating compliance with the criteria.
A. Responsiveness — The bidder must complete all required forms and bid documents and
provide all required and requested information. Refusal to provide such information may
cause the bid to be rejected. The City will consider all the material submitted by the
bidder to determine whether the bid is in compliance with the bid terms and documents
and responsive to the requested work.
B. Responsibility — The City will consider all the material submitted by the bidder, and other
evidence it may obtain including information from previous project owners, to determine
whether the bidder is responsible. The bidder must meet the following bidder
responsibility criteria and supplemental bidder responsibility criteria to be considered a
responsible bidder:
1. Mandatory Bidder Responsibility Criteria
a. Have a current certificate of registration as a contractor in compliance with
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chapter 18.27 RCW, which must have been in effect at the time of bid
submittal;
b. Have a current Washington Unified Business Identifier (UBI) number;
C. If applicable:
i. Have Industrial Insurance (workers' compensation) coverage for the
bidder's employees working in Washington, as required in Title 51
RCW;
ii. Have a Washington Employment Security Department number, as
required in Title 50 RCW;
iii. Have a Washington Department of Revenue state excise tax registration
number, as required in Title 82 RCW;
d. Not be disqualified from bidding on any public works contract under RCW
39.06.010 or 39.12.065(3).
e. Within a three-year period immediately preceding the date of the bid
solicitation, the bidder shall not be a willful violator, as defined in RCW
49.48.082, 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 judgment entered
by a court of limited or general jurisdiction.
2. Supplemental Bidder Responsibility Criteria
a. The bidder shall not have a record of excessive claims filed against the
retainage, payment, or performance bonds for public works projects during
the previous three years, that demonstrate a lack of effective management
by the bidder of making timely and appropriate payments to its
subcontractors, suppliers, and workers, unless there are extenuating
circumstances acceptable to the City.
b. The bidder shall have a reasonable history of successfully completed projects
of a similar size and scope as required by the contract documents for this
project. The City will evaluate whether the projects were "successfully
completed" and of a "similar size and scope."
c. The bidder shall have evidence that it is able to begin and complete the work,
and complete it in a timely fashion.
3. As evidence that the bidder meets the supplemental bidder responsibility criteria in
paragraph (B)(2) above, the apparent low bidder must submit the following
documentation to the City within 48 hours of the bid opening. The City reserves the
right to request such documentation from other bidders also. Refusal to provide such
information upon request may cause the bid to be rejected.
a. The bidder shall submit a list of the public works projects completed within
the previous three years and include for each project the following
information; the owner and contact information for the owner; a list of claims
filed against the retainage, payment, or performance bond for any of the
projects listed; a written explanation of the circumstances surrounding each
claim and the ultimate resolution of the claim.
b. The bidder shall submit a list of projects of similar size and scope to this
project and include information about each project, including the following:
the owner and contact information for the owner; the awarded contract
amount; the final contract amount; a description of the scope of the project
and how the project is similar to this project; the bidder's assessment of its
performance of each project. The information should include any information
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regarding performance in the following areas; quality control; safety record;
timeliness of performance; use of skilled personnel; management of
subcontractors; availability of and use of appropriate equipment; compliance
with contract documents; management of submittals process, contract
amendments, and close-out.
c. The bidder shall furnish acceptable evidence of the bidder's current ability to
perform, such as firm commitments by subcontractors, equipment, supplies
and facilities, and the bidder's ability to obtain the necessary personnel.
4. If the City determines the bidder does not meet the bidder responsibility criteria in
paragraph (B)(1) and (B)(2) above and is therefore not a responsible bidder, the City
shall notify the bidder in writing with the reasons for its determination. If the bidder
disagrees with this determination, it may appeal the determination within 24 hours
of receipt of the City's determination by presenting additional information to the City
and meeting the requirements of section 1-20(B). The City will consider the
additional information before issuing its final determination. If the final
determination affirms that the bidder is not responsible, the City will not execute a
contract with any other bidder until two business days after the bidder determined to
be not responsible has received the final determination.
C. Lowest Bid — The lowest bid shall be determined as set forth on the Bid Form.
The acceptance of a bid will be evidenced by a Notice of Award. No other act of the City
shall constitute acceptance of a bid. Within ten (10) days after receipt of Notice of
Award, the bidder whose bid is accepted, shall furnish the required performance bond,
certificate of insurance, execute the contract and perform all other acts required by the
bid and contract documents as conditions precedent to formation of the contract.
1-15 Procedures When Only One Bid is Received
In the event only a single responsive bid is received, the City reserves the right to conduct a
price and/or cost analysis of such bid. The sole bidder shall provide such information, data
and other documentation as deemed necessary by the City for such analysis. The City
reserves the right to reject such bid.
1-16 Bid Documents
Bidders are required to submit with the bid package the following:
A. AttachmentA — No Bid Response Form, if applicable.
B. Attachment B— Bid Form.
C. Attachment C— Not used.
D. AttachmentD— Bid Signature Page.
E. Attachment E— Not used.
F. Attachment F— Subcontractor List. (May Not Apply)
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G. Attachment G— Combined Affidavit and Certification Form.
H. Attachment H— Contractor's Compliance Statement.
I. Attachment I— Contractor Certification — Wage Law Compliance.
1-17 Conflicts of Interest and Noncompetitive Practices
By submitting a bid, the Contractor agrees as follows:
A. Conflict of Interest — That it has no direct or indirect pecuniary or proprietary interest,
that it shall not acquire any interest which conflicts in any manner or degree with the
work, services, equipment or materials required to be performed and/or provided under
this contract and that it shall not employ any person or agent having any such interests.
In the event that the Contractor or its agents, employees or representatives hereafter
acquires such a conflict of interest, it shall immediately disclose such interest to the City
and take action immediately to eliminate the conflict or to withdraw from this contract,
as the City may require.
B. Contingent Fees and Gratuities
1. That no person or selling agency except bona fide employees or designated agents
or representatives of the Contractor have been employed or retained to solicit or
secure this contract with an agreement or understanding that a commission,
percentage, brokerage, or contingent fee would be paid; and
2. That no gratuities in the form of entertainment, gifts or otherwise, were offered or
given by the Contractor or any of its agents, employees or representatives, to any
official, member or employee of the City or other governmental agency with a view
toward securing this contract or securing favorable treatment with respect to the
awarding or amending, or the making of any determination with respect to the
performance of this contract.
1-18 Bid Security
n/a
The City further reserves the right to hold all bids (and the accompanying bid security) from
the date of the bid opening until the contract and any performance/payment bond are
executed, provided that such period does not exceed ninety (90) days, and each bid shall
remain effective during that period.
1-19 Performance/Payment Bond
The bidder to whom the City has awarded this Contract will remove the
Performance/Payment Bond (Exhibit G) attached to the Public Works Contract and deliver it
to the City fully executed by the bidder and a surety company in the amount of one hundred
percent (100%) of the contract price as security for the faithful performance of the work
including the payment of all persons furnishing materials and performing labor on the work
and all payments arising from the performance of the work due the State of Washington
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pursuant to Titles 50 and 51 RCW. Such bond must be executed by a duly licensed surety
company, which is registered with the Washington State Insurance Commissioner, and the
surety's name shall appear in the current Authorized Insurance Company List in the State of
Washington, published by the Office of the Insurance Commissioner. The scope of the
Performance/Payment Bond (Exhibit G) shall in no way affect or alter the liabilities of the
Contractor to the City under Section 8 "Indemnification" of the Public Works Contract.
The City may require the surety company to appear and qualify itself upon the bond. If, at
any time, the City determines in its sole judgment that the surety company is insufficient,
the City may require the Contractor to furnish additional surety in form and arrangement
satisfactory to the City and in an amount not exceeding that originally required. The
Contractor shall submit a performance bond complying with the requirements of this
paragraph within ten (10) days after the award is made. Payments will not be made on the
Contract until sufficient surety as required is furnished.
1-20 Bid Dispute
A. Any actual or prospective bidder, including sub -contractors and suppliers showing a
substantial economic interest in this contract who is aggrieved in connection with the
solicitation or award of this contract, may protest to the City in accordance with the
procedures set forth herein. Protests based on the specifications or other terms in the
contract documents, which are apparent prior to the date established for submittal of
\bids, shall be submitted not later than ten (10) calendar days prior to said date, or shall
be deemed waived. All other protests shall be accepted only from actual bidders and
shall be submitted within five (5) calendar days after the aggrieved person knows or
should have known of the facts and circumstances upon which the protest is based;
provided, however, that in no event shall a protest be considered if all bids are rejected
or after the award of this contract.
B. In order to be considered, a protest shall be in writing and shall include: (1) the name
and address of the aggrieved person; (2) the RFB number and contract title under which
the protest is submitted; (3) a detailed description of the specific grounds for protest
and any supporting documentation; and (4) the specific ruling or relief requested. The
written protest shall be addressed to:
City of Federal Way
33325 8th Avenue South
Federal Way, Washington 98003-6325
Attention: Bid Protest -- Concrete Sidewalk Beveling - Trip Hazard Removal
RFB # 21-004
C. Upon receipt of a written protest, the City will promptly consider the protest. The City
may give notice of the protest and its basis to other persons, including bidders involved
in or affected by the protest; such other persons may be given an opportunity to submit
their views and relevant information. If the protest is not resolved by mutual agreement
of the aggrieved person and the City, the City will promptly issue a decision in writing
stating the reasons for the action taken and informing the aggrieved person of his or her
right to appeal the decision to the City Manager or his or her designee. A copy of the
decision shall be mailed (by certified mail, return receipt requested) or otherwise
promptly furnished to the aggrieved person and any other interested parties who
requested a copy of the decision. The decision will be considered final and conclusive
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unless appealed within five (5) calendar days after receipt of the decision to the City
Manager or his or her designee. If the decision is appealed, then the subsequent
determination of the City Manager or his or her designee shall issue within five (5) days
of the City Manager's receipt of the appeal and shall be final and conclusive.
D. Failure to comply with these protest procedures will render a protest untimely or
inadequate and shall result in rejection thereof by the City.
SECTION 2: GENERAL CONTRACTUAL TERMS AND CONDITIONS
2-1 Administration
This contract will be between the City and the Contractor who will be responsible for
delivering all equipment and performing all work and services described herein. The City is
not party to defining the division of work between the Contractor and the Contractor's
subcontractors, if any, and the specifications have not been written with this intent.
The Contractor represents that it has or will obtain all personnel and equipment required to
perform the services hereunder. Such personnel shall not be employees of the City.
The Contractor's performance under this contract will be monitored and reviewed by Desiree
Winkler, Deputy Public Works Director. Questions by the Contractor regarding interpretation
of the terms, provisions and requirements of this contract shall be addressed to Desiree
Winkler, Deputy Public Works Director, for response.
2-2 Proof of Compliance with Contract
In order that the City may determine whether the Contractor has complied with the
requirements of the contract documents, the Contractor shall, at any time when requested,
submit to the City properly authenticated documents or other satisfactory proofs as to the
Contractor's compliance with such requirements.
2-3 Contract Documents and Precedence
The documents embodying the legally binding obligations between the City and the
Contractor for completion of the work consist of the following: The City's Request for Bid,
Bid Form, Bid Signature Page, Instructions to Bidders, Bid Bond, Concrete Sidewalk Beveling
— Trip Hazard Removal Contract, General Contractual Terms and Conditions, Contractor's
Compliance Statement, Combined Affidavit and Certification Form, Technical Specifications,
Addenda and Contract Amendments, and the Concrete Sidewalk Beveling — Trip Hazard
Removal Scope and Specifications. The contract documents are intended to be
complementary so that what is required by any one of them shall be as binding as if called
for by all of them. In the event of any conflicting provisions or requirements within the
several parts of the contract documents, the City will issue an interpretation regarding the
controlling provision, which interpretation shall be binding.
2-4 Charges to Contractor
Charges which are the obligation of the Contractor under the terms of the contract shall be
paid by the Contractor to the City on demand and may be deducted by the City from any
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money due or to become due to the Contractor under the contract and may be recovered
by the City from the Contractor or its surety.
2-5 Contract Amendments
The City may, at any time, without notice to the sureties, by written order designated or
indicated to be a contract amendment, make any change in the specifications within the
scope of this contract. Oral orders will not be binding on the City unless confirmed in writing
by the City. Except as provided herein, no order, statement, or conduct of the City will be
treated as a change hereunder or will entitle the Contractor to an equitable adjustment.
If any change hereunder causes an increase or decrease in the Contractor's cost of, or time
required for, the performance or any part of the work under this contract, an equitable
adjustment will be made and the contract modified in writing accordingly. However, no
claim will be allowed for any costs incurred more than five (5) days before the Contractor
gives written notice as required.
If the Contractor intends to assert a claim for an equitable adjustment hereunder, it shall,
within five (5) days after receipt of a written contract amendment form from the City or
after giving the City the written notice required above, as the case may be, submit to the
City a written statement setting forth the general nature and monetary extent of such claim;
provided the City, in its sole discretion, may extend such five (5) day submittal period upon
request by the Contractor. The Contractor shall supply such supporting documents and
analysis for the claims as the City may require to determine if the claims and costs have
merit.
No claim by the Contractor for an equitable adjustment hereunder will be allowed if asserted
after final payment under this contract.
2-6 Work and Materials Omitted
The Contractor shall, when directed in writing by the City, omit work, services and materials
to be furnished under the contract and the value of the omitted work and materials will be
deducted from the contract price and the delivery schedule will be reviewed if appropriate.
The value of the omitted work, services and materials will be a lump sum or unit price, as
mutually agreed upon in writing by the Contractor and the City. If the parties cannot agree
on an appropriate deduction, the City reserves the right to issue a unilateral contract
amendment adjusting the price and the delivery schedule.
2-7 Washington State Sales Tax
The Contractor shall make payment directly to the State for all applicable Washington State
sales taxes and all other governmental taxes, assessments and charges.
2-8 Shipping Charges
All prices shall include freight. Requests for additional compensation for freight charges will
be rejected by the City.
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2-9 Warranty
All materials and equipment sold and labor performed under this contract are warranted by
the Contractor to be free from defects in materials or workmanship for a period of at least
one (1) year from date of delivery and installation; provided, however, that this warranty
may extend beyond this time period pursuant to any attached warranties. If the
merchandise sold or work performed hereunder is defective on account of workmanship or
materials, the Contractor agrees to replace the merchandise or, at the City's sole option,
repair the defective merchandise. All defects in work or materials shall be promptly
corrected.
2-10 No Waiver of Warranties and Contract Rights
Conducting of tests and inspections, review of specifications or plans, payment for goods or
services, or acceptance by the City does not constitute a waiver, modification or exclusion of
any express or implied warranty or any right under this contract or in law.
2-11 Legal Relations
The Contractor shall comply with all of the City's resolutions and regulations applicable
under this contract and with any local, state or federal law or regulation applicable to the
materials, equipment or service provided under this contract. Neither the Contractor nor the
City shall assign any interest, obligation or benefit under or in this contract or transfer any
interest in the same, whether by assignment or novation, without prior written consent of
the other party. This contract shall be binding upon and inure to the benefit of the
successors of the parties.
2-12 Applicable Law and Forum
Except as hereinafter specifically provided, this contract shall be governed by and construed
according to the laws of the State of Washington including, but not limited to, the Uniform
Commercial Code, Title 62A RCW. Any suit arising herefrom shall be brought in King County
Superior Court, which shall have sole and exclusive jurisdiction and venue.
2-13 Hazardous Chemical Communication
In order to comply with WAC 296-62-054, Hazard Communication, the Contractor shall
submit with each shipment a Material Safety Data Sheet (MSDS) for all products containing
any toxic products that may be harmful to the end user. The MSDS Sheet is to accompany
the toxic product(s) to the specified delivery sites.
Include the following information in the MSDS:
A. Chemical Abstract Service (CAS) numbers for every chemical that is listed in the
MSDS.
B. If the product is actually used diluted, the dilution rate should be so stated in the MSDS and
the hazards and corresponding personal protection, etc., also be listed.
C. A statement as to the intended use of the product.
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2-14 Delivery and Liquidated Damages
Time is of the essence of the contract and each and all of its provisions in which
performance is a factor. The Contractor will be held to strict compliance with the prescribed
date(s) set forth in these contract documents. For each and every day that delivery is
delayed beyond the specific date(s), damage will be sustained by the City. Because of the
difficulty in computing the actual damages and disadvantages to the City, and as a
reasonable forecast of actual damages which the City will suffer by the delay in delivery, the
parties agree that for each such delay the Contractor will pay the City liquidated damages
(and not as a penalty) in accordance with Section 1.3 of Attachment ], Public Works
Contract, to compensate for any damages caused by such delay. The City may deduct from
any payment owing to the Contractor, any liquidated damages, which may be incurred by
the Contractor pursuant to this paragraph.
2-15 Force Majeure
The Contractor's or City's failure to perform any of its obligations under this contract shall
be excused if due to causes beyond the control and without the fault or negligence of the
Contractor or City, respectively, including, but not restricted to, acts of God, acts of public
enemy, acts of any government, fire, floods, epidemics, and strikes.
2-16 Patents, Copyrights and Rights in Data
Any patentable result or material suitable for copyright arising out of this contract shall be
owned by and made available to the City for public use, unless the City shall, in a specific
case where it is legally permissible, determine that it is in the public interest that it not be
so owned or available.
The Contractor agrees that the ownership of any plans, drawings, designs, specifications,
computer programs, technical reports, operating manuals, calculations, notes and other
work submitted or which is specified to be delivered under this contract, whether or not
complete (referred to in this subsection as "Subject Data', shall be vested in the City or
such other local, state or federal agency, if any, as may be provided by separate contract
with the City.
All such Subject Data furnished by the Contractor pursuant to this contract, other than
documents exclusively for internal use by the City, shall carry such notations on the front
cover or a title page (or in such case of maps, in the same block) as may be requested by
the City. The Contractor shall also place their endorsement on all Subject Data furnished by
them. All such identification details shall be subject to approval by the City prior to printing.
The Contractor shall ensure that substantially the foregoing paragraphs are included in each
subcontract for the work on the project.
2-17 Patents and Royalties
The costs involved in license fees, royalties or in defending claims for any patented
invention, article, process or method that may be used in or connected with the work under
this contract or with the use of complete work by the City, shall be paid by the Contractor.
The Contractor and the Contractor's sureties shall, at their own cost, defend, indemnify and
hold the City, together with its officers and employees, harmless against any and all
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 18 2021
RFB ver. 9-18
demands made for such fees, royalties or claims brought or made by the holder of any
invention or patent. Before final payment is made on the account of this contract, the
Contractor shall, if requested by the City, furnish acceptable proof of a proper release of the
City, its officers, agents and employees from all such fees or claims.
Should the Contractor, its agent, servants or employees, or any of them be enjoined from
furnishing or using any invention, article, material, computer programs or equipment
supplied or required to be supplied or used under the contract, the Contractor shall
promptly substitute other articles, materials, computer programs or equipment in lieu
thereof of equal efficiency, quality, finish, suitability and market value, and satisfactory in all
respects to the City.
2-18 Disputes, Claims and Appeals
Questions or claims regarding meaning and intent of the contract or arising from this
contract, shall be referred by the Contractor in writing to the Purchasing Coordinator for
decision within five (5) days of the date in which the Contractor knows or should know of
the question or claim. The Purchasing Coordinator will ordinarily respond to the Contractor
in writing with a decision, but absent such written response, the question or claim shall be
deemed denied upon the tenth (10th) day following receipt by the Purchasing Coordinator.
In the event the Contractor disagrees with any determination or decision of the Purchasing
Coordinator, the Contractor shall, within fifteen (15) days of the date of such determination
or decision, appeal the determination or decision in writing to the City Manager. Such
written notice or appeal shall include all documents and other information necessary to
substantiate the appeal. The City Manager will review the appeal and transmit a decision in
writing to the Contractor within thirty (30) days from the date of receipt of the appeal.
Failure of the Contractor to appeal the decision or determination of the Purchasing
Coordinator within said 15-day period will constitute a waiver of the Contractor's right to
thereafter assert any claim resulting from such determination or decision. Appeal to the City
Manager shall be a condition precedent to litigation hereunder.
All claims, counterclaims, disputes and other matters in question between the City and the
Contractor that are not resolved between the Purchasing Coordinator and the Contractor will
be decided in the Superior Court of King County, Washington, which shall have exclusive
jurisdiction and venue over all matters in question between the City and the Contractor. This
contract shall be interpreted and construed in accordance with the laws of the State of
Washington.
Pending final decision of the dispute hereunder, the Contractor shall proceed diligently with
the performance of the contract and in accordance with the direction of the Purchasing
Coordinator. Failure to comply precisely with the time deadlines under the paragraph as to
any claim, shall operate as a release of that claim and a presumption of prejudice to the
City.
2-19 Recycled Products
The Contractor shall use recycled paper for proposals and for any printed or photocopied
material created pursuant to a contract with the City whenever practicable and use both
sides of paper sheets for reports submitted to the City whenever practicable.
City of Federal Way RFB # 21-004
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RFB ver. 9-18
In the event this RFB covers the sale of product to the City that is capable of containing
recycled materials, Contractor is hereby advised that the City intends to procure products
with recycled content, pursuant to the recycled content notice delivered with these bid
documents. Contractor shall certify the percentage of recycled content and products sold to
the City, including a percentage of post -consumer waste that is in the product. This
certification is required to be in the form of a label on the product or a statement by the
Contractor attached to the bid documents. The certification on multi -component or multi -
material products shall verify the percentage and type of past -consumer waste and recycled
content by volume contained in the major constituents of the product. The Contractor
agrees to grant the City, as a procuring agency, permission to verify the certification of
recycled content by review of the bidder's or manufacturer's records as a condition of any
bid award, in the event of a bidder's protest, or other challenge to the bid accepted.
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 20 2021
RFB ver. 9-18
AttachmentA
NO BID RESPONSE FORM
When submitting a "No Bid," mail this completed form to Federal Way Purchasing, 33325 8th
Avenue South. Federal Way, Washington 98003-6325. Be sure the form is in a sealed envelope with
the bid number and bid title indicated on the outside of the envelope. The form must be received
by the date and time specified for the bid opening as indicated in Section 1-1. Failure to return this
form if not submittin a formal bid,. -may result in your firm beiric
i removed from the Ci 's master
bidder's mailing list.
Bid Number: RFB No. 21-004
Bid Title: Concrete Sidewalk Beveling — Trip Hazard Removal
❑ Cannot comply with specifications.
❑ Cannot meet delivery requirement.
❑ Do not regularly manufacture or sell the type of commodity involved.
❑ Other (please specify).
Explanation of reason(s) checked:
Check one of the following:
❑ WE DO
❑ WE DO NOT desire to be retained on the mailing list for future procurements of this
commodity.
Firm Name:
Address:
Signature
Name (Type or Print)
Date
Title
Phone:
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 21 2021
RFB ver. 9-18
Attachment 0
BID FORM
CITY OF FEDERAL WAY
Concrete Sidewalk Beveling — Trip Hazard Removal Contract (RFB #21-004)
l BID FORM
Bidder: �r8ci4 m n Can! rp.� Cu 91 ..n Date:
Item #
Description
Est. Qty.
Unit of
Measurement
Unit Price
Extended Price
1
Sidewalk Repairs 1/4" to 1/2"
300
Inch Feet
3 DO
2
Sidewalk Repairs over 1/2" to
2"
200
Inch Feet
, y(
Oct zoo
TOTAL
000
To City Council Members
City of Federal Way
33325 8th Ave South
Federal Way, Washington 98003-6325
Pursuant to and in compliance with your advertisement for bids for construction of CONCRETE
SIDEWALK BEVELING -- TRIP HAZARD REMOVAL PROJECT and other documents relating thereto,
the undersigned has carefully examined all of the bid and contract documents as the premises and
conditions affecting the delivery, supply and maintenance of CONCRETE SIDEWALK BEVELING —
TRIP HAZARD REMOVAL PROJECT, and hereby proposes to furnish all labor, materials and perform
all work as required in strict accordance with the contract documents, for the above -referenced
amount, inclusive of Washington State sales tax and all other government taxes, assessments
and charges as required by law.
The City of Federal Way reserves the right to reject any and all bids, waive any informalities or
minor irregularities in the bidding, and determine which bid or bidder meets the criteria set forth in
the bid documents.
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 22 2021
RFB ver. 9-18
Receipt of the following Addendums is hereby acknowledged:
Addendum No. Date Issued:
Addendum No. Date Issued:
Addendum No. Date Issued:
C6 r 00 r 4-1 ee- j�j,C2 t1 Cr o n
Corporati n/Partnership/Individual Firm Name
(Delete Two)
(U3 OZ� Z�L
Bidder's State License No Signature
(Y4_3VO7 39 V
Bidder's State Tax No. Title
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 23 2021
RFB ver. 4-18
Attachment C
Not applicable
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 24 2021
RFB ver. 9-18
Attachment D
BID SIGNATURE PAGE
Date: 9 A 1
The undersigned bidder hereby proposes and agrees to deliver the equipment and/or
services pursuant to the Concrete Sidewalk Beveling — Trip Hazard Removal Project and comply
with all other terms and conditions of the contract and bid documents of RFB 21-004.
No bidder may withdraw his/her bid for a period of ninety (90) days after the day of bid
opening.
The undersigned individual represents and warrants that he or she is dully authorized to
execute the bid and all bid documents on behalf of any partnership, joint venture or corporation.
C 6 nac'AtcI� C0?1G,=.-4 C".gr
Corporati n/Partnership/Individual Company
(Delete Two)
By:
(Signature)
I Pririnked Name)
Its: _1 !�
(Title)
3191
(Address)
GI 3 3 606cv
(Telephone Number)
City of Federal Way RFB # 21-004
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RFB ver. 9-18
Attachment E
NOT USED
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 26 2021
RFB ver. 9-18
Attachment F
SUBCONTRACTOR LIST
Prepared in Compliance with RCW 39.30.060
Concrete Sidewalk Beveling — Trip Hazard Removal Contract
Failure to list subcontractors who are proposed to perform the work of heating, ventilation and air
conditioning, plumbing, as described in Chapter 18.106 RCW and electrical as described in Chapter
19.28 RCW, or identify the bidder for the work will result in your bid being non -responsive and
therefore void.
Subcontractors that are proposed to perform the work of heating, ventilation and air conditioning,
plumbing, as described in Chapter 18.106 RCW, and electrical as described in Chapter 19.28 RCW
must be named below, or name the bidder for the work.
The bidder verifies that each first tier subcontractor, and every subcontractor of any tier that hires
other subcontractors, has a current certificate of registration in compliance with chapter 18.27
RCW; a current Washington Unified Business Identifier (UBI) number; has Industrial Insurance
(workers' compensation) coverage for the subcontractor's employees working in Washington, as
required in Title 51 RCW, if applicable; has a Washington Employment Security Department
number, as required in Title 50 RCW, if applicable; has a Washington Department of Revenue state
excise tax registration number, as required in Title 82 RCW, if applicable; has an electrical
contractor license, if required by Chapter 19.28 RCW, if applicable; has an elevator contractor
license, if required by Chapter 70.87 RCW.
The following listed bid items (listed in numerical sequence) for this project have been proposed for
subcontracting to subcontractors as indicated.
SUBCONTRACTOR
NAME
ITEM NUMBERS
ESTIMATED AMOUNT
WMBE QUALIFIED?
Y/N
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 27 2021
RFB ver. 9-18
Attachment G
City of Federal Way
COMBINED AFFIDAVIT AND CERTIFICATION FORM
Non -Collusion, Anti -Trust, Prevailing Wage (Non -Federal Aid),
Debarment, Eligibility, and Certification of Lawful Employment
NON -COLLUSION AFFIDAVIT
Being first duly sworn, deposes and says, that he/she is the identical person who submitted the
foregoing proposal or bid, and that such bid is genuine and not sham or collusive or made in the
interest or on behalf of any person not therein named, and further, that the deponent has not
directly induced or solicited any other Bidder on the foregoing work equipment to put in a sham
bid, or any other person or corporation to refrain from bidding, and that deponent has not in any
manner sought by collusion to secure to himself/herself or to any other person any advantage over
other Bidder or Bidders; and
NOTICE TO ALL BIDDERS ON PROJECTS INVOLVING
THE U.S. DEPARTMENT OF TRANSPORTATION (USDOT)
To report bid rigging activities call: 1-800-424-9071
The U.S. Department of Transportation (USDOT) operates the above toll -free hotline Monday
through Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of possible bid
rigging, bidder collusion, or other fraudulent activities should use the hotline to report such
activities. The hotline is part of USDOT's continuing effort to identify and investigate highway
construction contract fraud and abuse and is operated under the direction of the USDOT Inspector
General. All information will be treated confidentially and caller anonymity will be respected; and
CERTIFICATION RE: ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER
Vendor and purchaser recognize that in actual economic practice, overcharges resulting from anti-
trust violations are, in fact, usually borne by the purchaser. Therefore, vendor hereby assigns to
purchaser any and all claims for such overcharges as to goods and materials purchased in
connection with this order or contract, except as to overcharges resulting from anti-trust violations
commencing after the date of the bid, quotation, or other event establishing the price under this
order or contract. In addition, vendor warrants and represents that each of his suppliers and
subcontractors shall assign any and all such claims to purchaser, subject to the aforementioned
exception; and
PREVAILING WAGE AFFADAVIT
I, the undersigned, having duly sworn, deposed say and certify that in connection with the
performance of the work of this project, will pay each classification of laborer, workperson, or
mechanic employed in the performance of such work, not less than the prevailing rate of wage or
not less than the minimum rate of wage as specified in the principal contract; that I have read the
above and forgoing statement and certificate, know the contents thereof and the substance as set
forth therein, is true to my knowledge and belief; and
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 28 2021
RFB ver. 9-18
DEBARMENT AFFIDAVIT
I certify that, except as noted below, the firm, association or corporation or any person in a
controlling capacity associated therewith or any position involving the administration of federal
funds, is not currently under suspension, debarment, voluntary exclusion, or determination of
ineligibility by any federal agency; has not been suspended, debarred, voluntarily excluded or
determined ineligible by any federal agency within the past three (3) years; does not have a
proposed debarment pending; and has not been indicted, convicted, or had a civil judgment
rendered against said person, firm, association or corporation by a court of competent jurisdiction
in any matter involving fraud or official misconduct within the past three (3) years.
AFFIDAVIT OF ELIGIBILITY
The Contractor certifies that it is properly licensed and registered under the laws of the State of
Washington and has not been determined to have been in violation of RCW 50.12.070(1)(b), RCW
51.16.070(1)(b), or RCW 82.32.070(2) within the last two years. The Contractor further certifies
that it has not been determined, within the last one year, to have committed any combination of
two of the following violations or infractions within a five-year period: (1) Violated RCW
51.48.020(1) or 51.48.103; or (2) Committed an infraction or violation under chapter 18.27 RCW.
CERTIFICATION OF LAWFUL EMPLOYMENT
The contractor hereby certifies that it has complied with all provisions of the Immigration and
Nationality Act, now or as herein after amended, 8 USC Section 1101 et. seq., and that all
employees, including subcontractor employees, are lawfully permitted to perform work in the
United States as provided in this agreement with the City of Federal Way.
FOR: Non -Collusion Affidavit, Assignment of Anti -Trust Claims to Purchaser, Prevailing Wage
Affidavit, Debarment Affidavit, Affidavit of Eligibility, and Certification of Lawful Employment.
Concrete Sidewalk Beveling — Trip Hazard Removal Project
Name of Bidder's Firm
Z&::� �_ e::��
Signature of Authorized Representative of Bidder
Subscribed and sworn to before me this qt�N day of v ii k 260.
�`tiasonc��,_ (printed/typed name of notary)
-'' Notary Public in and for the State of Washington
,n q My commission expires: I t I221-4D2A
�i o 'AL
per. ��np�p„asyt
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 29 2021
RFB ver. 9-18
Attachment H
CONTRACTOR'S COMPLIANCE STATEMENT
(President's Executive Order #11246)
Date:
This statement relates to a proposal contract with the City of Federal Way named
Concrete Sidewalk Beveling — Trip Hazard Removal Project
I am the undersigned bidder or prospective contractor. I represent that:
I [b have, ❑ have not, participated in a previous contract or subcontract subject to the President's
Executive Order #11246 (regarding equal employment opportunity) or a preceding similar
Executive Order.
��C'•Ci�51 do COnGre � L.�Gs ��i�c�
Name of Bidder
By: Ze4d Z;4/
ignature
Its, U
Title
317/
Address
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 30 2021
RFB ver. 9-18
Attachment I
Contractor Certification
Wage Law Compliance — Responsibility Criteria
FAILURE TO RETURN THIS CERTIFICATION AS PART OF THE BID PROPOSAL
PACKAGE WILL MAKE THIS BID NONRESPONSIVE AND INELIGIBLE FOR
AWARD.
I hereby certify, under penalty of perjury under the laws of the State of Washington, on
behalf of the firm identified below that, to the best of my knowledge and belief, this firm
has NOT been determined by a final and binding citation and notice of assessment issued
by the Washington State Department of Labor and industries or through a civil judgment
entered by a court of limited or general jurisdiction to have willfully violated, as defined in
RCW 49.48.082, any provision of Chapters 49.46, 49.48, and 49.52 RCW within three (3)
years prior to the date of the Request for Bids.
Bidder
C.C.rjdn ( -"' 7-I
Name of Contractor/Bidder — Print Full Legal Entity Name of Firm
.. _ BY: _ ZZ �d
Signahare of Authorized Person kr;nt Name of Person Making Certifications for Firm
Name:
Title: Vp Place: Pl 1 -�1a4z.(m,-16117
Title of Person Signing Certificate Print City artdjtate VV e; a Signed
Date: L/Z
Z
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 31 2021
RFB ver. 9-18
CITY of CITY HALL
Fe d le ra ! Wa 33325 Avenue South
� Federal
Way. WA 98003-6325
(253) 835-7000
www ciryoffederalway com
Attachment 1
PUBLIC WORKS MAINTENANCE AGREEMENT
FOR
Concrete Sidewalk Beveling — Trip Hazard Removal Project
This Public Works Maintenance Agreement ("Agreement") is made between the City of Federal Way, a
Washington municipal corporation ("City"), and Precision Concrete Cutting, Inc., , a Washington Foreign
Profit Corporation ("Contractor"). The City and Contractor (together "Parties") are located and do business at
the below addresses which shall be valid for any notice required under this Agreement:
PRECISION CONCRETE CUTTING, INC.:
Matt Haney, President
3191 N. Canyon Road
Provo, UT 84604
801.830.4060
WAAdmin(a,safesidewalks.com
The Parties agree as follows:
CITY OF FEDERAL WAY:
Desiree' S. Winkler, P.E.
Deputy Public Works Director
33325 8th Ave. S.
Federal Way, WA 98003-6325
253.835.2711
desiree.
.com
1. TERM. The term of this Agreement shall commence upon the effective date of this Agreement, which
shall be the date of mutual execution, and shall continue until the completion of the Work, but in any event no
later than December 31, 2022 ("Term"). This Agreement may be extended for additional periods of time upon
the mutual written agreement of the City and the Contractor.
2. WORK.
2.1 Work. The Contractor shall provide goods, materials or services and otherwise perform the work
more specifically described in Exhibit "A," attached hereto and incorporated by this reference ("Work"),
performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction
of the Mayor or his or her designee.
2.2 Warranties. The Contractor warrants that it has the requisite training, skill, and experience
necessary to provide the Work and is appropriately accredited and licensed by all applicable agencies and
governmental entities, including but not limited to obtaining a City of Federal Way business registration. The
Contractor warrants it will provide services in a manner consistent with the accepted practices for other similar
services within the Puget Sound region in effect at the time those services are performed. The Contractor
warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will
perform in accordance with their specifications and Contractor's representations to City. The Contractor shall,
at its sole cost and expense, correct all Work performed which the City deems to have defects in workmanship
and material discovered within one (1) year after the City's final acceptance of the Work. This Agreement is
subject to all warranty provisions established under the Uniform Commercial Code, Title 62A RCW. In the
event any part of the goods are repaired, only original replacement parts shall be used —rebuilt or used parts
will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for
one (1) year from the date such correction is completed and accepted by the City. The Contractor shall begin to
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 32 2021
RFB ver. 9-18
CITY of CITY HALL
At
Fe d e ra I M a 33325 8th Avenue South
�� Y Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederahvay com
correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the
Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City
may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish
the correction.
2.3 Time, Documentation and Inspection. Work shall begin immediately upon the effective date of
this Agreement. Work shall be subject, at all times, to observation and inspection by and with approval of the
City, but the making (or failure or delay in making) such inspection or approval shall not relieve Contractor of
responsibility for performance of the Work in accordance with this Contract, notwithstanding the City's
knowledge of defective or non -complying performance, its substantiality or the ease of its discovery.
2.4 Clean Up. At any time ordered by the City and immediately after completion of the Work, the
Contractor shall, at its own expense, clean up and remove all refuse and unused materials of any kind resulting
from the Work. In the event the Contractor fails to perform the necessary clean up, the City may, but in no event
is it obligated to, perform the necessary clean up and the costs thereof shall be immediately paid by the
Contractor to the City and/or the City may deduct its costs from any remaining payments due to the Contractor.
3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing
the other party thirty (30) days' written notice at its address set forth on the signature block of this Agreement.
The City may terminate this Agreement immediately if the Contractor fails to maintain required insurance
policies, breaches confidentiality, or materially violates Section 12 and may result in ineligibility for further
City agreements.
4. COMPENSATION.
4.1 Amount. In return for the Work, the City shall pay the Contractor an amount not to exceed a
maximum amount and according to a rate or method as delineated in Exhibit `B," attached hereto and
incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services
contracted for herein shall remain locked at the negotiated rate(s) for the Term. Except as otherwise provided in
Exhibit `B," the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful
jurisdiction as a result of the performance and payment of this Agreement.
4.2 Method of Payment. On a monthly basis, the Contractor shall submit a voucher or invoice in the
form specified by the City, including a description of what Work have been performed, the name of the
personnel performing such Work, and any hourly labor charge rate for such personnel. The Contractor shall also
submit a final bill upon completion of all Work. Payment shall be made on a monthly basis by the City only
after the Work has been performed and within thirty (30) days after receipt and approval by the appropriate City
representative of the voucher or invoice. If the Work does not meet the requirements of this Agreement, the
Contractor will correct or modify the work to comply with the Agreement. The City may withhold payment for
such work until the work meets the requirements of the Agreement.
4.3 Defective or Unauthorized Work. If any goods, materials, or services provided under this
Agreement are either defective, unauthorized, or otherwise do not meet the requirements of this Agreement, the
Contractor will correct or modify the work to comply with the Agreement and the City reserves the right to
withhold payment from the Contractor until the goods, materials, or services are acceptable to the City. If
Contractor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods,
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling— Trip Hazard Removal Page 33 2021
RFB ver. 9-18
CITY OF CITY HALL
IftFe d e ra I Wa 33325 Avenue South
�� Federall Way. WA 98003-6325
(253) 835-7000
�vww cityoffederalway corn
materials or services from other sources, and Contractor shall be liable to the City for any additional costs
incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees,
incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right
to deduct these additional costs incurred to complete this Agreement with other sources, from any and all
amounts due or to become due the Contractor.
4.4 Non -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment
under this Agreement for any future fiscal period, the City will not be obligated to make payments for Work or
amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the
completion of all remaining Work for which funds are allocated. No penalty or expense shall accrue to the City
in the event this provision applies.
4.5 Final Payment: Waiver of Claims. Contractor's acceptance of final payment shall constitute a
waiver of any and all claims, except those previously and properly made and identified by Contractor as
unsettled at the time request for final payment is made.
4.6 Bond. Pursuant to RCW 39.08 and RCW 60.28, Contractor shall post a bond in favor of the City,
in the form attached to this Agreement as Exhibit "C" and incorporated by this reference, in a dollar amount
satisfactory to the City; to guarantee Contractor's performance of the Work to the City's satisfaction; to insure
Contractor's performance of all of the provisions of this Contract; to insure payment of Contractor's state sales
tax; and to guarantee Contractor's payment of all laborers, mechanics, subcontractors and material persons.
Contractor's obligations under this Agreement shall not be limited to the dollar amount of the bond. The bond
shall not be released until the City has received all applicable documentation from the state and all outstanding
claims filed pursuant to RCW 39.08 and RCW 60.28 have been resolved.
5. INDEMNIFICATION.
5.1 Contractor Indemnification. The Contractor agrees to release indemnify, defend, and hold the
City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers
harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations,
proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses,
attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including, without
limitation, their respective agents, licensees, or representatives, arising from, resulting from, or in connection
with this Agreement or the performance of this Agreement, except for that portion of the claims caused by the
City's sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to
RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to
property caused by or resulting from the concurrent negligence of the Contractor and the City, the Contractor's
liability hereunder shall be only to the extent of the Contractor's negligence. Contractor shall ensure that each
sub -contractor shall agree to defend and indemnify the City, its elected officials, officers, employees, agents,
representatives, insurers, attorneys, and volunteers to the extent and on the same terms and conditions as the
Contractor pursuant to this paragraph. The City's inspection or acceptance of any of Contractor's work when
completed shall not be grounds to avoid any of these covenants of indemnification.
5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Contractor
waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51
RCW, solely for the purposes of this indemnification. Contractor's indemnification shall not be limited in any
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CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederahyay corn
way by any limitation on the amount of damages, compensation or benefits payable to or by any third party
under workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties
further acknowledge that they have mutually negotiated this waiver.
5.3 City indemnification. The City agrees to release, indemnify, defend and hold the Contractor, its
officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors harmless
from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings,
judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs,
and/or litigation expenses to or by any and all persons or entities, including without limitation, their respective
agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent
solely caused by the negligent acts, errors, or omissions of the City.
5.4 Survival. The provisions of this Section shall survive the expiration or termination of this
Agreement with respect to any event occurring prior to such expiration or termination.
6. INSURANCE. The Contractor agrees to carry insurance for liability which may arise from or in
connection with the performance of the services or work by the Contractor, their agents, representatives,
employees or subcontractors for the duration of the Agreement and thereafter with respect to any event
occurring prior to such expiration or termination as follows:
6.1. Minimum Limits. The Contractor agrees to carry as a minimum, the following insurance, in such
forms and with such carriers who have a rating that is satisfactory to the City:
a. Commercial general liability insurance covering liability arising from premises,
operations, independent contractors, products -completed operations, stop gap liability, personal injury, bodily
injury, death, property damage, products liability, advertising injury, and liability assumed under an insured
contract with limits no less than $1,000,000 for each occurrence and $2,000,000 general aggregate.
b. Workers' compensation and employer's liability insurance in amounts sufficient pursuant
to the laws of the State of Washington;
C. Automobile liability insurance covering all owned, non -owned, hired and leased vehicles
with a minimum combined single limits in the minimum amounts required to drive under Washington State law
per accident for bodily injury, including personal injury or death, and property damage.
6.2. No Limit of Liabilfty. Contractor's maintenance of insurance as required by the agreement shall
not be construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise
limit the City's recourse to any remedy available at law or in equity. The Contractor's insurance coverage shall
be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained
by the City shall be excess of the Contractor's insurance and shall not contribute with it.
6.3. Additional Insured Verification. The City shall be named as additional insured on all
commercial general liability insurance policies. Concurrent with the execution of this Agreement, Contractor
shall provide certificates of insurance for all commercial general liability policies attached hereto as Exhibit
"D" and incorporated by this reference. At City's request, Contractor shall furnish the City with copies of all
insurance policies and with evidence of payment of premiums or fees of such policies. If Contractor's insurance
policies are "claims made," Contractor shall be required to maintain tail coverage for a minimum period of three
(3) years from the date this Agreement is actually terminated or upon project completion and acceptance by the
City.
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CITY OF CITY HALL
Federal Wa F3325 8th Avenue South
�� Federal Way. WA 98003-6325
(253) 835-7000
www cityoffederalway com
6.4 Survival. The provisions of this Section shall survive the expiration or termination of this
Agreement.
7. CONFIDENTIALITY. All information regarding the City obtained by Contractor in performance of
this Agreement shall be considered confidential subject to applicable laws. Breach of confidentiality by the
Contractor may be grounds for immediate termination. The Contractor will fully cooperate with the City in
identifying and assembling records in case of any public disclosure request.
8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts,
designs, design specifications, records, files, computer disks, magnetic media or material which may be
produced or modified by Contractor while performing the Work shall belong to the City upon delivery. The
Contractor shall delivery all needed or contracted for work project upon demand. All records submitted by the
City to the Contractor will be safeguarded by the Contractor. Contractor shall make such data, documents, and
files available to the City upon the City's request. At the expiration or termination of this Agreement, all
originals and copies of any such work product remaining in the possession of Contractor shall be delivered to
the City.
9. BOOKS AND RECORDS. The Contractor agrees to maintain books, records, and documents which
sufficiently and properly reflect all direct and indirect costs related to the performance of the Work and
maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper
accounting of all funds paid pursuant to this Agreement. These records shall be subject, at all reasonable times,
to inspection, review or audit by the City, its authorized representative, the State Auditor, or other governmental
officials authorized by law to monitor this Agreement.
10. INDEPENDENT CONTRACTOR 1 EMPLOYEE CONDITIONS.
10.1 Independence. The Parties intend that the Contractor shall be an independent contractor and that
the Contractor has the ability to control and direct the performance and details of its work, the City being
interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to
pay Contractor sick leave, vacation pay or any other benefit of employment, nor to pay any social security,
income, or other tax which may arise as an incident of employment, except as specifically provided in Section
4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may
provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an
employment contract. If the Contractor is a sole proprietorship or if this Agreement is with an individual, the
Contractor agrees to notify the City and complete any required form if the Contractor retired under a State of
Washington retirement system and agrees to indemnify any losses the City may sustain through the Contractor's
failure to do so.
10.2 Safety. Contractor shall take all necessary precautions and shall be responsible for the safety of
its employees, agents, and subcontractors at the work site and in the performance of the contract work and shall
utilize all protection necessary for that purpose. Contractor shall comply with all applicable provisions of
federal, state and municipal safety and health laws and codes, including without limitation, all OSHA/WISHA
requirements, Safety and Health Standards for Construction Work (Chapter 296-155 WAC), General Safety and
Health Standards (Chapter 296-24 WAC), and General Occupational Health Standards (Chapter 296-62 WAC).
Contractor shall erect and properly maintain, at all times, all necessary guards, barricades, signals and other
safeguards at all unsafe places at or near the site for the protection of its employees and the public, safe
City of Federal Way RFB # 21-004
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CITY OF
00�1 Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253)835-7000
vvww ciryoflederalwaV com
passageways at all road crossings, crosswalks, street intersections, post danger signs warning against known or
unusual hazards and do all other things necessary to prevent accident or loss of any kind. Contractor shall
protect from damage all water, sewer, gas, steam or other pipes or conduits, and all hydrants and all other
property that is likely to become displaced or damaged by the performance of the Work. The Contractor shall, at
its own expense, secure and maintain a safe storage place for its materials and equipment and is solely
responsible for the same
10.3 Risk of Work. All work shall be done at Contractor's own risk, and Contractor shall be
responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with
the work. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether
such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this
Agreement to an employment contract. Even though Contractor is an independent contractor, the work must
meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory
completion
10.4 Prevailing Wages.
10.4.1 Wages of Employ. This Agreement is subject to the minimum wage requirements of
Chapter 39.12 of the Revised Code of Washington, as now existing or hereafter amended or
supplemented. In the payment of hourly wages and fringe benefits to be paid to any of Contractor's
laborers, workers and/or mechanics, Contractor shall not pay less than the "prevailing rate of wage" for
an hour's work in the same trade or occupation in the locality within the State of Washington where
such labor is performed, as determined by the Industrial Statistician of the Department of Labor and
Industries of the State of Washington, which current "prevailing rates of wage" are attached hereto as
Exhibit "E" and incorporated herein by this reference. Prevailing wages paid pursuant to this Agreement
shall be the prevailing wage rates that are in effect on the date when the bids, proposals, or quotes were
required to be submitted to the City.
10.4.2 Agreements Exceeding One Year. Pursuant to WAC 296-127-023, or hereafter amended,
the City agrees to pay any increase in the current prevailing wages if and when this Contract is extended
provided that the term of the Contract exceeds one year. The City further agrees to pay the current
prevailing wages at the time of additional yearly extensions, and the Contractor agrees to pay its
employees the increased prevailing wage.
10.4.3 Exemptions to Prevailing Wage. The prevailing wage requirements of Chapter 39.12
RCW, and as required in this Agreement do not apply to: Sole owners and their spouses; any partner
who owns at least 30% of a partnership; the President, Vice President and Treasurer of a corporation if
each one owns at least 30% of the corporation.
10.4.4 Reporting Requirements. Contractor shall comply with all reporting requirements of the
Department of Labor and Industries of the State of Washington. Upon the execution of this Agreement,
Contractor shall complete and file a Statement of Intent to Pay Prevailing Wages with the Department of
Labor and Industries. Upon completion of the Work, Contractor shall complete and file an Affidavit of
Wages Paid with the Department of Labor and Industries. Contractor shall deliver copies of both the
Statement of Intent to Pay Prevailing Wages and the Affidavit of Wages Paid, certified by the
Department of Labor and Industries, to the City.
City of Federal Way RFB # 21-004
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CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www dtyoffederalway com
10.4.5 Disputes. In the event any dispute arises as to what are the prevailing rates of wages for
work of a similar nature and such dispute cannot be resolved by the City and the Contractor, the matter
shall be referred for arbitration to the Director of the Department of Labor and Industries of the State of
Washington and the decision therein shall be final and conclusive and binding on all parties involved in
the dispute.
11. CONFLICT OF INTEREST. It is recognized that Contractor may or will be performing professional
services during the Term for other parties; however, such performance of other services shall not conflict with
or interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such conflicts of
interest in favor of the City. Contractor confirms that Contractor does not have a business interest or a close
family relationship with any City officer or employee who was, is, or will be involved in the Contractor's
selection, negotiation, drafting, signing, administration, or evaluating the Contractor's performance.
12. EQUAL OPPORTUMTV EMPLOYER. In all services, programs, activities, hiring, and employment
made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by
Contractor or its subcontractors of any level, or any of those entities' employees, agents, subcontractors, or
representatives against any person because of sex, age (except minimum age and retirement provisions), race,
color, religion, creed, national origin, marital status, or the presence of any disability, including sensory, mental
or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and
employment. This requirement shall apply, but not be limited to the following: employment, advertising, layoff
or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship.
Contractor shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil
Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49
CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non-
discrimination. Any material violation of this provision shall be grounds for termination of this Contract by the
City and, in the case of the Contractor's breach, may result in ineligibility for further City agreements. If this
project involves federal funds including USDOT funds administered by WSDOT, the contractor agrees to the
clauses contained in Exhibit F.
13. GENERAL PROVISIONS.
13.1 Inte retation and Modification. This Agreement, together with any attached Exhibits, contains
all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no
prior statements or agreements, whether oral or written, shall be effective for any purpose. Should any language
in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement
shall prevail. The respective captions of the Sections of this Agreement are inserted for convenience of
reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement.
Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal shall in no way
affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect.
Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of
the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed
under the Agreement. No provision of this Agreement, including this provision, may be amended, waived, or
modified except by written agreement signed by duly authorized representatives of the Parties.
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CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www crryoffederalway.com
13.2 Assignment and Beneficiaries. Neither the Contractor nor the City shall have the right to transfer
or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent
of the other Party. If the non -assigning party gives its consent to any assignment, the terms of this Agreement
shall continue in full force and effect and no further assignment shall be made without additional written
consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be
binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into
for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action
or interest in this Agreement based on any provision set forth herein.
13.3 Compliance with Laws. The Contractor shall comply with and perform the Services in
accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes,
ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended,
adopted, or made effective. If a violation of the City's Ethics Resolution No. 91-54, as amended, occurs as a
result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the
City's option.
13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in
which performance is a factor. Adherence to completion dates set forth in the description of the Services is
essential to the Contractor's performance of this Agreement. Any notices required to be given by the Parties
shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered
personally to the addressee of the notice or may be deposited in the United States mail, postage prepaid, to the
address set forth above. Any notice so posted in the United States mail shall be deemed received three (3) days
after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be
exclusive, but shall be cumulative with all other remedies available to the City at law, in equity or by statute.
The failure of the City to insist upon strict performance of any of the covenants and agreements contained in
this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be
construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and
remain in full force and effect. Failure or delay of the City to declare any breach or default immediately upon
occurrence shall not waive such breach or default. Failure of the City to declare one breach or default does not
act as a waiver of the City's right to declare another breach or default. This Agreement shall be made in,
governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to
settle any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that
dispute, difference, or claim, shall be by filing suit under the venue, rules and jurisdiction of the King County
Superior Court, King County, Washington, unless the parties agree in writing to an alternative process. If the
King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other
appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and
federal courts in King County, Washington and waives any objection that such courts are an inconvenient
forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal
costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all
appeals, in addition to any other recovery or award provided by law; provided, however, however nothing in
this paragraph shall be construed to limit the Parties' rights to indemnification under Section 5 of this
Agreement.
13.5 Execution. Each individual executing this Agreement on behalf of the City and Contractor
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with
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CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way. WA 98003-6325
(253) 835-7000
www ciryoffederalway com
the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed
together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce
one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled
together to form a single instrument comprised of all pages of this Agreement and a complete set of all
signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a
counterpart of this Agreement shall be the "date of mutual execution" hereof.
[Signature page follows]
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CITY OF CITY HALL
Federal Wa 8th Avenue South
� Feder Federal Way, WA 98003-6325
(253) 835-7000
www. cihroflederoAaoy- com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
By: AFerr
, Mayor
DATE: 7 -.D'I
PRECISION CONCRETE CUTTING, INC.:
By:S
Printed Name:
Title:
DATE:
STATE OF WASHINGTON )
ss.
COUNTY OF 1 C }
ATTEST:
[/*Aw&&Aq6 -
kwfihWnie Courtney, CMC, City le
APPROVED AS TO FORM:
�_Ow
J. Ryan Call, City Attorney
/� Onthis day personally appeared before me Co f" E1( c Yi . to me known to be the
&St S V- Mwr, of l i tCO uffiviC that executed the foregoing
instrument, and acknow%dged the said instrument to be the free and volu ary act and deed of said corporation,
for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said
instrument and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this O` day of SUY1f, 202i
Notary's signature
�evy G;f' ,6 ...,. Notary's printed name —t l
:. •;,yeian�� Notary Public in and for the �State of Washington.
��. r�OixR� .��•; My commission expires
�g PUBLIC
City of Fete RFB # 21-004
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CITY 4F CITY HALL
Federal 1Na Feder l Avenue South
Federal Way, WA 98003-6325
�� (253) 835-7000
mvw crlyoffederahvay corn
EXHIBIT "A"
SERVICES
1. The Contractor shall do or provide the following:
1) Precision Concrete Cutting, Inc. ("Contractor") shall provide on -call concrete beveling — trip hazard
repair services ("Services") as requested by the City of Federal Way ("City"). The Services may be requested
in various project locations throughout the City. Upon identification of a project by the City, the City and
Contractor will negotiate scope and schedule for the specific project which will be included in a Task Order. A
Task Order is work defined on a Task Order form. The "Task Order form is attached as "Exhibit A-1." The
Task Order will also include the budget based on estimated quantities and associated unit prices shown in
Exhibit `B." The City is not obligated to assign any specific number of tasks to the Contractor and the City and
Contractor's obligations hereunder are limited to the tasks assigned in written Task Orders.
City of Federal Way RFB # 21-004
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CIT
Federal Way
EXHIBIT A.1
TASK ORDER FORM
CITY HALL
33325 8th Avenue South
Federal Way. WA 98003-6325
(253) 835-7000
wwwWyoffederalway com
TASK ORDER No.
Date:
Contract Name: Contract Number:
Description of work:
Estimated Costs:
Original Contract Total Task Costs To This Task Order Contract Remaining
Value: Date: Estimate Cost:
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CITY of CITY HALL
ANINFederal Wa 33325 Avenue South
�/ Federall Way, WA 98003-6325
(253) 835-7000
www crlyoffederalway com
EXHIBIT "B"
COMPENSATION
1. Total Compensation: In return for the Services, the City shall pay the Contractor a total amount not to
exceed One Hundred Thousand and 00/100 Dollars ($100,000.00)
2. Method of Compensation:
Unit Price Plus Sale Tax.
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount,
calculated on the basis of the unit bid prices as shown on attached bid form plus sales tax.
Reimbursable Expenses.
The actual customary and incidental expenses incurred by Contractor in performing the Services including
traffic control and other reasonable costs; provided, however, that such costs shall be deemed reasonable in the
City's sole discretion and shall not exceed Five Thousand and 00/100 Dollars ($5,000.00).
City of Federal Way RFB # 21-004
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CITY OF CITY HALL
Fed a ra I Wa 33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www atyoffederalway com
Contractor, Per RCW 39.08.010, EXHIBIT "C"
requests city to retain 10% vs.
providing a bond CITY OF FEDERAL WAY
PERFORMANCE/PAYMENT/RETAINAGE BOND
KNOW ALL PEOPLE BY THESE PRESENTS:
We, the undersigned , ("Principal") and
, the undersigned corporation organized and existing under the laws of the State of
and legally doing business in the State of Washington as a surety ("Surety"), are held and firmly
bonded unto the City of Federal Way, a Washington municipal corporation ("City") in the penal sum of
Dollars and no/100 ($ ) for the payment of which we firmly bind ourselves
and our legal representatives, heirs, successors and assigns, jointly and severally.
This obligation is entered into pursuant to the statutes of the State of Washington and the ordinances,
regulations, standards and policies of the City, as now existing or hereafter amended or adopted.
The Principal has entered into an Agreement with the City dated , 20 for
NOW, THEREFORE, if the Principal shall perform all the provisions of the Agreement in the manner and
within the time period prescribed by the City, or within such extensions of time as may be granted under the
Agreement, and shall pay all laborers, mechanics, subcontractors and material men or women, and all persons
who shall supply the Principal or subcontractors with provisions and supplies for the carrying on of said work,
and shall pay all applicable state sales tax, and shall hold the City, its officials, agents, employees and
volunteers harmless from any loss or damage occasioned to any person or property by reason of any
carelessness or negligence on the part of the Principal, or any subcontractor in the performance of said work,
and shall indemnify and hold the City harmless from any damage or expense by reason of failure of
performance as specified in the Agreement within a period of one (1) year after its final acceptance thereof by
the City, then and in the event this obligation shall be void; but otherwise, it shall be and remain in full force
and effect.
And the Surety, for value received, hereby further stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the Agreement or to the work to be performed thereunder or the
specifications accompanying the same shall in any way affect its obligation on this bond, and it does hereby
waive notice of any change, extension of time, alterations or additions to the terms of the Agreement or to the
Work.
The Surety hereby agrees that modifications and changes may be made in terms and provisions of the
Agreement without notice to Surety, and any such modifications or changes increasing the total amount to be
paid the Principal shall automatically increase the obligation of the Surety on this Performance Bond in a like
amount, such increase, however, not to exceed twenty-five percent (25%) of the original amount of this bond
without the consent of the Surety.
Within forty-five (45) days of receiving notice that the Principal has defaulted on all or part of the terms of the
Agreement, the Surety shall make a written commitment to the City that it will either: (a) cure the default itself
within a reasonable time period, or (b) tender to the city, the amount necessary for the City to remedy the
City of Federal Way RFB # 21-004
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CITY OF
�AIN. Federal Way
CITY HALL
33325 Sth Avenue South
Federal Way. WA 98003-6325
(253) 835-7000
www cllyoffederalwey com
default, including legal fees incurred by the City, or (c) in the event that Surety's evaluation of the dispute is not
complete or in the event the Surety disputes the City's claim of default, the Surety shall notify the City of its
finding and its intent, if any, to interplead. The Surety shall then fulfill its obligations under this bond, according
to the option it has elected. Should Surety elect option (a) to cure the default, the penal sum of the Bond shall be
reduced in an amount equal to the costs actually incurred by the Surety in curing the default. If the Surety elects
option (b), then upon completion of the necessary work, the City shall notify the Surety of its actual costs. The
City shall return, without interest, any overpayment made by the Surety and the Surety shall pay to the City any
actual costs which exceed the City estimate, limited to the bond amount. Should the Surety elect option (c), the
Parties shall first complete participation in mediation, described in the below paragraph, prior to any interplead
action.
In the event a dispute should arise between the Parties to this Bond with respect to the City's declaration of
default by the Principal, the Parties agree to participate in at least four hours of mediation to resolve said
dispute. The Parties shall- proportionately share in the cost of the mediation. The mediation shall be
administered by Judicial Dispute Resolution, LLC, 1425 Fourth Avenue, Suite 300, Seattle, Washington 98101.
The Surety shall not interplead prior to completion of the mediation.
DATED this day of .20
CORPORATE SEAL OF PRINCIPAL:
M.
Its:
PRINCIPAL
(Name of Person Executing Bond)
(Title)
(Address)
(Phone)
CERTIFICATE AS TO CORPORATE SEAL
I hereby certify that I am the (Assistant) Secretary of the Corporation named as Principal in the within
bond; that , who signed the said bond on behalf of the Principal, was
of the said Corporation; that I know his or her signature thereto is genuine, and that said bond was duly
signed, sealed, and attested for and in behalf of said Corporation by authority of its governing body.
Secretary or Assistant Secretary
City of Federal Way RFB # 21-004
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4W Federal
CITY 01;
CITY HALL
Way 33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www citWffederatway com
CORPORATE SEAL OF SURETY:
APPROVED AS TO FORM:
J. Ryan Call, City Attorney
SURETY
By:
Attorney -in -Fact
(Attach Power of Attorney)
(Name of Person Executing Bond)
(Address)
(Phone)
City of Federal Way RFB # 21-004
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CITY OF
AN*. Federal Way
City of Federal Way
Concrete Sidewalk Beveling — Trip Hazard Removal
EXHIBIT `°D"
Certificate of Insurance
Page 48
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoifederahvay. com
RFB # 21-004
2021
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PRECCON-31 VEGGLESTC
ACORD" DATE (MM/DD1Y YY)
CERTIFICATE OF LIABILITY INSURANCE 6/9/2021
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 CONTACT Jason Gardner
_NAME'
InfiniTeam Insurance PHONE 80i 748-2825 FAx
39 West 9000 S (Arc, No, Exty: ( ) {qfC, Noj:
Sandy, UT 84070o'ss 'aeon arihrokers.com
INSURE S AFFORDING COVERAGE I NAIC #
INSURERA:The Phoenix Insurance Company 25623
INSURED INSURER e : Travelers Property Casualty Com any of America 26674
Precision Concrete Cutting, Inc INSURER C :The Travelers Indemnity Company of Connecticut 126682
Matthew Haney �14167
3191 N. Canyon Rd. INSURER D: GuideOne National Insurance Company
Provo, UT 84604 INSURER E'
INSURER F :
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 CONTRACTOR 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.
ISR TYPE OF INSURANCE ADDL SUBR I POLICY 9FF POLICY EXP
7 �' N WV POLICY NUMBER ry MID LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'0
DAMAGE TO. RENTED.. 300,0
CLAIMS -MADE 0 ocCUR X 1co-9K038046 5/21/2021 5/21/2022 �„ $
PE.90NAL& ADV INJURY
$ 1,000,00
CAE„N'LAGGREGATELIMIT APPLIES PER:
POLICY �I JECT LOC
OTHER:
GENERALAGGREGATE
$ 2'000'00
PRODUCTS-COMP/OPAGG
$ 2,000,00
$
B
AUTOMOBILE LIABILITY
X ANY AUTO _
OWNED I SCHEDULED
AUTOS ONLY -AUTOS
AUTOS ONLY — AUOTO ONLY
IB1001_025921 5/21/2021 5/21/2022
DD eI.B�IItlEeDS[NGLE�LIMIT
$ 1,000,00
BODILY INJURY EerggMon
$
BODILY INJURY IIN]N''JJfURY Per accident)
$
d �""n1 MADE
$
$
B
UMBRELLA LIAB
EXCESS LIAB
X ,_ OCCUR
CLAIMS -MADE
�CUP91<050059
5/21/2021 5/21/2022
EACH OCCURRENCE
I $ 3,000,00
X
AGGREGATE
I $ 3,000,00
DED X RETENTION $ 10,000
,Aggregate
S 3,000,00
C
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
FFICER/MEMBEREXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF -OPERATIONS below
NIA
X I PER OTH-
UB8K743862 5/21/2021 5/21/2022
E.LEACHACCIDEN7
__E.L DISEASE -EA EMPLOYEE
! El Dl EASE -POLICY LIMIT
1,000,0C
$
1,000,00
$
1,000,0C
$
D Pollution Liability IENV662004364-00 2/22/2021 2/22/2022 OCC $1,000,000 / AGG 2,000,OC
A Property IC101-91<038046 5/21/2021 5/21/2022 Deductible 1,0C
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required)
Re: 2021/2022 Contract
City of Federal Way is Blanket general liability additional insured on ongoing and completed operations form CGD246 applies. Coverage subject to terms and
conditions of policy. Forms attached.
City of Federal Way
33325 8th Ave S
Federal Way, WA 98003
ACORD 25 (2016/03)
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
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(includes Products -Completed Operations If Required By Contract)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:
Any person or organization that you agree in a
written contract or agreement to include as an
additional insured an this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury' caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury' or "property damage"
caused by ')pur work" and included in the
"products -completed operations hazard'
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
b. The insurance provided to such additional (2) If a claim is made or "suit' is brought against
insured does not apply to: the additional insured:
CG D2 46 0419 0 2018 The Travelers indemnity Company. All rights reserved. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit' and the date received; and
(b) Notify us as soon as practicable and see
to It that we receive written notice of the
claim or "suit' as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
Insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
Insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
Page 2 of 2 0 2018 The Travelers Indemnity Company. Ali rights reserved. CG D2 46 04 19
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modfies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
irgury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general
coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to
determine rights, duties, and what is and is not covered.
A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations
PROVISIONS
A. WHO IS AN INSURED — UNNAMED
SUBSIDIARIES
The following is added to SECTION 11— WHO IS
AN INSURED:
Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sale owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.
No such subsidiary is an insured for "bodily injury'
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.
For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as:
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability —Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govern Its structure.
B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR
AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION 11— WHO IS
AN INSURED:
Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily
injury", "property damage" or "personal and
advertising injury" arising out of such operations.
The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury', "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity, or
b. Any "bodily injury' or "property damage"
included in the "products -completed
operations hazard".
CG D316 0219 0 2017 The Travelers Indermity Company. All rights reserved. Page 1 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE
1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
b. An act or omission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.
2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION II — WHO IS
AN INSURED:
Unless you are in the business or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.
3. The following replaces the last sentence of
Paragraph 5. of SECTION III — LIMITS OF
INSURANCE:
For the purposes of determining the
applicable Each Occurrence Limit, all related
ads or omissions committed in providing or
failing to provide "incidental medical
services", first old or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".
pharmaceuticals committed by, or with the
knowledge or consent of, the insured.
5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other bass, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.
D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
4. The following exclusion is added to subsequent to the execution of the contract or
Paragraph 2., Exclusions, of SECTION 1 — agreement.
COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY — RAILROADS
INJURY AND PROPERTY DAMAGE
LIABILITY: 1. The following replaces Paragraph c. of the
Sale Of Pharmaceuticals definition of "insured contract" in the
"Bodily injury' or "property damage" arising DEFINITIONS Section:
out of the violation of a penal statute or C. Any easement or license agreement;
ordinance relating to the sale of
Page 2 of 3 G 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19
Includes copyrighted material of Insurance services Office, Inc., with its permission.
2. Paragraph Q1) of the definition of "insured
contract" in the DEFINITIONS Section is
deleted.
F. DAMAGE TO PREMISES RENTED TO YOU
The following replaces the definition of "premises
damage" in the DEFINITIONS Section:
"Premises damage" means "property damage" to:
COMMERCIAL GENERAL LIABILITY
a. Any premises while rented to you or
temporarily occupied by you with permission
of the owner; or
b. The contents of any premises while such
premises is rented to you, if you rent such
premises for a period of seven or fewer
consecutive days. ' '
CG D316 0219 0 2017 The Travelers Indemnity Company. AN rights reserved. Page 3 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: 4T-CO-9K038046-PBX-19
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 05-23-19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
DESIGNATED PROJECT(S)
GENERAL AGGREGATE LIMIT
This endorsement modes insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Project(s):
EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN
A WRITTEN CONTRACT WHICH IS IN EFFECT DURING
THIS POLICY PERIOD, TO PROVIDE A SEPARATE
GENERAL AGGREGATE LINITI PROVIDED THAT, THE
CONTRACT IS SIGNED BY YOU
BEFORE THE "BODILY INJURY" OR "PROPERTY
DAMAGE' OCCURS.
A. For a8 sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION Q, and
for all medical expenses caused by accidents un-
der COVERAGE C (SECTION 1), which can be
attributed only to operations at a single desig-
nated "project" shown in the Schedule above:
1. A separate Designated Project General Ag-
gregate Limit applies to each designated "pro-
ject", and that limit is equal to the amount of
the General Aggregate Limit shown in the
Declarations, unless separate Designated
Project General Aggregate(s) are sched-
uled above.
2. The Designated 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 "prop-
erty damage" included in the "products -
completed operations hazard", and for medi-
cal expenses under COVERAGE C, regard-
less of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
C. Persons or organizations malting claims
or bringing "suits".
Designated Project
General Aggregate(s):
GENERAL AGGREGATE
LIMIT SHOWN ON THE
DECLARATIONS.
3. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the Desig-
nated Project General Aggregate Limit for
that designated "project". Such payments
shall not reduce the General Aggregate Limit
shown in the Declarations nor shall they re-
duce any other Designated Project General
Aggregate Limit for any other designated
"project" shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented
To You and Medical Expense continue to
apply. However, instead of being subject to
the General Aggregate Limit shown in the
Declarations, such limits will be subject to the
applicable Designated Project General Ag-
gregate Limit
B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION Q, and
for all medical expenses caused by accidents un-
der COVERAGE C. (SECTION Q, which cannot
be attributed only to operations at a single desig-
nated "project" shown in the Schedule above:
CG D2 1101 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2
COMMERCIAL GENERAL LIABILITY
1. Any payments made under COVERAGE A. vided, any payments for damages because of
for damages or under COVERAGE C. for "bodily injury" or "property damage" included in
medical expenses shall reduce the amount the "products -completed operations hazard" will
available under the General Aggregate Limit reduce the Products -Completed Operations Ag-
or the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre-
gregate Limit, whichever is applicable; and gate Limit nor the Designated Project General
2. Such payments shall not reduce any Desig- Aggregate Limit
nated Project General Aggregate Limit ':: E. For the purposes of this endorsement the Defini-
C. Part 2. of SECTION III — LIMITS OF INSURANCE tions Section is amended by the addition of the
is deleted and replaced by the following: following definition:
2. The General Aggregate Limit is the most we
will pay for the sum of:
a. Damages under Coverage B; and
b. Damages from "occurrences" under
COVERAGE A (SECTION 1) and for all
medical expenses caused by accidents
under COVERAGE C (SECTION 9 which
cannot be attributed only to operations at
a single designated "project" shown in the
SCHEDULE above.
D. When coverage for liability arising out of the
"products -completed operations hazard" is pro -
"Project" means an area away from premises
owned by or rented to you at which you are per-
forming operations pursuant to a contract or
agreement. For the purposes of determining the
applicable aggregate limit of insurance, each
"project" that includes premises involving the
same or connecting lots, or premises whose con-
nection is interrupted only by a street, roadway,
waterway or right-of-way of a railroad shall be
considered a single "project".
F. The provisions of SECTION 1111 — LIMITS OF
INSURANCE not otherwise modified by this en-
dorsement shall continue to apply as stipulated.
Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS —INCREASED
LIMITS
F. HIRED AUTO — UMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION 11— COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
1. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II — COW
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.
2. The following replaces Paragraph b. in B.S.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "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
an "employee's" name, with your
CA T3 S3 021S C 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
permission, while performing duties
(a) With respect to any claim made or "suit"
related to the conduct of your busi-
brought outside the United States of
ness.
America, the territories and possessions
„
However, any auto that is leased, hired,
of the United States of America, Puerto
rented or borrowed with a driver is not a
Rico and Canada:
covered "auto".
(i) You must arrange to defend the "in-
D. EMPLOYEES AS INSURED
sured" against, and investigate or set-
tle any such claim or "suit" and keep
The following is added to Paragraph A.1., Who Is
us advised of all proceedings and ac-
An Insured, of SECTION II — COVERED AUTOS
tions.
LIABILITY COVERAGE:
(ii) Neither you nor any other involved
Any "employee" of yours is an "insured" while us-
"insured" will make any settlement
ing a covered "auto" you don't own, hire or borrow
without our consent.
in your business or your personal affairs.
(iii) may, at our discretion, participate
E. SUPPLEMENTARY PAYMENTS — INCREASED
in defending the "insured" against, or
in
LIMITS
in the settlement of, any claim or
1. The following replaces Paragraph A.2.a.(2),
"suit".
of SECTION II — COVERED AUTOS LIABIL-
(iv) We will reimburse the "insured" for
ITY COVERAGE:
sums that the "insured" legally must
(2) Up to $3,000 for cost of bail bonds (in-
pay as damages because of "bodily
cluding bonds for related traffic law viola-
injury" or "property damage" to which
tions) required because of an "accident"
this insurance applies, that the "in -
we cover. We do not have to furnish
sured" pays with our consent, but
these bonds.
only up to the limit described in Para-
2. The following replaces Paragraph A.2.a.(4),
graph C., Limits Of Insurance, of
SECTION 11 — COVERED AUTOS
of SECTION II — COVERED AUTOS LIABIL-
LIABILITY COVERAGE.
ITY COVERAGE:
(4) All reasonable expenses incurred by the
(v) We will reimburse the "insured" for
the reasonable expenses incurred
"insured" at our request, including actual
with our consent for your investiga-
loss of earnings up to $500 a day be-
tion of such claims and your defense
cause of time off from work.
of the "insured" against any such
F. HIRED AUTO — LIMITED WORLDWIDE COV-
"suit", but only up to and included
ERAGE — INDEMNITY BASIS
within the limit described in Para -
The following replaces Subparagraph (5) in Para-
graph C., Limits Of Insurance, of
graph B.7., Policy Period, Coverage Territory,
SECTION 11 — COVERED AUTOS
of SECTION IV — BUSINESS AUTO CONDI-
LIABILITY COVERAGE, and not in
TIONS:
addition to such limit. Our duty to
make such payments ends when we
(5) Anywhere in the world, except any country or
have used up the applicable limit of
jurisdiction while any trade sanction, ern-
insurance in payments for damages,
bargo, or similar regulation imposed by the
settlements or defense expenses.
United States of America applies to and pro-
hibits the transaction of business with or
(b) This insurance is excess over any valid
within such country or jurisdiction, for Cov-
and collectible other insurance available
ered Autos Liability Coverage for any covered
to the "insured" whether primary, excess,
"auto" that you lease, hire, rent or borrow
contingent or on any other basis.
without a driver for a period of 30 days or less
(c) This insurance is not a substitute for re -
and that is not an "auto" you lease, hire, rent
quired or compulsory insurance in any
or borrow from any of your "employees",
country outside the United States, its ter -
partners (if you are a partnership), members
ritories and possessions, Puerto Rico and
(if you are a limited liability company) or
Canada.
members of their households.
Page 2 of 4 0 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15
Includes copyrighted material of Insurance Services Office, Inc, with its permission.
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph AA.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1.500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
COMMERCIAL AUTO
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIONS:
Your duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident' or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against
age Extensions, of SECTION III — PHYSICAL Others To Us
DAMAGE COVERAGE: We waive any right of recovery we may have
Personal Property against any person or organization to the ex-
tent required of you by a written contract
We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident'
parel and other personal property which is: or "loss", provided that the "accident" or "loss"
(1) Owned by an "insured"; and arises out of operations contemplated by
CA T3 53 02 15 c 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
such contract. The waiver applies only to the The unintentional omission of, or unintentional
person or organization designated in such error in, any information given by you shall not
contract. prejudice your rights under this insurance. How-
N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col -
The fallowing is added to Paragraph B.2., Con- lect additional premium or exercise our right of
cealment, Misrepresentation, Or Fraud; - of cancellation or non -renewal.
SECTION IV — BUSINESS AUTO CONDITIONS:
Page 4 of 4 0 2015 The Travelers Indemnity Compa ny. All rights reserved. CA T3 53 02 15
Includes copyrighted material of insurance Services Office, Inc. with its permission.
TRAVFiLFRSWORKERS COMPENSATION
AND
ONE TOOTER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183 ENDORSEMENT WC 43 03 05 (00) - 001
POLICY NUMBER: UH-sx743862-18-26-G
UTAH WAIVER OF SUBROGATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A.of the
Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Our waiver of
rights does not release your employees' rights against third parties and does not release our authority as trustee
of claims against third parties.
Schedule
Designated Person:
Designated Organization:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS
WAIVER.
INCLUDING:
DATE OF ISSUE: 05-23-18 STASSIGN: PAGE 1 OF
TRAVELERS J� WORKERS COMPENSATION
AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 00 03 13 (00) - 001
POLICY NUMBER: vB-eR743862-18-26-0
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS
WAIVER.
DATE OF ISSUE: 05-23-18 ST ASSIGN: PAGE 1 OF
AMI
Taav�r�� WORKERS COMPENSATION
1'i i. R AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 99 03 76 ( A) - 001
POLICY NUMBER: UB-SR743862-18-26-G
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule.
The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre-
mium.
Schedule
Person or Organization Job Description
ANY PERSON OR ORGANIZATION FOR
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EBECUTED
PRIOR TO LOSS TO FURNISH THIS
WAIVER.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise
stated.
(The information below is required only when this endorsement is issued subsequent to preparation of
the policy.)
Endorsement Effective Polity No. Endorsement No.
Insured Premium
Insurance Company Countersigned by
DATE OF ISSUE: 05-23-18 ST ASSIGN: Page 1 of 1
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:
Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury' caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury' or "property damage"
caused by "your work" and included in the
"products -completed operations hazard'
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against
insured does not apply to: the additional insured:
CIS D2 46 0419 c 2018 The Travelers Indemnity Company. All rights reserved Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit' and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit' as soon as practicable.
(3) Irnmedlately send us copies of all legal
papers received in connection with the claim
or 'suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
O#w Insurance-, of Section IV — Commercial
General Liability Conditions.
Page 2 of 2 0 2018 The Travelers indemnity Comparry. All rights reserved. CG D2 4611418
CITY OF CITY HALL
Fe d e ra 1 Wa Feder l Avenue South
�� Federal Way, WA 98003-6325
(253) 835-7000
www.cityoffederahvay.com
EXHIBIT "E"
See Attached
Prevailing Wages
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 49 2021
RFB ver. 9-18
Exhibit E
Prevailing Wages
County
Trade
Job Classification
Wage
Holiday
Overtime
Notes
King
Flaggers
Journey Level
$44.40
7A
4V
8Y
King
King
Laborers
Air, Gas Or Electric Vibrating Screed
,Airtrac Drill Operator
$52.39
$54.01
7A
7A
4V
4V
BY
8Y
Laborers
King
Laborers
Ballast Regular Machine
$52.39
7A
4V
8Y
King
Laborers
Batch Weighman
$44.40
7A
4V
;By
King
(Laborers
Brick Pavers
$52.39
7A
4V
.BY
King
Laborers
Brush Cutter
$52.39 17A
4V 18Y
King,
Laborers
Brush Hog Feeder
$52.39 17A
4V
!BY
King
Laborers
Burner
$52.39
7A
4V
:BY
King
Laborers
Caisson Worker
$54.01
7A
4V
iBY
(King
(King
Laborers
Laborers
Carpenter Tender
Cement Dumper -paving
$52.39
7A
4V
4V
;BY
By
$53.35
7A
'King
Laborers
Cement Finisher Tender
$52.39
7A
4V
BY
King
Laborers
Change House Or Dry Shack
$52.39
7A 14V
BY
King
Laborers
Chipping Gun (30 Lbs. And Over)
$53.35 `7A
4V
BY
King
Laborers
Chipping Gun (Under 30 Lbs.)
$52.39
7A
4V
BY
King jLaborers
Choker Setter
$52.39
7A
4V
BY
King I
Laborers
Chuck Tender
$52.39
7A
4V
8Y
King
Laborers _
Laborers
Clary Power Spreader
Clean-up Laborer
_$S3.35
$52.39
7A
7A
4V
4V
8Y
King
8Y
King
Laborers
'Concrete Dumper/Chute Operator
$53.35
7A
14V
SY
King
Laborers ilconcrete
Form Stripper
$52.39
7A
4V
8Y
King
Laborers lConcrete
Placement Crew
$53.35
7A
4V
8Y
King
Laborers
Concrete Saw Operator/Core Driller
$53.35
7A
4V
BY
King
Laborers
Crusher Feeder
$44.40
7A
4V
BY
King
(Laborers
Curing Laborer
$52.39
7A
4V
8Y
King
Laborers
Demolition: Wrecking & Moving (Incl. Charred Material)
$52,39
7A
4V
8Y
king _
King
Laborers
Laborers
Ditch Digger
Diver
$52.39
7A
4V
4V
SY
8Y
$54.01
7A
King
Laborers
Drill Operator (Hydraulic, Diamond)
$53.35
7A
.4V
8Y
IKing
I Laborers
Dry Stack Walls
$52.39
7A
14V
8Y
IKing
Laborers
Dump Person
$52.39
7A
4V
BY
:King
Laborers
Epoxy Technician
$52.39
7A
4V
BY
King
Laborers
Erosion Control Worker
$52.39
7A
4V
8Y
King
Laborers
Faller & Bucker Chain Saw
$53.35
7A
4V
8Y
King
Laborers
Fine Graders
$52.39
7A
4V
8Y
King
Laborers
Firewatch
$44.40
7A
4V
8Y
King
Laborers
Form Setter
$52.39
7A
4V
8Y
King
Laborers
Gabian Basket Builders
$52.39
7A
4V
8Y
King
Laborers
General Laborer
$52.39
7A
14V
By
Kin
Laborers
Grade Checker & Transit Person
$54.01
7A
14V
:BY
King
Laborers
Grinders
$52.39
7A
4V
BY
King
Laborers
Grout Machine Tender
552.39
7A
4V
8Y
King
(Laborers
Groutmen (Pressure) Including Post Tension Beams
$53.35
7A
4V
;BY
King
Laborers
Laborers
'Guardrail Erector
Hazardous Waste Worker (Level A)
$52.39
$54.01
7A
4V
8Y
BY
King
7A
4V
King
Laborers
Hazardous Waste Worker (Level B)
$53.35
7A
4V
18Y
King
Laborers
Hazardous Waste Worker (Level C)
$52.39
7A
4V
'BY
IKing
Laborers
High Scaler
$54.01
7A
14V
;BY
King
Laborers
Jackhammer
$53.35
7A
4V
BY
King
Laborers
Laserbeam Operator
$53.35
7A
4V
;BY
King
Laborers
Maintenance Person
$52.39
7A
4V
BY
King
Laborers
Manhole Builder-Mudman
$53.35
'7A
4V
SY
King
Laborers
Material Yard Person
$52.39
'7A
4V
8Y
King
Laborers
Motorman -Dinky Locomotive
$53.35
'7A
4V
8Y
King
Laborers
Nozzleman (Concrete Pump, Green Cutter When Using Combination 0
$53.35
7A
14V
BY
King
Laborers
Pavement Breaker
$53.35
'7A
14V
SY
King
Laborers
Pilot Car
$44.40
7A
14V
BY
King
Laborers
Pipe Layer Lead
$54.01
'7A
14V
BY
King
Laborers
Pipe Layer/Tailor
$53.35
7A
14V
By
King
Laborers
Pipe Pot Tender
$53.35
7A
14V
BY
King
King
Laborers
Laborers
Pipe Reliner
Pipe Wrapper
$53.35
$53.35
7A
4V
8Y
7A
4V
By
King
'Laborers
Pot Tender
$52.39
7A
4V
8y
King.
Laborers
lPowderman
$54.01
7A
4V
8Y
King
Laborers
Powderman's Helper
552.39
7A
4V
8Y
Exhibit E
Prevailing Wages
County
Trade
Job Classification
Wage
Holiday
Overtime
Notes
King
Laborers
Power Jacks
$53,35
7A
4V
BY
King
Laborers
Railroad Spike Puller- Power
$53.35
7A
4V
8Y
King
King
Laborers
Raker -Asphalt
Re-timberman
$54.01
$54.01
7A
7A
4V _8Y
4V
Laborers
8Y
King
Laborers
Remote Equipment Operator
$53.35
7A
4V
8Y
King
Laborers
Rigger/Signal Person
$53.35
7A
4V
8Y
King
Laborers
Rip Rap Person
$52.39
7A
.4V
SY
King
Laborers
Rivet Buster
$53.35
7A
4V
SY
King
Laborers
Rodder
$53.35
7A
4V
BY
King
Laborers
Scaffold Erector
$52.39
7A
4V
8Y
King
Laborers
Scale Person
$52.39
7A
14V
8Y
King
King
Laborers
Laborers
Sloper (Over 20)"
Sloper Sprayer
$53.35
7A
4V
4V
8Y
SY
$52.39
7A
King
Laborers
Spreader (Concrete)
$53.35
7A
4V
8Y
King
Laborers
:Stake Hopper
$52.39
7A
4V
8Y
King
Laborers
Stock Filer
$52.39
17A
4V
8Y
King
Laborers
Swinging Stage/Boatswain Chair
$44.40
7A
4V
8Y
King
Laborers
'Tamper & Similar Electric, Air & Gas Operated Tools
$53.35
7A
14V
SY
King.
Laborers
'Tamper (Multiple & Self-propelled)
$53.35
7A
4V
BY
King
King
Laborers
Laborers
'Timber Person - Sewer (Lagger, Shorer & Cribber)
Toolroom Person (atJobsite)
$53.35
7A
7A
4V
4V
8Y
8Y
$52.39
King
Laborers
Topper
$52.39
7A
4V
8Y
King.
Laborers
Track Laborer
$52.39
7A
4V
BY
King
Laborers
Track Liner (Power)
$53.35
7A
4V
BY
King
Laborers
Traffic Control Laborer
$47.48
7A
4V
;9C
King
Laborers
Traffic Control Supervisor
$50.31
7A
4V
9C
King
Laborers
Truck Spotter
$52.39
7A
14V
8Y
King
Laborers
Tugger Operator
$53.35
7A
14V
BY
King
King
Laborers
Laborers
Tunnel Work -Compressed Air Worker 0-30 psi
Tunnel Work -Compressed Air Worker 30.01-44.00 psi
$129.67
7A
4V
!9B
19B
5134.70
7A
4V
King
Laborers
Tunnel Work -Compressed Air Worker44.01-54.00 psi
$138.38
7A
4V
96
King
Laborers
Tunnel Work -Compressed Air Worker 54.01-60.00 psi
$144.08
7A
4V
19B
King
Laborers
Tunnel Work -Compressed Air Worker 60.01-64.00 psi
$146.20
7A
4V
'9B
King
Laborers
Tunnel Work -Compressed Air Worker 64.01-68.00 psi
$151.30
7A
4V
19B
King
Laborers
Tunnel Work -Compressed Air Worker 68.01-70.00 psi
$153.20
7A
4V
'19B
King
Laborers
Tunnel Work -Compressed Air Worker 70.01-72.00 psi
$155.20
7A
4V
9B
King
Laborers
Tunnel Work -Compressed Air Worker 72.01-74.00 psi
$157.20
7A
4V
:9B
King
Laborers
Tunnel Work-Guage and Lock Tender
$54.11
7A
4V
BY
King
Laborers
Tunnel Work -Miner
$54.11
7A
14V
;BY
King
Laborers
Vibrator
$53.35
7A
14V
BY
King
(Laborers
'Vinyl Seamer
$52.39
7A
14V
;BY
King
Laborers
'Watchman
$40.36
7A
4V
BY
King
Laborers
'Welder
$53.35
7A
4V
BY
King
Laborers
'Well Point Laborer
553.35
7A
4V
BY
King
Laborers
Window Washer/Cleaner
$40.36
7A
4V
BY
King
King
Landscape Construction
Landscape Construction
Landscape Construction/Landscaping Or P.{art{{fig Laborers _
Landscape Operator
$40.36
$72.28
7A
7A
4V
3K
BY
8X
King
Landscape Maintenance
Groundskeeper
$17.87
1
King
Power Equipment Operators
Asphalt Plant Operators
$73,49
7A
3K
8X
King
Power Equipment Operators
.Assistant Engineer
$69,12
7A
3K
8X
King
Power Equipment Operators
Barrier Machine (zipper)
$72.84
7A
3K
18X
8X
King
Power Equipment Operators
Batch Plant Operator: concrete
$72.84
7A
3K
8X
(King
Power Equipment Operators
Bobcat
$69.12
7A
3K
8X
King
Power Equipment Operators
Brokk - Remote Demolition Equipment
$69.12
7A
3K
King
Power Equipment Operators
Brooms
$69.12
7A
3K
8X
King
Power Equipment Operators
Bump Cutter
$72.84
7A
3K
8X
King
Power Equipment Operators
Cableways
$73.49
7A
3K
8X
King
Power Equipment Operators
Chipper
$72.84
7A
3K
8X
King
Power Equipment Operators
Compressor
$69.12
7A
3K
8X
King
Power Equipment Operators
Concrete Finish Machine - Laser Screed
$69.12
7A
3K
8X
King
Power Equipment Operators
Concrete Pump - Mounted Or Trailer High Pressure Line Pump, Pump
$72.28
7A
3K
8X
King
Power Equipment Operators
Concrete Pump: Truck Mount With Boom Attachment Over 42 M
$73.49
7A
.3K
8X
King
King
(Power Equipment Operators
Power Equipment Operators
Concrete Pump: Truck Mount With Boom Attachment Up To 42m
Conveyors
$72.84
$72.28
7A
7A
13K
1.3K
8X
8X
King
Power Equipment Operators
Cranes friction: 200 tons and over
$75.72
7A
1.3K
8X
King
Power Equipment Operators
Cranes: 100 tons through 199 tons, or 150' of boom (includingjib with
$74.22
7A
13K
8X
King
I Power Equipment Operators
Cranes: 20 Tons Through 44 Tons With Attachments
1 $72.84
7A
1.3K
18X
Exhibit E
Prevailing Wages
County
Trade I
Job Classification
Wage
Holiday
Overtime
Notes
King
Power Equipment Operators
Cranes: 200 tons- 299 tons, or 250' of boom includingjib with attachtTli
$74.99
7A
3K
8X
King
Power Equipment Operators
Cranes: 300 tons and over or 300' of boom includingjib with attachme
$75.72
7A
3K
8X
King
Power Equipment Operators
Power Equipment Operators
Cranes: 45 Tons Through 99 Tons, Under 150' Of Boom (including Jib
Cranes: A -frame - 10 Tons And Under
$73.49
$69.12
7A
7A
3K
3K
8X
King
8X
King
Power Equipment Operators
Cranes: Friction cranes through 199 tons
$74.99
7A
3K
8X
King
Power Equipment Operators
Cranes: through 19 tons with attachments, A -frame over 10 tons
$72.28
7A 13K
8X
Kin
Power Equipment Operators
Crusher
$72.84
7A 13K
8X
King
Power Equipment Operators
Deck Engineer/Deck Winches_(power)
$72.84
7A
3K
8X
(King
Power Equipment Operators
Derricks, On Building Work
$73.49
7A
3K
8X
King
Power Equipment Operators
Dozers D-9 & Under
$72.28
7A
3K
8X
King
Power Equipment Operators
Drill Oilers: Auger Type, Truck Or Crane Mount
$72.28
7A
3K
8X
King
King
Power Equipment Operators
Drilling Machine
$74.22
'7A
3K
8X
8X
Power Equipment Operators
Elevator And Man -lift: Permanent And Shaft Type
$69.12
7A
3K
King
Power Equipment Operators
Finishing Machine, Bidwell And Gamaco & Similar Equipment
$72.84
7A
3K
8X
King
Power Equipment Operators
Forklift: 3000 Lbs And Over With Attachments
$72.28
7A
3K
8X
King
Power Equipment Operators
Forklifts: Under 3000 Lbs. With Attachments
$69.12
7A
3K
8X
King
Power Equipment Operators
Grade Engineer: Using Blue Prints, Cut Sheets, Etc
$72.84
'7A
3K
8X
King
Power Equipment Operators
Gradechecker/Stakeman
$69.12
7A
3K
8X
King
Power Equipment Operators
Guardrail Punch
$72.84
7A
3K
SX
King
King
Power Equipment Operators
Power Equipment Operators
Hard Tail End Dump Articulating Off- Road Equipment 45 Yards. & Ov
Hard Tail End Dump Articulating Off -road Equipment Under 45 Yards
$73.49
7A
3K
3K
8X
8X
$72.84
7A
King
Power Equipment Operators
Horizontal/Directional Drill Locator
$72.28
7A
.3K
8X
King
Power Equipment Operators
HorizontaVDirectional Drill Operator
I $72.84
7A
3K
8X
King
Power Equipment Operators
Hydralifts/Boom Trucks Over 10 Tons
$72.28
7A
3K
8X
King
Power Equipment Operators
Hydralifts/Boom Trucks, 10 Tons And Under
$69.12
7A
3K
8X
King
Power Equipment Operators
Loader, Overhead 8 Yards. & Over
$74.22
7A
3K
8X
King
Power Equipment Operators
Loader, Overhead, 6 Yards. But Not Including 8 Yards
$73.49
7A
3K
8X
King
Power Equipment Operators
Loaders, Overhead Under 6 Yards
$72.84
7A
3K
8X
King
King
Power Equipment Operators
Power Equipment Operators
Loaders, Plant Feed
Loaders: Elevating Type Belt
$72.84
7A
13K
8X
8X
$72.28
7A
3K
King
Power Equipment Operators
Locomotives, All
$72.84
7A
3K
8X
King
Power Equipment Operators
Material Transfer Device
$72.84
7A
3K
8X
King
Power Equipment Operators
Mechanics, All (leadmen - $0.50 Per Hour Over Mechanic)
$74.22
7A
3K
8X
KingPower
Equipment Operators
Motor Patrol Graders
$73.49
7A
3K
8X
King
Power Equipment Operators
Mucking Machine, Mole, Tunnel Drill, Boring, Road Header And/or Shi
$73.49
7A
3K
8X
King
Power Equipment Operators
Oil Distributors, Blower Distribution & Mulch Seeding Operator
$69.12
7A
3K
8X
King
Power Equipment Operators
Outside Hoists jElevators And Manlifts), Air Tuggers, Strato
$72.28
7A
3K
8X
King
Power Equipment Operators
Overhead, Bridge Type Crane: 20 Tons Through 44 Tons
$72.84
7A
3K
8X
King
Power Equipment Operators
Overhead, Bridge Type: 100 Tons And Over
$74.22
7A
13K
8X
King
Power Equipment Operators
Overhead, Bridge Type: 45 Tons Through 99 Tons
$73.49
7A
3K
8X
King
Power Equipment Operators
Pavement Breaker
$69.12
7A
3K
8X
King
Power Equipment Operators
Pile Driver (other Than Crane Mount)
$72.84
7A
3K
8X
King
Power Equipment Operators
Plant Oiler - Asphalt, Crusher
$72.28
7A
3K
8X
King
Power Equipment Operators
Posthole Digger, Mechanical
$69.12
7A
3K
8X
King
Power Equipment Operators
Power Plant
$69.12
7A
3K
8X
King
King
Power Equipment Operators
Power Equipment Operators
Pumps- Water
Quad 9, Hd 41, D10 And Over
$69.12
7A
7A
3K
3K
8X
8X
$73.49
King
Power Equipment Operators
Quick Tower- No Cab, Under 100 Feet In Height Based To Boom
$69.12
17A
3K
8X
King
Power Equipment Operators
Remote Control Operator On Rubber Tired Earth Moving Equipment
$73.49
7A
3K
8X
King
Power Equipment Operators
Ri er and Bellman
$69.12
7A
3K
IBX
King
Power Equipment Operators
Rigger/Signal Person, Bellman (Certified)
$72.28
7A
3K
iBX
King
Power Equipment Operators
Rolla on
$73.49
7A
3K
,BX
(King
Power Equipment Operators
Roller, Other Than Plant Mix
$69.12
7A
13K
8X
King
Power Equipment Operators
(Roller, Plant Mix Or Multi -lift Materials
$72.28
7A
13K
BX
King
Power Equipment Operators
Roto-mill, Roto-grinder
$72.84
7A
3K
,IBX
King
Power Equipment Operators
:Saws - Concrete
$72.28
7A
3K
IBX
King
Power Equipment Operators
:Scraper, Self Propelled Under 45 Yards
$72.84
7A
3K
IBX
King
Power Equipment Operators
Scrapers - Concrete & Carry All
$72.28
7A
3K
IBX
King
Power Equipment Operators
.Scrapers, Self-propelled: 45 Yards And Over
$73.49
7A
3K
IBX
King
Power Equipment Operators
Service Engineers - Equipment
$72.28
7A
3K
IBX
King
Power Equipment Operators
Shotcrete/Gunite Equipment
$69.12
7A
3K
8X
King
Power Equipment Operators
Shovel, Excavator, Backhoe, Tractors Under 15 Metric Tons
$72.28
7A
13K
IBX
King _
King
Power Equipment Operators
Shovel, Excavator, Backhoe: Over 30 Metric Tons To 50 Metric Tons
Shovel, Excavator,. Backhoes, Tractors: 15 To 30 Metric Tons
$73.49
$72.84
7A
3K
IBX
Power Equipment Operators
7A
3K
;8X
King
I Power Equipment Operators
Shovel, Excavator, Backhoes: Over 50 Metric Tons To 90 Metric Tons
$74.22
7A
3K
In
King
I Power Equipment Operators
Shovel, Excavator, Backhoes: Over 90 Metric Tons
$74.99
7A
3K
IBX
King
I Power Equipment Operators
Slipform Pavers
$73.49
7A
3K
IBX
Exhibit E
Prevailing Wages
County
Trade
Job Classification
Wage
Holiday
I Overtime
Notes
'King
Power Equipment Operators
Spreader, Topsider & Screedman
$73.49
7A
3K
;BX
King
Power Equipment Operators
Subgrader Trimmer
$72.84
7A
3K
,;BX
King
Power Equipment Operators
Power Equipment Operators
Tower Bucket Elevators
Tower Crane Up To 175' In Height Base To Boom
$72.28
7A
3K
In
8X
King.
$74.22
7A
3K
King
Power Equipment Operators
Tower Crane: over 175' through 250' in height, base to boom
$74.99
7A
3K
8X
King
Power Equipment Operators
Tower Cranes: over 250' in height from base to boom
$75_72
7A
3K
8X
King
Power Equipment Operators
Transporters, All Track Or Truck Type
$73.49
17A
3K
IBX
King
Power Equipment Operators
'Trenching Machines
$72.28
7A
3K
SX
King
Power Equipment Operators
'Truck Crane Oiler/driver -100 Tons And Over
$72.84
7A
13K
8X
King
Power Equipment Operators
Truck Crane Oiler/Driver Under 100 Tons
$72.28
7A
13K
BX
King
Power Equipment Operators
jTruck Mount Portable Conveyor
$72.84
7A
3K
8X
King
Power Equipment Operators
'Welder
'Wheel Tractors, Farmall Type
$73.49
7A_
7A
3K
3K
8X
King
Power Equipment Operators
$69.12
8X
King
Power Equipment Operators
'Yo Yo Pay Dozer
$72.84
7A
3K
BX
King
'Truck Drivers
,Asphalt Mix Over 16 Yards
$64.55
5D
4Y
81-
King
'Truck Drivers
.Asphalt Mix To 16 Yards
$63.71
5D
4Y
8L
King
'Truck Drivers
Dump Truck
$63.71
SD
4Y
8L
King
'Truck Drivers
Dump Truck & Trailer
$64.55
5D
14Y
8L
Kin
'Truck Drivers
Other Trucks
$64.55
SD
4Y
8L
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
:******s******•***sss*****s*s**s:s********ss**r*********s****s*************************s*****************.**
Overtime Codes
Overtime calculations are based on the hourly rate actually paid to the worker. On public works projects, the hourly rate
must be not less than the prevailing rate of wage minus the hourly rate of the cost of fringe benefits actually provided for
the worker.
i. ALL HOURS WORKED IN EXCESS OF EIGHT (8) HOURS PER DAY OR FORTY (40) HOURS PER WEEK SHALL BE
PAID AT ONE AND ONE-HALF TIMES THE HOURLY RATE OF WAGE.
B. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked on
Sundays and holidays shall be paid at double the hourly rate of wage.
C. The first two (2) hours after eight (8) regular hours Monday through Friday and the first ten (10) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other overtime hours and all hours worked on
Sundays and holidays shall be paid at double the hourly rate of wage.
D. The first two (2) hours before or after a five -eight (8) hour workweek day or a four -ten (10) hour workweek day and
the first eight (8) hours worked the next day after either workweek shall be paid at one and one-half times the hourly
rate of wage. All additional hours worked and all worked on Sundays and holidays shall be paid at double the hourly
rate of wage.
E. The first two (2) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other hours worked Monday through Saturday,
and all hours worked on Sundays and holidays shall be paid at double the hourly rate of wage.
F. The first two (2) hours after eight (8) regular hours Monday through Friday and the first ten (10) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other overtime hours worked, except Labor Day,
shall be paid at double the hourly rate of wage. All hours worked on Labor Day shall be paid at three times the hourly
rate of wage.
G. The fast ten (10) hours worked on Saturdays and the first ten (10) hours worked on a fifth calendar weekday in a four -
ten hour schedule, shall be paid at one and one-half times the hourly rate of wage. All hours worked in excess of ten
(10) hours per day Monday through Saturday and all hours worked on Sundays and holidays shall be paid at double
the hourly rate of wage.
H. All hours worked on Saturdays (except makeup days if work is lost due to inclement weather conditions or equipment
breakdown) shall be paid at one and one-half times the hourly rate of wage. All hours worked Monday through
Saturday over twelve (12) hours and all hours worked on Sundays and holidays shall be paid at double the hourly rate
of wage.
I. All hours worked on Sundays and holidays shall also be paid at double the hourly rate of wage.
The first two (2) hours after eight (8) regular hours Monday through Friday and the first ten (10) hours on Saturday
shall be paid atone and one-half times the hourly rate of wage. All hours worked over ten (10) hours Monday through
Saturday, Sundays and holidays shall be paid at double the hourly rate of wage.
K. All hours worked on Saturdays and Sundays shall be paid at one and one-half times the hourly rate of wage. All hours
worked on holidays shall be paid at double the hourly rate of wage.
M. All hours worked on Saturdays (except makeup days if work is lost due to inclement weather conditions) shall be paid
at one and one-half times the hourly rate of wage. All hours worked on Sundays and holidays shall be paid at double
the hourly rate of wage.
N. All hours worked on Saturdays (except makeup days) shall be paid at one and one-half times the hourly rate of wage.
All hours worked on Sundays and holidays shall be paid at double the hourly rate of wage.
1
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
O. The first ten (10) hours worked on Saturday shall be paid at one and one-half times the hourly rate of wage. All hours
worked on Sundays, holidays and after twelve (12) hours, Monday through Friday and after ten (10) hours on Saturday
shall be paid at double the hourly rate of wage.
P. All hours worked on Saturdays (except makeup days if circumstances warrant) and Sundays shall be paid at one and
one-half times the hourly rate of wage. All hours worked on holidays shall be paid at double the hourly rate of wage.
Q. The first two (2) hours after eight (8) regular hours Monday through Friday and up to ten (10) hours worked on
Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked in excess of ten (10)
hours per day Monday through Saturday and all hours worked on Sundays and holidays (except Christmas day) shall
be paid at double the hourly rate of wage. All hours worked on Christmas day shall be paid at two and one-half times
the hourly rate of wage.
R. All hours worked on Sundays and holidays shall be paid at two times the hourly rate of wage.
S. The first two (2) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All hours worked on holidays and all other overtime
hours worked, except Labor Day, shall be paid at double the hourly rate of wage. All hours worked on Labor Day
shall be paid at three times the hourly rate of wage.
U. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked on
Sundays and holidays (except Labor Day) shall be paid at two times the hourly rate of wage. All hours worked on
Labor Day shall be paid at three times the hourly rate of wage.
V. All hours worked on Sundays and holidays (except Thanksgiving Day and Christmas day) shall be paid at one and
one-half times the hourly rate of wage. All hours worked on Thanksgiving Day and Christmas day shall be paid at
double the hourly rate of wage.
W. All hours worked on Saturdays and Sundays (except make-up days due to conditions beyond the control of the
employer)) shall be paid at one and one-half times the hourly rate of wage. All hours worked on holidays shall be paid
at double the hourly rate of wage.
X. The first four (4) hours after eight (8) regular hours Monday through Friday and the first twelve (12) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All hours worked over twelve (12) hours Monday
through Saturday, Sundays and holidays shall be paid at double the hourly rate of wage. When holiday falls on
Saturday or Sunday, the day before Saturday, Friday, and the day after Sunday, Monday, shall be considered the
holiday and all work performed shall be paid at double the hourly rate of wage.
Y. All hours worked outside the hours of 5:00 am and 5:00 pm (or such other hours as may be agreed upon by any
employer and the employee) and all hours worked in excess of eight (8) hours per day (10 hours per day for a 4 x 10
workweek) and on Saturdays and holidays (except labor day) shall be paid at one and one-half times the hourly rate
of wage. (except for employees who are absent from work without prior approval on a scheduled workday during the
workweek shall be paid at the straight -time rate until they have worked 8 hours in a day (10 in a 4 x 10 workweek) or
40 hours during that workweek.) All hours worked Monday through Saturday over twelve (12) hours and all hours
worked on Sundays and Labor Day shall be paid at double the hourly rate of wage.
Z. All hours worked on Saturdays and Sundays shall be paid at one and one-half times the hourly rate of wage. All
hours worked on holidays shall be paid the straight time rate of pay in addition to holiday pay.
PA
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
ALL HOURS WORKED IN EXCESS OF EIGHT (8) HOURS PER DAY OR FORTY (40) HOURS PER WEEK SHALL BE
PAID AT ONE AND ONE-HALF TIMES THE HOURLY RATE OF WAGE.
B. All hours worked on holidays shall be paid at one and one-half times the hourly rate of wage.
C. All hours worked on Sundays shall be paid at one and one-half times the hourly rate of wage. All hours worked on
holidays shall be paid at two times the hourly rate of wage.
F. The first eight (8) hours worked on holidays shall be paid at the straight hourly rate of wage in addition to the holiday
pay. All hours worked in excess of eight (8) hours on holidays shall be paid at double the hourly rate of wage.
G. All hours worked on Sunday shall be paid at two times the hourly rate of wage. All hours worked on paid holidays
shall be paid at two and one-half times the hourly rate of wage including holiday pay.
H. All hours worked on Sunday shall be paid at two times the hourly rate of wage. All hours worked on holidays shall
be paid at one and one-half times the hourly rate of wage.
O. All hours worked on Sundays and holidays shall be paid at one and one-half times the hourly rate of wage.
R. All hours worked on Sundays and holidays and all hours worked over sixty (60) in one week shall be paid at double
the hourly rate of wage.
U. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked
over 12 hours in a day or on Sundays and holidays shall be paid at double the hourly rate of wage.
W. The first two (2) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other hours worked Monday through Saturday,
and all hours worked on Sundays and holidays shall be paid at double the hourly rate of wage. On a four -day, ten-
hour weekly schedule, either Monday thru Thursday or Tuesday thru Friday schedule, all hours worked after ten shall
be paid at double the hourly rate of wage. The first eight (8) hours worked on the fifth day shall be paid at one and
one-half times the hourly rate of wage. All other hours worked on the fifth, sixth, and seventh days and on holidays
shall be paid at double the hourly rate of wage.
ALL HOURS WORKED IN EXCESS OF EIGHT (8) HOURS PER DAY OR FORTY (40) HOURS PER WEEK SHALL BE
PAID AT ONE AND ONE-HALF TIMES THE HOURLY RATE OF WAGE.
A. Work performed in excess of eight (8) hours of straight time per day, or ten (10) hours of straight time per day when
four ten (10) hour shifts are established, or forty (40) hours of straight time per week, Monday through Friday, or
outside the normal shift, and all work on Saturdays shall be paid at time and one-half the straight time rate. Hours
worked over twelve hours (12) in a single shift and all work performed after 6:00 pm Saturday to 6:00 am Monday
and holidays shall be paid at double the straight time rate of pay. Any shift starting between the hours of 6:00 pm and
midnight shall receive an additional one dollar ($1.00) per hour for all hours worked that shift. The employer shall
have the sole discretion to assign overtime work to employees. Primary consideration for overtime work shall be given
to employees regularly assigned to the work to be performed on overtime situations. After an employee has worked
eight (8) hours at an applicable overtime rate, all additional hours shall be at the applicable overtime rate until such
time as the employee has had a break of eight (8) hours or more.
C. Work performed in excess of eight (8) hours of straight time per day, or ten (10) hours of straight time per day when
four ten (10) hour shifts are established, or forty (40) hours of straight time per week, Monday through Friday, or
outside the normal shift, and all work on Saturdays shall be paid at one and one-half times the hourly rate of wage.
All work performed after 6:00 pm Saturday to 5:00 am Monday and Holidays shall be paid at double the hourly rate
of wage. After an employee has worked eight (8) hours at an applicable overtime rate, all additional hours shall be at
the applicable overtime rate until such time as the employee has had a break of eight (8) hours or more.
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
E. All hours worked Sundays and holidays shall be paid at double the hourly rate of wage. Each week, once 40 hours of
straight time work is achieved, then any hours worked over 10 hours per day Monday through Saturday shall be paid
at double the hourly wage rate.
R All hours worked on Saturday shall be paid at one and one-half times the hourly rate of wage. All hours worked on
Sunday shall be paid at two times the hourly rate of wage. All hours worked on paid holidays shall be paid at two and
one-half times the hourly rate of wage including holiday pay.
H. All work performed on Sundays between March 16th and October 14th and all Holidays shall be compensated for at
two (2) times the regular rate of pay. Work performed on Sundays between October 15th and March 15th shall be
compensated at one and one half (1-1/2) times the regular rate of pay.
J. All hours worked between the hours of 10:00 pm and 5:00 am, Monday through Friday, and all hours worked on
Saturdays shall be paid at a one and one-half times the hourly rate of wage. All hours worked on Sundays and holidays
shall be paid at double the hourly rate of wage.
K. Work performed in excess of eight (8) hours of straight time per day, or ten (10) hours of straight time per day when
four ten (10) hour shifts are established, or forty (40) hours of straight time per week, Monday through Friday, or
outside the normal 5 am to 6pm shift, and all work on Saturdays shall be paid at one and one-half times the hourly
rate of wage. All work performed after 6:00 pm Saturday to 5:00 am Monday and Holidays, and all hours worked in
excess of twelve (12) hours in a single shift shall be paid at double the hourly rate of wage.
After an employee has worked eight (8) hours at an applicable overtime rate, all additional hours shall be at the
applicable overtime rate until such time as the employee has had a break of eight (8) hours or more. When an employee
returns to work without at least eight (8) hours time off since their previous shift, all such time shall be a continuation
of shift and paid at the applicable overtime rate until he/she shall have the eight (8) hours rest period.
4. ALL HOURS WORKED IN EXCESS OF EIGHT (8) HOURS PER DAY OR FORTY (40) HOURS PER WEEK SHALL BE
PAID AT ONE AND ONE-HALF TIMES THE HOURLY RATE OF WAGE.
A. All hours worked in excess of eight (8) hours per day or forty (40) hours per week shall be paid at double the hourly
rate of wage. All hours worked on Saturdays, Sundays and holidays shall be paid at double the hourly rate of wage.
B. All hours worked over twelve (12) hours per day and all hours worked on holidays shall be paid at double the hourly
rate of wage.
C. On Monday through Friday, the first four (4) hours of overtime after eight (8) hours of straight time work shall be
paid at one and one half (1-1/2) times the straight time rate of pay, unless a four (4) day ten (10) hour workweek has
been established. On a four (4) day ten (10) hour workweek scheduled Monday through Thursday, or Tuesday
through Friday, the first two (2) hours of overtime after ten (10) hours of straight time work shall be paid at one and
one half (1-1/2) times the straight time rate of pay. On Saturday, the first twelve (12) hours of work shall be paid at
one and one half (1-1/2) times the straight time rate of pay, except that if the job is down on Monday through Friday
due to weather conditions or other conditions outside the control of the employer, the first ten (10) hours on Saturday
may be worked at the straight time rate of pay. All hours worked over twelve (12) hours in a day and all hours worked
on Sunday and Holidays shall be paid at two (2) times the straight time rate of pay.
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
4. D. All hours worked in excess of eight (8) hours per day or forty (40) hours per week shall be paid at double the hourly
rate of wage. All hours worked on Saturday, Sundays and holidays shall be paid at double the hourly rate of pay. Rates
include all members of the assigned crew.
EXCEPTION:
On all multipole structures and steel transmission lines, switching stations, regulating, capacitor stations, generating
plants, industrial plants, associated installations and substations, except those substations whose primary function is
to feed a distribution system, will be paid overtime under the following rates:
The first two (2) hours after eight (8) regular hours Monday through Friday of overtime on a regular workday, shall
be paid at one and one-half times the hourly rate of wage. All hours in excess of ten (10) hours will be at two (2) times
the hourly rate of wage. The first eight (8) hours worked on Saturday will be paid at one and one-half (1-1/2) times
the hourly rate of wage. All hours worked in excess of eight (8) hours on Saturday, and all hours worked on Sundays
and holidays will be at the double the hourly rate of wage.
All overtime eligible hours performed on the above described work that is energized, shall be paid at the double the
hourly rate of wage.
E. The first two (2) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other hours worked Monday through Saturday,
and all hours worked on Sundays and holidays shall be paid at double the hourly rate of wage.
On a four -day, ten-hour weekly schedule, either Monday thru Thursday or Tuesday thru Friday schedule, all hours
worked after ten shall be paid at double the hourly rate of wage. The Monday or Friday not utilized in the normal four -
day, ten hour work week, and Saturday shall be paid at one and one half (I V2) times the regular shift rate for the first
eight (8) hours. All other hours worked Monday through Saturday, and all hours worked on Sundays and holidays
shall be paid at double the hourly rate of wage.
F. All hours worked between the hours of 6:00 pm and 6:00 am, Monday through Saturday, shall be paid at a premium
rate of 20% over the hourly rate of wage. All hours worked on Sundays shall be paid at one and one-half times the
hourly rate of wage. All hours worked on holidays shall be paid at double the hourly rate of wage.
G. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked
Monday through Saturday over twelve (12) hours and all hours worked on Sundays and holidays shall be paid at
double the hourly rate of wage.
H. The first two (2) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All other overtime hours worked, except Labor Day,
and all hours on Sunday shall be paid at double the hourly rate of wage. All hours worked on Labor Day shall be paid
at three times the hourly rate of wage.
I. The First eight (8) hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All
hours worked in excess of eight (8) per day on Saturdays shall be paid at double the hourly rate of wage. All hours
worked on Sundays and holidays shall be paid at double the hourly rate of wage.
J. The first eight (8) hours worked on a Saturday shall be paid at one and one-half times the hourly rate of wage. All
hours worked in excess of eight (8) hours on a Saturday shall be paid at double the hourly rate of wage. All hours
worked over twelve (12) in a day, and all hours worked on Sundays and Holidays shall be paid at double the hourly
rate of wage.
K. All hours worked on a Saturday shall be paid at one and one-half times the hourly rate of wage, so long as Saturday
is the sixth consecutive day worked. All hours worked over twelve (12) in a day Monday through Saturday, and all
hours worked on Sundays and Holidays shall be paid at double the hourly rate of wage.
5
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
4. L. The first twelve (12) hours worked on a Saturday shall be paid at one and one-half times the hourly rate of wage. All
hours worked on a Saturday in excess of twelve (12) hours shall be paid at double the hourly rate of pay. All hours
worked over twelve (12) in a day Monday through Friday, and all hours worked on Sundays shall be paid at double
the hourly rate of wage. All hours worked on a holiday shall be paid at one and one-half times the hourly rate of wage,
except that all hours worked on Labor Day shall be paid at double the hourly rate of pay.
M. All hours worked on Sunday and Holidays shall be paid at double the hourly rate. Any employee reporting to work
less than nine (9) hours from their previous quitting time shall be paid for such time at time and one-half times the
hourly rate.
X All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked on
Sundays and holidays, and all work performed between the hours of midnight (12:00 AM) and eight AM (8:00 AM)
every day shall be paid at double the hourly rate of wage.
O. All hours worked between midnight Friday to midnight Sunday shall be paid at one and one-half the hourly rate of
wage. After an employee has worked in excess of eight (8) continuous hours in any one or more calendar days, all
additional hours shall be at the applicable overtime rate until such time as the employee has had a break of six (6)
hours or more. All hours worked on Holidays shall be paid at double the hourly rate of wage.
P. All hours worked on Holidays shall be paid at one and one-half times the hourly rate of wage.
Q. The first four (4) hours after eight (8) regular hours Monday through Friday and the first eight (8) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. All hours worked over twelve (12) hours Monday
through Saturday shall be paid at double the hourly rate. All hours worked on Sundays and holidays shall be paid at
double the hourly rate of wage.
R. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage, so long as Saturday is
the sixth consecutive day worked. All hours worked on Sundays and holidays shall be paid at double the hourly rate
of wage.
S. All hours worked on Saturdays and Holidays shall be paid at one and one-half times the hourly rate of wage. All hours
worked on Sundays shall be paid at double the hourly rate of wage.
T. The first two (2) hours of overtime for hours worked Monday -Friday shall be paid at one and one-half times the hourly
rate of wage. All hours worked in excess of ten (10) hours per day shall be paid at double the hourly rate of wage. All
hours worked on Sundays and holidays shall be paid at double the hourly rate of wage. For work on Saturday which
is scheduled prior to the end of shift on Friday, the first six (6) hours work shall be paid at one and one-half times the
hourly rate of wage, and all hours over (6) shall be paid double the hourly rate of wage. For work on Saturday which
was assigned following the close of shift on Friday, all work shall be paid at double the hourly rate of wage.
U. The first four (4) hours after eight (8) regular hours Monday through Friday and the first twelve (12) hours on Saturday
shall be paid at one and one-half times the hourly rate of wage. (Except on makeup days if work is lost due to inclement
weather, then the first eight (8) hours on Saturday may be paid the regular rate.) All hours worked over twelve (12)
hours Monday through Saturday, and all hours worked on Sundays and holidays shall be paid at double the hourly
rate of wage.
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
4. V. Work performed in excess of ten (10) hours of straight time per day when four ten (10) hour shifts are established or
outside the normal shift (5 am to 6pm), and all work on Saturdays, except for make-up days shall be paid at time and
one-half (1 %z) the straight time rate.
In the event the job is down due to weather conditions, then Saturday may, be worked as a voluntary make-up day at
the straight time rate. However, Saturday shall not be utilized as a make-up day when a holiday falls on Friday. All
work performed on Sundays and holidays and work in excess of twelve (12) hours per day shall be paid at double (2x)
the straight time rate of pay.
After an employee has worked eight (8) hours at an applicable overtime rate, all additional hours shall be at the
applicable overtime rate until such time as the employee has had a break of eight (8) hours.
When an employee returns to work without a break of eight (8) hours since their previous shift, all such time shall be
a continuation of shift and paid at the applicable overtime rate until such time as the employee has had a break of eight
(8) hours.
W. All hours worked on Saturdays (except makeup days if work is lost due to inclement weather conditions) shall be paid
at one and one-half times the hourly rate of wage. All hours worked on Sundays and holidays shall be paid at double
the hourly rate of wage.
When an employee returns to work without at least eight (8) hours time off since their previous shift, all such time
shall be a continuation of shift and paid at the applicable overtime rate until such time as the employee has had a break
of eight (8) hours.
X. All hours worked on Saturdays shall be paid at one and one-half times the hourly rate of wage. All hours worked on
Sundays and holidays shall be paid at double the hourly rate of wage. Work performed outside the normal shift of 6
am to 6pm shall be paid at one and one-half the straight time rate, (except for special shifts or three shift operations).
All work performed on Sundays and holidays shall be paid at double the hourly rate of wage. Shifts may be established
when considered necessary by the Employer.
The Employer may establish shifts consisting of eight (8) or ten (10) hours of work (subject to WAC 296-127-022),
that shall constitute a normal forty (40) hour work week. The Employer can change from a 5-eight to a 4-ten hour
schedule or back to the other. All hours of work on these shifts shall be paid for at the straight time hourly rate. Work
performed in excess of eight hours (or ten hours per day (subject to WAC 296-127-022) shall be paid atone and one-
half the straight time rate.
When due to conditions beyond the control of the Employer, or when contract specifications require that work can
only be performed outside the regular day shift, then by mutual agreement a special shift may be worked at the straight
time rate, eight (8) hours work for eight (8) hours pay. The starting time shall be arranged to fit such conditions of
work.
When an employee returns to work without at a break of eight (8) hours since their previous shift, all such time shall
be a continuation of shift and paid at the applicable overtime rate until such time as the employee has had a break of
eight (8) hours.
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Overtime Codes Continued
4. Y. Work performed in excess of eight (8) hours of straight time per day, or ten (10) hours of straight time per day when
four ten (10) hour shifts are established, or forty (40) hours of straight time per week, Monday through Friday, or
outside the normal shift, and all work on Saturdays shall be paid at time and one-half the straight time rate. All work
performed after 6:00 pm Saturday to 6:00 am Monday and holidays shall be paid at double the straight time rate of
pay.
Any shift starting between the hours of 6:00 pm and midnight shall receive an additional one dollar ($1.00) per hour
for all hours worked that shift.
After an employee has worked eight (8) hours at an applicable overtime rate, all additional hours shall be at the
applicable overtime rate until such time as the employee has had a break of eight (8) hours or more.
Holiday Codes
A. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday after
Thanksgiving Day, and Christmas Day (7).
B. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday after
Thanksgiving Day, the day before Christmas, and Christmas Day (8).
C. Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the
Friday after Thanksgiving Day, And Christmas Day (8).
D. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday and
Saturday after Thanksgiving Day, And Christmas Day (8).
H. Holidays: New Year's Day, Memorial Day, Independence Day, Thanksgiving Day, the Day after Thanksgiving Day,
And Christmas (6).
1. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day
(6).
J. Holidays: New Year's Day, Memorial Day, Independence Day, Thanksgiving Day, Friday after Thanksgiving Day,
Christmas Eve Day, And Christmas Day (7).
K. Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day,
Friday After Thanksgiving Day, The Day Before Christmas, And Christmas Day (9).
L. Holidays: New Year's Day, Martin Luther King Jr. Day, Memorial Day, Independence Day, Labor Day, Thanksgiving
Day, Friday after Thanksgiving Day, And Christmas Day (8).
N. Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Veterans' Day,
Thanksgiving Day, The Friday After Thanksgiving Day, And Christmas Day (9).
P. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday And Saturday
After Thanksgiving Day, The Day Before Christmas, And Christmas Day (9). If A Holiday Falls On Sunday, The
Following Monday Shall Be Considered As A Holiday.
Q. Paid Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas
Day (6).
8
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Hotiday Codes Continued
R. Paid Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Day After
Thanksgiving Day, One -Half Day Before Christmas Day, And Christmas Day. (7 1/2).
S. Paid Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day,
And Christmas Day (7).
T. Paid Holidays: New Year's Day, Washington's Birthday, Memorial Day, Independence Day, Labor Day,
Thanksgiving Day, The Friday After Thanksgiving Day, Christmas Day, And The Day Before Or After Christmas (9).
Z. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day, the
Friday after Thanksgiving Day, And Christmas Day (8).
6. A. Paid Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day,
the Friday after Thanksgiving Day, And Christmas Day (8).
E. Paid Holidays: New Year's Day, Day Before Or After New Year's Day, Presidents Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, and a Half -
Day On Christmas Eve Day. (9 1/2).
G. Paid Holidays: New Year's Day, Martin Luther King Jr. Day, Presidents' Day, Memorial Day, Independence Day,
Labor Day, Veterans' Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, and Christmas Eve
Day (11).
H. Paid Holidays: New Year's Day, New Year's Eve Day, Memorial Day, Independence Day, Labor Day, Thanksgiving
Day, Friday After Thanksgiving Day, Christmas Day, The Day After Christmas, And A Floating Holiday (10).
I. Paid Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday
After Thanksgiving Day, And Christmas Day (7).
T. Paid Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day,
Thanksgiving Day, The Friday After Thanksgiving Day, The Last Working Day Before Christmas Day, And
Christmas Day (9).
Z. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday after
Thanksgiving Day, And Christmas Day (7). If a holiday falls on Saturday, the preceding Friday shall be
considered as the holiday. If a holiday falls on Sunday, the following Monday shall be considered as the
holiday.
A. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday and
Saturday after Thanksgiving Day, And Christmas Day (8). Any Holiday Which Falls On A Sunday Shall Be Observed
As A Holiday On The Following Monday. If any of the listed holidays falls on a Saturday, the preceding Friday shall
be a regular work day.
B. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday and
Saturday after Thanksgiving Day, And Christmas Day (8). Any holiday which falls on a Sunday shall be observed as
a holiday on the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the
preceding Friday.
C. Holidays: New Year's Day, Martin Luther King Jr. Day, Memorial Day, Independence Day, Labor Day, Thanksgiving
Day, the Friday after Thanksgiving Day, And Christmas Day (8). Any holiday which falls on a Sunday shall be
observed as a holiday on the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday
on the preceding Friday.
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Holiday Codes Continued
D. Paid Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day,
the Friday after Thanksgiving Day, And Christmas Day (8). Unpaid Holidays: President's Day. Any paid holiday
which falls on a Sunday shall be observed as a holiday on the following Monday. Any paid holiday which falls on a
Saturday shall be observed as a holiday on the preceding Friday.
E. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, And Christmas Day (7). Any holiday which falls on a Sunday shall be observed as a holiday on
the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the preceding Friday.
F. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, the last working day before Christmas day and Christmas day (8). Any holiday which falls on a
Sunday shall be observed as a holiday on the following Monday. Any holiday which falls on a Saturday shall be
observed as a holiday on the preceding Friday.
G. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day
(6). Any holiday which falls on a Sunday shall be observed as a holiday on the following Monday.
H. Holidays: New Year's Day, Martin Luther King Jr. Day, Independence Day, Memorial Day, Labor Day, Thanksgiving
Day, the Friday after Thanksgiving Day, the Last Working Day before Christmas Day and Christmas Day (9). Any
holiday which falls on a Sunday shall be observed as a holiday on the following Monday. Any holiday which falls on
a Saturday shall be observed as a holiday on the preceding Friday.
Holidays: New Year's Day, President's Day, Independence Day, Memorial Day, Labor Day, Thanksgiving Day, The
Friday After Thanksgiving Day, The Day Before Christmas Day And Christmas Day (9). Any holiday which falls on
a Sunday shall be observed as a holiday on the following Monday. Any holiday which falls on a Saturday shall be
observed as a holiday on the preceding Friday.
Holidays: New Year's Day, Independence Day, Memorial Day, Labor Day, Thanksgiving Day and Christmas Day (6).
Any holiday which falls on a Sunday shall be observed as a holiday on the following Monday. Any holiday which
falls on a Saturday shall be observed as a holiday on the preceding Friday.
K. Holidays: New Year's Day, Memorial Day, Independence Day, Thanksgiving Day, the Friday and Saturday after
Thanksgiving Day, And Christmas Day (8). Any holiday which falls on a Sunday shall be observed as a holiday on
the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the preceding Friday.
L. Holidays: New Year's Day, Memorial Day, Labor Day, Independence Day, Thanksgiving Day, the Last Work Day
before Christmas Day, And Christmas Day (7). Any holiday which falls on a Sunday shall be observed as a holiday
on the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the preceding
Friday.
M. Paid Holidays: New Year's Day, The Day after or before New Year's Day, President's Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, And the Day
after or before Christmas Day (10). Any holiday which falls on a Sunday shall be observed as a holiday on the
following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the preceding Friday.
N. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, And Christmas Day (7). Any holiday which falls on a Sunday shall be observed as a holiday on
the following Monday. When Christmas falls on a Saturday, the preceding Friday shall be observed as a holiday.
P. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday after
Thanksgiving Day, And Christmas Day (7). Any holiday which falls on a Sunday shall be observed as a holiday on
the following Monday.
10
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Holiday Codes Continued
Q. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, the Last Working Day before Christmas Day and Christmas Day (8). Any holiday which falls on
a Sunday shall be observed as a holiday on the following Monday. If any of the listed holidays falls on a Saturday, the
preceding Friday shall be a regular work day.
R. Paid Holidays: New Year's Day, the day after or before New Year's Day, President's Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, and the day
after or before Christmas Day (10). If any of the listed holidays fall on Saturday, the preceding Friday shall be observed
as the holiday. If any of the listed holidays falls on a Sunday, the day observed by the Nation shall be considered a
holiday and compensated accordingly.
& Paid Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday after
Thanksgiving Day, Christmas Day, the Day after Christmas, and A Floating Holiday (9). If any of the listed holidays
falls on a Sunday, the day observed by the Nation shall be considered a holiday and compensated accordingly.
T. Paid Holidays: New Year's Day, the Day after or before New Year's Day, President's Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, and The Day
after or before Christmas Day. (10). If any of the listed holidays falls on a Sunday, the day observed by the Nation
shall be considered a holiday and compensated accordingly. Any holiday which falls on a Saturday shall be observed
as a holiday on the preceding Friday.
V. Holidays: New Year's Day, President's Birthday, Memorial Day, Independence Day, Labor Day, Thanksgiving Day,
the Friday after Thanksgiving Day, Christmas Day, the day before or after Christmas, and the day before or after New
Year's Day. If any of the above listed holidays falls on a Sunday, the day observed by the Nation shall be considered
a holiday and compensated accordingly.
W. Holidays: New Year's Day, Day After New Year's, Memorial Day, Independence Day, Labor Day, Thanksgiving
Day, the Friday after Thanksgiving Day, Christmas Eve Day, Christmas Day, the day after Christmas, the day before
New Year's Day, and a Floating Holiday.
X. Holidays: New Year's Day, Day before or after New Year's Day, Presidents' Day, Memorial Day, Independence Day,
Labor Day, Thanksgiving Day, the Friday after Thanksgiving Day, Christmas Day, and the day before or after
Christmas day. If a holiday falls on a Saturday or on a Friday that is the normal day off, then the holiday will be taken
on the last normal workday. If the holiday falls on a Monday that is the normal day off or on a Sunday, then the holiday
will be taken on the next normal workday.
Y. Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the
Friday after Thanksgiving Day, and Christmas Day. (8) If the holiday falls on a Sunday, then the day observed by the
federal government shall be considered a holiday and compensated accordingly.
Z. Holidays: New Year's Day, President's Day, Independence Day, Memorial Day, Labor Day, Thanksgiving Day, The
Friday After Thanksgiving Day, And Christmas Day (8). Any holiday which falls on a Sunday shall be observed as a
holiday on the following Monday. Any holiday which falls on a Saturday shall be observed as a holiday on the
preceding Friday.
15. A. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, the day before Christmas Day and Christmas Day. (8) Any holiday which falls on a Sunday shall
be observed as a holiday on the following Monday.
B. Holidays: New Year's Day, Martin Luther King Jr. Day, President's Day, Memorial Day, Independence Day, Labor
Day, Veteran's Day, Thanksgiving Day, and Christmas Day. (9)
C. Holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, the Friday after
Thanksgiving Day, the day before Christmas Day and Christmas Day. (8)
11
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Holiday Codes Continued
15. D. Holidays: New Year's Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday
after Thanksgiving Day, Christmas Day, and the day after Christmas.
E. Holidays: the day before New Years's Day, New Year's Day, Martin Luther King, Jr. Day, Presidents' Day, Memorial
Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, Friday after Thanksgiving Day, the day before
Christmas, and Christmas Day. (12)
Note Codes
8. D. Workers working with supplied air on hazmat projects receive an additional $1.00 per hour.
L. Workers on hazmat projects receive additional hourly premiums as follows -Level A: $0.75, Level B: $0.50, And
Level C: $0.25.
M. Workers on hazmat projects receive additional hourly premiums as follows: Levels A & B: $1.00, Levels C & D:
$0.50.
N. Workers on hazmat projects receive additional hourly premiums as follows -Level A: $1.00, Level B: $0.75, Level
C: $0.50, And Level D: $0.25.
P. Workers on hazmat projects receive additional hourly premiums as follows -Class A Suit: $2.00, Class B Suit: $1.50,
Class C Suit: $1.00, And Class D Suit $0.50.
Q. The highest pressure registered on the gauge for an accumulated time of more than fifteen (15) minutes during the
shift shall be used in determining the scale paid.
S. Effective August 31, 2012 — A Traffic Control Supervisor shall be present on the project whenever flagging or spotting
or other traffic control labor is being utilized. Flaggers and Spotters shall be posted where shown on approved Traffic
Control Plans or where directed by the Engineer. All flaggers and spotters shall possess a current flagging card issued
by the State of Washington, Oregon, Montana, or Idaho. This classification is only effective on or after August 31,
2012.
T. Effective August 31, 2012 — A Traffic Control Laborer performs the setup, maintenance and removal of all temporary
traffic control devices and construction signs necessary to control vehicular, bicycle, and pedestrian traffic during
construction operations. Flaggers and Spotters shall be posted where shown on approved Traffic Control Plans or
where directed by the Engineer. All flaggers and spotters shall possess a current flagging card issued by the State of
Washington, Oregon, Montana, or Idaho. This classification is only effective on or after August 31, 2012.
U. Workers on hazmat projects receive additional hourly premiums as follows — Class A Suit: $2.00, Class B Suit: $1.50,
And Class C Suit: $1.00. Workers performing underground work receive an additional $0.40 per hour for any and all
work performed underground, including operating, servicing and repairing of equipment. The premium for
underground work shall be paid for the entire shift worked. Workers who work suspended by a rope or cable receive
an additional $0.50 per hour. The premium for work suspended shall be paid for the entire shift worked. Workers who
do "pioneer" work (break open a cut, build road, etc.) more than one hundred fifty (150) feet above grade elevation
receive an additional $0.50 per hour.
12
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Note Codes Continued
8. V. In addition to the hourly wage and fringe benefits, the following depth and enclosure premiums shall be paid. The
premiums are to be calculated for the maximum depth and distance into an enclosure that a diver reaches in a day.
The premiums are to be paid one time for the day and are not used in calculating overtime pay.
Depth premiums apply to depths of fifty feet or more. Over 50' to 100' - $2.00 per foot for each foot over 50 feet. Over
101' to 150' - $3.00 per foot for each foot over 101 feet. Over 151' to 220' - $4.00 per foot for each foot over 220 feet.
Over 221' - $5.00 per foot for each foot over 221 feet.
Enclosure premiums apply when divers enter enclosures (such as pipes or tunnels) where there is no vertical ascent
and is measured by the distance travelled from the entrance. 25' to 300' - $1.00 per foot from entrance. 300' to 600'
- $1.50 per foot beginning at 300'. Over 600' - $2.00 per foot beginning at 600'.
W. Meter Installers work on single phase 120/240V self-contained residential meters. The Lineman/Groundmen rates
would apply to meters not fitting this description.
X. Workers on hazmat projects receive additional hourly premiums as follows - Class A Suit: $2.00, Class B Suit:
$1.50, Class C Suit: $1.00, and Class D Suit: $0.50. Special Shift Premium: Basic hourly rate plus $2.00 per hour.
When due to conditions beyond the control of the Employer or when an owner (not acting as the contractor), a
government agency or the contract specifications requires that work can only be performed outside the normal 5 am
to 6pm shift, then the special shift premium will be applied to the basic hourly rate. When an employee works on a
special shift, they shall be paid a special shift premium for each hour worked unless they are in OT or Double-time
status. (For example, the special shift premium does not waive the overtime requirements for work performed on
Saturday or Sunday.)
Y. Tide Work: When employees are called out between the hours of 6:00 p.m. and 6:00 a.m. to work on tide work
(work located in the tide plane) all time worked shall be at one and one-half times the hourly rate of pay.
Swinging Stage/Boatswains Chair: Employees working on a swinging state or boatswains chair or under conditions
that require them to be tied off to allow their hands to be free shall receive seventy-five cents ($0.75) per hour above
the classification rate.
Z. Workers working with supplied air on hazmat projects receive an additional $1.00 per hour.
Special Shift Premium: Basic hourly rate plus $2.00 per hour. When due to conditions beyond the control of the
Employer or when an owner (not acting as a contractor), a government agency or the contract specifications require
that more than (4) hours of a special shift can only be performed outside the normal 6 am to 6pm shift, then the
special shift premium will be applied to the basic straight time for the entire shift. When an employee works on a
special shift, they will be paid a special shift premium for each hour worked unless they are in overtime or double-
time status. (For example, the special shift premium does not waive the overtime requirements for work performed
on Saturday or Sunday.)
13
Benefit Code Key — Effective 3/4/2020 thru 9/1/2020
Note Codes Continued
A. Workers working with supplied air on hazmat projects receive an additional $1.00 per hour.
Special Shift Premium: Basic hourly rate plus $2.00 per hour. When due to conditions beyond the control of the
Employer or when an owner (not acting as the contractor), a government agency or the contract specifications require
that more than four (4) hours of a special shift can only be performed outside the normal 6 am to 6pm shift, then the
special shift premium will be applied to the basic straight time for the entire shift. When an employee works on a
special shift, they shall be paid a special shift premium for each hour worked unless they are in overtime or double-
time status. (For example, the special shift premium does not waive the overtime requirements for work performed on
Saturday or Sunday.)
Certified Crane Operator Premium: Crane operators requiring certifications shall be paid $0.50 per hour above their
classification rate.
Boom Pay Premium: All cranes including tower shall be paid as follows based on boom length:
(A) — 130' to 199' — $0.50 per hour over their classification rate.
(B) — 200' to 299' — $0.80 per hour over their classification rate.
(C) — 300' and over — $1.00 per hour over their classification rate.
B. The highest pressure registered on the gauge for an accumulated time of more than fifteen (15) minutes during the
shift shall be used in determining the scale paid.
Tide Work: When employees are called out between the hours of 6:00 p.m. and 6:00 a.m. to work on tide work (work
located in the tide plane) all time worked shall be at one and one-half times the hourly rate of pay. Swinging
Stage/Boatswains Chair: Employees working on a swinging stage or boatswains chair or under conditions that require
them to be tied off to allow their hands to be free shall receive seventy-five cents ($0.75) per hour above the
classification rate.
C. Tide Work: When employees are called out between the hours of 6:00 p.m. and 6:00 a.m. to work on tide work (work
located in the tide plane) all time worked shall be at one and one-half times the hourly rate of pay. Swinging
Stage/Boatswains Chair: Employees working on a swinging stage or boatswains chair or under conditions that require
them to be tied off to allow their hands to be free shall receive seventy-five cents ($0.75) per hour above the
classification rate.
Effective August 31, 2012 — A Traffic Control Supervisor shall be present on the project whenever flagging or spotting
or other traffic control labor is being utilized. A Traffic Control Laborer performs the setup, maintenance and removal
of all temporary traffic control devices and construction signs necessary to control vehicular, bicycle, and pedestrian
traffic during construction operations. Flaggers and Spotters shall be posted where shown on approved Traffic Control
Plans or where directed by the Engineer. All flaggers and spotters shall possess a current flagging card issued by the
State of Washington, Oregon, Montana, or Idaho. These classifications are only effective on or after August 31, 2012.
D. Industrial Painter wages are required for painting within industrial facilities such as treatment plants, pipelines,
towers, dams, bridges, power generation facilities and manufacturing facilities such as chemical plants, etc., or
anywhere abrasive blasting is necessary to prepare surfaces, or hazardous materials encapsulation is required.
E. Heavy Construction includes construction, repair, alteration or additions to the production, fabrication or
manufacturing portions of industrial or manufacturing plants, hydroelectric or nuclear power plants and atomic
reactor construction. Workers on hazmat projects receive additional hourly premiums as follows -Level A: $1.00,
Level B: $0.75, Level C: $0.50, And Level D: $0.25.
14
CITY OF
Federal Way
EXHIBIT "F"
TITLE VI ASSURANCES
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
�vmv cityoffederahvay com
During the performance of this contract, the contractor/consultant, for itself, its assignees and successors in
interest (hereinafter referred to as the "contractor's agrees as follows:
1. Compliance with Regulations
The contractor shall comply with the Regulations relative to non-discrimination in federally assisted
programs of United States Department of Transportation (USDOT), Title 49, Code of Federal Regulations, part
21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein
incorporated by reference and made a part of this contract.
2. Non-discrimination
The contractor, with regard to the work performed by it during the contract, shall not discriminate on
the grounds of race, color, sex, or national origin in the selection and retention of sub -contractors, including
procurement of materials and leases of equipment. The contractor shall not participate either directly or
indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices
when the contract covers a program set forth in Appendix B of the Regulations.
3. Solicitations for Sub -contracts, Including Procurement of Materials and Equipment
In all solicitations either by competitive bidding or negotiations made by the contractor for work to be
performed under a sub -contract, including procurement of materials or leases of equipment, each potential
sub -contractor or supplier shall be notified by the contractor of the contractor's obligations under this contract
and the Regulations relative to non-discrimination on the grounds of race, color, sex, or national origin.
4. Information and Reports
The contractor shall provide all information and reports required by the Regulations or directives issued
pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the contracting agency or the appropriate federal agency to be pertinent to
ascertain compliance with such Regulations, orders and instructions. Where any information required of a
contractor is in the exclusive possession of another who fails or refuses to furnish this information, the
contractor shall so certify to WSDOT or the USDOT as appropriate, and shall set forth what efforts it has made
to obtain the information.
S. Sanctions for Non-compliance
In the event of the contractor's non-compliance with the non-discrimination provisions of this contract,
the contracting agency shall impose such contract sanctions as it or the USDOT may determine to be
appropriate, including, but not limited to: Withholding of payments to the contractor under the contract until
the contractor complies, and/or; Cancellation, termination, or suspension of the contract, in whole or in part
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 50 2021
RFB ver. 9-18
` �Federal
e d CITY HALL
ryie ra I Way 33325 8th Avenue South
�/ Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederalway com
6. Incorporation of Provisions
The contractor shall include the provisions of paragraphs (1) through (5) in every sub -contract,
including procurement of materials and leases of equipment, unless exempt by the Regulations, or directives
issued pursuant thereto. The contractor shall take such action with respect to any sub -contractor or
procurement as the contracting agency or USDOT may direct as a means of enforcing such provisions
including sanctions for non-compliance. Provided, however, that in the event a contractor becomes involved in,
or is threatened with, litigation with a sub -contractor or supplier as a result of such direction, the contractor
may request WSDOT enter into such litigation to protect the interests of the state and, in addition, the
contractor may request the USDOT enter into such litigation to protect the interests of the United States.
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 51 2021
RFB ver. 9-18
APPENDIX A
SCOPE AND SPECIFICATIONS
The contractor shall bevel the sidewalk at locations provided by the City. Work shall be completed within 30 days of the
City issuing the Task Order.
Beveling
All beveling shall meet the most recent proposed Public Right -of -Way Accessibility Guidelines (PROWAG)
• Beveling shall be performed at locations where the uplift is more than Y. inch and a maximum of 2 inches.
• Upon completion, the beveled edge shall be flush with the adjoining sidewalk
• The maximum slope for beveling is as follows:
• ''Y." to %" uplift - 2:1(2 Horizontal:) Vertical) httos://www.access-board.gov/prowag/chapter-r3-
technical-reg uirements/#r30272-vertical-surface-discontinuities
• Uplift M." to 2"—12:1(12 Horizontal:) Vertical) https://www.access-board.govLprowafl/chapter-r3-
technical-re uirements #r30422-runnin -slo e
• Contractor is responsible for removing and disposing of all debris and waste that was generated
• Should the uplift exceed 2" or if the contractor encounters a location that cannot be beveled, the City should
be contacted immediately
• Upon completion, the beveled edges shall not be smooth. The contractor shall roughen the newly beveled
surface with a wire brush to meet the following requirements:
ADA Accessibility Guidelines (ADAAG) Appendix 4.5: "The Occupational Safety and Health Administration
(OSHA) recommends that walking surfaces have a static coefficient of friction of 0.5." (ASTM test method
C 1028-96 on a dry surface).
Erosion and Dust Control
The contractor shall submit an erosion and dust control plan detailing means and methods utilized to prevent dust and
debris from migrating from the immediate work site prior to commencing work. At the completion of the concrete
beveling work, the contractor shall make the work are free of concrete dust and debris.
Pedestrian Traffic Control
The contractor shall submit a pedestrian traffic control plan prior to commencing work. The contractor shall conduct
work so one side of the street's sidewalk is always accessible to pedestrians. Signs and barricades shall be provided to
inform the pedestrians of "sidewalk closed ahead" and direction to cross the street at the nearest signal -controlled
intersection.
Deliverables
Upon the completion of work, the contractor shall provide the following Daily Report:
• The location (addresses or description) of the sidewalk that were beveled
• Locations (addresses or description) that could not be beveled and the reason why
Sidewalk identifier (will be provided by the City)
• Observation ID (will be provided by the City), if no ID provided leave blank
• The coordinates of each uplift being assessed
• The length and maximum height of each uplift being beveled
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 52 2021
RFB ver. 9-18
• The date the uplift was beveled
• Purchase Order (PO) number, if provided
• Task Order (WO) number, if provided
This information should be provided in one of the following formats:
• Shapefile
• ESRI feature class in a File Geodatabase
• Excel spreadsheet with X and Y coordinates
Should the contractor be unable to perform the work at the location provided by the City, the City should be
informed immediately. The location should also be included in the deliverables with a note about why it could not
be beveled.
Measurement
Work will be measured in "Inch -Feet." An inch -foot is calculated by measuring the average height of the sidewalk off-
set and multiplying this average by the length of the cut.
Example: A sidewalk off -set on a 4-foot wide sidewalk that consists of a 0.5" rise on one side and tapers down to zero
rise on the other side is calculated as follows:
(0.5" + O") x 4 FT = 1 inch -foot
2
Payment
The unit contract price per inch -foot of concrete beveling work completed shall be full pay for all labor, equipment,
materials, tools, and other to provide a completed repair, including, but not limited to: surface preparation; pedestrian
traffic control; pre- and post measurements; concrete beveling; erosion and dust control; surface roughening; clean-up;
waste removal and disposal; and deliverable documentation.
City of Federal Way RFB # 21-004
Concrete Sidewalk Beveling — Trip Hazard Removal Page 53 2021
RFB ver. 9-18
PRECISION CONCRETE CUTTING, INC.
=3-1 3191 N CANYON RD
PROVO UT 84604-3916
DETACH BEFORE POSTING
- BUSINESS LICENSE
STATE OF Issue Date: Jul 02, 2020
WASHINGTON Unified Business ID #: 603026241
Profit Corporation Business ID #: 001
Location: 0003
PRECISION CONCRETE CUTTING, INC. Expires: Jan 31, 2021
PRECISION CONCRETE CUTTING
I 3191 N CANYON RD
PROVO, UT 84604-3916
T
TAX REGISTRATION - ACTIVE
CITY ENDORSEMENTS:
BURIEN GENERAL BUSINESS- NON-RESIDENT #09496 -ACTIVE
REGISTERED TRADE NAMES:
PRECISION CONCRETE CUTTING
This document lists the registrations, endorsements, and licenses authorized for the business
-
named above. By accepting this document, the license@ certifies the Information on the application
was complete, true, and accurate to the best of his or her knowledge. and that business will be
conducted In compliance wllh all applicable Washington slate, county, and city regulations. Director. Department of Revenue
U B I : 603 026241 001 0003
PRECISION CONCRETE CUTTING,
INC.
PRECISION CONCRETE CUTTING
3191 N CANYON RD
PROVO. UT 84604-3916
STATE OF WASHINGTON
Expires: Jan 31, 2021
TAX REGISTRATION -ACTIVE
BURIEN GENERAL BUSINESS -
NON-RESIDENT #09496 - ACTIVE
DETACH THIS'E CDOY FOR YOUR WALLET Director, Department of R.--
r:.
�k S-,rATES Ql,,
57A7,
71*0
The bute of
Secretary of State
41111"
,rr
I, KIM WYMAN, Secretary of State of the State of Washington and custodian of its seal, hereby issue this
CERTIFICATE OF REGISTRATION
to
PRECISION CONCRETE CUTTING, INC.
A/AN UTAH PROFIT CORPORATION, effective on the date indicated below.
pFA- x
i:■ 0 %'k
r�
aE
d�
S�
Effective Date: 01124/2019
UBI Number: 603 026 241
(iii en under m\ hand and the Seal of the State
of' Washington at Okmhia, the State Capital
Kim Wyman, Secretar) of State
Date Issued: 01/24/2019
5/13/2021
Corporations and Charities System
BUSINESS INFORMATION
Business Name:
PRECISION CONCRETE CUTTING, INC.
UBI Number:
603 026 241
Business Type:
FOREIGN PROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
5624 128TH ST E, PUY.ALLUP, WA, 98373-5160, UNITED STATES
Principal Office Mailing Address:
3191 N CANYON RD, PROVO, UT, 84604-3916, UNITED STATES
Expiration Date:
01 /31/2022
Jurisdiction:
UNITED STATES, UT.AH
Formation/ Registration Date:
01/24/2019
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
OTHER SERVICES
REGISTERED AGENT INFORMATION
Registered Agent Name:
IRIANY TRUJILLO
Street Address:
5624 128TH ST E, PUYALLUP, VIA, 98373-5160, UNITED STATES
Mailing Address:
GOVERNORS
Title Governors Type
GOVERNOR INDIVIDUAL
GOVERNOR INDIVIDUAL
Entity Name First Name Last Name
MATT HANEY
AARON OLLIVIER
hftps://ccfs.sos.wa.gov/*/BusinessSearch/Businesslnformation 1 /1
5/1312021 Washington State Department of Revenue
vVa_i iiiyr, r, StaI,De [! �i�
C Business Lookup
License Information:
Entity name:
PRECISION CONCRETE CUTTING, INC.
Business name:
PRECISION CONCRETE CUTTING
Entity type:
Profit Corporation
UBI #:
603-026-241
Business ID:
001
Location ID:
0003
Location:
Active
Location address:
3191 N CANYON RD
PROVO UT 84604-3916
Mailing address:
3191 N CANYON RD
PROVO UT 84604-3916
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endorsements held at this location License # Count Details
Burien General Business - Non- 09496
Resident
Colville General Business - Non- 027935.0
Resident
Federal Way General Business -
Non -Resident
Sumner General Business - Non -
Resident
Governing People May! people not .egid.,dwith S Mblyofsr.r.
Governing people Title
HANEY, MATT
OLLIVIER, AARON
Registered Trade Names
Registered trade names Status
PRECISION CONCRETE CUTTING Active
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Trip Hazard Removal Speclallats
To Whom It May Concern:
3191 N. Canyon Road Provo, UT 84604
P: (801) 224-0026 F: (801) 224-0062
www.SafeSidowalks.com
Kent Emert is an authorized signer for Precision Concrete Cutting. He is the Washington
State Business Development Manager in the municipal market and as so is authorized to
sign contracts.
Mike Lamb
Vice President of Sales