AG 20-044.006 - 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.