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Nov ' 6 2024
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DIVISION 00 - CONTRACTING REQUIREMENTS
TALBOT HILL RESERVOIR PARK IMPROVEMENTS
Section 00 20 00 - Bidder's Qualification Statement
PART 1 -GENERAL
1.1 SECTION INCLUDES
A. Each Bidder submitting a Bid on Work included in these Contract Documents shall provide
as part of this Bid, the following information.
Name of Bidder: CO OIaeA C ornSlTh t ov
2. Business Address: _3-70, Scan ( , iMt j tz. 1 }e.& ("A
3. Telephone: Lab -cp
4. How many years has said Bidder been engaged in the contracting business under the
present firm name's VI)
5. Contracts now in hand (gross amount): $ COOVIA
6. Experience with similar projects: at least three (3)projects accomplished within the last
five (5)years in which the Bidder constructed comparable projects of similar scope of
Work and value. Include the name, telephone number and email address of the Owner
or Owner's Representative responsible for the project. Describe how the project met
customer satisfaction. The City of Renton will discuss performance with the named
references. This information to be submitted with the Bid Form.
a. Provide FORM E-Contractor Qualifications, per Section 00 80 00 FORMS.
7. Provide a resume for the Project Manager, Superintendent, Foreman, and other key
personnel that will be assigned and committed to this Project. This information to be
Completed by Apparent Low Bidder Within 48 hours following Bid Submittal: Assigned
Key Personnel:
a. Provide FORM F-Qualifications of Project Key Personnel, per Section 00 80 00
FORMS.
PART 2- NOT USED.
PART 3- NOT USED.
END OF SECTION
Contract No.CAG-24-229 00 20 00-1
Talbot Hill Reservoir Park Improvements October 29,2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
• DIVISION 00 — PROCUREMENT AND CONTRACTING REQUIREMENTS
TALBOT HILL RESERVOIR PARK IMPROVEMENTS
Section 00 42 10 — Bid Submittal Checklist
1.1 FORMS BELOW MUST BE TIMELY SUBMITTED FOR A BID TO BE CONSIDERED
RESPONSIVE:
1 . v' FORM A- BID FORM, includes CERTIFICATION OF COMPLIANCE WITH PREVAILING
WAGE PAYMENT STATUTE and NON-COLLUSION AFFIDAVIT, ASSIGNMENT OF
ANTI-TRUST CLAIMS TO PURCHASER AND MINIMUM WAGE AFFIDAVIT
2. ✓FORM B- PROPOSAL BID BOND
3. 11FORM C - LIST OF SUBCONTRACTORS, PART ONE (SUBMISSION OF PLUMBING
AND ELECTRICAL SUBCONTRACTORS)
4. ✓FORM D-LIST OF SUBCONTRACTORS, PART TWO (SUBMISSION OF STRUCTURAL
STEEL SUBCONTRACTORS)
5. ✓FORM E -CONTRACTOR QUALIFICATIONS/EVALUATION
6. /FORM F-QUALIFICATIONS OF PROJECT KEY PERSONNEL
7. 4'ORM G -CONTRACT BOND FORM
1.2 Confirm Items Below Are Complete At Time of Bid Submission:
1 /Have you included costs for Base Bid. and each of the Alternates (if any)as listed on the Bid
Form?
2. .moo written amounts in the Bid Form agree with amounts shown in figures?
3. Piave you certified receipt of addenda?
4. tAlas the Bid Form been properly signed?
5. .A-lave you completed the Deposit or Contract Bond Form?
6. ,/F-las a Bid Bond or certified check been enclosed with your Bid?
7. Js the amount of the Bid Bond at least 5% of the total amount of the Base Bid amount?
8. ✓Are Form A, Form B,and Form E listed above included in a sealed and properly endorsed
envelope?
1.3 Form To Be Completed Within 1 hour of Bid Submission:
1. Form C-List of Subcontractors, Part One (Submission of Plumbing, and Electrical
Subcontractors)
1.4 Form To Be Completed Within 48 hours of Bid Submission:
1 Form D-List of Subcontractors, Part Two (Submission of Structural Steel Subcontractors)
1.5 Forms To Be Completed By Apparent Low Bidder Within 2 Business Days of Notice by
Owner of Apparent Low Bid:
1 Form F-Qualifications of Key Personnel
END OF SECTION
Contract No.CAG-24-229 00 42 10-1
Talbot Hill Reservoir Park Improvements October 29,2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
CITY OF RENTON
HAND DELIVER TO: OFFICE OF THE CITY CLERK
RENTON CITY HALL— LOBBY
1055 S. GRADY WAY, RENTON, WA, 98057
BID FORM
for the
TALBOT HILL RESERVOIR PARK IMPROVEMENTS
CAG-24-229
(1 Bids Due: 1:30 PM PST November 26, 2024
Bidder's Name: Q V A' tI eIi (, 'V,1l,:t . lv _._•
Address: / 1ok VA fa24- tACt ‘ J WA CAM
Telephone: Lia) % 1 i U y3 4
(MUST BE COMPLETED AND SIGNED)
Having carefully examined the Bidding Documents and Instructions to Bidders, the Project site and
conditions affecting the Work, and all Addenda, the undersigned Bidder certifies that: (i) it has the
personnel and means to complete the Work and (ii) it will furnish all labor, materials, equipment, and
management to perform all Work required by, and in strict accordance with, the above-named documents
for the following sum within the time fixed. All Bid amounts shall include overhead, profit, bonds,
insurance, WA State Sales Tax (WSST)and any other expense required to complete the Work.
The undersigned Bidder certifies that it is, at the time of submitting the Bid, and shall remain throughout
the period of the Contract, licensed by the State of Washington to perform the type of work required
under the Contract Documents. It further certifies that it is skilled and regularly engaged in the general
class and type of work called for in the Contract Documents.
Talbot Hill Reservoir Park Improvements Bid Form
Page 1 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
' Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
A. BID SCHEDULE
Insert values for Unit Price (Dollars.Cents) and Total Price (Dollars.Cents) into Bid Table.
Measurement and payment descriptions for each item listed in the Schedule of Bid items are set forth in
Section 01 20 00.
Approx. Unit Price Total Amount
Item No. Qty Unit Description of Item Dollars.Cents Dollars.Cents
Mobilization & Demobilization
(not to exceed 8%of Total Base
A-1 1 LS Bid) Icb1U(JJ•UO &it)LA)•W
A-2 1 LS Erosion& Sediment Control •5%WO.00 5,000• oo
A-3 1 LS Demolition &Salvage 100)06.00 160500,00
A-4 1 LS Clear& Grub 51000.00 5,00D.Lk)
Earthwork&Subgrade
A-5 1 LS Preparation 16i000.00 161000.00
A-6 25 TON Structural Fill 2.00, 00 5,C .04)
A-7 1 EA ADA Parking Stall Sign w/Footing 111000. O ) t O(.).c)
A-8 71 TON Crushed Surfacing Top Course ISO.Oo ID 6o.00
A-9 57 TON HMA Cl. 3/8 IN. PG58H-22 400.CO 7 oo.00
A-10 1 LS Asphalt Parking Lot Crack Repair U(000.00 ptC )i).c7.0
A-11 6900 SF Asphalt Parking Lot Sealant 2,00 13,too.o0
Cement Concrete Pavement w/
A-12 11 CY Reinforcing 2,c oo•oa no)00.0
Reservoir Concrete Lid: Diamond �
A-13 1 LS Grind & Drainage Joint Retrofit 0 00-� 10).
CC0`
A-14 240 LF Extruded Cement Concrete Curb .JU.00 a.1000,0/.)
Asphalt Pavement
A-15 1 LS Markings &Striping ,5 00)•G Si 000.00
Sport Court Surfacing, Leveling,
A-16 1 LS Crack Repair, &Striping 10O,000.(h) 00 OCR.(..
Replace Wood (Studs & Panels) & (�
A-17 1 LS Repaint Practice Wall I IOW,O0 261100).00
Fabric Shade Structure including
Engineering Plans/Calculations for 39;156. (JO -gc 16o.oo
A-18 1 EA Building Permit
Fabric Shade Structure Four
Footings,Attachments, & 1 15006- U0 i51bO J`
(50
A-19 1 LS Reinforcing
Talbot Hill Reservoir Park Improvements Bid Form
Page 2 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
A-20 1 EA Bicycle Rack w/Attachments : ;600,W E000.00
Two Removable Bollards w/Four
A-21 1 LS Receivers f 00tx.) ,00 10 000 c.
Chain Link Fence w/Sleeved Posts, GG
A-22 1 LS Gates, & Windscreen IHO�UVJ,OJ IL4 OW.00
Drinking Fountain & Utilities
A-23 1 LS (Water&Sanitary Sewer) 2\,Uv0 .uJ 21,000 ,0a
A-24 1 EA Drinking Fountain '(Q,Ut0O.03 ku,,uJ0.06
A-25 1 EA Trash Receptacle 5,000,00 5,000.00
Six Moveable Pickleball Nets & G
A-26 1 LS Nine Pickleball Paddle Racks � ‘t lOO,( L�0G
tC1UO,0S
Planting (Sod, Soil, Mulch,
A-27 1 LS Watering) 101000. ) \ 0 0t .h..�
A-28 255 LF 12" Depth Root Barrier 40.00 101,200.00
A-29 10 EA Boulders Installation Soo.00 ,5,6a).co
Bench w/Back, Wood Beam, & I
A-30 4 EA Chain w/ Pad Lock 4lbOO.t Il.o'ODD,Oa
Divider Net Structure, Nets, &
A-31 2 EA Footings ``j‘LOUO.06 -S102o0•a)
Pedestrian Bridge—Shop
Fabricated Aluminum Structure including Engineering SLItUOthcJ 54
%000.(b
Plans/Calculations for Building
A-32 1 LS Permit
Pedestrian Bridge—Four Concrete
Footings, One Headwall, &Two
Wingwalls, w/Attachments & 30t00I).UJ 01000-00
A-33 1 LS Reinforcing
Plumbing, Traffic Control Plan,
Environmental Stormwater
Discharge, and other regulatory 1,5`600.00 61000,6
A-34 1 LS permits as required A-35 3 EA Tennis Court Nets 5050.Oo I514So.00
A-36 3 EA Pickleball Court Nets ' t()O0 .00 1 t00o.00
Additional Work for Minor
A-37 1 LS Changes $65,000 $65,000
SUBTOTAL = $ \ ,M3 ittS0 . vo
WA STATE SALES TAX (10.3%) = $ CZ,I11)5 6 . 15
Talbot Hill Reservoir Park Improvements Bid Form
Page 3 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
• Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
TOTAL = $ 1110.491�05 rJ
B. BASE BID
The Bidder agrees to complete the Work for this Project for the following Base Bid amount:
S
tALVkktth v Oik ..AvNi,k(er)l S,,crlt.),,SUrid (-LA IA tilkiLtaLc.A52 iG'A��DOLLARS (words)
4 c
(numerals)
C. TRENCH EXCAVATION SAFETY PROVISIONS
The Base Bid amount includes any trench-excavation safety provisions required for compliance with
Chapter 39.04 RCW and Chapter 49.17 RCW,as applicable,and the amount included in the Base Bid
is: $ ,()0•O—
D. SUBCONTRACTOR LISTING
If the project is expected to cost $1,000,000 or more, as required by RCW 39.30.060, every Bidder
must complete and provide the included Subcontractor listing forms (Forms C and D) in
accordance with the applicable timing requirements.
E. RECEIPT OF ADDENDA
Bidder acknowledges receipt of the following addenda:
Addendum No. A Addendum No.
Addendum No. 13 Addendum No.
Addendum No. Addendum No.
All requirements therein are included in the appropriate Bid amount.
F. CONDITIONS OF PROPOSAL
1. Determination of Low Bidder:
a. The City of Renton (alternatively referred to as "Owner" or "City") reserves the right
to award the Contract for the Project based on the Contractor's Base Bid and any
selected Alternates(s), in whatever manner is in the City's best interest.
2. Overhead and Profit:
All of the above Bid Prices shall include overhead, profit, bonds, insurance, and any other
expense required to complete the Work.
G. PERIOD OF BID VALIDITY/ACCEPTANCE OF BID
The undersigned hereby agrees that this Bid shall be a valid and firm offering for the period of sixty
(60) days from the Bids Due date.
Within sixty (60) days from the Bids Due date, the City will act either to accept the Bid from the
lowest responsive and responsible Bidder, or to reject all Bids. The City reserves the right to
Talbot Hill Reservoir Park Improvements Bid Form
Page 4 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
• Section 00 80 00— Bid Form
Revised — Addendum E November 22, 2024
request extensions of such Bid acceptance period.
The acceptance of a Bid will be evidenced by a written Notice of Intent to Award Contract to the
Bidder whose Bid is under consideration for acceptance,together with a request to furnish a bond
(if required), evidence of required insurance to execute the Agreement set forth in the Contract
Documents, and other designated documents.
H. EXECUTION OF CONTRACT
If the written Notice of Intent to Award Contract is mailed, telegraphed, or delivered via facsimile
to the undersigned within the period of Bid validity noted above, or any time thereafter before
this Bid is withdrawn,the undersigned will, within ten(10) days after the date of such notification,
execute the City of Renton Standard Form of Agreement Between Owner and Contractor where
the basis of payment is a Stipulated Sum ("Agreement") set forth in the Contract Documents.
I. TIME FOR COMPLETION
Substantial Completion- The undersigned hereby agrees to Substantially Complete all the Work
under the Base Bid (and accepted Alternates)no later than May 23, 2025, following Notice to
Proceed.
Notice to Proceed—Anticipated date for Notice to Proceed is January 6, 2025.
Final Completion—All the Work shall achieve Final Completion in accordance with the Contract
Documents within 30 calendar days after the date of Substantial Completion.
J. LIQUIDATED DAMAGES
The undersigned agrees to pay the Owner as liquidated damages the sum of$750.00 for each
calendar day beyond the date upon which Substantial Completion of the entire Work is required
to be complete until Substantial Completion is achieved, in accordance with the Contract
Documents.
K. BID SECURITY (As per the Bidding Documents)
If applicable, Bid Security must be submitted with the Bid Form.
L. BID FORM ATTACHMENTS TO BE COMPLETED WITH BID FORM
The following document is attached to the Bid Form and must be executed by the Contractor in
connection with the Bid From for it to be complete:
• Attachment 1 —Non-Collusion,Anti-Trust and Minimum Wage Affidavit
M. ACKNOWLEDGMENT
The undersigned acknowledges that it has read, understands, and agrees to comply with all
federal and state non-discrimination laws, regulations,and policies during the performance of the
Work.
Talbot Hill Reservoir Park Improvements Bid Form
Page 5 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00— Bid Form
Revised —Addendum E November 22, 2024
Legal Name of Person or Entity Submitting Bid: COVVA DAtilt4._ LiW5S Lu-tion V _-
N OTE:If Bidder is a corporation,write State of Incorporation;if a partnership,give full names and addresses of all parties below.
Authorized Signatory: _ � Title: 2Slc1-12—"-c
Printed Name:
Address: 1 7a( SOu ( -4 .
City: Y AtJ\G-ft, -ea State: Zip CCode:QV11 Date: h 11141 v
Telephone: riL6kp(O-14 Fax: (416 PIO—y 62 43
Washington Contractor's License No.: (oyvIS tc..1 ;NA 1 Federal Tax ID#: ` F-Wei72S 9
E-mail address: Ai Nnbjiz k,fr15t71/c..1"?Jn ieu...c0,�.t
Washington State UBI No.: &V3'I I4- Expiration Date: 6 10=5—
Talbot Hill Reservoir Park Improvements Bid Form
Page 6 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
CERTIFICATION OF COMPLIANCE WITH PREVAILING WAGE PAYMENT STATUTES
The undersigned Bidder hereby certifies, under the penalty of perjury, that within the three-
year period immediately preceding the Bid Submission date, the Bidder has not been
determined by a final and binding citation and notice of assessment issued by the
Department of Labor and Industries, or through a civil judgment entered by a court of
limited or general jurisdiction, to have willfully violated, as defined in RCW 49.48.082, any
provision of chapters 49.46, 49.48, or 49.52 RCW.
I certify under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Legal Name of Pe • . Is itting Bid
ignature of Aut • ' • '- *
■.
Printed Name
cc--Sk bx e r
Title
Date City State
Check One:
Sole Proprietorship ❑Partnership ❑Joint Venture corporation ❑ LLC ❑
State of Incorporation, or if not a corporation, State where business entity was formed:
If a co-partnership, give firm name under which business is transacted:
*If a corporation proposal must be executed in the corporate name by the president or vice-president
(or any other corporate officer accompanied by evidence of authority to sign) If a co-partnership.
proposal must be executed by a partner.
Talbot Hill Reservoir Park Improvements Bid Form
Page 7 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
Bid Form —Attachment 1
This form must be submitted with the Bid Form
NON-COLLUSION AFFIDAVIT
The undersigned, having been duly sworn, deposes and says,that he/she is the identical person who
submitted the forgoing Bid,and that such Bid is genuine and not sham or collusive or made in the
interest or on behalf of any person not therein named, and further, that the deponent has not directly
induced or solicited any other Bidder on the foregoing Work or equipment to put in a sham Bid, or any
other person or corporation to refrain from Bidding, and that deponent has not in any manner sought by
collusion to secure to himself or to any other person any advantage over the other Bidder or Bidders.
AND
CERTIFICATION RE: ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER
The City of Renton ("City") and Bidder recognize that in actual economic practice overcharges resulting
from anti-trust violations are in fact usually borne by the Bidder. Therefore,the Bidder hereby assigns
to the City any and all claims for such overcharges as to goods and materials purchased in connection
with this Contract, except as to overcharges resulting from anti-trust violations commencing after the
date of the bid, quotation, or other event establishing the price under this Contract. In addition,the
Bidder warrants and represents that such of his suppliers and subcontractors shall assign any and all
such claims to the City,subject to the aforementioned exception.
AND
MINIMUM WAGE AFFIDAVIT FORM
The undersigned, having been duly sworn, deposed, says and certif that in connection with the
performance of the Work of this Project, (a) I will pay each classification of laborer, workman,or
mechanic employed in the performance of such Work; not less than the prevailing rate of wage or not
less than the minimum rate of wages as specified in the principal Contract and (b) that I have read the
above and foregoing statement and certificate, know the contents thereof and the substance as set
forth therein is true to my knowledge and belief.
[SIGNATURE PAGE FOLLOWS]
Talbot Hill Reservoir Park Improvements Bid Form —Attachment 1
Page 8 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Section 00 80 00 — Bid Form
Revised — Addendum E November 22, 2024
FOR: NON-COLLUSION AFFIDAVIT, ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER AND
MINIMUM WAGE AFFIDAVIT
(A)1i1/11 i1-tect 'sire io►� dn -
Legal Name of Person or Entity Submitting Bid
SdgnatUre of Authorized Officia
,/
Printed Name
4r-te- '
Title
t112L��2`l 01101c % qea
Date City State
Subscribed and sworn to before me on this ''` day of Nov - , 2024.
���11111111U o,11N
▪ •
1
End of Bid Form • • • MOTANv • v.
LIC
'�11Cj111OF11111111N1j°````
Talbot Hill Reservoir Park Improvements Bid Form —Attachment 1
Page 9 of 9
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
Proposal Bid Bond—FORM B
% a i
FORM B
Proposal Bid Bond
KNOW ALL MEN BY THESE PRESENTS. That we, [Contractor] Combined Construction, Inc.
of [address] 3701 South Rd, Mukilteo, WA 98275 as
Principal, and [Surety] Arch Insurance Company
a corporation duly organized under the laws of the State of Missouri
and authorized to do business in the State of Washington, as Surety, are held and firmly bound unto the
City of Renton in the sum of five (5) percent of the total amount of the Bid of said Principal for the Work
hereinafter described. for the payment of which, well and truly to be made, we bind ourselves, our heirs,
executors, administrators and assigns, and successors and assigns, jointly and severally, firmly by these
presents.
The condition of this bond is such, that whereas the Principal herein is herewith submitting his/her or its
sealed Bid for the following construction, to wit:
Talbot Hill Reservoir Park Improvements, Project No. CAG-24-229
said Bid and proposal, by reference thereto. being made a part hereof.
NOW. THEREFORE, if the said proposal Bid by said Principal be accepted, and the Contract be awarded
to said Principal. and if said Principal shall duly make and enter into and execute said Contract and shall
furnish performance bond as required by the City of Renton within a period of ten (10) days from and after
said award, exclusive of the day of such award, then this obligation shall be null and void, otherwise it
shall remain and be in full force and effect.
IN THE EVENT the Principal, following award, fails to execute an Agreement with the City of Renton in
accordance with the terms of the Bidding Documents and furnish a performance bond with Surety or
Sureties approved by the City of Renton within ten (10) days from and after said award, then Principal
shall forfeit the Bid Bond/Bid Proposal Deposit or Surety shall immediately pay and forfeit to the City of
Renton the amount of the Proposal Bid Bond, as set forth in RCW 35A.40.200 and RCW 35.23.352.
IN TESTIMONY WHEREOF, the Principal and Surety have caused these presents to be signed and
sealed this 26th day of November . 2024
Combined Construction, Inc. Arch Insurance Company
[Principal �.
[ ignature of authorized office [Signature of authorized official.
By: Heather L. Allen, Attorney-in-Fact
[Title] [Attorney-in-Fact]
3701 South Rd, Mukilteo, WA 98275
[Address] PO Box 3018, Bothell, WA 98041
425-610-4334 425-489-4500
[Phone Number]
BID BOND PAGE 1 OF 1
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
10499
This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated
. Not valid for Note,Loan,Letter of Credit,Currency Rate,Interest Rate or Residential Value Guarantees.
POWER OF ATTORNEY
Know All Persons By These Presents:
That the Arch Insurance Company,a corporation organized and existing under the laws of the State of Missouri,having its principal administrative office in Jersey City,
New Jersey(hereinafter referred to as the"Company")does hereby appoint:
Chad Epple,Dana Brown,Emma C.Doleshel,Heather L. Allen,Jim S.Kuich,Jim W.Doyle,Natalie C.Chau,Steven Wagner and Theresa A.Lamb of
Bothell,WA(EACH)Amanda Ivey,Annette Troseth,Carol Lowell,Cheri Mrak,Clayton McCaul,Jacqueline Hansen,Tamara Combs,Tami Miller and Ted
Baran of Anchorage,AK(EACH)Sarah H.Behrens of Palmer,AK
its true and lawful Attorney(s)in-Fact,to make,execute,seal,and deliver from the date of issuance of this power for and on its behalf as surety,and as its act and deed:
Any and all bonds,undertakings,recognizances and other surety obligations,in the penal sum not exceeding One Hundred Fifty Million Dollars($150.000,000.00).
This authority does not permit the same obligation to be split into two or more bonds In order to bring each such bond within the dollar limit of authority as set forth
herein.
The execution of such bonds,undertakings,recognizances and other surety obligations in pursuance of these presents shall be as binding upon the said Company as
fully and amply to all intents and purposes,as if the same had been duly executed and acknowledged by its regularly elected officers at its principal administrative
office in Jersey City,New Jersey.
This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on August 31,2022,true and
accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect:
"VOTED,That the Chairman of the Board,the President,or the Executive Vice President,or any Senior Vice President,of the Surety Business Division,or their
appointees designated in writing and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attorneys-in-fact, and to
authorize them subject to the limitations set forth in their respective powers of attorney,to execute on behalf of the Company,and attach the seal of the Company
thereto,bonds,undertakings,recognizances and other surety obligations obligatory in the nature thereof,and any such officers of the Company may appoint agents for
acceptance of process."
This Power of Attorney is signed,sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of
Directors of the Company on August 31,2022:
VOTED,That the signature of the Chairman of the Board, the President, or the Executive Vice President,or any Senior Vice President,of the Surety Business
Division,or their appointees designated in writing and filed with the Secretary,and the signature of the Secretary,the seal of the Company,and certifications by the
Secretary,may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on August 31,2022,and
any such power so executed,sealed and certified with respect to any bond or undertaking to which it is attached,shall continue to be valid and binding upon the
Company.In Testimony Whereof,the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers,this 23'd day
of January,2024.
Attested and Certified �10 Arch Insurance Company
felir-**. $N . Uf cuan>�re 4SEAL
Slitheial �
1171
Regan .Shulman,Secretary Stephen C.Ruschak,Executive Vice President
STATE OF PENNSYLVANIA SS
COUNTY OF PHILADELPHIA SS %f1111i
I,Michele Tripodi,a Notary Public,do hereby certify that Regan A.Shulman and Stephen C.Ruschak personally known to me to be the same persons whose names
are respectively as Secretary and Executive Vice President of the Arch Insurance Company,a Corporation organized and existing under the laws of the State of
Missouri,subscribed to the foregoing instrument,appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed,
sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and
purposes therein set forth.
aan.osuawta Ponroolvagio.lbtarySealMOW 711/001,way PublicPhilodetphis SyCommiaton My31,202SAili:CE-A-7—;ir
podi,Notar Public
Cosus1111on MOWN man My commission expires 07/31/2025
CERTIFICATION '
I,Regan A.Shulman,Secretary of the Arch Insurance Company,do hereby certify that the attached Power of Attorney dated January 23,2024 on behalf of the
person(s)as listed above is a true and correct copy and that the same has been in full force and effect since the date thereof and is in full force and effect on the date of
this certificate;and I do further certify that the said Stephen C.Ruschak,who executed the Power of Attorney as Executive Vice President,was on the date of execution
of the attached Power of Attorney the duly elected Executive Vice President of the Arch Insurance Company. //t� �L/ 1
IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the Arch Insurance Company on this,C—day of L Gt;—
Re A.Shulman,Secretary
This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company
except in the manner and to the extent herein stated
PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: °swim&
A
Arch Insurance-Surety Division
11
3 Parkway,Suite 1500 0
UPhiladelphia,PA 19102
Ntssuri
To verify the authenticity of this Power of Attorney,please contact Arch Insurance Company at SuretyAuthenti :.arc insurence.com
Please refer to the above named Attorney-in-Fact and the details of the bond to which the power is attached.
AICPOA040120 Printed in U.S.A.
Talbot Hill Reservoir Park Improvements
List of Subcontractors, Part One-FORM C
C,
NT0
CITY OF RENTON
EMAIL TO: bsevertsen@rentonwa.gov
LIST OF SUBCONTRACTORS, PART ONE
Submission of HVAC, Plumbing, and Electrical Subcontractors
If Bid amount exceeds$1,000,000,this list must be submitted within one(1) hour of the time and date
specified for Bid Submission.
Bidder's Name: (jYY\ YTh1e( (.60,SilVt,j-i (14(---
Project: Talbot Hill Reservoir Park Improvements
1055 S. Grady Way
Renton,WA 98057
CAG-24-229
SUBCONTRACTOR LISTING
If the bid amount exceeds$1,000,000 or more including Washington State Sales Tax,Bidder must list the Heating,
Ventilation,and Air Conditioning(HVAC),Plumbing,and Electrical Subcontractors as required per RCW 39.30.060.
Subcontractor Name Work Category
1. HVAC
2. -VV/1"X— 1t uet1 Plumbing
3. -- N(k• Electrical
[SIGNATURE PAGE FOLLOWS]
Talbot Hill Reservoir Park Improvements Page 1 of 2
List of Subcontractors—FORM C October 29,2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
List of Subcontractors, Part One-FORM C
LET Y oi
+ +
IF
FNTOP'QP
Legal Name of Person or Entity Submitting Bid: Cpwlblvl2d �,(lrtcin,i.t ov ,ln—
NOTE: If Bidder is a corporation,write State of Incorporati •• a pact .rm ' ive full names and addresses of all parties below.
Authorized Signatur • Title: .S jd,.Qetr}-
Printed Name: S11iti .
Address: 51D\ v 9--el -
City: `VA,v\& . \ z State: ti,„k- ' 1Zip Code: 4's27)Date: tt\Zc.)2y
Telephone: 1-(ZS-(9(D•-�-1��y Fax: 41 40(U 'LI 1,y3
Washington Contractor's License No.: c11 0 lc-t 7)MT Federal Tax ID#: O -{s'.3R
E-mail address: L - C.0ni\IC)ri ata tOik'S• \)...1S.4:,4'A RL.C)
Washington State UBI No.: 1pol-\161.7.- Expiration Date: 0 c12A—
End of Form
Talbot Hill Reservoir Park Improvements Page 2 of 2
List of Subcontractors—FORM C October 29, 2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
• Talbot Hill Reservoir Park Improvements
List of Subcontractors, Part Two—FORM D
1 Y QT
a +
f tiro"
CITY OF RENTON
EMAIL TO: bsevertsen@rentonwa.gov
LIST OF SUBCONTRACTORS, PART TWO
Submission of Structural Steel and Rebar Installers
If Bid amount exceeds$1,000,000,this list must be submitted within forty-eight(48) hours of the time
and date specified for Bid Submission.
Bidder's Name: 00601Y1 (jv15 11Vv"�11 L -
Project: Talbot Hill Reservoir Park Improvements
1055 S. Grady Way
Renton,WA 98057
CAG-24-229
SUBCONTRACTOR LISTING
The Project is expected to cost $1,000,000 or more. Every Bidder must list the Structural Steel and Rebar
Subcontractors as required per RCW 39.30.060.
Subcontractor Name Work Category
SOX-.?� - '-- e—A- Ovv\ Structural Steel Installer
2. 3C -- eC C-+ry‘ Rebar Installer
If different from the list above,the Subcontractors we propose to use if an Alternate Bid is accepted are described
below (RCW 39.30.060 requires,in part,that the Bidder not list more than one Subcontractor for each category of
Work identified,unless a Subcontractor will vary depending on which Alternate Bids are accepted,in which case the
Bidder must indicate which Subcontractor will be used depending on which Alternate is accepted.)
Describe any change to list if Alternates are accepted: 1N[P-
[SIGNATURE PAGE FOLLOWS]
Talbot Hill Reservoir Park Improvements Page 1 of 2
List of Subcontractors—FORM D October 29,2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
List of Subcontractors, Part Two—FORM D
Legal Name of Person or Entity Submitting Bid: (26YAb1n.c k. C S% v. h .-i ttn -
NOTE: If Bidder is a corporation,write State of Incorporation. i,give full names and addresses of all parties below.
Authorized Signature: Title: 'It-6 VL *r1'r
Printed Name: Lam. 5 ii-
Address: -g'7p\ Saves. Q-cl•
City: kik-t 1}QJ State: Zip Code:t '7i 5—Date: I I JZ(o/24
Telephone: .4'(P L)- Liss L1 Fax: 112, --(9 I U—i lA43
Washington Contractor's License No.: LyiefRICA'S'il-27 \t I Federal Tax ID#: 3 '3 62.4
E-mail address: / q(yf�.Urn}�1N �t.((�vt5 tY1ic.'1 fv✓�:✓tc-.cavvA
Washington State UBI No.: (>003-1!4-2 IV Expiration Date: /I /Z(r124
End of Form
Talbot Hill Reservoir Park Improvements Page 2 of 2
List of Subcontractors—FORM D October 29,2024
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
Contractor QualificationslEvaluation - FORM E
(Must submit with Bid Form)
Contractor Name: Ciomiclitnth CoviSinoixltlYlt,. Date Incorporated: $'!2 Q I I
Mailing Address: S'io State Incorporated: (A./A....-
Business Phone: 41L6449l6— Owner/President's Name: LgLi � Ith
Contact Name and Title: VILAYv<rt Other or Former Organization Name(s) Nd}
' Contact Phone: Inc..4 p_ -r1� Contact Email: w , Reason for Name Chan e s
1 N � I�tul�Gowlblhcdc� Sinc, g ( ) /(lam
PERFORMANCE EXPERIENCE
• Has compan been disqualified (debarred) from performing public work by State of Washington or federal government?
• Yes n No
• Are there any judgments, claims, arbitration proceedings or suits pending against company or its officers? Yes I I No E.
If Yes, please describe: Judgments
• Has company ever failed to complete any work awarded to it? Yes ❑ No ,, If Yes, please describe:
Has company been obligated for liquidated damages within the past 5 years? Yes n No iLt
• If Yes, *lease describe:
FINANCIAL INFORMATION
1. Average total annual value of construction work performed during the past 5 years:yftSoryi
2. Provide at least three trade references:
• Name/Contact ''�j6:11C" x 5ut?Q1t-\ - 20t_. - trrS-
• Name/Contact ScnrA�� Z�v -V1�--��X-o
i
• Name/Contact trvtkv-S Sari _ 257 -tr33-1705
3. Provide sure com•an and asent name: Suret lv b jh
PROJECT EXPERIENCE - Projects of Similar Scope Requiring Prevailing or Davis Bacon Wages within Past 5 Years
(3 Required)
I PROJECT#1 Description Of Project: Original Contract Amount Final Contract Amount:
I Project Name: boD Mayor
LocationlAddress: Sit 5 `' Percent of Work Performed by Substantial Completion Date
1-(4.0 ‘11NRC ft_ vci+- 41n44. Cz4,v)ve,ttiavt. Own Forces: g oofD
Firm was General Contractor: If not GC,describe role:
Yes riti No
Owner Name: Architect Name: Project Required Prevailing or Yes No ❑
Ct14wMA V Davis Bacon Wages?
Talbot Hill Reservoir Park Improvements
Contractor Qualifications/Evaluation—FORM E
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
Contractor Qualifications/Evaluation - FORM E
(Must submit with Bid Form)
Phone: ,253—511- tlk)� Phone:
i
Email: Anet10,,t,,,,e ct-N GowK,ortiEmail:
I
PROJECT#2 Description Of Project: Original Contract Amount Final Contract Amount:
Project Name:
CoV�tiA k%t V--3cc � PK� g,r►4-y� tile .�, 2,1w,WJ
Location/Address: Percent of Work Performed by Substantial Completion Date
50)yvikA- CV.Ant.C%k"/CA 0 h Own Forces: Qo % ii/ip
f ri►4} t�^�p'� Firm was General Contractor: If not GC, describe role:
Yes X No n
Owner Name: Architect Name: Project Required Prevailing or Yes/14 No LI
CZ ivt S.t04t&'— Lr/5 7 Davis Bacon Wages?
Phone: Phone:
Email: �cv`,A. ter-@ Email:
I
PROJECT#3 Description Of Project: Original Contract Amount Final Contract Amount:
Project Name:
(DVtSovx Z(;4.6te, n a�� ,ram-�-cv� t-- \A 2 t6 coo t boz•Lk) Z,S0, ...0
Location/Address: Percent of Work Performed by Substantial Completion Date
�j VUX ?it lvl4-►✓ I Own Forces: "Moto /()IZ�i
Firm s General Contractor: If not GC,describe role
Yes[No ❑ ^iAr
Owner Name: ,`.,, Architect Name: Project Required Prevailing or Yes al No pi
Name:,, df Ab ` I '— Davis Bacon Wages?
�tc_IN 113.E Phone:
Email: Dxy„,e-cSo',0 t-,,,,,1 w'^ i,epail:
Talbot Hill Reservoir Park Improvements 2 I })a g e
Contractor Qualifications/Evaluation—FORM E
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
Qualifications of Project Key Personnel - FORM F
(Must submit within 48 hours following Bid Submittal)
Email to: bsevertsen@rentonwa.gov
PROJECT MANAGER
Name Current Position with Company Years'Experience
-! rLvw L (A.kiet4ter Total With Current Firm
�rrJ i-VW�.tnaq ems' ZJ i�-
Firm Name and Location(City and State):
\M,UN--tVJ t t..
Training/Education/Specialization:
IN Pr-
Years of Experience in the Proposed Role: ^
RELEVANT PROJECT 1 of 3(Minimum
Project Title: Spo .SA- \It a40vit- Year Completed
Project Owner: t .� �1i- 2L�J
Brief Description(Brief scope size,cost,etc.)and specific role: Check if project performed with current firm. A�
/'L)L Vet y _ it, -5 r v\. If performed with different firm list the firm name
Reference Name&Contact Information:
Project Owner: C t-114 de- -1- 1a•- Architect: T iv - {k-)
Name: itt_onvt r j -
Cr�1� aln
—i
Phone: /DU - v� Name: M.) .�i
- -7Utiri— Phone: KZS - t(Si -552 �LI5
E-mail \CC„V to • lr-k.cp1.Gr-C_ccrA l�te-..ci T/ E-mail: tM.She ttrJi 1 t..#e-i-(Orreir ie. h crier•4.4.44-.
RELEVANT PROJECT 2 of 3(Minimum
Project Title: Mt(.47)L1M1I,�-a _NFcr Year Completed
Project Owner: yvlu�(1.,c.Mt\-' Ns tr _ "70-LA-t
Brief Description(Brief scope,size, cost,etc.)and specific role: Check if project performed with current firm.SI
IV1 t::cbLbt,t,? .T�c..t t \A-t.1 �rsl- _ it � If performed with different firm list the firm name
Reference Name&Contact Information: -
Project Owner: M,ll.0.c.bn;t? Architect: (a"t` Ill tSh le.r
Name: C7,,_ IMt5►tler Name: �crr✓tex Crvr5-hr ►;>n ----
Phone: 503 - UV, - ol$ZS Phone: S,., 3 -22c-- q S.75—
E-mail G wt(511 tG,r-@ -Zw.c.,...---. E-mail: e V"t t s t l Ler0-77_co .L...,.,,
RELEVANT PROJECT 3 of 3(Minimum)
Project Title: 7ct tires Year Completed
Project Owner: t l„ e-,,Cn.t-.1\*-- '21
Brief Description(Brief scope,size, cost,etc.)and specific role: Check if projec performed with current firm. [
V ftc�. Lc 1�M.K0'J - �2604\ If performed with different firm list the firm Name
Reference Name&Contact Inform lion:
_Project Owner: CA 5.,�-4-1..— Architect: j!,vs p
Name. V,v,. �� Name: ��K wn (,vrr21
Phone: 2(_ -`Zo'�- (Alt- Phone: "Z�, -'6t?, -64v5—
E-mail �e�ltv`+ � Q {v,1-14.t •q,,,✓ E-mail:
Talbot Hill Reservoir Park Improvements
Qualifications of Project Key Personnel-FORM F Page 1 of 2
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Talbot Hill Reservoir Park Improvements
Qualifications of Project Key Personnel — FORM F
(Must submit within 48 hours following Bid Submittal)
Email to: bsevertsen@rentonwa.gov
SUPERINTENDENT
Name Current Position with Company: Years'Experience
r‘,(uN �\�Y,.n [. A'C-."-si-e--stk— Total With Current Firm
Firm Name and Location (City and State):
VMAQV-A o kea
Training/Education/Specialization:
N
Years of Experience in the Proposed Role:
O
RELEVANT PROJECT 1 of 3
Project Title: Al ,w \ky_ja i-c- „ 5 7.0 1u,n Year Completed
Project Owner: 04-xysvi („),.),n ��
Brief Description(Brief scope,size,cost,etc.)and specific role: Check if project performed with current firm.
If performed with different firm list the firm name
fvtr6 Kt-► )v eLptA(S - 2-1(V\
Reference Name&Contact Information:
Project Owner V,\v Cup Architect: y_xy,w )f 4."
Name: 60, ,)�n,s Name: S' �� \
Phone: ,_ y1 _ 6j22� Z Phone: ' t., -t fl -
E-mail .t-t-I-)1.45 Q 1Civu) L,x,n3.1 E-mail: S. A .t .-J 5 0 klr-w�C.,tJ.t-t�•y)✓
RELEVANT PROJECT 2 of 3
Project Title: i t't limp aw, Year Completed
Project Owner: VAIN)f 2)71)
Brief Description(Brief scope,size, cost,etc.)and specific role: Check if project performed with current firm.
1)LacSi :t:ort Gird lrfvt �e (04. — �� If performed with different firm list the firm name
Reference Name&Contact Information:
Project Owner: W S Architect: W S p v
Name: /C1r„L‘ Name: /t-hvtc.,1 SLkNtoe,-
Phone: 4-125*-130- (>3 evt. Phone: 1425-7';,� U) Fry
E-mail GlWtt? bva- J�6 E-mail:c/o/CI 1#1 -5(Anoirr e r",,c 40 t'.wr-t. .),c
RELEVANT PROJECT 3 of 3
Project Title: ft-. st.sye ��1 - t.liu� �� Year Completed
Project Owner: (
Brief Description(Brief scope,size, cost,etc.)and specific role: Check if project performed with current firm. [I'
1,, `�_ _ r 4)17 If performed with different firm list the firm Name
Reference Name&Contact Information:l�1 1
Project Owner: ( -1,,, tot-1-11-4- Architect: ,I r,F'
Name: c.V 1✓t 4-\c u .r Name: V,n --( tA
Phone: Tot, � 7 t - 4� Phone: d L, ?,�Z -j (oZ
E-mail "�.LViA. 4 pis- Cvt'�# -.lieu/ E-mail: ,4-t r- ( Se te. .tJJ✓
End of Form
Talbot Hill Reservoir Park Improvements
Qualifications of Project Key Personnel—FORM F Page 2 of 2
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
TALBOT HILL RESERVOIR PARK IMPROVEMENTS
Contract Bond—FORM G
(,STY 0c
+ + CONTRACT BOND TO THE CITY OF RENTON
�FN10 Bond No.
KNOW ALL MEN BY THESE PRESENTS,That we, (CONTRACTOR/PRINCIPAL)
of [address] _as PRINCIPAL, and
(SURETY) a corporation organized and existing under
the laws of the State of _as a SURETY corporation, and qualified under the
laws of the State of Washington to become SURETY upon bonds of contractors with municipal
corporations, as SURETY, are jointly and severally held and firmly bound to the City of Renton
(CITY/OWNER) in the sum of US Dollars
($ _)Total Contract Amount,for the payment of which sum on demand we
bind ourselves and our heirs, successors, assigns, executors, administrators and personal
representatives, as the case may be. This obligation is entered into pursuant to the laws of the State of
Washington and the ordinances of the City of Renton.
Dated at , Washington,this_ day of _, 20
NOW,THEREFORE THE CONDITIONS OF THE ABOVE OBLIGATION ARE AS FOLLOWS:
WHEREAS, under and pursuant to Contract No. CAG-24-229 providing for construction of the Talbot Hill
Reservoir Park Improvements;the PRINCIPAL has accepted,or is about to accept, the Contract, and
undertake to perform the Work therein provided for in the manner and within the time set forth.
• The SURETY indemnifies, defends, and protects and holds the CITY/OWNER, its officers, agents, and
assigns harmless from and against all claims, liabilities, causes of action, damages, and costs for such
payments for labor, equipment, and materials by satisfying all claims and demands incurred under
the Contract, and reimbursing and paying CITY/OWNER all expenses that CITY/OWNER may incur in
making good any default by PRINCIPAL; and, against any claim of direct or indirect loss resulting from
the failure of the PRINCIPAL, its heirs, executors, administrators, successors, or assigns, (or the
subcontractors or lower tier subcontractors of the PRINCIPAL) to pay all laborers, mechanics,
subcontractors, lower tier subcontractors material persons, and all persons who shall supply such
contractor or subcontractors with provisions and supplies for the carrying on of such work; and,
against any claim of direct or indirect loss resulting from the failure of the PRINCIPAL, its heirs,
executors, administrators, successors, or assigns (or any of the employees, subcontractors, or lower
tier subcontractors of the PRINCIPAL)to faithfully perform the Contract.
• The indemnities to CITY/OWNER shall also inure to the benefit of the Consulting Engineers and other
design professionals retained by OWNER in connection with the Project.
• No change, extension of time, alteration, or addition to the terms of the Contract or to the Work to
be performed under the Contract shall in any way affect SURETY 's obligation on the Contract Bond.
SURETY , for value received, hereby waives notice of any change, extension of time, alteration, or
addition to the terms of the Contract or the Work to be performed thereunder and agrees that
modifications and changes to the terms and conditions of the Contract that increase the total amount
to be paid the PRINCIPAL shall automatically increase the obligation of the SURETY on this Contract
Bond and notice to SURETY is not required for such increased obligation.
• This Contract Bond shall be governed and construed by the laws of the State of Washington, and
Talbot Hill Reservoir Park Improvements Page 1 of 2 Contract Bond to the CITY of Renton
03/08/2022 F clb
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
TALBOT HILL RESERVOIR PARK IMPROVEMENTS
Contract Bond—FORM G
venue shall be in King County, Washington.
FURTHERMORE, this Contract Bond shall be satisfied and released only upon the conditions that
PRINCIPAL or SURETY:
• Faithfully performs all provisions of the Contract and changes authorized by CITY/OWNER in the
manner and within the time specified as may be extended under the Contract;
• Pay, in accordance with Chapters 39.08, 39.12 and 60.28 Revised Code of Washington (RCW), the
sums due all workers, laborers, mechanics, subcontractors, lower tier subcontractors, material
suppliers, and all other persons or agents who supply labor, equipment, or materials for carrying on
of such work under the Contract;
• Pay all taxes, increases and penalties, if any, incurred on or related to the Contract under Titles 50 and
51 Revised Code of Washington (RCW) and any and all taxes imposed on the Principle under Title 82
RCW or any other law;
• Receives a written discharge/release of bond from CITY, signed by the Mayor or by a duly authorized
representative of CITY.
This Contract Bond shall be executed in two (2) original counterparts, and shall be signed by the parties'
duly authorized officers. This Contract Bond will only be accepted if is accompanied by a fully executed
and original power of attorney for the office executing on behalf of the SURETY.
PRINCIPAL SURETY
[PRINCIPAL]
[SURETY]
[Signature of Authorized Official] [Signature of Authorized Official]
[Printed Name] [Printed Name]
[Title] [Title]
[Date] __ - — --- -
[Date]
Name and address of local office of
Agent and/or SURETY Company:
Telephone:
Talbot Hill Reservoir Park Improvements Page 2 of 2 Contract Bond to the CITY of Renton
03/08/2022 F clb
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal