Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SWP272013 (2)
Allen Quynn From: Edward Horvath <eshorvath@trmvc.com> Sent: Wednesday, October 28, 2015 2:04 PM To: 'Lon Weaver' Cc: Allen Quynn Subject: RE: FW:Intent Attachments: vectolex-sup-sup-fg---specimen-label.pdf Here is a summary of the information requested; label attached as well. 2015 information as follows: Material Used: VectoLex° FG EPA Reg No: 73049-20 Total Lbs of Material: 312.33 Lbs The annual report,to follow, will detail out the distribution, etc... Regards, -ESH Edward Horvath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito &Vector Control Office: (541) 238-2272 Skype: edward_horvath www.trmvc.com Integrated and Innovative Pest Management Strategies From: Allen Quynn [mailto:aguynn@Rentonwa.gov] Sent: Wednesday, October 28, 2015 1:12 PM To: 'Edward S. Horvath' Cc: 'Lon Weaver' Subject: RE: FW: Intent Hi Edward, I just need the total number(lbs. of BS or BTi, etc.). Also, no immediate rush on the reports. Thanks, Allen 1 From: Edward S. Horvath [mailto:eshorvath(atrmvc.coml Sent: Wednesday, October 28, 2015 12:28 PM To: Lon Weaver; Allen Quynn Subject: RE: FW: Intent I will have this summary to you ASAP. Are the totals being reported per facility or for the City as a total? I am also working on the end of the year report, however I am a little behind my personal schedule right now due to having surgery. Sorry for the delay on that report. Edward S.Horvath,MPH Vector Eeologisr'Project Manager Three Rivers Mosquito & vector Control WWW.TRMVC.COM Office: (541) 238-2272 Mobile: (541) 880-4791 Skype: edward_horvath Sen{ji-om my Verizon Wireless 4G LTEsmartphone -------- Original message -------- From: Lon Weaver<lonw@formacc.com> Date: 2015/10/28 12:11 PM (GMT-08:00) To: "'Edward S. Horvath"' <eshorvath&trmvc.com> Subject: FW: Intent - Hey Edward see email below. Can you give me a totals page with all the chemicals used. Thank you LON WEAVER I FORMA CONSTRUCTION 1360.280.6650 From: Allen Quynn [mailto:aquynn(aaRentonwa.gov1 Sent: Wednesday, October 28, 2015 11:47 AM To: Lon Weaver Subject: RE: Intent Hey Lon, Please request that Whitworth and Three Rivers provide you all the chemical treatment data for the Mosquito Abatement and Vegetation Management Contracts. I need the quantity and type of chemical used so I can fill out and submit the final usage reports to Ecology(they are due in mid-December). 2 DeMayoLaw W City Of j � • Public Works Department-Gregg Zimmerman,P.E.,Administrator November 20, 2015 Attn: Aquatic Pesticide Permit Manager Washington State Department of Ecology PO Box 47600 Olympia, WA 98504 RE: 2015 NPDES Aquatic Mosquito Control General Permit Annual Report Dear Aquatic Pesticide Permit Manager: Attached is a signed 2015 Treatment Annual Report for the City's Aquatic Mosquito Control General Permit No. WAG992028. If you have any questions, please call me at 425-430-7247 or email me at aguVnn@rentonwa.gov. Sincerely, Allen Qu nn, P.E. Surface �Nater Utility Engineer Enclosure H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Reports\Mosquito Abatement 2015 Annual Report Cover Letter.docx\AQtp Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Mosquito General Permit-Annual Report Page 1 of 1 Treatment Annual Report - AQUATIC MOSQUITO CONTROL GENERAL PERMIT To comply with the terms of the statewide general permit for discharges of aquatic pesticides to control mosquito larvae to surface waters of the state. x A s H I N s T o N s r A l E Print, sign, and mail the Annual Report Form to the address below: D E P A H i N E N i o E Department of Ecology, Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504 ECOLOGY Permit Number Entity Name Active Ingredient Used Amount A.I. &Units Location Treated WAG992028 City of Renton Bacillus sphaericus 312.33 Lbs Stormwater Ponds, vaults and irrigation facilities within the City of Renton "I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible.for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." Signature: A,P111 '; ® zjt Date: Printed name of permittee: Greg Zimmerman, PW Administrator https://secureaccess.wa.gov/ecy/wgmosquito/PrintReport.aspx 11/10/2015 PUBLIC WORKS DEPARTMENT I M E M O R A N D U M DATE: November 12, 2015 TO: Gregg Zimmerman, Public Works Admi i ra r FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Engineering Manager, x7248 Allen Quynn, Surface Water Utility Engineer, x7247 SUBJECT: 2015 NPDES Aquatic Mosquito Control General Permit (WAG992028) Annual Report The City of Renton's Surface Water Utility has completed the 2015 NPDES Aquatic Mosquito Control General Permit Annual Report. This annual report is required to comply with the requirements on the NPDES Permit that covers discharges of pesticide(s) or pesticide residues to waters of the state of Washington. The annual report was prepared by the Surface Water Utility based upon monthly treatment reports provided by Three Rivers Mosquito & Vector Control, containing type and amount of larvicide used to treat mosquitoes on City stormwater ponds, vaults and irrigation facilities. Three Rivers Mosquito & Vector Control was selected by Forma Construction using the City's Job Order Contracting process. The Department of Ecology has specified, according to General Condition G15 of the NPDES Permit that, "all applications, reports, or information submitted to Ecology must be signed by a principal executive officer or ranking elected official." This annual report must be signed and submitted to the Department of Ecology by December 31, 2015. Please sign the attached Treatment Annual Report stating that the annual report was prepared by qualified personnel who properly gathered and evaluated the information submitted, and that the information is true, accurate, and complete. Please return the signed document to Allen Quynn, Surface Water Utility, for submission to the Department of Ecology. Attachment H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Reports\2015 Memo To Gregg.doc\AQtp Mosquito General Permit - Annual Report Page l of 1 ftm Treatment Annual Report - AQUATIC MOSQUITO CONTROL GENERAL PERMIT To comply with the terms of the statewide general permit for discharges of aquatic pesticides to control mosquito larvae to surface waters of the state. w A s I N c n s n r = Print, sign, and mail the Annual Report Form to the address below: " h N " i Department of Ecology, Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504 ECOLOGY Permit Number Entity Name Active Ingredient Used Amount A.I. & Units Location Treated WAG992028 City of Renton Bacillus sphaericus 312.33 Lbs Stormwater Ponds, vaults and irrigation facilities within the City of Renton "I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible.for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." Signature: A14 Date: l� Printed name of permittee: Gre Zimmerman PW Administrator https://secureaccess.wa.gov/ecy/wgmosquito/PrintReport.aspx 11/10/2015 Certification of Completion and Request for Release of Contract Retainage CAG#: 13-149 WO #43-15 Forma Construction Project Title: 2015 Mosquito Abatement Program I hereby certify, as Project Manager representing the City of Renton, that: 1. All work required by the above cited contract was completed on September 21, 2015. 2. Acceptance by the City Council was granted on Not Required, <$150,000 If City Council acceptance is not required (contracts less than $150,000), see acceptance by Mayor or Department Head below. (Reference Renton Policy and Procedure 250-02.) 3. No liens have been received within 30 days of completion date from any persons, subcontractors, or material men, who have performed or provided any work or material on subject contract. 4. All Intents to Pay Prevailing Wages and all Affidavits of Wages Paid (including all subcontractors) have been verified and copies have been forwarded to Finance. 5. NOTE: CAG-13-149 is a JOC contract with multiple work orders. The bond will not be released until all work orders for the contract are completed, and after all the required releases from the State have been obtained. Project Manager Da e J AP14 lemom 1)/Y h Z� Department e Le el Acceptance Da e (Small Work er Under$35,000) (Single Craft/Trade Under$40,000) (Multi le Craft/Trade Under$65,000) Mayor Level Acceptance Denis Law Date (Small Works Roster between $35,000 - $150,000) (Single Craft/Trade between $40,000 - $150,000) (Multiple Craft Trade between $65,000 - $150,000) H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Pay Estimate\2015-1013a CityCert-Completion-Release Retainage.doc\DCtp TO: FINANCE DIRECTOR r FROM: PUBLIC WORKS ADMINISTRATOR 18/0001948 CONTRACTOR: Forma Construction, Co. CONTRACT NO. CAG 13-149, WO#43-15 ESTIMATE NO. 1 (Final) PROJECT: Surface Water Utility 2015 Mosquito Abatement Contract 1. CONTRACTOR EARNINGS THIS ESTIMATE $2,230.02 2. SALES TAX @ 9.50% $211.85 3. TOTAL CONTRACT AMOUNT THIS ESTIMATE $2,441.87 4. EARNINGS PREVIOUSLY PAID CONTRACTOR $39,746.02 5. ' EARNINGS DUE CONTRACTOR THIS ESTIMATE $2,230.02 6. SUBTOTAL- CONTRACTOR PAYMENTS $41,976.04 7. RETAINAGE ON PREVIOUS EARNINGS $0.00 8. *' RETAINAGE ON EARNINGS THIS ESTIMATE N/A 9. SUBTOTAL - RETAINAGE $0.00 10. SALES TAX PREVIOUSLY PAID Sales Tax Rule 170 Applies $3,775.87 11. SALES TAX DUE THIS ESTIMATE $211.85 12. SUBTOTAL- SALES TAX $3,987.72 " (95%x LINE 1) (RETAINAGE: 5%) GRAND TOTAL: $45,963.76 FINANCE DEPARTMENT ACTION: CONTRACTOR Earnings (Lines 5): ACCOUNT # 427.475020.018.531.35.41.000 $2,230.02 # 0 # 001.000000.020.576.80.41.003 $0.00 # 404.000000.020.576.65.48.002 $0.00 # 504.000000.020.518.21.41.003 $0.00 $2,230.02 RETAINED AMOUNT (Line 8): ACCOUNT # Contract held by retainage bond N/A # Final Sales Tax (Line 11) # 427,475020.018.531.35.41.000 $211.85 # 0 # 001.000000.020.576.80.41.003 $0.00 # 404.000000.020.576.65.48.002 $0.00 # 504.000000.020.518.21.41.003 $0.00 $211.85 TOTAL THIS ESTIMATE: $2,441.87 CHARTER 116, LAWS OF 1965 CITY OF RENTON CERTIFICATION I,THE UNDERSIGNED DO HEREBY CERTIFY UNDER PENALTY OF II C PERJURY,THAT THE MATERIALS HAVE BEEN FURNISHED,THE SERVICES RENDERED OR THE LABOR PERFORMED AS DESCRIBED (J HEREIN,AND THAT THE CLAIM IS A JUST,DUE AND UNPAID OBLIGATION AGAINST THE CITY OF RENTON,AND THAT I AM AUTHORIZED TO AUTHENTICA 1,,AYD CERTIFY TO SAID C IM t -- Signed: Printed On: 11/03/2015 City of Renton Public Works Department Page 1 Printed Ont 11/03/2015 City of Renton Public Works Department Page 1 Project: Surface Water Utility 2015 Mosquito Abatement Contract Contract Number: CAG 13-149,WO#43-15 Contractor:Forma Construction,Co. Pay Estimate Final Closing Date: 09/25/15 Item Description Unit Est. Unit Previous Previous This This Total Total No. Quantity Price Quantity Amount Quantity Amount Quantity Amount ITEM DESCRIPT UNITS ESTQTY UPRICE PQTY PAMOUNT THISQTY TAMT TOTQTY TOTAMT 001. Surface Water LS 1 $50,817.76 0.7427722 $37,746.02 0.0438827 $2,230.02 0.79 $39,976.04 002. Parks LS 1 $3,290.73 0.0 $0.00 0.0 $0.00 0.00 $0.00 003. Golf Course LS 1 $1,862.62 0.829616 $1.545.26 0.0 $0.00 0.83 $1,545.26 004. Facilities LS 1 $495.21 0.918277 $454.74 0.0 $0.00 0.92 $454.74 Subtotal $39,746.02 $2,230.02 $41,976.04 Sales Tax Rule 170 Applies $3,775.87 $211.85 $3,987.72 TT Total $43,521.89 $2,441.87 $45,963.76 ti STArE. ❑ Original [ ❑ Revised# ay � oy NOTICE OF COMPLETION OF PUBLIC WORKS CONTRACT Date: 11/3/15 Contractor's UBI Number: 600604496 Name&Mailing Address of Public Agency Department Use Only City of Renton, Attn: Natalie Wissbrod Assigned to: 1055 S. Gradv Wav Renton, WA 98057 Date Assigned: UBI Number: Notice is hereby given relative to the completion of contract or project described below Project Name Contract Number Job Order Contracting 2015 Mosquito Abatement Program TCAG-1 13-149, WO#43-15 ❑ Yes V No Description of Work Done/Include Jobsite Address(es) Application of adulticide to upland areas of the Panther Creek Wetlands and Larvicide to City stormwater and irrigation facilities and catch basins for the control of mosquitoes as part of the 2015 Mosquito Abatement Program. Federally funded transportation project? ❑ Yes SK No (if yes,provide Contract Bond Statement below) Contractor's Name E-mail Address Affidavit ID* Forma Construction. ilonw@formacc.com 1605705 Contractor Address Telephone# PO Box 11489, Olympia, WA 98508 1206-626-0256 If Retainage is not withheld,please select one of the following and List Surety's Name&Bond Number. VRetainage Bond ❑ Contract/Payment bond(valid for federally funded transportation projects) Name: Liberty Mutual Insurance Company 1Bond Number: 023026860 Date Contract Awarded Date Work Commenced Date Work Completed Date Work Accepted 05/28/15 08/12/14 109/21/15 09/21/15 Were Subcontracters used on this project? If so,please complete Addendum A. Wyes ❑No Affidavit ID*-No L&I release will be granted until all affidavits are listed. Contract Amount $ 61,830.61 Additions (+) $ Liquidated Damages $ Reductions (-) $ 15,866.85 Amount Disbursed $ 45,963.76 Sub-Total $ 45,963.76 Amount Retained $ 0.00 Amount of Sales Tax 3,987.7 (If various rates apply,please send a breakdown) $ TOTAL $ 45,963.76 TOTAL $ 45,963.76 NOTE: These two totals must beequal Comments: Note:The Disbursing Officer must submit this completed notice immediately after acceptance of the work done under this contract. NO PAYMENT SHALL BE MADE FROM RETAINED FUNDS until receipt of all release certificates. Submitting Form:Please submit the completed form by email to all three agencies below. Contact Name: Allen Quynn Title: Civil Engineer III Email Address: aquynn@rentonwa.gov Phone Number: 425-430-7247 Department of Revenue Washington scam Depamnem of Employment Security Public Works Section Labor & Industries Department Registration,Inquiry, (360)704-5650 Contract Release Standards 8 Coordination PWC@dor.wa.gov (855)545-8163,option#4 Unit ContractRelease@LNI.WA.GOV (360)902-9450 publicworks@esd.wa.gov REV 31 0020e(4/28/14) F215-038-000 04-2014 Addendum A: Please List all Subcontractors and Sub-tiers Below This addendum can be submitted in other formats. Provide known affidavits at this time. No L&I release will be granted until all affidavits are listed. Subcontractor's Name: UBI Number: (Required) Affidavid ID* Whitworth Pest Solutions, Inc. 600494832 602773 Three Rivers Mosquito and Vector Control 603378113 600232 For tax assistance or to request this document in an alternate format,please call 1-800-647-7706.Teletype(TTY) users may use the Washington Relay Service by calling 711. REV 31 0020e Addendum(04/28/14) F215-038-000 04-2014 r RECEIVED a FORMA CONSTRUCTION NOV 01 20 5 LETTER OF TRANSMITTAL CITY OF REN ON UTILITY SYST MS FORMA CONSTRUCTION TO: Utilities Department DATE: 10/28/2015 1055 S. Grady Way 6th Floor JOB NO GAG 13 149 WO#43-15 OLYMPIA AND SEATTLE WASHINGTON Renton, WA 98057 WWWFORMACC.COM ATTN Allen Quynn RE 2015 Mosquito Abatement Program WE ARE SENDING YOU: Cj attached Q under separate cover via: THE FOLLOWING ITEMS. ❑ shop drawings ❑ prints ❑ plans ❑samples ❑specifications ❑ copy of letter ❑ change order ❑ other: COPIES DATE NO. DESCRIPTION 1 10/28/2015 Final Billing#2 THESE ARE TRANSMITTED: ❑ for approval and payment ❑ 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 review&comment ❑ other: ❑ FOR BIDS DUE ❑PRINTS RETURNED AFTER LOAN TO FORMA REMARKS: COPY TO: SIGNED: Ado , ( e)odL , (Amber 6ougherty,Project Administrator) FORMA CONSTRUCTION COMPANY 1016 1ST AVE SOUTH.SUITE 400 SEATTLE WASHINGTON 98134 P 206 626 0256 CONTRACT NO. mVOCL oA r -i or wCitrofs CAG-13-149 10/20/2015 2 WO#43-15 VENDOR'S CERTIFICATE.I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE ITEMS AND ................................. .......... . . ... ........ ..... TOTALS LISTED HEREIN ARE PROPER CHARGES FOR MATERIALS,MERCHANDISE OR SERVICES AGENCY AAME FURNISHED TO THE STATE OF WASHINGTON,AND THAT ALL GOODS FURNISHED OR SERVICES RENDERED HAVE BEEN PROVIDED WITHOUT DISCRIMINATION N THE GROUNDS OF RACE, CREED,COLOR,NATIONAL ORIGIN,SEX,OR AGE;THAT PREVAILING WAGES HAVE BEEN PAID IN ACCORDANCE WITH THE PREFILED STATEMENT OR STATEMENTS OF INTENT ON FILE WITH THE DEPARTMENT OF OR ANDAS APPROVED BY THE INDUSTRIAL Utilities Department AND THAT ALL SUBBCCONTRACTORSSTRIES AND/OR SUPPLIERS HAVE BEEN PAID LESS TEARNED IAN. 1055 S.Grady Way 6th Floor RETAINAGE AS THEIR INTEREST APPEARED IN THE LAST PAYMENT RECEIVED. Renton,WA 98057 PM In Charge: Allen Qu nn Forma Job# 14075-43 City of Renton Job# 43 Contract for. 2015 Mosquito Abatement Program Location: Renton,WA 98055 ::VENDOR aR CLAJMANT: FEDERAL TAX No.: -1319904 Forma Construction Co. FAILURETOPROV E I WILL ESULT IN DELAY MENT. PO Box 11489 BY Olympia, WA 98508 TITLE Project Manager DESCRIPTION ; :AfNOl3NT::: !:EORACiENCY .. .. .... . .. USE Total Earned to Date $41,976.04 Plus 9.5% Washington State Sales Tax $3,987.72 Gross Earned to Date $45,963.76 Less 0% Retained Retained Percentage on Total Amount Earned to Date $O.00 ................ ................ Not Including Sales Tax Net Earned to Date $45,963.76 Less Previously Invoiced $43,521.89 AMOUNT DUE THIS INVOICE $29441.87 PREPAREDBY TELEPHONE NUMBER OA AGENCY APPROVAL DATE DOC.DATE PMT DUE DATE CURRENT DOC,NO. REF DOC NO VENDOR NUMBER USE VENDOR MESSAGE UBI NUMBER M MAS IN EX WORK co, CI / REF TRANS O FUND APPEN PROG ':SUB:' SUB'. ORO CLASS BUDG TOWN :.:PRl1fE.C.T. UB.' PRO.1'.'.' AMOUNT INVOICE NUMBER SUF CODE D INDEX INDEX OBJ' OBJECT INDEX ALLOC UNIT MOB .PROJ.... ".PHAS . APPROVED FOR PAYMENT BY DATE WARRANT TOTAL WARRANT NUMBER STATE OF WASHINGTON APPLICATION AND CERTIFICATE FOR PAYMENT ON CONTRACT CERTIFICATE FOR PAYMENT. For period from: 9/25/2015 to 10/20/2015 Contractfor: 2015 Mosquito Abatement Program Date: 10/20/2015 Location: Renton,WA 98055 Certificate No.: 2 Contractor: Forma Construction Co. Contract No.: CAG-13-149 wo#43-15 Original Contract Amount: $41,976.04 Net change in Contract Amount to Date: $0.00 Adjusted Contract amount $41,976.04 -:ITEM SCH LLEVALUES ESTIMATED V $L HI No DETAIL VALUE EARNED CCAINFED INVOICE 1 General Conditions $6,230.02 $6,230.02 100% $4,000.00 $2,230.02 2 Site Construction $50,236.29 $50,236.29 100% $50,236.29 $0.00 3 Concrete $0.00 $0.00 #DIV/o! $0.00 $0.00 4 Masonry $0.00 $0.00 #DIV/O! $0.00 $0.00 5 Metals $0.00 $0.00 #DIV/o! $0.00 $0.00 6 Wood & Plastics $0.00 $0.00 #DIV/o! $0.00 $0.00 7 Thermal& Moisture Protection $0.00 $0.00 #DIV/o! $0.00 $0.00 8 Doors, Windows&Glass $0.00 $0.00 #DIV/O! $0.00 $0.00 9 Painting& Finishes $0.00 $0.00 #DIV/o! $0.00 $0.00 10 Specialties $0.00 $0.00 #DIV/o! $0.00 $0.00 11 Equipment $0.00 $0.00 #DIV/o! $0.00 $0.00 12 Furnishings $0.00 $0.00 #DIV/o! $0.00 $0.00 13 Special Construction $0.00 $0.00 #DIV/o! $0.00 $0.00 14 Conveying Systems $0.00 $0.00 #DIV/o! $0.00 $0.00 15 Mechanical $0.00 $0.00 #DIV/o! $0.00 $0.00 16 Electrical $0.00 $0.00 #DIV/o! $0.00 $0.00 17 Non Priced Items $0.00 $0.00 #DIV/o! $0.00 $0.00 18 Changes #DIV/o! 19 Change Order#1 ($14,490.27) ($14,490.27) t00% ($14,490.27) $0.00 $0.00 $0.00 #DIV/o! $0.00 $0.00 SUBTOTAL $41,976.04 $41,976.04 goo°i° $39,746.02 $2,230.02 TAX 9.50% SALES TAX $3,987.72 $3,987.72 $3,775.87 $211.85 TOTAL $45,963.76 $45,963.76 $43,521.89 $2,441.87 Less Retainage. 0% ......................... $0.00 $0.00 $0.00 NET $45,963.76 $43,521.89 $2,441.87 Less Previous Payments.... $43,521.89 Additional Tax 0.00% $0.00 $0.00 AMOUNT DUE THIS ESTIMATE $2,441.87 MOMEM $2,441.87 This is to certify that the contractor, g wmp ie the terms and conditions of the above mentioned contract,is due and payable from the State of Washington, the unt set after-AMOUNT DUE THIS ESTIMATE" t rma ns/Uction Co. (Cont c ng R ) (Architect or Engineer) B By SIGN IN I SIGN AND DAT E 14075-43 Inv#2 FINAL.As City of Renton, Community Service Department Purchasing & Contracting Services Division Revised 10/06/09 Public Works Prevailing Wage Certification Project: City of Renton JOC— 2015 Mosquito Abatement Project PW#: CAG-13-149 WO#43-15 Contractor Name: FORMA Construction Company I certify that the prevailing wages have been paid in accordance with the pre-filed Statement(s) of Intent to Pay Prevailing Wages on file with the Purchasing & Contracting Services Division of the Department of Finance and Administrative Services. This statement covers the following period: 09/25/2015 to 10/20/2015 month/day/year month/day/year The following subcontractors performed work on this project during this payment period: Subcontractor Name UBI# Statement of Intent Submitted to PCSD? Three Rivers Mosquito and Vector Control 603378113 X YES ❑ NO Whitworth Pest Solutions Inc 600494832 X YES ❑ NO ❑ YES ❑ NO YES ❑ NO YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO El YES ❑ NO YES NO This document shall be signed by an authorized representative of the Contractor prior to payment pursuant to RCW 39.12.040. FoucainstructiorkC=maanv Co tr c r f I N� SAnatuV V ate This Certification must be attached to each Progress Estimate along with any outstanding Statements of Intent to Pay Prevailing Wages. The City will not approve payments if this Certification or any Statements of Intent to Pay Prevailing Wages are outstanding. SECTION 00 73 03 SUPPLEMENTARY CONDITIONS - FINAL SUBCONTRACTOR LIST For public works contracts over $35,000 and completed after September 30, 2009, public agencies must not pay any retained funds to the contractor until the Department of Labor & Industries (L&I) has approved the release of payment. Part of obtaining L&I approval requires public agencies to provide a complete and final list of all subcontractors' who worked on the Project with each respective Tax Registration Number(UBI No.). As a result, the Contractor shall submit a final list of its project subcontractors and UBI numbers, and shall submit this Final Subcontractor List with the final pay application. Work Order No. CAG-13-149 WO #43-15 Prime Contractor Name: UBI Number Affidavit ID Forma Construction Company 600604496 605705 Subcontractor Name UBI Number Affidavit ID Whitworth Pest Solutions Inc 600494832 602773 Three Rivers Mosquito & Vector 603378113 600232 Control 1 L&I defines this as the prime contractor, and each and every subcontractor, required to be registered under chapter 18.27 RCW and/or licensed under chapter 19.28 RCW,that perform any work on a public works project site, and/or is required to pay industrial insurance premiums as a construction company. If an Intent to pay prevailing wage for the sub was filed,the sub should be listed here regardless of tier. 13 March 2013 00 73 03-1 Pagel of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Affidavit of Wages Paid Project Detail - Project Dashboard Document 10/20/2015 Intent 697854 Affidavit 605705 Affidavit Approved on Received Id Id Status 10/28/2015 Date Your Company Information Name FORMA CONSTRUCTION COMPANY Address PO BOX 11489 OLYMPIA,WA,98508 WA UBI no. 600604496 Contractor Registration no. FORMACC878OR Industrial Insurance Account Id 20213500 Email Address amberd@formacc.com Filed By Dougherty,Amber Project Information Awarding agency: RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding agency contact: Allen Quynn Awarding agency contact phone 425-430-7247 number: Project Details Project name 2015 Mosquito Abatement Program County where work was performed King City where work was performed Renton Job site address/directions: 1055 S. Grady Way Renton WA 98057 Prime contractor name FORMA CONSTRUCTION COMPANY Prime contractor registration no. FORMACC878OR https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/28/2015 Page 2 of 3 Contract no. CAG 13 149 WO #43-15 Prime contractor Phone Number 360-754-5788 Prime contractor Intent form Id# for 697854 this project Dollar amount of your contract: $ 45,963.76 Bid due date 5/21 /2015 Contract award date 5/28/2015 Intent filed date 6/2/2015 Job start date:MM-DD-YYYY 6/10/2015 Date work completed:MM-DD-YYYY 9/27/2015 Project Completion Did your subcontractors perform all Yes work on this project? Did your company hire any Yes subcontractors? Did your company have employees No perform work on this project? Did this project utilize American No Recovery and Reinvestment Act (ARRA) funds? Specifically, did this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Company Owner Information How many owner/operators performed 0 work on the project that own 30% or more of the company? No company owner added. Affidavit Subcontractor(s) Company Name UBI License# WHITWORTH PEST SOLUTIONS INC 600494832 WHITWPS944JE Three Rivers Mosquito and Vector Control 603378113 Journeylevel Wages https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/28/2015 Page 3 of 3 Apprentice Wages Public Notes i-iShow/Hide Existing Notes No note exists https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/28/2015 Page 1 of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Project Detail - Project Dashboard Document Received Date: Intent ID: Affidavit ID: Status: Approved On 6/2/2015 697854 6/3/2015 Company Details Company Name: FORMA CONSTRUCTION COMPANY Address: PO BOX 11489 OLYMPIA, WA, 98508 Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Industrial Insurance Account ID 20213500 Email Address amberd@formacc.com Filed By Dougherty, Amber Prime Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding Agency Contact Allen Quynn Awarding Agency Contact Phone Number 425-430-7247 Contract Number CAG 13 149 WO #43-15 Project Name 2015 Mosquito Abatement Program https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 Page 2 of 3 Contract Amount $611830.61 Bid due date 5/21 /2015 Award Date 5/28/2015 Project Site Address or Directions 1055 S. Grady Way Renton WA 98057 Payment Details Check Number: Transaction Id: 104786281 Intent Details Expected project start date: (MM-DD-YYYY) 6/10/2015 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is this $61,830.61 a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY Yes subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work Yes on this project? Do you intend to use any apprentices? Yes (Apprentices are considered employees.) How many owner/operators performing work on 0 the project own 30% or more of the company? ,Journey Level Wages County Trade Occupation Wage Fringe # Workers King Carpenters Carpenter $38.68 $13.68 1 https://fortress.wa.gov/lni/wagelookup/IntentDetaiIs.aspx 10/20/2015 Page 3 of 3 Public Notes o-Show/Hide Existing Notes No note exists https:Hfortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 Page 1 of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Affidavit of Wages Paid Project Detail - Project Dashboard Document 10/5/2015 Intent 718021 Affidavit 602773 Affidavit Approved on Received Id Id Status 10/19/2015 Date Your Company Information Name WHITWORTH PEST SOLUTIONS INC Address 2533 INTER AVE PUYALLUP,WA,98372 WA UBI no. 600494832 Contractor Registration no. WHITWPS944JE Industrial Insurance Account Id 44007400 Email Address pwillis@whitworthpestsolutions.com Filed By Project Information Awarding agency: RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding agency contact: Allen Quynn Awarding agency contact phone 425-430-7247 number: Project Details Project name 2015 Mosquito Abatement Program County where work was performed King City where work was performed Renton Job site address/directions: 1055 S. Grady Way Renton WA 98057 Prime contractor name FORMA CONSTRUCTION COMPANY Prime contractor registration no. FORMACC878OR https://fortress.wa.gov/lni/wac,elookup/AffidavitDetaiIs.aspx 10/20/2015 Page 2 of 3 Contract no. CAG 13 149 WO #43-15 Prime contractor Phone Number 360-754-5788 Prime contractor Intent form Id# for this project Dollar amount of your contract: $ 12,877.20 Bid due date 5/21/2015 Contract award date 5/28/2015 Intent filed date 4/9/2015 Job start date:MM-DD-YYYY 6/4/2015 Date work completed:MM-DD-YYYY 8/27/2015 Project Completion Did your subcontractors perform all No work on this project? Did your company hire any No subcontractors? Did your company have employees Yes perform work on this project? Did this project utilize American No Recovery and Reinvestment Act (ARRA) funds? Specifically, did this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Company Owner Information How many owner/operators performed 0 work on the project that own 30% or more of the company? No company owner added. Affidavit Subcontractor(s) No subcontractor is selected for this affidavit. Journeylevel Wages County Trade Occupation Wages Fringes # # Workers Hours https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/20/2015 Page 1 of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Project Detail - Project Dashboard Document Received Date: Intent ID: Affidavit ID: 602773 Status: Approved On 4/9/2015 718021 9/15/2015 Company Details Company Name: WHITWORTH PEST SOLUTIONS INC Address: 2533 INTER AVE PUYALLUP, WA, 98372 Contractor Registration No. WHITWPS944JE WA UBI Number 600494832 Phone Number 253-845-1818 Industrial Insurance Account ID 44007400 Email Address pwillis@whitworthpestsolutions.com Filed By Prime Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding Agency Contact Allen Quynn Awarding Agency Contact Phone Number 425-430-7247 Contract Number CAG 13 149 WO #43-15 Project Name 2015 Mosquito Abatement Program https://fortress.wa.gov/lni/wagelookup/IntentDetaiIs.aspx 10/20/2015 Page 2 of 3 Contract Amount $61,830.61 Bid due date 5/21 /2015 Award Date 5/28/2015 Project Site Address or Directions 1055 S. Grady Way Renton WA 98057 Payment Details Check Number: Transaction Id: 104719020 Intent Details Expected project start date: (MM-DD-YYYY) 6/4/2015 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is this $19,315.80 a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY No subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work Yes on this project? Do you intend to use any apprentices? Yes (Apprentices are considered employees.) How many owner/operators performing work on 0 the project own 30% or more of the company? Hiring Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Journey Level Wages https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 Page 3 of 3 County Trade Occupation Wage Fringe # Workers King Landscape Construction Landscape Equipment $28.17 $0.00 2 Operators Or Truck Drivers Public Notes -.Show/Hide Existing Notes -- On 9/1/2015:-- Filed by Patricia Willis -- On 9/11 /2015:-- We are subcontracted by Forma Construction to do mosquito abatement . The equipment used would be backpack sprayer mister used to fog landscape plants such as trees and shrubbery in the area to control mosquito activity. https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 Page I of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Affidavit of Wages Paid Project Detail - Project Dashboard Document 9/24/2015 Intent 710729 Affidavit 600232 Affidavit Approved Received Id Id Status on Date 10/1 /2015 Your Company Information Name Three Rivers Mosquito and Vector Control Address 214 N 1 st Ave Chiloquin,OR, WA UBI no. 603378113 Contractor Registration no. Industrial Insurance Account Id Email Address eshorvathCtrmvc.com Filed By Horvath,Edward Project Information Awarding agency: RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding agency contact: Allen Quynn Awarding agency contact phone 425-430-7247 number: Project Details Project name 2015 Mosquito Abatement Program County where work was performed King City where work was performed Renton Job site address/directions: 1055 S. Grady Way Renton WA 98057 Prime contractor name FORMA CONSTRUCTION COMPANY Prime contractor registration no. FORMACC878OR https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/20/2015 Page 2 of 3 Contract no. CAG 13 149 WO #43-15 Prime contractor Phone Number 360-754-5788 Prime contractor Intent form Id# for 697854 this project Dollar amount of your contract: $ 16,840.00 Bid due date 5/21 /2015 Contract award date 5/28/2015 Intent filed date 7/29/2015 Job start date:MM-DD-YYYY 7/1 /2015 Date work completed:MM-DD-YYYY 9/23/2015 Project Completion Did your subcontractors perform all No work on this project? Did your company hire any No subcontractors? Did your company have employees No perform work on this project? Did this project utilize American No Recovery and Reinvestment Act (ARRA) funds? Specifically, did this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Company Owner Information How many owner/operators performed 1 work on the project that own 30% or more of the company? First Name Last Name Edward Horvath Affidavit Subcontractor(s) No subcontractor is selected for this affidavit. Journeylevel Wages Apprentice Wages https://fortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/20/2015 Page 3 of 3 ,=,Show/Hide Existing, Notes No note exists https:Hfortress.wa.gov/lni/wagelookup/AffidavitDetails.aspx 10/20/2015 Page I of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Project Detail - Project Dashboard Document Received Date: Intent ID: Affidavit ID: 600232 Status: Approved On 7/29/2015 710729 7/31/2015 Company Details Company Name: Three Rivers Mosquito and Vector Control Address: 214 N 1 st Ave Chiloquin, OR, Contractor Registration No. WA UBI Number 603378113 Phone Number 541-238-2272 Industrial Insurance Account ID Email Address eshorvathCtrmvc.com Filed By Horvath, Edward Prime Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding Agency Contact Allen Quynn Awarding Agency Contact Phone Number 425-430-7247 Contract Number CAG 13 149 WO #43-15 Project Name 2015 Mosquito Abatement Program https://fortress.wa.gov/lni/wagelookup/IntentDetaiIs.aspx 10/20/2015 Page 2 of 3 Contract Amount $61,830.61 Bid due date 5/21 /2015 Award Date 5/28/2015 Project Site Address or Directions 1055 S. Grady Way Renton WA 98057 Payment Details Check Number: Transaction Id: 104863562 Intent Details Expected project start date: (MM-DD-YYYY) 7/1 /2015 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is this Time and materials a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY No subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work No on this project? Do you intend to use any apprentices? No (Apprentices are considered employees.) How many owner/operators performing work on 1 the project own 30% or more of the company? Hiring Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Journey Level Wages https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 Page 3 of 3 Public Notes Show/Hide Existing Notes No note exists https:Hfortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/20/2015 00city of PUBLIC WORKS DEPARTMENT D ���0� M E M O R A N D U M DATE: November 4, 2015 TO: Denis Law, Mayor,, FROM: Gregg Zimmerman; Administrator STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Allen Quynn, Surface Water Utility Engineer, x7247 SUBJECT: Certificate of Completion and Request for Release of Contract Retainage Form for Job Order Contract CAG-13-149, WO#43- 15, with Forma Construction for the 2015 Mosquito Abatement Program We are requesting your approval and signature on the attached Certification of Completion and Request for Release of Contract Retainage form for WO#43-15 to the Job Order Contract (JOC) CAG 13-149 with Forma Construction for the 2015 Mosquito Abatement Program The certification form was developed by the Finance Division as part of the project closeout procedures in the draft Policy & Procedure #250-02, Purchasing, Bidding, and Contracting Requirements. WO #43-15 was executed by the Mayor on May 28, 2015, in the amount of$61,830.61 for the purpose of applying adulticide in the areas upland and east of the Panther Creek Wetlands (Talbot Hill area) and larvicide to 70 City stormwater and irrigation facilities, and catch basins for the control of mosquitoes as part of the 2015 Mosquito Abatement Program. Due to the very hot and dry summer and the lack of complaints from citizens, the number of scheduled mosquito treatments was reduced resulting in a reduction in the awarded contract amount from $61,830.61 to $45,963.76 (Change Order#1-15). The contract included the following tasks: Task 1:Treatment of Upland Areas Adjacent to Panther Creek Wetlands: Application of an Environmental Protection Agency registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack-mounted, portable fogger. The applications were conducted at a maximum frequency of twice per week during the months of June through August. Denis Law, Mayor Page 2 of 2 November 4,2015 Task 2: Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins: Application of larvicide to stormwater facilities, irrigation facilities, and catch basins that are owned and maintained by the Surface Water Utility, the Community Services Department's Parks Division, the Facilities Division and the Maplewood Golf Course. The applications were conducted at a frequency of twice per month during the months of July through September. The project was funded through the approved 2015 Mosquito Abatement Program budget of $75,000 (#427.475020), the 2015 Golf Course Operating Fund (#404), the 2015 Parks Repairs and Maintenance Operating Fund (#001) and the Facilities 2015 Repairs and Maintenance Operating Fund (#504). There are sufficient funds in the approved 2015 Mosquito Abatement Program budget to fund the final pay estimate and staff costs. Forma has a retainage bond for JOC contract CAG-13-149. The bond will not be released until all work orders for the JOC contract are completed and after all the required releases from the state have been obtained. The staff recommends accepting the 2015 Mosquito Abatement Program Project by signing the attached Certification of Completion and Request for Release of Contract Retainage form. Please return the signed form to Allen Quynn, Surface Water Utility. He will submit the form and all required documentation to Finance for processing. Attachment cc: Lys Hornsby,Utility Systems Director H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Pay Estimate\Certification of Completion Mosquito 2015 Memo.doc\AQtp Certification of Completion and Request for Release of Contract Retainage CAG#: 13-149, WO#43-15 Forma Construction Project Title: 2015 Mosquito Abatement Program I hereby certify, as Project Manager representing the City of Renton, that: 1. All work required by the above cited contract was completed on September 21, 2015. 2. Acceptance by the City Council was granted on Not Required, < $150,000 If City Council acceptance is not required (contracts less than $150,000), see acceptance by Mayor or Department Head below. (Reference Renton Policy and Procedure 250-02.) 3. No liens have been received within 30 days of completion date from any persons, subcontractors, or material men, who have performed or provided any work or material on subject contract. 4. All Intents to Pay Prevailing Wages and all Affidavits of Wages Paid (including all subcontractors)have been verified and copies have been forwarded to Finance. 5. NOTE: CAG-13-149 is a JOC contract with multiple work orders. The bond will not be released until all work orders for the contract are completed, and after all the required releases from the State have been obtained. 7 Project Manager Da e Department JetV' l Ac eptance Da e(Small Work nder$35,000) (Single Craft/Trade Under$40,000) (Multiple Craft/Trade Under$65,000) Mayor Level Acceptance Date (Small Works Roster between$35,000 - $150,000) (Single Craft/Trade between $40,000 - $150,000) (Multiple Craft Trade between $65,000 - $150,000) H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Pay Estimate\2015-1013a CityCert-Completion-Release Retainage.doc\DCtp Certification of Completion co PY and Request for Release of Contract Retainage CAG#: 13-149 WO#43-15 Forma Construction Project Title: 2015 Mosquito Abatement Program I hereby certify, as Project Manager representing the City of Renton, that: 1. All work required by the above cited contract was completed on September 21, 2015. 2. Acceptance by the City Council was granted on Not Required, < $150,000 If City Council acceptance is not required (contracts less than $150,000), see acceptance by Mayor or Department Head below. (Reference Renton Policy and Procedure 250-02.) 3. No liens have been received within 30 days of completion date from any persons, subcontractors, or material men, who have performed or provided any work or material on subject contract. 4. All Intents to Pay Prevailing Wages and all Affidavits of Wages Paid (including all subcontractors) have been verified and copies have been forwarded to Finance. 5. NOTE: CAG-13-149 is a JOC contract with multiple work orders. The bond will not be released until all work orders for the contract are completed, and after all the required releases from the State have been obtained. /G l [ Project Manager Da e `> Departmentje;p/'.-Le el Acceptance Da e (Small Work I&oecer Under$35,000) (Single Craft/Trade Under$40,000) (Multi -le Craft/Trade Under$65,000) Mayor Level Acceptance Denis Law Date (Small Works Roster between $35,000 - $150,000) (Single Craft/Trade between $40,000 - $150,000) (Multiple Craft Trade between$65,000 - $150,000) H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Pay Estimate\2015-1013a CityCert-Completion-Release Retainage.doc\DCtp . r.• .. ......gJV01CB'aA'[@.. •.::. :..'INUOICEN(1..;;r, W 0#43-15 -149 9/24/2015 1 VENDOR'S CERTIFICATE.I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE ITEMS AND TOTALS LISTED HEREIN ARE PROPER CHARGES FOR MATERIALS,MERCHANDISE OR SERVICES .:':.: : ,::':':':':',':•:':': FURNISHED TO THE STATE OF WASHINGTON.AND THAT ALL GOODS FURNISHED OR SERVCES .'`......,...".".-.-'.•.'.•.......... ..............`. RENDERED HAVE BEEN PROVIDED WITHOUT DISCRIMINATION ON THE GROUNDS OF RACE, CREED,COLOR,NATIONAL ORIGIN,SEX,OR AGE;THAT PREVAILING WAGES HAVE BEEN PAID IN ACCORDANCE WITH THE PREFILED STATEMENT OR STATEMENTS OF INTENT ON FILE WITH THE DEPARTMENT OF LABOR AND INDUSTRIES AS APPROVED BY THE INDUSTRIAL STATISTICIAN; Utilities Department AND THATALL SUB CONTRACTORS AND IOR SUPPLIERS HAVE BEEN PAID LESS EARNED 1055 S.Grady Way Bth Floor RETAINAGE AS THEIR INTEREST APPEARED IN THE LAST PAYMENT RECEIVED. Renton,WA 98057 i PM In Charge: Allen Quynn i Forma Job# 14075-43 City of Renton Job# 43 Contract for. 2015 Mosquito Abatement Program L.00aoon: Renton,WA 98055 .................... 5>:VENRO)?:OR Ct:A1MAhJT: ................. FEDERAL TAX ID No.: 91-1 31 9904 Forma Construction Co. FAILURE TO PROVIDE THIS NUMBER WILL RESULT IN DELAY OF PAYMENT PO Box 11489 BY: Olympia, WA 98508 TITLE: Project Manager aJE3'E......N:.. ii:•:•:':•:•: ........... ....:•:•:•:::{::':::•::{'::•::>:':•:,:,: M UWT:,i:,i:::':i::FOR...ENC1":: :}:aJSE >' Total Earned to Date $41,976.04 Plus 9.5% Washington State Sales Tax $3,987.72 Gross Earned to Date $45,963.75 Less 0% Retained Retained Percentage on Total Amount Earned to Date $0.00 . Not Including Sales Tax Net Earned to Date $45,963.76 ............... Less Previously Invoiced $0.00 AMOUNT DUE THIS INVOICE $45,963.76 :, - � PREPARED Y TELEPHONE JAGENCY APPROVAL DATE J DOC.DATE PMT DUE DATE CURRENT DOC,NO. REF DOC No VENDOR NUMBER USE VENDOR MESSAGE UBI NUMBER WORK CO, REF TRANS O FUND APPEN FROG ':SL7§,":SUS'. ORO CLASS BURG TOWN ::PFftiJb t-:":SUB. 'PRbJ•;•.' AMOUNT INVOICE NUMBER ..... ....................... SUF CODE O INDEX INDEX OBJECT INDEX ALLOC UNIT MOS OJ ...................... .... '. i .•.•.'.•.. ... . APPROVED FOR PAYMENT BY CATS WARRANT TOTAL WARRANT NUMBER f i I STATE OF WASHINGTON APPLICATION AND CERTIFICATE FOR PAYMENT ON CONTRACT CERTIFICATE FOR PAYMENT. For period from: 7/3/2015 to 9/24/2015 contractfor: 2015 Mosquito Abatement Program Date: 9/24/2015 Location: Renton,WA 98055 certificate No.: 1 Contractor: Forma Construction Co. Contract No.: cAG-13-149wo#43-15 Original Contract Amount $41,976.04 Net change In Contract Amount to Date: $0.00 Adjusted Contract amount $41,976.04 vo. DEPAiL .' . :: :: : ::'::::'VAt UE, 'EARNt;R,: ... :CLA.tIuID . IfYQICE 1 General Conditions $6,230.02 $6,230.02 l00% $0.00 $6,230.02 2 Site Construction $50,236.29 $50,236.29 100% $0,00 $50,236.29 3 Concrete $0.00 $0.00 #DIV/o! $0.00 $0.00 4 Masonry $0.00 $0.00 #DII $0.00 $0.00 5 Metals $0.00 $0.00 #Div/0! $0.00 $0.00 6 Wood&Plastics $0.00 $0.00 #Dfv/0! $0.00 $0.00 7 Thermal&Moisture Protection $0.00 $0.00 #DfV101 $0.00 $0.00 8 Doors,Windows&Glass $0.00 $0.00 #DIV/01 $0.00 $0.00 9 Painting&Finishes $0.00 $0.00 #DIV/O! $0.00 $0.00 to Specialties $0.00 $0.00 #DIV/O! $0.00 $0.00 11 Equipment $0.00 $0.00 #DIV/O! $0.00 $0.00 12 Furnishings $0.00 $0.00 #DIV/O! $0.00 $0.00 13 Special Construction $0.00 $0.00 #DIV/01 $0.00 $0.00 14 Conveying Systems $0.00 $0.00 #DIV/O! $0.00 $0.00 15 Mechanical $0.00 $0.00 #DIV/O! $0.00 $0.00 16 Electrical $0.00 $0.00 #DIV/O! $0.00 $0.00 17 Non Priced Items $0.00 $0.00 #DIV/01 $0.00 $0.00 18 Changes #Div/0! 19 Change Order#1 ($14,490.27) ($14,490.27) t00% $0.00 ($14,490.27) $0.00 $0.00 #DIV/O! $0.00 $0.00 SUBTOTAL $41,976.04 $41,976.04 too°i $0.00 $41,976.04 TAX 9.50% SALES TAX $3,987.72 $3,987.72 $0.00 $3,987.72 TOTAL $45,963.76 $45,963.76 $0.00 $45,963.76 Less Retainage. 0% $0.00 $0.00 $0.00 NET $45,963.76 $0.00 $45,963.76 Less Previous Payments..... $0.00 Additional Tax 0.00% $0.00 $0.00 AMOUNT DUE THIS ESTIMATE $45,963.76 $45,963.76 This is to certify that the contractor,having compiled with the towma and conditions of the above Inentlnned oontreot,is due and payable From the State of waehington, the amount set after"AMOUNT DUE THIS ESTIMATE." Forma Construction Co. (Cantracting Firm) (Architect er Engineer) By B Slaty fN fNK 5lON AND DA7 E 1 REVISED WO#14075-43 Inv#1 FINAL.xIs i I Cost Breakdown Table Facilities(Task 2) Golf Course (Task 2) Parks Maintenance (task 2) Surface Water(Task 2) Surface Water(task 1) Total %of Total 0.00877 0.032986 0.058278 0.4739165 0.4260496 1 Subtotal: $465.00 $1,749.00 $3,090.00 $25,128.00 $22,590.00 $53,022.00 Index+Coeff $30.21 $113.62 $200.73 $1,632.31 $1,467.45 $3,444.31 Subtotal: $495.21 $1,862.62 $3,290.73 $26,760.31 $24,057.45 $56,466.31 Sales Tax $47.04 $176.95 $312.62 $2,542.23 $2,285.46 $5,364.30 Total: $542.25 $2,039.56 $3,603.35 $29,302.S4 $26,342.90 $61,830.61 Note 1 The "Subtotal" line is pulled from Forma table in the contract(second to last page) Note 3 The "Total" line factors in the Renton City cost index, Renton coefficient and state sales tax. CHG-ODR2015 CITY OF RENTON CAG-13-149, WO 43, CO #1-15 Public Works Department CONTRACT CHANGE ORDER AGREEMENT CONTRACT: CAG-13-149, WO #43-15, 2015 Mosquito Abatement Prgm, SWP-27-2013 ` C.O.# 1 CONTRACTOR: Forma Construction Company SUMMARY OF PROPOSED CHANGE: Credit of$15,866.85 for work not completed under this JOC. Total of change order: $14,490.27 Tax @9.5%: $1,376.58 Total: $15,866.85 ORIGINAL CONTRACT AMOUNT CURRENT CONTRACT AMOUNT ESTIMATED NET CHANGE ESTIMATED CONTRACT THIS ORDER TOTAL AFTER CHANGE $61,830.61 $61,830.61 ($15,866.85) $45,963.76 SIGNATURES: ` / f � ) C S Contractor: Date: « ✓ Project Engineer: Date: i Approved By: , Date: Lys HornsbyWility stems ire for Approved By: ✓ �/ Date: �(s Gregg Zim erman,PW A ini rator H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\Mosquito Abatement Deduct Change Order l.doc CHG-ODR2015 CITY OF RENTON CAG-13-149, WO 43, CO 41-15 Public Works Department CONTRACT CHANGE ORDER AGREEMENT CONTRACT: CAG-13-149, WO #43-15, 2015 Mosquito Abatement Prgm, SWP-27-2013 C.O.# 1 CONTRACTOR: Forma Construction Company SUMMARY OF PROPOSED CHANGE: Credit of$15,866.85 for work not completed under this JOC. Total of change order: $14,490.27 Tax @9.5%: $1,376.58 Total: $15,866.85 ORIGINAL CONTRACT AMOUNT CURRENT CONTRACT AMOUNT ESTIMATED NET CHANGE ESTIMATED CONTRACT THIS ORDER TOTAL AFTER CHANGE $61,830.61 $61,830.61 ($15,866.85) $45,963.76 SIGNATURES: Contractor: Date: (S Project Engineer: Date: i Approved By: Date: Lys Hornsby, ility stems ire for Approved By: Date: Io kl Ifj Gregg Zrniferman,PW A ini rator - H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\Mosquito Abatement Deduct Change Order 1.doc Section 2: Work Order Proposal Job Order Contract: CAG-13-149 Work Title: 2015 Mosquito Abatement Program Project Number: 63 Location: 1055 S.Grady Way,Renton WA Requesting Agency: Surface Water Utility Work Order No.: 43 Modification No.: 1 Date of Proposal: 9/25/2015 Completion Schedule: JOC Firm:IFORMA Construction Company Description of Work: Additional information can be found on the attached Work Order Plan Credit back to owner for ending season before all treatment completed per contract and crediting back treatments not completed. CSI Summary of Work Order Items Listed in Unit Price Book CSI CSI Division Description Bare Cost City Cost Contractor Division Total Total Index Coefficient Price 1 Task#1 Treatment of Upland Areas adjacent to Panther Creek Wetlands $22,590 1.024 1.040 24,057.45 2 Task#1 Credit -$4,922 1.024 1.040 -5,242.16 3 Task#2 Facilities Division $465 1.024 1.040 495.21 4 Facilities Division Credit -$38 1.024 1.040 -40A7 5 Task#2 Golf Course $1,749 1.024 1.040 1,862.62 6 Golf Course Credit -$298 1.024 1.040 -317.36 7 Task#2 Parks Maintenance $3,090 1.024 1.040 3.290.73 8 Parks Maintenance Credit -$3,090 1.024 1.040 -3,290.73 9 Task#2 Surface Water Utility $25,128 1.024 1,040 26,760.31 10 Surface Water Utility Credit -$5.258 1.024 1.040 -5,599.56 11 1 1.024 1.040 0.00 12 1.024 1.040 0.00 13 1,024 1.040 0.00 14 1.024 1.040 0.00 15 1.024 1.040 0.00 16 1.024 1 1.040 0.00 Total of all items listed is Price Book $ 41,976.04 Work Order Items Not Listed in Unit Price Book Materials Labor Item Work Item Description Include type of material, Unit Mat'I Unit Labor Item Price(Incl. No manufacture name,part number,type of work... Units Oty Price Labor Hours Price negot.Coeff.) 1 0 $ 0 $ $ 2 0 $ 0 $ $ 3 0 $ 0 $ $ 4 0 $ 0 $ $ Total of all items not listed in Price Book $ Total Work Order Amount $41,976.04 Washington State Sales Tax(9.5%City of Renton) $3,987.72 Total Funding Amount $45,963.76 Date: Notes: 1.This Work Order 2015 Mosquito Abatement Original Proposal Acual cost Credit Task#1 Treatment of Upland $ 24,057.45 $ 18,815.29 $ (5,242.16) Task#2 Facilities Division $ 495.21 $ 454.74 $ (40.47) Task#2 Golf Course $ 1,862.62 $ 1,545.26 $ (317.36) Task#2 Parks Maintenance $ 3,290.73 $ - $ (3,290.73) Task#2 Surface Water Utility $ 26,760.31 $ 21,160.75 $ (5,599.56) Total $ 56,466.32 $ 41,976.04 $ (14,490.28) Section 2: Work Ord Job Order Contract: CAG-13-149 Work Title: 2015 Mosquito Abatement Frogram Project Number: 63 Location: 1055 S.Grady Way,Renton WA Requesting Agency: Surface Water Utility Work Order No.: 43 Modification No.: 1 Date of Proposal: 9/24/2015 Completion Schedule: JOC Firm:IFORMA Construction Company Description of Work: Additional information can be found on the attached Work Order Plan Credit back to owner for ending season before all treatment completed per contract and crediting back treatments not completed. CSI Summary of Work Order Items Listed in Unit Price Book CSI CSI Division Description Bare Cost City Cost Contractor Division Total Total Index Coefficient Price 1 General Requirements -$936 1.024 1.040 -997.23 2 Site Construction -$12,670 1.024 1.040 -13,493.04 3 Concrete 1.024 1.040 0.00 4 Masonry 1.024 1.040 0.00 5 Metals 1.024 1.040 0.00 6 Wood and Plastics 1.024 1.040 0.00 7 Thermal and Moisture Protection 1.024 1.040 0.00 8 Op enin s 1.024 1.040 0.00 9 Finishes 1.024 1.040 0.00 10 Specialties 1.024 1.040 0.00 11 Equipment 1.024 1.040 0.00 12 Furnishings 1.024 1.040 0.00 13 Special Construction 1.024 1.040 0.00 14 Conveying Systems 1.024 1.040 0.00 15 Mechanical 1.024 1.040 0.00 16 Electrical 1.024 1.040 0.00 Total of all items listed is Price Book $ (14,490.27) Work Order Items Not Listed in Unit Price Book Materials Labor Item Work Item Description Include type of material, Unit Mat'I Unit Labor Item Price(Incl. No manufacture name,part number,type of work... Units QtY Price Labor Hours Price negot.Coeff.) 1 0 $ 0 $ $ 2 0 $ 0 $ $ 3 0 $ 0 $ $ - 4 0 $ 0 $ $ - Total of all items not listed in Price Book $ - Total Work Order Amount -$14,490.27 Washington State Sales Tax(9.5% City of Renton) -$1,376.58 Total Funding Amount -$15,866.85 Approval Signatures: Date: Notes: 1.This Work Order JOC ContractorVA 9/24/2015 Project Manager 1/7 5 �S� TO: FINANCE DIRECTOR FROM: PUBLIC WORKS ADMINISTRATOR 18/0001948 COPY CONTRACTOR: Forma Construction, Co. CONTRACT NO. CAG 13-149, WO #43-15 ESTIMATE NO. 1 PROJECT: Surface Water Utility 2015 Mosquito Abatement Contract 1. CONTRACTOR EARNINGS THIS ESTIMATE $39,746.02 2. SALES TAX @ 9.50% $3,775.87 3. TOTAL CONTRACT AMOUNT THIS ESTIMATE $43,521.89 4. EARNINGS PREVIOUSLY PAID CONTRACTOR $0.00 5. ' EARNINGS DUE CONTRACTOR THIS ESTIMATE $39,746.02 6. SUBTOTAL- CONTRACTOR PAYMENTS $39,746.02 7. RETAINAGE ON PREVIOUS EARNINGS N/A 8. "' RETAINAGE ON EARNINGS THIS ESTIMATE N/A 9. SUBTOTAL - RETAINAGE $0.00 10. SALES TAX PREVIOUSLY PAID Sales Tax Rule 170 Applies 11. SALES TAX DUE THIS ESTIMATE $3,775.87 12. SUBTOTAL - SALES TAX $3,775.87 (95%x LINE 1) (RETAINAGE: 5%) GRAND TOTAL: $43,521.89 FINANCE DEPARTMENT ACTION: CONTRACTOR Earnings (Lines 5): ACCOUNT # 427.475020.018.531.35.41.000 $37,746.02 # 0 # 001.000000.020.576.80.41.003 $0.00 # 404.000000.020.576.65.48.002 $1,545.26 # 504.000000.020.518.21.41.003 $454.74 $39,746.02 RETAINED AMOUNT (Line 8): ACCOUNT # Contract held by retainage bond N/A # Final Sales Tax (Line 11) # 427.475020.018.531.35.41.000 $3,585.87 # 0 # 001.000000.020.576.80.41.003 $0.00 # 404.000000.020.576.65.48.002 $146.80 # 504.000000.020.518.21.41.003 $43.20 $3,775.87 TOTAL THIS ESTIMATE: $43,521.89 CHARTER 116, LAWS OF 1965 141#//S CITY OF RENTON CERTIFICATION I,THE UNDERSIGNED DO HEREBY CERTIFY UNDER PENALTY OF /O'/ /5 PERJURY,THAT THE MATERIALS HAVE BEEN FURNISHED,THE SERVICES RENDERED OR THE LABOR PERFORMED AS DESCRIBED HEREIN,AND THAT THE CLAIM IS A JUST,DUE AND UNPAID OBLIGATION AGAINST THE CITY OF RENTON,AND THAT I AM AUTHORIZED TO AUTHENTICATE ANDT71RTIFY TO SAID CLAIM r Signed: Printed On: 10/19/2015 City of Renton Public Works Department Page 1 Printed On: 10/19/2015 City of Renton Public Works Department Page 1 Project: Surface Water Utility 2015 Mosquito Abatement Contract Contract Number: CAG 13-149,WO#43-15 Contractor:Forma Construction,Co. Pay Estimate 1 Closing Date: 09/25/15 Item Description Unit Est. Unit Previous Previous This This Total Total No. Quantity Price Quantity Amount Quantity Amount Quantity Amount ITEM DESCRIPT UNITS ESTQTY UPRICE PQTY PAMOUNT THISQTY TAMT TOTQTY TOTAMT 001. Surface Water LS 1 $50,817.76 0.0 $0.00 0.7427722 $37,746.02 0.74 $37,746.02 002. Parks LS 1 $3,290.73 0.0 $0.00 0.0 $0.00 0.00 $0.00 003. Golf Course LS 1 $1,862.62 0.0 $0.00 0.829616 $1,545.26 0.83 $1,545.26 004. Facilities LS 1 $495.21 0.0 $0.00 0.918277 $454.74 0.92 $454.74 Subtotal $0.00 $39,746.02 $39,746.02 Sales Tax Rule 170 Applies $0.00 $3,775.87 $3.775.87 TT Total $0.00 $43,521.89 $43,521.89 STATE OF WASHINGTON APPLICATION AND CERTIFICATE FOR PAYMENT ON CONTRACT CERTIFICATE FOR PAYMENT. For period from: 7/3/2015 to 9(24i2015 Contract for: 2015 Mosquito Abatement Program Date 10/16/2015 Location: Renton,WA 98055 Certificate No.. 1 Contractor. Forma Construction CO. Contract No.: CAG-13.149W0#43.15 Original Contract Amount: $41,976,04 Net change in Contract Amount to Date. $0.00 Adjusted Contract amount $41,976.04 ITIEV4 S HEDUL F VA MR L U % PREVIOUSLY THIS 6& . DETAIL VALUE EARNED CLAIMED INVOICE 1 General Conditions $6,230.02 $4,000.00 64% $0.00 $4,000.00 2 Site Construction $50,236.29 $50,236.29 t00% $0.00 $50,236.29 3 Concrete $0.00 $0.00 #DIVIO! $0.00 $0.00 4 Masonry $0.00 $0.00 #DIV/0! $0.00 $0.00 5 Metals $0.00 $0.00 #DIVrO! $0.00 $0.00 6 Wood& Plastics $0.00 $0.00 #DIVio! $0.00 $0.00 7 Thermal&Moisture Protection $0 00 $0.00 #DIV/O! $0.00 $0.00 a Doors,Windows&Glass $0.00 $0.00 #DIV/01 $0.00 $0.00 9 Painting&Finishes $0.00 $0.00 #DIVro! $0.00 $0.00 io $peciaities $0.00 $0.00 #DIV/O! $0.00 $0.00 11 Equipment $0.00 $0.00 #DIVIO! $0.00 $0.00 12 Furnishings $0.00 $0.00 #DIV10! $0.00 $0.00 13 Special Construction $0.00 $0.00 #DIV/O! $0.00 $0.00 14 Conveying Systems $0.00 $0,00 #DIV/O! $0.00 $0,00 15 Mechanical $0.00 $0.00 #DIVro! $0.00 $0.00 16 Electrical $0.00 $0.00 #DIV/o! $0.00 $0.00 17 Non Priced Items $0 00 $0.00 #DIV/01 $0.00 $0.00 18 Changes #DIV/0! 19 Change Order#1 ($14,490.27) ($14,490.27) 100% $0.00 ($14,490.27) $0.00 $0.00 #DEMO! $0.00 $0.00 }'r SUBTOTAL $41,976.04 $39,746.02 95% $0.00 $39,746.02 TAX 9.50% SALES TAX $3,987.72 $3,775.87 .}•;ti;ti:� $0.00 $3,775.87 TOTAL $45,963,76 $43,521.89 X. $0,00 $43.521.89 Less Retainage. 0% :' 'r' �' ' $0.00 '• 'f $0.00 $0.00 NET '$ ;.,rf:?:} $43,521&.89 .: $0.00 $43,521.89 Less Previous Payments.... f:':�t' r::: $0 :fray:`;': frf' Additional Tax 0.00% •.f.;;:•;AMOUNT DUE THIS ESTIMATE r• �: $43,521j�; ti' $43,521.89 Th-316 rertify that the ontfactor having comphed mth the terra and condNors or°w above memwned wntract is due and payable from the State of Wast-grc,,, / M amount set sfter'AMOUNT GUE THIS ESTIMATE' or a Construlation Co. (Conlracti Flrm) (Architect er Engineer) -By , SIG NK S-0 AND-IE REVISED WO# 14075-43 Inv#1.xis CONTRAGINa I I INVOICE DATE- .:MNOICE NO. -: AG 13 la 10/16/2015 1 —�t . �CC��� W0#43 15 VENDORS CERTIFICATE.I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE ITEMS AND - _ TOTALS LISTED HEREIN ARE PROPER CHARGES FOR MATERIALS,MERCHANDISE OR SERVICES AGENCY NAME - - FURNISHED TO THE STATE OF WASHINGTON,AND THAT ALL GOODS FURNISHED OR SERVICES RENDERED HAVE BEEN PROVIDED WITHOUT DISCRIMINATION ON THE GROUNDS OF RACE, CREED,COLOR,NATIONAL ORIGIN,SEX,OR AGE,THAT PREVAILING WAGES HAVE BEEN PAID IN ACCORDANCE WITH THE PREFILED STATEMENT OR STATEMENTS OF INTENT ON FILE WITH THE __ Utilities Department i DEPARTMENT OF LABOR AND INDUSTRIES AS APPROVED BY THE INDUSTRIAL STATISTICIAN, P AND THAT ALL SUB CONTRACTORS AND(OR SUPPLIERS HAVE BEEN PAID LESS EARNED 1055 S.Grady Way 6th Floor RETAINAGE AS THEIR INTEREST APPEARED IN THE LAST PAYMENT RECEIVED Renton,WA 98057 PM In Charge: Allen Qu nn Forma Job# 14075-43 City of Renton Job# 43 Contract for: 2015 Mosquito Abatement Program Location. Renton,WA 98055 VENDOWOR CLAIMANT y FEDERAL TAX ID NO.: 91-1 31 9904 Forma Construction CO. FAILURE TO PR IOE Rt7LJvh'-k��PO Box 11489 BY: � Olympia, WA 98508 TITLE: Project Manager DESCRIPTION AMOUNT FOR AGENCY USE Total Earned to Date $39,746.02 Plus 9.5% Washington State Sales Tax $3,775.87 Gross Earned to Date $43,521.89 L255 0% Retained Retained Percentage on Total Amount Earned to Date Not Including Sales Tax $0.00 Net Earned to Date $43,521.89 Less Previously Invoiced $0.00 AMOUNT DUE THIS INVOICE $43,521.89 PREPARED BY ITELEPHIONENUMBER DATEJAGENCYAPPROVAI DATE DOC.DATE PMT DUE DATE CURRENT DOC.NO, REF Doc NO VENDOR NUMBER USE VENDOR MESSAGE USI NUMBER M G SUO SUB ORG IN WORK CO. CITY/ REF TRANS O FUND APPEN FRO . CLASS BUDG TOWN PROJECT SUB: PROj AMOUNT INVOICE NUMBER SUF CODE D INDEX INDEX OKL OBJ C INDEX ALLOC UNIT MOB PROJ RHAS- APPROVED FOR PAYMENT BY DATE WARRANTTOTAL WARRANTNUMBER 2015 Mosquito Abatement Pay INV#1 Original Proposal Acual cost Credit Task#1 Treatment of Upland $ 24,057.45 S 18,815.29 $ (5,242.16) Paid for INV#1 task#1 $ 16,585.27 Task#2 Facilities Division $ 495.21 $ 454.74 $ (40.47) Task#2 Golf Course $ 1,862.62 $ 1,545.26 $ (317,36) Task#2 Parks Maintenance $ 3,290.73 $ - $ (3,290.73) Task#2 Surface Water Utility $ 26,760.31 $21,160.75 $ (5,599.56) Total $ 56,466.32 $ 41,976.04 $ (14,490.28) Pay INV#1 $ 39,746.02 City of Renton, Community,Service Department Purchasing & Contracting Services Division Revised 10/06/09 Public Works Prevailing Wage Certification Project: City of Renton JOC— 2015 Mosquito Abatement Project PW#: CAG-13-149 WO#43-15 Contractor Name: FORMA Construction Company I certify that the prevailing wages have been paid in accordance with the pre-filed Statement(s) of Intent to Pay Prevailing Wages on file with the Purchasing & Contracting Services Division of the Department of Finance and Administrative Services. This statement covers the following period: 07/03/2015 to 09/24/2015 month/day/year month/day/year The following subcontractors performed work on this project during this payment period: Subcontractor Name UBI# Statement of Intent Submitted to PCSD? Three Rivers Mosquito and Vector Control 603378113 X YES NO Whitworth Pest Solutions Inc 600494832 X YES NO YES El NO YES El NO YES El NO - ----- --- YES _O_NO YES E3 NO El YES 171 NO El YES El NO YES NO YES ❑ NO ❑YES El NO YES El NO This document shall be signed by an authorized repres ntative of the Contractor prior to payment pursuant to RCW 39.12.040. ' Form o s niction Company Contr r r�Nvy;�__ - Sign tur ate This Certification must be attached to each Progress Estimate along with any outstanding Statements of Intent to Pay Prevailing Wages. The City will not approve payments if this Certification or any Statements of Intent to Pay Prevailing Wages are outstanding. Page ] of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Project Detail - Project Dashboard Document Received Date: Intent ID: Affidavit ID: Status: Approved On 4/9/2015 718021 9/15/2015 Company Details Company Name: WHITWORTH PEST SOLUTIONS INC Address: 2533 INTER AVE PUYALLUP, WA, 98372 Contractor Registration No. WHITWPS944JE WA UBI Number 600494832 Phone Number 253-845-1818 Industrial Insurance Account ID 44007400 Email Address pwillis@whitworthpestsolutions.com Filed By Prime Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding Agency Contact Allen Quynn Awarding Agency Contact Phone Number 425-430-7247 Contract Number CAG 13 149 WO #43-15 Project Name 2015 Mosquito Abatement Program https://fortress.\,va.gov/lni/wagelookup/IntentDetails.aspx 10/16/2015 Page 2 of 3 Contract Amount $61,830.61 Bid due date 5/21/2015 Award Date 5/28/2015 Project Site Address or Directions 1055 S. Grady Way Renton WA 98057 Payment Details Check Number: Transaction Id: 104719020 Intent Details Expected project start date: (MM-DD-YYYY) 6/4/2015 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is this $19,315.80 a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY No subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work Yes on this project? Do you intend to use any apprentices? Yes (Apprentices are considered employees.) How many owner/operators performing work on 0 the project own 30% or more of the company? Hiring Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Journey Level Wages https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/16/201 5 Page 3 of 3 County Trade Occupation Wage Fringe # Workers King Landscape Construction Landscape Equipment $28.17 $0.00 2 Operators Or Truck Drivers Public Notes Show/Hide Existing Notes - On 9/1/2015:-- Filed by Patricia Willis -- On 9/11/2015:-- We are subcontracted by Forma Construction to do mosquito abatement . The equipment used would be backpack sprayer mister used to fog landscape plants such as trees and shrubbery in the area to control mosquito activity. https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/16/2015 Page I o f'3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Project Detail - Project Dashboard Document Received Date: Intent ID: Affidavit ID: 600232 Status: Approved On 7/29/2015 710729 7/31/2015 Company Details Company Name: Three Rivers Mosquito and Vector Control Address: 214 N 1 st Ave Chiloquin, OR, Contractor Registration No. WA UBI Number 603378113 Phone Number 541-238-2272 Industrial Insurance Account ID Email Address eshorvath@trmvc.com Filed By Horvath, Edward Prime Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 Phone Number 360-754-5788 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding Agency Contact Allen Quynn Awarding Agency Contact Phone Number 425-430-7247 Contract Number CAG 13 149 WO #43-15 Project Name 2015 Mosquito Abatement Program https:Hfortress.wa.gov/Ini/wagelookup/IntentDotails.aspx 10/16/2015 Page 2 of 3 Contract Amount $61,830.61 Bid due date 5/21/2015 Award Date 5/28/2015 Project Site Address or Directions 1055 S. Grady Way Renton WA 98057 Payment Details Check Number: Transaction Id: 104863562 Intent Details Expected project start date: (MM-DD-YYYY) 7/1 /2015 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is this Time and materials a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? Specifically, wilt this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY No subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work No on this project? Do you intend to use any apprentices? No (Apprentices are considered employees.) How many owner/operators performing work on 1 the project own 30% or more of the company? Hiring Contractor Company Name FORMA CONSTRUCTION COMPANY Contractor Registration No. FORMACC878OR WA UBI Number 600604496 ,Journey Level Wages https://fortress.wa.gov/lni/`wagelookup/IntentDetalls.aspx 10/16/2015 Page 3 of 3 Public motes eShow/Hide Existing Notes No note exists https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 10/16/2015 Public Works Department _ City o Y w �° ern .FANCY BOWES °� 46° 1055 South Grady Way 00 0 2 1M WIr 0004285528 APP..24 2015 Renton WA 98057-3232 ati MAILED FROM ZIPCODE 980 32 \ 8860500220 U" RESIDENT 2133 DAVIS AVE S RENTON,Wi 9.80 DE 1036 aiwe5,,`2.€15 I RETURN TO SENDER NOT DELIVERABLE AS ADDRESSED w UNABLE TO FORWARD BC: 98057323Z55 * 0526-07339- 26-19 ��:,� ;.-�►•�r•�fa+��t�� '��'� I'i�11�1'�III�'iIIIlj��ll�il��lp��;Il�lili�l����ll�ila��li,l����i Denis Law City Of Mayor O� Y O) T'&:R Public Works Department-Gregg Zimmerman,P.E.,Administrator 2015 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex (Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 391h Street on the south to 1-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray (Exhibit C). A portable fogger (gasoline-powered backpack-mounted) will be used to apply the spray to upland vegetation. During May through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit B) form, to allow the applicator access through your property, if needed, to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided by May 8, 2015. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you would like information on precautions you may take to help repel mosquitoes, please see Exhibit C. If you have any questions, or would like more information about the Mosquito Abatement Program, please contact Allen Quynn, Surface Water Utility Engineer, at 425-430-7247, or by email at aguynn@rentonwa.gov. Enclosures \\RvFPS-02\Depts\PW\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progmm\2015 Program\Release Request\2015 Release Request.doc Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov 6� cn m _ 4 5�405 Ra p y -r-S 1-5- I th St FT7 � ids N _ c}— O i \ I TT� , f - sw`zfi I �� I — CD S 27t �N\ LLI 7 Q to o - -- S r Mosquito Abatement Program N Exhibit A: Site Plan 0 500 1,000 W E I I I I I Note: Treatment will not be applied within 100' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge O Project Boundary can o� and the residential areas. Property owner approval required prior to �� treatment on private property. Surface Water Utility I G.Del Rosario I Printed 03/31/2010 Denis Law City Of Mayor - + � Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 8860500220 Resident 2133 DAVIS AVE S RENTON,WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov EXHIBIT C Insecticide Products: As in previous years, we will be using products containing the insecticide permethrin. See below for more information. Permanone'31-66: Permanone® 31-66 is sold under the trade names of BioMist®and Kontrol®4- 4. They contain a synthetic version of permethrin as an active ingredient. The insecticides are formulated for dilution with oil products, such as mineral oil, and are applied at a rate between 0.0035 and 0.0070 pounds of permethrin per acre. Permanone' 31-66 is degraded in soil and may last for several days. BioMist®and Kontrol®4-4 are not applied within 100-feet from water or wetland areas. Repel Mosquitoes: Not all mosquitoes will be eliminated during our Mosquito Abatement Program. Some precautions you may take to further reduce the number of mosquitoes in your area include: Mosquito Breeding Places: Some mosquitoes may breed in stagnant water. If you eliminate standing water around your home, you may eliminate their breeding places. Stagnant water may be found in ornamental pools, birdbaths, old tires, and flower pots. Methods to eliminate these and other potential breeding sites are listed in the Extension Bulletin PLS-121 April 2007 by the Washington State University Cooperative Extension titled "Pest Management for Prevention and Control of Mosquitoes". Natural Predators: By encouraging natural predators that feed on mosquitoes, you may also reduce the number of mosquitoes in your area. Natural predators include bats, swallows, frogs, and fish. In order to stock mosquito fish and three-spine stickleback fish, a permit is required from the Washington State Department of Fish and Wildlife. However,you may attract other natural predator animals by enhancing habitat and constructing cavity type houses. More information on attracting natural predators, such as instructions for constructing and locating bat houses, may be obtained from the State Department of Fish and Wildlife. Mosquito Repellent: By using mosquito repellent, netting, and screens you may reduce your exposure to mosquitoes. Additional precautions include: ♦ Wear clothes that reduce the area of exposed skin; ♦ Install screens or netting over open patios or windows; and/or ♦ Apply repellents, especially those containing the ingredient diethyltoluamide (DEET), to exposed skin. Since young children and certain adults can be sensitive to DEET, please follow application instructions carefully. Note: While bug lights eliminate some mosquitoes, they are not highly recommended, since studies show they also eliminate a large amount of beneficial and non-pest insects. Furthermore, Aedes,the most aggressive of the mosquito species,found in the Talbot Hill area, are not attracted to light and the noise emitted by the bug lights may annoy some neighbors. \\RvFPS-02\Depts\PW\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Description Exhibit C.doc/AQ/ad NO POSTAGE D � 'ty of�0 \` NECESSARY IF MAILED N THE UNITED STATES BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO.646 RENTON WA POSTAGE WILL BE PAID BY ADDRESSEE IIII���III�II�II�I�I���II���II�II��I�IIII��'I'I��I��II�I��II�I�I� CITY OF RENTON 1055 S GRADY WAY RENTON WA 98057-9808 Utility Systems Division Attn: Allen Quynn CAG-13-149, WO #43-15 CITY OF RENTON JOB ORDER CONTRACTING proposal No 63 rev.No 2 201.5 Mosquito Abatement Program date: 5'13'l5 contractor contact: Lon Wearer phone: 360,280 6650 —` email lom%:Pt fonnacc com — CO`;-� Work Order Form Scope of Work Line Item Cost Estimate a�la a RF] 11 FORMA FORMA CONSTRUCTION COMPANY SEATTLE WA 206.626.0256 t 0/4 lst hvv SatoN *q00 Sections Job Order Contract: CAG-13-149 Work Title: 2015 Mosquito Abatement Program Project Number: 63 Location: 1055 S.Grady Way,Renton WA Requesting Agency: Surface Water Utility Work Order No.: Modification No.: Date of Proposal: 5/13/2014 Completion Schedule: JOC Firm: FORMA Construction Company Description of Work: Additional information can be found on the attached Work Order Plan Provide treatment of upland areas adjacent to panther Creek wetlands and treatment of city storm water and irrigation facilities and catch basins. CSI Summary of Work Order Items Listed in Unit Price Book CSI CSI Division Description Bare Cost City Cost Contractor Division Total Total Index Coefficient Price 1 General Requirements $5,850 1.024 1.040 6,230.02 2 Site Construction $47,172 1.024 1.040 50,236.29 3 Concrete 1.024 1.040 0.00 4 Masonry 1.024 1.040 0.00 5 Metals 1.024 1.040 0.00 6 Wood and Plastics 1.024 1.040 0.00 7 Thermal and Moisture Protection 1.024 1.040 0.00 8 O enin s 1.024 1.040 0.00 9 Finishes 1.024 1.040 0.00 10 Specialties 1.024 1.040 0.00 11 Equipment 1.024 1.040 0.00 12 Furnishings 1.024 1.040 0.00 13 Special Construction 1.024 1.040 0.00 14 Conveying Systems 1.024 1.040 0.00 15 Mechanical 1.024 1.040 0.00 16 Electrical 1.024 1.040 0.00 Total of all items listed is Price Book $ 56,466.31 Work Order Items Not Listed in Unit Price Book Materials Labor Item Work Item Description Include type of material, Unit Mat') Unit Labor Item Price(Incl. No manufacture name,part number,type of work... Units OtY Price Labor Hours Price negot.Coeff.) 1 0 $ - 0 $ $ 2 0 $ 0 $ $ 3 0 $ 0 $ $ 4 0 $ 0 $ $ Total of all items not listed in Price Book $ - Total Work Order Amount $56,466.31 Washington State Sales Tax(9.5% City of Renton) $5,364.30 Total Funding Amount $61,830.61 Approval Signatures: ;;; Date: Notes: 1.This Work Order JOC Contractor E Project Manager 1 ''`� �<:• Denis Law, Mayor Attest: Jason Seth, City Clerk / CITY OF RENTON JOB ORDER CONTRACTING WORK ORDER PROPOSAL - SCOPE OF WORK DETAIL PROJECT: 2015 Mosquito Abatement Program Location: 1055 S Grady Way May 8,2015 Renton,WA 98057 Estimated duration: • Starting May ending in September Description:Provide treatment of upland areas adjacent to panther Creek wetlands and treatment of city storm water and irrigation facilities and catch basins. General information • The performance of all work will be in accordance with OSHA and WISHA safety requirements.Work in accordance with applicable construction and buildings codes. • The project start date will depend on award notice to proceed • This is a prevailing wage project. EXHIBIT A SCOPE OF WORK 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLAND AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted,portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance- Mitigated (Application Number LUA05-022, ECF)for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton,Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which FORMA CONSTRUCTION COMPANY !736 47H AVE SOUTH STE B SEAT T LE WA 206 626 0256 WORK ORDER PROPOSAL-SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING authorization and release for access and treatment has been granted by the property owner or the owner's legal representative.The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included.The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO.2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label,the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES)Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Amberwood/WQ Pond 315 Quincy Ave NE Utility 2 Surface Water Amberwood II/WQ Pond 304 Rosario PI NE Utility 3 Surface Water Aspenwoods/WQ Pond 808 Ilwaco PI NE Utility 4 Surface Water Aster Park Plat/WQ Pond 5516 NE 13th St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE.B SEATTLE WA 206.626.0256 WORK ORDER PROPOSAL SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING 5 Surface Water Auria Woods Tract C/WQ Pond 12152 SE 186th St Utility 6 Surface Water Beclan Place Plat/WQ Pond 5134 NE 2nd St Utility 7 Surface Water Brookefield II/WQ Pond 5305 NE 11th Ct Utility 8 Surface Water Chinquapin Ridge/WQ Pond 19123 113th Way SE Utility 9 Surface Water Christian Short Plat/WQ Pond 11129 SE 189th PI Utility 10 Surface Water Cottages at Honey Creek/WQ Pond NE Sunset Blvd/ Elma PI NE Utility 11 Surface Water Elliott Farm/Detention Pond Maple Valley Hwy/ 140th Way Utility SE 12 Surface Water Ellis Park aka Edenwood/WQ Pond 602 NE 6th St Utility 13 Surface Water Elmhurst/WQ Pond 215 Whitman PI NE Utility 14 Surface Water Emma's Plat/WQ Pond 5611 SE 1st PI Utility 15 Surface Water Evendell Plat/WQ Pond 6741 SE 4th St Utility 16 Surface Water Fredricks Place/WQ Pond 10301 SE 186th St Utility 17 Surface Water Greenfield II aka Highpointe II/WQ Pond 1318 Redmond PI NE Utility 18 Surface Water Hamilton Place Plat/WQ Pond 6743 NE 1st PI Utility 19 Surface Water Heritage Renton Hill/WQ Pond 1816 SE 8th PI Utility 20 Surface Water Highland Estates/WQ Pond 355 Rosario PI SE Utility 21 Surface Water Highlands Park/WQ Pond 202 Rosario Ave SE Utility 22 Surface Water Jericho Estates/WQ Pond 316 Hoquiam Ave NE Utility 23 Surface Water Kimberly Lane/WQ Pond 17228 125th Ave SE Utility 24 Surface Water Larson Parke Plat/WQ Pond 18469 114th Ave SE Utility 25 Surface Water Laurelhurst Phase I/WQ Pond 4615 NE 1st St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE.B SEATTLE WA 206 626 0256 WORK ORDER PROPOSAL-SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING 26 Surface Water Liberty Grove and Liberty Grove 13716 160th Ave SE Utility Contiguous/WQ Pond 27 Surface Water Liberty Ridge Phase I/WQ Pond 2511 NE 1st St(behind Utility residence) 28 Surface Water Liberty Ridge Phase I/WQ Pond 205 Index PI SE Utility 29 Surface Water Liberty Ridge Phase II/WQ Pond 2601 Ferndale Ave NE Utility 30 Surface Water Magnussen Plat/WQ Pond 202 Field Ave NE Utility 31 Surface Water Magnussen Plat/WQ Pond 4814 NE 2nd St(behind Utility residence) 32 Surface Water Maple Glen Addition/WQ Pond SE 182nd St/ 108th Ave SE Utility 33 Surface Water Maureen Highlands Tract A/WQ Pond 6118 NE 4th St Utility 34 Surface Water Morning Glen/WQ Pond 17612 114th PI SE Utility 35 Surface Water NE 10th St Pond/WQ Pond NE 10th/Anacortes Ave NE Utility 36 Surface Water NE 4th Detention/WQ Pond 234 Field Ave NE Utility 37 Surface Water Nichols Place/WQ Pond 13815 160th Ave SE Utility 38 Surface Water Olympic Peak Estates/WQ Pond 9402 S 196th PI Utility 39 Surface Water Parkside Court/WQ Pond 5621 SE 2nd St utility 40 Surface Water Pioneer Place/WQ Pond Maple Valley Rd/ 149th Ave SE Utility 41 Surface Water Serenity Ridge Tract A/WQ Pond 17927 110th PI SE Utility 42 Surface Water Serenity Ridge Tract B/WQ Pond 17707 110th PL SE Utility 43 Surface Water Shamrock Glen aka Martin Prop/WQ Pond 5507 NE 5th Cir Utility 44 Surface Water Shy Creek/WQ Pond 204 SE 2nd St Utility 45 Surface Water Sienna/WQ Pond 5402 NE 2nd St Utility 46 Surface Water Stonegate/WQ Pond 5500 NE 26th St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE B SEATTLE WA 206.626,0256 WORK ORDER PROPOSAL-SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING 47 Surface Water Sunnybrook/WQ Pond 712 S 36th PI Utility 48 Surface Water Talbot Estates/WQ Pond 9612 S 194th St Utility 49 Surface Water The Reserve at Stonehaven/WQ Pond 1003 S 47th St Utility 50 Surface Water Watershed Terrace/WQ Pond 19926 101st Ave SE Utility 51 Surface Water Wilkins Wood/WQ Pond 16603 113th Ave SE Utility 52 Surface Water Windsong/WQ Pond 4925 NE 4th PI Utility 53 Surface Water Windsor Circle aka Harmony Gro/WQ 13502 162nd Ave SE Utility Pond 54 Surface Water Winsper(Liberty View 1&II)/WQ Pond 611 S 32nd St Utility 55 Surface Water Zetterberg/WQ Pond 2100 Burnett P1 S Utility 56 Surface Water Honey Brooke West aka Sagecrest/WQ 505 Field PI NE Utility Pond 57 Surface Water Honey Creek Ridge Tract A/Detention 3203 NE 26th Ct Utility Pond with Bioswale 58 Surface Water Honey Creek Ridge Tract B/Detention 2407 Olympia Ave NE Utility Pond with Bioswale 59 Surface Water Langley Ridge at May Creek/WQ Pond 5302 NE 26th St Utility 60 Surface Water Maplewood Estates/Detention Pond with 5831 SE 2nd Ct Utility Bioswale 61 Surface Water Maureen Highlands Tract C/WQ Pond 653 Shadow Ave NE Utility 62 Surface Water River Ridge/Detention Pond with 1706 SE 7th Ct Utility Bioswale 63 Surface Water Summerwind/Detention Pond NE Sunset Blvd/ Field Ave NE Utility 64 Surface Water Victoria Hills/Detention Pond 1012 S 23rd St Utility 65 Surface Water Westmont/WQ Pond 3625 Monterey Ct NE Utility A Surface Water Catchbasins Various Utility 9-0—T Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) FORMA CONSTRUCTION COMPANY 1736 4Th AVE SOUTH STE.B SEATTLE WA 2066260256 WORK ORDER PROPOSAL.-SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING 91 Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course (west-central) 92 Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) 93 Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course(east) 98 Golf Course Maplewood Golf Course Catchbasins Various B Parks Maintenance Catchbasins Various Division 99 Facilities Division Renton City Hall/Water Quality Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment,the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date,time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. S. Name and address of person applying larvicide. 6. Larval count(larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course—The contractor shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course.Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property(this is a mandatory safety requirement). FORMA CONSTRUCTION COMPANY 17364TH AVE SOUTH STE.B SEATTLE WA 20,3626,0256 WORK ORDER PROPOSAL•SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING EXHIBIT B TIME OF COMPLETION 2015 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2015. EXHIBIT C COST ESTIMATE 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The maximum treatments shall not exceed 21 and shall include all necessary work to clear of the trails. Cost shall be based on a unit price per treatment. The billing rates include state sales tax. TASK NO. 2: Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 1. Material costs for larvicide. 2. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under"Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE B SEAT TLE WA 206626.0256 Allen Qu nn 2015 Mosquito Abatement Control FORMA CONSTRUCTION IMKdM4 Ibn tlaavri La.x 14a EgaP Gan4 coo. arecar O.oawr r4as a,msn usl seat TnW inC. ra.r TMak 02 Fav_vitwa Dnrnon 0154334D 7 t00B Rm1t ruck 3(4lan 2,heel dme-Ra,R day _ --- 20 da s ---� 117.00 1 t M 111613 0300 Chmnical termde Mgrvf,mlr�nnum IatgtiequgAnaM elrargr Mveq W0 trva0nrm of 2 lr"M.Ns pm.x fh 1 20 .bb 195.00 I 185.00 baq.,*q MMY b Saplamtror 20t5 at sam t-g6 � ... A and R 31Jf 1Bi3 + .ttaai,Ghrm W l—iw mnbvf,evil p i—ln}(WeriYzWiw) Mmqu trvalmmN d 2 r lmaxs par mon-0th 300.0 SF 21 0 t32.00 i 153.00 `C b.9m g May.Sa .O.2015 id aam 10 A Arv]B 11 , Teak 02 Gglf Culaaa _ 01543340 7 W R R,»t I..k ecL. 314 ker 2 whvW drive-Rmf avr da-- -� 501 da s 1 1 2112.50 f -292.50 3131 W 3 0300 Cham-A lamile ranrv(,minimum labmlequWwA charge kbsquk0 rmtnanl d 2 raatmergs par m nth S.0 J6b 487.50 48 50 begw—v May b Sapl--2015 al 54m 1-gg _ AaeMR _ 131J1 i61} 3000 Chamcai MrmOe wn7rd,sdl p0is0nwp(sterilvatpn) Maquilo rmtmenf 2 umlmertla par month i. A 7 3.0D RUM Do DO begkmiq May b SetBemba 2Ut5 at aam/-Bg � II _.. .t..._..._........_............_....._.._._----- Lw.e.rn.,..-.Lw,� rau ar n1.v.1 .n•al Task 02 Parka Mmnlaname 01543349 71006 R ,t truck . 314 tun 2 whorl dove_-RaM iret day 10 0 de 565 0tl 585.00 31311613 0J90 Ch...I tvmkle c_W,minimum laba/aquipnruM ctwlge ---- MOaquft trmti l d 2 rmtmvrrts per m0nd1 1010 Job 675.00 begkwk"May to Seplmnber 2015 al s4m t-g9 _3 A IApaqM-q 131}a i613 090 Chamw]l lennke cpnuoi,wit porwnmg latvnfizatgn) uv trestmentd?veatmer4s pet mondl 3,900 SF 2t 00 1,320(f0 —--------t,5J000 .-�_—_----_ be0rnrorr0 May b Sttpfembar 2015 al artm t-W A end B -- ra it ..re M,r Aauw%d. 1,IA�IkI r'Lm a� f.RI r Taak 92 Serf...WYarur Utrmy 01543340 1 71008 Rent Irudt -rp tarp 7/4 bn 2 wheel bNe-RwK m da i 63.0 da 3,685.501 3y gas.S0 3/3 i 1813 039g Chan-1 tannita &4-qudo I,eM.M of 2 trmlmanla per manor 63.0 Job (1,142.50 6 142.50 baginnklg My Iv Saplembw 20t5 of s4m 1.09 A erd R 31317613 3000 Chemical lartnkr epnrd,sail pasannlg(slerikZatirn) Mosquito trealmmlt d Taut par month 30,g70 U SF 2,t00 t10 TJ,200.00, 1$.300. beginnklg May toSeMemb.,2015 al skew 1-99 A aMB —"1I .377 � Taakm M at Tma4raoru nYt 4d.lWa u1la2a.w—nhl.t e paalv ders art Ra•vnmt to Pmltlwr Cwvk '.,d r.tiul.rn.4','.V,s ltlY.i.i:l u: 0 pa +a 9xp; :,Mao 170.... 1.1?000 000/84]J40 ! nrv, a porv•(afecarn 2t,420001161] a ' b nA1g Mey b M—bar 20t5 I I,o.. re .yrA 'ta.a �1Nm 1 E`( I 5/15/2015 1of2 Allen Quynn 2015 Mosquito Abatement Control FORMA CONSTRUCTION CSI Division Labor Mat Subs Equip Other User Total 01 General Re uirements 5,850 5,850 02 Site Construction 13,204 33,968 _ _ 47,172 Renton Cit Cost Index Subtotal 54,295 Renton Coefficient +1.04 2,172 . . ... ... ... . _..._...... . _ . Total Estimate 56,466 5/15/2015 2of2 Cost Breakdown Table Facilities (Task 2) Golf Course (Task 2) Parks Maintenance(task 2) Surface Water(Task 2) Surface Water(task 1) Total Subtotal: $465.00 $1,749.00 $3,090.00 $25,128.00 $22,590.00 $53,022.00 %of total: 0.00877 0.032986 0.058278 0.4739165 0.4260496 1 Total: $542.25 $2,039.56 $3,603.35 $29,302.55 $26,342.90 $61,830.61 Note 1 The"Subtotal" line is pulled from Forma table in the contract (second to last page) Note 2 "%of total" is the individual division/section cost as a perentage of the base subtotal ($53,022)shown in the Forma table(second to last page) Note 3 The "Total" line factors in the Renton City cost index, Renton coefficient and state sales tax. Page 1 / 1 t*lco"' CITY OF RENTON 1055 S. GRADY WAY DATE PoNUMBERRENTON, WA 98057 06/05/2015 18/000194R VENDOR: 009439 SHIP TO: FORMA CONSTRUCTION / BERSCHUER-PHILLIPS PO BOX 11489 OLYMPIA, WA 98508-1489 FOB Point: Req.No.: Terms: net term Dept.: Req.Del.Date: Contact: DRUCE, AMBER Pre-Assigned PO#?: NO Special Inst: Quantity Unit Descri tiort". . .,, . ,...> Un CAG-13 149, WO#43-15, 2015 Mosquito 55 645.45 Abatement Program-Surface Water,Exp„ " 12/31/2015 CAG-13-149, WO#43-15, 2015 Mosquito, � �.»• �� k ' FM : .,.. � Abatement Program- Parks, Exp 12/31/2015 0 CAG-13-149, WO#43-15, 2015 Mosquito 2,039.56 Abatement Program-Golf, Exp 12/31/2015 _ ""numov��. .o,p .. CAG-13-149, WO#43-15, 2015 Mosquito 542.25 Abatement Program-Facilities, Exp no,_ �» 12/31/2015 nrF ,. .. - Sw v „u,11 w s, qgi owmM -'�v r.. .v..,. 104 .a «"' » 0 r' If SUBTOTAL 61830.61 BILL TO: TAX 0.00 FREIGHT 0.00 TOTAL 61,830.61 Account Number , M '> aunt, w� E 001.000000.020.576.80.41.003 c V 3,603.35 E 404.000000.020.576.65.48.002 Coti 2,039.56 E 427.475020.018.531.35.41.000 u65020.f020.0000.0000 55,645.45 E 504,000000.020.518.21.41.003 542.25 Authorized Signature Authorized Signature STATE OF WASHINGTON KING O COUNTY F U AFFIDAVIT OF PUBLICATION PUBLIC NOTICE E I V E D Linda M Mills, being first duly sworn on oath that she is the Legal Public Notice AdvertisingRepresentative of the The City of Renton Apply p Mosquito Control Pesticides The City of Renton may use 1 1 2015 mosquito larvicides made of a natural bacterium (Bacillus y C R E NTO N Renton Reporter sphaericus) and adulticides P (BIOMISTO and/or Kontrol 4-40) to help control mosquitoes Y SYSTEM in accordance with the Washing- ton State Department of Ecolo- a weekly newspaper, which newspaper is a legal newspaper of gy's Aquatic Mosquito Control general circulation and is now and has been for more than six months General Permit. Treatments may rior to the date of publication hereinafter referred to, published in occur between June 1 and treatment Octo- p P P ber 31, 2015. Larvicide treatment the English language continuously as a weekly newspaper in King will generally occur in stormwa- County, Washington. The Renton Reporter has been approved as ter facilities owned or maintained by the City. Adulticide treatment a Legal Newspaper by order of the Superior Court of the State of areas are generally located in Washington for King County. upland areas east of SR-167 and west of Lake Avenue South/ The notice in the exact form annexed was published in regular issues Talbot Road South between SW of the Renton Reporter (and not in supplement form) which was 39th Street to the south and I-405 regularly distributed to its subscribers during the below stated period. to the north, within the City of Renton, Washington. Informa- The annexed notice, a: tion about the larvicides, adulti- Public Notice cides and a map of the specific locations are available at www. rentonwa.gov. For more information about the City's commitment to help was published on May 29, 2015. i� reduce the threat of West Nile "�? �►dy ��+; virus and control mosquitoes, please contact Allen Quynn, City ,, �P g �-►ifµ," �� of Renton Surface Water Utility The full amount of the fee charged for said foregoing publication is �' o1A�y %' Engineer, at 425-430-7247 or by the sum of$101.50. p _ tir email at aquynn@jentonwa.gov. U — For additional information about Ecology's Aquatic Mosquito ��✓� 'Q(�Et`� _w= Control General Permit, please �1��,.- ✓✓✓N}�4�i 4- Ly: � r contact the City of Renton or Jon Jennings, Water inda Mills ��ti��C'U ,�\\\\C,\., ` Program, Washington Quality Sta e Legal Advertising Representative, Renton Reporter '��t �� Department of Ecology, at g g l� P 360-407-6283 or by email at Subscribed and sworn to me this 29th day of May, 2015. ionathan.jenningsaecy.wa.gov. Jason A.Seth,City Clerk Published in the Renton Reporter on May 29, 2015. #1327663. K.C. Sherman, Notary Public for the State of Washington, Residing in Buckley,Washington PUBLIC WORKS DEPARTMENT City of M E M O R A N D U ; ®�� -- - NCE DATE: May 21, 2015 ME INITIA ATE S 1i b' TO: Denis Law, Mayor (LIOCN FROM: Gregg Zimmerman, Administrator A� STAFF CONTACT: Ronald Straka, Surface Water Engine . g Mana ;x7 Allen Quynn, Surface Water Engineer, x7247 SUBJECT: 2015 Mosquito Abatement Program—Job Order Contract Work Order#43 to CAG-13-149 with Forma Construction Company Please sign and execute the attached Job Order Contract Work Order No. 43 to CAG-13- 149 with Forma Construction Company, in the amount of$61,830.61, to apply adulticide in the areas upland and east of the Panther Creek Wetlands (Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes as part of the 2015 Mosquito Abatement Program. As authorized by Resolution No. 4177 and adopted by the City Council on April 1, 2013, the Job Order Contract (JOC) Work Order Limits and Signature Thresholds authorizes the Mayor to sign contracts between $35,000 and $150,000. Since the contract amount is $61,830.61, the Surface Water Utility requests your signature on the attached two original contracts. Last year, Washington had 10 human cases of West Nile virus that were contracted within the state. In addition, there were five horse/mammal cases, 80 positive mosquito samples, and no bird cases. In an effort to reduce the risk of human infection, the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities, and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment and adulticide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Department of Ecology. The total expenditure required for the 2015 Mosquito Abatement Program contract Work Order No. 43 is $61,830.61 and includes the following tasks: Denis Law, Mayor Page 2 of 3 May 21,2015 Task 1 (Treatment of Upland Areas Adjacent to Panther Creek Wetlands) Forma Construction Company will apply an Environmental Protection Agency registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack-mounted, portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of June through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit, and other federal and state regulations. The cost for adulticiding the areas upland and east of the Panther Creek wetland area is $26,342.90 and will be funded through the approved 2015 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$75,000. Task 2 (Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins) Larvicide treatment is scheduled to begin July 2015 and will continue for the duration of the mosquito season, which typically extends through the end of September. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities, and catch basins. These facilities and catch basins are owned and maintained by the Surface Water Utility, and the Community Services Department's Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile virus in King County. The total cost to treat City stormwater facilities, irrigation facilities, and catch basins is $35,487.71 and will be funded as follows: Surface Water Utility: Larvicide treatment will be funded through the approved Surface Water Utility 2015 Capital Improvement Program budget for the 2015 Mosquito Abatement Program. The approved budget for the Mosquito Abatement Program is $75,000 (#427.475020). The estimated cost to treat the stormwater facilities and catch basins with larvicide is $29,302.55. The remaining balance in the project account of$45,697.45 will be used to complete Task 1 ($26,342.90) leaving a balance of$19,354.55 for City staff time to administer both tasks. Maplewood Golf Course: Larvicide treatment will be funded through the 2015 Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\2015 Memo to Mayor Proposal No.63.doc\AQtp / Denis Law,Mayor Page 3 of 3 May 21,2015 and catch basins with larvicide is $2,039.56. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $2,039.56. Parks Division: Larvicide treatment will be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $3,603.35. Facilities Division: Larvicide treatment will be funded through the 2015 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $542.25. Attachments cc: Terry Higashiyama,Community Services Administrator Lys Hornsby, Utility Systems Division Director Kelly Beymer, Parks and Golf Course Director Greg Stroh, Facilities Maintenance Manager H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\2015 Memo to Mayor Proposal No.63.doc\AQtp Allen Quynn From: Steve Brown Sent: Monday, May 18, 2015 12:27 PM To: Allen Quynn Subject: RE: 2015 Mosquito Abatement Contract Allen, Terry forwarded your email to me. The cost looks good for Parks. Thanks for saving us some money! Steve From: Terry Higashiyama Sent: Monday, May 18, 2015 11:30 AM To: Steve Brown; Steve Meyers Subject: FW: 2015 Mosquito Abatement Contract Did you respond back on this request? 'Ferry IligaSliiVauia Cite of Rcntou Communitti Scn i(-cs Administrator Phonc: 125-1 0-f 606 Ccl l: 1-25-766-09,")7 ma From: Allen Quynn Sent: Friday, May 15, 2015 2:09 PM To: Gregory E Stroh; Kelly Beymer; Terry Higashiyama Cc: 'Lon Weaver' Subject: 2015 Mosquito Abatement Contract Hello Everyone, I am preparing the contract documentation for the 2015 Mosquito Abatement Program (larviciding of facilities and catch basins) and would like to get your approval for your share of the larviciding portion of the contract. This year I decided to use the JOC with Forma which has resulted in a considerable cost reduction compared to last year. Here is the cost breakdown: Facilities: $542.25 Golf Course: $2,039.56 Parks Maintenance: $3,603.35 1 have attached a copy of the contract with Forma for your review. Also included is a spreadsheet I put together that breaks out the total costs for each City Division/Section. Please reply to this email confirming you are in agreement with your share of the larviciding costs for the 2015 Mosquito Abatement Program. 1 Let me know if you have any questions. Thanks, Allen Quynn, P.E. Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aguynn@rentonwa.gov 2 Allen Quynn From: Steve Meyers Sent: Monday, May 18, 2015 12:26 PM To: Allen Quynn Cc: Kelly Beymer; Terry Higashiyama Subject: Mosquito Abatement Contract. Allen, The golf course is good with the price for the abatement this year. Thank you Stem Ateym Golf Course Supervisor Maplewood Golf Course 425-430-6806 smeyers@rentonwa.gov 1 Allen Quynn From: Gregory E Stroh Sent: Friday, May 15, 2015 2:57 PM To: Allen Quynn; Kelly Beymer; Terry Higashiyama Cc: 'Lon Weaver'; Peter Renner Subject: RE: 2015 Mosquito Abatement Contract I am in agreement with the stated total of$542.25 for Facilities. Best Regards, Greg Stroh Facilities/Project Manager Community Services Department Phone:425-430-6614 Cell:425-766-6162 mailto:gstroh@rentonwa.gov From: Allen Quynn Sent: Friday, May 15, 2015 2:09 PM To: Gregory E Stroh; Kelly Beymer; Terry Higashiyama Cc: 'Lon Weaver' Subject: 2015 Mosquito Abatement Contract Hello Everyone, I am preparing the contract documentation for the 2015 Mosquito Abatement Program (larviciding of facilities and catch basins) and would like to get your approval for your share of the larviciding portion of the contract. This year I decided to use the JOC with Forma which has resulted in a considerable cost reduction compared to last year. Here is the cost breakdown: Facilities: $542.25 Golf Course: $2,039.56 Parks Maintenance: $3,603.35 1 have attached a copy of the contract with Forma for your review. Also included is a spreadsheet I put together that breaks out the total costs for each City Division/Section. Please reply to this email confirming you are in agreement with your share of the larviciding costs for the 2015 Mosquito Abatement Program. Let me know if you have any questions. Thanks, Allen Quynn, P.E. 1 Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aquynn@rentonwa.Rov 2 City of Renton Card File Page 1 of 2 ..,..00� ti„<<,f, -' City Clerk Card File "' T rr r r i Electronic index of records on file at the City Clerk's Office The search criteria matches 124 records 3 l ' New Search Modify Search l Refresh Effective Date Title Keywords Created Modified Date Date Weblink View 05/15/2015 CONTRACT,SOLID GROUND KC CAG-15-119,SOLID GROUND 2015,KING COUNTY RSVP 05/19/2015 LF RETIRED&SENIOR VOLUNTEER 2015,KC RETIRED&SENIOR VOLUNTEER PROGRAM PROGRAM 2015 2015,INFORMATION DESK 2015,LOBBY VOLUNTEERS 2015 05/12/2015 CONTRACT,FORMA CAG-13-149 WO 42,FORMA CONSTRUCTION 05/14/2015 LF CONSTRUCTION/WO 42—AIRPORT 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB BLAST WALL ART 2015 ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,AIRPORT BLAST WALL ART 2015,LOWER BLAST FENCE 2015,ARTWORK INSTALLATION 2015 05/06/2015 CONTRACT,FORMA CAG-13-149 WO 40,FORMA CONSTRUCTION 05/12/2015 LF ov CONSTRUCTION/WO 40- 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB MAPLEWOOD PARK BASKETBALL ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT COURT 2015 BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,MAPLEWOOD PARK BASKETBALL COURT 2015 05/06/2015 CONTRACT,FORMA CAG-13-149 WO 39,FORMA CONSTRUCTION 05/12/2015 LF OV CONSTRUCTION/WO 39—NORTH 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB HIGHLANDS SPORTS COURT 2015 ORDER CONTRACT 2015,10C 2015,PUBLIC WORKS PROJECT BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,NORTH HIGHLANDS SPORTS COURT 2015 05/06/2015 CONTRACT,FORMA CAG-13-149 WO 37,FORMA CONSTRUCTION 05/12/2015 LF CONSTRUCTION/WO 37—WELL 1,2, 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB &3 ROOF REPLACEMENT 2015 ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,WELL 1 2015,WELL 2 2015,WELL 3 2015,ROOF REPLACEMENT 2015 05/11/2015 CONTRACT,FORMA CAG-13-149 WO 41,FORMA CONSTRUCTION 05/11/2015 LF CONSTRUCTION/WO 41—SUNSET 8 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB DUPLEX DEMO 2015 ORDER CONTRACT 2015,10C 2015,PUBLIC WORKS PROJECT BIDS 2015,SUNSET 4 PLEX DEMOLITION 2015,DEMO ON SUNSET 2015 05/06/2015 i CONTRACT,FORMA CAG-13-149 WO 38,FORMA CONSTRUCTION 05/11/2015 LF OV CONSTRUCTION/WO 38- 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB HIGHLANDS PARK SPORTS COURT ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT i 2015 BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,HIGHLANDS PARK SPORTS COURT 2015 04/13/201S j CONTRACT,FORMA CAG-13-149 WO 36,FORMA CONSTRUCTION 04/14/2015 LF CONSTRUCTION/WO 36-RENTON 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,IOB AIRPORT BUILDING 800 FINAL ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT IMPROVEMENTS 2015 BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,RENTON AIRPORT BUILDING 800 FINAL- IMPROVEMENTS 2015 04/09/2015 CONTRACT,FORMA CAG-13-149 WO 35,FORMA CONSTRUCTION 04/13/2015 LF CONSTRUCTION/WO 35—COULON 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB DOCK LIGHT PHASE 2 2015 ORDER CONTRACT 2015,JOC 2015,PUBLIC WORKS PROJECT BIDS 2015,PUBLIC WORKS CONTRACT SOLICITATION ALTERNATIVE 2015,COULON DOCK LIGHT PHASE 2 2015 2015,COULON PARK 2015 2015,GENE COULON MEMORIAL BEACH PARK 2015 04/06/2015 CAG-13-149 WO 34,FORMA CONSTRUCTION 04/09/2015 05/01/2015 LF 2015,BERSCHAUER PHILLIPS CONSTRUCTION CO 2015,JOB 1 2 3 4 5 6 7 8 9 Page:D1 of 9 Go Page size: 15 Change Item 1 to 15 of 124 http://rvl2rwebOl/CardFile/SearchResults.aspx 05/21/2015 �c n Contract Number: S ' J� (assigned by City Clerk) Select Type: ❑ Contract/Agr. ❑ Permit ❑ Lease ® Adden/Change Order Contract Type: Staff Name: Allen Quynn Extension: 7247 (assigned by City Clerk) Department/Division: Public Works/Utilities EDEN Queue- Addenda/CO #: 43-15 to City Clerk's CAG #: 13-149 (if applicable) Expiration Date: 12/31/15 Contract Class: ❑ Receivable ® Payable ❑ Grant ❑ Misc. (no $) Contract Solicitation Method: Contractor Name: Forma Construction Company Job Order ContracUVVork Order(JOC) Short Description: Full or Additional Description: 2015 Mosquito Abatement Program, WO#43-15 to JOC CAG-13-149 ❑ Legal Review(attach memorandum from City Attorney) ❑ Risk Management review for insurance (attach memorandum from Risk Management) ❑ Insurance certificate and/or policy (attach original) ❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been met) ❑ Performance bond and verification memo from staff(for Public Works type of contracts$35k& over only) ❑ Federal excluded parties list verification (Attach printout of search results from Website: www.sam.gov/portal/public/SAM) ® Active business license and Accounts payable W-9 vendor form? (obtain if not already on file with Finance Dept.) ® Yes ❑ No Submitted contracts are signed by contractor? If"No", provide explanation here: Fiscal Impact to City: ® Expenditure OR ❑ Revenue Amount Budgeted: (line item,see below):$ 75,000 Amount of Attached (including tax) $ 61,830.61 per year for_ years = Total Amount of Attached $ 61,830.61 Prior Council approval via agenda bill process required if: (see policy 250-02) ❑ Contract or addendum is $100k or over(non-Public Works) or$150k or over(Public Works). ❑ Budget adjustment or fund transfer is necessary. ❑ Interlocal Agreement (most Interlocal Agreements require Resolutions) Date of Council Approval: Resolution Number: NOTE: Mayor signs for the City,except that the Department Head may sign contracts: Under$35,000 when for non-Public Works&Small Public Works Roster(SWR); (�f applicable) (if applicable) Under$40,000 when for Public Works single craft -non-SWR;and Under$65,000 when for Public Works multi-craft -non SWR EXCEPT:Change Orders to PW contracts in any amount can be signed by Project Mgr IF within budget AND under Administrator's authorization. Key words for City Clerk's electronic card file: 2015 Mosquito Abatement Contract, SWP-27-2013, Forma Construction Co., Proposal No. 63 and Work Order No. 43-15 to CAG-13-149, Panther Creek Wetlands Print Form Revised 10/25/2013 PUBLIC WORKS DEPARTMENT City of M E M O R A N D U M DATE: May 26, 2015 TO: Denis Law, Mayors FROM: Gregg Zimmermalp; /Xdministrator STAFF CONTACT: Ronald Straka, Surface Water Engineering Manager, ext. 7248 Allen Quynn, Surface Water Engineer, ext. 7247 SUBJECT: 2015 Mosquito Abatement Program —Job Order Contract Work Order#43 to CAG-13-149 with Forma Construction Company Please sign and execute the attached Job Order Contract Work Order No. 43 to CAG-13- 149 with Forma Construction Company, in the amount of$61,830.61, to apply adulticide in the areas upland and east of the Panther Creek Wetlands (Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes as part of the 2015 Mosquito Abatement Program. As authorized by Resolution No. 4177 and adopted by the City Council on April 1, 2013, the Job Order Contract (10C) Work Order Limits and Signature Thresholds authorize the Mayor to sign contracts between $35,000 and $150,000. Since the contract amount is $61,830.61, the Surface Water Utility requests your signature on the attached two original contracts. Last year, Washington had 10 human cases of West Nile Virus that were contracted within the state. In addition, there were five horse/mammal cases, 80 positive mosquito samples and no bird cases. In an effort to reduce the risk of human infection, the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment and adulticide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit, or as directed by the Department of Ecology. The total expenditure required for the 2015 Mosquito Abatement Program contract Work Order No. 43 is $61,830.61 and includes the following tasks: Denis Law, Mayor Page 2 of 3 May 26, 2015 Task 1: Treatment of Upland Areas Adjacent to Panther Creek Wetlands Forma Construction Company will apply an Environmental Protection Agency registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack-mounted, portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of June through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state and federal requirements. Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. The cost for adulticiding the areas upland and east of the Panther Creek wetland area is $26,342.90 and will be funded through the approved 2015 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$75,000. Task 2: Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins Larvicide treatment is scheduled to begin July 2015 and will continue for the duration of the mosquito season, which typically extends through the end of September. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities, and catch basins. These facilities and catch basins are owned and maintained by the Surface Water Utility, and the Community Services Department's Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile Virus in King County. The total cost to treat City stormwater facilities, irrigation facilities and catch basins is $35,487.71 and will be funded as follows: Surface Water Utility: Larvicide treatment will be funded through the approved Surface Water Utility 2015 Capital Improvement Program budget for the 2015 Mosquito Abatement Program. The approved budget for the Mosquito Abatement Program is $75,000 (#427.475020). The estimated cost to treat the stormwater facilities and catch basins with larvicide is $29,302.55. The remaining balance in the project account of$45,697.45 will be used to complete Task 1 ($26,342.90) leaving a balance of$19,354.55 for City staff time to administer both tasks. Maplewood Golf Course: Larvicide treatment will be funded through the 2015 Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\2015 Memo to Mayor Proposal No.63.doc\AQtp Denis Law, Mayor Page 3 of 3 May 26,2015 and catch basins with larvicide is $2,039.56. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $2,039.56. Parks Division: Larvicide treatment will be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $3,603.35. Facilities Division: Larvicide treatment will be funded through the 2015 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $542.25. Attachments cc: Terry Higashiyama,Community Services Administrator Lys Hornsby,Utility Systems Division Director Kelly Beymer, Parks and Golf Course Director Greg Stroh, Facilities Maintenance Manager H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Contract\2015 Memo to Mayor Proposal No.63.doc\AQtp CITY OF RENTON JOB ORDER CONTRACTING pro o,if No 63 rev.No 2 2015 Mosquito Abatement Program date: 513'I5 contractor contact: Lon Weaver phone: 360 280 6650 email: Iom%it formacc com CO';- Work Order Form Scope of Work Line Item Cost Estimate Lam' 'J n O1i��11 FORMA FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH SEATTLE WA 206.626.0256 Section 2: Work Order Proposal Job Order Contract: CAG-13-149 Work Title: 2015 Mosquito Abatement Program Project Number: 63 Location: 1055 S.Grady Way, Renton WA Requesting Agency: Surface Water Utility Work Order No.: Modification No.: Date of Proposal:F 5/13/2014 Completion Schedule: JOC Firm:I FORMA Construction Company Description of Work: Additional information can be found on the attached Work Order Plan Provide treatment of upland areas adjacent to panther Creek wetlands and treatment of city storm water and irrigation facilities and catch basins. CSI Summary of Work Order Items Listed in Unit Price Book CSI CSI Division Description Bare Cost City Cost Contractor Division Total Total Index Coefficient Price 1 General Requirements $5,850 1.024 1.040 6,230.02 2 Site Construction $47,172 1.024 1.040 50,236.29 3 Concrete 1.024 1.040 0.00 4 Masonry 1.024 1.040 0.00 5 IMetals 1.024 1.040 0.00 6 lWood and Plastics 1.024 1.040 0.00 7 IThermal and Moisture Protection 1.024 1.040 0.00 8 Openings 1.024 1.040 0.00 9 Finishes 1.024 1.040 0.00 10 Specialties 1.024 1.040 0.00 11 Equipment 1.024 1.040 0.00 12 Furnishings 1.024 1.040 0.00 13 Special Construction 1.024 1.040 0.00 14 Conveying Systems 1.024 1.040 0.00 15 Mechanical 1.024 1.040 0.00 16 Electrical 1.024 1.040 0.00 Total of all items listed is Price Book $ 56,466.31 Work Order Items Not Listed in Unit Price Book Materials Labor Item Work Item Description Include type of material, Unit Mat'I Unit Labor Item Price Incl. No manufacture name,part number,type of work... Units Oty Price Labor Hours Price negot.C eff.) 1 0 $ 0 $ $ 2 0 $ 0 $ $ 3 0 $ 0 $ $ 4 0 $ 0 $ $ Total of all items not listed in Price Book $ - Total Work Order Amount $56,466.31 Washington State Sales Tax(9.5% City of Renton) $5,364.30 Total Funding Amount $61,830.61 Approval Signatures: Date: Notes: 1.This Work Order JOC Contractor - I Is- Project Manager Denis Law, Mayor Attest: Jason Seth, City Clerk CITY OF RENTON JOB ORDER CONTRACTING WORK ORDER PROPOSAL - SCOPE OF WORK DETAIL PROJECT: 2015 Mosquito Abatement Program Location: 1055 S Grady Way May 8,2015 Renton,WA 98057 Estimated duration: • Starting May ending in September Description: Provide treatment of upland areas adjacent to panther Creek wetlands and treatment of city storm water and irrigation facilities and catch basins. General information • The performance of all work will be in accordance with OSHA and WISHA safety requirements.Work in accordance with applicable construction and buildings codes. • The project start date will depend on award notice to proceed • This is a prevailing wage project. EXHIBIT A SCOPE OF WORK 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLAND AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance- Mitigated (Application Number LUA05-022, ECF)for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which :`CORK ORDER PROPOSAL-SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING authorization and release for access and treatment has been granted by the property owner or the owner's legal representative.The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included.The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO.2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label,the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Amberwood/WQ Pond 315 Quincy Ave NE Utility 2 Surface Water Amberwood II/WQ Pond 304 Rosario PI NE Utility 3 Surface Water Aspenwoods/WQ Pond 808 Ilwaco PI NE Utility 4 Surface Water Aster Park Plat/WQ Pond 5516 NE 13th St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE.B SEATTLE WA 206.6260256 V:ORK ORDER PrcOF05AL-SCOPE OF WORK DETAIL CITY OFF REs iTON JOB ORDER CONTRACTING 5 Surface Water Auria Woods Tract C/WQ Pond 12152 SE 186th St Utility 6 Surface Water Beclan Place Plat/WQ Pond 5134 NE 2nd St Utility 7 Surface Water Brookefield II/WQ Pond 5305 NE 11th Ct Utility 8 Surface Water Chinquapin Ridge/WQ Pond 19123 113th Way SE Utility 9 Surface Water Christian Short Plat/WQ Pond 11129 SE 189th PI Utility 10 Surface Water Cottages at Honey Creek/WQ Pond NE Sunset Blvd/ Elma PI NE Utility 11 Surface Water Elliott Farm/Detention Pond Maple Valley Hwy/ 140th Way Utility SE 12 Surface Water Ellis Park aka Edenwood/WQ Pond 602 NE 6th St Utility 13 Surface Water Elmhurst/WQ Pond 215 Whitman PI NE Utility 14 Surface Water Emma's Plat/WQ Pond 5611 SE 1st PI Utility 15 Surface Water Evendell Plat/WQ Pond 6741 SE 4th St Utility 16 Surface Water Fredricks Place/WQ Pond 10301 SE 186th St Utility 17 Surface Water Greenfield II aka Highpointe II/WQ Pond 1318 Redmond PI NE Utility 18 Surface Water Hamilton Place Plat/WQPond 6743 NE 1st PI Utility 19 Surface Water Heritage Renton Hill/WQ Pond 1816 SE 8th PI Utility 20 Surface Water Highland Estates/WQ Pond 355 Rosario PI SE Utility 21 Surface Water Highlands Park/WQ Pond 202 Rosario Ave SE Utility 22 Surface Water Jericho Estates/WQ Pond 316 Hoquiam Ave NE Utility 23 Surface Water Kimberly Lane/WQ Pond 17228 125th Ave SE Utility 24 Surface Water Larson Parke Plat/WQ Pond 18469 114th Ave SE Utility 25 Surface Water Laurelhurst Phase I/WQ Pond 4615 NE 1st St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE.8 SEATTLE WA 206 626 0256 WORK ORDER PROPOSAL-SCOPE OF WORK DETAIL CI TY OF RENTON JOE ORDER CONTRACTING 26 Surface Water Liberty Grove and Liberty Grove 13716 160th Ave SE Utility Contiguous/WQ Pond 27 Surface Water Liberty Ridge Phase I/WQ Pond 2511 NE 1st St(behind Utility residence) 28 Surface Water Liberty Ridge Phase I/WQ Pond 205 Index PI SE Utility 29 Surface Water Liberty Ridge Phase II/WQ Pond 2601 Ferndale Ave NE Utility 30 Surface Water Magnussen Plat/WQ Pond 202 Field Ave NE Utility 31 Surface Water Magnussen Plat/WQ Pond 4814 NE 2nd St (behind Utility residence) 32 Surface Water Maple Glen Addition/WQ Pond SE 182nd St/ 108th Ave SE Utility 33 Surface Water Maureen Highlands Tract A/WQ Pond 6118 NE 4th St Utility 34 Surface Water Morning Glen/WQ Pond 17612 114th PI SE Utility 35 Surface Water NE 10th St Pond/WQ Pond NE 10th/Anacortes Ave NE Utility 36 Surface Water NE 4th Detention/WQ Pond 234 Field Ave NE Utility 37 Surface Water Nichols Place/WQ Pond 13815 160th Ave SE Utility 38 Surface Water Olympic Peak Estates/WQ Pond 9402 S 196th PI Utility 39 Surface Water Parkside Court/WQ Pond 5621 SE 2nd St utility 40 Surface Water Pioneer Place/WQ Pond Maple Valley Rd / 149th Ave SE Utility 41 Surface Water Serenity Ridge Tract A/WQ Pond 17927 110th PI SE Utility 42 Surface Water Serenity Ridge Tract B/WQ Pond 17707 110th PL SE Utility 43 Surface Water Shamrock Glen aka Martin Prop/WQ Pond 5507 NE 5th Cir Utility 44 Surface Water Shy Creek/WQ Pond 204 SE 2nd St Utility 45 Surface Water Sienna/WQ Pond 5402 NE 2nd St Utility 46 Surface Water Stonegate/WQ Pond 5500 NE 26th St Utility FORMA CONSTRUCTION COMPANY 1736 4TH AVE SOUTH STE 8 SEATTLE WA 206626.0256 WCR',(ORDER PROPOSAL-SCOPE OF WORK DETAIL CiT Y OF REN T ON JOB ORDER CONTRACTING 47 Surface Water Sunnybrook/WQ Pond 712 S 36th PI Utility 48 Surface Water Talbot Estates/WQ Pond 9612 S 194th St Utility 49 Surface Water The Reserve at Stonehaven/WQ Pond 1003 S 47th St Utility 50 Surface Water Watershed Terrace/WQ Pond 19926 101st Ave SE Utility 51 Surface Water Wilkins Wood/WQ Pond 16603 113th Ave SE Utility 52 Surface Water Windsong/WQ Pond 4925 NE 4th PI Utility 53 Surface Water Windsor Circle aka Harmony Gro/WQ 13502 162nd Ave SE Utility Pond 54 Surface Water Win sper(Liberty View 1&II)/WQ Pond 611 S 32nd St Utility 55 Surface Water Zetterberg/WQ Pond 2100 Burnett PI S Utility 56 Surface Water Honey Brooke West aka Sagecrest/WQ 505 Field PI NE Utility Pond 57 Surface Water Honey Creek Ridge Tract A/Detention 3203 NE 26th Ct Utility Pond with Bioswale 58 Surface Water Honey Creek Ridge Tract B/Detention 2407 Olympia Ave NE Utility Pond with Bioswale 59 Surface Water Langley Ridge at May Creek/WQ Pond 5302 NE 26th St Utility 60 Surface Water Maplewood Estates/Detention Pond with 5831 SE 2nd Ct Utility Bioswale 61 Surface Water Maureen Highlands Tract C/WQ Pond 653 Shadow Ave NE Utility 62 Surface Water River Ridge/Detention Pond with 1706 SE 7th Ct Utility Bioswale 63 Surface Water Summerwind/Detention Pond NE Sunset Blvd/ Field Ave NE Utility 64 Surface Water Victoria Hills/Detention Pond 1012 S 23rd St Utility 65 Surface Water Westmont/WQ Pond 3625 Monterey Ct NE Utility A Surface Water Catchbasins Various Utility 90 Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) FORMA C0NGTRJCTION CON P+'t Y 1730:T,AVE SOUTH STE S S_AT TLE V.'-. 2 662,302vo WORK ORDER FROPOS11L -SCOPE OF WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING 91 Golf Course Hole #9 Pond/Irrigation Maplewood Golf Course (west-central) 92 Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) 93 Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course (east) 98 Golf Course Maplewood Golf Course Catchbasins Various B Parks Maintenance Catchbasins Various Division 99 Facilities Division Renton City Hall/Water Quality Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment,the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count(larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course—The contractor shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property(this is a mandatory safety requirement). FORMA CONSTRUCTION COMPANY 1736 irH AVE SOUTH STEB SEATTL E WA 20v62o0253 ViOP.K ORDER PR0�0_A_.SCOPE Oz WORK DETAIL CITY OF RENTON JOB ORDER CONTRACTING EXHIBIT B TIME OF COMPLETION 2015 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2015. EXHIBIT C COST ESTIMATE 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The maximum treatments shall not exceed 21 and shall include all necessary work to clear of the trails. Cost shall be based on a unit price per treatment. The billing rates include state sales tax. TASK NO, 2: Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 1. Material costs for larvicide. 2. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under"Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. FORMA CONSTRUCTION COMPANY 1736 4T'.A;E SOUTf- STE B S=ATT!E WA 206 62C 0250 Alien Quynn — 2015 Mosquito Abatement Control — _ FORMA CONSTRUCTION 1=_7—. r, � j 01J17413 OJYO L'nnucd;dnw...pd'W mhl, wni�slnuM 1er,l clwnn Mnnawloiroo8bnaud2kn—itmma to Par n,unlm .� :1000 SF ........ ,YS_�I..,— �— ...__ OI S�ODAO 7100�t R i 1 uck wh 3+4 ux 2 Iwnl env RmN a tla __ __ I__ 0 da a 117 00 t 7 7 00 17I-31.111n 1 7000 f,I d.s {,tx J( ) ---j t57 00�ff !` be9iw,n0 M.Y ro Sepemr..r 2U I5 al aAen,-90 I + Ot b3J40 J1JI 7v11 __7 �R. k p 1uN+31�1e a 7 Iwnl drive•Rnnl Par daY .__ __--. amL — ��I-_— U-d-a 611167Charlt dd Moquu nmlmM d: mper mN,O S. layb. 48 5U O_mgmv b spi_bm 20,5.I ss B 0131161J J00o�C,h.ancAl larmne aadrd.salt tuxsanxul Isl.rrWatnn) Mbsquau Irulm..nl Of 2lr.atm.nls Pa n,bnlh ` l,9Il0.0 S IJ3.00 I 870.00 060(s0 baQ.al.1g may to S.plembd 70I5.1 Mea 1.9U 1 A and f3 ` +.Jet:.r il:rr,i Yrr;ti _ Inaa a2 Palha — bb5 t7D Ot5430sU J 13)I613 .1 2 Pm a 7100[, Rwd lruckJ,ichup JfA tun Iwnld Rerx�icr O,Y _.__— .. __� _--.T daYs _ — i UD�Chnma:al Wrn,Aa cbnud m I bw/aquyar drl chalgn )+,•s4•••trufn,an baatrtwnta wrllh i too 075 oo JWI 1 I/S( .1 i LnLa,n9 tA.y W SaPlmn6er 7015 aa—141) I .1. J1311610 0000 i h G<unnal lmmwe wnbd M tl pwanrrxry(slaNiutun) -- --- -- - Mo+quao t (117 rosd,Ml d?b..201 17D i p--- -- 'I 000 o sue' 21 tXl ,.]20 1,and nU May b Sept embnr 2U15 at s.®1- 7 1 _ i k NtS rl W 1u Ul ley .— U15�3310 71f70B Ra 11 uek pxJ.p 14 lan 2 t wd Ut1 «nrN per day_ ____ + G3Q days_ —_+— 3,fiBS 50 9 OHS.hD .. ...�_— _ 1 319)IB J OJ9U�CI salt . mlyd un IaLwla7 Pn and 0-3. Mu t. 1—kit d d 2 h-vrunds pd month I O,1.0 loll 17,1�2 50 6 14250 ib.W..g May to S.pt.mbnr 2o15 ]131161"1 71N10 Chmnlcal lam�la rn,uioi sure lloiv«yell(slalpizatipn) ---- Masqud.nedmant W 2lr,wvn.nta pn._m I Df7,Do11 U I SF 2,i W n0 13,2Uo.W �! b.W. .. _.... "May to S.W"ber 2U15 w s.m 1-911 __. -------- �� t3 L_ I P ntlwr Cr.uk t116tl1t0 7 cY tl H 1 i m.k 1 . r _ «w 1 p, tl y -- —Sr -_.--- — -— — —10 --'11311fi1'I- '1WU�L1- �It mrt IiW nc r�, .nJ(Iwnf.al.,nl - squb.basement afd00.a.a 20 tf.atmw,ls 1 4.000�0 � 28�O OOI itl.1C00D —'v v--<7.42S1W days t.170 OD eau.. ... ...IIr 'r•A+., .1'/rtli I 1 I � 5/15/2015 - V-- — 1of2 Cost Breakdown Table Facilities (Task 2) Golf Course (Task 2) Parks Maintenance(task 2) Surface Water(Task 2) Surface Water(task 1) Total Subtotal: $465.00 $1,749.00 $3,090.00 $25,128.00 $22,590.00 $53,022.00 %of total: 0.00877 0.032986 0.058278 0.4739165 0.4260496 1 Total: $542.25 $2,039.56 $3,603.35 $29,302.55 $26,342.90 $61,830.61 Note 1 The "Subtotal" line is pulled from Forma table in the contract(second to last page) Note 2 "%of total" is the individual division/section cost as a perentage of the base subtotal ($53,022)shown in the Forma table(second to last page) Note 3 The "Total" line factors in the Renton City cost index, Renton coefficient and state sales tax. Denis Law City Mayor C) ♦(� ANT Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000020 RECEIVED Resident 3615 SHATTUCK AVE S RENTON, WA 98055 JUN 0 12015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquj o control on my property. ___T (tx &P- DATE SIGNATURE -ele ne Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor ► p1 Y OA I . [ I e..ri &NTO Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500210 RECEIVED Resident 2127 DAVIS AVE S MAY 14 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 5 Zo5 4VI Aala__� 15 DATE SIGNATURE V Telephone Number Print l4ameJ COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis o Law © City Of t� o Y Y � e WW Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000230 Resident / 2419 TALBOT CREST DR S RECEIVED RENTON,WA 98055 MAY 18 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authloirIt.0l`,Vtf cTiE'MS Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT SIG Telephon Number Prin Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 201S USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law --- r Mayor © City of UNJ Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401170 RECEIVED Resident 1521 LAKE AVE S MAY 18 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE NATURE IM Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMayoLaw City Of t r I r �'D �N�0 Public Works Department-Gregg Zimmerman,P.E.,Administrator 8860500120 R E C Cc IIJ Resident MAY 14 2015 2017 DAVIS AVE S RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. Si-7 �---- DATE SIGNATURE 42.s 2.Z7 dt"s c.t1 &4(1 Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401145 Resident RECEIVED 1711 LAKE AVE S RENTON,WA 98055 MAY 14 2m PUBLIC WORKS DEPARTMENT r, t v ;�I_. '` ' �)N U itT'Y YSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,_for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNA URE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMas Law ® Clt Of o yor y �Y. 15 Public Works Department-Gregg Zimmerman,P.E.,Administrator 8557000290 R E C tb Resident 2601 TALBOT CREST DR S MAY 14 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. /Z A,Z DATE 2 r SI ATURE �— Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Dena Mayor ® City Of y p N r0 Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000010 RECEIVE Resident 3621 SHATTUCK AVE S RENTON, WA 98055 MAY 11 2015 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods an i Is in its efforts to effect mosquito control on my property. DA E S GN URE 4Z,-S 5 7,?, 5 75 Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Dellnis a oaw --- City Of Y t ti� o Y [' W �o� sw..I N Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059081 RECEIVED Resident 3037 TALBOT RD S MAY 1 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIG ATURE a 06 - *9- Yq;6 e47h(LE,5.0 �: 1-- /A IQr Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeanaY or Law D City Of V � a Public Works Department-Gregg Zimmerman,P.E.,Administrator 8860500090 R E C E I V�,,,t BI BIT B Resident 200 S 20TH PL MAY 11 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE .,-'SIGNATURE 4/z :5- -Alb -1379 Ivi cic Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law city Of Mayor + INV =� p Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500150 RECEIVED Resident 2107 DAVIS AVE S RENTON, WA 98055 MAY i l 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTONUTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. � it DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Y Mayor +/ �-y- ��i p1 � O: N`t Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059116 Resident 3113 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities or any personal injury or property damage that may arise from the use of the above-mentioned ho s and chemicals in its eff o e ect mosquito ontrol on my property. DATE NATUR ` )-5 7.).. 13 ff T4 &t Telephone Number Print Name COMMENTS: RECE. I,/ED MAY 1 12015 CITY OF RENTON PLEASE RETURN THIS FORM BY May 8, 2015 UTILITY SYSTEMS USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis DeMa or Law City Of Y Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059063 Resident 3001 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE (7a.�, phone Number Print Name R I C E IVED COMMENTS: MAY 11 2015 CITY OF RENTON UTILITY SYSTEMS PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Mayor City Of ti�Y o 1VV Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059018 Resident 3101 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE I NATURE LlZs-zsy- O'� ►-VA 0I:S� ,� Telephone Number Print Name RECEIVED COMMENTS: MAY 1.1 2015 CITY OF RENTON UTILITY SYSTEMS PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denisoaw City Of �` C, Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000220 Resident 2413 TALBOT CREST DR S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE �dL - %HI - y (`c l_ � 1GC_ e Telephone Number Print Name ECEIVED COMMENTS: MAY 1.1 2015 CITY OF RENTON 171-.ITY SYSTEMS PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of } IV-""No e% 4 t�') I t0 Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 8860500350 VALLEY VUE ESTATES HOA 332 S 20TH PL RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE URE Telephone Number Print Name RECEIVED COMMENTS: MAY 0 4 2015 CITY OF RENTON UTILITY SYSTEMS PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\file Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Y Y Mayor � .( ' N'r Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500130 Resident 2023 DAVIS AVE S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE zrz, G IS�` Chi f Tn7 Telephone Number Print Name RECEIVED COMMENTS: MAY 0 4 Z015 CITY OF RENTON UTILITY SYSTEMS PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor 1 Y O� J Uvo Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 3023059012 Resident 3315 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. -) � 0 ( Z--o1 � DATE k SIGNATURE Zoe 4-N 536 �- Vt N t, Telephone Number Print Nam COMMENTS: RECEIVED PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE MAY a 4 2015 CITY OF RENTON \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (Cl 10) flLff�,Iti4nsau�o-MS Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad 1 I Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor U '� e Own ' IV O � Public Works Department-Gregg Zimmerman,P.E.,Administr�rCC 8557000260 G G Resident APR 3 0 Z015 2515 TALBOT CREST DR S RENTON,WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE (� b) � . Telep ne Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Dellis a Y o Law Clty Of �� o Y ILJ N Public Works Department-Gregg Zimmerman,P.E.,Administrator RE�IFmfVED 5070000070 Resident APR 3 0 2015 3509 SHATTUCK AVE S RENTON, WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. i DATE SIG TURE (y,25)ge-1I-.2S Z6 ,4-V�tg/,A((; a UC/ Lit Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law - City of Mayor �.SY Public Works Department-Gregg Zimmerman,P.E.,Administrator +r�V c �7�Rii1� E D 5070000050 Resident MAY 0 1 2015 3527 SHATTUCK AVE S RENTON, WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATU Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Y Mayor woo =M Public Works Department-Gregg Zimmerman,P.E.,Administrators 3340401150 R C CENtD Resident MAY Q 1 2015 1625 LAKE AVE S RENTON, WA 98055 CI PUBLIC WORKS DEPARTMENT Y Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. ab_-5- DATE SIGNAT RE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMayoLaw ® City Of ti�Y o i � No Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000170 RECEIVED Resident 2325 TALBOT CREST DR S MAY 01 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 4-In 115 14 a DATE SIGNATURE c425) 7g, -5140 w I Pwh Gos76GH� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis DeMayor w CiTr �� o Y r iINV $ Public Works Department-Gregg Zimmerman,P.E.,Administrator RECeFVED 3340401165 Resident MAY 01 2015 1615 LAKE AVE S RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DA E SIGNATURE TE�165-09 ZZDB�,�J 7,1' ,PF/i/my5-zFo 6.ng eQZZOW l Telephone Number Print Name COMMENTS: L��r3; �✓�e. ����'�i.�e'�r,',�-,�.,���u:��.,acvr�����,���i»u%ca-�a/�e� PLEASE RETURN THIS FORM BY May 8,2015 '�`�"' USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis oaw City Of �t o Y Y N f0 Public Works Department-Gregg Zimmerman,P.E.,Administrator RECEIVE E)HIBITB 9899200020 Resident MAY 01 2015 3425 SHATTUCK AVE S RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE < In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement thrgh the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. Z,/-- DA_(Ec SIGNATURE (T S eleph ne Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City of Mayor pti Y O� ® a "( OS Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401110 Resident RECEIVED 1819 LAKE AVE S RENTON, WA 98055 APR 3 0 2015 PUBLIC WORKS DEPARTMENT CITY OF REWON UTILITY SYZ-`T CMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and c icals in its efforts to effect mosquito control on my property. OYI 2 15" DATE /SIG ATURE ( S� 3 - � >It Teleph e Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DenisLdw ® City Ofo ;� Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500190 RECEIVED Resident 2115 DAVIS AVE S APR 3 0 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT SIGNATURE Telephone Number Print Name COMMENTS: 9 PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis o aw ® City Of v ® / ;1� • Public Works Department-Gregg Zimmerman,P.E.,Administrator � 3340401115 R E C E IVE Vg Resident APR 3 0 2015 1805 LAKE AVE S RENTON,WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. N . 2-7, �5 DATE SI ATURE cl,l 5 )34 z,zra130-r74 cwlev Lt_ Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way • Renton,Washington 98057 • rentonwa.gov 00�_ - ------— is Dena Y nilw, oawCity Of .1 Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401140 Resident 1717 LAKE AVE S RECEIVED RENTON, WA 98055 PUBLIC WORKS DEPARTMENT APR 3 0 2015 CITY OF RENTON Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authurriiin 9"EMS Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. I Z /7 �o1s- ATE SIGNATU Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of �Y o Mayor S rt Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000180 Resident RECEIVED 2331 TALBOT CREST DR S RENTON, WA 98055 APR 3 0 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-me o sand chemic n its efforts to effect mosquito control on my property. Q 4- �7- � t DATE GNATURE C46��) �4e� eerie) i FRS Do �3. �f�C Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Dellis a oraw City of y Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B Residentt RECEIVED Reside 3031 TALBOT RD S RENTON, WA 98055 APR 3.0 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. �%22 r " J DjATE SIGNATUR 0—?)-/a;�_0 R 6_ Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeM yor © Clty Of ��Y �� ♦�R + Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059107 RECEIVED Resident 2703 TALBOT RD S RENTON,WA 98055 APR 3 0 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8,2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMaY�Law city Of ��Y Op" i ul;�Iv 0; +ram Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 3340401151 RECEIVED Resident 1701 LAKE AVE S APR 3 0 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. D TE SI NA RE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of, �y Mayor �1 �,A e .(_ ��NT Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B Residentt RECEIVED Reside 3503 SHATTUCK AVE S RENTON, WA 98055 APR 3 0 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIdNATURE O -Vt 1 ,,,6- Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis Della oaw City Of ticY o y U a 0 1 + Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000270 RECEIVED Resident 2521 TALBOT CREST DR S RENTON, WA 98055 APR 3 0 2015 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. �- �- �5 DATE SIGNATURE 5 c5?,,g4;, -71F-7 70Sem(Xr CSS Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor _� _ 1 Y O� �/ , 117ii C , ��N'v0, M" APublic Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000200 RECEIVED Resident 2401 TALBOT CREST DR S APR 3 0 2015 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATU r �i5 -2(0 4 QU_0(�PrIf Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Integrated Mosquito Management Plan Prepared by City of Renton r c�cyoc J 1_ April 11, 2011 Public Works Department Utility Systems Division -Surface Water Utility Renton City Hall — 5th Floor 1055 South Grady Way Renton WA 98057-3232 1 Introduction The purpose of this integrated mosquito control plan is to protect the health, safety, and welfare of the citizens within the City of Renton. This plan is designed to present a balanced approach to mosquito control which considers the human health and environmental risks associated with mosquito management activities compared to quality of life issues and human health risks from vector borne diseases in the mosquito population. Mosquito populations fluctuate from year to year(as well as seasonally) in response to changing environmental conditions. This report provides a general description of the City's Mosquito Abatement Program, including related elements and considerations with a brief explanation about their significance to mosquito control. The control of mosquitoes is rarely as simple as taking one approach (e.g. the application of larvicide) to achieve an acceptable level of control. The City's mosquito abatement program is based on an integrated approach that combines more than one method to minimize interaction between mosquitoes and the public in order reduce the risk of mosquito-borne disease. Section S5 of the Aquatic Mosquito Control NPDES General Permit, requires the City to develop and implement an Integrated Management Plan to ensure that discharges from mosquito control activities do not cause or contribute to a violation of Water Quality Standards for Surface Water of the State of Washington (chapter 173-201A WAC), Ground Water Quality Standards (chapter 173- 200 WAC), Sediment Management Standards (chapter 173-204 WAC), and human health-based criteria in the National Toxics Rule (40 CFR 131.36). The Integrated Management Program includes the following components: a. Plan objectives b. General Information c. Surveillance d. Mapping e. Action Thresholds f. Mosquito Control Methods g. Monitoring of Efficacy/Resistance h. Record keeping and recording L Education and outreach j. New Staff training and continuing training for existing staff k. Signature Requirements I. Public access to the Integrated Management Plan A. PLAN OBJECTIVES The goal of this program is to provide guidelines to adequately control adult mosquitoes (as specified in the NPDES Mosquito Control Permit) while minimizing the incidental discharges to waters of the State, minimize the risk of vector borne decease transmission from mosquitoes and document the decision process (where, when, and how) of mosquito control. 2 B. GENERAL INFORMATION 1. City of Renton Public Works Department—Surface Water Utility 1055 S. Grady Way- 5th Floor- Renton, WA 98057 Staff Contact information — Hebe C. Bernardo Phone number: 425-430-7264 2. Permittee's permit coverage area—area within City of Renton Corporate boundaries 3. Map showing permit coverage areas—See attached Exhibit A and Exhibit B 4. Emergency reporting i. Immediately notify the Ecology regional office and the aquatic pesticides permit manager of the failure to comply via the regional spills telephone hotline and the aquatic pesticides permit manager's phone number below. 1. Northwest Regional Office: 1-425-649-7000 2. Aquatic Pesticide Permit Manager: 1-360-407-6283 ii. Follow the attached Spill Response Flowchart for City requirements. C. SURVEILANCE L Larva mosquito surveillance The City of Renton has identified drainage facilities (see to Exhibit B) where larvicide treatment is required in order to control population of mosquitoes. Pretreatment surveillance in accordance with section S4.C.1.a of the NPDES Permit shall be performed in all facilities by the contractor (a certified pesticide applicator) prior pesticide application. Section S2.C.1.a reads as follows: "Pretreatment surveillance of a potential larvicide application site indicates that at least one larvae/pupae is present in at least one of three dips. In the event that the Permittee finds larvae/pupae, and the area is treated, the Permittee may continue pre-emptive larvicide treatments without dipping for the remainder of the treatment season." ii. Adult Mosquito General Surveillance. The City of Renton surveillance records consist of the following: 1. Public complaints (most local governments keep a complaints register) 2. Department of Health Surveillance Reports 3. King County Surveillance Reports 4. Staff observation 3 D. MAPPING Currently, the City of Renton has a mapping system in place to document the following: L Mosquito Breeding Sites: Drainage facilities identified by the City are mapped in Exhibit B. ii. No Spray Zones: Wetlands and their buffers are mapped as no spray zones in Exhibit A. iii. Critical Areas: Wetlands and their buffers are mapped as no spray zones in Exhibit A. E. ACTION TESHOLDS L Larva Mosquito Action Thresholds- Larvicide treatment will be performed if the following thresholds are exceeded: 1. Pretreatment surveillance of a potential larvicide application site indicates that at least one larvae/pupae is present in at least one of three dips. 2. The application site is in, or adjacent to a county in which mosquito, bird, animal, or human mosquito-borne disease cases are confirmed during the current treatment season. 3. The treatment site is a catch basin, storm drain, and utility or transportation vault. 4. State or local health authorities declare a public health threat or emergency related to mosquito-borne disease. ii. Adult Mosquito Action Thresholds: Adulticide treatment will be performed on the location identified by surveillance and included in Exhibit A at a maximum frequency of once per week during the months of April through August in accordance with the NPDES Permit when: 1. An increase in mosquito population densities (e.g. community accepted mosquito population density levels) has been reported; 2. Routine adult mosquito control thresholds based on surveillance are exceeded; 3. A threat of disease outbreak is present; 4. A mosquito-borne disease outbreak. F. MOSQUITO CONTROL METHODS. The City of Renton may use mosquito larvicides made of a natural bacterium (Bacillus sphaericus) and adulticides (BIOMIST® and/or Kontrol 4-4®)to help control mosquitoes in accordance with the Washington State Department of Ecology's Aquatic Mosquito Control General Permit. Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City. Adulticide treatment areas are generally located in upland areas east of SR-167 and west of Lake Avenue South/Talbot Road South between SW 39th Street to the south and 1-405 to the north, within the City of Renton, Washington. 4 G. MONITORING FOR EFFICACY/ RESISTANCE The City of Renton has not implemented a pesticide resistance— monitoring program. H. RECORD KEEPING The City of Renton maintains all records related to the Mosquito Abatement Program for a minimum of five years. Such records include: i. Annual Report; ii. All monitoring information including complaints from residents; and iii. Noncompliance notifications. I. EDUCATION AND OUTREACH The City conducts public education and outreach through: i. City Website- Educational materials posted on the City website addressing the following topics: 1. Treatment areas 2. West Nile virus information 3. Maps 4. Pesticides ii. Mail— Educational materials are sent to the residents near the Panther Creek wetlands before any adulticide treatment is performed in the area. J. STAFF TRAINING: L For Project Management Activities - all new staff members working in the Mosquito Abatement Program work with experienced employees in order to obtain required training. ii. For Pesticide Application -A licensed pesticide applicator with the appropriate Washington State Department of Agriculture (WSDA) license and certification Js always on site and has direct management responsibilities for the use of pesticides during application. K. SIGNATURE REQUIREMENTS As required in section S5.K, the Integrated Management Plan will be signed by the person with signature authority. L. PUBLIC ACCESS TO THE INTEGRATED MANAGEMENT PLAN The Integrated Management Plan will be located on the City's website at www.rentonwa.gov. 5 -405 Ramp S.A� _ Vv 1,�th=�St ►- I ,`A� �, 1 r '� � f I ±'S I� ` ' T� r t R _ � _._..� _�_ ; , _. -fit � . °��_ LLr �� I ��-,� i • • ,�.. SV1/ 9th=St . _.: _ _ -__ r_ ig,2 S. y `` t. tr � I I _ S 23rd St, SW-23rd St II i , 8,26th S't' 111 _ 11 �.._ v : ,� . : . r SW_27th_St _ _._.... _i _......._ ;L i t I $� � �" I a _l. s 27.t i II A`n1 . . + t �r SW 29 Ih St _ U I LU wh l. .y', oJ � �al �rJ S� __3ath t ____ _ � a it !__ r I t� It r II 11 2n i-! I J _ I� I f �t .`�` r ' 'ff r - _ I tri$ r _: 1 i j a I—I I .,-. I `�� i O� i J I �l. 1 f _J �_._. i I 1. , ,-:SW_39t� St � j � .�. S r38th=�G�t ,. ' ? { �, Mosquito Abatement Program Exhibit A: Adulticide Treatment Area 0 500 1,000 W E I I I I l Note: Treatment will not be applied within 100' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge O Project Boundary ,,�::� toyer and the residential areas. Property owner approval required prior to _ { IOf ^IE�t4cmiy 40 t ,�,➢) P ra'ia,) Il�1 v I 1 �jid ►,. J1 , •, r 4 V� �'t O `:It S 4't ��f '+1 �r„.tY� `\��$\� .�` ��i`�.rl r I ..ilr�`��`i, s It tin it� 1+�� �( �t -�f����\ � t���}�'t 5��€ts'�`{✓{��I ,` '._ t i ;._ y ��%` aInt+tki .r✓ tiF�-., "r. ;- hir- r.h'+I' ',r•5"tl '.,t;",-4 '„g ; a} f�t"� ;"��j.' - '�'. � �� � �� r� �i }r j .� _T:> � : :��:•�7j i'�: i a/ '/.i\....,, I .;g�g�,�t �, _� �, -�±-i/lgrr t1 a -t> :t` -- � >,�, !�r` a 4 � � �a�' / � Ittl . $ t+ uf s ��•t�""'�]pl' t ":k} 4'f kir�,njj{,k�'r".9t��}L J eS4 �/ 1,,.1 �} ., IF'�' tin: �.���-}"`j�:'s1I (� ty l�s�.. � _»11{• t�-�.._ I I � �� 1 �' .'�. S'I�I �ei�l � "j� � t Ff,�'':- I �Q}.+ `t 5__,,r'At� !'t!. ��. I � !}} i tI� 't'�� ��li....�L 1 7 f-_r•� N rn rr... ' I l.„_.� ���d.�,.:'. ,,�l �r�� I. qj+Il I i f lily T t� � f atr+• t t !I,((1 '�..�L�f) {�I:Y o7ti: I.�A' _.... �. �A ?1 al, _ '.iL �._ A, Z:�d• � ;� t;,q�^ sf gg y T I. , # ,. rt� l�t� r,�'':t �,� I: f „� ." ,�� � "��'�»'(r i:� ?�'� ��t a,n'i1 c ,` �{I 17 cr iil 1 T `�,• '�dt':L�t � T•aEE �'`,{ 7 ,k7Fi �\'� �r_.—.:I ; _I, ` 9p t��jd, �"k+.tif[ li: I 1411 � �lr� I .!, tr' N:\ .t, •. ,. I 'l i. ����il.1 1 .?>...Ila I !�'�: ! IL��� A'I � ..( _ .._.. _.,�5IW . ,t.rl. (� ` t 3.1 �) t•t_....._, t 1,K4 :✓i� I _ u! 7 f u, _ �r ,k p et rz �. ILI t1 � ujvj 1r�ltr�tL�I ( t t� fr rl f1 �� `_ j� �V 1 � t ILtt } ya H I,py r,1 t tai4ler�t, - �' t<.:1� �.r.r i71 �.- ., d' � \,\� •I I �']If. �` ., s __ 1 Ij„ f it ;ii t I i ) •. r� `tY� t 4RN, 1�. � +� r � �, - . �,.. .t'? / llytyt � T<..._.1' ��tT: 1 �^r +xa. r.a 4r _ _t_._ 11 t;a-r! i tr y- "l. r�c'r .. � L�\ 3 9 7S� [ -� l t� ..w ...7 1..� `L�i v (� — F - e +f��_� f � �t !•r_ri�t� N\ i,;�� 1['r"_ 1 S' ,.•( �'C.tif _� a� 1"'y'�5 �lxE ,��� r I`��Ijrilx l�� "�Jt i�r. �� ���.rr9 r(r'c ��: _� i r �lj' 113 r ;r E S. {} �L r 4 s F1N t:*a •+ s 'rB �y -.. � .. r 1 �i�.-.1 L:•_/� 5.,,,I...�i I I �>r r� �� '�Y�,7 �f �) .i4a(..� • 1 a Y , I } t J� t 4fk� '1 1 r,.. 1 to .:; tJY� �71' q t . T tr •'-��\ t--r. I f�... `�'ts -q, 1 .- 'f(r II[17 # � i. I � ,>+•ri! �, I / ;f: �. � t .s;bt ;�t�` a�.f 2 '� �ww I rli r S I w�M f �' ` ,•� A. ' p - " k:.'.;,..., G S j i,r(h`A,.., 4� IyS��•. 1 �,i t Ilf Oe.� -I I� 4'a� II /, 11111 y)_ t ... y �� St��'� 35fL i« � 3. 7+. t }. r i7 , ^• J ` --) 1�2..t _ r I 0. 1 J 1YW - / 1 t F 1 0 a J JJ + rF I�t �� .._.__! I "`-n�{.. t-' � � 7. �ahu'�i' �� •�� Sj{t� ,ar / ; }S��`� I 1111L pk r_� �� I 'i1 [� (°1� 4 L1 +. -`'L I iA f ✓ y, ( :, i { +s*�, +� L , 1 I s t fir; 1 +t �� to a�e "" , 'u`� 9�I t ,' ' 1 v �1 r.. 1,J9 i: }I rz r ,�...:_ I '�l ) ) t I > ,rye p 4n >fit +l` I -.I_-�•r. f,f I _ 4't� �� r � r I rd \ I ' � �t I n °5�. L il1.I:1 1 t JL _t t...... lI J; I , I ��{�, .L '' t'�Iltilft�} � r11� i�f ��� Ilntl all 11 li t r�#1 �d dliti��f i ��`�� ���`�����x 0� ;•�_ 1 ., t r 1�1 �:. :.' , ._ ..-... iy i ' .�..._� 1�... ;.'"� ;� l'`, '` - � ��`�.�l�T��i't"•ak � #i'���`i�� I I)f - •-.... I� vy����_ t :.� .�*fit '.,I .} II I�i ir'r i l tj '•�I i ��C����� � )11C�{�I�_ ti � o`�tuiY 3 ':��,i 1 1,� �` ,4n #���,�I�`ti�; j���" ��'e '4 III' li� -. [� j�F;, t �lf p) �F>*��G � � t?t+r 1, 1�� 46 �11' , �r _ fa li i �k� f I I Jl;i r er J1 l I 1T ) �1f. � •. fl lllr I I11 ,'� � �trr.... t 7 �� ��f P� * � 1 � � + r. t ,{ �-? ,etc; 1 gg f � � ' ! �1 -s 'T - � xa I k T �n� it ,.1. r Ii 1t.fr1�� �.`J! , J4+ � � � � I IIAit�: ,..� to _... ' I?{r r � ��I�%I� -.r.:,,, .. _h� r i_ t'! s- L..ti!�t�� l i.�I � 1�i�r-it. f st Ch � I�. •��. ZL t- ✓,6A, •- fiPT I - Iylf g � .I� � Sla ~ )y7 -- s»aa c: a .�' i,..• � r- P.T'x�. � ... Y 14irM15'�I V.vt M. I I1��'t?}7.I t]t� _.—... Mosquito Abatement Program 0 0.5 N Exhibit B: Larvicide Treatment Locations ` MilIes I I W The City of Renton may use mosquito larvicides made of a natural bacterium(Bacillus sphaericus)help control S mosquitoes in accordance with the Washington State Department of Ecology's Aquatic Mosquito Control General Permit. Treatments may occur between July 27 and October 30,2011. Larvicide treatment will generally occur in • City Owned or Maintained Facilities stormwater facilities owned or maintained by the City. For more information about the City's commitment to help reduce the threat of West Nile virus and control mosquitoes, contact Hebb Bernardo,City of Renton Surface Water Utility Engineer,at 425-430-7264 or by email at hbernardo@rentonwa.gov. For additional information about Ecology's ,m,fc,tyor qMosquito_ p '-- y--- .. A uatic Control General Permit, lease contacctt the City of Renton or Jon Jennings,Water Quality Emergency/HazMat Spill Definition- i i A spill or discharge of oil or hazardous substances into or from the(MS4)storm drain system,which i presents a threat to human health,welfare,or Is it a the environment. NO Emerge ncy/HazMat rE5 Spill ? j --� Call 911 Call 425-430-7400 j Notify: I 1 PW Main.Div.X-7400 I i Ecology 425-649-7000 Fire Department WA EM Div.800-258-5990 PW Maintenance Division will be first responder NRC 800-424-9802 will be first responder I For Aquifer protection contact Abdoul Gafour 425-430-7210 I, Stop/Contain/Clean Up Is the HAZMAT SPILL within NO YES the resources of the Fire Department? Notify`Ecology Contact Retnon EOC Duty ] v No Is it Sanitary res 425-649-7000 Officer if neeeded Sewer? PHONE 425-766-2720 Il Contact PW Maintenance Contact Public Works Complete ERTS Form Division for assistance Stop/Contain/Clean Up Maintenance Division I Stop/Contain/Clean Up Complete ERTS Form Stop/Contain/Clean Up I � y i Complete ERTS Form € Complete ERTS Form 1 ? H:\File Sys\SWA-Surface Water Section Administration\SWA 30-NPDES Programs\200011)DE\Spill Response Plan\Spill Response Plan Flow Chart.xls Certification Per section G.15 of the Aquatic Mosquito Control NPDES General Permit, all applications, reports and information submitted to Ecology must be signed and certified by the responsible official(s) of permittee . Please print and sign this page of the reporting form. I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that Qualified Personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering information, the information submitted is, to the best of my knowledge and belief,true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for willful violations. Name: F,!r' 'ii; Title: Public Works Administrator Date: Gregg A. m man, P.E. t Dena nis oaw - City Of Y Public Works Department-Gregg Zimmerman,P.E.,Administrator 2015 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex (Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray (Exhibit C). A portable fogger (gasoline-powered backpack-mounted) will be used to apply the spray to upland vegetation. During May through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit B) form, to allow the applicator access through your property, if needed, to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided by May 8, 2015. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you would like information on precautions you may take to help repel mosquitoes, please see Exhibit C. If you have any questions, or would like more information about the Mosquito Abatement Program, please contact Allen Quynn, Surface Water Utility Engineer, at 425-430-7247, or by email at aguynn@rentonwa.gov. Enclosures \\RvFPS-02\Depts\PW\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Release Request.doc Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov 1 r hS 4t i -JO 1-405 Ramp t d 76> St �s C/) m rn m OD I sw � 1 , t i,l I 'II f .I s StS 31 st St'-T Ln i 32 i > 1 4 St Q E N Cu � o S 38t jCO I Mosquito Abatement Program N Exhibit A: Site Plan 0 500 1,000 W E 11 1 1 1 Note: Treatment will not be applied within 100' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge OProject Boundary v and the residential areas. Property owner approval required prior to ��........'". e�° ' ! f ' treatment on private property. Surface Water Utility i G.Del Rosario I Printed 03/31/2010 Denis a Law City Of y ti� o l�yy Y ■L JI � ice" v A .�� r, NTVO Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 9899200040 Resident 3422 SHATTUCK AVE S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 8, 2015 USING THE ENCLOSED BUSINESS REPLY ENVELOPE \\RVFPS-02\Depts\PW\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Signature Authorization Exhibit B.doc/AQad Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov i EXHIBIT C Insecticide Products: As in previous years, we will be using products containing the insecticide permethrin. See below for more information. Permanone'31-66: Permanone' 31-66 is sold under the trade names of BioMist'and Kontrol'4- 4. They contain a synthetic version of permethrin as an active ingredient. The insecticides are formulated for dilution with oil products, such as mineral oil, and are applied at a rate between 0.003S and 0.0070 pounds of permethrin per acre. Permanone® 31-66 is degraded in soil and may last for several days. BioMist®and Kontrol'4-4 are not applied within 100-feet from water or wetland areas. Repel Mosquitoes: Not all mosquitoes will be eliminated during our Mosquito Abatement Program. Some precautions you may take to further reduce the number of mosquitoes in your area include: Mosquito Breeding Places: Some mosquitoes may breed in stagnant water. If you eliminate standing water around your home,you may eliminate their breeding places. Stagnant water may be found in ornamental pools, birdbaths, old tires, and flower pots. Methods to eliminate these and other potential breeding sites are listed in the Extension Bulletin PLS-121 April 2007 by the Washington State University Cooperative Extension titled "Pest Management for Prevention and Control of Mosquitoes". Natural Predators: By encouraging natural predators that feed on mosquitoes,you may also reduce the number of mosquitoes in your area. Natural predators include bats, swallows, frogs, and fish. In order to stock mosquito fish and three-spine stickleback fish, a permit is required from the Washington State Department of Fish and Wildlife. However,you may attract other natural predator animals by enhancing habitat and constructing cavity type houses. More information on attracting natural predators, such as instructions for constructing and locating bat houses, may be obtained from the State Department of Fish and Wildlife. Mosquito Repellent: By using mosquito repellent, netting, and screens you may reduce your exposure to mosquitoes. Additional precautions include: ♦ Wear clothes that reduce the area of exposed skin; ♦ Install screens or netting over open patios or windows; and/or ♦ Apply repellents, especially those containing the ingredient diethyltoluamide (DEET), to exposed skin. Since young children and certain adults can be sensitive to DEET, please follow application instructions carefully. Note: While bug lights eliminate some mosquitoes, they are not highly recommended, since studies show they also eliminate a large amount of beneficial and non-pest insects. Furthermore,Aedes, the most aggressive of the mosquito species, found in the Talbot Hill area, are not attracted to light and the noise emitted by the bug lights may annoy some neighbors. \\RvFPS-02\Depts\PW\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2015 Program\Release Request\2015 Description Exhibit C.doc/AQ/ad PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 3023059012 NAKANISHI RUTH Y 3315 TALBOT RD S RENTON WA 98055 3315 TALBOT RD S RENTON,WA 98055 2 3023059016 SCHULTEK JEFF_& BERNADINE 2921 TALBOT RD S RENTON WA _ 98055 2921 TALBOT RD S _ _ RENTON,WA 98055 3 3023059018 OLSON SHAWN &JAIME 3101 TALBOT RD S RENTON WA 98055 3101 TALBOT RD S RENTON,WA 98055 4 3023059019 TATRO DON L 3211 TALBOT RD S RENTON WA 98055 3211 TALBOT RD S RENTON,WA 98055 5 3023059025 NOBLE JANICE M _ __� 2819 TALBOT RD S RENTON WA 98055 2819 TALBOT RD S ( RENTON,WA 98055 6 3023059036 LEE BRANDON V 2709 TALBOT RD S _ RENTON WA _ 98055 2709 TALBOT RD S RENTON,WA 98055 7 3023059050 HAWKINS JACK M+JANE 1 2825 TALBOT RD S RENTON WA 98055 2825 TALBOT RD S _ ! RENTON,WA 98055 8 3023059063 ! NGHIEM HOA 3001 TALBOT RD RENTON WA 98055 3001 TALBOT RD S _ RENTON,WA 98055 9 3023059068 PHAM VANG VAN+NGOCLOAN THI 408 S 33RD PL RENTON WA 98055 408 S 33RD PL RENTON,WA ( 98055 10 3023059075 ! TURNER DAVID E&JODIE D ! 3107 TALBOT RD S RENTON WA 98055 3107 TALBOT RD S RENTON,WA 98055 11 3023059081 SCHNEIDER KATHLEEN E 3037 TALBOT RD S RENTON WA 98055 3037 TALBOT RD S _ _ RENTON,WA 98055 12 3023059105 CLIFFORD CHRISTOPHER P/CHINN SHERI J 2721 TALBOT RD S RENTON WA 98055 2719 TALBOT RD S _ _ _ j RENTON,WA 98055 13 3023059106 CHINN MARY JEAN _ _ 2715 TALBOT RD S �RENTON WA 98055 2715 TALBOT RD S RENTON,WA 98055 14 3023059107 KREBS FREDERICK D 2703 TALBOT RD S RENTON WA _ 98055 2703 TALBOT RD S _ _ _ RENTON,WA 98055 15 3023059114 SMITH ARTHUR L& MARIE W PO BOX 59512 RENTON WA 98058 3117 TALBOT RD S _ RENTON,WA 98055 16 3023059115 BERRY PAUL 3129 TALBOT RD S RENTON WA 98055 3129 TALBOT RD S _ _ RENTON,WA 98055 17 3023059116 FULLER NATHAN C ! 3113 TALBOT RD S RENTON WA 98055 3113 TALBOT RD S _ _ RENTON,WA 98055 18 3023059121 TRAN THANH VAN+THU HA_NGUYEN ET ALTHI 3011 TALBOT ROAD SO RENTON WA 98055 3011 TALBOT RD S _ RENTON,WA 98055 19 3023059122 PENA ELMER C+EVELYN D 3021 TALBOT RD S _ RENTON WA 98055 3021 TALBOT RD S _ RENTON,WA 98055 20 3023059123 WOO PETER C 3031 TALBOT RD S RENTON WA 98055 3031 TALBOT RD S _ RENTON,WA 98055 21 3023059127 RAMIREZ RENE Q+DANILEE 426 S 33RD PL r RENTON WA _ 98055 426 S 33RD PL ! RENTON,WA 98055 22 30230591, CHEUNG MUI HO+CHIM KUEN KAU 420 S 33RD PL RENTON WA _ 98055 420 S 33RD PL RENTON,WA 98055 23 3023059129 WONG WING TIN 5537 17TH AVE S SEATTLE WA 98108 414 S 33RD PL RENTON,WA 98055 24 3023059130 HERNANDEZ JORGO& MARTHA 402 S 33RD PL RENTON WA 98055 402 S 33RD PL RENTON,WA 98055 25 3340401110 NGUYEN DAT&TINA 1819 LAKE AVE S _ RENTON WA 98055 1819 LAKE AVE S RENTON,WA 98055 26 3340401115 CARROLL ELIZABETH 1805 LAKE AVE S RENTON WA 98055 1805 LAKE AVE S RENTON,WA 98055 27 3340401120 LARSEN KELLY F+JESSICA E 1803 LAKE AVE S RENTON WA 98055 1803 LAKE AVE S RENTON,WA 98055 28 3340401125 ALLEN JUSTIN P 1801 LAKE AVE S RENTON WA __ 98055 1801 LAKE AVE S RENTON,WA 98055 29 3340401130 MONTANEZ CHERIE D+MEDILO BENJIE P 1737 LAKE AVE S RENTON WA 98055 1737_ LAKE AVE S 0� _ RENTON,WA 98055 o 3340401131 VILLA CHARLES A+CONSTANCE M 1717 LAKE AVE S RENTON WA 98055 VACANT RENTON,WA 31 3340401132 GIENG HONG 1731 LAKE AVE S RENTON WA _ 98055 1731 LAKE AVE S RENTON,WA 98055 3340401133 j VILLAR MARILOU 430 TEMPLETON DR VANCOUVER BC V5L 4N6 VACANT RENTON,WA 33 3340401140 VILLA CHARLES A+CONSTANCE M 1717 LAKE AVE S RENTON WA 98055 1717 LAKE AVE S RENTON,WA 98055 34 3340401145 BROWN WAYNE ARTHUR JR 1711 LAKE AVE S RENTON WA 98055 _ 1711 LAKE AVE S RENTON,WA 98055 35 3340401150 DELLA ROSSA EDWIN 1625 LAKE AVE S RENTON WA 98055 1625_ LAKE AVE S RENTON,WA 98055 36 3340401151 TOBACCO JANA A 1701 LAKE AVE S RENTON WA 98055 1701 LAKE AVE S RENTON,WA 98055 37 3340401160 WILLIAMS DON D 9308 46TH AVE S SEATTLE WA 98118 1619 LAKE AVE S RENTON,WA 98055 38 3340401165 POZZOBON TERESA& EDA _ 1615 LAKE AVE S RENTON WA 98055 1615 LAKE AVE S RENTON,WA 98055 3_ 3340401170 DOMINGCIL MARYANN _ 1521 LAKE AVE S _ RENTON WA 98055 1521 LAKE AVE S RENTON,WA I 98055 4o 3340401171 SCHNEIDER SHAWN M+KATRINA M 1523 LAKE AVE S RENTON WA 98055 1523 LAKE AVE S RENTON, WA 98055 41 3340401172 CHAVEZ KATHRYN G 1607 LAKE AVE S RENTON WA 98055 _ 1607 T LAKE AVE S _ RENTON,WA 98055 42 3340401180 GUAN QING HUA+LI QI FENG _ 6916 S 124TH ST SEATTLE WA 98178 1515 LAKE AVE S RENTON, WA 98055 43 3340401190 MCCALLISTER GLEN A 1503 LAKE AVE S RENTON WA 98055 1503 LAKE AVE S RENTON,WA 98055 44 5070000010 AGOO SILVER D+GRACE T 3621 SHATTUCK AVE S RENTON WA 98055 3621 SHATTUCK AVE S RENTON,WA 98055 45 5070000020 GILLILAN ANNE LIVING TRUST_ 3615 SHATTUCK AVE S ��— RENTON WA 98055 _ 3615 SHATTUCK AVE S RENTON,WA 98055 46 5070000030 HOANG BAY T- 3609 SHATTUCK AVE S _ RENTON WA 98055 3609 SHATTUCK AVE S RENTON, WA 98055 PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 47 5070000040 KUMARAN RUDRA+SAVITRI 3603 SHATTUCK AVE S _ RENTON WA— — 98055 3603_ SHATTUCK AVE S — RENTON, WA 98055 48 5070000050 BOSTICK HARRY G 3527 SHATTUCK AVE S RENTON WA 98055 3527 SHATTUCK AVE S RENTON, WA 98055 49 5070000060 HARVEY RICHARD D& FRANCINE 21015 148TH AVE SE KENT WA 98042 3521 SHATTUCK AVE S RENTON, WA 98055 5o 5070000070 MOSS KATHERINE E 3509 SHATTUCK AVE S RENTON WA 98055 3509 SHATTUCK AVE S j RENTON, WA 98055 si 5070000080 CAMERINI DONALD A+CARMEL D 3503 SHATTUCK AVE S RENTON WA 98055 3503 SHATTUCK AVE S I RENTON, WA 98055 52 7222000410 FORD GLEN 1925 SHATTUCK AVE RENTON WA 98055 1925 SHATTUCK AVE S RENTON, WA j 98055 4�3 7222000511 SIDHU HARMINDER 223 S 19TH ST RENTON WA 98055 VACANT RENTON, WA 54 8557000170 HURST CHARLES HERMAN 2325 TALBOT CREST DR S RENTON WA 98055 2325 TALBOT CREST DR S RENTON, WA 98055 55 8557000180 MAGNO LILY 0 2331 TALBOT CREST DR S RENTON WA 98055 2331 TALBOT CREST DR S RENTON, WA 98055 s6 8557000190 VU HAI V 16020 SE 156TH ST RENTON WA 98058 2337 TALBOT CREST DR S RENTON, WA 98055 57 8557000200 NGUYEN XIN 2401 TALBOT CREST DR S RENTON WA 98055 2401 TALBOT CREST DR S RENTON, WA 98055 58 8557000210 NGUYEN THANG T 2407 TALBOT CREST DR RENTON WA 98055 2407 TALBOT CREST DR S RENTON, WA 98055 59 8557000220 PICKREIGN CYNTHIA J 2413 TALBOT CREST DR S RENTON WA 98055 2413 TALBOT CREST DR S _ RENTON, WA j 98055 60 8557000230 ESPEY DIANE 2419 TALBOT CREST DR S RENTON WA 98055 2419 TALBOT CREST DR S RENTON, WA 98055 61 8557000240 WILLIAMS BARTOW JR+MINNIE L 2503 TALBOT CREST DR S RENTON WA 98055 2503 TALBOT CREST DR S_ RENTON, WA 98055 62 8557000250 CUMMINGS RAYMOND+MARILYN L 2509 TALBOT CREST DR S RENTON WA 98055 2509 TALBOT CREST DR S RENTON, WA 98055 63 8557000260 TONSGARD PATRICIA L 2515 TALBOT CREST DR RENTON WA 98055 2515 TALBOT CREST DR S RENTON, WA 98055 64 8557000270 NESS ROSEMARY 2521 TALBOT CREST DR S RENTON WA 98055 2521 TALBOT CREST DR S ! RENTON, WA 98055 65 8557000280 HOLZBOOG DAVID S+AMY L 2527 TALBOT CREST DR S RENTON WA 98055 2527 TALBOT CREST DR S RENTON, WA 98055 66 8557000290 TRAUTMANN JOHN F 2601 TALBOT CREST DR S RENTON WA 98055 2601 TALBOT CREST DR S RENTON, WA 98055 67 8557000300 GOLDMANN CHARLES J 2607 TALBOT CREST DR S RENTON WA 98055 2607 TALBOT CREST DR S RENTON, WA 98055 6s 8860500080 HOBSON LEE C/DIGGSHOBSON MARY 206 S 20TH PL RENTON WA _ 98055 206 S 20TH PL RENTON, WA 98055 69 8860500090 j THOENNES NICHOLAS A _ 200 S 20TH PL RENTON WA 98055 200 S 20TH PL j RENTON, WA 98055 70 8860500100 NGUYEN THUAN Q+ANH NGOC 545 INDUSTRY DR TUKWILA WA 98188 _ 2005 DAVIS AVE S RENTON, WA 98055 71 8860500110 MAI JOANNE 2011 DAVIS AVE S RENTON WA 98055 2011 DAVIS AVE S RENTON, WA 98055 72 8860500120 CHINN MARCUS 2017 DAVIS AVE S RENTON WA 98055 2017 ( DAVIS AVE S RENTON, WA 98055 73 8860500130 LUONG HINH 2O23 DAVIS AVE S RENTON WA 98055 2023 DAVIS AVE S RENTON, WA 98055 74 8860500140 KIAZIMOV ALI+JOULIA BOGACHOV 2101 DAVIS AVE S RENTON WA _ 98055 2101 DAVIS AVE S RENTON, WA 98055 75 8860500150 O'STEEN JONAKAN H 2107 DAVIS AVE S RENTON WA 98055 2107 DAVIS AVE S_ RENTON, WA 98055 76 8860500160 DAVIS GEORGE E+DAVIS DALIA P 671 HARRINGTON AVE NE RENTON WA 98056 303 S 21ST ST j RENTON, WA 98055 77 8860500170 DURDUEVA SVETLANA 307 S 21ST ST RENTON WA 98055 307 S 21ST ST RENTON, WA 98055 78 8860500180 MARTIN ROBERT P& NIDA B 2111 DAVIS AVE S RENTON WA 98055 2111 DAVIS AVE S RENTON, WA 98055 79 8860500190 KING ALBERT WONG+LYNN WING 2115 DAVIS AVE S RENTON WA 98055 2115 DAVIS AVE S j RENTON, WA 98055 so 8860500200 VO ANTHONY+LE TAMMIE 2121 DAVIS AVE S RENTON WA 98055 2121 DAVIS AVE S j RENTON, WA 98055 81 8860500210 FERARA CHERYL ANN 2127 DAVIS AVE S RENTON WA 98055 2127 DAVIS AVE S j RENTON, WA 98055 82 8860500220 1 BROADDUS SUSAN G PO BOX 58154 RENTON WA 98058 2133 DAVIS AVE S RENTON, WA 98055 kis3 8860500350 VALLEY VUE ESTATES HOA _ 332 S 20TH PL RENTON WA 98055 VACANT RENTON, WA 84 9899200010 FAST JOHN L 3431 SHATTUCK AVE S RENTON WA 98055 3431 SHATTUCK AVE S RENTON, WA 98055 ss 9899200020 HILL JAY G+DORI A 3425 SHATTUCK AVE S RENTON WA 98055 3425 SHATTUCK AVE S RENTON, WA 98055 86 9899200030 LEMAFA MOLIUILA M 3419 SHATTUCK AVE S RENTON WA 98055 3419 SHATTUCK AVE S ! RENTON, WA 98055 871 9899200040 BALDRIDGE BRUCE T 3422 SHATTUCK AVE S RENTON WA 98055 3422 SHATTUCK AVE S RENTON, WA 98055 `J I Nei obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name Vectol-ex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Stonegate/WQ Pond NE 26th and Lyons Ave 2 Surface Water Utility NE 10th St Pond/Detention NE 10th St and Anacortes Ave 3 Surface Water Utility Talbot Ridge 2/WQ Pond S 47" St and 102nd Ave SE (Main Ave S) .( 4 Surface Water Utility Talbot Estates/Pond Talbot Rd S J 5 Surface Water Utility Olympic Peak Estates/Pond S. 196th PL 6 Surface Water Utility Larson Parke/Pond 112th Ave SE 7 Surface Water Utility Watershed Terrace/Pond SE 200th St 8 Surface Water Utility Wilkens Wood/Pond 113th Ave SE 9 Surface Water Utility Serenity Ridge Tract A/Pond 110th PL SE 10 Surface Water Utility Serenity Ridge Tract B/Pond 110th PL SE 11 Surface Water Utility Auria Woods Tract C/Pond SE 186th St 12 Surface Water Utility SR-169/Pond 140th Way SE 13 Surface Water Utility Fredericks Place/Pond SE 1861h St J 14 Surface Water Utility Aster Park/Pond NE 131h PL 15 Surface Water Utility Hamilton Place/Pond 160th Ave SE J 16 Surface Water Utility Evendell/Pond 160th Ave SE J 17 Surface Water Utility Nichols Place/Pond 160th Ave SE/SE 5th St 18 Surface Water Utility Ellis Park 124th St. SE/ 1491h Ave. SE. 19 Surface Water Utility Windsor circle 13502 162nd AveSE J 20 Surface Water Utility Heritage Renton Hill S 7th St./S 7th Ct. f 21 Surface Water Utility Amberwood 6001 Ne 4th St. .( 22 Surface Water Utility Maureen Highlands 6118 Ne 4th St. 23 Surface Water Utility Sienna 250 Jericho Ave NE 24 Surface Water Utility Brookefield II 1100 Hoquiam Ave NE 25 Surface Water Utility Shy Creek 129 Jericho Ave NE •I 26 Surface Water Utility Aspen Woods 864 and 852 Hoquiam Ave NE 27 Surface Water Utility Amberwood II 6135 NE 4th St. 28 Surface Water Utility Morning Glen 176Th St. and 1141h PI SE 29 Surface Water Utility Chinquapin Ridge SE 192nd and 113 St. SE 30 Surface Water Utility Pioneer Place Maple Valey Rd and 149th Ave SE 31 Surface Water Utility Highland Estates SE 136th St and 152nd Ave SE 32 Surface Water Utility Jericho Plat Intersection of Jericho Ave NE And NE 4th St Extending West To Hoquiam Ave NE 33 Surface Water Utility Liberty Grove and Liberty Grove SE 136th St and 160th Ave SE. Contiguous Page 2 of 12 Piazza/Data_Cente r/Form s/City/Contracts 34 Surface Water Utility Laurelhurst Phase I Duval Ave and NE 1St. St 35 Surface Water Utility Parkside Court Lions Ave and SE 2nd PI. 36 Surface Water Utility Emma's SE 1st Place fronting Lyons Ave NE 37 Surface Water Utility Sunnybrook Plat 3721 Morris Ave S 38 Surface Water Utility Winsper (Liberty view Phase I & S. 32nd St and Talbot Rd. S. 11) 39 Surface Water Utility Kimberly Lane 17228 125t" Ave SE 40 Surface Water Utility Maple Glen Addition SE 182nd St and 108th Ave SE 41 Surface Water Utility Christian Short Plat 11129 SE 189t" PI 42 Surface Water Utility Greenfield II (Highpointe 11) 1318 Redmond PI NE 43 Surface Water Utility Windsong Field PI NE and NE 4t" PI 44 Surface Water Utility Liberty Ridge Phase 2 NE 1st St and Glennwood Ave SE 45 Surface Water Utility Liberty Ridge Phase 1 2511 NE 1st St (behind residence) 46 Surface Water Utility Liberty Ridge Phase 1 Index Ave SE and SE 1st St 47 Surface Water Utility Elmhurst Whitman PI NE and NE 2nd Ln 48 Surface Water Utility Zetterberg Burnett PI S and S 21st St 49 Surface Water Utility Magnussen Plat Field Ave NE and NE 2nd St 50 Surface Water Utility Magnussen Plat 4814 NE 2dn St (behind residence) 51 Surface Water Utility Cottages at Honey Creek NE Sunset Blvd and Elma PI NE 52 Surface Water Utility Highlands Park Rosario PI SE and SE 2nd PI 53 Surface Water Utility Shamrock Glen (aka Martin Lyons PI NE and NE 5t" Cir Prop) 54 Surface Water Utility Beclan Place Plat Hoquiam Ave NE and NE 2nd St 55 Surface Water Utility NE 4th Detention Field Ave NE and NE 2nd PI DMA 56 Surface Water Utility Maureen Highlands NE 4th St and Shadow Ave NE W(2L� 57 Surface Water Utility Summerwind NE Sunset Blvd and Field Ave NE 58 Surface Water Utility Maplewood Estates E 2nd Ct and Orcas PI SE 59 Surface Water Utility Westmont Monetery Ct NE and NE 36" St 60 Surface Water Utility Victoria Hills S 23rd St and Main Ct S 61 Surface Water Utility Honey Brooke West (Sagecrest) NE 5t" St and Field PI NE 62 Surface Water Utility Honey Creek Ridge, Tract 'A' NE 261h Ct and Lynnwood Ave NE 63 Surface Water Utility Honey Creek Ridge, Tract `B' NE 25t" St and Monroe Ct NE 64 Surface Water Utility River Ridge SE 7th St and SE 81h PI 65 Surface Water Utility Langley Ridge at May Creek NE 25th St and Ilwaco Ave NE 66 Surface Water Utility Catch Basins Various 67 Golf Course Hole #18 Pond/Irrigation Maplewood Golf Course (west) 68 Golf Course Hole #9 Pond/Irrigation Maplewood Golf Course (west- central) 69 Golf Course Hole #7 Pond/Irrigation Maplewood Golf Course (east- central) 70 Golf Course Hole #6 Pond/Irrigation Maplewood Golf Course (east) 71 Golf Course Catch Basins Various 72 Parks Maintenance Catch Basins Various Division Page 3 of 12 Piazza/Data Center/Forms/City/Contracts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name Vectol-ex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Stonegate/WQ Pond NE 26th and Lyons Ave 2 Surface Water Utility NE 10th St Pond/Detention NE 101h St and Anacortes Ave 3 Surface Water Utility Talbot Ridge 2/WQ Pond S 47th St and 102nd Ave SE (Main Ave S) 4 Surface Water Utility Talbot Estates/Pond Talbot Rd S 5 Surface Water Utility Olympic Peak Estates/Pond S. 196th PL 6 Surface Water Utility Larson Parke/Pond 112th Ave SE 7 Surface Water Utility Watershed Terrace/Pond SE 200th St 8 Surface Water Utility Wilkens Wood/Pond 1131h Ave SE 9 Surface Water Utility Serenity Ridge Tract A/Pond 1101h PL SE 10 Surface Water Utility Serenity Ridge Tract B/Pond 110th PL SE 11 Surface Water Utility Auria Woods Tract C/Pond SE 186th St 12 Surface Water Utility SR-169/Pond 140th Way SE 13 Surface Water Utility Fredericks Place/Pond SE 186th St 14 Surface Water Utility Aster Park/Pond NE 13th PL 15 Surface Water Utility Hamilton Place/Pond 160th Ave SE 16 Surface Water Utility Evendell/Pond 160th Ave SE 17 Surface Water Utility Nichols Place/Pond 160th Ave SE/SE 5th St 18 Surface Water Utility Ellis Park 124th St. SE / 149th Ave. SE. 19 Surface Water Utility Windsor circle 13502 162nd AveSE 20 Surface Water Utility Heritage Renton Hill S 7th St./S 7th Ct. 21 Surface Water Utility Amberwood 6001 Ne 4th St. 22 Surface Water Utility Maureen Highlands 6118 Ne 4th St. 23 Surface Water Utility Sienna 250 Jericho Ave NE 24 Surface Water Utility Brookefield II 1100 Hoquiam Ave NE 25 Surface Water Utility Shy Creek 129 Jericho Ave NE 26 Surface Water Utility Aspen Woods 864 and 852 Hoquiam Ave NE 27 Surface Water Utility Amberwood II 6135 NE 4th St. 28 Surface Water Utility Morning Glen 176Th St. and 114th PI SE 29 Surface Water Utility Chinquapin Ridge SE 192nd and 113 St. SE 30 Surface Water Utility Pioneer Place Maple Valey Rd and 149th Ave SE 31 Surface Water Utility Highland Estates SE 136th St and 152nd Ave SE 32 Surface Water Utility Jericho Plat Intersection of Jericho Ave NE And NE 4th St Extending West To Hoquiam Ave NE 33 Surface Water Utility Liberty Grove and Liberty Grove SE 136th St and 160th Ave SE. Contiguous Page 2 of 12 Piazza/Data_Center/Forms/City/Contracts 34 Surface Water Utility Laurelhurst Phase I Duval Ave and NE 1". St 35 Surface Water Utility Parkside Court Lions Ave and SE 2nd PI 36 Surface Water Utility Emma's SE 1st Place fronting Lyons Ave NE 37 Surface Water Utility Sunnybrook Plat 3721 Morris Ave S 38 Surface Water Utility Winsper (Liberty view Phase I & S. 32nd St and Talbot Rd. S. II) 39 Surface Water Utility Kimberly Lane 17228 125th Ave SE 40 Surface Water Utility Maple Glen Addition SE 182nd St and 108th Ave SE 41 Surface Water Utility Christian Short Plat 11129 SE 189th PI 42 Surface Water Utility Greenfield II (Highpointe 11) 1318 Redmond PI NE 43 Surface Water Utility Windsong Field PI NE and NE 4th PI 44 Surface Water Utility Liberty Ridge Phase 2 NE 1st St and Glennwood Ave SE 45 Surface Water Utility Liberty Ridge Phase 1 2511 NE it St (behind residence) 46 Surface Water Utility Liberty Ridge Phase 1 Index Ave SE and SE 1st St 47 Surface Water Utility Elmhurst Whitman PI NE and NE 2nd Ln 48 Surface Water Utility Zetterberg Burnett PI S and S 21st St 49 Surface Water Utility Magnussen Plat Field Ave NE and NE 2nd St 50 Surface Water Utility Magnussen Plat 4814 NE 2dn St (behind residence) 51 Surface Water Utility Cottages at Honey Creek NE Sunset Blvd and Elma PI NE 52 Surface Water Utility Highlands Park Rosario PI SE and SE 2nd PI 53 Surface Water Utility Shamrock Glen (aka Martin Lyons PI NE and NE 5th Cir Prop) 54 Surface Water Utility Beclan Place Plat Hoquiam Ave NE and NE 2nd St 55 Surface Water Utility NE 4th Detention Field Ave NE and NE 2nd PI 56 Surface Water Utility Maureen Highlands NE 4th St and Shadow Ave NE 57 Surface Water Utility Summerwind NE Sunset Blvd and Field Ave NE 58 Surface Water Utility Maplewood Estates E 2nd Ct and Orcas PI SE 59 Surface Water Utility Westmont Monetery Ct NE and NE 361h St 60 Surface Water Utility Victoria Hills S 23rd St and Main Ct S 61 Surface Water Utility Honey Brooke West (Sagecrest) NE 5th St and Field PI NE 62 Surface Water Utility Honey Creek Ridge, Tract 'A' NE 26th Ct and Lynnwood Ave NE 63 Surface Water Utility Honey Creek Ridge, Tract 'B' NE 25th St and Monroe Ct NE 64 Surface Water Utility River Ridge SE 7th St and SE 8th PI 65 Surface Water Utility Langley Ridge at May Creek NE 25th St and Ilwaco Ave NE 66 Surface Water Utility Catch Basins Various 67 Golf Course Hole #18 Pond/Irrigation Maplewood Golf Course (west) 68 Golf Course Hole #9 Pond/Irrigation Maplewood Golf Course (west- central) 69 Golf Course Hole #7 Pond/Irrigation Maplewood Golf Course (east- central) 70 Golf Course Hole #6 Pond/Irrigation Maplewood Golf Course (east) 71 Golf Course Catch Basins Various 72 Parks Maintenance Catch Basins Various Division Page 3 of 12 Piazza/Data_Ce me r/Forms/City/Contracts 7T I Facilities Division City Hall/WQ Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course —Whitworth Pest Solutions, Inc. shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 12 Piazza/Data_Ce nter/Forms/City/Contracts ' r Old ID ID Site Name Facility Type Facility Location 66 Catchbasins Catchbasins Various 72 Catchbasins Catchbasins Various 21 1 Amberwood Water Quality Pond 315 Quincy Ave NE 27 2 Amberwood II Water Quality Pond 304 Rosario PI NE 26 3 Aspenwoods Water Quality Pond 808 Ilwaco PI NE 14 4 Aster Park Plat Water Quality Pond 5516 NE 13th St 11 5 Auria Woods Tract C Water Quality Pond 12152 SE 186th St 56 6 Beclan Place Plat Water Quality Pond 5134 NE 2nd St 24 7 Brookefield II Water Quality Pond 5305 NE 11th Ct 29 8 Chinquapin Ridge Water Quality Pond 19123 113th Way SE 43 9 Christian Short Plat Water Quality Pond 11129 SE 189th PI 53 10 Cottages at Honey Creek Water Quality Pond NE Sunset Blvd/ Elma PI NE 12 11 Elliott Farm Detention Pond Maple Valley Hwy/ 140th Way SE 18 12 Ellis Park aka Edenwood Water Quality Pond 602 NE 6th St 49 13 Elmhurst Water Quality Pond 215 Whitman PI NE 37 14 Emma's Plat Water Quality Pond 5611 SE 1st PI 16 15 Evendell Plat Water Quality Pond 6741 SE 4th St 13 16 Fredricks Place Water Quality Pond 10301 SE 186th St 44 17 Greenfield II aka Highpointe II Water Quality Pond 1318 Redmond PI NE 15 18 Hamilton Place Plat Water Quality Pond 6743 NE 1st PI 20 19 Heritage Renton Hill Water Quality Infiltration Pond 1816 SE 8th PI 31 20 Highland Estates Water Quality Pond 355 Rosario PI SE 54 21 Highlands Park Water Quality Pond 202 Rosario Ave SE 32 22 Jericho Estates Water Quality Pond 316 Hoquiam Ave NE 41 23 Kimberly Lane Water Quality Pond 17228 125th Ave SE 6 24 Larson Parke Plat Water Quality Pond 18469 114th Ave SE 35 25 Laurelhurst Phase I Water Quality Pond 4615 NE 1st St 33 26 Liberty Grove and Liberty Grove Contiguous Water Quality Pond 13716 160th Ave SE 47 27 Liberty Ridge Phase I Water Quality Infiltration Pond 2511 NE 1st St (behind residence) 48 28 Liberty Ridge Phase I Water Quality Pond 205 Index PI SE 46 29 Liberty Ridge Phase II Water Quality Infiltration Pond 2601 Ferndale Ave NE 51 30 Magnussen Plat Water Quality Pond 202 Field Ave NE 52 31 Magnussen Plat Water Quality Pond 4814 NE 2nd St (behind residence) 42 32 Maple Glen Addition Water Quality Pond SE 182nd St/ 108th Ave SE 22 33 Maureen Highlands Tract A Water Quality Pond 6118 NE 4th St 28 34 Morning Glen Water Quality Pond 17612 114th PI SE 2 35 NE 10th St Pond Water Quality Pond NE 10th/Anacortes Ave NE 57 36 NE 4th Detention Water Quality Pond 234 Field Ave NE 17 37 Nichols Place Water Quality Pond 13815 160th Ave SE 5 38 Olympic Peak Estates Water Quality Pond 9402 S 196th PI 36 39 Parkside Court Water Quality Pond 5621 SE 2nd St 30 40 Pioneer Place Water Quality Pond Maple Valley Rd/ 149th Ave SE 9 41 Serenity Ridge Tract A Water Quality Pond 17927 110th PI SE 10 42 Serenity Ridge Tract B Water Quality Pond 17707 110th PL SE 55 43 Shamrock Glen aka Martin Prop Water Quality Pond 5507 NE 5th Cir 25 44 Shy Creek Water Quality Pond 204 SE 2nd St 23 45 Sienna Water Quality Pond 5402 NE 2nd St 1 46 Stonegate Water Quality Pond 5500 NE 26th St 39 47 Sunnybrook Water Quality Pond 712 S 36th PI 4 48 Talbot Estates Water Quality Pond 9612 S 194th St 3 49 The Reserve at Stonehaven Water Quality Pond 1003 S 47th St 7 50 Watershed Terrace Water Quality Pond 19926 101st Ave SE 8 51 Wilkins Wood Water Quality Pond 16603 113th Ave SE 45 52 Windsong Water Quality Pond 4925 NE 4th PI 19 53 Windsor Circle aka Harmony Gro Water Quality Pond 13502 162nd Ave SE 40 54 Winsper(Liberty View I&II) Water Quality Pond 611 S 32nd St 50 55 Zetterberg Water Quality Pond 2100 Burnett PI S 61 56 Honey Brooke West aka Sagecrest Water Quality Pond 505 Field PI NE 62 57 Honey Creek Ridge Tract A Detention Pond with Bioswale 3203 NE 26th Ct 63 58 Honey Creek Ridge Tract B Detention Pond with Bioswale 2407 Olympia Ave NE 65 59 Langley Ridge at May Creek Water Quality Pond 5302 NE 26th St 58 60 Maplewood Estates Detention Pond with Bioswale 5831 SE 2nd Ct 56 61 Maureen Highlands Tract C Water Quality Pond 653 Shadow Ave NE 64 62 River Ridge Detention Pond with Bioswale 1706 SE 7th Ct 57 63 Summerwind Detention Pond NE Sunset Blvd/ Field Ave NE 60 64 Victoria Hills Detention Pond 1012 S 23rd St 59 65 Westmont Water Quality Pond 3625 Monterey Ct NE w 67 90 Maplewood Golf Course (west) Golf Course Pond Hole #18 Pond 68 91 Maplewood Golf Course (west-central) Golf Course Pond Hole#9 Pond 69 92 Maplewood Golf Course (east-central) Golf Course Pond Hole#7 Pond 70 93 Maplewood Golf Course (east) Golf Course Pond Hole#6 Pond 71 98 Maplewood Golf Course Catchbasins Catchbasins Various 73 99 Renton City Hall Water Quality Grady Way Parking Lot Owner AssetlD Notes Surface Water Utility Parks Maintenance Division Surface Water Utility 145360 Surface Water Utility 145528 Surface Water Utility 145538 Surface Water Utility 111396 Surface Water Utility 111360 Surface Water Utility 195487 Surface Water Utility 145352 Surface Water Utility 111364 Surface Water Utility 111371 Surface Water Utility 145523 Surface Water Utility 111403 Surface Water Utility 111424 Surface Water Utility 145409 Surface Water Utility 145364 Surface Water Utility 111383 Surface Water Utility 111367 Surface Water Utility 145339 Surface Water Utility 111401 Surface Water Utility 145401 Surface Water Utility 111380 Surface Water Utility 145539 Surface Water Utility 145536 Surface Water Utility 111355 Surface Water Utility 111385 Surface Water Utility 145362 Surface Water Utility 111400 Surface Water Utility 145382 Surface Water Utility 145383 Surface Water Utility 145373 Surface Water Utility 145520 Surface Water Utility 145521 e Surface Water Utility 111368 Surface Water Utility 145358 Surface Water Utility 111363 Surface Water Utility 111336 Surface Water Utility 111347 Surface Water Utility 111406 Surface Water Utility 111353 Surface Water Utility 145367 Surface Water Utility 111404 Surface Water Utility 111358 Surface Water Utility 111359 Surface Water Utility 146777 Surface Water Utility 145408 Surface Water Utility 145366 Surface Water Utility 111395 Surface Water Utility 145325 Surface Water Utility 111362 Surface Water Utility 145393 Surface Water Utility 111352 Surface Water Utility 111409 Surface Water Utility 145351 Surface Water Utility 177996 Surface Water Utility 111343 Surface Water Utility 145512 Surface Water Utility 145414 Surface Water Utility 145534 Surface Water Utility 145535 Surface Water Utility 146774 Surface Water Utility 145381 Surface Water Utility 145357 Surface Water Utility 145584 Surface Water Utility 145376 Surface Water Utility 145407 Surface Water Utility 145396 Golf Course Golf Course Golf Course Golf Course Golf Course Facilities Division r 40 Pioneer Place Maple Valley Rd/149th Ave SE Water Quality Pond Surface Water Utility 111404 41,Serenity Ridge Tract A 17927 110th PI SE Water Quality Pond Surface Water Utility 111358 42 Serenity Ridge Tract B 17707 110th PL SE Water Quality Pond Surface Water Utility 111359 43 Shamrock Glen aka Martin Prop 5507 NE 5th Cir Water Quality Pond Surface Water Utility 146777 44 Shy Creek 204 SE 2nd St Water Quality Pond Surface Water Utility 145408 45 Sienna 5402 NE 2nd St Water Quality Pond Surface Water Utility 145366' 46 Stonegate _ 5500 NE 26th St Water Quality Pond Surface Water Utility 111395 47 Sunnybrook 712 S 36th PI Water Quality Pond Surface Water Utility 145325 48 Talbot Estates 9612 S 194th St Water Quality Pond Surface Water Utility 111362 49 The Reserve at Stonehaven 1003 S 47th St Water Quality Pond Surface Water Utility 145393 50I Watershed Terrace 19926 101st Ave SE Water Quality Pond Surface Water Utility 111352 51'Wilkins Wood 16603 113th Ave SE Water Quality Pond Surface Water Utility 111409 52 Windsong 4925 NE 4th PI Water Quality Pond Surface Water Utility 145351 53 Windsor Circle aka Harmony_Gro _ 13502162nd Ave SE Water Quality Pond Surface Water Utility 177996. 54 Winsper(Liberty View 1&II) 611 S 32nd St Water Quality Pond Surface Water Utility 111343 i 55 Zetterberg 2100 Burnett PI S Water Quality Pond Surface Water Utility 145512 56 Honey Brooke West aka Sagecrest 505 Field PI NE Water Quality Pond Surface Water Utility 145414 57 Honey Creek Ridge Tract A 3203 NE 26th Ct Detention Pond with Bioswale Surface Water Utility 145534 58 Honey Creek Ridge Tract B 2407 Olympia Ave NE Detention Pond with Bioswale Surface Water Utility 145535 59 Langley Ridge at May Creek 5302 NE 26th St Water Quality Pond Surface Water Utility 146774 60 Maplewood Estates 5831 SE 2nd Ct Detention-Pond-with Bioswale ISurface Water Utility 145381 61 Maureen Highlands Tract C 653 Shadow Ave NE Water Quality Pond Surface Water Utility 145357 62 River Ridge 1706 SE 7th Ct Detention Pond with Bioswale Surface Water Utility 145584 63 Summerwind NE Sunset Blvd/Field Ave NE Detention Pond Surface Water Utility 145376 64 Victoria Hills 1012 S 23rd St Detention Pond _ Surface Water Utility 145407 65,Westmont_ 3625 Monterey Ct NE Water Quality Pond _ Surface Water Utility 145396 901 Maplewood Golf Course(west) Hole#18 Pond Golf Course Pond Golf Course 91 Maplewood Golf Course(west-central) Hole#9 Pond Golf Course Pond Golf Course 92 Maplewood Golf Course(east-central) Hole#7 Pond Golf Course Pond Golf Course 93-Maplewood Golf Course(east) Hole#6 Pond Golf Course Pond Golf Course 98 Maplewood Golf Course Catchbasins Various Golf Course Catchbasins Catchbasins Golf Course 9 s Catchbasins IV ' Catchbasins Surface Water Utility ID Site Name Facility Location Facility Type Owner Asset ID Notes 1 Amberwood 315 Quincy Ave NE Water Quality Pond Surface Water Utility 145360 2 Amberwood II 304 Rosario PI NE Water Quality Pond Surface Water Utility 145528 3 Aspenwoods 808 Ilwaco PI NE Water Quality Pond Surface Water Utility 145538 4Aster Park Plat 5516 NE 13th St Water Quality Pond Surface Water Utility 111396 5 iAuria Woods Tract C 12152 SE 186th St Water Quality Pond Surface Water Utility 111360 6 Beclan Place Plat 5134 NE 2nd St Water Quality Pond Surface Water Utility 195487 7 Brookefield II 5305 NE 11th Ct Water Quality Pond Surface Water Utility 145352 8 Chinquapin Ridge 19123 113th Way SE Water Quality Pond Surface Water Utility 111364 9 Christian Short Plat 11129 SE 189th PI Water Quality Pond Surface Water Utility 111371 10 Cottages at Honey Creek NE Sunset Blvd/Elma PI NE Water Quality Pond Surface Water Utility 145523 11 Elliott Farm Maple Valley Hwy/140th Way SE Detention Pond Surface Water Utility 111403 12 Ellis Park aka Edenwood 602 NE 6th St Water Quality Pond Surface Water Utility 111424 13 Elmhurst 215 Whitman PI NE Water Quality Pond Surface Water Utility 145409 14 Emma's Plat 5611 SE 1st PI I Water Quality Pond Surface Water Utility 145364 15 Evendell Plat 6741 SE 4th St 'i Water Quality Pond Surface Water Utility 111383 16 Fredricks Place 10301 SE 186th St Water Quality Pond Surface Water Utility 111367 17 Greenfield II aka Highpointe II 1318 Redmond PI NE Water Quality Pond Surface Water Utility 145339 18 Hamilton Place Plat 6743 NE 1st PI Water Quality Pond Surface Water Utility 111401 19 Heritage Renton Hill 1816 SE 8th PI Water Quality Infiltration Pond Surface Water Utility 145401 20 Highland Estates 355 Rosario PI SE Water Quality Pond Surface Water Utility 111380 21 Highlands Park 202 Rosario Ave SE Water Quality Pond Surface Water Utility 145539 22 Jericho Estates 316 Hoquiam Ave NE Water Quality Pond Surface Water Utility 145536 23 Kimberly Lane 17228 125th Ave SE Water Quality Pond Surface Water Utility 111355 24 Larson Parke Plat 18469 114th Ave SE Water Quality Pond Surface Water Utility 111385 25 Laurelhurst Phase I 4615 NE 1st St Water Quality Pond Surface Water Utility 145362 26 Liberty Grove and Liberty Grove Contiguous 13716 160th Ave SE Water Quality Pond Surface Water Utility 111400 27 Liberty Ridge Phase 1 2511 NE 1st St(behind residence) Water Quality Infiltration Pond Surface Water Utility 145382 28 Liberty Ridge Phase 1 205 Index PI SE Water Quality Pond Surface Water Utility 145383, 29 Liberty Ridge Phase II 2601 Ferndale Ave NE Water Quality Infiltration Pond Surface Water Utility 145373 30 Magnussen Plat 202 Field Ave NE Water Quality Pond Surface Water Utility 14SS20 31 Magnussen Plat 4814 NE 2nd St(behind residence) Water Quality Pond Surface Water Utility 145521 32 Maple Glen Addition SE 182nd St/108th Ave SE Water Quality Pond Surface Water Utility 111368 33 Maureen_ Highlands Tract A 6118 NE 4th St Water Quality Pond Surface Water Utility 145358 34 Morning Glen 17612 114th PI SE Water Quality Pond Surface Water Utility 111363 35'NE 10th St Pond NE 10th/Anacortes Ave NE Water Quality Pond Surface Water Utility 111336 36 NE 4th Detention 234 Field Ave NE Water Quality Pond Surface Water Utility 111347 37 Nichols Place 13815 160th Ave SE Water Quality Pond Surface Water Utility 111406 38 Olympic Peak Estates 9402 S 196th PI Water Quality Pond Surface Water Utility 111353 39 Parkside Court 5621 SE 2nd St Water Quality Pond Surface Water Utility 145367 t Allen Quynn From: Edward Horvath <eshorvath@trmvc.com> Sent: Tuesday, April 14, 2015 7:37 AM To: Allen Quynn Subject: RE: Mosquito control RFP Attachments: Edward Horvath-CV-2015.pdf Good Morning Mr. Quinn- Please find attached my CV for relevant experience. Our work processes are state of the art; utilizing the most up to date technologies, products and equipment. We are consulted with by many agencies, both in the US and overseas. I have trained agencies in the USA and in the Middle East and Africa for efficient and effective mosquito control. In one City in the ME, we have even been successful in eliminating malaria. We have the ability to apply larvicides through backpack blowers, manual seeders and even by truck,ATV and by aircraft. In addition, our adulticides can be applied through backpack, hand held foggers, ATV mounted foggers and truck mounted foggers. All of our equipment is up to date and calibrated bi-weekly to ensure pesticides are applied properly and effectively. All pesticide applications are tracked with GPS/GIS technology. Inspections and treatments for larvicides are recorded in a handheld Trimble Nomad utilizing an ArcPad application. The field technician records what is used,where it is being used at the location. ArcPad then records the GPS location, date and time of where the field technician is recording the application. This ensures accountability of the technicians applications. A couple of the web sites for our current municipal mosquito control projects are below: www.sbwmc.com www.chiloquinmosquito.org www.trmvc.com I look forward to talking with you in more detail to discuss how our company is the best fit for the City of Renton. Be assured, our results speak for themselves. Respectfully, -ESH Edward Horvath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito &Vector Control Office: (541) 238-2272 Skype: edward_horvath www.trmvc.com 1 From: Allen Quynn [mailto:aquynn@Rentonwa.gov] Sent: Monday, April 13, 2015 10:56 AM To: 'eshorvath@trmvc.com' Subject: RE: Mosquito control RFP Hi Mr. Horvath, Please send me a description of the work you do, your qualifications and list of references. Thanks, Allen Quynn, P.E. Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aquynn@rentonwa.gov From: Edward Horvath [mailto:eshorvath@trmvc.com] Sent: Tuesday, March 31, 2015 9:46 PM To: Allen Quynn Cc: 'TRMVC Office Manager' Subject: RE: Mosquito control RFP Good morning Mr. Quynn- I was just wanting to touch base with you again now that we are coming into April. Do you know when will the City of Renton be putting the mosquito control project out for bid? Would you please ensure our company is on the list to be notified? Respectfully, -ESH Edward Horvath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito &Vector Control Office: (541) 238-2272 Cellular: (541) 880-4791 Skype: edward_horvath www.trmvc.com _ r 2 From: Allen Quynn [mailto:aguynn(&Rentonwa.gov] Sent: Wednesday, October 22, 2014 12:25 PM To: 'Edward Horvath' Subject: RE: Mosquito control RFP Any time after 1:00 PM From: Edward Horvath [mailto:eshorvath@trmvc.com] Sent: Wednesday, October 22, 2014 12:13 PM To: Allen Quynn Subject: Re: Mosquito control RFP I will call this afternoon if you are free. -Edward Edivard S. Hol-oath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito and Vector Control iviviv.trmvc.cons Office: (541) 238-2272 Cellular: (541) 880-4791 Sent from mY l'erizon Wireless 4G LTE DROID Allen Quynn <aquynn��Rentonwa.ov> wrote: Hi Mr. Horvath, You can call me anytime today. Allen Quynn, P.E. Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aquynn@rentonwa.gov 3 From: Edward Horvath [mailto:eshorvath@trmvc.coml Sent: Wednesday, October 22, 2014 10:27 AM Cc: Allen Quynn Subject: RE: Mosquito control RFP Mr Quynn- Not sure if you received my email, but just wondering when you are available to discuss mosquito control and the potential to put it out for bid this coming season. Respectfully, -ESH Edward Horvath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito &Vector Control (S41) 238-2272 www.trmvc.com From: Ronald Straka [mailto:rstraka@Rentonwa.govl Sent: Monday, October 20, 2014 8:12 AM To: 'Edward Horvath' Cc: Allen Quynn Subject: RE: Mosquito control RFP 4 Our Mosquito control program consists of upland spraying in an area and treatment of stormwater flow control facilities and has been completed this year. We have been using the same contractor for many years through a sole source contract due to the lack of vendors that can provide the specialized service needed for our Mosquito Abatement program. Allen Quynn is the project manager for the mosquito abatement program. He can be contacted by email at Aquynn@Rentonwa.Rov or by phone at 425-430-7247. Please provide information to Allen Quynn about you company, the services you provide, the type of mosquito control work you perform and a list of some of your clients that have worked for in the state of Washington. We will consider this information next year when contracting for the 2015 Mosquito Abatement program work. Thank you Ron Straka, P.E. Utility Engineering Manager City of Renton I Public Works I Surface Water Utility 1055 S. Grady Way 15th Floor I Renton,WA 98057 Direct: 425.430.7248 Cell: 206.919.4281 Email: rstraka@rentonwa.gov From: Edward Horvath [mailto:eshorvath@trmvc.com] Sent: Sunday, October 19, 2014 7:05 AM To: Ronald Straka Subject: Mosquito control RFP Good morning. Who can I talk with to get information on your mosquito control bidding process and how/when bids will be taken next. Imam interested in providing a proposal. Respectfully, -Edward 5 Edward S. Horvath, MPH Vector Ecologist/Project Manager Three Rivers Mosquito and Vector Control www.trmvc.com Office: (541) 238-2272 Cellular: (541) 880-4791 Sent from my Verizon Wireless 4G LTE DROID 6 Edward S. Horvath Edward Stephen Horvath PO Box 192 Chiloquin, Oregon 97624-0192 USA Email: eshorvath antrmvc.com Cellular: (541) 880-4672 (Updated 15 January 2015) LICENSURE,CERTIFICATES AND DOCUMENTS Certified Public Manager Expires: N/A NORTHWEST FLORIDA STATE COLLEGE Public Health Pesticide Operators License Expires: 12/31/2015 WASHINGTON STATE DEPARTMENTS OF AGRICULTURE Public Health Pest Control Certification Expires: 12/31/2015 OREGON DEPARTMENT OF AGRICULTURE Public Health Pest Control Director's Certification Expires: 08/31/2015 FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES(FLDACS) Public Health Pesticide Applicator,#0203 Expires: 08/31/2015 FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES(FLDACS) Public Health Applicators Certification, ONJ-231-02-1209 Expires: 12/12/2017 Aerial Application Aquatic Weed Control Right-of-Way Regulatory Demonstration and Research U.S. DEPARTMENT OF DEFENSE,ARMED FORCES PEST MANAGEMENT BOARD Qualified Supervisor(Public Health Vector Control), #24634 Expires: 12/24/2015 COLORADO DEPARTMENT OF AGRICULTURE Oregon Boaters Education Card Expires: N/A OREGON STATE MARINE BOARD Oregon All-Terrain Vehicle Safety Education Card Expires: N/A OREGON STATE PARKS EDUCATION M.P.H., Epidemiology 2004 OREGON STATE UNIVERSITY CORVALLIS, OREGON Thesis title: "Improving Vector Control Operations and Surveillance in preparation of the West Nile Virus in Southern Oregon." B.S., Health/Biological Sciences 2002 OREGON INSTITUTE OF TECHNOLOGY KLAMATH FALLS, OREGON Minor: Entomology MUNICIPAL CONTROL CONTRACTED PROJECTS(CURRENT) City of South Bend,Washington 2014- Present INTEGRATED MOSQUITO MANAGEMENT PROGRAM www.sbwmc.com http://www.southbend-wa.gov/en/ Edward S. Horvath Chiloquin Vector Control District 2012- Present INTEGRATED MOSQUITO MANAGEMENT PROGRAM www.chiloquinmosquito.org Wild River Owners Association 2012- Present INTEGRATED MOSQUITO MANAGEMENT PROGRAM http://www.wiIdriveroa.org/ City of La Pine, Oregon 2013- Present ADULT MOSQUITO MANAGEMENT PROGRAM http://www.ci.la-pine.or.us/ RELEVANT EXPERIENCE Vector Ecologist/Project Manager 2009-2010 OTTERTAIL ENVIRONMENTAL, INC. WHEAT RIDGE,COLORADO Evaluated and set-up efficient and effective processes for the mosquito management programs covering 700 square miles, utilizing 35 seasonal field technicians, three full-time field employees and three lab technicians. Conduct mosquito population and arbovirus surveillance, identify species and train personnel. Coordinate daily adulticide missions. Established a data collection system to improve customer service, efficiency and accountability. Implemented a cost effective GPS based field data collection system to improve efficiency accountability. Program Manager/Principal Environmental Scientist 2007-2009 SEMINOLE COUNTY MOSQUITO CONTROL DISTRICT SANFORD, FLORIDA Established a State Approved, in-house mosquito control district, covering 345 square miles and servicing 430,000 residents, with a $1 M budget, utilizing four full-time and seven seasonal staff. Coordinated ground and aerial control operations. Identified the mosquito species. Maintained sentinel chicken flocks and drew blood samples for arbovirus surveillance. Manager 2002-2007 CHILOQUIN VECTOR CONTROL DISTRICT CHILOQUIN, OREGON Managed an independent Vector Control District with all field and administrative duties. Established the first Integrated Mosquito Management and population/arbovirus surveillance programs for the District. Vector Control Technician (Seasonal) 1999-2002 KLAMATH VECTOR CONTROL DISTRICT KLAMATH FALLS,OREGON Conducted routine surveys of mosquito breeding sites, applied pesticides and conducted arbovirus surveillance including both adult mosquito pool testing and sentinel chicken flock maintenance and bleeding. Created an adult mosquito reference library for species identification in conjunction with my undergraduate studies. CONSULTING AND ADVISORY POSITIONS • Malaria Surveillance and Control Alternatives. Arusha, Tanzania, 2011-2012. • Pest and Chemical Program Development and Management for Private Pest Control Company. Santa Rosa Beach, Florida, 2011. • Evaluate and prepare operational plan for lawn and ornamental insect control. Santa Rosa beach, Florida, 2011. • Contracted service alternatives for Vector Control and Surveillance in Jordan. Amman, Jordan, 2011. • Prepared, presented and implemented a plan to establish a Vector Control Program for 12 US and Department of Defense staffed military installation in Iraq. Basrah and Baghdad, Iraq, 2010. • Prepared and presented an Implementation Plan and Budget Proposal to establish a Vector Control Agency for four Regional Providences in Saudi Arabia. Riyadh, Saudi Arabia, 2010. • Evaluation, prediction and distribution model for vector-borne diseases of the Saudi Arabia (mosquitoes, ticks, mites, fleas, flies and rodents). Riyadh, Saudi Arabia, 2009-2010. Edward S. Horvath • Establishing a Mosquito Surveillance and Control Program. Lahore, Pakistan, 2009. • National Pollutant Discharge Elimination System (NPDES) Development Committee, Colorado Department of Public Health and Environment. Denver, Colorado, 2009. • City of Boulder Mosquito Control Advisory Committee. Boulder, Colorado, 2009. • Seminole County Mosquito Control Advisory Board. Sanford, Florida, 2007-2009. • Fort Klamath Community, Mosquito Control Advisory Board. Ft. Klamath, Oregon, 2005-2007. • Bly Vector Control Board. Bly, Oregon, 2005. • Lake of the Woods Mosquito Control Advisory Board. Lake of the Woods, Oregon, 2004-2005. • Coos County Health Department West Nile Virus Preparation Study and Vector Control Operations Feasibility Report. Coquille, Oregon, 2003-2004. VARIOUS RELATED TRAINING Department of Defense Pest Management Recertification Course 2011 ARMED FORCED PEST MANAGEMENT BOARD, KANDAHAR,AFGHANISTAN Adult Mosquito Insecticide Resistance Training 2010 CENTER FOR DISEASE CONTROL(CDC), FORT COLLINS,COLORADO Larval Mosquito Insecticide Resistance Training 2008-2009 UNIVERSITY OF FLORIDA MID-FLORIDA RESEARCH AND EDUCATION CENTER,APOPKA,FLORIDA Advanced Mosquito Identification and Certification Course 2008 UNIVERSITY OF FLORIDA, Florida Medical Entomology Laboratory, IFAS, Vero Beach, FLORIDA Department of Defense Pest Management Certification Course 2002 ARMED FORCED PEST MANAGEMENT BOARD,JACKSONVILLE, FLORIDA MEMBERSHIPS IN SCIENTIFIC/PROFESSIONAL/HONORARY/CIVIC ORGANIZATIONS AND SOCIETIES • American Mosquito Control Association • Oregon Vector Control Association • Texas Mosquito Control Association 0 Society for Vector Ecology • West Central Mosquito and Vector Control 0 International Society for Infectious Diseases Association 0 Boy Scouts of America(Leadership) • Florida Mosquito Control Association 0 Knights of Columbus • Northwest Mosquito and Vector Control Association PRESENTATIONS/PAPERS(PROFESSIONAL&CIVIC CLUB MEETINGS AND CONFERENCES) • Establishing Vector Control in the Iraqi Provinces of Basrah. Ministry of Health, Basrah, Iraq, December 2010. • Establishing a Vector Control Agency for the Saudi Arabian Provinces of Asir, Baha, Jizan and Najran. Ministry of Health, Riyadh, Saudi Arabia, June 2010. • Outbreak prediction model presentation for controlling rodents, mosquitoes, ticks, fleas and flies in Saudi Arabia. Ministry of Health, Riyadh, Saudi Arabia, June 2010. • Preparing an effective request for proposal and evaluating responses to find the best outsourced solution. American Mosquito Control Association, 75th Annual Meeting, Lexington, Kentucky, April 2010. • Advantages of incorporation of GPS & GIS technologies in ULV adulticiding application programs. Prepared for the West Central Mosquito and Vector Control Association 361h Annual Meeting, Fort Collins, Colorado, 2010. • What is an Integrated Mosquito Management Program anyway? The Rotary Club of Denver, Colorado, August 2009. Edward S. Horvath • An update of the consolidation of Programs into a Countywide Mosquito Control District: A Scientific Approach. The Rotary Club of Lake Mary, Florida, May 2009. • An operational evaluation of the B&G SentinelTm Larviciding software. American Mosquito Control Association, 74th Annual Meeting, New Orleans, Louisiana, USA, April 2009. • An operational evaluation of the B&G SentinelTm Larviciding software. Florida Mosquito Control Association 80th Annual Meeting, Panama City Beach, Florida, USA, November 2008. • What Does Mosquito Control Really Do? The Rotary Club of Sanford, Florida, October 2008. • Evaluation of Gambusia affinis as effective biological control of Culex mosquitoes in irrigation drainage canals of Fort Klamath, Oregon. City of Chiloquin Council Meeting, Chiloquin, Oregon, 2006. • Malathion resistance in Aedes vexans of Chiloquin Vector Control District, Chiloquin, Oregon. City of Chiloquin Council Meeting, Chiloquin, Oregon, 2005. • Chiloquin Vector Control District's West Nile Virus Plan. Klamath County West Nile Response Team, Klamath Falls, Oregon, 2003. POSITIONS IN SCIENTIFIC/PROFESSIONAL/HONORARY/CIVIC ORGANIZATIONS AND SOCIETIES • Bylaws Committee Member, American Mosquito Control Association, 2010-Present. • Bylaws Committee Chair, West Central Mosquito and Vector Control Association, 2010-Present. • Editor, West Central Mosquito and Vector Control Association's Newsletter, 2009-Present. • South East Regional Director, Florida Mosquito Control Association, November 2007-2009. • Chairman, Seminole County Mosquito Control Advisory Board, Sanford, Florida, 2007-2009. SELECTED RECENT CONFERENCES ATTENDED(2005-PRESENT) • American Mosquito Control Association (AMCA), 76th Annual Meeting, Anaheim, California, 2011. • Florida Mosquito Control Association (FMCA), Annual Meeting, Duck Key, Florida, 2010. • AMCA, 751h Annual Meeting, Lexington, Kentucky, 2010. • West Central Mosquito and Vector Control Association, 36th Annual Meeting, Fort Collins, Colorado, 2010. • FMCA, Annual Meeting, Tampa, Florida, 2009. • AMCA, 74th Annual Meeting, New Orleans, Louisiana, 2009. • FMCA, Dodd Short Courses, Ocala, Florida, 2009. • FMCA, Annual Meeting, Panama City Beach, Florida, 2008. • AMCA, 73'd Annual Meeting, Reno, Nevada 2008. • FMCA, Dodd Short Courses, Ocala, Florida, 2008. • FMCA, Annual Meeting, Jacksonville, Florida 2007. • Northwest Mosquito and Vector Control Association (NWMVCA), Annual Meeting, Newport, Oregon, 2006. • Oregon Mosquito and Vector Control Association (OVCA), Annual Meeting, Newport, Oregon, 2006. • NWMVCA, Annual Meeting, Oregon, 2005. • OVCA, Annual Meeting, Oregon, 2005. RESEARCH AND EXPERIENCE INCORPORATING ARCGIS • Vector and vector-borne disease prediction model utilizing GIS, Riyadh, Saudi Arabia, 2010. • Implementation of the Sentinel TmGIS Larviciding software into OtterTail's Mosquito Control Projects, 2010. • Donlin Creek Stream Habitat mapping. Donlin, Alaska 2009. • Developed a multi-composite address geocoder. Boulder/Jefferson/Weld Counties, Colorado, 2009. • Midge larvae (Glyptotendipes paripes & Chironomus crassicaudatus) population survey of Lake Harney. Casselberry, Florida, 2008-2009. Edward S. Horvath • Web-based customer complaint and mosquito populations mapping model. Seminole County Mosquito Control, Sanford, Florida 2008-2009. • Mosquito Habitat Mapping. Seminole County Mosquito Control, Sanford, Florida 2007-2009. • Pestiferous aquatic midge (Diptera: Chironomidae) population survey of the Upper Klamath Lake. Klamath Tribes, Chiloquin, Oregon, 2006. • Mosquito Habitat Mapping. Ft. Klamath Community, Fort Klamath, Oregon, 2005-2007. • Gunnison's Prairie Dog (Cynomys gunnisoni) survey. Klamath Tribes, Chiloquin, Oregon, 2005. • Mosquito Habitat Mapping. Chiloquin Vector Control District, Chiloquin, Oregon, 2002-2006. • Public Works Geodatabase and Shapefile Development for the City of Chiloquin. Chiloquin, Oregon, 2004- 2006. • Mosquito Habitat Mapping. Klamath Vector Control District, Klamath Falls, Oregon, 2002. REFERENCES WORK AND EXPERIENCE RELATED Michael McLean Commissioner, Seminole County 1101 East First Street Sanford, Florida 32771 mmclean(o-)cfl.rr.com (407) 324-5662 Julie Struck Mayor, City of South Bend P.O. Box 860 Chiloquin, Oregon iu lie.struck(a)south bend-wa.gov (360) 363-6701 Dennis Jefcoat Chairman, Chiloquin Vector Control District P.O. Box 860 Chiloquin, Oregon dni245Co)yahoo.com (541) 363-6701 Floyd Hescock Trustee, Chiloquin Vector Control District P.O. Box 526 Chiloquin, Oregon (541) 783-2213 Janet McAllister, PhD Centers for Disease Control and Prevention CCID/NCZVED/VBI 3150 Rampart Rd. Ft. Collins, Colorado 80521 imcallister(a_cdc.gov (970)225-4239 THREE RIVERS MOSQUITO AND or Nlt�Y 2015 i VECTOR CONTROL r. MOSQUITO APATEMENT PROGRAM n a A PROPOSAL 'I°(? �rt THE CITY RENTON, WASHINe-TON''. THREE RIVERS MOSQUITO AND VECTOR CONTROL PO BOX 192,CHILOQUIN,OREGON ' i ' Three Rivers Mosquito and Vector Control PO Box 192 Chiloquin, Oregon 97624-0192 (541) 238-2271 Cellular(541) 880-4791 info@trmvc.com www.trmvc.com 01 May 2015 City of Renton,Washington Attn: Jesse Trujillo Renton, Washington 97739 Re: Proposal for Mosquito Abatement Services Please find enclosed for your consideration our estimate in response to the Request for Quotes in support of Mosquito Abatement Services for the Renton, Washington for the 2015 mosquito season. Three Rivers Mosquito and Vector Control entered into an agreement in 2013 with one of the largest mosquito control pesticide distributers in the world, providing us with the clout of lower prices for superior pesticides. Even with our great discount,the majority of the expense for mosquito abatement is with pesticide costs. Pesticide costs for catch basins per hour alone could range from$2.00 to $150.00. That in mind,Three Rivers Mosquito and Vector Control's intent is to provide the most mosquito control services for the buck. Our intent is to be as effective and efficient as possible. Our costs are based on the maximum estimated acres treated. Should less pesticide be used,those costs will be refunded to the City of Renton. TRMVC respectfully submits the enclosed estimate for service for the 2015 Mosquito Abatement Season. Respectfully, Edward S.�Hath, MPH Vector Ecologist/Owner Integrated and Innovative Pest Management Strategies EXHIBIT A SCOPE OF WORK 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05-022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label, the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City Page 1 of 8 Piazza/Data_Center/Forms/City/Contracts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Amberwood/WQ Pond 315 Quincy Ave NE 2 Surface Water Utility Amberwood II/WQ Pond 304 Rosario PI NE 3 Surface Water Utility Aspenwoods/WQ Pond 808 Ilwaco PI NE 4 Surface Water Utility Aster Park Plat/WQ Pond 5516 NE 13th St 5 Surface Water Utility Auria Woods Tract C/WQ Pond 12152 SE 186th St 6 Surface Water Utility Beclan Place Plat/WQ Pond 5134 NE 2nd St 7 Surface Water Utility Brookefield II/WQ Pond 5305 NE 11th Ct 8 Surface Water Utility Chinquapin Ridge/WQ Pond 19123 113th Way SE 9 Surface Water Utility Christian Short Plat/WQ Pond 11129 SE 189th PI 10 Surface Water Utility Cottages at Honey Creek/WQ Pond NE Sunset Blvd/Elma PI NE 11 Surface Water Utility Elliott Farm/Detention Pond Maple Valley Hwy/140th Way SE 12 Surface Water Utility Ellis Park aka Edenwood/WQ Pond 602 NE 6th St 13 Surface Water Utility Elmhurst/WQ Pond 215 Whitman PI NE 14 Surface Water Utility Emma's Plat/WQ Pond 5611 SE 1st PI 15 Surface Water Utility Evendell Plat/WQ Pond 6741 SE 4th St 16 Surface Water Utility Fredricks Place/WQ Pond 10301 SE 186th St 17 Surface Water Utility Greenfield II aka Highpointe II/WQ Pond 1318 Redmond PI NE 18 Surface Water Utility Hamilton Place Plat/WQ Pond 6743 NE 1st PI 19 Surface Water Utility Heritage Renton Hill/WQ Pond 1816 SE 8th PI 20 Surface Water Utility Highland Estates/WQ Pond 355 Rosario PI SE 21 Surface Water Utility Highlands Park/WQ Pond 202 Rosario Ave SE 22 Surface Water Utility Jericho Estates/WQ Pond 316 Hoquiam Ave NE 23 Surface Water Utility Kimberly Lane/WQ Pond 17228 125th Ave SE 24 Surface Water Utility Larson Parke Plat/WQ Pond 18469 114th Ave SE 25 Surface Water Utility Laurelhurst Phase I/WQ Pond 4615 NE 1st St 26 Surface Water Utility Liberty Grove and Liberty Grove 13716 160th Ave SE Contiguous/WQ Pond 27 Surface Water Utility Liberty Ridge Phase I/WQ Pond 2511 NE 1st St(behind residence) 28 Surface Water Utility Liberty Ridge Phase I/WQ Pond 205 Index PI SE 29 Surface Water Utility Liberty Ridge Phase II/WQ Pond 2601 Ferndale Ave NE 30 Surface Water Utility Magnussen Plat/WQ Pond 202 Field Ave NE 31 Surface Water Utility Magnussen Plat/WQ Pond 4814 NE 2nd St(behind residence) 32 Surface Water Utility Maple Glen Addition/WQ Pond SE 182nd St/108th Ave SE 33 Surface Water Utility Maureen Highlands Tract A/WQ Pond 6118 NE 4th St 34 Surface Water Utility Morning Glen/WQ Pond 17612 114th PI SE 35 Surface Water Utility NE 10th St Pond/WQ Pond NE 10th/Anacortes Ave NE 36 Surface Water Utility NE 4th Detention/WQ Pond 234 Field Ave NE Page 2 of 8 Piazza/Data_Center/Form s/City/Contracts 37 Surface Water Utility Nichols Place/WQ Pond 13815 160th Ave SE 38 Surface Water Utility Olympic Peak Estates/WQ Pond 9402 S 196th PI 39 Surface Water Utility Parkside Court/WQ Pond 5621 SE 2nd St 40 Surface Water Utility Pioneer Place/WQ Pond Maple Valley Rd/149th Ave SE 41 Surface Water Utility Serenity Ridge Tract A/WQ Pond 17927 110th PI SE 42 Surface Water Utility Serenity Ridge Tract B/WQ Pond 17707 110th PL SE 43 Surface Water Utility Shamrock Glen aka Martin Prop/WQ Pond 5507 NE 5th Cir 44 Surface Water Utility Shy Creek/WQ Pond 204 SE 2nd St 45 Surface Water Utility Sienna/WQ Pond 5402 NE 2nd St 46 Surface Water Utility Stonegate/WQ Pond 5500 NE 26th St 47 Surface Water Utility Sunnybrook/WQ Pond 712 S 36th PI 48 Surface Water Utility Talbot Estates/WQ Pond 9612 S 194th St 49 Surface Water Utility The Reserve at Stonehaven/WQ Pond 1003 S 47th St 50 Surface Water Utility Watershed Terrace/WQ Pond 19926 101st Ave SE 51 Surface Water Utility Wilkins Wood/WQ Pond 16603 113th Ave SE 52 Surface Water Utility Windsong/WQ Pond 4925 NE 4th PI 53 Surface Water Utility Windsor Circle aka Harmony Gro/WQ Pond 13502 162nd Ave SE 54 Surface Water Utility Winsper(Liberty View 1&11)/WQ Pond 611 S 32nd St 55 Surface Water Utility Zetterberg/WQ Pond 2100 Burnett PI S 56 Surface Water Utility Honey Brooke West aka Sagecrest/WQ Pond 505 Field PI NE 57 Surface Water Utility Honey Creek Ridge Tract A/Detention Pond 3203 NE 26th Ct with Bioswale 58 Surface Water Utility Honey Creek Ridge Tract B/Detention Pond 2407 Olympia Ave NE with Bioswale 59 Surface Water Utility Langley Ridge at May Creek/WQ Pond 5302 NE 26th St 60 Surface Water Utility Maplewood Estates/Detention Pond with 5831 SE 2nd Ct Bioswale 61 Surface Water Utility Maureen Highlands Tract C/WQ Pond 653 Shadow Ave NE 62 Surface Water Utility River Ridge/Detention Pond with Bioswale 1706 SE 7th Ct 63 Surface Water Utility Summerwind/Detention Pond NE Sunset Blvd/Field Ave NE 64 Surface Water Utility Victoria Hills/Detention Pond 1012 S 23rd St 65 Surface Water Utility Westmont/WQ Pond 3625 Monterey Ct NE A Surface Water Utility Catchbasins Various 90 Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) 91 Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course (west-central) 92 Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) 93 Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course (east) 98 Golf Course Maplewood Golf Course Catchbasins Various B Parks Maintenance Catchbasins Various Division 99 Facilities Division Renton City Hall/Water Quality Grady Way Parking Lot Page 3 of 8 Piazza/Data_Center/Forms/City/Contracts Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course —The contractor shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 8 Piazza/Data_Center/Forms/City/Contracts EXHIBIT B TIME OF COMPLETION 2015 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2015. Page 5 of 8 Piazza/Data_Cente r/Forms/City/Contracts EXHIBIT C COST ESTIMATE 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The maximum treatments shall not exceed 21 and shall include all necessary work to clear of the trails. Cost shall be based on a unit price per treatment. The billing rates include state sales tax. Cost per treatment $13.50/acre x 60 acres = $810.00/tx Subtotal Contract Cost for 21 treatments: $810.00/tx x 21 tx= $17,010.00 State Sales Tax (9.5%) $1,615.95 Total Cost Task 1: $18,625.95 TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is 29 959.20. The cost for Task 2 shall be based on total manhours per stormwater/irrigation facility and catch basins multiplied by the rate of$160 (stormwater/irrigation facility) and $40 (catch basins) per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under "Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. Below is the estimated contract cost for the three City divisions, based on the billing rate of 160 (stormwater/irrigation facility) and $40 (catch basins) per manhour for a total of 454 manhours: Surface Water Utility Costs Stormwater facilities: 55 (Average of 0.29 acres/facility) Total number of treatments per stormwater facility: 8 Total manhours per stormwater facility (including travel time): 0.25 hrs (Per site) Total stormwater facility manhours: 130 hrs (Survey&Treat 148.64 acres) Subtotal cost for stormwater facilities: $20,800.00 Sales Tax (9.5%): $1,976.00 Total cost for stormwater facilities: $22,776.00 Page 6 of 8 P iazza/Data_Center/Forms/City/Contracts Total manhours available for catch basin treatment: 60 hrs (Provided by Ciri) Total cost for catch basin treatment: $2,400.00 Sales Tax (9.5%): $228.00 Total cost for catch basin treatment: $2,628.00 Total manhours (stormwater facilities +catch basins): 190 hrs Subtotal cost (stormwater facilities + catch basins): $23,200.00 Sales Tax (9.5%): $Z204.00 Total cost (stormwater facilities +catch basins): $25,404.00 Golf Course Costs Irrigation facilities: (Average of 0.29 acres/facility) Total number of treatments per facility: 8 Total manhours per irrigation facility (including travel time): 0.25 hrs (Per site) Total irrigation facility manhours: 8.00 hrs (Survey& Treat 9.28 acres) Subtotal cost for irrigation facilities: $1,280 Sales Tax (9.5%): $121.60 Total cost for irrigation facilities: $1,401.60 Total manhours available for catch basin treatment: 3, i; (Provided by Citv) Subtotal cost for catch basin treatment: $120.00 Sales Tax (9.5%): $11.40 Total cost for catch basin treatment: $131.40 Total manhours (irrigation facilities+ catch basins): 11.00 hrs Subtotal cost (stormwater facilities+ catch basins): $1,400.00 Sales Tax (9.5%): $133.00 Total cost (stormwater facilities+ catch basins): 1 533.00 Parks Division Costs Irrigation facilities: 0 (Provided by City) Total manhours available for catch basin treatment: 61 hrs (Provided by Cin.) Subtotal cost for catch basin treatment: $2,440.00 Sales Tax (9.5%): $231.80 Total cost for catch basin treatment: $2,671.80 Total manhours (irrigation facilities+ catch basins): 61 hrs (Provided bi City) Page 7 of 8 P iazza/Data_Center/Forms/City/Contracts Subtotal cost (stormwater facilities+ catch basins): $2,440.00 Sales Tax (9.5%): $231.80 Total cost (stormwater facilities+ catch basins): 2 671.80 Facilities Division Costs Stormwaterfacilities: 1 (Average of0.29acres/facility) Total number of treatments per facility: 8 Total manhours per stormwater facility (including travel time): 0.25 hrs (Per site) Total stormwater facility manhours: 2.00 hrs (Survey& Treat2.32 acres) Subtotal cost for stormwater facilities: $320.00 Sales Tax (9.5%): $30.40 Total cost stormwater facilities: $350.40 Catch Basin: 0 (Provided by City) Total manhours (stormwater facilities + catch basins): 2.00 hrs Subtotal cost (stormwater facilities +catch basins): $320.00 Sales Tax (9.5%): $30.40 Total cost: 350.40 Total Contract Cost for all Divisions: $27,360.00 State Sales Tax (9.5%): $2,599.20 Total Cost Task 2: $29,959.20 B. Total Contract Cost (Task 1+Task 2): $48,585.15 C. Invoicing The constractor shall submit all invoices to the City of Renton Surface Water Utility Section. Invoices shall include the division (Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division) for which the service was provided under this project. Payment cannot be authorized or payment may be delayed until the invoices include the division to which the service was provided. Page 8 of 8 Piazza/Data_Center/Forms/City/Contracts -I-405 Ramp r 6s I I _ , I I S 15th St SW 16th St � y in CO �—� ; -S 16th St I w 0 — -- CO - S� 19th Sf — ; --, L � 20th F Z'J — -- SW21stSt --' _ 21stSt \. J. 5 — — S 2nd S 22 rid Ct \`\ 23rd St -._ 1 - Vlt=23rd St-- j. ` _-- S� (P li I i I� t S 28th`PI 52�tirC�G _` �- �� ?1, OD r sou r-- N ;I �St StS 31st St I N _ S 32nd PT' ��� s Q `t II � Ir �- L o �I I II i i S 32nd a o r I �34th St SW 34th St -I -- '_ i ! '- T; S 35th St SF� ��r� 2 rid_ T-I! _ \ Q) :L --M L i� i — S 36th St Q �'� I CO1 S 37th St \ o SW 39th St_ S 38th Ct Z r r I CO , Mosquito Abatement Program N Exhibit D: Site Plan 0 500 1,000 W' E I i I I I Note: Treatment will not be applied within 100' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge Project Boundary and the residential areas. Property owner approval required prior to treatment on private property. Surface water utility I G.Del Rosario I Printed 04/17/2013 0 n PF q SF B�f�P\ �jsc N 30th St Creep y MaY �P 0 Lake a K Washington Phi I? Q SE MayL y O Pf © 61 7 6 w 6 2 Z. Q v o wC 5Pset Blvd NE Park Or 90o w © SE Renton Issaquah Rd z Q © w Zw 900 2 Q o HIGHLANDS ¢ E w m g = © z w z w d z S a' P z �� NE 7th`5' °1 o M _ G N Q z m a o ® 'm x a z NE 4th St ®© © SE 128th St N 3rd Si QD NE 3r d s� O z © ±r EAST PLATEAU gh p c cn S 3rd St eOa�Rive� + f CITY CENTEP. ood Creek '1oPtc1 Hardie Ave SW Maple Valley Hwy 169 S Grady Way +� - W CEDAR RIVER � Cedar Rive.. '0 Q 169 �� p��� v4�7h Maple SE Jones Rd O Q Jai day SF Valley Hwy 1 s9 515 4 0 0� GtQD A ye a rn m" m �o o m m on reey n SE 168th St Mods C N BENSO� ni 167 Q N W W V) N N w Q ® Q L iD O `�d Q^ SE PelrovRsKy Rd SSG m Mosquito Abatement Program ,e ® Exhibit B: Larvicide Treatment Sites m m The City of Renton may use mosquito larvicides made of a natural bacterium(Bacillus sphaericus)I, help control mosquitoes in accordance with the Washington State Department of Ecology's j 167 515 ® Aquatic Mosquito Control General Permit.Treatments may occur between July 27,2015 and October 30,2015.Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City.For more information about the City's commitment to help reduce the threat of West Nile virus and control mosquitoes,contact Allen Guynn,City of Renton Surface Water Utility Engineer,at 425-430-7247 or by email at aquynn@rentonwa.gov. t O For additional information about Ecology's Aquatic Mosquito Control General Permit,please © SE 192nd contact the City of Renton or Jon Jennings,Water Quality Program,Washington State w Department of Ecology,at 360-407-6283 or by email at jonathan.jennings@ecy.wa.gov. N I LU a' 0 t m 0 0.25 0.5 1 Miles L a ( _ Lake Date:04/21/2015 SE� _ A- , qualuer' 20=20 AIIPM@ A Synergized Permethrin Formulation. woo"-� For Effective Control to Adult Mosquitoes(including icing)and phate resistant mosquitoes),Midges(Biting and Non-Biting)and cj Blackl3 ies. V�iar o u P For ULV,Thermal and Barrier Applications using Ground and Aerial Equipment for control of Adult Mosquitoes and other biting ties. For use only by federal,state,tribal,or local government officials responsible • Formulation Allows Dilution with Water or Oil. for public health or vector control,or by persons certified in the appropriate . May be Applied Undiluted. category or otherwise authorized by the state or tribal lead pesticide regula- tory agency to perform adult mosquito control applications,or by persons • For surface and barrier applications using handheld equipment. under their direct supervision. • Quick Knockdown and Effective Control of Target Insects. • For ULV applications at rates up to 0.007 lbs.a.i.per acre. ACTIVE INGREDIENTS t For barrier application at rates up to 0.1 lbs.a.i.per acre. *Permethrin ............. 206°/u Compatible with injector mixing systems or other insecticide mixing **Piperonyl Butoxide Technical................. ................. 20 6% systems. Inert Ingredients:................................__..... .._ ....._....... 58.8% Total:................................................................................... 100.0% DIRECTIONS FOR USE *(3-phenoxvphenyl)methyl(+/-)Cis/trans 3-(2,2-dichloroethenyl)2,2-Di�methyl cy- It is a violation of Federal law to use this product in a manner inconsistent with its clopropanecarboxy late. Cis/trans ratio:min.35/o(+/-)cis and max.65/o(+l-)trans. labeling. "Equivalent to 80%(butylcarbityl)(6-propylpiperonyl)ether and 20%related compounds Note Before making the first application in a season,it is advisable to consult Contains 1.75 pounds of Permethrin and 1.75 pounds of Piperonyl Butoxide per gallon. with the state or tribal agency with primary responsibility for pesticide regulation KEEP OUT OF REACH OF CHILDREN to determine ifother regulatory requirements exist. CAUTION HOW TO APPLY AND WHERE TO USE Aqualuer 20-20 is designed for application as an Ultra-Low Volume(ULV)or PRECAUCION AL USUARIO:Si usted no entienda la etiqueta,busque a thermal aerosol to control adult mosquitoes and flies of nuisance,public health alguien para que se la explique a usted en detalle.(If you do not understand the or disease vector importance in areas such as but not limited to:residential areas, label,find someone to explain it to you in detail). industrial areas,commercial areas,urban areas,parks,campgrounds,woodlands, athletic fields,golf courses,playgrounds,recreational areas,overgrown waste First Aid areas,roadsides,and other areas where adult mosquitoes and flies may be found. If •Immediately call a Poison Control Center or doctor. Aqualuer 20-20 is recommended for application with ULV cold aerosol genera- Swallowed: •Do not induce vomiting unless told to do so by a poison control tors,thermal aerosol generators,mist-blowers,backpack sprayers,or handheld center or doctor. sprayers.Mist-blowers,backpack sprayers,handheld sprayers and low-pressure •have person sip a glass of water if able to swallow. hand sprayers may be used for barrier or surface applications. •Do not give anything by mouth to an unconscious person. FOR BEST RESULTS treat when mosquitoes or insects are most active and If on skin or •Take off contaminated clothing. weather conditions are conducive to keeping the fog near the ground e.g.cool clothing: •Rinse skin immediately with plenty of water for 15-20 minutes. temperatures,and consistent wind speeds are not greater than 10 m.p.h.Applica- •Call a poison control center or doctor for treatment advice. tions during the cool hours of night or early morning are usually preferable. Have the product container or label with you when calling a poison control Do not retreat the same site more than once in 12 hours.Do not apply more than center or doctor,or going for treatment. 0.18 lbs.of Permethrin per acre per year to any site.More frequent treatments may be made to prevent or control a threat to public and/or animal health deter- mined by a state,tribal or local health or vector control agency on the basis of PRECAUTIONARY STATEMENTS documented evidence of disease causing agents in vector mosquitoes or the occur- Hazards to Humans and Domestic Animals rence of mosquito-borne disease in animal or human populations,or if specifically CAUTION:Harmful if swallowed or absorbed through skin.Avoid contact approved by the state or tribe during a natural disaster recovery effort. with eyes,skin or clothing.Prolonged or frequently repeated skin contact may cause allergic reaction in some individuals.Wash hands before eating,drink- Aqualuer 20-20 can be applied over specific growing crops and range grasses ing,chewing gum,using tobacco or using the toilet. prior to harvest for the control of adult mosquitoes and biting flies within or adjacent to these areas.Application can only be made where the following crops ENVIRONMENTAL HAZARDS are present: This product is extremely toxic to aquatic organisms,including fish and aquat- ic invertebrates.Runoff from treated areas or deposition of spray droplets into Almonds Corn,fodder Onions,dry bulb a body of water may be hazardous to fish and aquatic invertebrates.Do not Apples Corn,forage Peaches apply over bodies of water(lakes,rivers,permanent streams,natural ponds, Broccoli Corn grain Pears commercial fish ponds,swamps,marshes or estuaries),except when necessary Brussels sprouts Eggplant Peppers,bell to target areas where adult mosquitoes are present,and weather conditions Cabbage Range Grasses Soybeans will facilitate movement of applied material away from the water in order to minimize incidental deposition into the water body.Do not contaminate bodies Celery Leafy Vegetables(except Brassica)Tomatoes of water when disposing of equipment rinsate or washwaters. Cauliflower Lettuce,head Vegetables,cucurbit Cherries Mushrooms Walnuts Bee Warning:This product is highly toxic to bees exposed to direct treatment on blooming crops or weeds.Do not apply to blooming crops or weeds while Do not allow spray treatment to drift on cropland(other than crops listed)or water bees are visiting the treatment areas,except when applications are made to supplies.In treatment of corrals,feedlots,animal confinements/houses,swine lots prevent or control a threat to public and/or animal health determined by a and zoos,cover any exposed drinking water,drinking fountains and animal feed state,tribal or local health or vector control agency on the basis of documented before application. evidence of disease causing agents in vector mosquitoes or the occurrence of mosquito-borne disease in animal or human populations,or if specifically Aqualuer 20-20 provides effective control of adult mosquitoes,black flies,gnats, approved by the state or tribe during a natural disaster recovery effort. biting and non-biting midges,stable flies,horse flies,deer flies,sheep flies,horn PHYSICALAND CHENHCAL HAZARDS and heel flies,and nuisance flying insects such as houseflies_ Combustible.Do not use or store near heat or open flame. Air temperatures should be greater than 50'F when conducting all types of applications. GROUND APPLICATION When this product is applied as a barrier application using low pressure hand Vehicle-Mounted ULV Cold Aerosol Generators(Cold Fog):Apply through sprayers,hydraulic sprayers or ground ULV equipment,do not apply within 100 non-thermal ULV application equipment and base all acreage calculations on the feet(30 meters)of lakes and streams. equipment manufacturer's recommended swath width. Spray equipment must To apply this product using low pressure hand sprayers or other similar equip- be adjusted so the volume median diameter or mass median diameter is less than ment,for the control of mosquitoes on resting or aggregation surfaces mix 0.126 30 microns(Dv 0.5<30 µm)and that 90%of the spray is contained in droplets oz.(3.73 ml)in one gallon of water and apply sufficient spray to dampen the smaller than 48 microns(Dv 0.9<48 µm). Directions from the equipment surface-approximately 700-750 square feet of treated area.Use equipment that manufacturer or vendor,pesticide registrant or a test facility using a laser-based is capable of delivering an even distribution of the labeled rate over the treatment measurement instrument must be used to adjust equipment to produce acceptable area.For application using backpack or truck-mounted mist-blower equipment droplet size spectra.Application equipment must be tested at least annually to apply Aqualuer 20-20 undiluted at a rate not to exceed 7.3 oz.per acre.If confirm that pressure at the nozzle and nozzle flow rates are properly calibrated diluted apply at a rate not to exceed 0.1 lbs.permethrin a.i.per acre.Diluted or Apply at a rate not to exceed 0.007 pounds of permethrin per acre. An optimum undiluted applications may be made onto foliage at the perimeter of areas such as swath is created when Aqualuer 20-20 is applied from a truck being driven per- recreational areas,parks,or golf courses from which mosquitoes or flies are to be pendicular to the wind direction.Direct the spray head of the equipment to ensure excluded.Applications may be directed into harborage areas or other resting areas an optimum distribution of the spray cloud throughout the area.For best results, where adult mosquitoes or flies may be found. apply when insects are most active and meteorological conditions are conducive URBAN ULV MOSQUITO CONTROL APPLICATIONS:For control of rest- to keeping the spray cloud near the ground.An inversion of air temperatures and ing or flying adult mosquitoes,biting flies and biting midges in harborage areas a light breeze of approximately 1 to 3 mph is preferable.During applications such as but not limited to utility tunnels,sewers,storm drains and catch basins, consistent ground wind speeds should not exceed 10 MPH.Application of this pipe tunnels,basements,underground passages,parking decks,crawl spaces product during cooler hours of the night or early morning is recommended. under buildings,abandoned buildings or uninhabited buildings.Apply Aqualuer Aqualuer 20-20 may be applied through all ULV Cold Aerosol Generators,or 20-20 diluted or undiluted using mechanical tuggers,hand-held or truck-mounted other similar equipment designed for non-thermal ULV aerosol applications.The ULV equipment,thermal foggers or other spray equipment suitable for this type desired application rate may be obtained from the chart below or by altering the of application.Aqualuer 20-20 may be applied at rates up to but not exceeding dilution rate of Aqualuer 20-20,the flow rate of the insecticide from the applica- 0.007 lbs.permethrin per acre. tion equipment and the vehicle speed.Some examples are provided in the fol- AERIAL APPLICATION lowing chart.When an alternate rate is required,adjust the flow rate accordingly, provided the droplet size and spectrum remain within the label specifications. Apply Aqualuer 20-20 either diluted or undiluted at rates up to 0.007 lbs.Perme- thrin/PBO per acre by fixed wing or rotary aircraft equipped with a spraying system FLOW RATE(Fluid Ounces Per Minute) capable of making a ULV application.For aerial applications of Aqualuer 20-20, Dilutions Based on a l5 Gallon Tank* use ULV equipment and nozzles such as rotary atomizers or similar spray equip- ment.Spray equipment must be adjusted so the volume median diameter produced Application is less than 60 microns(Dv 0.5<60 µm)and that 90%of the spray is contained in Rate(Pounds of Vehicle droplets smaller than 115 microns(Dv 0.9<115 µm).Directions from the equipment Permethrin a.i./ Speed Diluted Diluted Diluted Diluted manufacturer or vendor,pesticide registrant or a test facility using a wind tunnel and Acre) (MPH) Undiluted 1:3 1:4.5 1:6.5 1:9 laser-based measurement instrument must be used to adjust equipment to produce acceptable droplet size spectra.Application equipment must be tested at least 10 0.7 2.8 3.7 5.25 6. annually to confirm that pressure at the nozzle and nozzle flow rate(s)are properly 0.0015 15 1.05 4.2 5.5 7.88 10 0 calibrated. 20 1.4 5.6 7.3 10.50 14.0 Aerial application of Aqualuer 20-20 shall be made at altitudes ranging from 100 10 1.55 6.2 8.6 11.7 15.6 feet to 300 feet.Do not apply when ground wind speed equals 0 MPH or when 0.0035 15 2.35 9.3 12.8 17.5 23.3 ground wind exceeds 10 MPH.Aerial applications of Aqualuer 20-20 shall only be made when recommended by public health officials and trained personnel of 20 3.1 12.5 17.2 23.4 mosquito abatement districts and other mosquito control programs.To ensure best 10 3.1 12.4 17.0 23.2 results applications shall be made when temperatures are greater than 50'F. 0.007 15 4.65 18.6 25.5 For best results,apply Aqualuer 20-20 when insects are most active and meteo- 20 6.2 24.7 rological conditions are conducive to keeping the spray cloud near the ground. Aerial applications using aircraft equipped with global positioning systems(GPS) *Dilution Instructions:Fill tank with the recommended amount of water,start may be needed to compensate for windy conditions and to ensure drift into target agitation then add the correct amount of Aqualuer 20-20.The use of metering areas. pumps,injector systems or other mixing systems is optional.Note:When using IN FLORIDA:Do not apply by aircraft unless approved by the Florida Depart- oil as a diluent agitate well before use. ment of Agriculture and Consumer Services. Where dense vegetation is present,use higher rates of application and/or a slower speed for best results.AI I applications should be conducted when temperatures are STORAGE AND DISPOSAL greater than 50`F. Do not contaminate water food or feed by storage or disposal. BACKPACK OR HANDHELD SPRAYER APPLICATION:Apply through Pesticide Storage and Spill Procedures:Store upright at room temperature. non-thermal ULV application equipment and base acreage calculations on a Avoid exposure to extreme temperatures.In case of spill or leakage,soak up 300-foot swath.To apply undiluted at 0.007 pounds of permethrin per acre adjust with an absorbent material such as sand,sawdust,earth,fuller's earth,etc. equip-ment to an output rate of 1.24 ounces per minute and walk at 4 mph.To Dispose of with chemical waste. apply 0.0035 pounds of permethrin per acre,dilute 1 part Aqualuer 20-20 with 5 Pesticide Disposal:Pesticide,spray mixture or rinse water that cannot be used parts of diluent and apply at a rate of 3.8 ounces per minute and walk at 4 mph. according to label instructions must be disposed of at or by an approved waste THERMAL AEROSOL APPLICATION:For use in truck-mounted,handheld disposal facility. or other thermal fogging equipment.Spray equipment must be adjusted so the vol- Container Disposal:Triple rinse or equivalent,then offer for recycling or ume median diameter or mass median diameter is less than 30 microns(Dv 0.5< reconditioning or puncture and dispose of in a sanitary landfill or by incinera- 30 m)and that 90%of the spray is contained in droplets smaller than 48 microns tion,or if allowed by State and local authorities,by burning.If burned,stay out (Dv 0.9<48 m).Directions from the equipment manufacturer or vendor,pesticide of smoke. registrant or a test facility using a laser-based measurement instrument must be used to adjust equipment to produce acceptable droplet size spectra.Application NOTICE:Buyer and user assume all risk and liability of use,storage and/or equipment must be tested at least annually to confirm that pressure at the nozzle handling of this product not in accordance with the terms of this Zabel. and nozzle flow rates are properly calibrated.Apply this product mixed with EPA Reg.No 769-985 Value Garden Supply water or oil at a rate not to exceed 0.007 lbs.per acre.Base acreage calculations EPA Est.No.44616-MO-1 P.O.Box 585 on a 300 feet swath.For best results,direct the thermal fog into and allow to drift EPA Est.No.44616-GA-I St.Joseph,MO 64502 through areas where adult mosquitoes are found. (952)884-6477 BARRIER APPLICATIONS:To exclude and control resting or flying adult www.allprovector.com mosquitoes in areas such as animal quarters,roadsides,urban areas,residential RM#22039-10-2 areas,commercial areas,industrial areas,golf courses,parks,recreational areas, tire piles and all public areas where adult mosquitoes occur or find harborage. May be used to treat aggregation and harborage areas such as the perimeter of residential buildings,commercial buildings,storage buildings,crawl spaces, transport trailers,abandoned or uninhabited buildings and other areas where adult mosquitoes find harborage. 2.2 ENVIRONMENTAL HAZARDS Do not contaminate water when cleaning equipment or disposing of equipment washwaters. VectoLexe wDG 3.0 DIRECTIONS FOR USE It is a violation of Federal law to use this product in a BIOLOGICAL manner inconsistent with its labeling. Do not apply directly to treated finished drinking water reservoirs or drinking water receptacles. WATER DISPERSIBLE GRANULE 3.1 Chemigation Do not apply this product through any type of irrigation system. ACTIVE INGREDIENT: 4.0 STORAGE AND DISPOSAL Bacillus sphaericus 2362, Serotype H5a5b, Strain ABTS 1743 dried concentrate ................................ 51.2%w/w Do not contaminate water,food,or feed by storage or disposal. OTHER INGREDIENTS............................................ 48.8%w/w Storage: Store in cool [59-86°F (15-30°C)], dry place. TOTAL .................................................................... 100.0%w/w Pesticide Disposal:Wastes resulting from the use of this Potency: This product contains 650 BsITU/mg or 0.299 Billion product may be disposed of on site or at an approved BsITU/Ib. waste disposal facility. The percent active ingredient does not indicate product performance Container Disposal: Nonrefillable container.Do not reuse and potency measurements are not federally standardized. or refill this container.Triple rinse container(or equivalent) EPA Reg. No.73049-57 promptly after emptying.Triple rinse as follows:empty the EPA Est. No.33762-IA-001 List No. 60201 remaining contents into application equipment or a mix tank and drain for 10 seconds after the flow begins to drip.Fill the INDEX: container 1/4 full with water and recap.Shake for 10 seconds. 1.0 First Aid Pour rinsate into application equipment or a mix tank or store 2.0 Precautionary Statements rinsate for later use or disposal.Drain for 10 seconds after 2.1 Hazard to Humans (and Domestic Animals) flow begins to drip.Repeat this procedure two more times. 2.2 Environmental Hazards Once cleaned, offer container for recycling, if available or 3.0 Directions for Use puncture and dispose of in a sanitary landfill, or by inciner- 3.1 Chemigation ation,or,if allowed by state and local authorities,by burning. 4.0 Storage and Disposal If burned, stay out of smoke. 5.0 Application Directions 6.0 Ground and Aerial Application 5.0 APPLICATION DIRECTIONS 7.0 Notice to User Do not apply when wind speed favors drift beyond the area of treatment. KEEP OUT OF REACH OF CHILDREN I. For control of mosquito larvae species* in the CAUTION following non-crop sites. 1.0 FIRST AID Habitats Rate Range Wastewater: 0.5-1.5 Ibs/acre If in eyes . Hold eye open and rinse slowly and gently Sewage effluent, sewage lagoons, (8 oz-24 oz/acre) with water for 15-20 minutes. oxidation ponds, septic ditches, • Remove contact lenses, if present,after the animal waste lagoons, impounded first 5 minutes,then continue rinsing eye. • Call a poison control center or doctor for wastewater associated with fruit treatment advice, and vegetable processing HOT LINE NUMBER Stormwater/Drainage Systems: 0.5-1.5 Ibs/acre Storm sewers, catch basins, (8 oz-24 oz/acre) Have the product container or label with you when calling a poison drainage ditches, retention, control center or doctor, or going for treatment.You may also contact 1-877-315-9819 for emergency medical treatment detention and seepage ponds and/or transport emergency information.For all other information, Marine/Coastal Areas: 0.5-1.5 Ibs/acre call 1-800-323-9597. Salt marshes, mangroves, estuaries (8 oz-24 oz/acre) 2.0 PRECAUTIONARY STATEMENTS Water Bodies: 0.5-1.5 Ibs/acre Natural and manmade aquatic (8 oz-24 oz/acre) 2.1 HAZARD TO HUMANS (AND DOMESTIC ANIMALS) sites such as lakes, ponds, rivers, CAUTION canals and streams Causes moderate eye irritation.Avoid contact with eyes or Dormant Rice Fields: 0.5-1.5 Ibs/acre clothing.Wash thoroughly with soap and water after handling. Impounded water in dormant rice (8 oz-24 oz/acre) Mixer/loaders and applicators not in enclosed cabs or aircraft fields (For application only during must wear a dust/mist filtering respirator meeting NIOSH the interval between harvest and standards of at least N-95,R-95,or P-95.Repeated exposure preparation of the field for the to high concentrations of microbial proteins can cause allergic next cropping cycle) sensitization. II. For control of mosquito larvae species* in agricul- For ground spraying, apply 8-24 oz./acre (227-680 g/acre) tural/crop sites where mosquito breeding occurs. of VectoLex WDG in 5-100 gallons of water per acre using Habitats Rate Range hand-pump, airblast, mist blower, or other spray equipment. Rice, pastures/hay fields, 0.5-1.5 Ibs/acre For aerial application, apply 8-24 oz./acre(227-680 g/acre) orchards, citrus groves, (8 oz-24 oz/acre) of VectoLex WDG through fixed wing or helicopter aircraft irrigated crops equipped with either conventional boom and nozzle systems Use higher rates(1 to 1.5 Ibs/acre)in areas where extended or rotary atomizers at a convenient dilution rate.For aerial residual control is necessary, or in habitats having deep application, apply 0.5-10 gallons/acre of the final spray water or dense surface cover. mixture to provide uniform coverage of the target area. Apply uniformly by aerial or conventional ground equipment. Avoiding spray drift at the application site is the responsibility Reapply as needed after 1-4 weeks. of the applicator.The interaction of many equipment-and- *Mosquito species effectively controlled by VectoLex WDG: weather-related factors determine the potential spray drift. Culex spp. The applicator and treatment coordinator are responsible Aedes vexans for considering all these factors. Ochlerotatus melanimon (Aedes melanimon) Rinse and flush spray equipment thoroughly following each Ochlerotatus stimulans (Aedes stimulans) use. Ochlerotatus nigromaculis (Aedes nigromaculis) Amount of VectoLex WDG needed to treat small areas: Psorophora columbiae Psorophora ferox Rate of VectoLex WDG/Acre Ochlerotatus triseriatus (Aedes triseriatus) Area To Treat 8 oz. 16 oz. 24 oz. Ochlerotatus sollicitans (Aedes sollicitans) Anopheles quadrimaculatus 1/4 Acre 2 oz 4 oz 6 oz Coquillettidia perturbans 1/2 Acre 4 oz 8 oz 12 oz 6.0 GROUND AND AERIAL APPLICATION 10 Acres 5 lb 10 lb 15 lb 20 Acres 10 lb 20 lb 30 lb VectoLex WDG may be applied using conventional ground or aerial application equipment with quantities of water 7.0 NOTICE TO USER sufficient to provide uniform coverage of the target area. Seller makes no warranty, express or implied, of mer- For application, first add the VectoLex WDG to water to chantability, fitness or otherwise concerning use of this produce a final spray mixture. The amount of water will product other than as indicated on the label.User assumes depend on weather,spray equipment,and mosquito habitat all risks of use,storage or handling not in strict accordance characteristics. For application, fill the mix tank or plane with accompanying directions. hopper with the desired quantity of water.Start the mechan- ical or manual agitation to provide moderate circulation of water before adding the VectoLex WDG. Backpack and compressed air sprayers may be agitated by shaking after adding VectoLex WDG to the water in the sprayer. VectoLex WDG suspends readily in water and will stay VectoLex is a registered trademark of Valent BioSciences suspended over normal application periods.Brief recirculation Corporation. may be necessary if the spray mixture has sat for several hours or longer.Do not mix more VectoLex WDG than can be used in a 48 hour period.AVOID CONTINUOUS AGITA- TION OF THE SPRAY MIXTURE DURING SPRAYING. VALENTBIOSCIENCES - COR P O RATIO N 870 TECHNOLOGY WAY LIBERTYVILLE, IL 60048 USA PH:800-323-9597 04-7320/116©Valent BioSciences Corporation,August 2012 1.0 FIRST AID If in eyes Hold eye open and rinse slowly and gently oLex WSPwith water for 15-20 minutes. • Remove contact lenses, if present,after the Vectfirst 5 minutes,then continue rinsing eye. • Call a poison control center for treatment BIOLOGICAL LARVICIDE advice. If on skin • Take off contaminated clothing. or clothing . Rinse skin immediately with plenty of water WATER SOLUBLE POUCH for 15-20 minutes. • Call a poison control center or doctor for treatment advice. HOT LINE NUMBER ACTIVE INGREDIENT: Have the product container or label with you when calling a Bacillus sphaericus 2362, Serotype H5a5b, strain ABTS poison control center or doctor, or going for treatment.You may 1743 Technical Powder 670 BsITU/m 7 also contact 1-877-315-9819(24 hours)for emergency medical ( g) • • • • • • • • • 5% treatment and/or transport emergency information.For all other OTHER INGREDIENTS . . . . . . . . . . . . . . . . . . . . . . . . 92.5% information,call 1-800-323-9597. TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0% Potency:This product contains 50 BsITU/mg or 0.023 Billion 2.0 PRECAUTIONARY STATEMENTS BsITU/Ib. Expiration Date: (Two years from the date of manufacture). 2.1 HAZARDS TO HUMANS AND DOMESTIC ANIMALS The percent active ingredient does not indicate product CAUTION performance and potency measurements are not federally Harmful if absorbed through the skin.Causes moderate eye standardized. irritation. Avoid contact with skin, eyes or clothing. Wash EPA Reg. No.73049-20 List No.05722 thoroughly with soap and water after handling. EPA Est. No.33762-IA-001 (Lot No.Suffix`N8') 2.2 ENVIRONMENTAL HAZARDS EPA Est. No. 33967-NJ-1 (Lot No.Suffix`Q5') Do not contaminate water when disposing of equipment washwaters or rinsate. Do not apply directly to treated, INDEX: finished drinking water reservoirs or drinking water receptacles 1.0 First Aid when the water is intended for human consumption. 2.0 Precautionary Statements 2.1 Hazards to Humans and Domestic Animals 3.0 DIRECTIONS FOR USE 2.2 Environmental Hazards 3.0 Directions for Use It is a violation of Federal law to use this product in a manner 4.0 Storage and Disposal inconsistent with its labeling. 5.0 Directions for Use -VectoLex Water Soluble Pouches (WSP) 5.1 Application Directions 4.0 STORAGE AND DISPOSAL 6.0 Notice to User Do not contaminate water, food or feed by storage or disposal. Do not contaminate water when disposing of equipment washwaters. KEEP OUT OF REACH OF CHILDREN Pesticide Storage: Store in a cool, dry place. CAUTION Pesticide Disposal:Wastes resulting from the use of this product may be disposed of on site or at an approved waste disposal facility. Container Disposal: Non refillable container. Do not reuse or refill this container.Offer for recycling if available. Completely empty bag into application equipment. Then dispose of empty bag in a sanitary landfill or by incineration, or, if allowed by State and local authorities, by burning.If burned,stay out of smoke.For Water Soluble Pouches, dispose of empty outer foil bag in trash. Continued 5.0 DIRECTIONS FOR USE-VECTOLEX WATER 5.1 APPLICATION DIRECTIONS (cont'd) SOLUBLE POUCHES(WSP) Longer periods of mosquito population suppression may result where sufficient numbers of non-target aquatic invertebrate parasites and Once the foil bag containing Water Soluble Pouches is opened, predators are present since these are not affected by the product use pouches within one day. and contribute to mosquito population reduction. Mosquito species effectively controlled by VectoLex WSP,including 5.1 APPLICATION DIRECTIONS many of those known to carry/transmit West Nile Virus: Culex spp. MOSQUITO CONTROL Aedes vexans Ochlerotatus me/animon (Aedes me/animon) VectoLex WSP is a selective microbial insecticide for use Ochlerotatus nigrostimu a c (Aedes nigro a c against mosquito larvae in a variety of habitats.VectoLex Ochlerotatus olumbiaculis (Aedes nigromaculis} g q Y Psorophora columbine WSP can be applied to areas that contain fish, other Psorophora ferox aquatic life, and plants.VectoLex WSP can be applied to Ochlerotatus triseriatus (Aedes triseriatus) areas used by or in contact with humans, pets, horses, Ochlerotatus sollicitans (Aedes sollicitans) livestock, birds or wildlife. Anopheles quadrimaculatus I. For control of mosquito larvae species*in the following Coquillettidia perturbans non-crop sites: Habitat Rate Range 6.0 NOTICE TO USER Drainage/Drainage Systems: Storm drains, catch basins, 1 pouch/50 sq.ft.0) To the fullest extent permitted by law, seller makes no retention, detention and warranty, express or implied, of merchantability, fitness seepage ponds. or otherwise concerning the use of this product other Treatment Areas(For Use In)0): than as indicated on the label. User assumes all risks of Ponds Standing water Unused swimming use, storage or handling not in strict accordance with Lagoons Storm water pools or spas accompanying directions. Water gardens retention areas Flooded basements Hollow trees and Catch basins Pool covers tree holes Birdbaths Gutters and drains Urns Fountains Wheelbarrows Rain barrels Flowerpots Garbage cans Livestock watering and planters and covers troughs/ponds/tanks Snowmelt pools Discarded tires Irrigation ditches Abandoned Roadside ditches swimming pools Flood water Any location where water accumulates and remains standing for periods of time, except treated, finished drinking water for human consumption. (I)Treat on basis of surface area of potential mosquito breeding sites by placing one (1)VectoLex Soluble Pouch for up to 50 square feet of treatment area.Re-apply as needed after 1 to 4 weeks. VALENTBIOSCIENCES. VrCO R P O RATION 870 TECHNOLOGY WAY LIBERTYVILLE,IL 60048 USA PH:800-323-9597 04-7321/136©Valent BioSciences Corporation,August 2012 Mixers/loaders and applicators not in enclosed cabs or aircraft, must wear a dust/mist filtering respirator meeting NIOSH standards of at least N-95, R-95, or P-95. Repeated exposure to high concentrations of microbial proteins can cause allergic Vect FG oLeX sensitizations. 2.2 Environmental Hazards Do not contaminate water when disposing of equipment washwaters or rinsate.Do not apply directly to treated,finished BIOLOGICAL drinking water reservoirs or drinking water receptacles when the water is intended for human consumption. FINE GRANULE 3.0 DIRECTIONS FOR USE It is a violation of Federal law to use this product in a manner ACTIVE INGREDIENT: inconsistent with its labeling. Bacillus sphaericus 2362, Serotype H5a5b, strain ABTS 1743 Technical Powder 7.5% 4.0 STORAGE AND DISPOSAL .. . . . . . . . . ........... . . .. ....... . . OTHER INGREDIENTS .. . . . . . . . . ....... . . . . ........ 92.5% TOTAL . .. . . . . ..... . ... . . . . . .. ....... . . . . .........100.0% Do not contaminate water,food or feed by storage or disposal. Do not contaminate water when disposing of.equipment washwaters. Potency:This product contains 50 BsITU/mg or 0.023 Billion BsITU/Ib. Pesticide Storage: Store in a cool dry" ace. Expiration Date:(Two years from the date of manufacture). Pesticide Disposal:Wastes resulting from the use of this product The percent active ingredient does not indicate product performance may be disposed of on site or at an approved waste disposal facility. and potency measurements are not federally standardized. Container Disposal: Nonrefillable container. Do not reuse or EPA Reg.No.73049-20 refill this container. Offer for recycling, if available. Completely EPA Est.No. 33762-IA-001 List No.05722 empty bag into application equipment.Then dispose of empty bag in a sanitary landfill or by incineration,or, if allowed by State and local authorities,by burning.If burned,stay out of smoke. INDEX: 5.0 DIRECTIONS FOR USE-VECTOLEX FG 1.0 First Aid 2.0 Precautionary Statements 5.1 Application Directions 2.1 Hazard to Humans (and Domestic Animals) 2.2 Environmental Hazards MOSQUITO CONTROL 3.0 Directions for Use VectoLex FG is a selective microbial insecticide for use against 4.0 Storage and Disposal mosquito larvae in a variety of habitats.VectoLex FG can be applied 5.0 Directions for Use-VectoLex FG to areas that contain fish,other aquatic fife,and plants.VectoLex FG 5.1 Application Directions can be applied to areas used by or in contact with humans,pets, 6.0 Notice to User horses,livestock, birds,or wildlife. I. For control of mosquito larvae species* in the following non-crop sites: KEEP OUT OF REACH OF CHILDREN Habitat Rate Range CAUTION Wastewater: Sewage effluent,sewage lagoons, 5-20 Ibs/acre** 1.0 FIRST AID oxidation ponds,septic ditches,animal --- waste lagoons,impounded wastewater If in eyes . Hold eye open and rinse slowly and gently associated with fruit and vegetable with water for 15-20 minutes. processing. • Remove contact lenses,if present,after the Stormwater/Draina e Systems: first 5 minutes,then continue rinsing eye. 9 Y • Call a poison control center for treatment advice. Storm sewers,catch basins,drainage 5-20 Ibs/acre** If on skin ditches, retention,detention and seepage • Take off contaminated clothing. ponds. or clothing . Rinse skin immediately with plenty of water for 15-20 minutes. Marine/Coastal Areas: • Call a poison control center or doctor for Salt marshes,mangroves, estuaries. 5-20 Ibs/acre** treatment advice. HOT LINE NUMBER Water Bodies: Natural and manmade aquatic sites such 5-20 Ibs/acre** Have the product container or label with you when calling a poison as lakes,ponds, rivers,canals,streams control center or doctor,or going for treatment.You may also contact and livestock watering ponds and troughs. 1-877-315-9819(24 hours)for emergency medical treatment and/or transport emergency information.For all other information, Dormant Rice Fields: call 1-800-323-9597. Impounded water in dormant rice fields. 5-20 Ibs/acre" (For application only during the interval 2.0 PRECAUTIONARY STATEMENTS between harvest and preparation of the field for the next cropping cycle.) 2.1 HAZARDS TO HUMANS AND DOMESTIC ANIMALS Waste Tires: CAUTION Tires stockpiled in dumps, landfills, 20-80 Ibs/acre(1) Harmful if absorbed through the skin.Causes moderate eye irritation. recycling plants,and other similar sites. Avoid contact with skin, eyes or clothing.Wash thoroughly with (1)0.5-2 Ibs/1000 sq.ft. soap and water after handling. CONTINUED II.For the control of mosquito larvae species*in agricultural/ crop sites where mosquito breeding occurs: Habitats: Rate Range Rice,pastures/hay fields,orchards, 5-20 Ibs/acre** citrus groves, irrigated crops. Apply uniformly by aerial or conventional ground equipment.Reapply as needed after 1 to 4 weeks. 'Mosquito species effectively controlled by Vectol-ex FG: Culex spp. Aedes vexans Ochlerotatus melanimon (Aedes melanimon) Ochlerotatus stimulans (Aedes stimulans) Ochlerotatus nigromaculis (Aedes nigromaculis) Psorophora columbiae Psorophora ferox Ochlerotatus triseriatus (Aedes triseriatus) Ochlerotatus sollicitans (Aedes sollicitans) Anopheles quadrimaculatus Coquillettidia perturbans **Use higher rates(10 to 20 Ibs/acre)in areas where extended residual control is necessary,or in habitats having deep water or dense surface cover. Avoiding spray drift at the application site is the responsibility of the applicator.The interaction of many equipment and weather related factors determine the potential for spray drift. The applicator and the treatment coordinator are responsible for considering all these factors when making decisions. 6.0 NOTICE TO USER To the fullest extent permitted by law,seller makes no warranty, express or implied, of merchantability, fitness or otherwise concerning use of this product other than as indicated on the label.User assumes all risks of use,storage or handling not in strict accordance with accompanying directions. VALENT&OSCIENCES. -"" CORPORATION 870 TECHNOLOGY WAY LIBERTYVILLE,IL 60048 USA PH:800-323-9597 04-7456/R1©Valent BioSciences Corporation,November 2012 SPECIMEN LABEL UPDATES AVAILABLE AT WWW.GREENBOOKNET l Valent BioSciences Habitat Rate Range (�\_(�.1� Storm Waters/Drainage Systems: Veeto LexO V V Storm sewers,catch basins,age drainage ditches, 5-20 Ibs/acrc•• retention,detention and seepage ponds. Biological j.wvicide Marine/Coastal Areas: Granules Salt marshes,mangroves,estuaries. 5-20 ibs/acre" ACTIVE INGREDIENT: water Bodies: Bacillus sphaericus Serotype H5a5b,strain 2362 Technical Powder Natural and manmade aquatic sites such as lakes, 5-201bs/acre" (670 BSiTU/mg)............................................... 7.5% ponds,rivers,canals,streams and livestock watering OTHER INGREDIENTS....................................... 92.5% ponds and troughs. TOTAL.................................................... 100.0% Dormant Rice Fields: Potency: This product contains 50 BsITU/mg or 0.023 Billion BsITU/lb. impounded water in dormant rice fields. (For 5-20 lba/acre** application only during the interval between harvest The percent active ingredient does not indicate product performance and potency and preparation of the field for the next cropping measurements are not federally standardized. cycle.) EPA Reg. No. 73049-20 EPA Est. No. 33762-IA-001 List No. 05722 Waste Tires: Tires stockpiled in dumps,landfills,recycling 20-90 lbs/acretr' plants,and other similar sites. KEEP OUT OF REACH OF CHILDREN CAUTION (t)0.5-2 lbs/to0o sq. It. 11,For the control of mosquito larvae species*in agricultural/crop sites where 1.0 FIRST AID mosquito breeding occurs: If in eyes •Hold eye open and rinse slowly and gently with water for 15-20 minutes. Habitats: Rate Range a Remove contact lenses,if present,after the first 5 minutes,then * continue rinsing eye. Rice,pastures/hay fields,orchards citrus groves 5-201bs/acre* a Call a poison control center for treatment advice. irrigated crops. Apply uniformly by aerial or conventional ground equipment. Reapply as needed If on skin .Take off contaminated clothing. after I 4 weeks. or clothing •Rinse skin immediately with plenty of water for 15-20 minutes. •Call a poison control center or doctor for treatment advice. Mosquito species effectively controlled by VectoLez CG: HOT LINE NUMBER Cuter spP. AedesYawns Have the product container or label with you when calling a poison control center or Ochle otatus p Y g Po Ochlerotatus melanimon (Aedes melarrimon) doctor,or going for treatment. You may also contact I-877-315-9819(24 hours)for Ochkrotatus stimulans (Aedes stimulam) emergency medical treatment and/or transport emergency information. For all other Ochlerotatus ngromaculis (Aedes nigromacuGs) information,call I-800-323-9597. Psorophora cvlumbiae Psorop2.0 PRECAUTIONARY STATEMENTS Ochlerhora terns Ochlerotatus triseriatus (Aedes uiserfatus) 2.1 Hazards To Humans and Domestic Animals Ochlerotaw sofficltans (Aedes sollicitans) CAUTION Anopheles quadrlmaculatus Coquilletudia perturbans Harmful if absorbed through the skin. Causes moderate eye irritation. Avoid "Use higher rates(10 to 20 lbs/acre)in areas where extended residual control is necessary, contact with skin,eyes or clothing. Wash thoroughly with soap and water after or in habitats having deep water or dense surface cover. handling. Avoiding spray drift at the application site is the responsibility of the applicator. Mixers/loaders and applicators not in enclosed cabs or aircraft, must wear a The interaction of many equipment and weather related factors determine the po- dusdmist filtering respirator meeting NIOSH standards of at least N-95,R-95,or tential for spray drift. The applicator and the treatment coordinator are responsible P-95. Repeated exposure to high concentrations of microbial proteins can cause for considering all these factors when making desicions. allergic sensitizations. 6.0 NOTICE TO USER 21 Environmental Hazards Seller makes no warranty,express or implied,of merchantability,fitness or oth- Do not contaminate water when disposing of equipment washwaters or rinsate. erwise concerning use of this product other than as indicated on the label. User Do not apply directly to treated, finished drinking water reservoirs or drinking assumes all risks of use,storage or handling not in strict accordance with accom- water receptacles when the water is intended for human consumption. panying directions. 3.0 DIRECTIONS FOR USE VALENT BIOSCIENCES®CORPORATION 870 TECHNOLOGY WAY It is a violation of Federal law to use this product in a manner inconsistent with LIBERTYVII.LE,IL 60048--800-323-9597 its labeling. 04-5000/R6 4.0 STORAGE AND DISPOSAL ®Valent BioSciences Corporation April,2005 VID.7.14.05 Do not contaminate water,food or feed by storage or disposal. Do not contam- inate water when disposing of equipment washwatcrs. Pesticide Storage: Store in a cool,dry place. Pesticide Disposal: Wastes resulting from the use of this product may be disposed of on site or at an approved waste disposal facility. Container Disposal: Completely empty bag into application equipment Then dispose of empty bag in a sanitary landfill or by incineration,or,if allowed by State and local authorities,by burning. If burned,stay out of smoke. 5.0 APPLICATION DIRECTIONS MOSQUITO CONTROL L For control of mosquito larvae species*in the following,non-crop sites: Habitat Rate Range Wastewater: Sewage effluent,sewage lagoons,oxidation ponds, 5-20 lbs/acre** septic ditches,animal waste lagoons,impounded wastewater associated with fruit and vegetable processing. Database and format copyright©by Vance Communication Corporation. All rights reserved. EXHIBIT A SCOPE OF WORK 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05-022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label,the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City Page 1 of 8 Piazza/Data_Center/Forms/City/Co ntracts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: ID owner Facility Name/Type Facility Location 1 Surface Water Utility Amberwood/WQ Pond 315 Quincy Ave NE 2 Surface Water Utility Amberwood II/WQ Pond 304 Rosario PI NE 3 Surface Water Utility Aspenwoods/WQ Pond 808 Ilwaco PI NE 4 Surface Water Utility Aster Park Plat/WQ Pond 5516 NE 13th St 5 Surface Water Utility Auria Woods Tract C/WQ Pond 12152 SE 186th St 6 Surface Water Utility Beclan Place Plat/WQ Pond 5134 NE 2nd St 7 Surface Water Utility Brookefield II/WQ Pond 5305 NE 11th Ct 8 Surface Water Utility Chinquapin Ridge/WQ Pond 19123 113th Way SE 9 Surface Water Utility Christian Short Plat/WQ Pond 11129 SE 189th PI 10 Surface Water Utility Cottages at Honey Creek/WQ Pond NE Sunset Blvd/ Elma PI NE 11 Surface Water Utility Elliott Farm/Detention Pond Maple Valley Hwy/140th Way SE 12 Surface Water Utility Ellis Park aka Edenwood/WQ Pond 602 NE 6th St 13 Surface Water Utility Elmhurst/WQ Pond 215 Whitman PI NE 14 Surface Water Utility Emma's Plat/WQ Pond 5611 SE 1st PI 15 Surface Water Utility Evendell Plat/WQ Pond 6741 SE 4th St 16 Surface Water Utility Fredricks Place/WQ Pond 10301 SE 186th St 17 Surface Water Utility Greenfield II aka Highpointe II/WQ Pond 1318 Redmond PI NE 18 Surface Water Utility Hamilton Place Plat/WQ Pond 6743 NE 1st PI 19 Surface Water Utility Heritage Renton Hill/WQ Pond 1816 SE 8th PI 20 Surface Water Utility Highland Estates/WQ Pond 355 Rosario PI SE 21 Surface Water Utility Highlands Park/WQ Pond 202 Rosario Ave SE 22 Surface Water Utility Jericho Estates/WQ Pond 316 Hoquiam Ave NE 23 Surface Water Utility Kimberly Lane/WQ Pond 17228 125th Ave SE 24 Surface Water Utility Larson Parke Plat/WQ Pond 18469 114th Ave SE 25 Surface Water Utility Laurelhurst Phase I/WQ Pond 4615 NE 1st St 26 Surface Water Utility Liberty Grove and Liberty Grove 13716 160th Ave SE Contiguous/WQ Pond 27 Surface Water Utility Liberty Ridge Phase I/WQ Pond 2511 NE 1st St(behind residence) 28 Surface Water Utility Liberty Ridge Phase I/WQ Pond 205 Index PI SE 29 Surface Water Utility Liberty Ridge Phase II/WQ Pond 2601 Ferndale Ave NE 30 Surface Water Utility Magnussen Plat/WQ Pond 202 Field Ave NE 31 Surface Water Utility Magnussen Plat/WQ Pond 4814 NE 2nd St(behind residence) 32 Surface Water Utility Maple Glen Addition/WQ Pond SE 182nd St/108th Ave SE 33 Surface Water Utility Maureen Highlands Tract A/WQ Pond 6118 NE 4th St 34 Surface Water Utility Morning Glen/WQ Pond 17612 114th PI SE 35 Surface Water Utility NE 10th St Pond/WQ Pond NE 10th/Anacortes Ave NE 36 Surface Water Utility NE 4th Detention/WQ Pond 234 Field Ave NE Page 2 of 8 Pia zza/Data_Center/Forms/City/Contracts 37 Surface Water Utility Nichols Place/WQ Pond 13815 160th Ave SE 38 Surface Water Utility Olympic Peak Estates/WQ Pond 9402 S 196th PI 39 Surface Water Utility Parkside Court/WQ Pond 5621 SE 2nd St 40 Surface Water Utility Pioneer Place/WQ Pond Maple Valley Rd/149th Ave SE 41 Surface Water Utility Serenity Ridge Tract A/WQ Pond 17927 110th PI SE 42 Surface Water Utility Serenity Ridge Tract B/WQ Pond 17707 110th PL SE 43 Surface Water Utility Shamrock Glen aka Martin Prop/WQ Pond 5507 NE 5th Cir 44 Surface Water Utility Shy Creek/WQ Pond 204 SE 2nd St 45 Surface Water Utility Sienna/WQ Pond 5402 NE 2nd St 46 Surface Water Utility Stonegate/WQ Pond 5500 NE 26th St 47 Surface Water Utility Sunnybrook/WQ Pond 712 S 36th PI 48 Surface Water Utility Talbot Estates/WQ Pond 9612 S 194th St 49 Surface Water Utility The Reserve at Stonehaven/WQ Pond 1003 S 47th St 50 Surface Water Utility Watershed Terrace/WQ Pond 19926 101st Ave SE 51 Surface Water Utility Wilkins Wood/WQ Pond 16603 113th Ave SE 52 Surface Water Utility Windsong/WQ Pond 4925 NE 4th PI 53 Surface Water Utility Windsor Circle aka Harmony Gro/WQ Pond 13502 162nd Ave SE 54 Surface Water Utility Winsper(Liberty View 1&11)/WQ Pond 611 S 32nd St 55 Surface Water Utility Zetterberg/WQ Pond 2100 Burnett PI S 56 Surface Water Utility Honey Brooke West aka Sagecrest/WQ Pond 505 Field PI NE 57 Surface Water Utility Honey Creek Ridge Tract A/Detention Pond 3203 NE 26th Ct with Bioswale 58 Surface Water Utility Honey Creek Ridge Tract B/Detention Pond 2407 Olympia Ave NE with Bioswale 59 Surface Water Utility Langley Ridge at May Creek/WQ Pond 5302 NE 26th St 60 Surface Water Utility Maplewood Estates/Detention Pond with 5831 SE 2nd Ct Bioswale 61 Surface Water Utility Maureen Highlands Tract C/WQ Pond 653 Shadow Ave NE 62 Surface Water Utility River Ridge/Detention Pond with Bioswale 1706 SE 7th Ct 63 Surface Water Utility Summerwind/Detention Pond NE Sunset Blvd/Field Ave NE 64 Surface Water Utility Victoria Hills/Detention Pond 1012 S 23rd St 65 Surface Water Utility Westmont/WQ Pond 3625 Monterey Ct NE A Surface Water Utility Catchbasins Various 90 Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) 91 Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course (west-central) 92 Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) 93 Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course (east) 98 Golf Course Maplewood Golf Course Catchbasins Various B Parks Maintenance Catchbasins Various Division 99 Facilities Division Renton City Hall/Water Quality Grady Way Parking Lot Page 3 of 8 Pia zza/Data_Center/Forms/City/Contracts Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment,the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course—The contractor shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 8 Piazza/Data_Center/Forms/City/Contracts EXHIBIT B TIME OF COMPLETION 2015 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2015. Page 5 of 8 Piazza/Data_Center/Forms/City/Contracts EXHIBIT C COST ESTIMATE 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The maximum treatments shall not exceed 21 and shall include all necessary work to clear of the trails. Cost shall be based on a unit price per treatment. The billing rates include state sales tax. Cost per treatment $ 840 Subtotal Contract Cost for 21 treatments: $ 17640 State Sales Tax (9.5%) $ 1675.80 Total Cost Task 1: $ 19315.80 TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is $ The cost for Task 2 shall be based on total manhours per stormwater/irrigation facility and catch basins multiplied by the rate of$ 125.00 per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under "Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. Below is the estimated contract cost for the three City divisions, based on the billing rate of$ 125.00 per manhour for a total of 180 manhours: Surface Water Utility Costs Stormwater facilities: 65 Total number of treatments per stormwater facility: 8 Total manhours per stormwater facility(including travel time): 0.6 hrs Total stormwater facility manhours: 312 hrs Subtotal cost for stormwater facilities: $ 39000 Sales Tax (9.5%): $ 3705 Total cost for stormwater facilities: $42705.00 Page 6 of 8 Pia zza/Data_Center/Forms/City/Contracts Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $ 7500 Sales Tax (9.5%): $ 712.50 Total cost for catch basin treatment: $ 8212.50 Total manhours (stormwater facilities + catch basins): 372 hrs Subtotal cost (stormwater facilities + catch basins): $ 50917.50 Sales Tax (9.5%): $ 4837.16 Total cost (stormwater facilities + catch basins): $ 55754.66 Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility (including travel time): 1 hrs Total irrigation facility manhours: 32 hrs Subtotal cost for irrigation facilities: $ 4000 Sales Tax (9.5%): $ 380 Total cost for irrigation facilities: $ 4380 Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $ 375.00 Sales Tax (9.5%): $ 35.63 Total cost for catch basin treatment: $ 410.63 Total manhours (irrigation facilities + catch basins): 35 hrs Subtotal cost (stormwater facilities + catch basins): $ 4375 Sales Tax (9.5%): $ 415.63 Total cost (stormwater facilities + catch basins): $ 4790.63 Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Subtotal cost for catch basin treatment: $ 7625 Sales Tax (9.5%): $ 724.38 Total cost for catch basin treatment: $ 8349.38 Total manhours (irrigation facilities+ catch basins): 61 hrs Page 7 of 8 Pi azza/Data_Center/Forms/City/Contracts Subtotal cost (stormwater facilities + catch basins): $ 7625 Sales Tax (9.5%): $ 724.38 Total cost (stormwater facilities+ catch basins): $ 8349.38 Facilities Division Costs Stormwater facilities: 1 Total number of treatments per facility: 8 Total manhours per stormwater facility (including travel time): 0.75 hrs Total stormwater facility manhours: 6 hrs Subtotal cost for stormwater facilities: $ 750 Sales Tax(9.5%): $ 71.25 Total cost stormwater facilities: $ 821.25 Catch Basin: 0 Total manhours (stormwater facilities +catch basins): 6 hrs Subtotal cost (stormwater facilities+catch basins): $ 750 Sales Tax(9.5%): $ 71.25 Total cost: $ 821.25 Total Contract Cost for all Divisions: $ 69715.92 State Sales Tax (9.5%): $ 6623.01 Total Cost Task 2: $ 76338.93 B. Total Contract Cost (Task 1+Task 2): $ 95654.73 C. Invoicing The constractor shall submit all invoices to the City of Renton Surface Water Utility Section. Invoices shall include the division (Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division) for which the service was provided under this project. Payment cannot be authorized or payment may be delayed until the invoices include the division to which the service was provided. Page 8 of 8 Piazza/Data_Center/Forms/City/Contracts N • s ENNYDALE I, r, N 30th St-•--� Cr66� Lake dsh Washington .;� 1-. W- ® yL o w Z Z { _I 1 > t fl c t o w 5�nset Blvd i- � 1 NE Park Dr f w _ SE Renton Issaquah-Rd ® Z o ® w > w Z �? 900 Z� CD a) > o > _a o HIGHLANDS Q Z Z m W Q m © > w y z a D Q z NE 7th S' > _° a) ' u > `n a z w m m Q € o ® v o Y E <p m o z NE 4th St N 3rd St ® SE 128th St NE 3ta S< ® O EAST PLATEAU CD ® U < > N S 3rd St C aer Riv r e er CITY CENTER C od Creek-rJ o Hardie Ave SW Maple Valley Hwy MaP{e� ® .Fa 4011 S Grady Way /f, 4, ap W vex Q� _ dar r rEpt...R RI~JRR Ce bti m M SE Jones Rd o A�� lyay aPle Valley N QJ s�C WY 169 515 X G� n, y co \�5 Q N t Ir a 1 t Madson-Gr68K N BENSON SE 168th St 167 N W W > In C/) ! n > N W Q Q Rd SE P trov% 611 `.5 Mosquito Abatement Program b Exhibit B: Larvicide Treatment Sites t The City of Renton may use mosquito larvicides made of a natural bacterium(Bacillus sphaericus) © help control mosquitoes in accordance with the Washington State Department of Ecology's 167 515 Aquatic Mosquito Control General Permit. Treatments may occur between July 27,2015 and October 30,2015. Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City. For more information about the City's commitment to help reduce the « O t threat of West Nile virus and control mosquitoes,contact Allen Quynn,City of Renton Surface Water Utility Engineer,at 425-430-7247 or by email at aquynn@rentonwa.gov. For additional information about Ecology's Aquatic Mosquito Control General Permit, please ® SE 192nd contact the City of Renton or Jon Jennings,Water Quality Program,Washington State W Department of Ecology,at 360-407-6283 or email at onathan.ennin s e wa. ov. CO P 9Y. Y 1 1 9@ cY• 9 f TALBOT Q 0 0.25 0.5 1 Miles 1 0 Panther Lake Date: 04/21/2015 i �S� t N(o _ S3th S . S� __.. I-405 Ramp S_ Q S `:. i ,p S 15th St E t.. tP I NO i p CO > S 16th St I CO ................. Cl�..:..5 .:t. Q ........ Ca I �_ .. _...._.. (II \ SW �9th..St S 19th St �► . t s t i S C-St St r ` ` I W 2 _._. x 2'I-St.St: I, ► d p1 s 22na Ct 1 _..._ _ .._..._...., Y�5 3rd St Sw..M. rdtt . S 23rd St i ...._. __. S 25th St 19 S 26tt �Stf _, St !I _ SWW2 -SI�;_� St` .�27t n S 2'1 S 28th PI $�� Ca { 2 SVV.29t) S N } 133 LLI 4 ( > Q - Li _........ r �}: , ;....... .... _ t. — s StS 31 st St .... mm . • S 32nd PI I: r ' II' uJf i o : 1..... I S 32nd S� o A.j ........ ..._._.___ , i _ S 34th St _.. ... t........P L, _ - _ S 35th St SF tt , 1. , , �.. '- nd J CO....._ CO \ A t A { �. �„T i \ .. \\ t.\\. S36thSt Q_ COS"37t � h St o l SW-39th-St S 38th Ct l CO; Mosquito Abatement Program N Exhibit D: Site Plan 0 500 1,000 w _ 1 E I i 1 i l Note: Treatment will not be applied within 100' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge Project Boundary and the residential areas. Property owner approval required prior to {y "'°` ' treatment on private property. Surface water Utility I G.Del Rosario I Printed 04n7/2013 2014 Mosquito Abatement Area 15th St _ .. ..� - S,Py9e sw lstn st '�� boh� °� Treatment Are t Tr t as City Owned Parcel « co 1615 Owner Approved Parcel 3 t 1625U v ' - aQ Public Easement r 1701 j' N -- s ... _ S 17th 1717 CD 3 C 4 � S 18th St v 1803 SW 19th St , S19th St� n _a v > z : 206 1 200 20th S S t" 3 "'S 2(1th p ' 2011 a d 2101 . 3 � P�cXs � - S 21 st St307 = --jar -17 2127 �� Private Rd � s AcP-d 33 � U Y n.'sz � �j t K.,p X= ' 3 �k o y tea. w � -�� _.4 ; . � 232s Qnqj ��t.� y Y. 24i: 'r0 . ,�- Talbot 2413 e M y 2419 t_ t g 25th St , _. ... 2515 '' S' E , - 2521 . E o- , s s 2601 - ,`d SW 27th St "" 71 % w r t + 1t n i t V l ,43.p T - 166thA t SW�29t PI Y a � - 3001 3 S 30th u CD " Ct J " 3 113 3031 _ z y � 3037 'O I1 3101 W 8) ro 1-1*W-1 ;,. ._ , PNP S3-thSt = 3 3315 SW,34th St 7 ' I �S 34thlP,I 3425 r Mosquito Abatement Program -;' 3503 r Exhibit A: Adulticide Treatment Area 1-4 a _ 3521 tj Note: Treatment will not be applied within 100' of water. -- 1, 3527, Treatments will not be performed near homes. Treatment will only i be done on the upland A , th st and the residential areasf e Property owneWapp ovaa between the wetland arequired pstern rior to � °`1 74 E ` " 21 treatment on private property. S 5' S 37,th g{� ' 0 250 500 1,000 Feet t i i i I i i i I N Jr f „ �` Date: 07/03/2014 EXHIBIT A SCOPE OF WORK 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05-022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label, the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City Page 1 of 8 Piazza/Data_Center/Forms/City/Contracts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Amberwood/WQ Pond 315 Quincy Ave NE 2 Surface Water Utility Amberwood II/WQ Pond 304 Rosario PI NE 3 Surface Water Utility Aspenwoods/WQ Pond 808 Ilwaco PI NE 4 Surface Water Utility Aster Park Plat/WQ Pond 5516 NE 13th St 5 Surface Water Utility Auria Woods Tract C/WQ Pond 12152 SE 186th St 6 Surface Water Utility Beclan Place Plat/WQ Pond 5134 NE 2nd St 7 Surface Water Utility Brookefield II/WQ Pond 5305 NE 11th Ct 8 Surface Water Utility Chinquapin Ridge/WQ Pond 19123 113th Way SE 9 Surface Water Utility Christian Short Plat/WQ Pond 11129 SE 189th PI 10 Surface Water Utility Cottages at Honey Creek/WQ Pond NE Sunset Blvd/Elma PI NE 11 Surface Water Utility Elliott Farm/Detention Pond Maple Valley Hwy/140th Way SE 12 Surface Water Utility Ellis Park aka Edenwood/WQ Pond 602 NE 6th St 13 Surface Water Utility Elmhurst/WQ Pond 215 Whitman PI NE 14 Surface Water Utility Emma's Plat/WQ Pond 5611 SE 1st PI 15 Surface Water Utility Evendell Plat/WQ Pond 6741 SE 4th St 16 Surface Water Utility Fredricks Place/WQ Pond 10301 SE 186th St 17 Surface Water Utility Greenfield II aka Highpointe II/WQ Pond 1318 Redmond PI NE 18 Surface Water Utility Hamilton Place Plat/WQ Pond 6743 NE 1st PI 19 Surface Water Utility Heritage Renton Hill/WQ Pond 1816 SE 8th P1 20 Surface Water Utility Highland Estates/WQ Pond 355 Rosario PI SE 21 Surface Water Utility Highlands Park/WQ Pond 202 Rosario Ave SE 22 Surface Water Utility Jericho Estates/WQ Pond 316 Hoquiam Ave NE 23 Surface Water Utility Kimberly Lane/WQ Pond 17228 125th Ave SE 24 Surface Water Utility Larson Parke Plat/WQ Pond 18469 114th Ave SE 25 Surface Water Utility Laurelhurst Phase I/WQ Pond 4615 NE 1st St 26 Surface Water Utility Liberty Grove and Liberty Grove 13716 160th Ave SE Contiguous/WQ Pond 27 Surface Water Utility Liberty Ridge Phase I/WQ Pond 2511 NE 1st St(behind residence) 28 Surface Water Utility Liberty Ridge Phase I/WQ Pond 205 Index PI SE 29 Surface Water Utility Liberty Ridge Phase II/WQ Pond 2601 Ferndale Ave NE 30 Surface Water Utility Magnussen Plat/WQ Pond 202 Field Ave NE 31 Surface Water Utility Magnussen Plat/WQ Pond 4814 NE 2nd St(behind residence) 32 Surface Water Utility Maple Glen Addition/WQ Pond SE 182nd St/ 108th Ave SE 33 Surface Water Utility Maureen Highlands Tract A/WQ Pond 6118 NE 4th St 34 Surface Water Utility Morning Glen/WQ Pond 17612 114th PI SE 35 Surface Water Utility NE 10th St Pond/WQ Pond NE 10th/Anacortes Ave NE 36 Surface Water Utility NE 4th Detention/WQ Pond 234 Field Ave NE Page 2 of 8 Piazza/Data_Center/Form s/City/Contracts 37 Surface Water Utility Nichols Place/WQ Pond 13815 160th Ave SE 38 Surface Water Utility Olympic Peak Estates/WQ Pond 9402 S 196th PI 39 Surface Water Utility Parkside Court/WQ Pond 5621 SE 2nd St 40 Surface Water Utility Pioneer Place/WQ Pond Maple Valley Rd / 149th Ave SE 41 Surface Water Utility Serenity Ridge Tract A/WQ Pond 17927 110th PI SE 42 Surface Water Utility Serenity Ridge Tract B/WQ Pond 17707 110th PL SE 43 Surface Water Utility Shamrock Glen aka Martin Prop/WQ Pond 5507 NE 5th Cir 44 Surface Water Utility Shy Creek/WQ Pond 204 SE 2nd St 45 Surface Water Utility Sienna/WQ Pond 5402 NE 2nd St 46 Surface Water Utility Stonegate/WQ Pond 5500 NE 26th St 47 Surface Water Utility Sunnybrook/WQ Pond 712 S 36th PI 48 Surface Water Utility Talbot Estates/WQ Pond 9612 S 194th St 49 Surface Water Utility The Reserve at Stonehaven/WQ Pond 1003 S 47th St 50 Surface Water Utility Watershed Terrace/WQ Pond 19926 101st Ave SE 51 Surface Water Utility Wilkins Wood/WQ Pond 16603 113th Ave SE 52 Surface Water Utility Windsong/WQ Pond 4925 NE 4th PI 53 Surface Water Utility Windsor Circle aka Harmony Gro/WQ Pond 13502 162nd Ave SE 54 Surface Water Utility Winsper(Liberty View 1&II)/WQ Pond 611 S 32nd St 55 Surface Water Utility Zetterberg/WQ Pond 2100 Burnett PI S 56 Surface Water Utility Honey Brooke West aka Sagecrest/WQ Pond 505 Field PI NE 57 Surface Water Utility Honey Creek Ridge Tract A/Detention Pond 3203 NE 26th Ct with Bioswale 58 Surface Water Utility Honey Creek Ridge Tract B/Detention Pond 2407 Olympia Ave NE with Bioswale 59 Surface Water Utility Langley Ridge at May Creek/WQ Pond 5302 NE 26th St 60 Surface Water Utility Maplewood Estates/Detention Pond with 5831 SE 2nd Ct Bioswale 61 Surface Water Utility Maureen Highlands Tract C/WQ Pond 653 Shadow Ave NE 62 Surface Water Utility River Ridge/Detention Pond with Bioswale 1706 SE 7th Ct 63 Surface Water Utility Summerwind/Detention Pond NE Sunset Blvd/Field Ave NE 64 Surface Water Utility Victoria Hills/Detention Pond 1012 S 23rd St 65 Surface Water Utility Westmont/WQ Pond 3625 Monterey Ct NE A Surface Water Utility Catchbasins Various 90 Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course (west) 91 Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course (west-central) 92 Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) 93 Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course (east) 98 Golf Course Maplewood Golf Course Catchbasins Various B Parks Maintenance Catchbasins Various Division 99 Facilities Division Renton City Hall/Water Quality Grady Way Parking Lot Page 3 of 8 Piazza/Data_Center/Forms/City/Contracts Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course—The contractor shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 8 Piazza/Data_Center/Forms/City/Contracts EXHIBIT B TIME OF COMPLETION 2015 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2015. Page 5 of 8 Piazza/Data_Center/Form s/City/Contracts EXHIBIT C COST ESTIMATE 2015 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The maximum treatments shall not exceed 21 and shall include all necessary work to clear of the trails. Cost shall be based on a unit price per treatment. The billing rates include state sales tax. Cost per treatment $ Subtotal Contract Cost for 21 treatments: $ State Sales Tax (9.5%) $ Total Cost Task 1: $ TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is $ The cost for Task 2 shall be based on total manhours per stormwater/irrigation facility and catch basins multiplied by the rate of$ per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under "Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. Below is the estimated contract cost for the three City divisions, based on the billing rate of$ per manhour for a total of manhours: Surface Water Utility Costs Stormwater facilities: 65 Total number of treatments per stormwater facility: 8 Total manhours per stormwater facility (including travel time): hrs Total stormwater facility manhours: hrs Subtotal cost for stormwater facilities: $ Sales Tax (9.5%): $ Total cost for stormwater facilities: $ Page 6 of 8 Piazza/Data_Center/Forms/City/Contracts Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $ Sales Tax (9.5%): $ Total cost for catch basin treatment: $ Total manhours (stormwater facilities + catch basins): hrs Subtotal cost (stormwater facilities + catch basins): $ Sales Tax (9.5%): $ Total cost (stormwater facilities + catch basins): $ Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility (including travel time): hrs Total irrigation facility manhours: hrs Subtotal cost for irrigation facilities: $ Sales Tax (9.5%): $ Total cost for irrigation facilities: $ Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $ Sales Tax (9.5%): $ Total cost for catch basin treatment: $ Total manhours (irrigation facilities + catch basins): hrs Subtotal cost (stormwater facilities + catch basins): $ Sales Tax (9.5%): $ Total cost (stormwater facilities + catch basins): $ Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Subtotal cost for catch basin treatment: $ Sales Tax (9.5%): $ Total cost for catch basin treatment: $ Total manhours (irrigation facilities + catch basins): 61 hrs Page 7 of 8 Piazza/Data_Center/Form s/City/Contracts Subtotal cost (stormwater facilities + catch basins): $ Sales Tax (9.5%): $ Total cost (stormwater facilities + catch basins): $ Facilities Division Costs Stormwater facilities: 1 Total number of treatments per facility: 8 Total manhours per stormwater facility (including travel time): hrs Total stormwater facility manhours: hrs Subtotal cost for stormwater facilities: $ Sales Tax (9.5%): $ Total cost stormwater facilities: $ Catch Basin: 0 Total manhours (stormwater facilities + catch basins): hrs Subtotal cost (stormwater facilities + catch basins): $ Sales Tax (9.5%): $ Total cost: $ Total Contract Cost for all Divisions: $ State Sales Tax (9.5%): $ Total Cost Task 2: $ B. Total Contract Cost (Task 1 +Task 2): $ C. Invoicing The constractor shall submit all invoices to the City of Renton Surface Water Utility Section. Invoices shall include the division (Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division) for which the service was provided under this project. Payment cannot be authorized or payment may be delayed until the invoices include the division to which the service was provided. Page 8 of 8 Piazza/Data_Center/Forms/City/Contracts Debra Mikolaizik From: Allen Quynn Sent: Wednesday, May 06, 2015 8:23 AM To: Debra Mikolaizik Subject: 2015 Mosquito Abatement Program File Folder Hi Debra, Could you please prepare a file folder for the Mosquito Abatement Program. It is already setup under SWP-27-2013 All I need is a 1" folder that says "2015 Mosquito Abatement Program". Please place labels on side and top of folder. Let me know if there is anything else you need. Thanks, Allen Quynn, P.E. Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aguynn@rentonwa.gov 1