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Home My WebLink AboutWWP273712 (5)ROAD CONSTRUCTION NORTHWEST, INC. 11/4/2016 Force Account Summary City of Renton - Central Renton Sewer Interceptor Reline and Upsize Sub 'tte#d ,tc . 3t� Mali en in naer/ oxer , u oil ri �%U Des-cl 99-001 8/11/16 &1 $ 3,777.30 $ - $ - $ - 99-002 99-002 99-002 99-002 99-002 99-003 8/15/16 a. _ Z7 L V7 Z'7 - 4,790.25 4,396.22 _ _ - 8/16/16 8/17/16 7,88222 Zo 22 $ 1 8/18/16 7,303.86 $ - 8/19/16 5,169.08 $ - -_ 9/6/16 12,585.51 $ - 9/7/16 27 t. - 11301.95 , $ - - -- -- _ _99-003 99-004 99-005 9/8/16 19,561.22 it 1,9 5 2 $ - 9/12/16 Z 14,515.85 - $ 99-005 9/13/16 29 16,429.42 ' . e,3 $ -- $ - 99-006 9/14/16 1 15,792.77 9 $ - 99-006 9/15/16 'SD Al Krazan Invoice 11,700.26 99-007 Varies 3,040.13 - - - -- — $138,246.04 $ - - $ - I $ - - - - - S:IRCNW\PROJECTS11509 Renton Sewer Interceptor Reline & Upsize\Change Order Requests -Force Accounts11509 Renton Sewer Intercptr Force Acct and Summary 11-4-16 ROAD CONSTRUCTION NORTHWEST, INC. DATE: 08/11/16 Force Account Request for Payment F.A. # 1 Bid Item # NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Potholing for existing utilities At STA. 1+00 - 1+15. Vactor Truck hit unknown concrete and asphalt 3" to 8" thick, needed excavator and laborer to remove unforeseens. `Hours NAM - Classification Name Rate of Pay Taxes/Fringe Gross Rater Total Foreman Kye VanHoof 8 $ 45.00 $ 20.97 $ 65.97 $ 527.76 Laborer Robbie Sherwood 2 $ 42.67 $ 6.97 $ 49.64 99.28 Laborer Josh Doolittle 2 $ 42.67 $ 6.97 S 49.64 99.28 Subtotal $ 726.32 Contractor M/U @ 29% 210.63 Total $ 936.95 T., s T•Z MOVE MEnr x^� •r . - 'k Equipment # Class Type Hours Gross Rate Total 30-104 Tool Truck 8 $ 40.74 $ 325.92 24-887 Crawler Mounted Hydraulic Excavator 135 2 $ 88.86 177.72 United Rental 1 $ 216.98 216.98 Subtotal $ 720.62 Contractor WU @ 21 % 151.33 Total $ 871.95 . �fi . V Description Vendor UOM Quantit Cost Total Subtotal $ - Contractor M/U @ 21% Total $ w �- Classification Vendor UOM Quantit Cost Total Sweeping/ Vactor Best Parking Lot HOURLY 7.5 $ 196.00 $ 1,462.50 Disposal Best Parking Lot EA 5 $ 45.00 225.00 Water Charge Best Parking Lot Load 2 $ 35.00 70.00 Subtotal $ 1,757.50 Contractor WU @ 12% 210.90 Total $ 1,968.40 Total labor, equipment, material, subcontractors $ 3,777.30 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Account Job Name en�z.1 Semj f 2j-Vjper( Job # fib Force Acet # Vic! -&6 / BID ITEM #: Is this work associated with a DVN? If so attacli form D VjV, Yes No Date work performed/-/G Additional Days To Be Added To Original Contract Description of Work t-a rl C ✓ !g at' i e-Ce p�1%. Qe r 0j S -VA 1-t•D u •- 1 4- 1 - cA- �. o r m s -3 1 �Se _ .('-f^ auk (n►.tvr�4t_ arr�{.e=1.1 .QC -&.)Li k&d fp rac'i _.hnlc_..d i C)& mc) e c�uk ©( c tti LABOR FORCE RCNW Employee Name Classification Hours WL'e Wt �/ �boT 9 nbUl[ Sktr►e)nr, EQUIPMENT FORCE (including p/us, flat beds, tight towers etc.) RCNW Equipment # Classification Hours _ r9go 3a�lo��_ _ 1 ao_LJ3--'Je- _ t- I i MATERIAL UTILIZED Type or Class Vendor Del ive /Packing Slip # Quantity Cost I I I SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost CSC &-Y—vAo) Lai I "I rd i I --- +— )_ Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) S:\RCNW\Forms\Foreman\Foreman Forms Rev 091812 Seattle 206-382-9340 Tacoma 253-863-3330 Puyallup 253-841.-7406 www.bestoarkin-glot.com FOR: JOB NAME: ADDRESS: LOCATION: CITY & ZIP: CITY: ` OFFICE PHONE: JOB PHONE: REQUESTED BY:.-� nN nATP-.' JOB SLIP # 21889 SWEEPER VACUUM WATER EDUCTOR OPERATOR LABORER. LEAVE SHOP :ON JOB OFF JOB ARRIVE SHOP TOTAL HOURS., .. MINIMUM UE5CRI1' I ION OF SERVICE$: FIRE HOSE \ POLYBROOMS SPILL RESPONSE: S-k r5 PRESSURE WASHER BIO DEGREASER ,. t. .. BIO ABSORBENT SPILL KIT BOOMS EDUCTORS: SPECIALTY HEADS ; i POTHOLING TYPE 2 CBS TYPE 1 CBS CONFINED SPACE ENTRY CB SOCKS HOSE PER FT POND CLEANING BOOMS ALL DEBRIS HAULED OFF IS: SUBJECT TO A PER YARD FEE $45- $178 20 AND UP Dump on Site YES, `NO' Yards Diisp: Gallons Disp Loads of Water to Bill: (IF REQUIRED) SIGNED BY: PRESSURE WASHING DE-ICING VACTORS SWEEPERS a VACUUMS. WATER TRUCKS. White - Original Yellow- Remittance Pink.; Contractors Copy . Best Parking lot Cleaning Inc 2412 Inter Ave Puyallup Wa M72 After 30 days 1.75% per month Interest -n Or be charged. Signature of this Invoice will be considered your notice of our intent to lien. ROAD CONSTRUCTION NORTHWEST, INC. DATE: 08/15/16 Force Account Request for Payment F.A. # 2 Bid Item # NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Excavated out for new manholes and ditch, hit concrete rubble & Asphalt around duct bank and sewer manhole, removing rubble by hand or slowly with an excavator. aTotal Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Foreman Kye VanHoof 4 $ 45.00 $ 20.97 $ 65.97 $ 263.88 Laborer Robbie Sherwood 4 $ 42.67 $ 6.97 $ 49.64 198.66 Laborer Josh Doolittle 4 $. 42.67 $ 6.97 $ 49.64 198.56 Subtotal $ 661.00 Contractor M/U @ 29% 191.69 Total $ 852.69 t IP 6 Eauipment # Class Type Hours Gross Rate Total 30-104 Tool Truck F450 4 $ 40.74 $ 162.96 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 4 $ 88.86 355.44 24-879 Crawler Mounted Hydraulic Excavator 350D LC 2 $ 198.86 397.72 24-874 Crawler Mounted Compact Excavator Deere 50D 2 $ 36.04 72.08 Sunbelt Pumps and Fittings 1 $ 2,049.00 2,049.00 United Rentals 1 $ 216.98 216.98 Subtotal $ 3,254.18 Contractor WU @ 21% 683.38 Total $ 3,937.56 9Cost Description Vendor UOM Quantit Total Subtotal $ Contractor M/U @ 21% Total $ - x Classification Vendor UOM Quantlt Cost Total Subtotal $ Contractor M/U @ 12% Total $ - Total labor, equipment, material, subcontractors $ 4,790.25 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Account Job Name i�ea.�o� , ,e p Job # /$�`0 9 Force Acet # o 62 BID ITEM #: Is this work associated with a DVN? If so attach form DVN. Yes No Date work performed Additional Days To Be Added To Original Contract Description of Work �ue&U j OJ kc niw flNa dye raj ate. hi4 i� Cw1cr c T Ct �661.c_ k- fycy r i rtcrd- &' 4 kj `5 LLxr v>,.�� sir spy .oinr loll h n_r.,.A nr 51bLA.A iJA4�. ex-o Gw�7� pP LABOR FORCE RCNW Employee Name Classification Hours A{ („J_A.&L}hO I'bb; L jj"' s�o q AA kt EQUIPMENT FORCE (including p/us, flat beds, light towers etc.) RCNW Equipment # Classification Hours Iy'Y75 " 00S aH- J6, MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost i i - SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost t NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) SARCNW1FormslForeman\Foreman Forms Rev 091812 BEST PARKING LOT CLEANING INC 2412 INTER AVE PUYALLUP, WA 98372 Voice: 253-863-3330 Fax: 253-770-0724 Invoice Bill To: ROAD CONSTRUCTION NORTHWEST IobSite: P 0 BOX 188 RENTON, WA 98057 RECEIVED AUG 2 2 2016 R Ct N W 1509—RENTON SEWER 4TH & HOUSER RENTON CLIA0111cr ID Customer 130 1 Payment Terms RCNW-LXRp17 - ----- Ncc 30 Days Job Slip Description EDUCTOR & OPERATOR JOB SLIP#21939 8115/2016 EDUC Hours P] EDUCTOR & OPERATOR JOB SLIPt22575 8/12/2016,0' EDUC 2.00 FIATER CHARGE PER LOAD (UP TO 2,000 gallons) LOAD 2.00 EDUCTOR & OPERATOR JOB SLIP921889 8/11/2016e EDUCI 1.00 DISPOSAL OF MATERIALS $178.20 PER YARD 10.50 <Eac 5.00 (-?110-00/ton) ,1 .ATER CHARGE PER LOAD (UP TO 2f000 gallons) LOAD� 2.00 `qt 9.)kgp, Oty /'LO ad /, Verifii,d // A c TERMS: NET 30 DAYS MONTHLY FIN CHRG = 1.75% PLEASE SHOW INVOICE NUMBER WITH YOUR PAYMENT ALL INVOICE DISPUTES MUST BE SUBMITTED IN WRITING PRIOR TO INVOICE DUE DATE RENTON EX Invoice Number: V149333 Invoice Date: Aug 1.5, 2016 Page: Due Date 9/1-4/16 'ice T\ret 195.00 �90.00 195.00 390.00 35.00 35.00 195.00 2,047.50 45.00n225.00 35.00 1 70.00 Document CerI', - , : ;Xpp, In(vt Affidavit Nd;e Subtotal 3, 157.50 Sales Tax Total Invoice Amount 3,157.50 Payment/Credit Applied TOTAL 3,105 7. 5 0 R 0.00 r ROAD CONSTRUCTION NORTHWEST, INC. Force Account Request for Payment F.A. # 2A Bid Item # DATE: 08/16/16 NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Excavated slowly thru the concrete rubble for new manhole and around exisitng power duct, chunks of concrete 4" to 12" thick. . r... Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Total Foreman Kye VanHoof 4 $ 45.00 $ 20.97 $ 65.97 $ 263.88 Laborer Robbie Sherwood 4 $ 42.67 $ 6.97 $ 49.64 198.56 Laborer Josh Doolittle 4 $ 42.67 $ 6.97 $ 49.64 198.56 Subtotal $ 661.00 Contractor M/U @ 29% 191.69 Total $ 852.69 s Equipment # Class Type Hours Gross Rate Total 30-104 Tool Truck F450 4 $ 40.74 $ 162.96 24-874 Crawler Mounted Compact Excavator Deere 50D 4 $ 36.04 144.16 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 4 $ 88.86 355.44 Sunbelt Pumps and Fittings 1 $ 2,049.00 2,049.00 United Rentals 1 $ 216.98 216.98 Subtotal $ 2,928.54 Contractor M/U @ 21 % 614.99 Total $ 3,543.53 Description Vendor UOM Quantlt Cost Total S $ Subtotal $ Contractor M/U @ 21% Total $ - U Classification Vendor UOM Quantit Cost Total Subtotal $ Contractor M/U @ 12% Total $ Total labor, equipment, material, subcontractors $ 4,396.22 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Account Job Name 94"ka'►- &,ja- Job # 11':�p 5 Force Aect # % 5-60z BID ITEM #: Is this work associated with a DV ? If so attach form DVN.. Yes No Date work performed Additional Days To Be Added To Original Contract Description of Work - qKe In (twl e �C uh �t C� LABOR FORCE RCNW Employee Name Classification Hours EQUIPMENT FORCE (including p/us, flat beds, light towers etc.) RCNW Equipment # Classification Hours 30- lu-( 0 LnV-L _ 13 MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost SUBCONTRACTORS UTILIZED Vendor Name Tye of work Invoice/Ticket # Cost i j a-,,A-4zof Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) S:\RCNW\Forms\Foreman\Foreman Forms Rev 091812 ROAD CONSTRUCTION NORTHWEST, INC. Force Account Request for Payment F.A. # 2B Bid Item # DATE: 08/17/16 NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Best Parking Lot vactoring around the exisitng locates and concrete rubble, crews and excavator slowly digging around rubble. Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Total Foreman Kye VanHoof 6.5 $ 45.00 $ 20.97 $ 65.97 $ 428.81 Laborer Robbie Sherwood 6.5 $ 42.67 $ 6.97 $ 49.64 322.66 Laborer Josh Doolittle 6.5 $ 42.67 $ 6.97 $ 49.64 322.66 Subtotal $ 1,074.13 Contractor M/U @ 29% 311.50 Total $ 1,386.63 fy. Equipment # Class Type Hours Gross Rate Total 30-104 Tool Truck F450 6.5 $ 40.74 $ 264.81 24-874 Crawler Mounted Compact Excavator Deere 50D 4 $ 36.04 144.16 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 3 $ 88.86 266.58 Sunbelt Pumps and Fittings 1 $ 2,049.00 2,049.00 United Rentals 1 $ 709.06 709.06 Subtotal $ 3,433.61 Contractor M/U @ 21% 721.06 Total $ 4,154.67 Description Vendor 1.10M Quantit cost Total Subtotal $ Contractor M/U @ 21% Total $ Classification Vendor U0M Quantity Cost Total Vactor Best Parking Lot Hourly 5 $ 195.00 975.00 Material Disposal Best Parking Lot Each 5 $ 178.20 891.00 Disposal of Liquid Best Parking Lot GAL 500 $ 0.38 190.00 Water Charge Per Best Parking Lot Load 1 $ 35.00 35.00 Subtotal $ 2,091.00 Contractor M/U @ 12% 250.92 Total $ 2,341.92 Total labor, equipment, material, subcontractors $ 7,882.22 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction (Northwest, Inc. FA Force Account Job Name ��,ti ,n �eA�ie✓L Job # 0i'01 Force Acct # 59-60Z BID ITEM #: Is this work associated witli a DVN? If so attach form DIN. Yes No Date work performed 94-)- I L Additional Days To Be Added To Original Contract Description of Work &-"'k eLVII-yeL r')Wak 9 -x e-'O' A -10� ext 0a Ls� dA h W —QQ,2.0ed-e LABOR FORCE RCNW Employee Name Classification Hours cvh b� l_ S I EQUIPMENT FORCE (including phis, flat beds, light towers etc.) RCNW Equipment # Classification Hours Q - - &� 05 _ MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost i I � I SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost --- �esSri_po'.'1Li_.r�'A- rubd-� Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) SARCMFormsVoremanlForeman Forms Rev 091812 BEST" PARKING LOT CLEANING INC 2 412 INTER AVE RECEIVED PUYALLUP, WA 98372 AUG 2 2 20183 Voice: 253-863-3330 P%CNW Fax: Invoice 253-770-0729 Bill To: ROAD CONSTRUCTION NORTHWEST Job Site: 1509—RENTON SEWER P O BOX 188 4TH & HOUSER RENTON, WA 98057 RENTON I Customer ID j RCNW-EXRP17 Customer PO Payment Terms Net 30 Days I Invoice Number: V149368 Invoice Date: Aug 17, 2016 Page: 1 Due Datc 9/16/16 Job Slip # / Description Hours Price Net EDUCTOR & OPERATOR JOB SLIP#22376 8/17/2016 EDUCa 6.00 195.00 1,170.00 DISPOSAL OF MATERIALS $178.20 PER YARD <Eac 5.00 178.20 891.00 ($110.00/ton) DISPOSAL OF LIQUID BY GALLON -STORM DISP 500.00 0.38 1.90.00 WATER CHARGE PER LOAD (UP T0.2,000 gallons) LOADIE 1.00 35.00 35.00- APPRO3 D q--7-(4 PROJECT- I SO -I -- COST CODE &-5 G/L sty I 20a r Verlfi3O usint B/U ;jai Nm P!DrL - TERMS: NET 30 DAYS MONTHLY FIN CHRG = 1.75% PLEASE SHOW INVOICE NUMBER WITH YOUR PAYMENT ALL INVOICE DISPUTES MUST BE SUBMITTED IN WRITING PRIOR TO INVOICE DUE DATE Subtotal 2,286.00 Sales Tax Total Invoice Amount 86. 00 Payment/Credit Applied TOTAL 2,286.00 F RENTON EX 0.00 ROAD CONSTRUCTION NORTHWEST, INC. DATE: 08/18/16 Force Account Request for Payment F.A. # 2C Bid Item # NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Excavated Concrete rubble & Asphalt, Located existing 8" clay pipe at Manhole going to the south east, next to Burger King 15" Pipe, concret rubble buired around pipe and manhole. Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Total Foreman Kye VanHoof 6 $ 45.00 $ 20.97 $ 65.97 $ 395.82 Laborer Robbie Sherwood 6 $ 42.67 $ 6.97 $ 49.64 297.84 Laborer Josh Doolittle 6 $ 42.67 $ 6.97 $ 49.64 297.84 Subtotal $ 991.50 Contractor M/U @ 29% 287.54 Total $ 1,279.04 i•� Equipment # Class Type Hours Gross Rate Total 30-104 Tool Truck F450 6 $ 40.74 $ 244.44 24-874 Crawler Mounted Compact Excavator Deere 50D 3 $ 36.04 108.12 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 6 $ 88.86 533.16 24-879 Crawler Mounted Hydraulic Excavator 350D LC 3 $ 198.86 596.58 Sunbelt Pumps and Fittings 1 $ 2,049.00 2,049.00 United Rentals 1 $ 709.06 709.06 Subtotal $ 4,240.36 Contractor MN @ 21% 890.48 Total $ 5,130.84 MIA g SAW Description Vendor UOM Quantity Cost Total Subtotal $ Contractor M/U @ 21 % Total $ Classification Vendor UOM Quantit Cost Total Vector Best Parking Lot Hourly 3 $ 195.00 585.00 Material Disposal Best Parking Lot Each 1 $ 178.20 178.20 Water Charge Per Best Parking Lot Load 1 $ 35.00 35.00 Subtotal $ 798.20 Contractor WU @ 12% 95.78 Total $ 893.98 Total labor, equipment, material, subcontractors $ 7,303.86 RacelvedlAccepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Acennnt Job Name Job Force Acct # Cj of-QUZ_ BID ITEM #: Is this work associated with a DVN? If so attach form DVN. Yes No Date work performed g� ��(-�(� Additional Days To Be Added To Original Contract Description of Work T' l Ct. I ' -.. e o,Ii r ,t,1r c+ �.� aank,L(� t-a c ��i . LABOR FORCE RCNW Employee Name Classification Hours EQUIPMENT FORCE (including p/us, flat beds, liglit towers etc.) RCNW Equipment # Classification Hours 4�b �r- SDI 5 35U MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost � I I SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost V' rV3 Lak _� V e�►tir—_ Qu,�c� l•,rS i Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29112) SARCNW1FormsToremanlForeman Forms Rev 091812 S BEST PARKING LOT CLEANING INC RECEIVE© Invoice Number: 2412 INTER AVE AUG 2 4 20 V149422 PUYALLUP , WA 98372 FZCNW Invoice Date: Aug 19, 2016 Voice: 253-863-3330 Pax: 253-770-0724 Invoiee Page: 7_ Bill To. ROAD CONSTRUCTION NORTHWEST P O BOX 188 RENTON, WA 98057 Job Site: 150 9 —RENTON SEWER 4TH & HOUSER RENTON l Customer IDCustomer PO I Payment Terms I Due Date RCNW-EXR217 - j Net 30 Days f 9/18/16 Job Slip # / Description Hours Price Net EDUCTOR & OPERATOR JOB SLIP*22438 8/1.B/2.016 EDUCa 3.00 195.00 585.00 DISPOSAL OF MATERIALS $178.20 PER YARD <Each 1.00 178.20 178.20 ($110.00/ton) WATER CHARGE PER LOAD (UP TO 2,000 gallons) LOADS 1.00 35.00 35.00� POST)FQ (e APP OVEI) R091 E�a�eC�/pI �O I�.ow— rr'1� �P DE Post GIL # _ _ err) '8.219• ty / _oad / erlfl d / ACC Using E/U CompllanceDocumeitVeriecatlon pre -lien Certified In ntAf idavit Notice F1ece red None On ile I Attuned (project Ong ) A09 _ Vedfied B 1571 _ Comments: TERMS: NET 30 DAYS MONTHLY FIN CHRG = 1.75% PLEASE SHOW INVOICE NUMBER WITH YOUR PAYMENT ALL INVOICE DISPUTES MUST BE SUBMITTED IN WRITING PRIOR TO INVOICE DUE DATE RENTON EX Subtotal 798.20 Sales Tax Total Invoice Amount 79s .20 Payment/Credit Applied TOTAL 7 98 ]20 0.00 t=N/1 Q. ;z,I • I (n ROAD CONSTRUCTION NORTHWEST, INC. DATE: 08/19/16 Force Account Request for Payment F.A. # 2D Bid Item # NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Excavating around concrete rubble in ditch line above existing 12 " clay pipe, laborers hand shovel around concrete rubble. Q O _'Tag..' MN Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Total Foreman Kye VanHoof 3 $ 45.00 $ 20.97 $ 65.97 $ 197.91 Laborer Robbie Sherwood 3 $ 42.67 $ 6.97 $ 49.64 148.92 Laborer Josh Doolittle 3 $ 42.67 $ 6.97 $ 49.64 148.92 Subtotal $ 495.75 Contractor M/U @ 29% 143.77 Total $ 639.52 Equipment # Class Type Hours Gross Rate Total 30-104 Tool Truck F450 3 $ 40.74 $ 122.22 24-879 Crawler Mounted Hydraulic Excavator 350D LC 3 $ 198.86 596.58 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 3 $ 88.86 266.58 Sunbelt Pumps and Fittings 1 $ 2,049.00 2,049.00 United Rentals 1 $ 709.06 709.06 Subtotal $ 3,743.44 Contractor M/U @ 21 % 786.12 Total $ 4,529.56 Description Vendor UOM Quantity Cost Total Subtotal $ - Contractor M/U @ 21 % Total $ Classification Vendor UOM Quantity cost Total Subtotal $ Contractor M/U @ 12% Total $ Total labor, equipment, material, subcontractors $ 5,169.08 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Account Job Name �aw.ko�� .� Job # /Sa q Force Acet 9-602 BID ITEM #: Is this work associated with a DVN? If so attach form D VN. Yes No Date work performed W —) 9 l6 Additional Days To Be Added To Original Contract Description of Work 1 ' GLn J ctjl-+'ne: lky-w-j- r.Q (rl,nr•1Ye ,�-� lr'1��11�t 1 n r p I� ,� .,,. n r.ioov g�stshl.S tit" CA&'. LABOR FORCE RCNW Employee Name Classification Hours EQUIPMENT FORCE (including p/us, flat beds, light towers etc.) RC..NW Fnninment t! 0I� -:F:,,'i:-- rr_..--_ -8 1 \3 -- MATERIAL UTILIZED Type or Class Vendor Deli ve /Packing Slip # Quantity Cost i SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost a road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) SARCNW\Fors\Foreman\Foreman Forms Rev 091812 ROAD CONSTRUCTION NORTHWEST, INC. DATE: 09/06/16 Force Account Request for Payment F.A. # Bid Item # NAME: Central Renton Sewer Interceptor Reline and Upslze (CAG-15-118) REMARKS: Vactor Truck Potholing around concrete rubble and 2 exisitng 15" pipes running to the south different aligmmnet than on plans 1 exisitng pipe is not live with sewer coming from Enterprise Parking Lot. Classification Name Hours Rate of Pay Taxes/Fringe Gross Rate Total Foreman Kye Van Hoof 4 $ 45.00 $ 20.97 $ 65.97 $ 263.88 Foreman Chad VanWiedgan 4 $ 47.00 $ 20.06 $ 67.06 268.24 Foreman Steve Olsen 4 $ 42.00 $ 20.01 ^21.47 $ 62.01 248.04 Foreman Clint Willis 4 $ 42.00 $ $ 63.47 253.88 Laborer Jeremy Bonin 4 $ 42.67 $ 6.97 $ 49.64 198.56 Laborer Brandon Armistead 4 $ 42.67 $ 6.97 $ 49.64 198.66 Laborer Andrew Pygott 4 $ 42.67 $ 6.97 $ 49.64 198.56 Subtotal $ 1,629.72 Contractor MIU @ 29% 472.62 Total $ 2,102.34 Eautnment 4 Class Type Hours Gross Rat a Total 30-104 Tool Truck F450 4 $ 40.74 $ 162.96 38-88 F550 4 $ 51.60 $ 206.40 38-99 C-2500 4 $ 26.85 $ 107.40 24-891 Crawler Mounted Hydraulic Excavator 316 Cal 4 $ 106.74 426.96 24-887 Crawler Mounted Hydraulic Excavator 135 C RTS 4 $ 88.86 355.44 30.721 4-WD Articulated Wheel Loader Deere 544J 4 $ 63.21 252.84 37-961 Portable Light Towers 4 $ 14.17 56.68 37-963 Portable Light Towers 4 $ 15.03 60.12 Sunbelt Pumps and Fittings 1 $ 2,210.00 2,210.00 United Rentals 1 $ 1,038.27 1,038.27 Subtotal $ 4,877.07 Contractor MIU @ 21 % 1,024.18 Total $ 5,901.25 ry QUWWIt� t^ W Description Vendor UOM Quantity cost Total Subtotal $ Contractor M/U @ 21% Total $ r , Classification Vendor UOM Quantity 929 = Total TCS Traffic Control Services Hourly 4 $ 84.00 336.00 Flagger Traffic Control Services Hourly 4 $ 82.60 330.00 Flagger Traffic Control Services Hourly 4 $ 82.50 330.00 Flagger Traffic Control Services Hourly 4 $ 82.60 330.00 Traffic Signs wl Stands Traffic Control Services EA 31 $ 5.000 155.00 28' Traffic Cones Traffic Control Services EA 60 $ 0.75 45.00 S.A.S. Traffic Control Services Nightly 1 $ 65.00 65.00 Type III Barricade Traffic Control Services EA 8 $ 2.50 20.00 PCMS Board Traffic Control Services Nighty 1 $ 225.00 225.00 Equipment Truck Traffic Control Services EA 4 $ 55.00 220.00 Mobilization Charge Traffic Control Services EA 4 $ 12.60 50.00 Vector Best Parking Lot Hourly 10 $ 195.00 1,950.00 Water Charge Per Best Parking Lot Load 1 $ 35.00 35.00 Subtotal $ 4,091.00 Contractor MIU @ 12% 490.92 Total $ 4,681.92 Total labor, equipment, material, subcontractors $ 12,585.51 Received/Accepted by (Owner) Submitted by (RCNW) Date Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. FA Force Account Job Name kut.'i�i1 Sr.wea Job # Force Acet # 1?9-063 BID ITEM #: Is this work associated with a DVN? If so attach form DVN. Yes No Date work performed 9--10-A. Additional Days To Be Added To Original Contract Description of Work V tlmr ck C1 e-eAe-yc- r.shl,lr n.nn(„� 'f"'Lo. gooH, s " ts— Jis n&k Lyz— wrVk se-w-r - (arnrnt� aw(e LABOR FORCE RCNW F.mninvee Name. C9acc;41—flnn I'A (" L,, 1 \ EQUIPMENT FORCE (including phis, flat beds, light towers etc.) RCNW F.nninment # Claccificatinn LTn„rc l q ' 1 C -z S -go-rU-r 1- "1 bu y MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost SUBCONTRACTORS UTILIZED Vendor Name T,ma of --I, Tmmina/ r;A,.f :4 f nc4 V %x> A ( e eD c w e - (bo.-c iG -ir is Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) SARCNW\Forms\Foreman\Foreman Forms Rev 022912 Road Construction Northwest, Inc. FA Force Account Job Name Job # Force Acet # 9 i-06 BID ITEM #: Is this work associated with a DVN? If so attach form DVN. Yes No Date work performed Additional Days To Be Added To Original Contract Description of Work LABOR FORCE RCNW(Employee Name Classification Hours t'Sy-Q-r�B EQUIPMENT FORCE (including p/us, flat beds, light towers etc.) RCNW Fnuinment # Classification Hours MATERIAL UTILIZED Type or Class Vendor Delivery/PackingDelivery/Packing Slip # Quantity Cost i I SUBCONTRACTORS UTILIZED Vendor Name Type of work Invoice/Ticket # Cost Road Construction NW Representative Date Owner/GC Representative Date Form No. 11 (Rev. 02/29/12) S:\RCNW\Forms\Foreman\Foreman Forms Rev 022912 Seattle 206-382-9340 Tacoma 253-863-3330 Puyallup 253-841-7406 www.best arkin Ig ot.com JOB SLIP If 1511-2 FOR: C ti Gv ;```:. JOB NAME: ADDRESS: LOCATION: !�/' } 1 �_!"i`->-e: CITY & ZIP: CITY:0.A1A. OFFICE PHONE: JOB PHONE: REQUESTED BY: ON DATE: `'i % 'f t :•'r' . SWEEPER VACUUM WATER EDUCTOR OPERATOR LABORER LEAVE SHOP ON JOB OFF JOB ARRIVE SHOP TOTAL HOURS MINIMUM J 5 DESCRIPTION OF SERVICES: FIRE HOSE POLYBROOMS SPILL RITSPONSE PRESSURE WASHER j BIO DEGREASER .. BIO ABSORBENT SPILL KIT BOOMS EDUCTORS: ' SPECIALTY HEADS POTHOLING TYPE 2 CBS TYPE 1 CBS CONFINED SPACE ENTRY CS SOCKS HOSE PER FT POND CLEANING BOOMS ALL DEBRIS HAULED OFF IS SUBJECT TO A PER YARD FEE $45- $178.20 AND UP Dump on Site YES NO Yards Disp: Gallons Disp Loads of Water to Bill: (IF REQUIRED) SIGNED BY: PRESSURE WASHING DE-ICING - VACTORS SWEEPERS 9.. VACUUMS WATER TRUCKS White - Original Yellow - Remittance Pink - Contr'actors Copy Best Parking lot Cleaning Inc:2412 Inter Ave Puyallup Wa 98372 After 30 days 1,75% per month interest will be charged. Signature of this invoice will be considered your notice of our intent to lien. PARKING LOT ._CLEANING INCgDf I nvoice NLuiiberBEST . �RE 2412 INTER AVE : V150005 ; PUYALLUP , .`.WA 98372 SEf j: Invoice Date �CNW :. Sep 8, 2016 Voice:. 253-863-3330 :: • IIZv01CL' Page 1 Fax: 253-770-0724 Bill To: ROAD CONSTRUCTION NORTHWEST Job Site: 1509-RENTON SEWER P 0 BOX 188 4TH &. HOUSER: RENTON, WA 98057 RENTON -Due Date Customer ID Customer PO Payment Terms RCNW-EXRP17. ...Net,30 Days` TERMS: NET 30 DAYS MONTHLY FIN CHRG = 1.75% PLEASE SHOW INVOICE NUMBER WITH YOUR PAYMENT ALL INVOICE DISPUTES MUST BE SUBMITTED IN WRITING PRIOR TO INVOICE DUE DATE RENTON EX F7'1 A OI . t r- • i f„ Subtotal Sales Tax Total Invoice Amount Payment/Credit Applied TOTAL 0.00 1,985.00 1,985.00 1,985.00 TRAFFIC CONTROL SERVICES A professional flagging service. 3ox 52665 Bellevue, WA 98015 Phone: (425)658-3655 Fax: (425)658-3658 Bill To: ROAD CONSTRUCTION NW ATTN: ACCOUNTS PAYABLE P0Box 188 Renton, WA 98057 Invoice 4797 MR D..11 l 10/13/201(3 Re: 1-405 & SUNSET BLVD ROAD CONSTRUCTION NW RENTON, WA 00000-0000 r .::;lob: 1 : r-�:�C' sto .,o . � � ✓ , i , a eri :Term„_ . Du. a D002219 �r` � 10/13/2016 po:Ta 7ni7l tt�/ ❑ e. M g♦�'�, 6 ate i 9/6/2016 13.00 TCS Bell OT 84.00 1,092.00 9/6/2016 12.50 Prevailing Wage 82.50 1,031.25 9/6/2016 13.00 Prevailing Wage -.Upson OT 82.50 1,072.50 9/6/2016 11.50 Prevailing Wage Dever OT 82.50 948.75 9/6/2016 12.50 Prevailing Wage Benedix OT 82.50 1,031.26 9/7/2016 12.50 TCS Bell Reg 84.00 1,050.00 9/7/2016 12.50 Prevailing Wage Benedix OT 82.50 1,031.25 9/7/2016 12,50 Prevailing Wage Thompson OT 82.50 1,031.25 9/7/2016 12.50 Prevailing Wage Dever OT 82.50 1,031.25 31.00 Sign w/stand 31 @ 10.00 each x 2 days 10.00 310.00 60.00 28" Cones 60 @ 1.50 each x 2 days 1.50 90.00 2.00 Sequential Arrow Board 2 @ 130.00 each x 2 days 130.00 260.00 2.00 Variable Message Board 2 @ 450.00 each x 2 days 450.00 900.00 8.00 Type III Barracade 8 @ 5.00 per day 5.00 40.00 8.00 Mobilization Charge 4 per day @ 25.00 x 2 days 25.00 200.00 8.00 Equipment Truck 4 per day @ 110.00 x 2 days 110.00 880.00 Total Due $11,999.50 Thank you for your business! ROAD CONSTRUCTION NORTHWEST, INC. Force Account Request for Payment F.A. # 3A Bid Item # DATE: 09/07/16 NAME: Central Renton Sewer Interceptor Reline and Upsize (CAG-15-118) REMARKS: Ran in to unknown 12" exisitng pipe with concrete around pipe 3rd stick out from manhole, crew had to torch cut pipe used strap for removal. Vactor potholed around 18" water and concrete rubble. Classification Name Hours Rate of Pa v Taxes/Frinne Gross Rate Total Foreman Kye VanHoof 4 $ 45.00 $ 20.97 $ 65.97 $ 263.88 Foreman Chad VanWierigan 4 $ 47.00 $ 20.06 $ 67,06 268.24 Foreman Steve Olsen 4 $ 42.00 $ 20.01 $ 62.01 248.04 Foreman Cllnt Willis 4 $ 42.00 $ 21.47 $ 63.47 253.88 Laborer Jeremy Bonin 4 $ 42.67 $ 6.97 $ 49.64 198.56 Laborer Brandon Armistead 4 $ 42.67 $ 6.97 $ 49.64 198.56 Laborer AndrewPygotl 4 $ 42.67 $ 6.97 $ 49.64 198.56 Subtotal $ 1,629.72 Contractor M/U Q 29 % 472.62 Total $ 2,102.34 Equipment N Class Tyne Hours Gross Rate Total 38-99 4x4 1 112 360 Crew Diesel 4 $ 26.85 $ 107.40 38-101 C-2500 4 $ 16.38 $ 65.52 30-104 F450 4 $ 40.74 $ 162.96 38-88 Ford F550 12' Flatbed 4 $ 51,60 $ 206.40 38.102 F350 4 $ 16.96 $ 67.84 24-874 Crawler Mounted Compact Excavator Deere 50D 4 $ 36.04 $ 144.16 24-887 Crawler mounted Hyrdraulic Excavator Deere 135C RTS 4 $ 88.86 $ 355.44 24-891 Craver Mounted Hydraulic Excavator 316 Cat 4 $ 108.74 $ 426.96 38-721 4-WD Articulated Wheel Loaders 544J 4 $ 63.21 $ 252.84 37-961 Portable Light Tourers 4 $ 14.17 $ 56.68 37-963 Portable Light Towers 4 $ 15.03 $ 60.12 37-956 Portable Light Towers 4 $ 14.D7 $ 56.28 21-112 6x412 YD 50 KGVW 4 $ 69.52 $ 278.08 19-994 Arrowboard 1 $ 10.50 $ 10.50 19-993 Arrowboard 1 $ 3.36 $ 3.36 8X15 Steel Sheet 1 S 44.10 $ 44.10 8x20 Steel Sheet 1 $ 44.80 $ 44.80 Sunbelt Pumps and Fittings 1 $ 2,210.00 $ 2,210.00 United Rentals 1 $ 1,038.27 $ 1,038.27 Subtotal $ 5,591.71 Contractor WU Q 21% 1,174.26 Total $ 6.765.97 Description Vendor Sack Concrete Mix Shope Classification vendor TCS Traffic Control Services Flagger Traffic Control Servlces Flagger Traffic Control Services Flagger Traffic Control Services Traffic Signs w/ Stands Traffic Control Services 28" Traffic Cones Traffic Control Services S.A.S. Traffic Control Services Type III Barricade Traffic Control Services PCMS Board Traffic Control Services Equipment Trucks Traffic Control Services Mobilization Charge Traffic Control Services Roeelvod/Accopted by (Owner) UOM Quand Cost Total EA 4 $ 18.950 $ 75.80 Subtotal $ 75.80 Contractor MAJ Q 21 % 15.92 Total $ 91.72 UOM Quantity Cost Total Hourly 4 $ 84.00 $ 336.00 Hourly 4 $ 82.50 330.00 Hourly 4 $ 82.50 330.00 Hourly 4 $ 82.50 330.00 EA 30 $ 5.000 150.00 EA 60 $ 0.75 45.00 Nightly 1 $ 65.00 65.00 EA 4 $ 2.50 10.00 Nightly 1 $ 226.00 225.00 EA 4 $ 55.00 220.00 EA 4 $ 12.50 50.00 Subtotal $ 2,091.00 Contractor MN Q 12% 250.92 Total $ 2.341.92 Total labor, equipment, material, eubmlited by (RCNW) Dote Phone (425) 254-9999 PO Box 188, Renton WA 98057 Fax (425) 254-1334 Road Construction Northwest, Inc. Force Account Job Name A"'L sc" "Z— Job # Force Aect # 7-9-603 BID ITEM #: Is this work associated with a DVN? If so attach form DVN. Yes No Date work performed Additional Days To Be Added To Original Contract Description of Work 1^1A►1 j v'-l-n 9V"1i n �� h `� .L ><S1 �'� •c� F� I e t�., 1 '��_ Cc.��c�. r L ['An^nGtnr^� P! r� g 1-cl s 3u L! _ n t.�- (v c> r . M • N • s h,u i arc L. A C'A (��/c' c� �rr�n •Ih. 01 Jr • V(2=61 I- �nc"C �cY ` 1 fv t�./-✓ D.c.y{ L' ©v�crr.%� r—iJ �,Y, �t� LABOR FORCE RCNW F.mnlovee Name Classification Hours 441--t 14 Ll Ll Ll EQUIPMENT FORCE (including p/us, flat beds, light towers etc.) RCNW Eauioment 4 Classification Hours '3 % C ` 96-6o 4 -a S-06 L/ o a� Lr sco r - I d Z. F3sb MATERIAL UTILIZED Type or Class Vendor Delivery/Packing Slip # Quantity Cost rile 5�d�ln� 1 c SUBCONTRACTORS UTILIZED Vendor Name Tvne of work Tnvoice/Ticket # Cost I EAL Road Constructio/NW Representative Owner/GC Representative Form No. 11 (Rev. 02/29/12) FA 9- 7- /6 Date Date SARCMFormsToremanlForeman Forms Rev 022912 CITY OF RENTON BID TABULATION SHEET Project: Sewer Radio Panel Relocation and Lift Station Improvements Page 1 of 1 CAG-14-078 Date: June 10, 2014 FORMS Bidder Proposal L&I Bid Add. Bid Total from Schedule of Prices Trip. Form Cert Bond 1 *Includes Sales Tax Equity Builders, LLC 5066 E. 26th PI. Bellingham, WA 98226 1-- Gary Gary Harper Construction (� 4"`'r• S �.. 14831 223rd St. SE Snohomish, WA 98296 R.L. Alia Company 107 Williams Ave. S. Renton, WA 98057 - 1 2��ua24 4, d Engineer's Estimate: $166,440.00 CITY OF RENTON COUNCIL AGENDA BILL Subject/Title: Contract Award for Bid Opening on 6/10/2014; CAG-14-078; Sewer Radio Panel Relocation and Lift Station Improvements Project Meeting: Regular Meeting - 16 Jun 2014 Exhibits: Submitting Data: Dept/Div/Board: Staff Recommendation City Clerk Bid Tab (three bids) Staff Contact: Bonnie Walton, City Clerk ext. 6502 Recommended Action: Refer to Utilities Committee Fiscal Impact: Expenditure Required: $ 145,799.25 Transfer Amendment: $ Amount Budgeted: $ Revenue Generated: $ Total Project Budget: $ 160,000 City Share Total Project: $ SUMMARY OF ACTION: Engineer's Estimate: $166,440.00 In accordance with Council procedures, bids submitted at the subject bid opening met the following three criteria: There was more than one bid, the low bid was within total project budget, and there were no irregularities with the low bid. However, the total project budget is not sufficient to cover the entirety of the project. Therefore, staff recommends that $30,000 from the 2014 Sewer Replacement/Rehabilitation account (426.465502) be transferred to the Mill Avenue S. Manhole Rehabilitation account (426.465504) to cover the budget shortfall. Additionally, staff recommends accepting the low bid submitted by Equity Builders, LLC, in the amount of $145,799.25 for the Sewer Radio Panel Relocation and Lift Station Improvements Project and to refer the bid to the Utilities Committee for discussion of funding. STAFF RECOMMENDATION: Accept the low bid submitted by Equity Builders, LLC in the amount of $145,799.25 for the Sewer Radio Panel Relocation and Lift Station Improvements project, subject to discussion of funding. PUBLIC WORKS DEPARTMENT leaf M E M O R A N D U M CITY OF RENTON DATE: June 11, 2014 .jUNI # 2014 TO: Bonnie Walton, City Clerk BEceIVED FROM: Michael Benoit, Wastewater Utility, x7206 CITY CLERK'S QFFtGE SUBJECT: Bid Award for the Sewer Radio Panel Relocation and Lift Station Improvements Project, CAG-14-078 The Public Works Department has reviewed the bids that were submitted for the Sewer Radio Panel Relocation and Lift Station Improvements project (CAG-14-078) and we recommend that the bid be awarded to Equity Builders, LLC. We are requesting that an agenda bill for "Referral to Utilities Committee" be prepared for the Council Meeting on June 16, 2014. The bid opening was on Tuesday, June 10, 2014. There were three bids received. There were no errors of significance on any of the bids. The low bidder is Equity Builders, LLC with a bid of $145,799.25. The engineer's estimate was $166,440. The project budget amount for the project (426.465504) is $160,000. This amount is not sufficient to cover the project. The referral to the Utilities Committee is with the recommendation that Council award the project to Equity Builders, LLC and to approve a budget adjustment in the amount of $30,000 from the 2014 Sewer Replacement/ Rehabilitation project account (426.465502) to the Mill Avenue 5 Manhole Rehabilitation project account (426.465504). The project will rehabilitate the deep manhole about the 500 block of Mill Avenue S to provide ventilation and access improvements; provide improvements to lift stations to mitigate fall protection concerns; and will provide revisions to our telemetry radio system to improve access safety. 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 425-430-7206 or by email at mbenoit@rentonwa.gov. Attachments cc: Gregg Zimmerman, PW Administrator Lys Hornsby, Utility Systems Director Dave Christensen, Wastewater Utility Manager H:\File Sys\WWP - WasteWater\WWP-27-3711 Sewer Radio Panel Relocation and Lift Station Improvements\Bid Documents\Award-Clerk-Radio Panel Relocation.doc/MABtp Project Titl(Sewer Radio Panel Relocation and Lift Station Improvements BID DATE: June 10, 2014 E Item Unit Est. � No. Descri tion Ouantitv R.L Alia Company Unit Bid Price Amount Average Bid Unit Bid Price Amount 1 ibilization and Demobilization not to exceed 10% of contract to Lump Sum 1 15,000.00 15,000.00 12,166.67 12,166.67 2 Traffic Control Lump Sum 1 1,000.00 1,000.00 2,666.67 2,666.67 3 Mill Ave Manhole Improvements Lump Sum 1 20,000.00 20,000.00 21,766.67 21,766.67 4 Main Avenue Manhole Improvements Lump Sum 1 10,000.00 10,000.00 4,633.33 4,633.33 5 Adjustable Guard Rail and Chaln Each 2 3,070.00 6,140.00 2.090.00 4,180.00 6 Access Hatch Modification - Guard Rail System Each 30 3,070.00 92,100.00 2,048.33 61,450.00 7 Access Hatch Modification - Guard Post and Chain System Each 10 3,070.00 30,700.00 2,073.33 20,733.33 8 Hazen Reservoir Radio Repeater Relocation Lump Sum 1 8,000.00 8,000.00 15,733.33 15,733.33 9 West Hill Reservoir Radio Repeater Relocation Lump Sum 1 8,000.00 8,000.00 15,733.33 15,733.33 190,940.00 $159,063.33 18,139.30 $15,111.02 209,079.30 174,174.35 Numbers in red indicate corrections of errors s* y CITY OF RENTON BID TABULATION SHEET Project: Sewer Radio Panel Relocation and Lift Station Improvements Page 1 of 1 CAG-14-078 Date: June 10. 2014 FORMS Bidder Proposal L&I Bid Add. Bid Total from Schedule of Prices Trip. Form Cert Bond 1 *Includes Sales Tax Equity Builders, LLC 5066 E. 26th PI. X X Cashier's X $145,799.25 Bellingham, WA 98226 Check George Hochstein Gary Harper Construction 14831 223rd St. SE X X X X $167,644.50 Snohomish, WA 98296 Gary Harper R.L. Alia Company 107 Williams Ave. S. X X X X $209,079.30 Renton, WA 98057 Richard Alia Engineer's Estimate: $166,440.00 DeM YoLaw C1tV 00000 � Of , . } —� ' �r� r� mil► . .� _._,,,..� - -. T July 8, 2014 George Hochstein Equity Builders, LLC 5066 E. 26th PI. Bellingham, WA 98226 City Clerk -Bonnie I. Walton RECEIVED JUL 0 9 2014 CITY OF RENTON UTILITY SYSTEMS RE: Sewer Radio Panel Relocation & Lift Station Improvements Project; CAG-14-078 Dear Mr. Hochstein: At its regular meeting of July 7, 2014 the Renton City Council accepted your bid for the above - referenced project in the amount of $145,799.25. Please contact Mike Benoit, Civil Engineer at 425-430-7206, for submission of required documents to complete the contract. These may include proof of City and State business licenses, performance bond, and insurance certificates. Sincerely, Jason A. Seth Deputy City Clerk cc: Mike Benoit, 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 Denis Clty Of r 1 1� b g City Clerk -Bonnie I.Walton. July 8, 2014 _.Gary Harper Gary Harper Construction 14831 22rd St. SE Snohomish, WA 98296 RE: Sewer Radio Panel Relocation & Lift Station Improvements Project; CAG-14-078 Dear Mr. Harper: At its. regular meeting on. July 7; 2014 the Renton City -Council accepted the lowest responsive bid submitted by Equity Builders, LLC for the above -referenced project in the amount of $145,799.25. 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, aso A. et Deputy City Clerk cc: Mike Benoit, Project Manager 1055 South Grady Way • Renton, Washington 98057 • (425) 430-6510 / Fax (425) 430-6516 r rentonwa.gov Denis Ma Mayor �i . City -Of City Clerk - Bonnie I. Walton July 8, 2014 Richard L. Alia RL Alia Company 107 Williams Ave. S. Renton, WA 98057 RE: Sewer Radio Panel Relocation &Lift Station Improvements Project; CAG-14-078 Dear Mr. Alia: At. its regular meeting on July, 7,. 2014 the Renton City Council accepted the lowest responsive bid submitted by.Equity Builders; LLC for the above -referenced project in the amount of $145,799.25. 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. h Y. Seth City Clerk cc: Mike Benoit, Project Manager 1055 South Grady Way • Renton, Washington 98.057 •. (425) 430-6510 / Fax (425) 430-6516 • rentonwa.gov Denis Law _ Cl Off ��y o Mayor Y. ♦ Public Works Department-- Gregg Zimmerman, P. E., Administrator July 10, 2014 Mr. George Hochstein Equity Builders, LLC 5066 E 26th Drive Bellingham, WA 98226 RE: BID AWARD — SEWER RADIO PANEL RELOCATION AND LIFT STATION IMPROVEMENTS Dear Mr. Hochstein: At the Renton City Council meeting on July 7, 2014, Council accepted Equity Builders, LLC's bid.of $145,799.25 for the Sewer Radio Panel Relocation and Lift Station . Improvements 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. Your current business license expires on July 31, 2014. To renew your 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), lJ"4DATED. The date will be filled in vJhe.. 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 page_ of all required insurance policies obtainled from the insurance carrier. Renton City Hall •.1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov Mr. Hochstein Page 2 of 2 July 10, 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 forthe work involved with thisjob. Th.is 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.; mechanical, electrical, 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 both Mill Avenue S and Main Avenue S S. Street Cleaning and Sweeping Plan 6. Disposal Site 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 425-430-7206 or mbenoit@rentonwa.gov, if you have any questions. Sincerely, -- Michael A. Benoit Wastewater Utility Enclosures H:\rlle SyS\WVJP - Waste Water\WVv P-L7-3%11 Sewer Radio Panel Relocation and Lift Station I proven eats\Bid Documents\Award\Equity Builders Award Letter S-3711.doc\MABad Denis Law Mayor �i City Of p R � ice— f ter— Cj A� r, mums 4 Public Works Department - Gregg Zimmerman, P. E., Administrator March 11, 2014 Mr. Robert Schommer Systems Interface, Inc. 1916 220th Street SE #M-102 Bothell, WA 98021 RE: 2012 Sewer Telemetry Upgrades Project Completion Dear Mr. Schommer: The City has received notification from RH2 Engineering that they have reviewed the status of the Wastewater Supervisory Control and Data Acquisition (SCADA) system upgrades implemented by Systems Interface, Inc. under City Contract CAG-12-150, 2012 Sewer Telemetry Upgrades Project. RH2 Engineering reviewed the final system, the system operations and maintenance documents, and the spare parts list and has recommended that the City accept the SCADA system upgrades as complete. This letter is to notify Systems Interface, Inc. that we consider the work complete and we are preparing the paperwork to close-out the contract and to have our Council formally accept the work. We appreciate the work that Systems Interface, Inc. and subcontractors have done on this project. Sincerely, Michael A. Benoit Wastewater Utility Project Manager H:\File Sys\WWP - WasteWater\WWP-27-3656 2012 Telemetry Upgrades\Systems Interface 04.doc\MABtp Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov PUBLIC WORKS DEPARTMENT p City of M E M O R A N D U M DATE: June 11, 2014 TO: Bonnie Walton, City Clerk FROM: Michael Benoit, Wastewater Utility, x7206 `''`� SUBJECT: Bid Award for the Sewer Radio Panel Relocation and Lift Station Improvements Project, CAG-14-018 The Public Works Department has reviewed the bids that were submitted for the Sewer Radio Panel Relocation and Lift Station Improvements project (CAG-14-078) and we recommend that the bid be awarded to Equity Builders, LLC. We are requesting that an agenda bill for "Referral to Utilities Committee" be prepared for the Council Meeting on June 16, 2014. The bid opening was on Tuesday, June 10, 2014. There were three bids received. There were no errors of significance on any of the bids. The low bidder is Equity Builders, LLC with a bid of $145,799.25. The engineer's estimate was $166,440. The project budget amount for the project (426.465504) is $160,000. This amount is not sufficient to cover the project. The referral to the Utilities Committee is with the recommendation that Council award the project to Equity Builders, LLC and to approve a budget adjustment in the amount of $30,000 from the 2014 Sewer Replacement/ Rehabilitation project account (426.465502) to the Mill Avenue S Manhole Rehabilitation project account (426.465504). The project will rehabilitate the deep manhole about the 500 block of Mill Avenue S to provide ventilation and access improvements; provide improvements to lift stations to mitigate.fall protection concerns; and will provide revisions to our telemetry radio system to improve access safety. 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 425-430-7206 or by email at mbenoit@rentonwa.gov. Attachments cc: Gregg Zimmerman, PW Administrator Lys Hornsby, Utility Systems Director Dave Christensen, Wastewater Utility Manager H:\File Sys\WWP - WasteWater\WWP-27-3711 Sewer Radio Panel Relocation and Lift Station Improvements\Bid Documents\Award-Clerk-Radio Panel Relocation.doc/MABtp ACOR& �� C.ERTIFICAT,E OF LIABILITY INSURANCE DATE (MWDD/YYYY) 12/10/2014 THIS .CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT ,CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sammamish Insurance, Inc. 704 228th Ave NE, PMB 373 Sammamish WA 98074 CONTACT Allen Fu itt CPCU NAME: g PHONE (425) 8,98-8780 aC No: (425)836-2865 ADDRESS:Allen F.ugitt@msn.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Hartford Casualty Ins. Co. 29424 INSURED RH2 ENGINEERING INC 22722 29TH DR SE STE 210 BOTHELL WA 98021 INSURER B :Sentinel Insurance Co. , Ltd 11000 INSURERC:Continental Casualty Company INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:CL1471702444 REVISION NUMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I SUER - POLICY NUMBER POLICY EFF MMIDDIYYW POLICY EXP MMIDDIY.YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X 2SBANM5475 8/16/2014 8/16/2015 DAMAGE RENTED PREMISES Ea occurrence PREMISES $ 300 , 000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS X 2UECHY3821 8/16/2014 8/16/2015 BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Medical, i5ayments $ 10,000 X .UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2 , 000•, 000 AGGREGATE $ 2 , 000 , 000 A EXCESS LIAB CLAIMS -MADE DED. I RETENTION$ $ 52SBANM5475 8/16/2014 B/16/2015 A)�)N ,)W EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A 2SBANM5475 8/16/2014 8/16/2015 WC STATU- X OTH- 1 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liability AEH004312321 /29/2014 /29/2015 Per occurrence $3,000,000 Claims Made Deductible $150,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Renton is named as an additional insured. Coverage is Primary and Non -Contributory. Project: Mill Avenue S. Manhole and Lift Station Fall Restraint CAG 13-095 Project L;tK 1 WIUA I t MULUtK ;Ne\k'[4[a0will I[*I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Renton ACCORDANCE WITH THE POLICY PROVISIONS. 1055 South Grady Way AUTHORIZED REPRESENTATIVE Renton, WA 98055 A Fugitt CPCU/JONA ACORD 25 (2010105) INS025 mmnnsi m ©1988-2010 ACORD CORPORATION. All rights reserved. Th. Ar:nion name .nrl I— ern -rife of Ar:r1Dn 0001city of PUBLIC WORKS DEPARTMENT p M E M O R A N D U M DATE: December 10, 2014 TO: Gregg Zimmerman, PW Administrator r FROM: Mike Benoit, Wastewater Utility, x7206�'J SUBJECT: Addendum No. 1 to CAG-13-095 with RH2 Engineering for the Attached for your signature are two originals of Addendum No. 1 to CAG-13-095 with RH2 Engineering for the Mill Avenue Manhole and Lift Station Fall Restraint project. The addendum is for a time extension only. The original contract expires at the end of this year and the construction will not be completed by then. The consultant work is within the budgeted amount in the original contract. Also attached is the contract checklist and requisite forms needed by the City Clerk for the execution of this addendum. Attachments H:\File Sys\WWP - WasteWater\WWP-27-3711 Sewer Radio Panel Relocation and Lift Station Improvements\Addendum 1 Memo to Gregg.doc\MABtp FORM: AT-2010 ADDENDUM NO. 1 ENGINEERING CONSULTANT AGREEMENT FOR PROFESSIONAL SERVICES for Mill Avenue S. Manhole and Lift Station Fall Restraint, CAG-13-095 This Addendum is made and entered into this , day of December, 2014, by and between the City of Renton, hereinafter called the "City", and RH2 Engineering, Inc, whose address is, 22722 29th Drive SE, Suite 210, Bothell, WA 98021, hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS, the City engaged the services of the consultant under Engineering Consultant Agreement CAG-13-095, dated May 7, 2013, to provide engineering services necessary for the Mill Avenue S. Manhole and Lift Station Fall Restraint project; and WHEREAS, the City and consultant have determined that additional time is needed to complete the work for the Mill Avenue S. Manhole and Lift Station Fall Restraint project; NOW, THEREFORE, in accordance with Section V Time of Beginning and Completion of the Master Agreement CAG-13-095, dated May 7, 2013, it is mutually agreed upon that Engineering Consultant Agreement CAG-13-095, is amended to include a time extension as follows: The Time of Completion (Section V of the Master Agreement CAG-13-09S) for the above referenced contract is extended until December 31. 2015. All other provisions of Consultant Agreement CAG-13-095, dated May 7, 2013 shall apply to this addendum. EXECUTION IN WITNESS WHEREOF, the parties have executed this Addendum No. 1 to ENGINEERING CONSULTANT AGREEMENT CAG-13-095 as of the day and year first above written. CONSULTANT CITY OF RENTON -Aev/ z Sign Cre Date Gregg e a Date Public W rks Administrator Randy L. Asplund Type or Print Name Director Title ADDENDUM 01 Time Extension CAG-13-095.doc RH2 ENGINEERING, INC. 300 Simon Street SE, Suite 5 East Wenatchee, WA 98802 _.. ENGINEERS_ (509) 886-2900 or (800) 720-8052 F L A,N.N E R S S C I E N T I S T s._..... Fax: (509) 886-2313 TO: City of Renton Planning/Building/Public Works 1055 S. Grady Way, 5th Floor Renton, WA 98057 Sent Via: Hand Delivery WE ARE SENDING YOU THE FOLLOWING: Letter of Transmittal DATE: 12/3/2014 1 JOB NO.: REN /S40 ATTENTION: Mr. Mike Benoit I RE: Mill Avenue S. Manhole and Lift Station Fall Restraint, CAG-13-095 Addendum No. 1 X Attached Under Separate Cover Via: Shop Drawings Prints Plans Samples Specifications Copy of Letter Change Order Submittals COPIES DATE NO. DESCRIPTION 2 1 pg. Addendum No. 1 for Engineering Consultant Agreement for Professional Services for Mill Avenue S. Manhole and Lift Station Fall Restraint, CAG-13-095 — signed by RH2 Engineering, Inc., Randy L. Asplund. For approval Approved as submitted Resubmit copies for approval For your use Approved as noted Submit copies for distribution As requested Returned for corrections Return _ corrected prints For your information X Signature For review and comment For bids due: Prints returned after loan to us REMARKS: Please sign both original Addendum No. 1 return ONE copy to RH2 Engineering, Inc., and retain ONE copy for your files. Thank you. COPY TO: File/cc SIGNED: Randy L. Asplund, P. E. — Director EXT. 1 5366 12/03/14 3:31 PM Z:\Bothell\Data\REN\113-076\Contract\Trans to MBenoit re —Amend —No. I_Mill Ave S Manhole & LS Fall Restraint signed by RH2(RLA)_l2-3-2014.docx RH2 ENGINEERING, INC. 22722 29`h Dr. SE. Suite 210 Bothell, WA 98021 E N a t N E E w S__ r L A N N E R_9 (425) 951-5400 or (800) 720-8052 s c t e N r t Y T a Fax: (425) 398-2774 TO: Engineering Specialist I11, WW Engineering, Tech/Services Planning/Building/Public Works 1055 S. Grady Way, 5`h Floor Renton, WA 98057 Sent Via: US Mail WE ARE SENDING YOU THE FOLLOWING: Letter of Transmittal DATE: June 12, 2013 JOB NO.: REN 113.076.01.104 ATTENTION: Mr. Mike Benoit RE: City of Renton Sewer Radio Panel Relocatiorr�RDEIVED Improvements WWP-27-3711 JUN 16 2014 X Attached Under Separate Cover Via: UTILITY SYSTEM` Shop Drawings Prints Plans Samples Specifications Copy of Letter Change Order Submittals COPIES DATE NO. DESCRIPTION 1 5/14/14 Original signed cover and title page for the WWP-27-3711 project THESE ARE TRANSMITTED AS CHECKED BELOW: For approval Approved as submitted Resubmit copies for approval X For your use Approved as noted Submit _ copies for distribution As requested Returned for corrections Return _ corrected prints For your information Signature For review and comment For bids due: Prints returned after loan to us REMARKS: For your records. RECEIVED JUN 13 2014 I COPY TO: I I SIGNED: I Mark Miller, P.E. PLANNING DIVISION I 06/12/14 2:58 PM k0ata\REN\113-076\Specs\Trans to M. Benoit re original PE stamp cover and title page.docx City of Renton TECHNICAL SPECIFICATIONS FOR: Sewer Radio Panel Relocation and Lift Station Improvements Project No. WWP-27-3711 SPRING 2014 THE CONTENT OF THIS DOCUMENT, AS A MEANS OF PROFESSIONAL SERVICE, IS PROTECTED BY 17 U.S.C. § 101, ET SEQ. AS SUCH, IT SHALL NOT BE USED, IN WHOLE OR IN PART, FOR ANY OTHER PROJECT OR PURPOSE WITHOUT WRITTEN AUTHORIZATION FROM RH2 ENGINEERING. © 2012 RH2 ENGINEERING, INC. V. AA �0 t WASH 978 le� rs ¢ 1 S T hC��: '\A L 1 Signed: May 14, 2014 WAS/, J 38613 � � k�CIST0R Signed: May 14, 2014 CITY OF RENTON RENTON, WASHINGTON CONTRACT DOCUMENTS forthe Sewer Radio Panel Relocation and Lift Station Improvements PROJECT NO. WWP-27-3711 Spring 2014 BIDDING REQUIREMENTS CONTRACT FORMS CONDITIONS OF THE CONTRACT SPECIFICATIONS PLANS rt i } 38613 I! �t*�S�ltz'ti It *''+�''��*,• Signed: May 14, 2014 PUBLIC WORKS DEPARTMENT c1t%of DATE: TO: FROM: STAFF CONTACT SUBJECT: M E M O RAN D U -M---- CONCURRENCE May 2, 2013 Denis Law, Mayor Gregg Zimmerman, Administrator Dave Christensen, Wastewater Utility Supervisor, x7212 Consultant Contract for Engineering Services with RH2 Engineers, Inc for the Mill Avenue South Manhole and Lift Station Fall Restraint Project Attached for your signature are two original engineering consultant contracts with RH2 Engineering, Inc, in the amount of $47,628.84, for the Mill Avenue South Manhole and Lift Station Fall Restraint project. The purpose of this project is to provide access and ventilation to our existing deep manhole (just over 60-feet in depth) located on Renton Hill and to provide proper fall restraint at our existing lift stations. The existing deep manhole was installed in the early 1990's as part of the 1-405 S-curve project by WSDOT. The manhole was originally installed per Labor & Industries (L&I) standards for ventilation and fall restraint. Since that time, the ventilation system has stopped working and the fall restraint is no longer in compliance with safety standards. In addition, as a result of our work with L&I, we also need to provide better fall restraint around our wet wells and valve vaults at our existing lift stations to be in compliance with current L&I standards. The Consultant will provide design plans for a new ventilation system and updates to the fall restraint. RH2 Engineering, Inc was selected from our approved 2013 Utility Systems Annual Consultant Roster under the General Engineering Category. The Wastewater Utility has $100,000 in its approved 2013 Capital Improvement Program budget for the Renton Hill Deep Manhole project (426/465504). (The Mill Avenue South Manhole and Lift Station Fall Restraint project is listed as the Renton Hill Deep Manhole project in the budget.) Also attached is the contract checklist and requisite forms needed by the City Clerk for the execution of this consultant agreement. Attachments cc: Lys Hornsby, Utility Systems Director 3 h:\file sys\wwp - wastewater\wwp-03-0000 correspondence - wastewater\davec\2013 correspondence\renton hill deep manhole contract memo to mayor.doc\DMCtp PUBLIC WORKS DEPARTMENT city of M E M O R A N D U M DATE: May 6, 2013 TO: Denis Law, Mayor FROM: Gregg Zimmermzl�lministrator STAFF CONTACT: Dave Christensen, Wastewater Utility Supervisor, x7212 SUBJECT: Consultant Contract for Engineering Services with RH2 Engineers, Inc for the Mill Avenue South Manhole and Lift Station Fall Restraint Project Attached for your signature are two original engineering consultant contracts with RH2 Engineering, Inc, in the amount of $47,628.84, for the Mill Avenue South Manhole and Lift Station Fall Restraint Project. The purpose of this project is to provide access and ventilation to our existing deep manhole (just over 60 feet in depth) located on Renton Hill and to provide proper fall restraint at our existing lift stations. The existing deep manhole was installed in the early 1990s as part of the 1-405 S-curve Project by WSDOT. The manhole was originally installed per Labor & Industries (L&I) _ standards for ventilation and fall restraint. Since that time, the ventilation system has stopped working and the fall restraint is no longer in compliance with safety standards. In addition, as a result of our work with L&I, we also need to provide better fall restraint around our wet wells and valve vaults at our existing lift stations to be in compliance with current L&I standards. The consultant will provide design plans for a new ventilation system and updates to the fall restraint. RH2 Engineering, Inc was selected from our approved 2013 Utility Systems Annual Consultant Roster under the General Engineering Category. The Wastewater Utility has $100,000 in its approved 2013 Capital Improvement Program budget for the Renton Hill Deep Manhole Project (426/465504). (The Mill Avenue South Manhole and Lift Station Fall Restraint Project is listed as the Renton Hill Deep Manhole Project in the budget.) Also attached is the contract checkiist and requisite forms needed by the City Clerk for the execution of this consultant agreement. Attachments cc: Lys Hornsby, Utility Systems Director h:\file sys\wwp - wastewater\wwp-03-0000 correspondence - wastewater\davec\2013 correspondence\renton hill deep manhole contract memo to mayor.doc\DMCtp HUMAN RESOURCES AND RISK MANAGEMENT M E M O R A N D U M DATE: December 22, 2011 TO: Dave Christensen FROM: R. Robertson, Risk Manager SUBJECT: Insurance Review/Engineering Annual Consultant Agreement E-2012 I have reviewed the certificate of insurance for the above -mentioned contract. The insurance coverage evidenced for this contract, meets City Risk Management requirements. cAdocuments and settings\dchristen\local settings\temporary internet files\content.outlook\Oxrn70jh\insurance review memo do .docx �O_Ip. ACORO CERTIFICATE OF LIABILITY INSURANCE `-� DATE 01D/Y 4/8/23 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sammamish Insurance, Inc. 704 228th Ave NE, PMB 373 CONTACT Allen Fugitt CPCU NAME PHONE (425)898-8780 FAX No:(425)836-2865 ADMDARESS:Allen Fugitt@msn.com INSURERS AFFORDING COVERAGE NAIC # Sammamish WA 98074 INSURERA:Hartford Casualty Ins. Co. 29424 INSURED INSURERB:Sentlnel Insurance Co., Ltd 11000 RH2 ENGINEERING INC INSURERC:Continental Casualty Company 22722 29TH DR SE STE 210 INSURERD: INSURER E : BOTHELL WA 98 021 INSURER F : COVERAGES CERTIFICATE NUMBER:CL1271902127 R1=VISIr1N NI IMRFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER MM/ D/YYYYY MM DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR 52SBANM5475 /16/2012 /16/2013 DAMAGE TO RENTED PREMISES Ea occurrence S 300,000 MED EXP (Any one person) S 10,060 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE S 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 4,000,00 X POLICYFJ PRO- JECTLOC S AUTOMOBILE LIABILITY COMBINED aBINED_idenISINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) S B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 2UECHY3821 /16/2012 /16/2013gODILYINJURY Per accident ( )X $ HIRED AUTOS NON -OWNED AUTOS r PROPERTY DAMAGE Per accident $ Medical payments $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 2,000,000 AGGREGATE S 2,000,000 A EXCESS LIAB CLAIMS -MADE DIED X RETENTIONS 10,00 S 2SBANM5475 /16/2012 /16/2013 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) If yes, describe under N / A 2SBANM5475 /16/2012 /16/2013 WC STATU- X OTH- M E.L. EACH ACCIDENT I S 1,000,000 E.L. DISEASE - EA EMPLOYE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below C Professional Liability AEH004312321 /29/2012 /29/2013 Per Occurrence & Agg $2 000 000 Claims Made Deductible $150 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Renton is added as an additional insured. Coverage is Primary and Non -Contributory. Project: Mill Avenue S. Manhole and Lift Station Fall Restraint City of Renton 1055 South Grady Way Renton, WA 98055 %,MN% r_LLA 1IVIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE NVVRV ,LV IV/VU) INS025 r9mnnst nt Fugitt CPCU/JONA U 1988-2010 ACORD CORPORATION. All rights reserved. Thn Ar npn nnmo onrl Innn mro rnnict-A m=rlre of Ar_f1Rn POLICY NUMBER: 52 SBA NM5475 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY OF SEATTLE IT'S EMPLOYEES AND AGENTS AS ADDITIONAL INSUREDS RISK MANAGEMENT DIVISION 700 5TH AVE, SUITE 4350 P.O. BOX 94669 SEATTLE, WA 98124-4669 CITY OF RENTON 1055 S GRADY WAY RENTON, WA 98055 THE TOWN OF EATONVILLE PO BOX 309 EATONVILLE, WA 98328 CITY OF BELLINGHAM 210 LOTTIE ST BELLINGHAM, WA 98225 WASTE MANAGEMENT 1821 180TH ST. SE BOTHELL, WA 98012 CITY OF BONNEY LAKE P.O. BOX 7380 BONNEY LAKE WA 98390 ATTN: JOHN WOODCOCK CITY OF RICHLAND 505 SWIFT AVENUE RICHLAND, WA KING COUNTY HOUSING AUTHORITY 625 ANDOVER PARK WEST SUITE 107 TUKWILA, WA 98188 Form IH 12 00 11 85 T SEQ. NO. 003 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 07/02/12 Expiration Date: 08/16/13 CITY OF RENTON INSURANCE INFORMATION FORM FOR: Mill Avenue S. Manhole and Lift Station Fall Restraint Certificate of Insurance indicates the coverage/limits x Yes _ No specified in contract? Are the following coverages and/or conditions in effect? Yes No The Commercial General Liability policy form is an x Yes No ISO 1993 Occurrence Form or Equivalent? (If no, attach a copy of the policy with required coverages clearly identified.) CG 0043 Amendatory Endorsement provided?* Yes x No General Aggregate provided on a "per project basis (CG2503)? Yes x No Additional Insured wording provided?* x Yes No Coverage on a primary basis and non-contributing basis? _x Yes No Waiver of Subrogation Clause applies? x Yes No Severability of Interest Clause (Cross Liability) applies? x Yes No Notice of Cancel lation/Non-Renewal amended to 45 days? x Yes No * To be shown on certificate of insurance AM BEST'S RATING FOR CARRIERS: GL A+XV Auto A+XV Umb A+XV Professional AXV This Questionnaire is issued as a matter of information. This questionnaire is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies indicated on the attached CERTIFICATE OF INSURANCE. The CITY OF RENTON, at its option, shall obtain copies of the policies and/or specific declaration pages FROM awarded bidder/proposer prior to execution of contract. Sammamish Insurance, Inc Agency/Broker Allen H. Fu¢itt / Completed B Type or Pint Natiie) ,f 704 228`4 Ave NE P B 373 Sammamish OVA 98074 Address �.�� l,r Completed By (Signature) _Allen p'. rugitt 425-898-8780 Name of person to contact Telephone Number NOTE: THIS QUESTIONNAIRE MUST BE COMPLETED AND ATTACHED TO CERTIFICATE OF INSURANCE Water & Wastewater Systems SCADA Upgrade BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 © 2005, The Hartford QUICK REFERENCE BUSINESS LIABILITY COVERAGE FORM READ YOUR POLICY CAREFULLY BUSINESS LIABILITY COVERAGE FORM Beginning on Page A. COVERAGES 1 Business Liability 1 Medical Expenses 2 Coverage Extension - Supplementary Payments 2 B. EXCLUSIONS 3 C. WHO IS AN INSURED 10 D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 14 E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 15 1. Bankruptcy 15 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit 15 3. Financial Responsibility Laws 16 .4. Legal Action Against Us 16 5. Separation Of Insureds 16 6. Representations 16 7. Other Insurance 16 8. Transfer Of Rights Of Recovery Against Others To Us 17 F. OPTIONAL ADDITIONAL INSURED COVERAGES 18 Additional Insureds 18 G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 20 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us" and "our" refer to the stock insurance company member of The Hartford providing this insurance. The word "insured" means any person or organization qualifying as such under Section C. - Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section G. - Liability And Medical Expenses Definitions. A. COVERAGES (a) The "bodily injury" or "property 1. BUSINESS LIABILITY COVERAGE (BODILY damage" is caused by an INJURY, PROPERTY DAMAGE, PERSONAL "occurrence" that takes place in the AND ADVERTISING INJURY) "coverage territory"; Insuring Agreement We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury", "property damage" or "personal and advertising injury" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" or offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section D. - Liability And Medical Expenses Limits Of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or medical expenses to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Coverage Extension - Supplementary Payments. b. This insurance applies: (1) To "bodily injury" damage" only if: and "property (b) The "bodily injury" or "property damage" occurs during the policy period; and (c) Prior to the policy period, no insured listed under Paragraph 1. of Section C. — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. (2) To "personal and advertising injury" caused by an offense arising out of your business, but only if the offense was committed in the "coverage territory" during the policy period. c. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section C. — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; Form SS 00 08 04 05 Page 1 of 24 © 2005, The Hartford BUSINESS LIABILITY COVERAGE FORM (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has occurred or has begun to occur. d. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". e. Incidental Medical Malpractice (1) "Bodily injury" arising out of the rendering of or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic shall be deemed to be caused by an "occurrence", but only if: (a) The physician, dentist, nurse, emergency medical technician or paramedic is employed by you to provide such services; and (b) You are not engaged in the business or occupation of providing such services. (2) For the purpose of determining the limits of insurance for incidental medical malpractice, any act or omission together with all related acts or omissions in the furnishing of these services to any one person will be considered one "occurrence". 2. MEDICAL EXPENSES Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursing and funeral services. 3. COVERAGE EXTENSION - SUPPLEMENTARY PAYMENTS a. We will pay, with respect to any claim or "suit" we investigate or settle, or any "suit' against an insured we defend: (1) All expenses we incur. (2) Up to $1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish these bonds. (3) The cost of appeal bonds or bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. (5) All costs taxed against the insured in the "suit'. (6) Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. (7) All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. Any amounts paid under (1) through (7) above will not reduce the limits of insurance. Page 2 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM b. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: (1) The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; (2) This insurance applies to such liability assumed by the insured; (3) The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; (4) The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the interests of the insured and the interest of the indemnitee; (5) The indemnitee and the insured ask us to conduct and control the defense B. of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and (6) The indemnitee: (a) Agrees in writing to (i) Cooperate with us in the investigation, settlement or defense of the "suit"; (ii) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (iii) Notify any other insurer whose coverage is available to the indemnitee; and (iv) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (b) Provides us with written authorization to: Obtain records and other information related to the "suit"; and Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 1.b.(b) of Section B. — Exclusions, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the Limits of Insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when: (1) We have used up the applicable limit of insurance in the payment of judgments or settlements; or (2) The conditions set forth above, or the terms of the agreement described in Paragraph (6) above, are no longer met. EXCLUSIONS 1. Applicable To Business Liability Coverage This insurance does not apply to: a. Expected Or Intended Injury (1) "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property; or (2) "Personal and advertising injury" arising out of an offense committed by, at the direction of or with the consent or acquiescence of the insured with the expectation of inflicting "personal and advertising injury". b. Contractual Liability (1) "Bodily injury" or "property damage'; or (2) "Personal and advertising injury" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages because of: (a) "Bodily injury", "property damage" or "personal and advertising injury" that the insured would have in the absence of the contract or agreement; or Form SS 00 08 04 05 Page 3 of 24 BUSINESS LIABILITY COVERAGE FORM (b) "Bodily injury" or "property damage" assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purpose of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage" provided: (i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract", and (ii) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages ,to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business, or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". f. Pollution (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to any insured. However, this subparagraph does not apply to: (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (ii) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or Page 4 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (iii) "Bodily injury" or "property released as part of the damage" arising out of heat, operations being performed smoke or fumes from a by such insured, contractor or "hostile fire"; subcontractor; (b) At or from any premises, site or (ii) "Bodily injury" or "property location which is or was at any damage" sustained within a time used by or for any insured or building and caused by the others for the handling, storage, release of gases, fumes or disposal, processing or treatment vapors from materials brought of waste; into that building in connection (c) Which are or were at any time with operations being performed transported, handled, stored, by you or on your behalf by a treated, disposed of, or processed contractor or subcontractor; or as waste by or for: (iii) "Bodily injury" or "property (i) Any insured; or damage" arising out of heat, (ii) Any person or organization for smoke or fumes from a"hostile whom you may be legally fire"; or responsible; (e) At or from any premises, site or (d) At or from any premises, site or location on which any insured or any location on which any insured or contractors or subcontractors any contractors or subcontractors working directly or indirectly on any working directly or indirectly on insured's behalf are performing any insured's behalf are operations if the operations are to performing operations if the test for, monitor, clean up, remove, 'pollutants" are brought on or to contain, treat, detoxify or neutralize, the premises, site or location in or in any way respond to, or assess connection with such operations the effects of, the by such insured, contractor or (2) Any loss, cost or expense arising out subcontractor. However, this of any: subparagraph does not apply to: (a) Request, demand, order or statutory (i) "Bodily injury" or "property or regulatory requirement that any damage" arising out of the insured or others test for, monitor, escape of fuels, lubricants or clean up, remove, contain, treat, other operating fluids which are detoxify or neutralize, or in any way needed to perform the normal respond to, or assess the effects of, electrical, hydraulic or "pollutants'; or mechanical functions (b) Claim or suit by or on behalf of a necessary for the operation of governmental authority for "mobile equipment" or its parts, damages because of testing for, if such fuels, lubricants or other monitoring, cleaning up, removing, operating fluids escape from a containing, treating, detoxifying or vehicle part designed to hold, neutralizing, or in any way store or receive them. This responding to, or assessing the exception does not apply if the effects of, "pollutants". "bodily injury" or "property However, this paragraph does not damage" arises out of the apply to liability for damages because intentional discharge, dispersal of "property damage" that the insured or release of the fuels, would have in the absence of such lubricants or other operating request, demand, order or statutory or fluids, or if such fuels, regulatory requirement, or such claim lubricants or other operating or "suit" by or on behalf of a fluids are brought on or to the governmental authority. premises, site or location with the intent that they be discharged, dispersed or Form SS 00 08 04 05 Page 5 of 24 BUSINESS LIABILITY COVERAGE FORM g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment"; or (6) An aircraft that is not owned by any insured and is hired, chartered or loaned with a paid crew. However, this exception does not apply if the insured has any other insurance for such "bodily injury" or "property damage", whether the other insurance is primary, excess, contingent or on any other basis. h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice or preparation for, a prearranged racing, speed or demolition contest or in any stunting activity. i. War "Bodily injury", "property damage" or "personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. Professional Services "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional service. This includes but is not limited to: (1) Legal, accounting or advertising services; (2) Preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; (3) Supervisory, inspection, architectural or engineering activities; (4) Medical, surgical, dental, x-ray or nursing services treatment, advice or instruction; (5) Any health or therapeutic service treatment, advice or instruction; (6) Any service, treatment, advice or instruction for the purpose of appearance or skin enhancement, hair removal or replacement or personal grooming; (7) Optical or hearing aid services including the prescribing, preparation, fitting, demonstration or distribution of ophthalmic lenses and similar products or hearing aid devices; Page 6 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (8) Optometry or optometric services including but not limited to examination of the eyes and the prescribing, preparation, fitting,demonstration or distribution of ophthalmic lenses and similar products; (9) Any: (a) Body piercing (not including ear piercing); (b) Tattooing, including but not limited to the insertion of pigments into or under the skin; and (c) Similar services; (10) Services in the practice of pharmacy; and (11) Computer consulting, design or programming services, including web site design. Paragraphs (4) and (5) of this exclusion do not apply to the Incidental Medical Malpractice coverage afforded under Paragraph 1.e. in Section A. - Coverages. k. Damage To Property "Property damage" to: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate Limit of Insurance applies to Damage To Premises Rented To You as described in Section D. - Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3) and (4) of this exclusion do not apply to the use of elevators. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraphs (3) and (4) of this exclusion do not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". I. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. m. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products -completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. n. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. Form SS 00 08 04 05 Page 7 of 24 BUSINESS LIABILITY COVERAGE FORM o. Recall Of Products, Work Or Impaired (c) Title of any literary or artistic work; Property (8) Arising out of an offense committed by Damages claimed for any loss, cost or an insured whose business is: expense incurred by you or others for the (a) Advertising, broadcasting, loss of use, withdrawal, recall, inspection, publishing or telecasting; repair, replacement, adjustment, removal (b) Designing or determining content or disposal of: of web sites for others; or (1) "Your product"; (c) An Internet search, access, (2) "Your work"; or content or service provider. (3) "Impaired property"; However, this exclusion does not if such product, work or property is apply to Paragraphs a., b. and c. withdrawn or recalled from the market or under the definition of "personal and from use by any person or organization advertising injury" in Section G. — because of a known or suspected defect, Liability And Medical Expenses deficiency, inadequacy or dangerous Definitions. condition in it. For the purposes of this exclusion, p. Personal And Advertising Injury placing an "advertisement" for or "Personal and advertising injury": linking to others on your web site, by (1) Arising out of oral, written or electronic itself, is not considered the business publication of material, if done by or at of advertising, broadcasting, the direction of the insured with publishing or telecasting; knowledge of its falsity; (9) Arising out of an electronic chat room (2) Arising out of oral, written or electronic or bulletin board the insured hosts, publication of material whose first owns, or over which the insured publication took place before the exercises control; beginning of the policy period; (10) Arising out of the unauthorized use of (3) Arising out of a criminal act committed another's name or product in your e-mailaddress, by or at the direction of the insured; domain name or metatags, or any other similar tactics to mislead (4) Arising out of any breach of contract, another's potential customers; except an implied contract to use "advertising (11) Arising out of the violation of a another's idea" in your "advertisement"; person's right of privacy created by any state or federal act. (5) Arising out of the failure of goods, However, this exclusion does not products or services to conform with apply to liability for damages that the any statement of quality or insured would have in the absence of performance made in your "advertisement"; such state or federal act; (6) Arising out of the wrong description of (12) Arising out of: the price of goods, products or services; (a) An "advertisement" for others on (7) Arising out of any violation of any your web site; intellectual property rights such as (b) Placing a link to a web site of copyright, patent, trademark, trade others on your web site; name, trade secret, service mark or (c) Content from a web site of others other designation of origin or displayed within a frame or border authenticity. on your web site. Content includes However, this exclusion does not information, code, sounds, text, apply to infringement, in your graphics or images; or "advertisement", of (d) Computer code, software or (a) Copyright; programming used to enable: (b) Slogan, unless the slogan is also (i) Your web site; or a trademark, trade name, service (ii) The presentation or functionality mark or other designation of origin of an "advertisement" or other or authenticity; or content on your web site; Page 8 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (13) Arising out of a violation of any anti- (a) May be awarded or incurred by trust law; reason of any claim or suit (14) Arising out of the fluctuation in price or alleging actual or threatened injury value of any stocks, bonds or other or damage of any nature or kind to securities; or persons or property which would (15) Arising out of discrimination or not have occurred in whole or in humiliation committed by or at the part but for the "asbestos hazard"; direction of any "executive officer", (b) Arise out of any request, demand, director, stockholder, partner or order or statutory or regulatory member of the insured. requirement that any insured or q. Electronic Data others test for, monitor, clean up, remove, encapsulate, contain, Damages arising out of the loss of, loss of treat, detoxify or neutralize or in use of, damage to, corruption of, inability any way respond to or assess the to access, or inability to manipulate effects of an "asbestos hazard"; or "electronic data". (c) Arise out of any claim or suit for r. Employment -Related Practices damages because of testing for, "Bodily injury" or "personal and advertising monitoring, cleaning up, removing, injury" to: encapsulating, containing, treating, (1) A person arising out of any: detoxifying or neutralizing or in any way responding to or assessing the (a) Refusal to employ that person; effects of an "asbestos hazard". (b) Termination of that person's t. Violation Of Statutes That Govern E- employment; or Mails, Fax, Phone Calls Or Other (c) Employment -related practices, Methods Of Sending Material Or policies, acts or omissions, such as Information coercion, demotion, evaluation, "Bodily injury", "property damage", or reassignment, discipline, "personal and advertising injury" arising defamation, harassment, humiliation directly or indirectly out of any action or or discrimination directed at that omission that violates or is alleged to person; or violate: (2) The spouse, child, parent, brother or (1) The Telephone Consumer Protection sister of that person as a Act (TCPA), including any amendment consequence of "bodily injury" or of or addition to such law; "personal and advertising injury" to the (2) The CAN-SPAM Act of 2003, including person at whom any of the employment -related practices any amendment of or addition to such described in Paragraphs (a), (b), or (c) law; or above is directed. (3) Any statute, ordinance or regulation, This exclusion applies: other than the TCPA or CAN-SPAM Act of 2003, that prohibits or limits the (1) Whether the insured may be liable as sending, transmitting, communicating or an employer or in any other capacity; distribution of material or information. and Damage To Premises Rented To You — (2) To any obligation to share damages Exception For Damage By Fire, Lightning with or repay someone else who must or Explosion pay damages because of the injury. Exclusions c. through h. and k. through o. do s. Asbestos not apply to damage by fire, lightning or (1) "Bodily injury", "property damage" or explosion to premises rented to you or "personal and advertising injury" temporarily occupied by you with permission of arising out of the "asbestos hazard". the owner. A separate Limit of Insurance (2) Any damages, judgments, settlements, applies to this coverage as described in loss, costs or expenses that: Section D. - Liability And Medical Expenses Limits Of Insurance. Form SS 00 08 04 05 Page 9 of 24 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees We will not pay expenses for "bodily injury": are also insureds, but only with respect to a. Any Insured their duties as trustees. To any insured, except "volunteer workers". 2• Each of the following is also an insured: b. Hired Person a. Employees And Volunteer Workers To a person hired to do work for or on behalf Your "volunteer workers" only while of any insured or a tenant of any insured. performing duties related to the conduct of c. Injury On Normally Occupied Premises your business, or your "employees", other "executive than either your officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership, joint venture or limited liability normally occupies. company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts Laws within the scope of their employment by To a person, whether or not an you or while performing duties related to "employee" of any insured, if benefits for the conduct of your business. the "bodily injury" are payable or must be However, none of these "employees" or provided under a workers' compensation "volunteer workers" are insureds for: or disability benefits law or a similar law. (1) "Bodily injury" or "personal and e. Athletics Activities advertising injury": To a person injured while practicing, (a) To you, to your partners or instructing or participating in any physical members (if you are a partnership exercises or games, sports or athletic or joint venture), to your members contests. (if you are a limited liability f. Products -Completed Operations Hazard company), or to a co -"employee" while in the course of his or her Included with the "products -completed employment or performing duties operations hazard". related to the conduct of your g. Business Liability Exclusions business, or to your other Excluded under Business Liability Coverage. "volunteer workers" while performing duties related to the C. WHO IS AN INSURED conduct of your business; 1. If you are designated in the Declarations as: (b) To the spouse, child, parent, a. An individual, you and your spouse are brother or sister of that co - insureds, but only with respect to the "employee" or that "volunteer conduct of a business of which you are the worker" as a consequence of sole owner. Paragraph (1)(a) above; b. A partnership or joint venture, you are an (c) For which there is any obligation insured. Your members, your partners, and to share damages with or repay their spouses are also insureds, but only with someone else who must pay respect to the conduct of your business. damages because of the injury c. A limited liability company, you are an described in Paragraphs (1)(a) or insured. Your members are also insureds, (b) above; or but only with respect to the conduct of your (d) Arising out of his or her providing business. Your managers are insureds, but or failing to provide professional only with respect to their duties as your health care services. managers. If you are not in the business of d. An organization other than a partnership, providing professional health care joint venture or limited liability company, you services, Paragraph (d) does not apply are an insured. Your "executive officers" and to any nurse, emergency medical directors are insureds, but only with respect technician or paramedic employed by to their duties as your officers or directors. you to provide such services. Your stockholders are also insureds, but only (2) "Property damage" to property: with respect to their liability as stockholders. (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance. e. Unnamed Subsidiary Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and b. Coverage under this provision does not apply to: (1) "Bodily injury" or "property damage" that occurred; or (2) "Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Operator Of Mobile Equipment With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. 'Bodily injury" to a co -"employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 5. Operator of Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written Form SS 00 08 04 05 Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However, no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by an endorsement issued by us and made a part of this Coverage Part, including all persons or organizations added as additional insureds under the specific additional insured coverage grants in Section F. — Optional Additional Insured Coverages. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally. undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or a. Vendors (h) "Bodily injury" or "property Any person(s) or organization(referred to damage" arising out of the soles) below as vendor), but only with respect to negligence of the vendor for its "bodily injury" or "property damage" arising own acts or omissions or those of out of "your products" which are distributed its employees or anyone elseacting or sold in the regular course of the vendor's on its behalf. However, this business and only if this Coverage Part exclusion does not apply to: provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d) or (f); or "products -completed operations hazard". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to: course of business, in connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products. vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for "bodily "property in the product made intentionally injury", damage" or "personal by the vendor; and advertising injury" caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) Any 'occurrence" which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations performed by you or on your behalf. (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. e. Permits Issued By State Or Political Subdivisions (1) Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) 'Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) 'Bodily injury" or "property damage" included within the "products - completed operations hazard". f. Any Other Party (1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products - completed operations hazard", but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products - completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard" is the Products -Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury", "property damage" or "personal and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your "locations" owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right-of-way of a railroad. This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion. 3. Each Occurrence Limit Subject to 2.a. or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury", "property damage" and medical expenses arising out of any one "occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b. above, the most we will pay for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5. Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 6. How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political subdivision; or b. The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. Page 14 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this policy and any endorsements attached thereto applies to any claim or "suit", the most we will pay under this policy and the endorsements is the single highest limit of liability of all coverages applicable to such claim or "suit". However, this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3. above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. Notice Of Occurrence Or Offense You or any additional insured must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. Notice Of Claim If a claim is made or "suit" is brought against any insured, you or any additional insured must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You or any additional insured must see to it that we receive a written notice of the claim or "suit" as soon as practicable. c. Assistance And Cooperation Of The Insured You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation, settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization that may be liable to the insured because of injury or damage to which this insurance may also apply. d. Obligations At The Insured's Own Cost No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. e. Additional Insured's Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance. f. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs a. and b. apply to you or to any additional insured only when such "occurrence", offense, claim or "suit" is known to: (1) You or any additional insured that is an individual; (2) Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to you and any additional insured. 3. Financial Responsibility Laws a. When this policy is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by the policy for "bodily injury" liability and "property damage" liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law. b. With respect to "mobile equipment" to which this insurance applies, we will provide any liability, uninsured motorists, underinsured motorists, no-fault or other coverage required by any motor vehicle law. We will provide the required limits for those coverages. 4. Legal Action Against Us No person or organization has a right under this Coverage Form: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Form unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this insurance or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 5. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought. 6. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If unintentionally you should fail to disclose all hazards relating to the conduct of your business at the inception date of this Coverage Part, we shall not deny any coverage under this Coverage Part because of such failure. 7. Other Insurance If other valid and collectible insurance is available for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. b. Excess Insurance This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (1) Your Work That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section A. — Coverages. (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section A. — Coverages. Page 16 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured - Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you. by Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured — Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional insured in part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s) or organization(s). for "bodily injury", "property damage" or b. With respect to the insurance afforded to "personal and advertising injury" caused, in these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any 'occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment. a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or rented to you. a. WHO IS AN INSURED under Section C. is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured —Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s) or organization(s) shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization; but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of the premises leased to you and shown in the b. With respect to the insurance afforded to Declarations. these additional insureds, the following additional exclusions apply: b. With respect to the insurance afforded to these additional insureds, the following This insurance does not apply to: additional exclusions apply: (1) Any 'occurrence" that takes place This insurance does not apply to: after you cease to lease that land; or (1) Any 'occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations premises; or performed by or on behalf of such person or organization. (2) Structural alterations, new construction or demolition operations 6. Additional Insured - State Or Political performed by or on behalf of such Subdivision — Permits person or organization. a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision .shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, (1) "Bodily injury", "property damage" or except such operations performed 'personal and advertising injury' at the vendor's premises in connection with the sale of the arising out of operations performed for product; the state or municipality; or (g) Products which, after distribution (2) "Bodily injury" or "property damage" or sale by you, have been labeled included in the "product -completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured —Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor; or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (i) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (f); or provides coverage for "bodily injury" or "property damage" included within the (ii) Such inspections, "products -completed operations hazard". adjustments, tests or servicing as the vendor has agreed to b. The insurance afforded to the vendor is make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured — Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 9. Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Organization a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for the additional insured(s); or (2) In connection with "your work" performed for that additional insured and included within the "products - completed operations hazard", but only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal an advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 10. Additional Insured — Co -Owner Of Insured Premises WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or Organization(s) shown in the Declarations as an Additional Insured — Co - Owner Of Insured Premises, but only with respect to their liability as co-owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale of goods, products or services; or c. Any other publication that is given widespread public distribution. However, "advertisement' does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods, or products; or b. An interactive conversation between or among persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semi -trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM a. The United States of America (including its b. You have failed to fulfill the terms of a territories and possessions), Puerto Rico contract or agreement; and Canada; if such property can be restored to use by: b. International waters or airspace, but only if a. The repair, replacement, adjustment or the injury or damage occurs in the course removal of "your product" or "your work"; of travel or transportation between any or places included in a. above; b. Your fulfilling the terms of the contract or c. All other parts of the world if the injury or agreement. damage arises out of: 12. "Insured contract" means: (1) Goods or products made or sold by you in the territory described in a. above; a. A contract for a lease of premises. However, that portion of the contract for a (2) The activities of a person whose home lease of premises that indemnifies any is in the territory described in a. person or organization for damage by fire, above, but is away for a short time on lightning or explosion to premises while your business; or rented to you or temporarily occupied by (3) "Personal and advertising injury" you with permission of the owner is offenses that take place through the subject to the Damage To Premises Internet or similar electronic means of Rented To You limit described in Section communication D. — Liability and Medical Expenses Limits provided the insured's responsibility to pay of Insurance. damages is determined in the United States of b. A sidetrack agreement; America (including its territories and c. Any easement or license agreement, possessions), Puerto Rico or Canada, in a including an easement or license "suit" on the merits according to the agreement in connection with construction substantive law in such territory, or in a or demolition operations on or within 50 settlement we agree to. feet of a railroad; 7. "Electronic data" means information, facts or d. Any obligation, as required by ordinance, programs: to indemnify a municipality, except in a. Stored as or on; connection with work for a municipality; b. Created or used on; or e. An elevator maintenance agreement; or c. Transmitted to or from f. That part of any other contract or computer software, including systems and agreement pertaining to your business applications software, hard or floppy disks, (including an indemnification of a CD-ROMS, tapes, drives, cells, data municipality in connection with work processing devices or any other media which performed for a municipality) under which are used with electronically controlled you assume the tort liability of another equipment. parry to pay for "bodily injury" or "property 8. "Employee" includes a 'leased worker". damage" to a third person or organization, "Employee" does not include a "temporary provided the "bodily injury" or "property worker". damage" is caused, in whole or in part, by you or by those acting on your behalf. 9. "Executive officer" means a person holding Tort liability means a liability that would be any of the officer positions created by your imposed by law in the absence of any charter, constitution, by-laws or any other contract or agreement. similar governing document. Paragraph f. includes that part of any 10. "Hostile fire" means one which becomes contract or agreement that indemnifies a uncontrollable or breaks out from where it was railroad for "bodily injury" or "property intended to be. damage" arising out of construction or 11. "Impaired property" means tangible property, demolition operations within 50 feet of any other than "your product" or "your work", that railroad property and affecting any railroad cannot be used or is less useful because: bridge or trestle, tracks, road -beds, tunnel, a. It incorporates "your product" or "your work" underpass or crossing. that is known or thought to be defective, However, Paragraph f. does not include deficient, inadequate or dangerous; or that part of any contract or agreement: Form SS 00 08 04 05 Page 21 of 24 BUSINESS LIABILITY COVERAGE FORM (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. 13. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 14. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or ,.auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 15. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, on which are permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in a., b., c., or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in a., b., c., or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment, of at least 1,000 pounds gross vehicle weight, designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or.resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. 16. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 17. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; Page 22 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that the person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral, written or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral, written or electronic publication of material that violates a person's right of privacy; f. Copying, in your "advertisement", a person's or organization's "advertising idea" or style of "advertisement"; g. Infringement of copyright, slogan, or title of any literary or artistic work, in your "advertisement"; or h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person. 18. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 19. "Products -completed operations hazard"; a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed to be completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. The "bodily injury" or "property damage" must occur away from premises you own or rent, unless your business includes the selling, handling or distribution of "your product" for consumption on premises you own or rent. b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; or (2) The existence of tools, uninstalled equipment or abandoned or unused materials. 20. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of "occurrence" that caused it. As used in this definition, "electronic data" is not tangible property. 21. "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 22. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 23. "Volunteer worker" means a person who: a. Is not your "employee"; Form SS 00 08 04 05 Page 23 of 24 BUSINESS LIABILITY COVERAGE FORM b. Donates his or her work; c. Acts at the direction of and within the scope of duties determined by you; and d. Is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24. "Your product': a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product'; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 25. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. Page 24 of 24 Form SS 00 08 04 05 CITY ATTORNEY RECEIVED M E M O R A N D U M DEC 0 5 2011 CRY OF RENTON .tea EMS DATE: December 5, 2011 TO: Teresa Phelan, Administrative Secretary, Public Works Department, Utilities Systems Division FROM: Lawrence J. Warren, City Attorney Staff Contact: Mark Barber, Senior Assistant City Attorney Telephone ext. 6485 SUBJECT: Continuing approval as to legal form of 2012 Engineering Annual Consultant Agreement (E1-2012) Please be advised that I have reviewed the above -referenced 2012 Engineering Annual Consultant Agreement (E1-2012), and the same is approved as to legal form, and may be used in the future so long as there are no material changes or modifications to the standard form language or revisions required by future legislation or appellate court decisions. cAcity forms\2011-04-11 sandard form memo with swush and signature and continuing approval.doc E1-2012 ORIGINAL-- ,PAGE N0...LOFWf PAGES ENGINEERING ANNUAL CONSULTANT AGREEMENT THIS AGREEMENT, made and entered into on this , day of by and between the CITY OF RENTON, WASHINGTON, A MUNICIPAL CORPORATION HEREINAFTER CALLED THE "CITY," and RH2 Engineering, Inc. whose address is 22722 29`h Drive SE, Suite 210, Bothell, WA 98021 at which work will be available for inspection, hereinafter called the "CONSULTANT." PROJECT NAME: Mill Avenue S. Manhole and Lift Station Fall Restraint WHEREAS, the City has not sufficient qualified engineering employees to provide the engineering within a reasonable time and the City deems it advisable and is desirous of engaging the professional services and assistance of a qualified professional consulting firm to do the necessary engineering work for the project, and WHEREAS, the Consultant has represented and by entering into this Agreement now represents, that it is in full compliance with the statutes of the State of Washington for registration of professional engineers, has a current valid corporate certificate from the State of Washington or has a valid assumed name filing with the Secretary of State and that all personnel to be assigned to the work required under this Agreement are fully qualified to perform the work to which they will be assigned in a competent and professional manner, and that sufficient qualified personnel are on staff or readily available to Consultant to staff this Agreement. WHEREAS, the Consultant has indicated that it desires to do the work set forth in the Agreement upon the terms and conditions set forth below. NOW THEREFORE, in consideration of the terms, conditions, covenants and performances contained herein below, the parties hereto agree as follows: SCOPE OF WORK The Consultant shall furnish, and hereby warrants that it has, the necessary equipment, materials, and professionally trained and experienced personnel to facilitate completion of the work described in Exhibit A, Scope of Work, which is attached hereto and incorporated into this Agreement as though fully set forth herein. The Consultant shall perform all work described in this Agreement in accordance with the latest edition and amendments to local and state regulations, guidelines and policies. The Consultant shall prepare such information and studies as it may deem pertinent and necessary, in order to pass judgment in a sound engineering manner on the features of the work. The Consultant shall make such minor changes, amendments or revisions in the detail of the work as may be required by the City. This item does not constitute an "Extra Work" item as related in Section Vill of the Agreement. The work shall be verified for accuracy by a complete check by the Consultant. The Consultant will be held responsible for the accuracy of the work, even though the work has been accepted by the City. 11 DESIGN CRITERIA The City will designate the basic premises and criteria for the work needed. Reports and plans, to the extent feasible, shall be developed in accordance with the latest edition and amendments of local and State regulations, guidelines, and specifications, including, but not limited to the following: Page 1 of 15 Piazza/Data_Center/Forms/City/Contracts 1--PAGES E1-2012 1. Washington State Department of Transportation/American Public Works Association (WSDOT/APWA), "Standard Specifications for Road, Bridge, and Municipal Construction," as amended by Renton Standard Specification. 2. WSDOT/APWA, "Standard Plans for Road, Bridge and Municipal Construction." 3. Washington State Department of Transportation, "Highway Design Manual." 4. American Association of State Highway and Transportation Officials, "Standard Specifications for Highway Bridges." 5. Washington State Department of Transportation, "Bridge Design Manual, Volumes 1 and 2." 6. Washington State Department of Transportation, "Manual of Highways Hydraulics," except hydrologic analysis as described in item 14. 7. Washington State Department of Transportation, "Materials Laboratory Outline." 8. Transportation Research Board, "Highway Capacity Manual." 9. U.S. Department of Transportation, Federal Highway Administration, "Manual on Uniform Traffic Control Devices for Streets and Highways." 10. Washington State Department of Transportation, "Construction Manual." 11. Washington State Department of Transportation, "Local Agency Guidelines." 12. Standard drawings prepared by the City and furnished to the Consultant shall be used as a guide in all cases where they fit design conditions. Renton Design Standards, and Renton Specifications shall be used as they pertain. 13. Metro Transit, design criteria. 14. King County Surface Water Design Manual, Sections 1.2 and 1.3 of Chapter 1, and Chapters 3, 4, and 5. 15. American Association of State Highway and Transportation Officials, "A Policy on Geometric Design of Highways and Streets." III ITEMS TO BE FURNISHED TO THE CONSULTANT BY THE CITY The City will furnish the Consultant copies of documents which are available to the City that will facilitate the preparation of the plans, studies, specifications, and estimates within the limits of the assigned work. All other records needed for the study must be obtained by the Consultant. The Consultant will coordinate with other available sources to obtain data or records available to those agencies. The Consultant shall be responsible for this and any other data collection to the extent provided for in the Scope of Work. City will provide to Consultant all data in City's possession relating to Consultants services on the project. Consultant will reasonably rely upon the accuracy, timeliness, and completeness of the information provided by the City. Should field studies be needed, the Consultant will perform such work to the extent provided for in the Scope of Work. The City will not be obligated to perform any such field studies. Page 2 of 15 Piazza/Data_Center/Forms/City/Contracts ORIGINAL_ l_ PAGE NO3 OFo� E1-2012 PAGFG IV OWNERSHIP OF PRODUCTS AND DOCUMENTS TO BE FURNISHED BY THE CONSULTANT Documents, exhibits or other presentations for the work covered by this Agreement shall be furnished by the Consultant to the City upon completion of the various phases of the work. All such material, including working documents, notes, maps, drawings, photo, photographic negatives, etc. used in the project, shall become and remain the property of the City and may be used by it without restriction. Any use of such documents by the City not directly related to the project pursuant to which the documents were prepared by the Consultant shall be without any liability whatsoever to the Consultant. All written documents and products shall be printed on recycled paper when practicable. Use of the chasing -arrow symbol identifying the recycled content of the paper shall be used whenever practicable. All documents will be printed on both sides of the recycled paper, as feasible. V TIME OF BEGINNING AND COMPLETION The work detailed in the Scope of Work will be performed according to Exhibit B, Time Schedule of Completion, attached hereto and incorporated herein as though fully set forth. It is agreed that all the Consultant's services are to be completed and all products shall be delivered by the Consultant unless there are delays due to factors that are beyond the control of the Consultant. The Consultant shall not begin work under the terms of this Agreement until authorized in writing by the City. If, after receiving Notice to Proceed, the Consultant is delayed in the performance of its services by factors that are beyond its control, the Consultant shall notify the City of the delay and shall prepare a revised estimate of the time and cost needed to complete the Project and submit the revision to the City for its approval. Time schedules are subject to mutual agreement for any revision unless specifically described as otherwise herein. Delays attributable to or caused by one of the parties hereto amounting to 30 days or more affecting the completion of the work may be considered a cause for renegotiation or termination of this Agreement by the other party. VI PAYMENT The Consultant shall be paid by the City for completed work for services rendered under this Agreement as provided hereinafter as specified in Exhibit C, Cost Estimate. Such payment shall be full compensation for work performed or services rendered and for all labor, materials, supplies, equipment, and incidentals necessary to complete the work. All billings for compensation for work performed under this Agreement will list actual time (days and/or hours) and dates during which the work was performed and the compensation shall be figured using the rates in Exhibit C. Payment for this work shall not exceed $47,628.84 without a written amendment to this contract, agreed to and signed by both parties. Cost Plus Net Fee Payment for work accomplished shall be on the basis of the Consultant's actual cost plus a net fee. The actual cost includes direct salary cost, overhead, and direct non -salary cost. The direct salary cost is the salary expense for professional and technical personnel and principals for the time they are productively engaged in the work necessary to fulfill the terms of this Agreement. The direct salary costs are set forth in the attached Exhibit C and by this reference made a part of this Agreement. Page 3 of 1S Piazza/ Mace nter/Form s/City/Contracts ORIGINAL_ I PAGE NO ( _04, .PAGES E 1-2012 2. The overhead costs as identified on Exhibit C are determined as 177.93 percent of the direct salary cost and by this reference made a part of this Agreement. The overhead cost rate is an estimate based on currently available accounting information and shall be used for all progress payments over the period of the contract. 3. The direct non -salary costs are those costs directly incurred in fulfilling the terms of this Agreement, including, but not limited to travel, reproduction, telephone, supplies, and fees of outside consultants. The direct non -salary costs are specified in Exhibit C, Cost Estimate. Billings for any direct non -salary costs shall be supported by copies of original bills or invoices. Reimbursement for outside consultants and services shall be on the basis of times the invoiced amount. 4. The net fee, which represents the Consultants profit shall be 12.00 percent of direct salary plus overhead costs. This fee is based on the Scope of Work and the estimated labor hours therein. In the event a supplemental agreement is entered into for additional work by the Consultant, the supplemental agreement will include provision for the added costs and an appropriate additional fee. The net fee will be prorated and paid monthly in proportion to the percentage of the project completed as estimated in the Consultant's monthly progress reports and approved by the City. Any portion of the net fee not previously paid in the monthly payments shall be included in the final payment, subject to the provisions of Section XI entitled TERMINATION OF AGREEMENT. 5. Progress payments may be claimed monthly for direct costs actually incurred to date as supported by detailed statements, for overhead costs and for a proportionate amount of the net fee payable to the Consultant based on the estimated percentage of the completion of the services to date. Final payment of any balance due the Consultant of the gross amount earned will be made promptly upon its verification by the City after completion and acceptance by the City of the work under this Agreement. Acceptance, by the Consultant of final payment shall constitute full and final satisfaction of all amounts due or claimed to be due. Payment for extra work performed under this Agreement shall be paid as agreed to by the parties hereto in writing at the time extra work is authorized. (Section VIII "EXTRA WORK"). A short narrative progress report shall accompany each voucher for progress payment. The report shall include discussion of any problems and potential causes for delay. To provide a means of verifying the invoiced salary costs for consultant employees, the City may conduct employee interviews. Acceptance of such final payment by the Consultant shall constitute a release of all claims of any nature, related to this Agreement, which the Consultant may have against the City unless such claims are specifically reserved in writing and transmitted to the City by the Consultant prior to its acceptance. Said final payment shall not, however, be a bar to any claims that the City may have against the Consultant or to any remedies the City may pursue with respect to such claims. The Consultant and its subconsultants shall keep available for inspection, by the City, for a period of three years after final payment, the cost records and accounts pertaining to this Agreement and all items related to, or bearing upon, these records. If any litigation, claim or audit is started before the expiration of the three-year retention period, the records shall be retained until all litigation, claims or audit findings involving the records have been resolved. The three-year retention period starts when the Consultant receives final payment. Page 4 of 15 Pi a zza/Data_Cente r/Forms/City/Co ntracts ZVZON ORIGINALLPAGE NO S'OF PAGES Vil CHANGES IN WORK The Consultant shall make all such revisions and changes in the completed work of this Agreement as are necessary to correct errors appearing therein, when required to do so by the City, without additional compensation. Should the City find it desirable for its own purposes to have previously satisfactorily completed work or parts thereof revised, the Consultant shall make such revisions, if requested and as directed by the City in writing. This work shall be considered as Extra Work and will be paid for as provided in Section VIII. VIII EXTRA WORK The City may desire to have the Consultant perform work or render services in connection with the Project in addition to or other than work provided for by the expressed intent of the Scope of Work. Such work will be considered as Extra Work and will be specified in a written supplement which will set forth the nature and scope thereof. Work under a supplement shall not proceed until authorized in writing by the City. Any dispute as to whether work is Extra Work or work already covered under this Agreement shall be resolved before the work is undertaken. Performance of the work by the Consultant prior to resolution of any such dispute shall waive any claim by the Consultant for compensation as Extra Work. IX EMPLOYMENT The Consultant warrants that it has not employed or retained any company or person, other than a bona fide employee working solely for the Consultant, to solicit or secure this contract and that he has not paid or agreed to pay any company or person, other than a bona fide employee working solely for the Consultant, any fee, commission, percentage, brokerage fee, gifts or any other consideration, contingent upon or resulting from the award or making of this contract. For breach or violation of this warranty, the City shall have the right to annul this Agreement without liability, or in its discretion to deduct from the Agreement price or consideration or otherwise recover, the full amount of such fee, commission, percentage, brokerage fee, gift or contingent fee. Any and all employees of the Consultant, while engaged in the performance of any work or services required by the Consultant under this Agreement, shall be considered employees of the Consultant only and not of the City and any and all claims that may or might arise under the Workman's Compensation Act on behalf of said employees, while so engaged and any and all claims made by a third party as a consequence of any negligent act or omission on the part of the Consultant's employees, while so engaged on any of the work or services provided to be rendered herein, shall be the sole obligation and responsibility of the Consultant. The Consultant shall not engage, on a full or part-time basis, or other basis, during the period of the contract, any professional or technical personnel who are, or have been at any time during the period of this contract, in the employ of the City except regularly retired employees, without written consent of the City. If during the time period of this Agreement, the Consultant finds it necessary to increase its professional, technical, or clerical staff as a result of this work, the Consultant will actively solicit minorities through their advertisement and interview process. X NONDISCRIMINATION The Consultant agrees not to discriminate against any client, employee or applicant for employment or for services because of race, creed, color, national origin, marital status, sexual orientation, sex, age or handicap except for a Page 5 of 15 Piazza/Data_Cente r/Forms/City/Contracts I _PAGE NQ� 0Fa.(_PAGES E 1-2012 bona fide occupational qualification with regard to, but not limited to the following: employment upgrading; demotion or transfer; recruitment or any recruitment advertising; layoff or termination's; rates of pay or other forms of compensation; selection for training; rendition of services. The Consultant understands and agrees that if it violates this Non -Discrimination provision, this Agreement may be terminated by the City and further that the Consultant shall be barred from performing any services for the City now or in the future, unless a showing is made satisfactory to the City that discriminatory practices have terminated and that recurrence of such action is unlikely. XI TERMINATION OF AGREEMENT A. The City reserves the right to terminate this Agreement at any time upon not less than ten (10) days written notice to the Consultant, subject to the City's obligation to pay Consultant in accordance with subparagraphs C and D below. In the event of the death of a member, partner or officer of the Consultant, or any of its supervisory personnel assigned to the project, the surviving members of the Consultant hereby agree to complete the work under the terms of this Agreement, if requested to do so by the City. This section shall not be a bar to renegotiations of this Agreement between surviving members of the Consultant and the City, if the City so chooses. In the event of the death of any of the parties listed in the previous paragraph, should the surviving members of the Consultant, with the City's concurrence, desire to terminate this Agreement, payment shall be made as set forth in Subsection C of this section. C. In the event this Agreement is terminated by the City other than for fault on the part of the Consultant, a final payment shall be made to the Consultant for actual cost for the work complete at the time of termination of the Agreement, plus the following described portion of the net fee. The portion of the net fee for which the Consultant shall be paid shall be the same ratio to the total net fee as the work complete is to the total work required by the Agreement. In addition, the Consultant shall be paid on the same basis as above for any authorized extra work completed. No payment shall be made for any work completed after ten (10) days following receipt by the Consultant of the Notice to Terminate. If the accumulated payment made to the Consultant prior to Notice of Termination exceeds the total amount that would be due as set forth herein above, then no final payment shall be due and the Consultant shall immediately reimburse the City for any excess paid. D. In the event the services of the Consultant are terminated by the City for fault on the part of the Consultant, the above stated formula for payment shall not apply. In such an event the amount to be paid shall be determined by the City with consideration given to the actual costs incurred by the Consultant in performing the work to the date of termination, the amount of work originally required which was satisfactorily completed to date of termination, whether that work is in a form or of a type which is usable to the City at the time of termination, the cost to the City of employing another firm to complete the work required and the time which may be required to do so, and other factors which affect the value to the City of the work performed at the time of termination. Under no circumstances shall payment made under this subsection exceed the amount which would have been made if the formula set forth in subsection C above had been applied. In the event this Agreement is terminated prior to completion of the work, the original copies of all Engineering plans, reports and documents prepared by the Consultant prior to termination shall become the property of the City for its use without restriction. Such unrestricted use not occurring as a part of this project, shall be without liability or legal exposure to the Consultant. Page 6 of 15 Piazza/Data_Center/Forms/City/Contracts E 1-2012 "?RlGINAt J-PAGE N(- 7 FI_PAGFF Payment for any part of the work by the City shall not constitute a waiver by the City of any remedies of any type it may have against the Consultant for any breach of this Agreement by the Consultant, or for failure of the Consultant to perform work required of it by the City. Forbearance of any rights under the Agreement will not constitute waiver of entitlement to exercise those rights with respect to any future act or omission by the Consultant. XII DISPUTES Any dispute concerning questions of facts in connection with work not disposed of by agreement between the Consultant and the City shall be referred for determination to the Public Works Administrator or his/her successors and delegees, whose decision in the matter shall be final and conclusive on the parties to this Agreement. In the event that either party is required to institute legal action or proceedings to enforce any of its rights in this Agreement, both parties agree that any such action shall be brought in the Superior Court of the State of Washington, situated in King County at the Maleng Regional Justice Center in Kent, Washington. XIII LEGAL RELATIONS The Consultant shall comply with all Federal Government, State and local laws and ordinances applicable to the work to be done under this Agreement. This contract shall be interpreted and construed in accordance with the laws of Washington. The Consultant agrees to indemnify, defend and hold the City and its officers and employees harmless from and shall process and defend at its own expense all claims, demands or suits at law or equity arising in whole or part from the Consultant's errors, omissions, or negligent acts under this Agreement provided that nothing herein shall require the Consultant to indemnify the City against and hold harmless the City from claims, demands or suits based upon the conduct of the City, its officers or employees and provided further that if the claims or suits are caused by or result from the concurrent negligence of (a) the Consultant's agents or employees and (b) the City, its agents, officers and employees, this provision with respect to claims or suits based upon such concurrent negligence shall be valid and enforceable only to the extent of the Consultant's negligence or the negligence of the Consultant's agents or employees except as limited below. Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, or employees. No Limitation A. Consultant's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Consultant to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. Page 7 of 15 Piazza/Data_Center/Forms/City/Contracts E1-2012 ORIGINt' % '►qt^,� ►NIn 0 04(_PAGFP B. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non -owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the Consultant's profession. C. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. D. Other Insurance Provision The Consultant's Automobile Liability and Commercial General Liability insurance policies are to contain, or be endorsed to contain that they shall be primary insurance as respect to the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. G. Notice of Cancellation The Consultant shall provide the City with written notice of any policy cancellation, within two business days of their receipt of such notice. Page 8 of 15 Piazza/ Data_Center/Forms/City/Contracts ORIGINAL_ 1- . PArE N '? 02 ( °AGES E1-2012 H. Failure to Maintain Insurance Failure on the part of the Consultant to maintain the insurance as required shall constitute a material breach of contract, upon which the City may, after giving five business days notice to the Consultant to correct the breach, immediately terminate the contract or, at its discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion of the City, offset against funds due the Consultant from the City. The limits of said insurance shall not, however, limit the liability of Consultant hereunder. The Consultant shall also submit copies of the declarations pages of relevant insurance policies to the City within 30 days of contract acceptance if requested. The Certification and Declaration page(s) shall be in a form as approved by the City. If the City's Risk Manager has the Declaration page(s) on file from a previous contract and no changes in insurance coverage has occurred, only the Certification Form will be required. The Consultant shall verify, when submitting first payment invoice and annually thereafter, possession of a current City of Renton business license while conducting work for the City. The Consultant shall require, and provide verification upon request, that all subconsultants participating in a City project possess a current City of Renton business license. The Consultant shall provide, and obtain City approval of, a traffic control plan prior to conducting work in City right-of-way. The Consultant's relation to the City shall be at all times as an independent contractor. It is further specifically and expressly understood that the indemnification provided herein constitute the Consultant's waiver of immunity under the Industrial Insurance Act, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this agreement. XIV SUBLETTING OR ASSIGNING OF CONTRACTS The Consultant shall not sublet or assign any of the work covered by this Agreement without the express consent of the City. XV ENDORSEMENT OF PLANS The Consultant shall place their certification on all plans, specifications, estimates or any other engineering data furnished by them in accordance with RCW 18.43.070. XVI COMPLETE AGREEMENT This document and referenced attachments contain all covenants, stipulations, and provisions agreed upon by the parties. Any supplements to this Agreement will be in writing and executed and will become part of this Agreement. No agent, or representative of either party has authority to make, and the parties shall not be bound by or be liable for, any statement, representation, promise, or agreement not set forth herein. No changes, amendments, or modifications of the terms hereof shall be valid unless reduced to writing and signed by the parties as an amendment to this Agreement. The invalidity or unenforceability of any provision in this Agreement shall not affect the other provisions hereof, and this Agreement shall be construed in all respects as if such invalid or unenforceable provision were omitted. Page 9 of 1S Piazza/Data_Center/Forms/City/Contracts E1-2012 lo XVII EXECUTION AND ACCEPTANCE This Agreement may be simultaneously executed in several counterparts, each of which shall be deemed to be an original having identical legal effect. The Consultant does hereby ratify and adopt all statements, representations, warranties, covenants, and agreements contained in the Request for Qualifications, and the supporting materials submitted by the Consultant, and does hereby accept the Agreement and agrees to all of the terms and conditions thereof. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first above written. CONSULTANT -A " X"'Cj' nature Date Randy L. Asplund type or print name Vice Preside Title CITY OF RENTON Mayor ATTEST: Bonnie I. Walton, City Clerk Date Page 10 of 15 Piazza/Data_Center/ Forms/City/Contracts EXHIBIT A Scope of Work City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Improvements for Below -grade Structures April 2013 Background The City of Renton (City) has requested RH2 Engineering, Inc., (RH2) to prepare plans and specifications necessary to detail improvements needed at 18 wastewater lift stations, the lift stations need fall restraint systems added at the entry points to their below -grade structures. The project also involves improving access and safety to a deep manhole structure located on Mill Avenue S. The deep manhole involves adding a ventilation system and a safer method for entering the manhole for required maintenance. The manhole system connects to a manhole located at plain Avenue S. that may require ventilation equipment. The lift stations included as part of this project are as follows. 1. Baxter 2. Cottonwood 3. Denny's 4. Devil's Elbow 5. East Valley 6. Falcon Ridge 7. Kensington Crest 8. Lake Washington Beach 9. Lake Washington Flush 10. Lake Washington No. 2 11. Long 12. Oakesdale (Surface Water) 13. Rainer (Surface Water) 14. Shy Creek 15. Stonegate 16. Talbot Crest 17. Wedgewood 18. Westview Task 1— Visit Each Lift Station and the Mill Avenue S. Deep Manhole Structures Objective: Visit each lift station and the deep manhole structures with City maintenance crew to identify, the required improvements. Approach: 1 4/ 18, 2u1 3 1 u9:36 PM % Bothell ,Data .REN \S*) 2 I13 Deep Manhole Access 1mprocemtnts`,PSA_SO\\"_21,13 US lmprowmcnts.does I PAGE NO 1 PAGES City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Exhibit A Improvements for Below -grade Structures Scope of Work 1.1 Photograph each lift station to document existing access system to underground vault. 1.2 Document dimensions and special considerations for each entry point at each lift station. 1.3 Evaluate a workable solution for each lift station while at the site. 1.4 Photograph the deep manhole facility at both Main Avenue S. and Mill Avenue S. to document existing conditions and project details. 1.5 Document dimensions and design aspects for achieving improved access and ventilation at the deep manhole. Review options for power supply and equipment installation. 1.6 Discuss the planned improvements with the City project manager before moving to Task 2. Assumptions: It is assumed that survey information will not be used. RH2 intends to show the locations of the improvements using digita/photographs on the construction plans. Provided by City: Provide access to each lift station and the deep manholes during the site visits. Assist RH2 with measurement verifications. Task 2 — Prepare Preliminary Construction Plans and Details Objective: Prepare preliminary construction plan and details for each lift station and the deep -manhole. Some details will be common to several of the lift stations. Approach: ?.1 Prepare preliminary plans and sufficient details to identify the work required at each lift station to add the fall restraint systems. Each lift station plan will have a site photo to demonstrate where the fall restraint system is to be installed with reference to a detail. 2.2 Prepare preliminary plans and details to identify the work required at the deep manhole to improve the access and ventilation. 2.3 Prepare a cover sheet and general construction notes for the project. 2.4 Prepare a vicinity map that identifies the location of each of the lift stations included in this project and the deep manhole. 2.5 Prepare a preliminary set of three (3) color construction plans (11-inch by 17-inch) in PDF format for City review. The preliminary plan set will be delivered to the City by email or on RH2's file sharing website. 2.6 Prepare a preliminary construction cost estimate for the City's review. 2.7 Meet with the City to review and discuss comments for the preliminary plan set before moving to Task 3. Document meeting minutes and distribute to group. Assumptions: It is assumed that retractable steel poles with stainless steel ebains will work as a fall restraint ystem in most cases with minor modifications for some as necessary. RH2 Deliverables: • One (1) electronic copy of the color plan set for City review. • One (1) electronic copy of the preliminary engineer's cost estimate. Task 3 — Technical Specifications Objective: Develop project specifications to accompany the construction plans. 2 114 1 i 1 09 p\I %;\BothdI ,Data',WiN\SMr',2o13 Deep Manhole Access ImprovLments TSA_SO\C _2(113 US Impr)vemcnts.doc% 3 ',( City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Exhibit A Improvements for Below -grade Structures Scope of Work Approach: 3.1 Prepare technical specifications for specified equipment, materials, and construction tasks using RH2 technical specifications tailored for this project. 3.2 Coordinate with the City to update the standard specifications and general conditions as warranted for this project. 3.3 Prepare review documents and address City comments. The review documents will be delivered by email in electronic format unless requested otherwise by the City. Assumptions: RH2 will review the specification ronrments from the City at the meeting scheduled under Task 2 to review the preliminary plans. Provided by City: • Standard specifications and general conditions for review with project. RH2 Deliverables: • One (1) electronic copy of preliminary specifications, to be provided at preliminary plan review. Task 4 — Prepare Final Plans and Specifications Objective: Prepare final plans and specifications for bidding the proposed improvements. Approach: 4.1 Prepare final plans and specifications for competitive bidding of the proposed project improvements based on the City's review comments. Provide an electronic color bid set of the plans for final approval by the City before the plans are made available for bidders. RH2 will address final review comments from the City. 4.2 Perform an in-house quality control review of the plans and specifications prior to the 90-percent complete submittal. Incorporate the review comments into the final plans and specifications. 4.3 Prepare bid quantities and an engineer's construction cost estimate based on the final plans. Develop schedule of prices and payment requirements. RH2 Deliverables: • One (1) electronic copy of the color plan set for final review. • One (1) electronic copy of the technical specifications. • One (1) electronic copy of the final engineer's cost estimate. • Schedule of prices and payment requirements. Task 5 — Services During Bidding and Award Objective: Provide engineering services during the bidding phase of the project to assist with securing a qualified contractor to construct the project. Approach: 5.1 Prepare bid advertisement and coordinate the timing and placement of the bid advertisement with the City. The City will submit the advertisement to the appropriate publications. 5.2 Produce one (1) electronic set and four (4) hard copy color sets of plans and technical specifications: one (1) set for City use and bidding purposes; and three (3) sets for RH2 files and 3 4/18/13 1U9 P11 L ,B,,thell Data ',AI:N\5411`,2ut 1 Deep Manhole Access Impvnrrmnt%\PSA_So\\ _21113I S Improcementsdoex ;Pir�UAL f ?AGE Nq 0)_ pAGEc City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Exhibit A Improvements for Below -grade Structures Scope of Work staff use during bidding. Plan sheets will be provided on 11-inch by 17-inch sheets. The City will produce bid document sets as needed for the purpose of the project. 5.3 Respond to questions from bidders and revise construction plans, technical specifications, or construction contract conditions during the bidding process if needed. This may include the preparation and issuance of up to two (2) addenda. 5.4 Assist the City with the evaluation of the qualifications and references for the apparent low bidder. Prepare recommendation of bid award letter. It is assumed the City will handle bid award and construction contract execution. 5.5 Prepare construction plan sets and specifications for pre -construction meeting. Produce PDF version of documents. Provided by City • Management of the Builder's Exchange online bidding process. • Distribution of bid documents and maintenance of the planholder's list, if applicable. • Bid opening attendance and tabulation of received bids. • Issuance of addenda, if any, to all bid document holders. RH2 Deliverables • Bid plan sets: one (1) electronic set, and one (1) hard copy. • Phone assistance to vendors and bidders during the bidding phase. • Reference check of lowest bidder. • Preparation of recommendation of bid award letter. • Three (3) full-size and three (3) half-size plan sets for construction. • PDF file of construction plans for City use. Task 6 — Services During Construction Objective: Assist the City during construction of the improvements. It is RH2's understanding and assumption that the City will perform the day-to-day construction administration; RH2 will provide only the following services during construction. Approach: 6.1 Prepare agenda for and attend the pre -construction conference. 6.2 Respond, in writing, to Requests for Information. Correspond via email and written letters with the City and contractor to document construction issues as necessary. It is anticipated that two (2) hours per week will be required for this subtask. 6.3 Change Orders Process — Review and prepare change orders, if necessary. Deliver to City for processing. 6.4 Receive and review project submittals and maintain a submittal list. 6.5 Conduct periodic site visits to determine the progress and quality of the work and to check that the project is being completed in general conformance with the project documents. Attend periodic progress meeting with the City staff and contractor at City Hall. Prepare inspection reports for RH2 inspection visits. RH2 will not make exhaustive or continuous on -site inspections, but will visit the site during construction operations for approximately four (4) 4 4/18/13 Lug PM I:\Bothell\Data\RF.N\S40\2013 Decp Manhole Access Improvements\PSA SO\\'_2u131S Improvments.drxx City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Exhibit A Improvements for Below -grade Structures Scope of Work hours per week for a total of ten (10) weeks. Following the visits, RH2 will inform the City of the progress of the work and may recommend rejection of the work if it fails to conform to the project documents. 6.6 Review project progress pay estimate submittals from the contractor. Prepare progress payments using standard City format. 6.7 assist the City with testing and startup of the ventilation system for the deep manhole project. 6.8 Assist with preparing the project punchlist and attend the final project walk-through inspection with the City and the contractor. 6.9 Revise plans with as -built information received from the Contractor and the City. Provide one (1) hard copy (11-inch by 7-inch), one (1) hard copy of full-size Alylars (black and white), and one (1) electronic copy each of PDF and AutoCAD formats to the City. Compile final project documentation and deliver to City. Documents will include inspection reports, digital photos, and other documents described in this Scope of Work. Assumptions: • RH2 is not responsible for site safet}t or anj contractor's failure to perjbmi its work in accordance with the contract documents, nor is RH2 responsible for directing the contractor in the contractor's work or ensuring pmper construction techniques. • The Ciy will manage and etiecute the construction phase of the project. • The Qy wi11 pmi) de full --lime inspection during construction. RH2 Deliverables • Submittal review documentation. • Change order documentation. • Punchlist. • As -built records: o one (1) 11-inch by 17-inch color set o one (1) full-size Nlylar (black and white) set o one (1) electronic PDF set o one (1) set of AutoCAD files • Inspection reports. • Digital photos. 5 4 I8/13 Lu9 PM / B�,thcll Data RI.\ S W' 2u13 Dccp Manhole Access Improvements' Pti.A S(1\C_2u131 S Impn,cemLnts.Jocs r/ 4 )1 Exhibit B: Time Schedule of Completion City of Renton Mill Avenue S. Manhole and Lift Station Fall Restraint Improvements for Below -Grade Structures Task Completion Task 1 — Visit Each Lift Station and the Aiill Ave S. Deep-1\1anhole June 30, 2013 Task 2 — Prepare Preliminary Construction Plans and Details July- 31, 2013 Task 3 —Technical Specifications July 31, 2013 Task 4 — Prepare Final Plans and Specifications September 30, 2013 Task 5 — Services During Bidding Unknown Task 6 — Services During Construction Unknown CONTRACT COMPLETION DATE: December 31, 2014 2/7/2012 4:45 PM Z:\Bothe11\Data\REN\S40\2013 Deep Manhole Access Improvements\PS_ —Exhibit B_Completion Schedule-2013 LS Improvements.docx /_PAG5 NO/-- 104f PAGES EXHIBIT C-1 RH2 Engineering, Inc. SCHEDULE OF RATES AND CHARGES 2013 HOURLY RATES CLASSIFICATION MAX DSC RATE CLASSIFICATION MAX DSC RATE Professional IX $109.73 Technician IV SOO) Professional Vill $76.58 Technician SUM Professional V1I $70.27 Technician -Iffill 11 $27.46 Technician 1 $27.17 Professional VI $65.65 -------- Professional V ------------------ $56.58 Administrative V S41.93 Professional IV $43.90 Administrative IV S36.38 Administrative III $25.65 Professional 111 $38.70 Administrative $19.36 Professional 11 — ------------ - - $35.88 Administrative I $16.30 Professional 1 $29.15 IN-HOUSE SERVICES In-house copies (each) 8 5" X I I" SO.09 CAD Plots : ----- — — — — - — — --------- ------ — ----- Large $25.00 In-house copies (each) 8.5" X IV_ $0.14 CAD Plots - — — Full Size — ------ $10.00 In-house copies (each) -11" X 17" SO.20 CAD Plots Half Size $2.50 In-house copies (color) (each) .8.5" X I 1 11 S0.90 CAD System Per Hour $27.50 In-house copies (color) (each) .8.5" X 14" S1.20 GIS System Per Hour $27.50 In-house copies (color) (each) 11 X 17" $2.00 Technology Charge 2.5% of Direct Labor Mileage Current IRS Rate OUTSIDE SERVICES Outside direct costs for permit fees, reports, maps, data, reprographics, couriers, postage, and non -mileage related travel expenses that are necessary for the execution of the project and are not specifically identified elsewhere in the contract will be invoiced at cost. All Subconsultantsenices are billed at cost plus 15%. CHANGES IN RATES Rates listed here are adjusted annually. The current schedule of rates and charges is used for billing purposes. Payment for work accomplished shall be based on the hourly rates and expenses in effect at the time of billing as stated in this Exhibit. DELIVERY TICKET ® CUS'TQfAER COPY ��MILES�� SAND & GRAVEL COMPANY ' 400 VALLEY AVE NE, PUYALLUP, WA 98372-2516 SALES/OFFICE www.MilesSandandGravel.com (253) 833-3705 CONCRETE ORDERS SAND & GRAVEL ORDERS (2.531 922-0327 (253) 833-3700 (253) 536-9100 SHELTON OLYMPIA tax (253) 833 3716 (253) 922-9116 (253) 843-1787 (360) 426 3344 (360) 40'-7777 CUSTQMVR NO., , , ORDER NO , , I CUSTOMER PO. OR JOB NO, PLANT NO. i DELIVER i )KE i N3. BRED CY D V D LOAD NC. SLUM l ' 4R�- .. ,, � � - I 1 � 1 Gallo of Water PLANT TIME OUT JOB TIME IN JOB TIME OUT-rPLANT TIME IN Adped By Customer% Request wMF=. SPECIAL INSTRUGTIQNS DRIVk R NO. TRUCK NO. TAX CODE. DRIVER. . t reyca� t�:y,I:u�,t "A -I.. .i :M�art.;•li:�. sl(yAc.. 1di3�i�.' I Tip F�.ylf-1�1 CQ E F DESCRIPTION 'Y.'�1J1: f 1'{•./!{<!ii')('�;-i'iF11' {,f1t'?f'� tl•ai!!'. (' I ti l Y d I ": 1 ) f� rl"�+ TERMS: NET 30 DAYS. INTEREST THE MAXIMUM ALLOWABLE RATE WILL BE SUB TOTAIC AAAT CHARGED ON PAST DUE A OUNTS IF COLT FCTION BFCOMFS NECES- SARY REASONABLE ATTORNEYS FEES WILL BE ASSESSED. RELEASE - CUSTOMER RELEASES & AGREES TO HOLD HARMLESS THE MILES CO FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY CAUSED BY DFLIVFRY OF MATERIALS I ISTFD ABOVE GALLONS OF WATER ADDED BY CUSTOMER'S REQUEST - SALES TAX SIGNATURE X TOIAL AMOUNT rf- . v %I' Ir Itl •� I'< � 1 •..:, a .Y ,: � .::R.. �•lv.tk'.'., < +7o�%t ! •fi1547 I>•• [ �t1., � t'e�rrrlt "9ttNgr' ,i ti1 li'r if{. rdwIlmel. 7511 1h I U : UNIT PRICE AMOUNT y CORLISS: EESOURCES �i� CUSTOw' .., I Quality Concrete JKgAed Sand &Gravel • Crushed Rock ire t,Ser06e, Since 194.5 ! II i1 'TbU POUR c P.O. Box 487 • SU knfi&, Washington 98390 -oncrete Dispatch: Phone 253 :8916680 • FAX 253 891, 6691 Gravel Dispatch: Phone 253 8916686 • FAX 253 8916692 ATE . , .., ' 71AAEL PLANT M ` TICKET NO. 0089115 UST. P.O NO. JOB NUMBER SELF/DELVD DRIVER TflUCK ID ;OLD TO CUANTITYORDERED GROSS•WEIGHT OAD CONSTRUCTION IOW '' Ftil;l` 4 QUANTITY DELIVERED TODAY TARE WEIGHT Fiwrbl\l, WA 9805_j ' a, 40 GOO -QELIVEREDTODATE .Mfrs.. 36' NETWEIGHT 6,4 R'0 =L]VERYADDRESS AND INSTRUCTIONS ENTAL. RE:NTON SEWFR INTFRI L..-.P--f-c)f3 MAFtION S f &, I{CiWr�;lt . WAY .N ENTON LOAD NO. ; 1 UNITS PRODUCT CODE AND DESCRIPTION t0VJ197fd 2" SCR OkAVFI.. k.31']RIti: W Dr -:I-. TT •�..�2liL-_CLi1.Ld_1t1.1Y.-_I!'�tL.,�c.'hc��__..-•--1.11.{'-��.il ".'S •. +��, i. _ �r_.� .-._. _ `_..�_.� — __ -al ,4. + CORLISS RESOURCES CUSTOMER Quality Concrete • Bashed Sand & Gravel - Crushed Rock i "Great Seryice Since 194J" x' 1800 YOU POUR P.O. Box 487 • SaAer, Washington 98390 s bncrete Dispatch: Phone 253 8916680 • FAX 253.8916691 Gravel Dispatch:`Phone 253 8916686 *'FAX. 1538416692 ATE TIME OUST. NO.. PLANT M TICKET NO. 789 i 171 7 — ry UST: P.O. NO; JOB NUMBER SELF/DELVID DRIVER TRUCK ID TOLD TO: QLJANTITYQRDERED GROSS WEIGHT 1. Ci &4 �irh. rtlirti 1 _9 QUANTITfDELIVEREDT.00AY. _ TAREWEIGHT 'GAD CONSTRUCTION NW '" RCNW 'O' BOX 18 #. 67. Qi 40,600. !ENTON, wry 98055 DELIVERr=D TO QATC NET WEIGI IT 67" � r� 7 ` �i' ' ELIVERY ADDRESS AND INSTRUCTIONS LOAD`NO. UNITS FNTAI_ RENTON SEWER INTERt EPTOR . " 34. ! , MA R I ON Fj T & HU"` SE. R WAY N PRODUCT CODE AND DESCRIPTION :ENTON . 001970 2" SCR GRAVEL. BORROW DE_I._ TT :.-S. 306 , 8e6 i HAT JOB i 5e`l . UNIT PRICE ArAOUNT 34.66 '-rN Report�ruck Time PLANT TIME OUT J0BTIMEIN JORTIMEOUT! PLANT TIME IN SUBTOTAL LUST. SIGN X DgVR. SIGN X WEIGHMASTER4114 X n additionalcharge will be made on deliveries less than 12 yards. Loads quoted Ky the yard, are sold by volume, approximately 1.35 ms per yard. Any dump delays over 10 minutes will be charged at the current hourly truck rate. Not responsible for damages beyond ie curb. TERMS: DUE 10TH:.017 MONTH -`FOLLOWING DATE OF PURCHASE. ,---.FINANCE CHARGE OF 1.833% PER 1 IONTH (22%PER ANNL BE t, :CHARGED ON ALL PAST DUE ,ACCOUNTS. tCScale Ticket 4-11 A .. AINRVICE CHARGE WILL BE COLLECTED ON ALL RETURNED CHECKS. 189171 CORLISS- RESOURCES - CUSTOMER Quality Concrete • Washed Sand & Gravel •Crushed Rock "Great &kvice Since 1945 1800 YYOU POUR . P.O. Box 487 • Sgntner, Washington 98390 mcrete Dispatch: Phone 253 5916680 FAX 253 8916691 Grava'l-bispatch: Phone 253 8916686 • FAX 253 8916692 TE TIME CUST. NO, PLANT 8 TICKEFNO. E 789147 r S P.O. NO. J09.NUMBER SELF/OELVD DRIVER TRUCKID - - �Dg10� 1 EIS -FF. 31 OLD TO' E�384 �i QUANTITY ORDERED ORoss WEIGHT i c� 3tn. f00 . 3AD CONSTRUCTION NW - RCNW QUANTITY DEGVEREDTODAY TARE WEIGHT 5 �� V BOX 18S 3 ir�l 40; t:,i�IZ► ,.NTi7N,. WA 9815 DELIVERED TO DATE NE1 wEIGH7 :c) . :1VERYADDRESS'AND INSTRUCTIONS 3R''-'48 LOAD NO - , UNITS, -- NTAI_ RENTON SaEW4 INTSIRCEPTOR3cr.46 '.MAR ST - R HOWSaER. WAY '.N pRooucrcoDE.ANooEscI31PTT — — ht'�Tf3N : I� wr :30G 80..Gi KAI!.JOIB 1509 QUANTITY p 3a. zt8 rri ,ick Time Report �I PLANT TIME OUT PLANTTIMEIN _ - },� SUBTOTAL JL TOTAL J 3T, SIGN X DRVR. SIGN X WOpiMASTER SIGN X +LS additional Charge will be made on deliveries less than 12.yards. Loads quoted by the 4ard are sold by volume, approximately 1.36 Is per yard. Any dump delays over 1.0 minutes will be charged at the current hourly truQk calve, Not responsible for damages beyond curb..TERMi: DUE LOTH OF MONTH FOLLOWING DATE OF PURCHASE. i"`-FINANCE CHARGE OF 1 833% PER )NTH (22%PER ANNU'M) WILL $E CHARGEID ON ALL PAST DUE ACCOUNTS.. Scale .T"Oi4-11 A $35.00 SERVICE CHARGE WILL -SE°COLLECTED ON ALL RETURNED CHECKS. :.E -.T99147. �•�� w �- -,�--�-----r—�-•-�--�-s�•--•-�--� •-- ram --.:•tea-'►'. : �T'.,r"--_,-, _ V ORLI SS heRESrOURCES QCon "Great Sefy-ice Slice 1945" 180o YOU POUR P.O. Box 487 •Sumner;Washington 98390 ,rete,) 9atch.' Plione 253 89 t 6680 • FAX 253 8916,691 Gravel D> snatch Phone 253 8916686 FAX 253 89166�2 TIME CUST NO, PLANTq TIGKETNO 7 8321 ti �. 9 JOB NUMBER SELP/D LVD . DRh" Tpum it) 4 I z rC _D TO, QUANTITY ORDERED . GROSS WEIGHT • - 1832'S4 InE LINE r RUC7'•I t7N 'NW RCNW QUANTITY DELIVERED TODAY TARE WFJGHT �•. BOX 188 LF:'1 �� I i UNI, WA 98055 DELIVERED TO DATE NETV&IGHT =RY ADDRESS AND INSTRUCTIONS' LOAD NO. UNITS ITAL. RENTow, SEWER; `INTERCEPTOR. 1 69, 89 IARION .ST u{ .HOWSER. W1 Y .N PRODUCTCQDEAND QESCRIPTION ITON +4 170 GRA1/E;'t.: BORR OW TRF1N 1509 .=—x�.. CORLISS ROSOURCES CUSTOMER! Qualit y Concrete •{mashed SandA Gravel • Crashed Rock + • •, . , 'GnedtSarvi¢eSince1945" , a 1800 YOU PO JR : I P.O. Box 487: • Sumner, Washington' 98390 i Icrete- Dispatch: Phone 8916680 • FAX 253 9916691 Gravel Dispatch: Phone 253 8916686 *.FAX 253 8916692 TIME OUST. NO, PLAW-i ]"NO . pp. ,. 09/"14 / 1 12 a l b Pm 18384 lei . 149249 S 8 Q.G 2 0 2 '. P.O. NO. 03 NUMBER SELF/DE-VD DRIVER . TRUCK ID I 001A 115 DEL i VER ' PRESTON ear 9 ILD T0: QUANTITY ORDERED GROSS WEIGHT 18384 ROAD CONSTRUCTION NW -- Rr-NW PO Box_ A 88 RENToNt WA •98055 /ERY ADDRESS AND INSTRUCTIONS CENTAL .R9NTON SEWE:R INTERCEPTOR N `MAR1.ON ST R HOWRE R WAY N -RENTON - 42 "89,1-?9— 472 425-919-9 131 JOB 1509 PLANT TIME OUT /''J. PLANT TIME IN QUANTITY DELVERED TODAY TARE WEIGHT 59.5.3 45, 85e::= DELIVERED TO DATE 5�• NET WEIGHT' 680 ' LOAD NO. UNITS 29■ 84 PRODUCT CODE AND DESCRIPTION 5004970 2" SCR GRAVEL BORROW TRAN QUANTITY UNIT PRICE AMOUNT 2 84' TN � S-0 D� SUBTOTAL T. SIGN X DRVR. SIGN x _.�f G%� WEIGHMASTER SIGN X additional charge will be made on dellverr'es less than 12 yards.. Loads quoted by the yard, are sold by volume, approximately 1.35 s per yard. Any dump delays over 10,minutes will be charged at the current hourly truck rate. Not responsible for damages beyond curb. TERMS: DUE. 1OTH OF MONTH. '`ti FOLLOWING DATE OF PURCHASE. FINANCE CHARGE OF 1.833%;IRER ,'NTH (990API=P ANNIIMI WII I RF. ! r.HARr;Fn nN Al 1 PACT r11iF I. 1 Annr)iINTR r% 0%drA^0%0%0% CORUSS RESOURCES CUSTOMER vh ality Concrete • Washed Sand &(k%c�j Cri1rshed Aock , 'Great �ervlce Sine* 9 3.?y 18WYO17 POUR : tt P.O. Box 487 • Sumgkv M,gshington 9839Q I .oncrete Dispatch: Phone _ 8916680 • FAX 253 8916691 \ - GY vel �ispatch:.Afione, 253 V! 6686 • FAX 253 8916692 ATE TIME OUST. NO ` ALiWT>< —f C TICKET N t 19/ 4/16 01:513 p� 18384 �, . !041 � � 36AJ 33 _ E 7$93$3 i UST. P.O. N6..JOB NUMBER GEL F _ ELVD ' ANFR *) TRUCK ID } 16 0130115 � EtfIVE'R PZE.:S1-QN . � 1T13w9 } >OLD TO: QUANrrrroRDER9q r GROSS WEIGHT � 18384 ' :. n . ? 104, 160 lOhD . CONSTRUCTION NW ' ,— • .RCNW DELNEIi�D TO _ �.� '^ TAPE WEIGHT o . BOX 188 9. 15 " 45, 860 .ENTON, WA 91305. _ D RED T DA �' NET WEIGHT a a, 9. 11'ul 58,300 EUVEAY ADDRESS AND INSTAUC71ON3 "^ ;Eh1TAL..RENTQN SEWER' INTERCEPTOR LOApNo. uNITs 09. 11 r f I MARIbN S7~ & HOWSER WAY N' tI-�NTfIN PROOLICT CQ.QE ARD.MSCRiPrioW 0&& 941. 15 A-, CR MIh11IMTRANI 3 Cc.3TC; 2,05-.9119--91.31 30B 1509 CORLISS RESOURCES i CUSTOMER ; ' �Oality Concrete •Washed Sand:& Gravel - Crushed Rock r. "Great Service Since 1945" 1 800 YOU POUR ' P.O. Box 487 • Sumner, Washington 98390 ,oricrete Dispatch: Phone 253 8916680 • FAX 253 8916691 Gravel Dispatch: Phone 253 891-----J.6686 FAX 253 8916692 ATE TIME COST. NO: 7SELI.F/DELVD M TICKET NO. �+ 09/ 15/ 1 is 1 1 0 55 dim 18384 '101 149307 S 8 0 6 3 4 0� UST. P.O. NO. JOE NUMBER DRIVER TRUCK ID 000115 ELIVER BOB 0322 ;OLD TO: 1 (y ? QUANTITYORDERED GROSS WEIGHT { 7.//' arJ 1 C7J 4 30. 00 1 VJ l—J �., rF YJ ROAD CONSTRUC1`TC1N NW - R01W ,. L'U BOX 188 QUANTITYDELIVEREDTODAY TARE WEIGHT REhITCIN, WA 3E10, °,5 DELIVERED TO DATE NETWEIGHT CC 5, .5. 40 :LIVERY .ADDRESS AND INSTRUCTIONS 6 3F1. 77 CENTAIL R NTON SEWER I: N'I' L_RC:E PTOR I CAD NO. UNITS I3. 77 N MAF2Z (]N 5T R HCIWISF F•2 WAY N U.N PRODUCT CODE AND DESCRIPTION 5001970 SCR BRAVE'L. BORROW DI L. TT GCS-89`1-9172' 425�-' 1 -91;31 jO13 1`-f0�3 ;2. 77 TN Report77 ,uck Time PLANT T'ME OUT ' . J06 TIME IN JOB TIME OUT - PLANT TIME IN SUBTOTAL 1 L-4- ... IST. SIGN X DRVR. 810N ;' !+ , WEIGHMASTER SKIN X I additional harge will be made on deliveries less than 12 yards. Loads quoted by the yard, are sold by volume, approximately 1.35 . is per yard. Any dump delays over 10 minutes will be' charged at the current hourly truck rate. Not responsible for damages beyond 3 curb. TERMS:. DUE 10TH OF MONTH {{" N FOLLOWING DATE OF PURCHASE. FINANCE CHARGE OF 1.833% PER DNTH (22%PER ANNUM) WILL BE l ,) CHARGED ON ALL PAST DUE �. ) ACCOUNTS. S $06340 Scale Ticket4-11 A $35.00 SERVICE CHARGE WILL BCF F nl 1 CTEn ON Al I RFT7"IRKIM r•ucrrve DELIVERY TICKET ® I L SAND & GRAVEL COMPANY 400 VALLEY AVE NE, PUYALLUP, WA 98372-2516 SALES/OFFICE www.MilesSandandGravel.com (253) B33-3705 CONCRETE ORDERS SAND & GRAVEL ORDERS (253) 922-0327 (253) 833-3700 (253) 536-9100 SHELL ON OLYMPIA fax L2531833-3746 (253) 922-9116 (253) 843-1787 (360) 426-3344 (3601491-7777 i I CUSTOMER COPY i DATE CUS rOMER NO. ORDER NO, CUSTOMER P.O. OR JOB NO. PLANT NO. DELIVERY TICKET NO. i•,'ii' CY ORDERED NO. SLUMP Gallons of Water PLANT TIME OUT JOBTIME IN JOB TIME OUT PLANT TIME IN =DLVRDLOAD a 1 l)t. Added By Customers Request `'^":1 �..�5 1 ..! CUSTOMER NAME SPECIAL INSTRUCTIONS t•i T. •il l i�S6 (%f JOB ADDRFSS ---- MAR It0i ST tz HQUISEP iiEt`tI'�lkl QTY UNITS PROD. CODE DESCRIPTION UNIT PRICE AMOUNT 5 010 YJ 1lI.:I''Ai I 1 1:I1. DAL5 — 71 04) i:Y 4000 -Alp, VN } RA UNWN' T i 00 FA `i 1(to MIN UOAV CI Is"RUE: 5 00 Illy ""i 3tlt;, FI-iti X F':FYI' IAF (I Al (;WiPf 10-0 -- (<; F-1 iT I N IX 1 DRIVER NO. TRUCK NO. Ell I Cl 1013 I TERMS: NET 30 DAYS. INTEREST AT THE MAXIMUM ALLOWABLE RATE WILL BE SUB TOTAL CHARGED ON PAST DUE ACCOUNTS. IF COLLECTION BECOMES NECES- TAX CODE. r SA, RY REASONAJBLE ATTORNEYS FEES WILL BE ASSESSED. 01 t!1 .%•i.' RELEASE - CUSTOMER RELEASES & AGREES TO HOLD HARMLESS THE MILES CO. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE. --- DRIVER. IcApF`Y , J01j" i "LLONS OF WATER ADDED BY CUSTOMER'S REQUEST SALES TAX SIGNATURE X f TOTAL AMOUNT ) 9'r.tic, k- Cat.tt. U-I:' 4 Di.at.,- i ket tnad zl.a.a7.i'L Lyy�=l.y.(t,'t.�:' - L3rl.(.Irfie •L't 1•I+v �-�• Y{titica. _.�c!�:.; �r..!;t'A r.l; ,lt tlstl9 L'ta_rll:ii•`tl tr�:1 ai :k7 �_r�.l+C:! BCA•'n?d ';1t'; :-'.!. !.1+1?1:8: �•. R..; Le ,! $�Pl)Ct3 : fy C--!,A 2t Z;"c w• l.l'.'::u it' dY_ii it I tf5 na- !tCt yi. ' i T i k Itti ;111�; i 10: 1C.. Cu°i iYi '?5 Tv : •17.`.�; mu'17II: t7 -AT i, tYi•. 1i'ij to 4'.:. i.., 1r,:: ]CI TO O�� TM GTE I SMITH ISLAND ASPHALT EVERETT WA 98205 425-252-9592 Customer: NORTHSHORE PAVING INC 327209 Order ID: 175858 Job/PO# : 895 Cost Code Location: RENTON SEWER, 2111 ROSS AVE Comments Weighmaster: Granite Construction Company Deputy: SHANIN COFFMAN WEIGHMASTER CERTIFICATE COPY Ticket No 2572204 9/20/2016 12:30:00AM Vehicle: NS9TR RED KW License: I I Carrier: Gross 75,520 34.26 37.76 Tare 43,320 19.65 21.66 Net 32,200 14.61 16.10 FOB: PICK-UP This Load: 16.10 TON: Load No: 3 Shipped: 80.26 TON: Accepted by: WARNING: THIS PRODUCT CONTAINS CRYSTALLINE SILICA (QUARTZ). CRYSTALLINE SILICA IS A COMMON NATURALLY OCCURING MINERAL FOUND IN SAND AND ROCK. PROLONGED AND REPEATED BREATHING OF CRYSTALLINE SILICA DUST MAY CAUSE RESPIRATORY AND OTHER HEALTH PROBLEMS, INCLUDING LUIJG DISEASE, SILICOSIS AND CANCER, WHICH MAY RESULT IN PERMANENT INJURY OR DEATH. BEFORE USING OR HANDLING THIS PRODUCT READ THE MATERIAL SAFETY DATA SHEET FOR MORE DETAILED INFORMATION INCLUDING INFORMATION ON APPROPRIATE RESPIRATORY PROTECTION. MSDS SHEETS AVAILABLE AT WWW,GRANITECONSTRUCTION.COM/MSDS OR BY CONTACTING YOUR LOCAL OFFICE. gd rev. 05/05 COPY GRAnITE'm SMITH ISLAND ASPHALT EVERETT,WA 98205 425-252-9592 Customer: NORTHSHORE PAVING INC 327209 Order ID: 175858 Job/PO# : 895 Cost Code Location: RENTON SEWER, 2111 ROSS AVE Comments Weighmaster: Granite Construction Company Deputy: SHANIN COFFMAN WEIGHMASTER CERTIFICATE Vehicle: NS10TR RED PETE License: I I Carrier: Gross Tare Net FOB: PICK-UP Accepted by: Ticket No 9/20/2016 2572201 12:08:OOAM 04,920 47.59 52.46 42,100 19.10 21.05 62,820 28.49 31.41 This Load: Load No: Shipped: 31.41 TONIc 31.41 TONE WARNING: THIS PRODUCT CONTAINS CRYSTALLINE SILICA (QUARTZ). CRYSTALLINE SILICA IS A COMMON NATURALLY OCCURING MINERAL FOUND IN SAND AND ROCK. PROLONGED AND REPEATED BREATHING OF CRYSTALLINE SILICA DUST MAY CAUSE RESPIRATORY AND OTHER HEALTH PROBLEMS, INCLUDING LUNG DISEASE, SILICOSIS AND CANCER, WHICH MAY RESULT IN PERMANENT INJURY OR DEATH. BEFORE USING OR HANDLING THIS PRODUCT READ THE MATERIAL SAFETY DATA SHEET FOR MORE DETAILED INFORMATION INCLUDING INFORMATION ON APPROPRIATE RESPIRATORY PROTECTION. MSDS SHEETS AVAILABLE AT WWW.GRANITECONSTRUCTION.COWMSDS OR BY CONTACTING YOUR LOCAL OFFICE. gci rev. 05105 I COPY TM, SMITH ISLAND ASPHALT ITE 2111 ROSS AVE. EVERETT,WA 9B205 425-252-9592 r: I NORTHSHORE PAVING INC 1 327209 1 175858 895 le RENTON SEWER, 2111 ROSS AVE nts: )master: Granite Construction Company I�. I ; y"I;i: I SHANIN COFFMAN Vehicle: NS15TR RED KW License: Carrier: Product -2998 1/2"HMA64-22N Pounds Gross 104,980 Tare 39,480 Net 65,500 FOB: PICK-UP Ticket No 2572203 9/20/2016 12:19:OOAM 47.62 52.49 17.91 19.74 29.71 32.75 This Load: 32.75 TONS Load No: 2 Shipped: 64.16 TONE i WEIGHMASTER CERTIFICATE Accepted by: IS PRODUCT CONTAINS CRYSTALLINE SILICA (QUARTZ). CRYSTALLINE SILICA IS A COMMON NATURALLY OCCURING MINERAL FOUND IN SAND AND ROCK. PROLONGED AND REPEATED BREATHING ' NE SILICA DUST MAY CAUSE RESPIRATORY AND OTHER HEALTH PROBLEMS, INCLUDING LUNG DISEASE, SILICOSIS AND CANCER, WHICH MAY RESULT IN PERMANENT INJURY OR DEATH. BEFORE 'DLING THIS PRODUCT READ THE MATERIAL SAFETY DATA SHEET FOR MORE DETAILED INFORMATION INCLUDING INFORMATION ON APPROPRIATE RESPIRATORY PROTECTION, MSDS SHEETS tVWW.GiiANITECONSTRUCTICN.COMMSDS OR BY CONTACTING YOUR LOCAL OFFICE. ga'". 05/Cb I DELIVERY TICKET M I S SAND & GRAVEL COMPANY 400 VALLEY AVE NE, PUYALLUP, WA 98372-2516 SALES/OFFICE www.MilesSandandGravel.com (253) 833-3705 CONCRETE ORDERS SAND & GRAVEL ORDERS (253) 922-0327 (253) 833-3700 (253) 536-9100 SHELTON OLYMPIA fax (253) 833-3746 (253) 922-9116 (253) 843-1787 (360) 426-3344 (3601 491-7777 CUSTOMER COPY DATE CUSTOMER NO. ORDER NO. CUSTOMER P.O. OR JOB NO. PLANT NO. DELIVERY TICKET NO. or)/ I i/r-'t)16 1),1 fir, 1`I 109"P9 t-'+1r 169611 ? CY ORDERED rl CY DLVRD LOAD NO. SLUMP Gallons of Water Added By Customers Request PLANT TIME OUT ` Z� t J JOB TIME IN �0 JOB TIME OUT PLANT TIME IN CUSTOMER NAME SPECIAL INSTRUCTIONS RCN14 656 1)1 JOB ADDRESS MAR ION ST & 1101LISFR RFNI ON OTY UNITS PROD. CODE DESCRIPTION UNIT PRICE AMOUNT 5 00 wd 1 IC DA1 1 I ICVA15 5 0o CY 4001) AIR F.NIRAINMENF 1 00 EA 5100 MIN 1 0AD C:t1ARGE 5 (x) CY 531*) ENVIRCJNMENIAI COW[ IAW..E R; 1 00 LD 5413I FUEL S1111101ARGf: READY MI V DRIVER NO. TRUCK NO. 21.119 Mf)5 I TERMS: NET 30 DAYS. INTEREST AT THE MAXIMUM ALLOWABLE RATE WILL BE SUB TOTAL CHARGED ON PAST DUE ACCOUNTS. IF COLLECTION BECOMES NECES- SARY REASONABLE ATTORNEYS FEES WILL BE ASSESSED. TAX CODE. 1J1 �I' rc RELEASE - CUSTOMER RELEASES & AGREES TO HOLD HARMLESS THE MILES CO. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE. DRIVER. CAPPY , J0511 GALLONS OF WATER ADDED BY CUSTOMER'S REQUEST SALES TAX SIGNATURE X TOTAL AMOUNT Truck Dri:*et: User Disc Ticket Plum Ticket ID Tian Date- ri 1�I 5 1510 G L U -is C 1.. 1 fg c o •� a S) � CJU 1 C .? r, { •_� ►� 1 V V -1.1.11 n i. , 't . i. d. .. 1 s 1. 5_! Load Size MX Cede Retutned OtY Mix Agp 4eq Load ICI 5. 01) CY 1 ICDAI 5 w 58651 11dwid pli:111711r711 besIggla* Recill 0411 d %6 /w%mc4suse Actual Nvjd 5AtD Cta 2 3040Ct04so 2 2,1713 ID 147M Ib 144a0 11b 1 in 5 7_3% A 1w q! IN PE 141 2me's to$ 10 I'm IL ; 15 M 1 42% Nrt+EyLI MRA&LM 1 i 6e 5 ar e6 U ce 0 76% -#.;lei. i ,-AMORI s:u i; Z li• %vTER : "^-TER : it, s lb Ib t-01 v4A1£R NUT k4^TF1✓ 46 f 1t It -#ATF.P.4 v1ATUF+4 luu 4s t Sffi Ib 4t4 W. -13 Z^ c1 01 Act" t*AM OdChe£ / L"d 1962- 1t• De-Agn64tc 1 i1S wtate c&ywY 1 m A CkOgn 162D 91 Acwd 151 3 1$ T,A,ji in pl slvnp. 4 [O in 6 •ata In Twk. all III) Tdrn wider 190 Ib ! Cr REPRESENTATIONS -DISCLAIMERS 1. Warranty of concrete strength or other performance apply only when concrete is tested by qualified technicians in strict conformance to the provisions of ASTM; Strength test are evaluated according to the provisions of AC 318, latest revision, "Building Code Requirements for Reinforced Concrete." We will not be responsible for tests or for other expenses incurred without prior approval. 2. Supplier shall not be liable for the condition of the concrete if additional water is added. 3. Supplier shall not be liable for any damage done to shrubbery, flowers, city or private sidewalks, roadway or private property in the delivery of this material. 4. If the supplier's truck shall become immobilized due to terrain during the delivery of this material, property owner shall pay all towing charges incurred in the removal of the said truck. 5. All prices subject to change without notice. CAUTION 1. Please note that freshly mixed cement, mortar, concrete or grout may cause skin injury. Avoid contact with skin where possible & wash exposed areas promptly with water. If any cement mixture gets into eyes, rinse immediately & thoroughly with water & get prompt medical attention. 2. Keep all cement mixtures out of reach of children. 3. Please keep concrete from freezing & protect it from adverse weather conditions at all time. DUMPING TIME 1. Free unloading time is calculated at 8 minutes per cubic yard. A "Standby Time" charge may be applied beyond this period. SHORT LOAD CHARGES 1. For deliveries under 7 cubic yards of concrete or 10 tons of gravel, there will be a minimum load charge. Witness Signature Customer Signature