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Lakeside Industries
IL' LAKESIDE INDUSTRIES KENT DIVISION , 18808 S.E. 256th Street A.v" 1044(Z$ Covington, WA 98042 4 Phone: (253) 631-3611 Fax: (253) 630-2011 / (7.A CITY OF RENTON OCT 14 2025 RECEIVED CITY CLERK'S OFFICE To: (misty D 'i-NevNic-coA Loss 5 out k G oaety w0.7 (kco-von L)74 s Bid For: Oakes Adult' Ave- 5(1) --- 14)GW1eN* 01N. Bid No: LA - S — x7g Bid Date: /a/ (4 / 2 - Bid Time: II: DD AO I 8. Bidders are not required to be in possession of a current City of Renton business license in order to bid on City projects. However, Contractors and all subcontractors of all tiers must be in possession of a current City business license while conducting work in the City. 9. Bidding Checklist Each bid must be submitted in a sealed envelope bearing on the outside the name and address of the Bidder, and the name and number of the project for which the bid is submitted. It is the responsibility of each bidder to ascertain if all the documents listed below and in the Table of Contents are included in their copy of the Contract Provisions. If documents are missing, it is the sole responsibility of the Bidder to contact the City of Renton to obtain the missing documents prior to the date and time bids are due. The following documents shall be submitted with the bid. ❑ Project Proposal Cover Sheet—The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Proposal —The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Schedule of Prices —The form(s) included in these Bid Documents must be used; no substitute will be accepted. Bidders must bid on all schedules and items shown on the Schedule of Prices. If any unit price is left blank, it will be considered no charge for that bid item, regardless of what has been placed in the extension column. ❑ Local Agency Certification for Federal-Aid Contracts. ❑ Non-Collusion Declaration —The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Local Agency Subcontractor List— This form is available at https://wsdot.wa.gov/forms/pdfForms.html. Bidder may download, print and complete the form to include with Bid. The DOT form, DOT Form Number and revision date must match the form included in these Bid Documents, otherwise the Bid will be considered irregular and non-responsive and the Bid will be rejected. ❑ Proposal for Incorporating Recycled Materials into the Project—The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Contractor Certification, Wage Law Compliance — Responsibility Criteria, Washington State Public Works Contracts—This form is available at https://wsdot.wa.gov/forms/pdfForms.html. Bidder may download, complete, print, and sign the form to include with Bid. The DOT form, DOT Form Number and revision date must match the form included in these Bid Documents, otherwise the Bid will be considered irregular and non-responsive and the Bid will be rejected. ❑ DBE Utilization Form— This form is available at https://wsdot.wa.gov/forms/pdfForms.html. The form included in these Bid Documents must be used; no substitute will be accepted. Contract Documents Page 6 Oakesdale Ave SW Pavement Preservation September 2025 ❑ DBE Written Confirmation Form—This form is available at https://wsdot.wa.gov/forms/pdfForms.html. The form included in these Bid Documents must be used; no substitute will be accepted. ❑ DBE Trucking Credit Form—This form is available at https://wsdot.wa.gov/forms/pdfForms.html. The form included in these Bid Documents must be used; no substitute will be accepted. ❑ DBE Bid Item Breakdown Form—This form is available at https://wsdot.wa.gov/forms/pdfForms.html. The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Proposal Signature Page - The form included in these Bid Documents must be used; no substitute will be accepted. Evidence of signatory's authority to sign the Proposal on behalf of the business entity shall be submitted with the Bid. Otherwise, the submitted Bid will be considered irregular and non- responsive and the Bid will be rejected. ❑ Proposal Bid Bond —The form included in these Bid Documents must be used; no substitute will be accepted. If an attorney-in-fact signs bond, the power of attorney authorizing such execution must be current and enforceable, be properly executed by the Surety in accordance with the Surety's by-laws or other applicable rules and resolutions, and include all necessary corporate seals, signatures, and notaries. 10. Contract Checklist The following forms are to be executed by the successful Bidder after the Contract is awarded. ❑ Agreement—The form included in these Bid Documents must be used; no substitute will be accepted. Two originals shall be executed by the successful Bidder. ❑ Contract Bond —The form included in these Bid Documents must be used; no substitute will be accepted. Two originals shall be executed by the successful Bidder and its surety company. This bond covers successful completion of all work and payment of all laborers, subcontractors, suppliers, etc. If an attorney-in- fact signs bond, the power of attorney authorizing such execution must be current and enforceable, be properly executed by the Surety in accordance with the Surety's by-laws or other applicable rules and resolutions, and include all necessary corporate seals, signatures, and notaries. ❑ Fair Practices Policy Affidavit of Compliance - The form included in these Bid Documents must be used; no substitute will be accepted. ❑ Certificates of Insurance —To be executed by an insurance company acceptable to the Owner, on ACORD Forms. Required coverages are listed in Section 1- 07.18 of the Special Provisions. The City of Renton shall be named as "Additional Insureds" on the insurance policies as well as the entities listed in Section 1-07.18(2) of the Special Provisions. Contract Documents Page 7 Oakesdale Ave SW Pavement Preservation September 2025 City of Renton Contract Provisions for Oakesdale Ave SW Pavement Preservation III. PROJECT PROPOSAL Contract Documents Page 10 Oakesdale Ave SW Pavement Preservation September 2025 PROJECT PROPOSAL Project: Oakesdale Ave SW Pavement Preservation Federal Aid No: STBGUL-1277(002) City Contract Number: CAG-25-278 Company: Lk $ 0k TAoLskrie5 c' — Address: 1Jd k 7r� L �(2 c oak, CA)A— Phone Number: aS3 '(93l- 3(ol Fax Number: 'Ion- S 30 -c2 10ao Total Bid Amount: $ I cog, 0 3 ao (Total of Bid Schedule) Contract Documents Page 11 Oakesdale Ave SW Pavement Preservation September 2025 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal PROPOSAL Oakesdale Ave SW Pavement Preservation TO THE CITY OF RENTON RENTON, WASHINGTON Ladies and/or Gentlemen: The undersigned (Bidder) hereby certify that the Bidder has examined the location and construction details of the proposed work and has read and thoroughly understands the Contract Documents governing the work, and the nature of the work, and the method by which payment will be made for said work. Bidder hereby proposes to undertake and complete the work detailed in and in accordance with these Contract Documents, for the Total Bid Amount shown on the attached Schedule of prices. The Bidder understands that the quantities mentioned herein are approximate only and are subject to increase or decrease, and hereby proposes to perform all quantities of work as either increased or decreased in accordance with the Contract Documents. As evidence of good faith, pursuant to RCW 35.23.352(1), an original Bid Proposal Deposit in the form of(check one) Er bid bond, or ❑ cashier's check(made payable to the City of Renton), or ❑ postal money order(made payable to the City of Renton), in an amount equal to five percent (5%) of the Total Bid Price, is attached hereto. If a bid bond is signed by an attorney-in-fact, Bidder agrees that the power of attorney authorizing such execution must be current and enforceable, be properly executed by the Surety in accordance with the Surety's by-laws or other applicable rules and resolutions, and include all necessary corporate seals, signatures, and notaries. Bidder understands that Contract Award or Bid rejection will occur within 60 calendar days after the opening of bids, as specified in Section 1-03.2 of the Standard Specifications. Bidder further understands that should Bidder fail to enter into this contract in accordance with his or her Bid and furnish a contract bond within a period of ten(10)days from the date at which he or she is notified that he or she is the successful bidder, the Bid Proposal Deposit shall be forfeited to the City of Renton, as set forth in RCW 35A.40.200 and RCW 35.23.352. Bidder hereby agrees to complete the Physical Work in all respects within 8 working days. Contract time shall begin on the first working day following the Notice to Proceed date. Contract Documents Page 12 Oakesdale Ave SW Pavement Preservation September 2025 PROPOSAL (BID SCHEDULE-Oakesdale Ave SW, SW 34th St to SW 16th St) Oakesdale Ave SW Pavement Preservation ALL ENTRIES SHALL BE WRITTEN IN INK OR TYPED TO VALIDATE BID Note: Unit prices for all items, all extensions, and total amount of Bid shall be shown. Enter unit prices in numerical figures only in dollars and cents, i.e. to two (2) decimal places (including for whole dollar amounts). All figures must be clearly legible. Bids with illegible figures in the Unit Price column will be rejected as unresponsive. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shall be corrected to conform thereto. Item Spec. Description Quantity Unit Unit Price* Amount No. Section 1. 1-05 Roadway Surveying 1 LS $ 13,000.00 $ 13,000.00 2. 1-05 ADA Feature Surveying 1 LS $ 5,000.00 $5,000.00 3. 1-07.15 SPCC Plan 1 LS $ 1,000.00 $ 1,000.00 4. 1-09 Mobilization 1 LS $100,000.00 $100,000.00 5. 1-10 Work Zone Safety Contingency 1 FA $11,000 $11,000 6. 1-10 Pedestrian Traffic Control 1 LS $ 6,000.00 $6,000.00 7. 1-10 Traffic Control Supervisor 603 HR $ 125.00 $75,375.00 8. 1-10 Flagger 48 HR $ 80.00 $ 3,840.00 9. 1-10 Other Traffic Control Labor 1205 HR $ 80.00 $ 96,400.00 10. 1-10 Construction Signs Class A 126 SF $ 35.00 $ 4,410.00 11. 1-10 Other Temporary Traffic Control Devices 1 LS $ 28,000.00 $ 28,000.00 12. 1-10 Sequential Arrow Board 1315 HR $ 5.00 $ 6,575.00 13. 2-01 SP Clearing and Grubbing 1 LS $ 9,000.00 $ 9,000.00 14. 2-02 GSP Removal of Structures and Obstructions 1 LS $ 45,000.00 $ 45,000.00 15. 4-04 Crushed Surfacing Top Course 315 TON $ 125.00 $ 39,375.00 16. 5-04 Planing Bituminous Pavement 41500 SY $ 5.10 $ 21 1,650.00 17. 5-04 SP HMA CL 1/2" , PG 64-22" 4866 TON $ 124.00 $ 603,384.00 18. 7-05 SP Adjust and Replace Utility Lid 4 EA $ 1,100.00 $ 4,400.00 19. 8-01 Erosion Control and Water Pollution Prevention 1 LS $ 1,100.00 $ 1,100.00 20. 8-01 Inlet Protection 64 EA $ 1 10.00 $ 7,040.00 21. 8-02 Seeded Lawn Installation 19 SY $ 55.00 $ 1,045.00 Contract Documents-Addendum#2 Page 13 Oakesdale Ave SW Pavement Preservation October 2025 PROPOSAL (BID SCHEDULE—Oakesdale Ave SW, SW 34th St to SW 16th St) Oakesdale Ave SW Pavement Preservation ALL ENTRIES SHALL BE WRITTEN IN INK OR TYPED TO VALIDATE BID Note: Unit prices for all items, all extensions, and total amount of Bid shall be shown. Enter unit prices in numerical figures only in dollars and cents, i.e. to two (2) decimal places (including for whole dollar amounts). All figures must be clearly legible. Bids with illegible figures in the Unit Price column will be rejected as unresponsive. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shall be corrected to conform thereto. Item Spec. Description Quantity Unit Unit Price* Amount No. Section 22. 8-02 SP Topsoil, Type A(8"Depth) 5 CY $ 220.00 $ 1,100.00 23. 8-33 SP Synthetic Turf,Complete 1660 SF $ 21.00 $ 34,860.00 24. 8-22 SP Plastic Crosswalk Treatment 9979 SF $ 20.00 $ 199,580.00 25. 8-04 Cement Conc.Traffic Curb and Gutter 159 LF $ 62.00 $ 9,858.00 26. 8-04 Extruded Curb 4256 LF $ 21.00 $ 89,376.00 27 8-04 Cement Conc. Pedestrian Curb 121 LF $ 60.00 $ 7,260.00 28. 8-09 Raised Pavement Marker Type 2 6 HUND $ 900.00 $5,400.00 29. 8-10 SP Traffic Separator with Flexible Delineator 59 EA $ 320.00 $ 18,880.00 30. 8-14 Cement Conc.Sidewalk 65 SY $ 90.00 $ 5,850.00 31. 8-14 Cement Conc.Curb Ramp Type Combination 2 EA $ 2,200.00 $ 4,400.00 32. 8-14 Cement Conc.Curb - .1.)Type Perpendicular 7 EA $ 1,900.00 $ 13,300.00 33. 8-14 Cement Conc. Curb Ramp Type Parallel 1 EA $ 3,100.00 $ 3,100.00 34. 8-14 Cement Conc.Curb Ramp Type Bike 4 EA $ 500.00 $ 2,000.00 35. 8-20 SP Traffic Signal System Modification - 1 LS $ 55,000.00 $ 55,000.00 Oakesdale Ave SW&SW 27th St 36. 8-20 SP Traffic Signal System Modification - 1 LS $ 40,000.00 $ 40,000.00 Oakesdale Ave SW&SW 20th St 37 8-20 SP Traffic Signal System Modification- 1 LS $ 33,000.00 $ 33,000•00 Oakesdale Ave SW& SW 16th St 38. 8-21 Permanent Signing 1 LS $ 25,000.00 $ 25,000.00 39. 8-22 Remove Pavement Markings 1 LS $ 4,000.00 $ 4,000.00 40, 8-23 Temporary Pavement Markings 1 LS $43,000.00 $43,000.00 41. 8-22 Plastic Bicycle Lane Symbol 40 EA $ 400.00 $ 16,000.00 42. 8-22 Plastic Traffic Arrow 38 EA $ 400.00 $ 15,200.00 Contract Documents—Addendum#2 Page 14 Oakesdale Ave SW Pavement Preservation October 2025 PROPOSAL (BID SCHEDULE—Oakesdale Ave SW, SW 34th St to SW 16th St) Oakesdale Ave SW Pavement Preservation ALL ENTRIES SHALL BE WRITTEN IN INK OR TYPED TO VALIDATE BID Note: Unit prices for all items, all extensions, and total amount of Bid shall be shown. Enter unit prices in numerical figures only in dollars and cents, i.e. to two (2) decimal places (including for whole dollar amounts). All figures must be clearly legible. Bids with illegible figures in the Unit Price column will be rejected as unresponsive. Where conflict occurs between the unit price and the total amount specified for any item, the unit price shall prevail, and totals shall be corrected to conform thereto. Item Spec. Description Quantity Unit Unit Price* Amount No. Section 43. 8-22 Plastic Traffic Letter 14 EA $ 110.00 $ 1,540.00 44. 8-22 Plastic Stop Line 330 LF $ 13.00 $ 4,290.00 45. 8-22 Plastic Crosswalk Line 1100 SF $ 12.00 $ 13,200.00 46. 8-22 SP Plastic Shared Lane Marking 2 EA $ 400.00 $ 800.00 47. 8-22 SP MMA Profiled Embossed Line 42000 LF $ 3.80 $ 159,600.00 48 8-22 SP MMA Crosshatch Marking 6000 LF $ 7.00 $ 42,000.00 49. 8-22 SP MMA Crosswalk Line(Green) 1300 SF $ 19.00 $ 24,700.00 50. 8-22 SP MMA Transit Box(Red) 980 SF $ 19.00 $ 18,620.00 51. 8-22 SP KCM Red and Yellow Curb Paint 90 LF $ 5.50 $ 495.00 Total Schedule (Oakesdale Ave SW, SW 34th St to SW 16th St)* $ 2,164,003.00 *All applicable sales tax shall be included in the unit and lump sum Bid price per Section 1-07.2(1) and WAC 458-20-171. Contract Documents—Addendum#2 Page 15 Oakesdale Ave SW Pavement Preservation October 2025 Local Agency Certification for Federal-Aid Contracts The prospective participant certifies by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment. or modification of any Federal contract, grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Farm-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. This certification is material representation of the fact upon which reliance was placed when this transaction was made or entered into, Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31. U.S. Code, Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in III lower tier subcontracts, which exceed S100,000 and that all such subrecipients shall certify and disclose accordingly. sK DOT Form 272-040A EF 07,2011 Failure to return this Declaration as part of the bid proposal package will make the bid nonresponsive and ineligible for award. NON-COLLUSION DECLARATION I, by signing the proposal, hereby declare, under penalty of perjury under the laws of the United States that the following statements are true and correct: 1 , That the undersigned person(s), firm, association or corporation has (have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the project for which this proposal is submitted. 2. That by signing the signature page of this proposal, I am deemed to have signed and to have agreed to the provisions of this declaration. NOTICE TO ALL BIDDERS To report rigging activities call: 1-800-424-9071 The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through Friday; 8:00 a.rn. to 5:00 p.m., eastern time. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the 'hotline" to report such activities. The "hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will be treated confidentially and caller anonymity will be respected. `SH DOT Firm 2 T2-03fi1 EF 077201 I Washington State �1 Department of Transportation Subcontractor List Prepared in compliance with RCW 39.30.060 as amended To Be Submitted with the Bid Proposal Project Name OCILt kik kit! SL) .oH Y w►tv'4 I cvul'1!GtC'�Q✓� Failure to list subcontractors with whom the bidder, if awarded the contract,will directly subcontract for performance of the work of structural steel installation, rebar installation, heating, ventilation and air conditioning, plumbing, as described in Chapter 18.106 RCW, and electrical, as described in Chapter 19.28 RCW or naming more than one subcontractor to perform the same work will result in your bid being non-responsive and therefore void. Subcontractor(s)with whom the bidder will directly subcontract that are proposed to perform the work of structural steel installation, rebar installation, heating, ventilation and air conditioning, plumbing, as described in Chapter 18.106 RCW, and electrical as described in Chapter 19.28 RCW must be listed below.The work to be performed is to be listed below the subcontractor(s) name. If RCW 39.30.060 requires a proof of license,the license number of that Subcontractor is required.To the extent the Project includes one or more categories of work referenced in RCW 39.30.060, and no subcontractor is listed below to perform such work,the bidder certifies that the work will either(i) be performed by the bidder itself, or(ii) be performed by a lower tier subcontractor who will not contract directly with the bidder. Subcontractor Name 1l n Lb C (0v6kIt!t4- (and License Number if required) Work to be performed ncA'Cltp I &eicAr Subcontractor Name 0. /_ ZAL (and License Number if required) v Work to be performed L ' ctiehr CAA Subcontractor Name (and License Number if required) Work to be performed Subcontractor Name (and License Number if required) Work to be performed Subcontractor Name (and License Number if required) Work to be performed Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal AMNIA APWA-WA Division 1 Committee rev. 5/13/2022 Proposal for Incorporating Recycled Materials into the Project In compliance with RCW 70A.205.700, the Bidder shall propose below, the total percent of construction aggregate and concrete materials to be incorporated into the Project that are recycled materials. Calculated percentages must be within the amounts allowed in Section 9-03.21(1)E, Table on Maximum Allowable Percent (By Weight) of Recycled Material, of the Standard Specifications. Proposed total percentage: 41 percent. Note: Use of recycled materials is highly encouraged within the limits shown above, but does not constitute a Bidder Preference, and will not affect the determination of award. unless two or more lowest responsive Bid totals are exactly equal, in which case proposed recycling percentages will be used as a tie-breaker, per the APWA GSP in Section 1-03. 1 of the Special Provisions. Regardless, the Bidder's stated proposed percentages will become a goal the Contractor should do its best to accomplish. Bidders will be required to report on recycled materials actually incorporated into the Project, in accordance with the APWA GSP in Section 1-06.6 of the Special Provisions. Bidder: 1-6(rGSIA c- .Incl v5 fei e5 inc. Signature of Authorized Official: 7"s; ' Date: I0/7/25 v71Washington State Department of Transportation Contractor Certification Wage Law Compliance - Responsibility Criteria Washington State Public Works Contracts FAILURE TO RETURN THIS CERTIFICATION AS PART OF THE BID PROPOSAL PACKAGE WILL MAKE THIS BID NONRESPONSIVE AND INELIGIBLE FOR AWARD I hereby certify, under penalty of perjury under the laws of the State of Washington, on behalf of the firm identified below that, to the best of my knowledge and belief, this firm has NOT been determined by a final and binding citation and notice of assessment issued by the Washington State 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 RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the Call for Bids. Bidder Name: L.akes:dc- Sr,.Iv5fr ►cS -114C• Name of Contractor/Bidder- Print full legal entity name of firm By: 7 /dh r p 1 Signature of u7J �; thonzd person Print Name/of person making certifications for firm Title: .�Dle Cf v"LA ne,jec Place: Col K9 fors WA Title of person signing certificate Print city and state where signed Date: IOh?/25 Form 272-009 08/2017 WiWashington State Disadvantaged Business Department of Transportation 9 Enterprise Utilization Certification To be eligible for Award of this Contract the Bidder shall fill out and submit, as a supplement to its sealed Bid Proposal, a Disadvantaged Business Enterprise (DBE) Utilization Certification. The Contracting Agency shall consider as non- responsive and shall reject any Bid Proposal that does not contain a DBE Utilization Certification which properly demonstrates that the Bidder will meet the DBE participation requirements in one of the manners provided for in the proposed Contract. Refer to the instructions on Page 2 when filling out this form or the Bid may be rejected.An example form has been provided on Page 3.The successful Bidder's DBE Utilization Certification shall be deemed a part of the resulting Contract. Box 1: LA C Si ./iA VS it'r.es certifies that the DBE firms listed below have been contacted regarding participation on this project. If this Bidder is successful on this project and is awarded the Contract, it shall assure that subcontracts or supply agreements are executed with named DBEs. (If f necessary, use additional sheets.) Box 2: bot.\re Se3kek`L r /M<- St.� ?atr+�evt� �C�Ser0arit►✓• Column 1 Column 2 Column 3 Column 4 Column 5 Name of DBE Project Role Description of Work Dollar Amount Dollar Amount (See instructions) (See instructions) (See instructions) Subcontracted to be Applied to DBE Towards Goal (See instructions) (See instructions) M /(.9 1 / D 6 Disadvantaged Business Enterprise 0 Total DBE Commitment Dollar Amount Q Condition of Award Contract Goal Box 3 Box 4 5 Q By checking Box 5 the Bidder is stating that their attempts to solicit sufficient DBE participation to meet the COA Contract goal has been unsuccessful and good faith effort will be submitted in accordance with Section 1-02.9 of the Contract DOT Form 272-056 C Revised 03/2018 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Instructions for Disadvantaged Business Enterprise Utilization Certification Form Box 1: Name of Bidder (Proposal holder) submitting Bid. Box 2: Name of the Project. Column 1: Name of the Disadvantaged Business Enterprise (DBE). DBE firms can be found using the Diversity Management and Compliance System web page: ,.s.rlwsdot.diversitycompliarrce.corn Repeat the name of the DBE for each Project Role that will be performed. Column 2:The Project Role that the DBE will be performing as follows; • Prime Contractor • Subcontractor • Subcontractor (Force Account) • Work sublet as Force Account must be listed separately. • Manufacturer • Regular Dealer • Work sublet to a Regular Dealer must be listed separately. • Regular Dealer status must be approved prior to Bid submittal by the Office of Equal Opportunity, Washington State Department of Transportation, on each Contract. • Broker • Work sublet to a Broker must be listed separately. List each project role to be performed by a single DBE individually on a separate row. The role is used to determine what portion of the amount to be subcontracted (Column 4) may be applied toward meeting the goal (column 5) Column 3: Provide a description of work to be performed by the DBE. The work to be performed must be consistent with the Certified Business Description of the DBE provided at the Diversity Management and Compliance System web page https.//wsdot.diversitycomplrance.corn • A Bidder subletting a portion of a bid item shall state"Partial"and describe the Work that is included • For example; "Electrical (Partial) —Trenching". • "Mobilization" will not be accepted as a description of Work. Column 4: List the total amount to be subcontracted to each DBE for each Project Role they are performing. Column 5:This is the dollar amount for each line listed in the certification that the prime intends to apply towards meeting the COA Contract goal. It may be that only a portion of the amount subcontracted to a DBE in Column 4 is eligible to be credited?_.,urd meeting the goal See Note 1, Note 2, Note 3.The Contracting Agency will utilize the sum of this column (Box 4) to determine whether or not the bidder has met the goal. In the event of an arithmetic error in summing column 5 or an error in making appropriate reductions in the amounts in column four, See Note 1, Note 2, Note 3, then the mathematics will be corrected and the total (Box 4)will be revised accordingly. Note 1: For Work sublet as Force Account the bidder may only claim 50%of the amount subcontracted (Column 4) towards meeting the goal (Column 5). This information will be used to demonstrate that the DBE contract goal is met at the time that the bidder submits their bid. For example; amount sublet as force account= $100,000 (Column 4) equates to ($100,000 X 50%) = $50,000 (Column 5) to be applied towards the goal. Note 2: For Work sublet to a Regular Dealer the bidder may only claim 60% of the cost of the materials or supplies (Column 4) towards meeting the goal (Column 5). For example; Material cost= $100,000 (Column 4) equates to ($100,000 X 60%) = $60,000 (Column 5) to be applied towards the goal Note 3: For Work sublet to a Broker the bidder may only claim the fees paid to a Broker towards meeting the goal (Column 4). For example; amount sublet to a broker= $100,000 (Column 4) equates to ($100,000 X reasonable fee %) = $ (Column 5)to be applied towards the goal. Box 3: Box 3 is the COA Contract goal which is the minimum required DBE participation. The goal stated in the Contract will be in terms of a dollar amount or a percentage in the Contract. When expressed as a percentage you must multiply the percentage times the sum total of all bid items as submitted in the Bidder's Proposal to determine the dollar goal and write it in Box 3. In the event of an error in this box, the Contracting Agency will revise the amount accordingly. Box 4: Box 4 is the sum of the values in column 5. This value must equal or exceed the COA Contract goal amount written in Box 3 or; Box 5: Check Box 5 if insufficient DBE Participation has been achieved and a good faith effort is required. Refer to the subsection titled, Selection of Successful Bidder/Good Faith Efforts(GFE) in the Contract. See the Disadvantaged Business Enterprise Participation specification in the Contract for more information. DOT Form 272-056 Revised 03/2018 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Washington State Disadvantaged Business vAllr Department of Transportation Enterprise Utilization Certification To be eligible for Award of this Contract the Bidder shall fill out and submit, as a supplement to its sealed Bid Proposal. a Disadvantaged Business Enterprise (DBE) Utilization Certification. The Contracting Agency shall consider as non- responsive and shall reject any Bid Proposal that does not contain a DBE Utilization Certification which properly demonstrates that the Bidder will meet the DBE participation requirements in one of the manners provided for in the proposed Contract. Refer to the instructions on Page 2 when filling out this form or the Bid may be rejected.An example form has been provided on Page 3.The successful Bidder's DBE Utilization Certification shall be deemed a part of the resulting Contract. Box 1: A Plus Construction Company certifies that the DBE firms listed below have been contacted regarding participation on this project. If this Bidder is successful on this project and is awarded the Contract, it shall assure that subcontracts or supply agreements are executed with named DBEs. (If necessary, use additional sheets.) Box 2: US 395, Spokane City Limits to Stevens County Line - Paving and Safety Cdumn 1 Column 2 Cdumn 3 Cdumn 4 Cdumn 5 Name of DBE Project Role Description of Work Dollar Amount Dollar Amount See instructions) See instructions) See instructions) Subcontracted to be Applied to DBE Towards Goal See instructions) See instructions) A Plus Construction Prime Asphalt and concrete paving,asphalt milling,prelcvelmg N/A 900,000 Company and pavement repair In the Line Services,Inc Subcontractor(Force Crack sealing 20,000 10,000 Account) In the Line Services,Inc Subcontractor Guideposts,Joint seal,pavement markers,temporary 200,000 200.000 srgnage,construction sign installation The Regular Dealer Rental and sales of highway construction and related 100,000 60,000 Everything Guys,LLC equipment and materials Optrmus Prime Trucking, Subcontractor Dump Trucking 50,000 50,000 Inc Metalheads,Inc Manufacturer Dowel Bars 75.000 75,000 Erosion Under Control Broker Erosion control blankets,straw bales and wattles,sand bags 15,000 250 Co -111kVV.V) Disadvantaged Business Enterprise 356,968.16 Total DBE Commitment Dollar Amount 1,295,250 Condition of Award Contract Goal Box 3 Box 4 5^ By checking Box 5 the Bidder is stating that their attempts to solicit sufficient DBE participation to meet the C,OA Contract goal has been unsuccessful and good faith effort will be submitted in accordance with Section 1-02.9 of the Contract DOT Form 272-056 Revised 03/2018 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal WWashington State Disadvantaged Business Enterprise (DBE) ir— Department of Transportation Written Confirmation Document See Contract Provisions: DBE Document Submittal Requirements Disadvantaged Business Enterprise Participation THIS FORM SHALL ONLY BE SUBMITTED TO A DBE THAT IS LISTED ON THE CONTRACTOR'S DISADVANTAGED BUSINESS ENTERPRISE UTILIZATION CERTIFICATION. THE CONTRACTOR SHALL COMPLETE PART A PRIOR TO SENDING TO THE DBE. PART A: To be completed by the bidder The entries below shall be consistent with what is shown on the Bidder's Disadvantaged Business Enterprise Utilization Certification. Failure to do so will result in Bid rejection. Contract Title: 66,krccs Lae Ave_. SW 17c.:tP (-es c lie.AZan Bidder's Business Name: Lit S/4, lwkvski`.1t5 Le.. DBE's Business Name: )JtA Description of DBE's Work: Dollar Amount to be Applied Towards DBE Goal: Dollar Amount to be Subcontracted to DBE*: *Optional Field PART B: To be completed by the Disadvantaged Business Enterprise As an authorized representative of the Disadvantaged Business Enterprise, I confirm that we have been contacted by the Bidder with regard to the referenced project for the purpose of performing the Work described above. If the Bidder is awarded the Contract,we will enter into an agreement with the Bidder to participate in the project consistent with the information provided in Part A of this form. Name (printed): f�f Signature: Title: Address: Date: DOT Form 422-031 Revised 07/2016 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal WWashington State Disadvantaged Business Enterprise IAP Department of Transportation (DBE) Bid Item Breakdown Form 1. Contract Number 2. Contract Name CAG-25-278 Oakesdale Ave. SW Pavement Preservation 3 Prime Contractor 4. Prime Contractor Representative Name Lakeside Industries Inc. Tony Sippl 5. Prime Contractor Representative Phone Number 6. Prime Contractor Representative Email 206.638.0072 tony.sippl@lakesideindustries.com Column 8 Column 1 Column 2 Column 3 Column 4 Column 5 Column 6 Column 7 Dollar Amount Name of UDBE Bid Item# Full/Partial Quantity Description Unit Price Total Unit to be Applied Cost (See Instructions) (See Instructions) (See Instructions) (See Instructions) (See Instructions) (See Instructions) Towards Goal (See Instructions) (See Instructions) N/A N/A N/A N/A N/A N/A $0 $0 Subtotal: $ 0 00 $0.00 Total Unit Dollar Amount Name of UDBE Bid Item# Full/Partial Quantity Description Unit Price Cost to be Applied Towards Goal Subtotal: $000 $ 000 Total Unit Dollar Amount Name of UDBE Bid Item# Full/Partial Quantity Description Unit Price Cost to be Applied Towards Goal Subtotal: $0.00 $ 0 00 Total Unit Dollar Amount Name of UDBE Bid Item# Full/Partial Quantity Description Unit Price Cost to be Applied Towards Goal Subtotal: $ 000 $000 TOTAL UDBE Dollar Amount: $0.00 $0 00 DOT Form 272-054 Revised 09/2020 Instructions for Disadvantaged Business Enterprise (DBE) Bid Item Breakdown Form Box 1: Provide the Contract Number as stated in the project information webpage. Box 2: Provide the Name of the project as stated in the project information webpage. Box 3: Provide the Name of the bidder (Proposal holder) submitting Bid. Box 4: Provide the name of the prime contractor's representative available to contact regarding this form. Box 5: Provide the phone number of the prime contractor's representative available to contact regarding this form. Box 6: Provide the email of the prime contractor's representative available to contact regarding this form. Column 1: Provide the Name of the Disadvantaged Business Enterprise (DBE) Firm. DBE Firms can be found using the search tools under the Firm Certification section of the Diversity Management and Compliance System (DMCS)webpage https://wsdot.diversitycompliance.com. Column 2: Provide the Bid Item Number (as it appears in the engineer's estimate bid check report) available on the project information webpage. Column 3: If the DBE is performing only part of the bid item, mark"Partial". If the DBE is performing the entire bid item, mark"Complete". Column 4: Provide the estimated quantity for the specific bid item. For trucking firms, use hour or another unit of measure. Column 5: Provide a description of the work to be performed by the DBE. Column 6: Provide the price per unit and specify the type of unit used. For trucking firms, use hour or another unit of measure. Column 7: Provide the estimated total unit cost amount per bid item. Column 8: Provide the amount of the bid item being used to fulfil the DBE goal. The work to be performed must be consistent with the Certified Business Description of the DBE provided in the DMCS webpage https://wsdot. diversitycompliance.com. Mobilization up to 10% is acceptable. If mobilization is more than 10% additional information and/or justification may be requested. The total amount shown for each DBE shall match the amount shown on the DBE Utilization Certification Form. Use Additional Sheets if necessary. DOT Form 272-054 Revised 09/2020 Provided to 13':ilders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal Washington State 41116. Disadvantaged Business Enterprise Department of Transportation (DBE)Trucking Credit Form PART A: TO BE COMPLETED BY THE BIDDER This form is in support of the trucking commitment identified on the DBE Utilization Certification Form submitted with the proposal Please note that DBE's must be certified prior to time of submittal Federal Aid# Contract# Project Name Oaka5 ? m6v‘-' 44 risen/ C If listing items by hours or by lump sum amounts, please provide calculations to substantiate the quantities listed Bid Item Item Description Alf A Ai/14 Use additional sheets as necessary. Bidder I Name/Title (please print) L-e ke s;deneA✓s f�.e s Ty <J 31 1 Proecf ►�1 1CtS(� Phone Fax Signature A .ts)'3� OO1 Address 1?0130x OW) 50. Jthk` ` cr©a r I certify that the above information is complete and accurate. Email Date 10/U / aOd•-.5 PART B: TO BE COMPLETED BY THE DBE TRUCKING FIRM Note: DBE trucking firm participation may only be credited as DBE participation for the value of the hauling services. not for the materials being hauled unless the trucking firm is also recognized as a supplier of the materials used on the project and approved for this project as a regular dealer ��� 1 Type of Material expected to be hauled? 2 Number of fully operational trucks Tractor/trailers: Dump trucks: expected to be used on this project? 3 Number of trucks and trailers owned by Tractor/trailers. Dump trucks: the DBE that will be used on this project? 4 Number of trucks and trailers leased by Tractor/trailers. Dump trucks. the DBE that will be used on this prnjPct' DBE Firm Name Name/Title (please print) Certification Number Phone Fax Signature Address I certify that the above information is complete and accurate. Email Date DOT Form 272-058 Revised 09/2020 Submit this form to in accordance with section 1-02.9 of the Contract. Instruction to Bidder: The Bidder shall complete and submit the Disadvantaged Business Enterprise (DBE)Trucking Credit Form in accordance with Section 1-02.9 of the Contract. INSTRUCTIONS Please note—All Fields are required PART A: TO BE COMPLETED BY THE BIDDER Federal Aid: Include the project federal-aid number. County: Specify the County where the project will take place. Contract#: Specify the Project Contract Number which can be found in the Engineer's estimate bid check report. Bid Item: Provide the Bid Item Number (as it appears in the engineer's estimate bid check report) for which trucking services will be utilized. Item Description: Provide description of the bid item (as it appears in the engineer's estimate bid check report) for which trucking will be utilized. Bidder: In this section, provide the bidder's legal name, title, Business address, Phone and email. The bidder's representative signature is required in addition to the date the form was signed. PART B: TO BE COMPLETED BY THE DBE TRUCKING FIRM Question 1: Specify type of material that will be hauled (i.e. Sand, HMA, gravel) Question 2: Specify the total number of operational trucks that will be used on the project. Question 3: Specify the total number of operational trucks and trailers owned by the DBE that will be used on the project. Question 4: Specify the total number of operational trucks and trailers leased by the DBE that will be used on the project. DBE Firm: In this section, provide the DBE Firm's legal name, DBE Firm's representative legal name and title, certification Number (Found in the firm's OMWBE Profile page in the OMWBE directory), Business address, Phone, fax and email. The DBE Firm's representative signature is required in addition to the date the form was signed. DOT Form 272-058 Revised 09/2020 1171 Washington State �I/ Department of Transportation Bidder Questionnaire Agency Name Federal Aid Number City of Renton STBGUL-1277(002) Prime Contractor Name Contract Number Lakeside Industries Inc. CAG-25-278 Contract Name Oakesdale Ave SW Pavement Preservation Firm/ Address DBE NAILS Subcontractor (incl.Zipcode) Status Race Gender Codes Scope of Work Firm Age Firm Gross Receipts Name J&G Concrete Corp P.O. Box 0162 DBE Hispanic American Male 237310 Cement Concrete Flat 17 yrs $1-3 million Milton, WA. 98354 238990 Work Ground Up Po Box 1690 Milton WA Non-DBE White Male 237310 Grinding 34 yrs $10-20 million Construction Inc. 98354 The Bag Lady Inc 11124 Valley Ave Easy DBE N/A Female 561730 Inlet Protection 34 yrs $1-3 million Puyallup WA 98372 G&G Inc. 18044 SE 224th ST Kent DBE Hispanic American Female '43821 Electrical 33 yrs $6-10 million WA 98042 A&H RoadWurx 26819 173rd St E DBE White Female 237310 Asphalt Milling 2 yrs Less than$1 million Buckley,WA 98321 PR Systems LLC 8351 30th Ave NE Lacey Non-DBE White Male 237310 Asphalt Milling 38 yrs $6-10 million WA 98516 NorthLine 1580 Port Drive, Non-DBE White Male 541370 Roadway Surveying 7 yrs $1-3 million Surveying, Inc. Burlington,WA 98233 Obunco 33650 6th Ave S STE 102 DBE Black American Male 541370 Surveying 26 yrs $6-10 million Engineering Federal Way WA 98003 BC Traffic LLC PO BOX 1670 Port DBE Asian-Pacific American Male 561990 Traffic Control 29 yrs $3-6 million Orchard WA 98366 Field Turf PO Box 1647 Snohomish Non-DBE White Male 238990 Install Turf 20 yrs $1-3 million Northwest Inc. WA 98291 If you have additional Firms or Subcontractors that submitted Bids, please complete additional forms. Tony Sippl Project Manager 10/7/25 Prime Contractor Representative Title Date DOT Form 272-022 Revised 09/2024 •Previous Versions Obsolete• Illli � Washington State �I/ Department of Transportation Bidder Questionnaire Agency Name Federal Aid Number City of Renton STBGUL-1277(002) Prime Contractor Name Contract Number Lakeside Industries Inc. CAG-25-278 Contract Name Oakesdale Ave SW Pavement Preservation Firm/ Address DBE NAICS Subcontractor (incl.Zipcode) Status Race Gender Codes Scope of Work Firm Age Firm Gross Receipts Name Specialized 14329 32nd Street E, Non-DBE White Male 237310 Striping 27 yrs Greater than$30.72 million Pavement Marking Sumner,WA 98390 Salinas 7804 40th Ave W DBE Hispanic American Male 237310 Concrete Flatwork 46 yrs $20-30.72 million Construction Inc Mukilteo WA 98275 AAA Contractors 24816 Pacific HWY S DBE Subcontinent Asian American Male 237310 Grinding 16 yrs $3-6 million INC. Kent WA 98032 Lee's Demolition Po Box 698 Spanaway DBE Black American Male 237310 Utility Adjustments 4 yrs $1-3 million LLC WA 98387 Transportation 6917 166th Ave E Non-DBE White Male 238210 Electrical 18 yrs $10-20 million Systems Sumner WA 98390 W.E. Coates 9825 Glory Drive SE DBE Black American Male 541370 Surveying 18 yrs $1-3 million Surveying L.L.C. Olympia,WA. 98513 Sebastian GC Inc 3310 S 250th PL Non-DBE Hispanic American Male 237310 Concrete Flatwork 4 yrs $1-3 million Kent WA 98032 Wilson Concrete 43205 Auburn Enumclaw Non-DBE White Male 237310 Concrete Flatwork 20 yrs $10-20 million Rd SE Enumclaw,WA 98 If you have additional Firms or Subcontractors that submitted Bids, please complete additional forms. Tony Sippi Project Manager 10/7/25 Prime Contractor Representative Title Date DOT Form 272-022 Revised 09/2024 •Previous Versions Obsolete• Form Instructions The following information on each firm that submitted a bid is required as part of part of 49 CFR 26.11(c)(2): Firm/Subcontractor Name: Enter the name of each firm or subcontractor who submitted a quote or a bid on the contract. Address: Enter the date the main address of the firm/subcontractor. Include the zip code. DBE Status: Enter the DBE status. Options are DBE and Non-DBE. Race: Enter the race of the majority Owner. Options are "Black American", "Hispanic American", "Native American". "Asian-Paci is American", "Subcontinent Asian American". and"White". N/A should only be used if there is not a majority owner such as when the Firm is a corporation. Gender: Enter the gender of the majority Owner. Options are "Female'and"Male". N/A should only be used if there is not a majority owner such as when the Firm is a corporation. NAICS Codes: Enter the appropriate NAICS Codes for the work the bid was submitted. Scope of Work: Enter the scope of the work the bid was submitted for. Firm Age: Enter the age of the Firm. Firm Gross Receipts: Enter the annual gross receipts. Options are "Less than$1 million", "$1-$3 million". "$3-$6 million", "$6-$10 million", "$10-$20 million ". "$20- $30.72 million ", "Greater than$30.72 million ". Prime Contractor Representative: The name of the person who filled out the form. DOT Form 272-022 Revised 09/2024 •Previous Versions Obsolete• ���Y O� PROPOSAL SIGNATURE PAGE AENSoa By signing below, Bidder acknowledges receipt and understanding of the following Addenda to the Bid Documents: Addendum No. Date of Receipt Addendum No. Date of Receipt 1 I b/a fa0as 4 2 10! /.20aS 5 3 10/s pba S 6 Note:a Proposal maybe considered irregular and maybe rejected if the receipt of Addenda is not acknowledged. The Bidder is hereby advised that by signature of this proposal, he/she is deemed to have acknowledged all requirements and signed all certificates contained herein. 717 Kcsi t %"(t) s [Signature o Authorized Official]* [Business Name] /o n y st',pl ?OBr 70( I [Printed Name] [Address Line 1] ?cojtck Wjaoat .1ss vat., (.45/4 WeR7 [Title] [Address Line 2] ID f (3 / aoas o253 -0( - 36,tl [Date] [Telephone Number] *Note:Evidence of the signatory's authority to sign the Proposal on behalf of the business entity shall be submitted with the Bid. Otherwis_e,the submitted Bid will_be considered irregular and non- responsive and the Bid will be rejected. Note: The address and phone number listed will be used for all communications regarding this Proposal. Type of business entity(e.g. corporation, partnership, etc.) C.o9 pb rovk 0ee\ State of Incorporation,or State where business entity was formed: (.)ci.sin� \,.401,‘ Contract Documents Page 31 Oakesdale Ave SW Pavement Preservation September 2025 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal WA State Contractor's Registration# L A I(E S I* 27 N Zr D UBI# 601 -16G — V+7 Industrial Insurance Account# 7001 22.1 Employment Security Department# L 1 SN 22-003 State Excise Tax Registration# q( -6751 6 S 7 DUNS# 05g 352e22. The Surety Company which will furnish the required Contract Bond is: Par RI). i 5 PA‘' 2 233 112 t-11 Ave, w e et h c vve ivA q [Surety] [Address Line 1] y25- 7e1 -3G2.5 [Telephone Number] [Address Line 2] Contract Documents Page 32 Oakesdale Ave SW Pavement Preservation September 2025 PROPOSAL BID BOND TO THE CITY OF RENTON KNOW ALL MEN BY THESE PRESENTS,That we, [Bidder] Lakeside Industries, Inc. of[address] 18808 S.E. 256th Street, Kent, WA 98042 as Principal,and [Surety] Travelers Casualty and Surety Company of America a corporation organized and existing under the laws of the State of Connecticut 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 unto the City of Renton in the full sum of five (5) percent of the total amount of the proposal of said Principalfor the work hereinafter described,for the payment of which,well and truly to be made,we bind ourselves and 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 proposal for the following public works construction project,to wit: Oakesdale Ave SW Pavement Preservation 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 contract 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 Proposal and furnish a contract 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. This Proposal Bid Bond shall be governed and construed by the State of Washington,and venue shall be in King County,Washington. IN TESTIMONY WHEREOF, the Principal and Surety have caused these presents to be signed and sealed this 7th day of, October 20 25 Contract Documents Page 33 Oakesdale Ave SW Pavement Preservation September 2025 PRINCIPAL SURETY Lakeside Industries, Inc. Travelers Casualty and Surety Company of America [PRINCIPAL] [SURETY] 141-7 • Si nature64 Aut orized Official] [Signature of Authorized Official] ,,,,,,,,,"" p Nicholas A Fredrickson 71ART=oeo, [Printed Name] ff [Printed Name] __�,�: coNN. -o A` P�('6 C� q h agtr Attorney in Fact ,„ "'' [Title] J� [Title] 10/07/2025 10/07/2025 [Date] [Date] Name and address of local office of IMA Financial Group, Inc. Agent and/or SURETY Company: 10400 NE 4th Street, Suite 900 Bellevue, WA 98004 Telephone:(425) 709-3600 Surety WAOIC# 10 Surety NAIC# 31194 Contract Documents Page 34 Oakesdale Ave SW Pavement Preservation September 2025 ' ••' '''''• - ••••••- • : 1 •, : • .--- • • `v •.‘ - - - - Travelers Casualty and Surety Company of America TRAVELERS Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Nicholas A Fredrickson of BELLEVUE , Washington , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. ie vis+rm �rY .+,'MIS trtI is0/ t..,..' ow i ; c , State of Connecticut ##�� By: City of Hartford ss. Robert L.Rane , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission expires the 30th day of June,2026 �I/ Anna P.Nowik Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies,which resolutions are now in full force and effect,reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this 7 day of OCTOBER, 2025 . ' • • �� • Kevin E.Hughes,Assi tant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached. rrrrii�� Lakeside Industries, Inc. AUTHORIZED SIGNATURES -COVINGTON Division- List the name and title of those individuals in your organization who are authorized to execute proposals, contracts, bonds and other documents and/or Instruments on behalf of the organization. Specify If more than one signature Is required. Note: Signature must appear next to name. NAME SIGNATURE TITLE Craig Nickel Operations Manager rLt-. 1cA,,t Tony Sippl �J � Project Manager — — The undersigned,being duly sworn,deposes and says that the foregoing is a true statement of facts concerning the individual, corporation, co-partnership or Joint venture herein named, as of the date indicated: LAKESIDE INDUSTRIES, INC. (Name of Firm,be exact) (AN' SYy�KI)) Sworn to before me this day of jir.i ' ,20z-Y Notary Pu,'' :�JG� Q T•q,q tidy<„'• O zG My Comm,Expires 2 February 20,2027 S Cr) I. No.23005309 T . '7'.':oU8 L\G, ,A0: � ,c'WAS " '� 05/19/25 Authorized Signers 120 Covington