HomeMy WebLinkAboutWWP273685 (3)CITY OF RENTON COUNCIL AGENDA BILL C `
Subject/Title:
Contract Award for Bid Opening on 7/1/2014 for
CAG-14-089; S. 132nd St. Sewer Extension Project
Meeting:
REGULAR COUNCIL - 07 Jul 2014
Exhibits:
Submitting Data: Dept/Div/Board:
Staff Recommendation
City Clerk
Bid Tab (six bids)
Staff Contact:
Bonnie Walton, City Clerk ext. 6502
Recommended Action:
Council concur
Fiscal Impact:
Expenditure Required: $ 213,447.44 Transfer Amendment: $
Amount Budgeted: $ Revenue Generated: $
Total Project Budget: $ 400,000 I City Share Total Project: $
SUMMARY OF ACTION:
Engineer's Estimate: $254,752
In accordance with Council procedure, bids submitted at the subject bid opening met the following thr
criteria: There was more than one bid, the low bid was within total project budget, and there were no
major irregularities with the low bid. Therefore, staff recommends accepting the bid submitted by A
Advanced Septic Services, Inc. in the amount of $213,447.44 for the S. 132nd St. Sewer Extension
Project.
STAFF RECOMMENDATION:
Accept the low bid submitted by A Advanced Septic Services, Inc. in the amount of $213,447.44 for the
S. 132nd St. Sewer Extension Project.
CITY OF RENTON
BID TABULATION SHEET
Project: S. 132nd St. Sewer Extension
CAG-14-089
Date: July 1, 2014
Page 1 of 1
FORMS
Bidder
Proposal
L&I
Bid
Bid Total from Schedule of Prices
Trip. Form
Cert.
Bond
*Includes Sales Tax
A Advanced Septic Services
11603 Canyon Rd. E.
Puyallup, WA 98373
�
Archer Construction
,y
7855 S. 206th St
ZIC 774-, o$
Kent, WA 98032
Hoffman Construction
PO BOX 845
Enumclaw, WA 98022
U
Kar-Vel Construction
PO BOX 58275
t/
✓
✓
33 Z, e73 j . 17
Renton, WA 98058
�
Laser Underground & Earthworks
20417 87th Ave. SE
�'`
v
✓'"
3 2 / 3 2—� 7s
Snohomish, WA 98296
(over)
CITY OF RENTON
BID TABULATION SHEET
Project: S. 132nd St. Sewer Extension
CAG-14-089
Date: July 1, 2014
Page 1 of 2
Bidder
FORMS
Bid Total from Schedule of Prices
*Includes Sales Tax
Proposal
Trip. Form
L&I
Cert.
Bid
Bond
RL Alia Company
107 Williams Ave. S.
Renton, WA 98057
91/ 3S
Engineer's Estimate $254,752.00
Advanced
CONSTRUCTION
Services, Inc.
South 132nd Street Sewer Extension Project ; CAG-14-089
City of Renton
Mobilization Plan
• Meet with homeowners
• Secure a staging area
• Move equipment for grubbing and clearing on site
• Move equipment and materials for stream crossing on site
• Remove grubbing equipment
• Move trenching equipment on site
• Move traffic controls on site
• Remove all equipment
South 132nd
Sewer
ACTIVITY
PLAN PLAN
START DURATION
Mobilization
1
3
Trench SSMH 01 to SSMH02
4
3
Set SSMH 01
7
1
Set concrete blocks
7
1
Weld and coat steel casing
5
3
Install spacers and 8"PVC
8
2
Lay steel casing and pvc
10
2
Set SSMH 02
11
1
Fill trench portion between SSMH 01 and SSMH 02
12
1
Place spawls and cover soil with straw
13
1
Clear and grub tree line
13
5
Trench set SSMH 03 & 04 and lay 8" PVC side connections in field
18
6
Implement traffic control plan
24
20
Saw cut for trench
24
1
Trench set SSMH 05 and lay 8"pvc SSHIM 05 to SSMH 04 fill and compa
26
5
Trench set SSMH 06 and lay 8"pvc SSHM 06 to SSMH 04 fill and compa
31
7
Repair asphalt
37
5
Replace paint and traffic markings -
42
2
Install fence
42
4
Planting and restoration
46
6
Clean up and demobilization
51
3
e n d SewerExtension Period Highlight 1 Plan Actual . %Complete Actual
South�. 3 Se e
PLAN PLAN
A( IIVITY START DURATION:RIODS
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Mobilization 1 3
Trench SSMH 01 to SSMH02 4 3
Set SSMH 01 7 1
Set concrete blocks 7 1
Weld and coat steel casing 5 3
Install spacers and 8"PVC 8 2
Lay steel casing and pvc 10 2
Set SSMH 02 11 1
Fill trench portion between SSMH 01 and SSMH 02 12 1
Place spawls and cover soil with straw 13 1
Clear and grub tree line 13 5
Trench set SSMH 03 & 04 and lay 8" PVC side connections in field 18 6
Period Highlight: %Complete (beyond plan)
South 132nd Sewer Extension
PLAN PLAN
START DURATIONIRIODS
i 1 124 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 S7 58 59 60
Implement traffic control plan
24
20
I
Saw cut for trench
24
1
t
Trench set SSMH 05 and lay 8"pvc SSHM 05 to SSMH 04 fill and comp&
26
5
Trench set SSMH 06 and lay 8"pvc SSHM 06 to SSMH 04 fill and comps,
31
7
Repair asphalt
37
5
Replace paint and traffic markings
42
2
Install fence
42
4
Planting and restoration
46
6
Clean up and demobilization
51
3
South 132nd Street Sewer Extension
Selected Sub contractors, suppiers and products
Company Service, Material Contact # Contact Person Licence # Address City
H.D. Fowler Company
Structures, fittings and pipe
253-863-8600
Derek Hughes
1417 Thornton Avenue SW
Pacific, WA 98047
Lakeridge Paving Company
Asphalt Repair
206-396-0810c 206-395-0803
Jeff Sprouse, Dar Looker
PO Box 8500
Covington, WA
C & P Fencing
Chain Link Fencing
360-802-1059 253-740-5841c
Paul Pohlman
CPFENPF882ME
1516 Chinook Ave
Enumclaw, WA 98022
Skyline Steel
Steel Sleeve
253-250-4002 253-549-6842c
Dave Rayfield
30154th Ave E, Suite 100
Fife, WA 98424
Apply -A -Line Inc
Striping
253-299-1200
Mike Susner
#APPLYI*161RU
175 Roy Rd SW, Bldg C
Pacific, WA 98047
Miles Sand and Gravel
Bank Run, gravel and disposal
253-833-3705 253-569-3261c
Marty Bernard
PLS Inc
Surveying
425-313-9378
Ben Petersen
355 NW Gilman Blvd #102
Issaquah, WA 98027
Alwest Undeground
Trench Safety and signage
253-255-8482
Mike Grimm
799 Valentine Ave SE
Pacific WA 98047
PRECONSTRUCTION CONFERENCE Sign -in Sheet p a City of
Project Name: Airport Lift Station Replacement
Location: South 132nd St
Project Manager: John Hobson Contractor Name: A Advanced Septic Services, Inc.
Contact Name:
Please print clearly
Phone Number: 253-435-9999
Name
Company
Contact Phone/E-Mail
John Hobson
City of Renton
City of Renton
425-430-7279/ jhobson@rentonwa.gov
206-794-6162 / pmiller@rentonwa.gov
Pat Miller
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H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\precon signin sheet - South 132 Sewer Extension.doc
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PRECONSTRUCTION CONFERENCE
PROJECT NAME: South 132nd Street Sewer Extension
PROJECT NO. S-3685
DATE: Sept. 3, 2014
I. Introductions
CAG# CAG-14-089
TIME: 9:00 AM
II ORDER OF WORK BY CONTRACTOR (PROJECT DESCRIPTION AND PROGRESS
SCHEDULE)
A. Estimated Start Date / Anticipated Notice to Proceed
B. Construction Schedule (45 working days)
C. Work hours are weekdays, 7:00 AM to 5:00 PM. Work on Saturday by approval only and no
Sundays. The normal straight time working hours for the Contract shall be any consecutive 8-hour
period between 7:00 a.m. and 5:00 p.m. of a working day with a maximum 1-hour lunch break and
a 5-day Work week. (1-08.0(2) Hours of Work)
Any changes to work hours shall have prior approval from the City of Renton. (Alternate
Schedules / four -tens)
No work on Sundays or holidays. No equipment shall be started prior to 7:00 a.m.
III. UTILITY COMPANIES (OUTSIDE)
A. ryy - Power CrrY 146.k•-r--
B. Puget Sound Energy - Gas
C. AT&T
D. Century Link Telephone
E. Comcast Cable
DISMISS ALL DISINTERESTED PARTIES
IV. CITY DEPARTMENTS/DIVISIONS
A. Wastewater Utility Maintenance
B. City Water and Surface Water?
V. SUBCONTRACTORS AND AGENTS
A. Subcontractors route correspondence via Prime Contractor
B. Prime Contractor must have a representative with authority on the job at all times.
C f'fnrmaLjnnfnrFl. �!�c--�-
VI PERMITS AND PERMITTING AGENCIES
HPA — WDFW
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer ExtensionWonstruction\Precon Agenda South 132nd Street Sewer Extension.doc
VII. TRAFFIC CONTROL AND SAFETY
A. Manual on Uniform Traffic Control Devices (M.U.T.C.D.)
B. Traffic Control Plan
C. Flagman — Certified by State
D. Safety and health requirements - O.S.H.A./W.I.S.H.A. AND DESIGNATION OF SAFETY
OFFICER.
E. Staging
VIII. RECORDS AND REPORTS
A. Intent to pay prevailing wages (form 1&i #700-29) must be approved by department of labor and
industries and received by the city prior to any pay schedule being completed by the project
engineer (ALL PRIME AND SUBS) REF. RCW 39.12.040).
B. "Affidavit Of Wages Paid" (FORM L&I #700-7) for prime and all subs and "release for the
protection of property owners and general.
IX. INSPECTION
A. City Public Works: Pat Miller (public works)
B. Special Inspection (Steel Casing): Stantec
X. ACCESS REQUIREMENTS
A. Stay within existing easement limits.
XI. PROGRESS PAYMENTS
A. Typically once a month. When we issue the notice to proceed, we will agree on the schedule (first
pay period or second pay period of the month). Quantities from inspection reports will take
precedence. Our deadline to have the pay estimate ready for signature will be the end of the
working day before the cutoff day. Submittal of quantities should be by the end of the day four
working days prior to cutoff. This should give us the opportunity to work out discrepancies. If they
can not be worked out prior to our cutoff, we will use the City's quantities and work it out for the
next pay estimate.
B. ✓ Direct Deposit: If you would like to have your progress payments made by direct deposit, we can
get you the paperwork to set it up. If you are on record for direct deposit from a previous project,
you will continue to have future payments made by direct deposit unless you specifically stop
them. If you have previous direct deposit, please confirm that your accounts have not changed.
XII. FINAL ACCEPTANCE
A. Final acceptance shall be after final walk through inspection and approval of as-builts ands.
XIV. GENERAL CONSTRUCTION DISCUSSION
A. CONTRACTOR SHALL NOTIFY FIRE AND POLICE OF CONSTRUCTION SCHEDULE.
KEEP THEM UP TO DATE ON ANY ROAD CLOSURES. CALL 911 FROM A LOCAL
LAND LINE ONLY. FIRE DISPATCH FROM CELL PHONE: 852-2121.
B. The City may cover inspection overtime hours when determined to be beneficial to the City.
C. Keep the streets clean. Truck washing and other measures as approved required for the duration of
the project. Provide whatever measures necessary for cleanup and dust control during job and at
night. All truck maneuvering and materials storage to be on -site only. Right of way to remain
unobstructed when possible.
H:\File Svs\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Precon Agenda South 132nd Street Sewer Extension.doc
D. All trench lines shall be plated or cold -mix patch at end of day. Secure steel plates. Cold -mix all
removed or broken sidewalk. Install filter material over existing catch basins in construction area.
Clean out catch basins after completion of work. Repair all broken storm lines from construction
activities.
E. Haul legal loads.
F. Keep a set of approved (by the City) drawings and construction documents on -site at all times.
Contractors are advised to only use sets of drawings stamped and signed by the City of Renton for
constructing utility improvements. The approved plans do not constitute a fill and grade permit or
grant any rights to fill and/or grade outside of the right-of-way.
G. All utilities must be inspected prior to backfill.
H. For any field changes: If minor, submit a shop drawing or schematic through the inspector or by
email Ohobson@rentonwa.gov). If major, the project engineer should submit drawings and
complete justification, information and calculations as applicable to the project engineer. The City
will answer by memo or schedule a meeting within two days.
I. No construction vehicles on residential streets outside of the project area.
J. Access for emergency vehicles (fire, medical, police) shall be maintained at all times.
K. Be careful to keep the site clean of mud and dust.
L. The contractor shall keep as -built drawings. Show all inverts and elevations. All changes shall be
shown on as-builts. As-builts shall be per City specifications. For any field changes, if minor, give
City a shop drawing (by FAX- 430-7241 or email); if major, need a day or two to review and
approve. Approval for construction changes shall be provided by either the field inspector or the
project manager. The construction inspector, at their discretion, may defer the decision to the
project manager.
HAFile Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Precon Aeenda South 132nd Street Sewer Extension.doc
DCry
eORM
Contract Number:
(assigned by City Clerk)
Select Type: ® Contract/Agr. ❑ Permit ❑ Lease ❑ Adden/Change Order Contract Type:
(assigned by City Clerk)
Staff Name: John Hobson Extension: 7279
Department/Division: public Works / Utility Svstems
EDEN Queue:
Addenda/CO #: to City Clerk's CAG #: 14-089 (if applicable) Expiration Date: July 31, 2015
Contract Class: ❑ Receivable ® Payable ❑ Grant ❑ Misc. (no $) Contract Solicitation Method:
Contractor Name: A Advanced Septic Services, Inc. Formal Call for Bid (CFB) Advertised via City Clerk
Short Description: Snirth 139nd Street Sewer Fxtensinn
Full or Additional Installation of 785 linear feet of 8" sanitary sewer main, 5-Manholes and 131 linear feet of 18" steel
Description: casing in the Earlington area.
® Legal Review (attach memorandum from City Attorney)
® Risk Management review for insurance (attach memorandum from Risk Management)
® Insurance certificate and/or policy (attach original) �,✓
❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been met)
® Performance bond and verification memo from staff (for Public Works type of contracts $35k & over only)
® Federal excluded parties list verification (Attach printout of search results from Website: www.sam.gov/portal/public/SAM)
® Active business license and Accounts payable W-9 vendor form? (obtain if not already on file with Finance Dept.)
® Yes ❑ No Submitted contracts are signed by contractor? If "No", provide explanation here:
Fiscal Impact to City: ® Expenditure OR ❑ Revenue Amount Budgeted:
(line item; see below ):$ 400,000
Amount of Attached
(including tax) $ 213,447.44 per year for years = Total Amount of Attached $ 213,447.44
Prior Council approval via agenda bill process required if: (see policy 250-02)
® Contract or addendum is $100k or over (non -Public Works) or $150k or over (Public Works).
❑ Budget adjustment or fund transfer is necessary.
❑ Interlocal Agreement (most Interlocal Agreements require Resolutions)
Date of Council Approval: Resolution Number: NOTE: Mayor signs for the City, except that the Department Head may sign contracts:
Under $35,000 when for non -Public Works & Small Public Works Roster (SWR);
(if applicable) (if applicable) Under $40,000 when for Public Works single craft non-SWR; and
Under $6S,000 when for Public Works multi -craft non SWR
EXCEPT: Change Orders to PW contracts in any amount can be signed by Project Mgr IF
July 7, 2014 N/A within budget AND under Administrator's authorization.
_11Key words for City Clerk's electronic card file:
South 132nd Street Sewer Extension Special Assessment District, South 132nd Street Sewer Extension SAD
Print Form . Revised 10/25/2013
PUBLIC WORKS DEPARTMENT City of
0
M E M O R A N D U M
DATE: July 31, 2014
TO: Jason Seth
FROM: John Hobson )*1-
SUBJECT: CAG-14-089 Construction Bond Verification
At 10:50 am today, I spoke with a representative of Bannon, Carlson & Kessel, Inc. and
she confirmed that they issued Bond No. SUR40001SS3 in the amount of $213,447.44
for A Advanced Septic Services, Inc. for the South 132" d Street Sewer Extension project.
h:\file sys\wwp - wastewater\wwp-27-3685 s 132nd st sewer extension\award info\bond verification - south 132nd
street sewer extension.doc
Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54 72 79 36
Mutual.
Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Common Policy Declarations 12.01 am Standard Time
at Insured Mailing Location
Named Insured & Mailing Address Agent Mailing Address & Phone No.
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
11603 CANYON RD E BANNON CARLSON & KESSEL INC
PUYALLUP, WA 98373 2121 70TH AVE W STE B
UNIVERSITY PL, WA 98466-7668
Named Insured Is: CORPORATION
Named Insured Business Is: SEPTIC INSTALLATION AND REPAIR
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to
provide the insurance as stated in this policy.
SUMMARY OF COVERAGE PARTS AND CHARGES - CUSTOM PROTECTOR
This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts
(which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of
them) and any other forms and endorsements issued to be part of this policy.
COVERAGE PART
CHARGES
Commercial Property $726.00
Commercial Inland Marine $6, 726.00
Commercial General Liability $12 ,115.00
Total Charges for all of the above coverage parts: $19,567.00
Certified Acts of Terrorists Coverage: $338.00 (Included)
Note: This is not a bill
IMPORTANT MESSAGES
. This policy is auditable. Please refer to the conditions of the policy for details or contact your agent.
Servicing Office Western Washington
and Issue Date 03/28/14 Authorized Representative
ro report a claim, call your Agent or 1-800-362-0000
DS 70 21 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 27 OF 250
Liberty
Mutual.
INSURANCE
Coverage Is Provided In.
Ohio Security Insurance Company
Common Policy Declarations
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC
SUMMARY OF LOCATIONS
Policy Number:
BKS 115) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2015
12.01 am Standard Time
at Insured Mailing Location
(253) 565-3500
BANNON CARLSON & KESSEL INC
This policy provides coverage for the following under one or more coverage parts. Please refer to the individual
Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that
specific Coverage Part.
0001 11603 Canyon Rd E. Puyallup, WA 98373-4361
POLICY FORMS AND ENDORSEMENTS
This section lists the Fonns and Endorsements for your policy. Refer to these documents as needed for detailed
information concerning your coverage.
FORM NUMBER TITLE
CG 00 01 04 13
Commercial General Liability Coverage Form - Occurrence
CG 01 81 05 08
Washington Changes
CG 01 97 12 07
Washington Changes - Employment -Related Practices Exclusion
CG 04 42 11 03
Stop Gap - Employers Liability Coverage Endorsement - Washington
CG 04 50 05 08
Washington Changes - Who Is An Insured
CG 21 7001 08
Cap on Losses From Certified Acts of Terrorism
CG 21 7601 08
Exclusion of Punitive Damages Related to a Certified Act of Terrorism
CG 21 86 1204
Exclusion - Exterior Insulation and Finish Systems
CG 21 96 03 05
Silica or Silica -Related Dust Exclusion
CG 22 7904 13
Exclusion - Contractors - Professional Liability
CG 24 2604 13
Amendment of Insured Contract Definition
CG 26 77 12 04 Washington - Fungi or Bacteria Exclusion
CG 32 21 01 07 Washington Conditional Exclusion of Terrorism Involving Nuclear, Biological or
Chemical Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance
Act)
CG 84 94 12 08 Exclusion - Consolidated Insurance Programs Wrap -Up
In witness whereof, we have caused this policy to be signed by our authorized officers.
Dexter Legg Paul Condrin
Secretary President
To report a claim, call your Agent or 1-800-362-0000
DS 70 21 01 08
03/28/14 54727936 N0108648 235
NCAOPPNO INSURED COPY 000662 PAGE 28 OF 250
Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54727936
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13IM5
Common Policy Declarations 12.01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
POLICY FORMS AND ENDORSEMENTS - CONTINUED
This section lists all of the Fors and Endorsements for your policy. Refer to these documents as needed for
detailed information concerning your coverage.
FORM NUMBER TITLE
CG 84 99 08 09
Non -Cumulation Liability Limits Same Occurrence
CG 88 10 04 13
Commercial General Liability Extension
CG 88 60 1208
Each Location General Aggregate Limit
CG 88 65 1208
Voluntary Property Damage Extension
CG 88 67 1208
Property Damage - Borrowed Equipment - $100,000 Limit
CG 88 70 1208
Construction Project(s)-General Aggregate Limit (Per Project)
CG 88 72 1208
Off Premises Property Damage Including Care, Custody or Control
CG 88 77 1208
Medical Expense At Your Request Endorsement
CG 88 80 1208
Property Damage - Customers' Goods ($100,000 Limit)
CG 89 27 1009
Washington Exclusion - Asbestos
CG 89 58 09 10
Cyber Liability -Amendment of Coverage B--Personal Injury and Advertising Injury
CL 01 03 03 10
Common Policy Conditions - Washington
CL 04 65 01 01
Loss Payable Endorsement - Washington
CL 06 00 01 08
Certified Terrorism Loss
CL 07 00 10 06
Virus or Bacteria Exclusion
CL 16 50 08 06
Conditional NBC Terrorism Exclusion- Exclusion Conditional Exclusion of
Terrorism Involving Nuclear, Biological or Chemical Terrorism (Relating to
Disposition of Federal Terrorism Risk Insurance Act)
CM 00 01 09 04
Commercial Inland Marine Conditions
CM 01 07 0108
Washington Changes
CM 76 13 07 13
Waiver of Theft Deductible
CM 88 02 04 08
Commercial Computer Coverage For
CM 88 12 08 10
Washington Replacement Cost Endorsement
CP 00 10 04 02
Building and Personal Property Coverage For
CP 00 50 04 02
Extra Expense Coverage For
CP 00 90 07 88
Commercial Property Conditions
CP 01 26 01 08
Washington Changes
CP 01 40 07 06
Exclusion of Loss Due to Virus or Bacteria
CP 01 60 12 98
Washington Changes - Domestic Abuse
CP 10 30 04 02
Causes of Loss - Special For
CP 12 18 08 88
Loss Payable Provisions - Washington
To report a claim, call yoor Agent or 1-800-362-0000
DS 70 21 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 29 OF 250
10�Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Common Policy Declarations 12:01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
POLICY FORMS AND ENDORSEMENTS - CONTINUED
This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for
detailed information concerning your coverage.
FORM NUMBER
TITLE
CP 72 97 04 02
Equipment Breakdown Enhancement Endorsement - Special Form
CP 91 00 11 09
Contractors Custom Protector Endorsement
CP 91 32 11 08
Identity Theft Expense Coverage
CP 91 42 It 09
Custom Protector Plus Endorsement
IL 01 46 08 10
Washington Common Policy Conditions
IL 01 57 07 02
Washington Changes - Actual Cash Value
IL Ot 73 07 02
Washington Changes - Excluded Causes of Loss
IL 01 98 09 08
Nuclear Energy Liability Exclusion Endorsement (Broad Form)
IL 09 35 07 02
Exclusion of Certain Computer -Related Losses
IL 09 52 03 08
Cap on Losses From Certified Acts of Terrorism
IL 09 96 Ot 07
Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical
Terrorism (Relating to Dispostion of Federal Terrorism Risk Insurance Act)
IM 20 97 04 04
Amendatory Endorsement - Washington
IM 70 00 04 04
Contractors' Equipment Coverage
IM 70 34 06 04
Tools Endorsement
IM 71 00 06 04
Installation Floater Coverage
IM 78 54 04 04
Loss Payable Options
IM 79 02 05 04
Loss Payable Schedule
OC 70 35 06 93
Removal Permit
To report a claim, call your Agent or 1-800-362-0000
DS 70 21 0108
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 30 OF 250
Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04A3/2015
Commercial Property 12:01 am Standard Time
Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC
SUMMARY OF CHARGES
(253) 565-3500
BANNON CARLSON & KESSEL INC
Explanation of DESCRIPTION PREMIUM
Charges
Property Schedule Totals S706.00
Certified Acts of Terrorism Coverage S20.00
Total Advance Charges: $726.00
Note: This is not a bill
To report a claim, call your Agent or 1-800-362-0000
DS 70 22 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 31 OF 250
Coverage Is Provided In: Policy Number:
_ Liberty Ohio Security Insurance Company BKS (15) 54727936
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Commercial Property 12:01 am Standard Time
Declarations Schedule at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF PROPERTY COVERAGES - BY LOCATION
Insurance at the described premises applies only for coverages for which a limit of insurance is shown. Optional
coverages apply only when entries are made in this schedule.
9091 11603 Canyon Rd E, Puyallup, WA 98373-4361
Property Description:
Characteristics
Your Business
Personal Property
Coverage
Extra Expense
Coverage
Construction: Frame
Occupancy: Septic Tank Systems - Installation, Servicing Or Repair -
Contractors Storage Including Office Occupancies
Limit of Insurance - Replacement Cost
$50, 000
Coinsurance
100 ti
Inflation Guard - Annual Increase
2%
Covered Causes of Loss
Special Form - Including Theft
Deductible
$1, 000
Premium $274.00
Description
Limit of Insurance
$51, 000
Limits on Loss Payment
40%-80%-100%
Covered Causes of Loss
Special Form - Including Theft
Premium $359.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 23 01 08
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INSURED COPY 000662 PAGE 32 OF 250
Coverage Is Provided In.
Liberty Ohio Security Insurance Company
Policy Number:
BKS 54 72 79
ft
(15) 36
Mutual.
Policy Period:
INSURANCE
Commercial Property
From 04/13/2014 To 04/13/2015
12.01 am Standard Time
Declarations Schedule
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC
SUMMARY OF PROPERTY COVERAGES - BY LOCATION
(253) 565-3500
BANNON CARLSON & KESSEL INC
Continuation of 11603 Canyon Rd E, Puyallup, WA 98373-4361
Equipment This Equipment Breakdown insurance applies to the coverages shown for this
Breakdown location. The Equipment Breakdown limit(s) of insurance and deductible are
Coverage included in, and not in addition to, the limits and deductible shown for the Building,
Your Business Personal Property, Your Business Personal Property of Others,
Tenants Improvements and Betterments, Business Income and Extra Expense,
Business Income Without Extra Expense, and Extra Expense coverages.
Premium $12.00
SUMMARY OF OTHER PROPERTY COVERAGES
Property
Extension
Endorsement
Property
Extension
Endorsement
Description
Custom Protector Plus Endorsement $11.00
Premium $11.00
Description
Contractors Custom Protector Endorsement $50.00
Commercial Property Schedule Total:
To report a claim, call your Agent or 1-800-362-0000
Premium $50.00
$706.00
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Liberty
Mutual.
INSURANCE
Named Insured
Coverage Is Provided In:
Ohio Security Insurance Company
Commercial Inland Marine
Declarations
Agent
Policy Number:
BKS (15) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
at Insured Mailing Location
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF CHARGES
Explanation of DESCRIPTION PREMIUM
Charges
Commercial Inland Marine Schedule Totals $6.480.00
Certified Acts of Terrorism Coverage $246.00
Total Advance Charges: $6, 726.00
Note: This is not a bill
To report a claim, call your Agent or 1-800-362-MM
DS 70 22 01 08
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AtUS
INI 7005 01 12
PAGE I OF 2
SCHEDULE OF COVERAGES
CONTRACTORS' EQUIPMENT
(The entries required to complete this schedule
will be shown below or on the "schedule of coverages".)
PROPERTY COVERED
(check one)
9N/oo Scheduled Equipment (Refer to Equipment Schedule)
° %o Schedule On File
"LIMIT'
Catastrophe Limit -- The most "we" pay
for loss in any one occurrence is: $ 616,148
COVERAGE EXTENSIONS
Additional Debris Removal Expenses $ 5,000
SUPPLEMENTAL COVERAGES
Employee Tools
$
5,000
Equipment Leased or Rented Form Others
$
75,000
Newly Purchased Equipment (check one)
9P/oo Percentage of Catastrophe Limit
30 %
° %o Dollar Limit
$
Pollutant Cleanup and Removal
$
25,000
Rental Reimbursement
-- Reimbursement Limit
$
5,000
--Waiting Period
72 Hours
Spare Parts and Fuel
$
5,000
BKS (15) 54 72 79 36
Copyright, American Association of Insurance Services, Inc., 2012
03/28/14 54727936 P40108648 235 NCAOPPNO INSURED COPY 000662 PAGE 36 OF 250
03/28/14
AAIS
IM 7005 01 12
PAGE 2 OF 2
COINSURANCE (check one)
° %0 80% ° %0 90% °IP/oo 100% ° %o OTHER %
REPORTING CONDITIONS (check if applicable)
9(%o Equipment Leased or Rented From Others
- Reporting Rate $
-- Deposit Premium $
- Minimum Premium $
VALUATION (check if applicable)
° %0 Actual Cash Value ° %o Replacement Cost
° %o Indicated on Equipment Schedule
DEDUCTIBLE (check one)
9N/oo Flat Deductible Amount $
° %o Percentage Deductible
Maximum Deductible Amount $
Minimum Deductible Amount $
ADDITIONAL INFORMATION
IM 7005 01 12
2
50
Copyright, American Association of Insurance Services, Inc., 2012
54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 37 OF 250
AAIS
IM 7031 01 12
BKS (15) 54 72 79 36
EQUIPMENT SCHEDULE
CONTRACTORS' EQUIPMENT
VALUATION BASIS
(The entries required to complete this schedule
will be shown below or on the "schedule of coverages".)
SCHEDULED EQUIPMENT
AA = Agreed Amount ACV = Actual Cash Value RP = Replacement Cost
Item
No.
Valuation
Description of Equipment
"Limit"
1
ACV
2000 Terralift Machine #1 S#3040698
$
17,850
2
ACV
2007 Kubota Mini Excavator S#U1543700
$
15,000
3
ACV
2007 Terex Backhoe S#SMFH44TR07BFM1313
$
40,000
4
ACV
2010 Kubota #3 S#71577
$
40,000
5
ACV
Laser
$
2,500
6
ACV
Pipe Camera
$
7,500
7
ACV
Pipe Camera
$
7,500
8
ACV
2011 Kubota #4 S#15101
$
31,910
IM 7031 01 12
Copyright, American Association of Insurance Services, Inc., 2012
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 38 OF 250
Liberty
Mutual.
INSURANCE
Coverage Is Provided In.
Ohio Security Insurance Company
Commercial Inland Marine
Declarations Schedule
Policy Number:
BKS (15) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2015
12.01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
COMMERCIAL COMPUTER COVERAGE
COVERED PREMISES
Prem.
No. PREMISES
0001 11603 Capon Rd E Puyallup, WA 98373
PREMISES LIMITS
EQUIPMENT
Valuation: Replacement Cost
Limit
0001 Prem. No.
$ 50.0Q4
All Covered Property in Any One Occurrence
$ 50.000
SOFTWARE
All Covered Property in Any One Occurrence
$
EXTRA EXPENSE
0001 Prem. No.
$ 50,000
All Covered Property in Any One Occurrence
$ 5 -10-0
DEDUCTIBLE
$ 504
WIIIIII
To report a claim, call your Agent or 1-800-362-0000
CM88110310
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 39 OF 250
10�Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Commercial Inland Marine 12:01 am Standard Time
Declarations Schedule at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
INSTALLATION FLOATER COVERAGE
PROPERTY COVERED
(X) Blanket Coverage
Jobsite Limit -- The most "we" pay for
loss to any one "jobsite" is:
Catastrophe Limit -- The most "we" pay for
loss to any one occurrence is:
() Scheduled Locations Coverage
Loc .
No.
Location
Limit
$ 250.000
$ 25.000
Limit
Catastrophe Limit -- The most "we" pay for
loss to any one occurrence is:
$
_
COVERAGE EXTENSIONS
Additional Debris Removal Expenses
$
5,000
Emergency Removal
10 days
Limited Fungus Coverage
$
15. 000
SUPPLEMENTAL COVERAGES
Contract Penalty
$
_ 5,000
Pollutant Cleanup and Removal
$
10'000
Sewer Backup Coverage
$
5,000
Storage Locations
$
5,000
Testing
$
_ 5,000
Transit
$
5,000
To report a claim, call your Agent or 1-800-362-0000
IM 71 05 04 04
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 40 OF 250
Liberty
Mutual.
INSURANCE
Coverage Is Provided lo.
Ohio Security Insurance Company
Commercial Inland Marine
Declarations Schedule
Policy Number:
BKS (15) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUPPLEMENTAL COVERAGES (cont)
Earthquake Coverage
(X) Coverage Not Provided
( ) Coverage Provided, as described below:
Earthquake Limit -- The most "we" pay
for loss to any one building or
structure is:
Earthquake Catastrophe Limit -- The most
"we" pay for loss in any one occurrence is:
Flood Coverage
(X) Coverage Not Provided
( ) Coverage Provided, as described below:
Flood Limit -- The most "we" pay
for loss to any one building or
structure is:
Flood Catastrophe Limit -- The most
"we" pay for loss in any one occurrence is:
DEDUCTIBLE
Deductible Amount
() Earthquake Coverage
() Flood Coverage
() Sewer Backup Coverage
COINSURANCE
( ) Not Applicable
()80% ()90%
(X) 100% ( ) Other
To report a claim, call your Agent or 1-W0-362-0000
EM 71 05 04 04
$ 5
Deductible Amount
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 41 OF 250
This page intentionally left blank.
ft Liberty
Mutual.
INSURANCE
Coverage Is Provided In:
Ohio Security Insurance Company
Commercial General Liability
Declarations
Basis: Occurrence
Policy Number:
BKS (15) 54 72 79 36
Policy Period:
From 04/1312014 To 04/13/2015
12:01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF LIMITS AND CHARGES
Commercial
DESCRIPTION
LIMIT
General
Each Occurrence Limit
1,000,000
Liability
Damage To Premises Rented To You Limit (Any One Premises)
1,000,000
Limits of
Insurance
Medical Expense Limit (Any One Person)
15,000
Personal and Advertising Injury Limit
1,000,000
General Aggregate Limit (Other than Products - Completed Operations)
2,000,000
Products - Completed Operations Aggregate Limit
2,000,000
Explanation of
DESCRIPTION
PREMIUM
Charges
General Liability Schedule Totals
12, 043.00
Certified Acts of Terrorism Coverage
72.00
Total Advance Charges:
$12,115.00
Note: This is not a bill
To report a claim, call your Agent or 1-800-362-0000
DS 70 22 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 43 OF 250
Liberty
Mutual.
INSURANCE
Policy Number:
BKS (15) 54 72 79 36
Policy Period:
Commercial General Liability From 04/13/2014 To 04/13/2015
Declarations Schedule 12:01 am Standard Time
at Insured Mailing Location
Coverage Is Provided In. -
Ohio Security Insurance Company
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF CLASSIFICATIONS - BY LOCATION
0001 11603 Canyon Rd E, Puyallup, WA 98373-4361
Insured: A ADVANCED SEPTIC SERVICES INC
CLASSIFICATION - 98806
Septic Tank Systems - Installation, Servicing Or Repair
RATED / PER
COVERAGE DESCRIPTION PREMIUM BASED ON - Executive Officers 1,000 PREMIUM
Premise/Operations 35,600 Dollars Of Payroll 8.027 $286.00
Total: $286.00
Products/Completed Operations 17.254 $614.00
Total: $614.00
CLASSIFICATION - 98806
Septic Tank Systems - Installation, Servicing Or Repair
RATED / PER
COVERAGE DESCRIPTION PREMIUM BASED ON - Employees Payroll 1,000 PREMIUM
Premise/Operations 400,000 Dollars Of Payroll 8.027 $3, 211.00
Total: $3,211.00
Products/Completed Operations 17.254 $6,902.00
Total. $6, 902.00
To report a claim, call your Agent or 1-800-362-0000
IDS 70 23 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 44 OF 250
Coverage Is Provided In:
I.1berLy Ohio Security Insurance Company
Policy Number:
BKS (15) 54727936
Mutual.
Policy Period:
INSURANCE Commercial General Liability
From 04/13/2014 To 04/13/2015
Declarations Schedule
12.01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF CLASSIFICATIONS - BY LOCATION
CLASSIFICATION - 91581
Contractors - Subcontracted Work - In Connection With
Construction, Reconstruction, Erection or Repair -
Not Buildings
RATED / PER
COVERAGE DESCRIPTION PREMIUM BASED ON -
1,000 PREMIUM
Premise/Operations 60,000 Dollars Of Total Cost
3.723 $223.00
Total.
$223.00
Products/Completed Operations
2.751 $165.00
Total:
$165.00
CLASSIFICATION - 91585
Contractors - Subcontracted Work - In Connection With
Construction, Reconstruction, Repair or Erection Of
Buildings NOC
RATED / PER
COVERAGE DESCRIPTION PREMIUM BASED ON -
1,000 PREMIUM
Premise/Operations Dollars Of Total Cost - if any
2.330
Total:
Products/Completed Operations
1.298
Total.
To report a claim, call your Agent or 1-800-362-MM
DS 70 23 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000662 PAGE 45 OF 250
10�Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BKS (15) 54727936
Mutual. Policy Period:
INSURANCE Commercial General Liability From 04/13/2014 To 04/13/2015
D12.01 am Standard Time
Declarations Schedule
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF OTHER COVERAGE
COVERAGE DESCRIPTION
PREMIUM
Contractors Custom Protector Coverages See Policy Fonns and Endorsements List $570.00
RATED / PER
CLASSIFICATION - 92400 PREMIUM BASED ON - 1,000
Stop Gap - Employers Liability
Stop Gap Employers' Liability - WA 260,000 Dollars of Payroll 145 $38.00
Minimum Premium Adjustment $34.00
Commercial General Liability Schedule Total $12,043.00
To report a claim, call your Agent or 1-800-36247000
DS 70 23 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO
INSURED COPY 000662 PAGE 46 OF 250
v
'O�Liberty
Mutual.
INSURANCE
Coverage Is Provided In:
Ohio Security Insurance Company
Common Policy Declarations
Policy Number:
BAS (15) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
at Insured Mailing Location
Named Insured & Mailing Address Agent Mailing Address & Phone No.
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
11603 CANYON RD E BANNON CARLSON & KESSEL INC
PUYALLUP, WA 98373 2121 70TH AVE W STE B
UNIVERSITY PL, WA 98466-7668
Named Insured Is: CORPORATION
Named Insured Business Is: SEPTIC INSTALLATION AND REPAIR
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to
provide the insurance as stated in this policy.
SUMMARY OF COVERAGE PARTS AND CHARGES
This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts
(which consist of coverage forms and other applicable fortes and endorsements, if any, issued to form a part of
them) and any other forms and endorsements issued to be part of this policy.
COVERAGE PART
Business Auto
IMPORTANT MESSAGES
Servicing Office Western Washington
and Issue Date 03/28/14
CHARGES
$33,750.00
Total Charges for all of the above coverage parts: $33, 750.00
Coverage for Terrorism resulting from Nuclear,
Biological or Chemical Acts is Excluded
To report a claim, call your Agent or 1-800-362-0000
Note: This is not a bill
Authorized Representative
DS 70 42 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 11 OF 76
10kCoverage Is Provided In: Policy Number:
Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From W13/2014 To 04/13/2015
Common Policy Declarations 12:01 am Standard Time
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
POLICY FORMS AND ENDORSEMENTS
This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed
information concerning your coverage.
FORM NUMBER TITLE
CA 00 01 03 06
Business Auto Coverage Form
CA 01 35 01 08
Washington Changes
CA 21 3401 08
Washington Underinsured Motorists Coverage
CA 23 9301 06
Washington Exclusion of Terrorism Involving Nuclear, Biological or Chemical
Terrorism
CA 85 47 12 93
Temporary Substitute Auto - Physical Damage Insurance
CA 85 53 12 93
Recreational Trailers and Boat Trailers
CA 88 1001 10
Business Auto Coverage Enhancement Endorsement
CA 99 03 03 06
Auto Medical Payments Coverage
CA 99 54 07 97
Covered Auto Designation Symbol
CA 99 89 05 01
Washington Loss Payable Form Reg-335
IL 01 46 08 10
Washington Common Policy Conditions
IL 01 98 09 08
Nuclear Energy Liability Exclusion Endorsement (Broad Form)
In witness whereof, we have caused this policy to be signed by our authorized officers.
Dexter Legg Paul Condrin
Secretary President
To report a claim, call your Agent or 1-800-362-0000
DS 70 21 O1 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 12 OF 76
- Liberty
Mutual.
INSURANCE
Coverage Is Provided In:
Ohio Security Insurance Company
Business Automobile
Policy Declarations
ITEM ONE:
Named Insured Agent
Policy Number:
BAS (15) 54 72 79 36
Policy Period:
From 04/13/2014 To 04/13/2(115
12.01 am Standard Time
at Insured Mailing Location
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS
This policy provides only those coverages where a charge is shown in the premium column below. Each of these
coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a
particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business
Auto Coverage Form next to the name of the coverage.
*See Business Auto Coverage Form CA 00 01 for Covered Auto Symbol Descriptions
COVERAGES
LIMIT
PREMIUM
Liability Insurance
$1,000,000 each accident
$25, 749.00
Covered Auto Symbol(s)
01,
10*
Medical Payments
$5,000 per person
$1,054.00
Covered Auto Symbol(s)
02,
10*
Underinsured Motorist
Coverage
Limit
$2, 085.00
Washington
Underinsured Motorists Bodily Injury and Property
Darna&%1,000,000
each accident
Covered Auto Symbol(s)
02,
10*
Physical Damage
Comprehensive
$1, 476.00
Covered Auto Symbol(s)
07,
08*
Collision
$2, 838.00
Covered Auto Symbol(s)
07,
08*
Miscellaneous Coverages
Business Auto Enhancement Endorsement
$548.00
Terrorism Coverage
Included
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 13 OF 76
Liberty
Mutual.
Named Insured
Coverage Is Provided In:
Ohio Security Insurance Company
Business Automobile
Policy Declarations
A ADVANCED SEPTIC SERVICES INC
Agent
Policy Number:
BAS (15) 54727936
Policy Period:
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
at Insured Mailing Location
(253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM TWO: SCHEDULE OF COVERAGES AND COVERED AUTOS - continued
Total Provisional Charges: $33,750.00
Note: This is not a bill
SUMMARY OF COVERED VEHICLES
UNIT YEAR MAKE/MODEL
YIN
TERR
ST
CLASS
ZIP
SYM/COST
001
1996 International4700
IHTSLAAM6TH300349
005
46
31489
98373
$41,600
002
2000 Freightliner C1206
IFUYSZYB6YPF25215
005
46
50489
98373
$88,500
003
2006 PJ Trailer
4PSDT122961081893
005
46
68489
98373
$6,000
004
2007 TNT Trailer
IT9FS22267R506415
005
46
68489
98373
$7,000
005
1994 International 8100
1 HSHBAZN8RH555236
005
46
36479
98373
$76,098
006
2007 Contrell Trailer
4KNFC192XXI63900
005
46
68489
98373
$9,000
007
2011 DODGE 1500
1 D7RV I CT5BS578290
005
46
01489
98373
$41,585
008
2007 Dodge 3500 ST
3D6WH46A57G764811
005
46
21489
98373
$24,285
009
2003 Freightliner CL120
IFUJA6CG23LL02138
005
46
50489
98373
$94,75t
010
2006 DODGE 1500
ID7HA16N86J205812
005
46
01489
98373
$21,585
Off
2007 Freightliner M2 10
IFVACWDC87DY45625
005
46
21489
98373
$74,921
012
1988 GMC/CHEVY C71)042
IGDP7DIYOJV528028
005
46
33489
98373
$32,395
Ot3
2012 EAGLE BLACK H 7X20
184BU2027CCOI1377
005
46
68489
98373
$5,000
014
2012 DODGE RAM 1500
3C6JD6DT8CG254207
005
46
01489
98373
$24,070
015
2012 Nissan NV2500 SV
I N6AFOLX8CN 105563
005
46
01489
98373
$30,490
016
2005 Freightliner M2 10
IFVACVDD25DV 16354
005
46
21489
98373
$71,092
To report a claim, call your Agent or 1-80o-362-o000
DS 70 43 OI 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 14 OF 76
Coverage Is Provided In:
Liberty Ohio Security Insurance Company
Policy Number:
BAS (15) 54 72 79 36
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
SUMMARY OF COVERED VEHICLES, continued
UNIT YEAR MAKE/MODEL YIN TERR ST CLASS ZIP SYM/COST
017 1997 FREIGHTLINER FLD12
018 2006 Yamaha R66/AT
019 2007 COACHMEN LEGE 40FT
020 1999 STERLING PUMP TRUC
021 2014 HAULMARK PASSPORT
022 2013 DODGE RAM 3500
023 1995 GMC 2500
To report a claim, call your Agent or 1-600-362-0000
DS 70 43 01 08
1FV4FSYB1VP698607
005
46
50489
98373
$50,800
5Y4AM04Y96A024252
005
46
7996
98373
$9,199
4UZACHCY27CZ27632
005
46
7996
98373
$189,305
2FWYHWEB8XAF40611
005
46
50489
98373
$75,000
575GB2026EU087960
005
46
68489
98373
$7,500
3C63R3ML4DG544616
005
46
21489
98373
$56,030
IGTFK24KXSZ522421
005
46
01489
98373
$19,868
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 15 OF 76
10�Coverage Is Provided In:
Policy Number:
Liberty Ohio Security Insurance Company
BAS (15) 54 72 79 36
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL
UNIT
001 1996
International 470OLP VIN:
1 HTSLAAM6TH300349
Rating
CLASS
SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors
31489
$41,600 005 WA
98373 0217
DESCRIPTION
PREMIUM
Physical Damage
Comprehensive - Actual Cash Value Less $1000 Deductible $51.00
Total Premium
$51.00
UNIT
002 2000
Freightliner C12064T VIN:
1 FUYSZYB6YPF25215
Rating
CLASS
SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors
50489 $88,500 005 WA
Loss Payee
Puget Sound Leasing Company Inc
PO Box 1295
ISSAQUAH, WA 98027
98373 0217
DESCRIPTION
PREMIUM
Liability Insurance
$2,937.00
Medical Payments
$64.00
Underinsured Motorist Bodily Injury and Property Damage
$139.00
Physical Damage
Comprehensive - Actual Cash Value Less $1000 Deductible $77.00
Collision - Actual Cash Value Less $1000 Deductible $208.00
Total Premium
$3,425.00
To report a claim, call your Agent or 1-800-362-0000
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INSURED COPY 000664 PAGE 16 OF 76
Coverage Is Provided In.
tft Liberty Ohio Security Insurance Company
Policy Number:
BAS (15) 54 72 79 36
Mutual.
Policy Period:
INSURANCE
Business Automobile
4/1 From 03/2014 To 04/13/2015
12.01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 003 2006 PJ Trailer VIN: 4PSOT122961081893
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 68489 $6,000 005 WA 98373 0217
DESCRIPTION PREMIUM
Liability Insurance $108.00
Medical Payments $6.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $18.00
Collision - Actual Cash Value Less $1000 Deductible $13.00
Total Premium $145.00
UNIT 004 2007 TNT Trailer VIN: 1T9FS22267R506415
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 68489 $7,000 005 WA 98373 0217
DESCRIPTION PREMIUM
Liability Insurance $108.00
Medical Payments $6.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $22.00
Collision - Actual Cash Value Less $1000 Deductible $17.00
Total Premium $153.90
To report a claim, call your Agent or 1-800-362-0000
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INSURED COPY 000664 PAGE 17 OF 76
Coverage Is Provided In:
Policy Number:
_ Liberty
Ohio Security Insurance Company
BAS (15) 54727936
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured
Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 005 1994
International 8100 VIN:
1 HSHBAZN8RH555236
Rating CLASS
SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors 36479
$76,098 005 WA
98373 0217
Loss Payee
HERITAGE BANK
10318 GRAVELLY
LAKE DR SW
LAKEWOOD, WA
98499
DESCRIPTION
PREMIUM
Liability Insurance
$1, 995.00
medical Payments
$64.00
Underinsured Motorist Bodily Injury and Property Damage
$139.00
Physical Damage
Comprehensive - Actual Cash Value Less $1000 Deductible $60.00
Collision - Actual Cash Value Less $1000 Deductible
$164.00
Total Premium
$2,422.90
UNIT 006 2007
Contrell Trailer VIN:
4KNFC192X7063900
Rating CLASS
SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors 68489
$9,000 005 WA
98373 0217
DESCRIPTION
PREMIUM
Liability Insurance
$108.00
Medical Payments
$6.00
Physical Damage
Comprehensive - Actual Cash Value Less $1000 Deductible $25.00
Collision - Actual Cash Value Less $1000 Deductible
$30.00
Total Premium
$169.90
To report a claim, call your Agent or 1-899-362-11000
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235 NCAOPPNO INSURED COPY
000664 PAGE 18 OF 76
Coverage Is Provided In. Policy Number:
'O�Ube Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Business Automobile 12:01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 007 2011 DODGE 1500 VIN: 1 D7RV1 CT5BS578290
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 01489 $41,585 005 WA 98373 0217
Loss Payee
HERITAGE BANK
10318 GRAVELLY LAKE DR SW
LAKEWOOD, WA 98499
DESCRIPTION PREMIUM
Liability Insurance $1, 010.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $132.00
Collision - Actual Cash Value Less $1000 Deductible $283.00
Total Premium $1,628.90
UNIT 008 2007 Dodge 3500 ST VIN: 306WH46A57G764811
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 21489 $24,285 005 WA 98373 0217
Loss Payee
HERITAGE BANK
10318 GRAVELLY LAKE DR SW
LAKEWOOD, WA 98499
DESCRIPTION PREMIUM
Liability Insurance $1, 063.00
Medical Payments $64.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 19 OF 76
Coverage Is Provided In.
Policy Number:
_ Liberty Ohio Security Insurance Company
BAS (15) 54 72 79 36
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12.01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
Underinsured Motorist Bodily Injury and Property Damage
$139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible
Collision - Actual Cash Value Less $1000 Deductible
$51.00
$75.00
Total Premium
$1,392.00
UNIT 009 2003 Freightliner CL120T VIN: 1 FUJA6CG23LL02138
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP
TOWN CODE
Factors 50489 $94,751 005 WA 98373
Loss Payee
Summit Leasing Inc.
P.O. Box 7
Yakima, WA 98907
0217
DESCRIPTION
PREMIUM
Liability Insurance
$2, 937.00
Medical Payments
$64.00
Underinsured Motorist Bodily Ir_jury and Property Damage
$139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible
Collision - Actual Cash Value Less $1000 Deductible
$79.00
$275.00
Total Premium
$3,494.00
UNIT 010 2006 DODGE 1500 VIN: 1 D7HA16N86J205812
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP
TOWN CODE
Factors 01489 $21,585 005 WA 98373
0217
DESCRIPTION
PREMIUM
Liability Insurance
$1 , 010.00
To report a claim, call your Agent or 1-809-362-0000
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PAGE 20 OF 76
VpCoverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Business Automobile 12.01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $69.00
Collision - Actual Cash Value Less $1000 Deductible $94.00
Total Premium $1,376.90
UNIT 011 2007 Freightliner M2106 VIN: 1 FVACWDC87DY45625
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 21489 $74,921 005 WA 98373 0217
Loss Payee
Summit Leasing Inc.
P.O. Box 7
Yakima, WA 98907
DESCRIPTION PREMIUM
Liability Insurance $1, 063.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $85.00
Collision - Actual Cash Value Less $1000 Deductible $199.00
Total Premium $1,550.00
To report a claim, call your Agent or 1-800-362-0000
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INSURED COPY 000664 PAGE 21 OF 76
Coverage Is Provided In:
_ Liberty Ohio Security Insurance Company
Policy Number:
BAS (15) 54 72 79 36,
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 012 1988 GMC/CHEVY C70042 VIN: 1 GOP701 YOJV528028
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 33489 $32,395 005 WA 98373 0217
DESCRIPTION PREMIUM
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $48.00
Total Premium $48.00
UNIT 013 2012 EAGLE BLACK H 7X20 TRAILER VIN: 184BU2027CCO11377
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 68489 $5,000 005 WA 98373 0217
Loss Payee
HERITAGE BANK
10318 GRAVELLY LAKE DR SW
LAKEWOOD, WA 98499
DESCRIPTION PREMIUM
Liability Insurance $108.00
Medical Payments $6.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $25.00
Collision - Actual Cash Value Less $1000 Deductible $22.00
Total Premium $161.00
To report a claim, call your Agent or 1-809-362-0000
DS 70 43 01 OK
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Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Business Automobile 12:01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 014 2012 DODGE RAM 1500 VIN: 3C6JD6DT8CG254207
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 01489 $24,070 005 WA 98373 0217
Loss Payee
Ally Financial
PO Box 8105
COCKEYSVILLE, MD 21030
DESCRIPTION
PREMIUM
Liability Insurance
$1, 010.00
Medical Payments
$64.00
Underinsured Motorist Bodily Injury and Property Damage
$139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $93.00
Collision - Actual Cash Value Less $1000 Deductible $157.00
Total Premium
$1,40.00
UNIT 015 2012 Nissan NV2500 SV VIN:
1 N6AFOLX8CN105563
Rating CLASS SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors 01489 $30,490 005 WA
Loss Payee
Nissan Motor Acceptance Corp
PO Box 660672
DALLAS, TX 75266
98373 0217
DESCRIPTION
PREMIUM
Liability Insurance
$1, 010.00
Medical Payments
$64.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 Ol 08
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Coverage Is Provided In:
Policy Number:
_ Liberty Ohio Security Insurance Company
BAS (15) 5472 79 36
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location '
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $115.00
Collision - Actual Cash Value Less $1000 Deductible $206.00
Total Premium $1,534.00
UNIT 016 2005 Freightliner M2106 VIN: 1 FVACVD0250V16354
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 21489 $71,092 005 WA 98373 0217
Loss Payee
Summit Leasing Inc.
P.O. Box 7
Yakima, WA 98907
DESCRIPTION PREMIUM
Liability Insurance $1, 063.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $79.00
Collision - Actual Cash Value Less $1000 Deductible $168.00
Total Premium $1,513.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 Ol 08
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INSURED COPY 000664 PAGE 24 OF 76
Coverage Is Provided In: Policy Number:
Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Business Automobile 12:01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 017 1997 FREIGHTLINER FLO120 DUMP T VIN: 1 FV4FSYB1 VP698607
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 50489 $50,800 005 WA 98373 0217
Loss Payee
Summit Leasing Inc.
P.O. Box 7
Yakima, WA 98907
DESCRIPTION
PREMIUM
Liability Insurance $2,937.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $69.00
Collision - Actual Cash Value Less $1000 Deductible $149.00
Total Premium $3,358.00
UNIT 018 2006 Yamaha R66/AT
VIN: 5Y4AMO4Y96A024252
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 7996 $9,199 005 WA 98373 0217
DESCRIPTION PREMIUM
Liability Insurance $979.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage Included
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $45.00
Collision - Actual Cash Value Less $1000 Deductible $42.00
Total Premium $1,130.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 01 08
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10� Coverage Is Provided In. Policy Number:
Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutua
l. Policy Period:
INSURANCE From 04/13/2014 To 04/13/2015
Business Automobile 12:01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 019 2007 COACHMEN LEGE 40FT MOTORHO VIN: 4UZACHCY27CZ27632
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 7996 $189,305 005 WA 98373 0217
Loss Payee
Harborstone Credit Union
PO Box 4207
TACOMA, WA 98438
DESCRIPTION PREMIUM
Liability Insurance $979.00
Medical Payments $64.00
Underinsured Motorist $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $100.00
Collision - Actual Cash Value Less $1000 Deductible $257.00
Total Premium $1,539.00
UNIT 020 1999 STERLING PUMP TRUCK TRACTO VIN: 2FWYHWEB8XAF40611
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors. 50489 $75,000 005 WA 98373 0217
DESCRIPTION PREMIUM
Liability Insurance $2,937.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $77.00
Collision - Actual Cash Value Less $1000 Deductible $208.00
Total Premium $3,425.09
To report a claim, call your Agent or 1-800-362-0090
DS 70 43 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 26 OF 76
Coverage Is Provided In. Policy Number:
ft Liberty Ohio Security Insurance Company BAS (15) 54 72 79 36
Mutual. Policy Period:
INSURANCE From 04/1312014 To 04/13=15
Business Automobile 12:01 am Standard Time
Policy Declarations at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 021 2014 HAULMARK PASSPORT TRAILER VIN: 575GB2026EU087960
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 68489 $7,500 005 WA 98373 0217
DESCRIPTION PREMIUM
Liability Insurance $108.00
Medical Payments $6.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $29.00
Collision - Actual Cash Value Less $1000 Deductible $26.00
Total Premium $169.L70
UNIT 022 2013 DODGE RAM 3500 VIN: 3C63R3ML4DG544616
Rating CLASS SYM/COST TERRITORY RISK STATE RATING ZIP TOWN CODE
Factors 21489 $56,030 005 WA 98373 0217
Loss Payee
Chrysler Financial Co LLC
PO Box 9001921
LOUISVILLE, KY 40290
DESCRIPTION PREMIUM
Liability Insurance $1, 063.00
Medical Payments $64.00
Underinsured Motorist Bodily Injury and Property Damage $139.00
Physical Damage Comprehensive - Actual Cash Value Less $1000 Deductible $102.00
Collision - Actual Cash Value Less $1000 Deductible $220.00
Total Premium
$1,588.90
To report a claim, call your Agent or 1-800-362-D000
DS 70 43 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 27 Of 76
Coverage Is Provided In:
Policy Number:
= Ube' ' Ohio Security Insurance Company
BAS (15) 54727936
Mutual,
Policy Period:
INSURANCE
Business Automobile
From 04/13/2014 To 04/13/2015
12.01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM THREE: COVERED VEHICLES AND PREMIUM DETAIL - continued
UNIT 023 1995 GMC 2500 VIN:
1 GTFK24KXSZ522421
Rating CLASS SYM/COST TERRITORY RISK STATE
RATING ZIP TOWN CODE
Factors 01489 $19,868 005 WA
98373 0217
DESCRIPTION
PREMIUM
Liability Insurance
$1, 010.00
Medical Payments
$64.00
Underinsured Motorist Bodily Injury and Property Damage
$139.00
Total Premium
$1,213.09
ITEM FOUR: HIRED AUTO COVERAGE
Estimated Annual
Rate Per Each
Cost of Hire
$100 Annual
Cost of Hire
Liability If Any
1.021 $78.00
Comprehensive If Any
.660 $25.00
Actual Cash Value or Cost of Repairs, whichever
is less, minus $0 Ded. for each covered auto, but
no deductible applies to loss caused by fire or lightning.
Collision If Any
.835 $25.00
Actual Cash Value or Cost of Repairs, whichever
is less, minus $1000 Ded. for each covered auto.
Cost of Hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you
borrow or rent from your partners or employees or their family or their family members). Cost of hire does not
Include charges for services performed by motor carriers of property or passengers.
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000664 PAGE 28 OF 76
Coverage Is Provided In.
Liberty Ohio Security Insurance Company
Policy Number:
BAS 54 72 79 36
(15)
Mutual.
Policy Period:
INSURANCE
Business Automobile
From 04/13/=4 To 04/13/2015
12:01 am Standard Time
Policy Declarations
at Insured Mailing Location
Named Insured Agent
A ADVANCED SEPTIC SERVICES INC (253) 565-3500
BANNON CARLSON & KESSEL INC
ITEM FIVE: NON -OWNERSHIP LIABILITY COVERAGE
Named Insnred's Raciness Rating Rasis Numhe. Preminm
Other than Garage Service Number of Employees 9 $128.00
Operations and Other Than
Social Service Agencies (Not
Applicable in CA)
MISCELLANEOUS COVERAGES
RATING TERRITORY RISK RATING TOWN
FACTORS STATE _ ZIP CODE
0000 WA 98373 0217
Business Auto Enhancement Endorsement $548.00
To report a claim, call your Agent or 1-800-362-0000
DS 70 43 01 08
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Coverage Is Provided In. Policy Number:
Liberty The Ohio Casualty Insurance Company USO (15) 54 72 79 36
Mutual.
INSURANCE
Commercial Umbrella
Policy Declarations
Basis: Occurrence
(ITEM 1) NAMED INSURED & MAILING ADDRESS AGENT MAILING ADDRESS & PHONE NO.
A ADVANCED SEPTIC SERVICES INC
11603 CANYON RD E
PUYALLUP, WA 98373-4361
Named Insured Is: CORPORATION
(253) 565-3500
BANNON CARLSON & KESSEL INC
2121 70TH AVE W STE B
UNIVERSITY PL, WA 98466-7668
Named Insured Business Is: SEPTIC INSTALLATION AND REPAIR
(ITEM 2) POLICY PERIOD
From 04/13/2014 TO 04/13/2015 12:01 AM Standard Time at Insured Mailing Location
(ITEM 3) PREMIUM CHARGES
Explanation of DESCRIPTION PREMIUM
Charges Commercial umbrella $7,707-00
Certified Acts of Terrorism Coverage $76 _ nn (Inc1 ndpd)
Total Advance Charges
BASIS OF PREMIUM: NON-AUDITABLE( X) AUDITABLE( )
$7, 707.00
Note: This is not a bill
IN THE EVENT OF CANCELLATION BY THE NAMED INSURED, THE COMPANY WILL RECEIVE AND
RETAIN NO LESS THAN (0% ) OF THE POLICY PREMIUM AS THE MINIMUM RETAINED PREMIUM
PLUS CERTIFIED ACTS OF TERRORISM COVERAGE AND ANY APPLICABLE TAXES AND SURCHARGES.
(ITEM 4) LIMITS OF INSURANCE
DESCRIPTION
EACH OCCURRENCE
AGGREGATE (WHERE APPLICABLE)
PRODUCTS -COMPLETED OPERATIONS AGGREGATE
SELF -INSURED RETENTION
Servicing Office Western Washington
and Issue Date 03/28/14 Authorized Representative
To report a claim, call your Agent or 1-i300-362-ML70
LIMIT
$2,000,000
$2,000,000
$2,000,000
$10,000
DS 70 22 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000660 PAGE 9 OF 54
Coverage Is Provided In.
Policy Number:
Liberty
The Ohio Casualty Insurance Company
USO (15) 54 72 79 36
Mutual.
INSURANCE
(ITEM 5) SCHEDULE OF UNDERLYING
INSURANCE:
CARRIER, POLICY
NUMBER AND PERIOD
TYPE OF COVERAGE
LIMITS OF INSURANCE
OHIO SECURITY INSURANCE
GENERAL
$1,000,000 EACH OCCURRENCE
COMPANY
LIABILITY
LIMIT
$1,000,000 PERSONAL AND
BKS(15)54727936
ADVERTISING INJURY
04/ 13/2014 - 04/ 13/2015
LIMIT
$2,000,000 GENERAL AGGREGATE
LIMIT
$2,000,000 PRODUCTS - COMPLETED
OPERATIONS AGGREGATE
LIMIT
OHIO SECURITY INSURANCE
OWNED AND HIRED
$1,000,000 COMBINED SINGLE
COMPANY
AND/OR NONOWNED
LIMIT
AUTO LIABILITY
BAS(15)54727936
04/13/2014 - 04/13/2015
OHIO SECURITY INSURANCE
STOP GAP
$1,000,000 BODILY INJURY EACH
COMPANY
I
LIABILITY
ACCIDENT LIMIT
i
$1,000,000 BODILY INJURY BY
BKS(15)54727936
DISEASE AGGREGATE
I 04/ 13/2014 - 04/ 13/2015
LIMIT
$1,000,000 BODILY INJURY BY
DISEASE EACH
EMPLOYEE LIMIT
To report a claim, call your Agent or 1-800-362-0000
DS 70 23 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000660 PAGE 10 OF 54
Liberty
Mutual.
INSURANCE
Coverage Is Provided In: Policy Number:
The Ohio Casualty Insurance Company I USO (15) 54727936
POLICY FORMS AND ENDORSEMENTS
This section lists all the Forms and Endorsements for your policy. Refer to these documents as needed for detailed
information concerning your coverage.
FORM NUMBER TITLE
CU 60 02 06 97
Commercial Umbrella Coverage Form
CU 60 39 01 08
Cap on Losses from Certified Acts of Terrorism
CU 60 40 01 08
Underlying Coverage Requirement for Certified Acts of Terrorism
CU 61 06 06 97
Auto Liability - Following Form
CU 61 50 11 06
Contractors Limitation Endorsement
CU 61 90 08 10
Washington Changes - Cancellation and Nonrenewal
CU 63 44 06 97
Foreign Liability - Following Form
CU 6400 1204
Exterior Insulation and Finish System - Exclusion
CU 6430 1204
Washington - Fungi or Bacteria Exclusion
CU 64 32 03 99
Washington Asbestos Exclusion
CU 64 79 05 09
Exclusion - Recording and Distribution of Material or Information in Violation
of the Law
CU 64 82 11 04
Amendment to Definition of Property Damage
CU 64 87 10 05
Economic or Trade Sanctions Condition Endorsement
CU 64 92 01 07
Mobile Equipment - Following Form
CU 65 08 01 09
Exclusion of Punitive Damages Related to Certified Acts of Terrorism
CU 88 01 12 02
War Liability Exclusion
CU 88 02 05 09
Non -Cumulation of Liability (Same Occurrence)
CU 88 27 12 07
Washington Employment Related Practices Exclusion
CU 88 31 0509
Personal and Advertising Injury - Following Form
CU 88 39 02 10
Amendment of Definition of Insured
CU 88 41 02 10
Amendment of Pollution Exclusion
CU 89 31 01 07
Washington Conditional Exclusion Of Terrorism Involving Nuclear, Biological Or
Chemical Terrorism (Relating To Disposition Of Federal Terrorism Risk Insurance
Act)
In witness whereof, we have caused this policy to be signed by our authorized officers.
D I'X* g. �, I
Dexter Legg Paul Condrin
Secretary President
To report a claim, call your Agent or 1-500-362-0000
DS 70 23 01 08
03/28/14 54727936 N0108648 235 NCAOPPNO INSURED COPY 000660 PAGE 11 Of 54
Denis Law - i Cly O� Y o
Mayor ,
Public Works Department - Gregg Zimmerman, R E., Administrator
July 9, 2014
J. Andrew Gunia
A Advanced Septic Services, Inc.
11603 Canyon Rd -E.
Puyallup, WA 98373
RE: BID AWARD — SOUTH 132ND STREET SEWER EXTENSION
Dear Mr. Gunia:
At the Renton City Council meeting on July 7, 2014, Council accepted A Advanced Septic
Services, Inc.'s bid of $21.3,447.44 for the South 132"d Street Sewer Extension project.
You should be receiving a letter from the City Clerk with the official bid award.
For execution of the contract, please submit the following information as soon as
possible so we can prepare the contract documents for review and signature by the
Mayor:
1. A list of names, addresses, phone numbers, and emergency phone numbers for:
Responsible Officer, Job Foreman, and Bonding Agent.
2. Documentation of those parties authorized to sign the contract on behalf of the
company and samples of their signatures.
3. Photocopy of your current State Contractor's License (not master license).
4. Photocopy of your current City of Renton Business License. To obtain a City Business
License, please contact Linda Weldon at 425-430-6851, or visit our website at
www.rentonwa.gov.
5. Two signed.contract bonds on City of Renton forms (enclosed), UNDATED.
The date will be filled in when signed by the Mayor.
6. One City of Renton Fair Practices Affidavit of Compliance (enclosed).
7. Two signed contracts, also UNDATED (enclosed).
8. One Certificate of Insurance for 2014 in accordance with Section 1-07.18 of the
Special Provisions. Please add the City of Renton as additional insured.
9. The insurance policy declaration ,pages of all required insurance policies. obtained
from the insurance carrier.
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Mr. Gunia
Page 2 of 2
July 9, 2014
After the contract information is submitted, we will need the following information to
review and approve before construction.can start.
1. Provide material submittals as required for the work involved with this job. This will
include, but not be limited to, information on the proposed source and
specifications of all materials that will be used in the project (e.g.; structures, pipe,
imported aggregate materials, etc.), showing that the proposed material meets the
project specifications, per Standard Specifications and Special Provisions Section 1-
06.1. Provide any shop drawings and submittals needed for the project per Standard
Specifications and Special Provisions Section 1-06.
2. Work Plan. Include the following items:
1. Proposed construction sequencing and schedule for the project
2. Mobilization Plan
3. Temporary Erosion and Sediment Control Plan
4. Traffic Control Plan for South 132"d Street
5. Street Cleaning and Sweeping Plan
6. Trench Excavation Safety Systems Plan
7. Disposal Site
3. Construction Surveying. Identify the surveying firm/surveyor and a letter showing
that the surveyor is licensed in the State of Washington.
Please let me know when you would like to have the pre -construction conference. We
will need to notify the private utilities and City Inspector, so there should be a lead-time
of at least one week before the conference.
Please contact me at 425-430-7279 or ihobson@rentonwa.gov, if you have any
questions.
Sincerely,
Roln Hobson, Project Manager
Wastewater Utility
Enclosures
H:\fi!e Sys\WWP - WasteWater\1AIWP-27-3685 S 132nd St Sewer Extension\A.ward Info\Award Letter -.A Advanced
Septic Services - South 132nd Street Sewer Extension.doc\JDHad
Denis Law C11y Of
�}
Mayor
..
City Clerk -Bonnie I.Walton
July 8, 2014
J. Andrew Gunia
A Advanced Septic Services
11603 Canyon Rd. E.
Puyallup, WA 98373
RE: S. 132nd St. Sewer Extension Project; CAG-14-089
Dear Mr. Gunia:
RECEIVED
JUL 0 9 2014
CITY OF RENTON
UTILITY SYSTEMS
At its regular meeting of July 7, 2014 the Renton City Council accepted your bid for the above -
referenced project in the amount of $213,447.44.
Please contact John Hobson, Civil Engineer at 425-430-7279, for submission of required
documents to complete the contract. These may include proof of City and State business
licenses, performance bond,.and insurance certificates.
Si erely,
i•
ason A. Seth
Deputy City Clerk
cc: John Hobson, Project Manager
Linda Weldon, Accounting Assistant
Natalie Wissbrod, Accounting Assistant IV
1055 South Grady Way • Renton, Washington 98057 • (425) 430-6510 / Fax (425) 430-6516 • rentonwa.gov
DenisLawCity Of _}
Mayor
Aft
City Clerk - Bonnie I. Walton
July 8, 2014
Allyson Gregersen
Archer Construction
7855 S. 206th St.
Kent, WA 98032
RE: S. 132nd St. Sewer Extension Project; CAG-14-089
Dear Ms. Gregersen:
At its regular meeting on July 7, 2014 the Renton City Council accepted the lowest.
responsive bid submitted by A Advanced Septic Services for the above -referenced
project in the amount of $213,447.44. If you would like. your bid bond document'
returned, please email your request to jseth@rentonwa.gov:
Thank you for your interest and your bid.
Sincerely,
Jas n A. Seth
Deputy City Clerk
cc:- John Hobson, Project Manager
.1055 South Grady Way Renton, Washington 98057 • (425) 430-6510 / Fax (425) 430-6516 • rentonwa.gov
Denis Law City Of
Mayor N 1 r
� u •
City Clerk -Bonnie I. Walton
July 8, 2014
Brad Hoffman
Hoffman Construction
PO BOX .845
Enumclaw, WA 98022
RE: S. 132nd St. Sewer Extension Project; CAG-14-089.
Dear Mr. Hoffman:
At its regular meeting on July 7, 2014 the. Renton City. Council accepted the lowest
responsive bid submitted by A Advanced Septic Services for the above -referenced
project in the amount of $213,441.44. If you would like your bid bond document.
returned, please email your request to jseth@rentonwa.gov.
Thank you for your interest and your bid.
Sincerely,
son A. Seth
Deputy City Clerk
cc: John Hobson, Project Manager
Denis Law rr
City CI `� p
City Clerk - Bonnie I. Walton
July 8, 2014
Mike Waldner
Kar-Vel Construction
PO BOX 58275
Renton, WA 98058
RE: S. 132nd St. Sewer Extension Project; CAG-14-089
Dear Mr. Waldner:
At its regular meeting on July 7, 2014 the Renton City Council accepted the lowest
responsive bid submitted by A Advanced Septic Services for the above -referenced
project in the amount. of $213,447.44. If you would. like your bid bond document
returned, please email your request to jseth@rentonwa.gov.
Thank you for your interest and your bid.
Since ely,
Jason A. Seth
Deputy City Clerk
cc: John Hobson, Project Manager
1055 South Grady Way • Renton, Washington 98057 • (425) 430-6510 / Fax (425) 430-6516 • rentonwa.gov
Denis Law City of/�
Mayorso
It
)
E / •, e
City Clerk - Bonnie I. Walton
July 8, 2014
Bret Lane
Laser Underground & Earthworks
20417 87th Ave. SE
Snohomish, WA 98296
RE: S. 132nd St. Sewer Extension Project; CAG-14-089
Dear Mr. Lane:
At its regular meeting on July 7, 2014 the Renton City Council accepted the lowest
responsive bid submitted by A Advanced Septic Services for the above -referenced .
project in the amount of $213,447.44. If you would like your bid bond document
returned, please.errlail your request to jseth@rentonwa.gov.
Thank.you for your interest and your bid.
Sincerely;
4eputy
eth
ity Clerk
cc: John Hobson, Project.Manager .
1055 South Grady Way • Renton; Washington 98057 • (425) 430-6510 / Fax (425) 430-6516 • rentonwa.gov
Denis Law Cl Of
. Mayor � __ � ♦`fit ��
AN E '_
City Clerk - Bonnie I.Walton
July 8, 2014
Richard L. Alia
RL Alia Company
107 Williams Ave. S.
Renton, WA 98057
RE: S. 132nd St. Sewer Extension Project; CAG-14-089
Dear Mr. Alia:
At its regular meeting on July 7, 2014 the Renton City Council accepted the lowest
responsive bid submitted by A Advanced Septic Services for the above -referenced
project in the amount. of $213,447.44. If you would; like your bid bond document
returned, please email your request to jseth@rentonwa.gov.
Thank you for your interest and your bid:
Sincerely,
n
AJason.Seth City Clerk
cc: John Hobson, Project Manager
1055 South Grady Way • Renton, Washington 98057 • (425) 430-6510 / Faz (425) 430-6516 • rentonwa.gov
PUBLIC WORKS DEPARTMENT � ^C+�.�f�O�
M E M O R A N D U M
DATE: July 2, 2014
TO: Bonnie Walton, City Clerk
FROM: John Hobson, Wastewater Utility, x7279
SUBJECT: Bid Award for the South 132nd Street Sewer Extension Project
The Public Works Department has reviewed the bids that were submitted for the South
132"d Street Sewer Extension project and we recommend that the bid be awarded to A
Advanced Septic Services, Inc. We are requesting that an agenda bill for "Council
Concur" be prepared for the July 7, 2014, Council Meeting.
The bid opening was on Tuesday, July 1, 2014. There were seven bids received. There
were minor errors on the low bid. These errors did not change the ranking of the bids.
The low bidder's (A Advanced Septic Services, Inc.) bid of $210,874.20 had a couple of
math errors that resulted in a corrected bid of $213,447.44
The engineer's estimate was $254,752.00.
The project budget amount for the South 132nd Street Sewer Extension project
(426.465500) is $400,000. The low bid for the South 132nd Street Sewer Extension
project is within the amount approved in the 2014 budget for this project.
The project will extend an 8" diameter sewer main north, from the City's existing
Earlington Interceptor, to South 132"d Street.
Attached for your reference, is the bid tabulation showing the engineer's estimate, the
low bid, and the other bids submitted.
If you have any questions, please contact me at 425-430-7279 or by email at
jhobson@rentonwa.gov.
Attachments
cc: Gregg Zimmerman, PW Administrator
Lys Hornsby, Utility Systems Director
Dave Christensen, Wastewater Utility Supervisor
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Award Info\Award-Clerk-South 132nd
Street Sewer Extension.doc/JDHad
Project :
South 132nd Street Sewer Extension
city of Renton A,Advanced`'Septic. Services
Archer Construction
BID DATE:
July 01, 2014
Engineers Estimate
Item
Unit
Est.
Unit
Bid V.
Unit,
Bid
Unit
Bid
No.
Description
Quantity
Price
Amount 1
,Price .'
Amount
Price
Amount
1
Mobilization
Lump Sum
1
21,150.00
21,150.00
3750.W-
3,750:Q0i
20,000.00
20,000.00
2
Trench Excavation Safety Systems
Lump Sum
1
3,000.00
3,000.00 I'
:4 687.`20
4,687 20+
4,000.00
4,000.00
3
Construction Surveying, Staking, and As-Builts
Lump Sum
1
5,500.00
5,500.00 y'
3 210 4Q
3;21.0.401
3,000.00
3,000.00
4
Traffic Control
Lump Sum
1
10,000.00
10,000.00 j' _ '
1'261:20"
:6
1'1 ,=261:204'
12,000.00
12,000.00
5
Temporary Erosion/Sedimentation Controls
Lump Sum
1
5,000.00
5,000.00 }
13;418.49
3;4,18.491
4,000.00
4,000.00
6
Site Clearing and Grubbing
Lump Sum
1
10,000.00
10,000.00 j _
9r9A'S.00
9;91'5.001
4,500.00
4,500.00
7
Furnish and Install 8-inch PVC Sewer Pipe
Linear Foot
785
100.00
78,500.00
36:87
28;942:95i
80.00
62,800.00
8
Furnish and Install 6-inch PVC Side Sewer Pipe
Linear Foot
60
80.00
4,800.00 ; :•
34.27
,2;Q56.20i
135.00
8,100.00
9
Furnish and Install 18-Inch Steel Casing with Anchor Blocks
Lump Sum
1
25,000.00
25,000.00 4..
-32680:00
32,680,00i
19,000.00
19,000.00
10
Furnish and Install 54-inch Diam. Sanitary Sewer Manhole
Each
1
5,000.00
5,000.00 (
4;042 60 -
4 042 ;60i
3,500.00
3,500.00
11
Furnish and Install 48-inch Diam. Sanitary Sewer Manhole
Each
4
4,000.00
16,000.00
4 847;65
19'390.60(
3,500.00
14,000.00
12
Furnish and Install 48-inch Diam. Saddle Manhole
Each
1
4,500.00
4,500.00
3733`.78"
`31733.78i
6,000.00
6,000.00
13
Removal and Replacement of Unsuitable Foundation Material
Ton
15
25.00
375.00 (.
6W'00•' .':
,900:ooi
54.00
810.00
14
Bank Run Gravel for Trench Backfill Sewer
Ton
1,150
18.00
20,700.00 �'
i29:50-
33,925 001
25.00
28,750.00
15
Asphalt Patch including CSTC
Square Yard
425
25.00
10,625.00
132Z3,
13;867J5�
45.00
19,125.00
16
Replace Pavement Markings and Traffic Buttons
Lump Sum
1
1,000.00
1,000.00
,�5,620:00
5;620.00:
2,500.00
2,500.00
17
Chain Link Fence
Lump Sum
1
1,500.00
1,500.00 i -.•,31820;00
3,820'm0'
1,800.00
1,800.00
18
Landscape Restoration
Lump Sum
1
10,000.00
10,000.00 ; -"
4,70&00 .,
.417081001
6,000.00
6,000.00
Subtotal
232,650.00 1
'
194,9291,7)
219,885.00
Tax 9.5% 22,101.75 1'8$' 8271 20,889.08
Total 254,751.75 i 213 4'47•44( 240,774.08
r' '
Project : South 132nd Street Sewer Extension
BID DATE: July 01, 2014
Item
No. Description
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Mobilization
Trench Excavation Safety Systems
Construction Surveying, Staking, and As-Builts
Traffic Control
Temporary Erosion/Sedimentation Controls
Site Clearing and Grubbing
Furnish and Install 8-inch PVC Sewer Pipe
Furnish and Install 6-inch PVC Side Sewer Pipe
Furnish and Install 18-Inch Steel Casing with Anchor Blocks
Furnish and Install 54-inch Diam. Sanitary Sewer Manhole
Furnish and Install 48-inch Diam. Sanitary Sewer Manhole
Furnish and Install 48-inch Diam. Saddle Manhole
Removal and Replacement of Unsuitable Foundation Material
Bank Run Gravel for Trench Backfill Sewer
Asphalt Patch including CSTC
Replace Pavement Markings and Traffic Buttons
Chain Link Fence
Landscape Restoration
Unit
Lump sum
Lump Sum
Lump Sum
Lump Sum
Lump Sum
Lump Sum
Linear Foot
Linear Foot
Lump Sum
Each
Each
Each
Ton
Ton
Square Yard
Lump Sum
Lump Sum
Lump Sum
Est.
Quanti
1
1
1
1
1
1
785
60
1
1
4
1
15
1,150
425
1
1
1
Hoffman Construction
Unit
Bid
Price
Amount
19,000.00
19,000.00
2,500.00
2,500.00
2,775.00
2,775.00
9,550.00
9,550.00
4,250.00
4,250.00
4,000.00
4,000.00
65.50
51,417.50
77.00
4,620.00
32,450.00
32,450.00
5,050.00
5,050.00
5,050.00
20,200.00
7,550.00
7,550.00
40.00
600.00
20.25
23,287.50
61.00
25,925.00
1,800.00
1,800.00
2,000.00
2,000.00
5,000.00
5,000.00
221,975.00
21,087.63
243,062.63
R.L. Alia
Unit
Price
30, 000.00
500.00
5,000.00
20, 000.00
2,000.00
5,000.00
188.00
90.00
20,000.00
5,000.00
4,000.00
5,000.00
30.00
1.00
50.00
2,000.00
2,000.00
2,000.00
Bid
Amount
30, 000.00
500.00
5,000.00
20, 000.00
2,000.00
5,000.00
147,580.00
5,400.00
20,000.00
5,000.00
16, 000.00
5,000.00
450.00
1,150.00
21,250.00
2,000.00
2,000.00
2,000.00
290,330.00
27,581.35
317,911.35
Laser Underground
Unit Bid
Price Amount
25,000.00
25,000.00
20,000.00
20,000.00
8,000.00
8,000.00
15,000.00
15,000.00
7,000.00
7,000.00
20,000.00
20,000.00
100.00
78,500.00
80.00
4,800.00
35,000.00
35,000.00
6,000.00
6,000.00
5,000.00
20,000.00
5,000.00
5,000.00
40.00
600.00
7.00
8,050.00
60.00
25,500.00
3,000.00
3,000.00
7,000.00
7,000.00
5,000.00
5,000.00
293,450.00
27, 877.75
321,327.75
Project : South 132nd Street Sewer Extension
BID DATE: July 01, 2014
Item
No. Description
Unit
Est.
Quantity
Kar-Vel Construction
Unit
Price
26,000.00
Bid
Amount
26,000.00
Average
Unit
Price
20,625.00
Bid
Bid
Amount
20,625.00
1 Mobilization Lump Sum 1
2
Trench Excavation Safety Systems
Lump Sum
1
20,000.00
20,000.00
8,614.53
8,614.53
3
Construction Surveying, Staking, and As-Builts
Lump Sum
1
7,000.00
7,000.00
4,830.90
4,830.90
4
Traffic Control
Lump Sum
1
5,000.00
5,000.00
12,968.53
12,968.53
5
Temporary Erosion/Sedimentation Controls
Lump Sum
1
1,500.00
1,500.00
3,694.75
3,694.75
6
Site Clearing and Grubbing
Lump Sum
1
4,000.00
4,000.00
7,902.50
7,902.50
7
Furnish and Install 8-inch PVC Sewer Pipe
Linear Foot
785
130.00
102,050.00
100.06
78,548.41
8
Furnish and Install 6-inch PVC Side Sewer Pipe
Linear Foot
60
110.00
6,600.00
87.71
5,262.70
9
Furnish and Install 18-Inch Steel Casing with Anchor Blocks
Lump Sum
1
40,000.00
40,000.00
29,855.00
29,855.00
10
Furnish and Install 54-inch Diam. Sanitary Sewer Manhole
Each
1
5,400.00
5,400.60
4,832.10
4,832.10
11
Furnish and Install 48-inch Diam. Sanitary Sewer Manhole
Each
4
5,500.00
22,000.00
4,649.61
18,598.43
12
Furnish and Install 48-inch Diam. Saddle Manhole
Each
1
6,000.00
6,000.00
5,547.30
5,547.30
13
Removal and Replacement of Unsuitable Foundation Material
Ton
15
20.00
300.00
40.67
610.00
14
Bank Run Gravel for Trench Backfill Sewer
Ton
1,150
10.00
11,500.00
15.46
17,777.08
15
Asphalt Patch including CSTC
Square Yard
425
75.00
31,875.00
53.94
22,923.79
16
Replace Pavement Markings and Traffic Buttons
Lump Sum
1
3,000.00
3,000.00
2,986.67
2,986.67
17
Chain Link Fence
Lump Sum
1
3,000.00
3,000.00
3,270.00
3,270.00
18
Landscape Restoration
Lump Sum
1
8,000.00
8,000.00
5,118.00
5,118.00
303,225.00
$253,965.70
28, 806.38
$24,126.74
332,031.38
278,092.44
Denis Law Cl� Of
Mayor { �.. _ 1, Y Qt,
1r 'l &
l P'n
o
Public Works Department - Gregg Zimmerman, P. E., Administrator
September 10, 2014
Mr. and Mrs. James & Sandra Dolge
8216 S. 134th St
Renton, WA 98178
RE: SOUTH 132ND STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Mr. and Mrs. Dolge:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 84th Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132"d Street.
If you have any questions, please contact me at 425-430-7279 or by email at
jhobson@ci.renton.wa.us.
Sincere ,
John Hobson
Wastewater Utility Engineer
Attachment
H:\rile Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Dolge.doc\JHad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
nis
Della Mayor City Of sty
v
A G(At„y
%Nry _Y
Public Works Department -Gregg Zimmerman, P. E.,Administrator
September 10, 2014
Ms. Sandra Dolge
13239 84th Ave S
Renton, WA 98178
RE: SOUTH 132ND STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Ms. Dolge:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 84th Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
hobsonPci.renton.wa.us.
Sincerely,
JoAnHobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification- Ms
Dolge.doc\1Had
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Denis Law Clty Of
Mayor 1 Y O
Public Works Department - Gregg Zimmerman, P. E., Administrator
September 10, 2014
Ms. Carolyn Hasbrook
8210 S. 134th St
Renton, WA 98178
RE: SOUTH 132ND STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Ms. Hasbrook:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 841h Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
ihobson @ci.renton.wa.us.
Sincerely,
John Hobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Hasbrook.doc\JHad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Denis Law Clty Of
Mayot �� U
da +�
Public Works Department - Gregg Zimmerman, P. E., Administrator
September 10, 2014
Mr. Robert Brockmeyer
8234 S. 134th St
Renton, WA 98178
RE: SOUTH 132N0 STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Mr. Brockmeyer:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 84th Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
jhobson@ci.renton.wa.us.
Sincerely,
'e
J hn Hobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Brockmeyer.doc\JHad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Denis Law Clty y
Mayor ti Y O
Public Works Department - Gregg Zimmerman, P. E., Administrator
September 10, 2014
Mr. Craig Cole
8238 S. 134th St
Renton, WA 98178
RE: SOUTH 132ND STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Mr. Cole:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 841h Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
jhobson@ci.renton.wa.us.
Sincerely,
*Ae
John Hobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - WasteWater\WWP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Cole.doc\JHad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Denis Law City of y o Mayor �
Public Works Department - Gregg Zimmerman, P. E., Administrator
September 10, 2014
Mr. Steve Brozozowski
P.O. Box 7022
Bellevue, WA 98008
RE: SOUTH 132ND STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Mr. Brozozowski:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014, The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 84th Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
jhobson@ci.renton.wa.us.
Sincer ,
John Hobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - Wastewater\W WP-27-3685 S 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Brozozowski.doc\J H ad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
Legend
City and County Boundary
Other
�� City of Renton
C.
--
Addresses
Parcels
8043
8205
822,1
❑ 1st Floor
❑ 1st Floor
8223
❑ 2nd Floor
❑ 1st Floor
❑ Other Buildings
8215
Buildings
Sites
Other
8207
Municipal Government Facility
8211
13223
Community / Recreation Center
Library
Museum
Fire Station / EMS Station
Airport Runway /Airfield
A
Park
Openspace
8050
Golf Course
Greenhouse / Nursery
1
rUndeveloped
Park
A
13249
■ Parking Lot Structure / Garage
`
Lift Station
It
Clean Outs
^�
® Manholes
80- 0
Casings
8072
— Pressurized Mains
8026
Gravity Mains
Q KC Metro Manholes
i
8060
A
Notes
S. 132nd St Sewer Extension Project
8200 8210
8216 13269
O
8228 8234
1.3273
+
City of
John Hobson This map is a user generated static output from an Internet mapping site and
is for Data layers that appear on this map may or may not be
128 0 64 128
Feet
reference only
nt�---
eon
- -
accurate, current, or otherwise reliable
WGS_1984_Web_Mercator_Auxiliary_Sphere
09/05/2014
THIS MAP IS NOT TO BE USED FOR NAVIGATION
Finance & IT Division
Denis Law
Mayor
September 10, 2014
Mr. Craig Cole
8238 S. 134th St
Renton, WA 98178
City of eF,
Public Works Department - Gregg Zimmerman, P. E., Administrator
RE: SOUTH 132No STREET SEWER EXTENSION PROJECT CONSTRUCTION
Dear Mr. Cole:
This letter is to inform residents that the City of Renton will have a contractor performing
sanitary sewer installation work within your neighborhood beginning on or about the week
of September 15, 2014. The work being performed includes the installation of a new sewer
main that will extend from an existing City sewer main through easements across private
property and into the right-of-way of South 132nd Street (see attached map).
The contractor will utilize portions of the existing gravel road off of 84th Avenue South (those
portions that are within the City's existing easements) to access the project area that is
located on the south side of the existing creek. The road will be used for access only and
there will be no work taking place that would block access to residents. Work in this area of
the project is anticipated to take between 2 to 3 weeks.
There are a total of 45 working days for the project. Most of this work will take place in or
near South 132nd Street.
If you have any questions, please contact me at 425-430-7279 or by email at
ihobson(@ci.renton.wa.us.
Sincerely,
*//Z
John Hobson
Wastewater Utility Engineer
Attachment
H:\File Sys\WWP - WasteWater\W WP-27-3685 s 132nd St Sewer Extension\Construction\Public Notices\Construction Notification -
Cole.doc\JHad
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
128 0 64 128 Feet
WGS_1984_Web_Mercator Auxiliary_Sphere
John Hobson
09/05/2014
Legend
City and County Boundary
Other
City of Renton
lw
Addresses
Parcels
[j
1st Floor
1st Floor
C]
2nd Floor
1st Floor
Other Buildings
Buildings
Sites
Other
Municipal Government Facility
Community / Recreation Center
Library
Museum
■ Fire Station / EMS Station
Airport Runway / Airfield
Park
Openspace
Goff Course
Greenhouse / Nursery
Undeveloped Park
1 Parking Lot Structure / Garage
Lift Station
t♦
Clean Outs
Manholes
Casings
Pressurized Mains
Gravity Mains
(
KC Metro Manholes
Notes
S. 132nd St. Sewer Extension Project
19
This map is a user generated static output from an Internet mapping site and
is for reference only. Data layers that appear on this map may or may not be City of ■■
accurate, current, or otherwise reliable. - Re - on r'. ',-
THIS MAP IS NOT TO BE USED FOR NAVIGATION Finance & IT Division