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AG 21-120 - LAKEHAVEN WATER & SEWER DISTRICTRETURN TO: PW ADMIN EXT: 2700 ID #: 3906 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Capital Projects 2. ORIGINATING STAFF P>FRSON:John Mulkey EXT: 261-3668 3. DATE REQ. BY: 4/21/21 3. TYPE OF DOCUMENT (CHECK ONE): O 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#): 0 INTERLOCAL ❑ OTHER I aSK Vraer Tor LaKenven U17 ny aQjij 4. PROJECTNAME: SW 356th Street Preservation Project 5. NAME OF CONTRACTOR: Lakehaven Water and Sewer District ADDRESS: TELEPHONE: 253-946-541 1 E-MAIL: hlte lakehaven.or FAX: SIGNATURE NAME: Tom Zawackl TITLE: Wtr ODs Asst Mar 6. EXHIBITS AND ATTACHMENTS: 0 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: Upon Execution COMPLETION DATE: Upon Completion 8. TOTAL COMPENSATION: $ 5,980.46 aid to Cit (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: NIA ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED O PURCHASING: PLEASE CHARGE TO: 306-4400-215-344-10-000 9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED 6 PROJECT MANAGER JRM-4-14-21 8 DIVISION MANAGER SLH 4/15/2021 8 DEPUTY DIRECTOR DSw4nsi2l 8 DIRECTOR — ❑ RISK MANAGEMENT (IF APPLICABLE) 6 LAW DEPT ER 4/26/2021 10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 11. CONTRACT SIGNATURE ROUTING Lj n ` _ I kzj ( -\ ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC' D: l� ❑ 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 IS NEEDED.) INITIAL I DATE SIGNET) ❑ FINANCE DEPARTMENT A F— LAW DEPT 'x -f2d21 ❑ SIGNATORY (MAYOR OR DIRECTOR) -f✓ I so'Lk ❑ CITY CLERK W i11J 11 f w ❑ ASSIGNED AG # A. -4+42-0-"-044-006 ❑ SIGNED COPY RETURNED DATE SENT: Comm NTS. EXECUTE " " ORIGINALS Originally assigned as AG 21-120 but reassigned as 20-044-006 due to new number convention for task orders. 1/2020 SERVICES AGREEMENT BETWEEN THE CITY OF FEDERAL WAY AND LAKEHAVEN WATER AND SEWER DISTRICT FOR, SERVICES, COSTS AND CONSTRUCTION RELATED TO Task Order 21-003 Project Title: 2021 SW 356th Street Preservation This Task Order is issued under the Inter Local Agreement between the City of Federal Way and Lakehaven Water and Sewer District. This Task Order establishes the scope, schedule, and budget for the City of Federal Way 2021 SW 356th Street Preservation Project. The Parties agree to perform the Services in the manner set forth in this Task Order. The effective date of this Task order is April 6 , 2021. Project Description. General Description of the work to be performed. • Attachment 1. Manhole and Valve Can, Iron Adjustment Counts with Cost • Attachment 2. Lakehaven Specifications and Contact Information • Attachment 3. Schedule The authorized representatives of the parties have agreed to the terms of this Task Order by signing below. For the City Sig ture h\:c. Title L1 `2cl,'tO-L\ Date Approved as to Form: J. Ryan Call, City Attorney i me 5[�2��� Date Approv as to Form: .. A. .� ��� - - Name, Lakehaven Legal Counsel Attachment 1 2021 CITY OF FEDERAL SW 356th Preservation Project Lakehaven Water and Sewer District Iron Adjustment Counts and Pricing Item Quantity J Unit I Price Total SCHEDULE A 1 Adjust Water Valve To Grade 12 EA $ 350.00 $ 4,200.00 2 Traffic Control (0.5% of bid items 4-11) 1 LS $ 1,000.40 $ 1,000.40 Subtotal Schedule A $ 5,200.40 Sub Total= $ 5,200.40 Construction Inspection (10%)= Admin (5%)= Total= $ 520.04 $ 260.02 $ 5,980.46 *Lakehaven iron adjustment counts have been verified by Lakehaven Water and Sewer District and are based on engineering plans provided by the City of Federal Way. Actual adjustment counts may vary with scope changes made by the City of Federal Way, but maximum funding shall not exceed this listed estimate. Attachment 2 Lakehaven Specifications and Contact Information 1.1. All adjustments/replacements shall be in accordance with the City of Federal Way and Lakehaven Water and Sewer District requirements. 1.2. The work for Lakehaven valve adjustment shall include all labor, mobilization, tools and equipment necessary for performing utility structure (iron) adjustments or replacements in pavement. 1.3. The Lakehaven shall provide all Riser Rings, Valve Boxes, and covers required to complete the work. 1.4. The finished surface of the surface structures must be within one quarter of an inch (1/4") of the surrounding finished surface. 1.5. Valve box covers shall be installed with tabs (ears) indicating the orientation of the associated water main, when applicable. 1.6. Lakehaven shall provide an onsite technician to inspect, provide guidance, supply material, or otherwise facilitate the contractor performing the iron adjustment for the District. Coordinating the Lakehaven staff to be onsite shall be done at least one week prior to work beginning. Valve Can adjustment coordination, contact Tom Zawacki, Water Operations Assistant Manager: tzawacki@lakehaven.or , 253-946-5411 (office), 253-405-6674 (cell) Responsible Party Lakeside Industries Attachment 3 Schedule Task Complete Adjustments Start Date Duration April 1, 2021 45 days City of Federal Way Submit Invoice for Work Performed May 15, 2021 30 days Lakehaven Water Payment for Work Performed June 15, 2021 45 days and Sewer District *Scheduled start dates are estimated and may be adjusted at any time, by the City of Federal Way. RETURN TO: PW ADMIN EXT: 2700 ID #: 3905 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Capital Projects 2. ORIGINATING STAFF PERSON: John Mulkey EXT: 261-3668 3. DATE REQ. BY: 4/21 /21 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#): 0 INTERLOCAL ❑ OTHER I aSK Vraer Tor LaKenyen umay aQJjw 4. PROJECT NAME: SW 320th Street Preservation Project 5. NAME OF CONTRACTOR: LakehaVen Water and Sewer District ADDRESS: TELEPHONE: 253-946-541 1 E-MAIL: phite(MakehaVen.arg FAX: SIGNATURE NAME: TORT ZawaCki TITLE: Wtr Or)S ASSt Mtlr 6. EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES I3 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: Upon Execution COMPLETIONDATE: Upon Completion 8. TOTAL COMPENSATION: $ 11,060.50 (paid to City) (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 13 YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: 13 YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: NIA n RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: 306-4400-214-344-10-000 9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED 8 PROJECT MANAGER JRM-4-14-21 8 DIVISION MANAGER SLH 4/15/2021 8 DEPUTY DIRECTOR osw 4115/21 8 DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) d LAW DEPT ER 4/26/2021 10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 11. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 4j I 12-q 21 DATE REC' D, l ❑ 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 SIGNET] ❑ FINANCE DEPARTMENT - le� LAW DEPT ZO z- i /[r SIGNATORY (MAYOR OR DIRECTOR) -Lc(k 1011 .,CITY CLERK ❑ ASSIGNED AG # AG# ❑ SIGNED COPY RETURNED DATE JEN 1. COMMENTS: EXECUTE" "ORIGINALS 112020 SERVICES AGREEMENT BETWEEN THE CITY OF FEDERAL WAY AND LAKEHAVEN WATER AND SEWER DISTRICT FOR, SERVICES, COSTS AND CONSTRUCTION RELATED TO Task Order 21-001 Project Title: 2021 SW 320th Street Preservation This Task Order is issued under the Inter Local Agreement between the City of Federal Way and Lakehaven Water and Sewer District. This Task Order establishes the scope, schedule, and budget for the CitV of Federal Way 2021 SW 320th Street Preservation Project. The Parties agree to perform the Services in the manner set forth in this Task Order. The effective date of this Task order is March 23 , 2021 Project Description. General Description of the work to be performed. • Attachment 1. Manhole and Valve Can, Iron Adjustment Counts with Cost • Attachment 2. Lakehaven Specifications and Contact Information Attachment 3. Schedule The authorized representatives of the parties have agreed to the terms of this Task Order by signing below. For the City Sig ature �r')\7\ L, �ocws Title L-1 \ 2-CAVLO2 \ Date Approved as to Form: &,� p, Name, City Attorney J. A,..., C.,l) Signature Title 2 Date Approv as to F rm: Nam , Lakehaven Legal Counsel Attachment 1 2021 CITY OF FEDERAL SW 320th Preservation Project Lakehaven Water and Sewer District Iron Adjustment Counts and Pricing Item Quantity Unit Price Total SCHEDULE A 1 Adjust Water Valve To Grade 8 EA $ 784.00 $ 6,272.00 2 Adjust Sanitary Sewer Manhole to Grate 1 EA $ 672.00 $ 672.00 3 4 Adjust Water Vault To Grade 1 EA $ 1,680.00 $ 1,680.00 Traffic Control (1%of bid -items 4-10) 1 LS $ 993.83 $ 993.83 Subtotal Schedule A $ 9,617.83 Sub Total= $ 9,617.83 Construction Inspection (10%)= Admin (5%)= Total= $ 961.78 $ 480.89 $11,060.50 *Lakehaven iron adjustment counts have been verified by Lakehaven Water and Sewer District and are based on engineering plans provided by the City of Federal Way. Actual adjustment counts may vary with scope changes made by the City of Federal Way, but maximum funding shall not exceed this listed estimate. Attachment 2 Lakehaven Specifications and Contact Information 1.1. All adjustments/replacements shall be in accordance with the City of Federal Way and Lakehaven Water and Sewer District requirements. 1.2. The work for Lakehaven valve, vault, and manhole adjustment shall include all labor, mobilization, tools and equipment necessary for performing utility structure (iron) adjustments or replacements in pavement. 1.3. The District shall provide all Riser Rings, Manhole Ring and Covers, Valve Boxes, and covers required to complete the work. 1.4. The finished surface of the surface structures must be within one quarter of an inch (1/4") of the surrounding finished surface. 1.5. Valve box covers shall be installed with tabs (ears) indicating the orientation of the associated water main, when applicable. 1.6. Lakehaven shall provide an onsite technician to inspect, provide guidance, supply material, or otherwise facilitate the contractor performing the iron adjustment for the District. Coordinating the Lakehaven staff to be onsite shall be done at least one week prior to work beginning. W Valve Can adjustment coordination, contact Tom Zawacki, Water Operations Assistant Manager: taawacki@lakehaven.o, 253-946-5411 (office), 253-405-6674 (cell) ® Manhole adjustment coordination, contact Dale Haase, Field Operations Assistant Manager: dhaase@lakehaven.org, 253-946-5408 (office), 253-261-1736 (cell) Responsible Party Miles Resources City of Federal Way Lakehaven Water and Sewer District Attachment 3 Schedule Task _ Complete Adjustments Submit Invoice for Work Performed Payment for Work Performed Start Date Duration March 1, 2021 60 days April 29, 2021 30 days May 28, 2021 45 days *Scheduled start dates are estimated and may be adjusted at any time, by the City of Federal Way.