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CITY OF RE VON
MAY 2 0 2026 , \
REC ED 1
CITY CLER 'S OFFICE
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
City of Renton
Public Works Department
Contract Documents for
PRV Station 1 Rehabilitation Project
CAG-26-096
DOCUMENTS TO BE SUBMITTED WITH BID
8/PROPOSAL & COMBINED AFFIDAVIT & CERTIFICATE FORM
8/PROPOSAL BID BOND FORM
DEPARTMENT OF LABOR AND INDUSTRIES CERTIFICATE OF
EGISTRATION INFORMATION FORM
ACHEDULE OF PRICES
CCKNOWLEDGEMENT OF RECEIPT OF ADDENDA
ERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES
SUBCONTRACTOR (IF LISTAPPLICABLE)
S
PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
This form must be submitted with the Bid Proposal
PROPOSAL&COMBINED AFFIDAVIT
AND CERTIFICATE FORM
CITY OF RENTON
PRV STATION 1 REHABILITATION PROJECT
CAG-26-096
WTR-27-4321
TO THE CITY OF RENTON
RENTON,WASHINGTON
To whom it may concern:
The undersigned hereby certify that the bidder has examined the site of the proposed work and has
read and thoroughly understand the plans, specifications and contract governing the work
embraced in this improvement, and the method by which payment will be made for said work, and
hereby propose to undertake and complete the work embraced in this improvement,or as much
thereof as can be completed with the money available, in accordance with the said plans,
specifications and contract and the schedule of prices.
(Note: Unit prices for all items, all extensions, and
total
amount of bid should be shown.Show unit prices
both in writing and in figures.)
The undersigned further certifies and agrees to the following provisions:
NON-COLLUSION AFFIDAVIT
Being duly sworn,deposes and says,that he is the identical person who submitted the foregoing
proposal or 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 other Bidder or Bidders.
AND
CERTIFICATION RE:ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER
Vendor and purchaser recognize that in actual economic practice overcharges resulting from anti-
trust violations are in fact usually borne by the purchaser.Therefore,vendor hereby assigns to
purchaser any and all claims for such over-charges as to goods and materials purchased in
connection with this order or 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
order or contract. In addition,vendor warrants and represents that such of his suppliers and
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
1 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
subcontractors shall assign any and all such claims to purchaser, subject to the aforementioned
exception.
AND
MINIMUM WAGE AFFIDAVIT FORM
I,the undersigned, having been duly sworn,deposed,say and certify that in connection with the
performance of the work of this project, I wilt 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.
I have read the above and foregoing statements and certificate, know the contents thereof and the
substance as set forth therein is true to my knowledge and belief.
FOR: PROPOSAL, NON-COLLUSION AFFIDAVIT,ASSIGNMENT OF ANTI-TRUST CLAIMS TO
PURCHASER AND MINIMUM WAGE AFFIDAVIT
o.l,cc_► ,.6vi-S ID
L Gor.I Gt/e,'-k LLc
Name of Bidder's Firm
Signature of Authorized Re resentative of Bidder*:
Printed Name: CiCv'e- �u.P-4.1.hl,I.&& Title: Guile✓
Address: /3/0r / 3 (-11) Sir- ctiitie -, i/i4
Contact Name(please print): 5;1 v e_ % cdc,//_..''wSh- /- / �/
Phone: (3 0) 499-38 Email: f e a�rd. jd.e GkrI e4r1/�K1c SS. CN"
*The above signature must be notarized using the applicable notary language found on pages
3 and 4.
If business is a CORPORATION,please complete this section:
Name of President of Corporation
Name of Secretary of Corporation
Corporation Organized under the laws of
With Main Office in State of Washington at
If business is a PARTNERSHIP or LIMITED LIABILITY COMPANY, please complete this
section:
Name: Title(Partner, Member, Manager):
J a Ke- Aauci.Kb kSt Own.ee-
S-fve 12-4.4A.4+ Krt.. Owre c
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
2 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
INDIVIDUAL FORM
STATE OF WASHINGTON )
):ss
County of
On this day of 2026,before me personally appeared
to me known to be the individual(s)described in and who executed the foregoing instrument,and
acknowledged under oath that they signed and seated the same as their free and voluntary act and
deed,for the uses and purposes therein mentioned.
GIVEN under my hand and official seal the day and year last above written.
(SEAL)
Dated:
(Signature)
(Print Name)
Notary Public in and for the State of
Commission Expires:
CORPORATION FORM
STATE OF WASHINGTON
):ss
County of
On this day of ,2026, before me personally appeared
to me known to be the (President,Secretary,Treasurer)of the
corporation that executed the foregoing instrument,and acknowledged said instrument to be the
free and voluntary act and deed of said corporation,for the uses and purposes therein mentioned,
and on oath stated that they are authorized to execute said instrument.
GIVEN under my hand and official seal the day and year last above written.
(SEAL)
Dated:
(Signature)
(Print Name)
Notary Public in and for the State of
Commission Expires:
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
3 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
PARTNERSHIP FORM
STATE OF WASHINGTON
):ss
County of
On this day of , 2026, before me personally appeared
to me known to be a General Partner of the partnership known as that
executed the foregoing instrument, and acknowledged said instrument to be the free and voluntary
act and deed of said partnership,for the uses and purposes therein mentioned, and on oath stated
that they are authorized to execute said instrument.
GIVEN under my hand and official seat the day and year last above written.
(SEAL)
Dated:
(Signature)
(Print Name)
Notary Public in and for the State of
Commission Expires:
LIMITED LIABILITY COMPANY(LLC) FORM
STATE OF WASHINGTON
):ss
County of ''/n�,^� � C,�
On this day of Vv�y , 2026, before me personally appeared ✓' e/91') Ave/e14451
to me icnown to be a Mana ing Member of the Limited Liability Company known as
, and that they executed the foregoing instrument, and
acknowledged said instrument to be the free and voluntary act and deed of said Limited Liability
Company,for the uses and purposes therein mentioned,and on oath stated that they are
authorized to execute said instrument.
GIVEN under my hand and official seal the day and year last above written.
(SEAL) c,
Dated: 544�r
,,,,
•••••�S1N�N Rq
• N
O� 'sxp.•
.g. ° oTA/i L. o ; (Signature)
AUB1.\G ,:
(Print Name)
=.,,9T� c' Notary Public in and for the State of
OF WASNW
',,,,,,,,,,,,,, •` Commission Expires: W.05/&27
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
4 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
•
Bond No. T-055
This form must be submitted with the Bid Proposal
PROPOSAL BID BOND
KNOW ALL MEN BY THESE PRESENTS,That we, [Contractor] Raudenbush Earthworks, LLC
of[address] 13180 155th Lane SE, Rainier WA,98576 as Principal,
and[Surety] Travelers Casualty and Surety Company of America
a corporation duly organized under the laws of the State of Connecticut
r
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 proposal 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 proposal for the following project,to wit:
PRV STATION 1 REHABILITATION PROJECT,CAG-26-096
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,faits to execute an Agreement with the City of Renton
in accordance with the terms of the Proposal 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 14th day of May ,2026.
Raudenbush Earthworks, LLC Travelers CasualtyCaand Surety Company of America
[Principal] [Surety] C"'/ ��
/Z L`-' By: t '"y
[Sign atyt�re of authorized official] [Signature of authorized official]
L'l,,,iieK Chris A. Fix ""�D SU
[Title] By: �-'- L 4 ,1' ,�y _ RFjy.,,�
[Attorney-in-Fact] a 00
1.
do CB&MS of WA.,INC. 1.
6 (3, -RTFORD AqOr Fes ; CONN. ' -o; ..� a
[
P �ox 681 .1`, �;�f 0 i
Bothell, WA 98041 ��''�.l�,� *v0��j' ,,s
206-361-9693 4,'O',,hiiu,,,.uu,,,°
[Telephone Number]
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
1 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
Travelers Casualty and Surety Company of America
AIM Travelers Casualty and Surety Company
TRAVELERS J 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 CHRIS A FIX of
BOTHELL , 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. ce
rIrr 6J',TY.40 J (IN P 4m
a
Q.,14,9 -.1„ —
? t tr. ,
,ate
of , ,v 4
State of Connecticut 4151(‘'
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. j', ii�E �
NO TRAY
My Commission expires the 30th day of June,2026 • ' " aY-4 rue is = 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 Compan e$,,,w 1ttIPfgrn,ins in full force and effect.
May �°SW�r
Dated this /� day of /�1�-�/ ,aQ a(Q . ��� C'�
I I J ' •ems,, �
°"�—� •°��L� `''A* = ; HARTFORD, �z
9
s T j _ ; CONN. ; -c
wr+T+ a W ca+". /o $tx #j' z d
ay � A �y1f , , oLE
. Hughes,Assi tant Secretary
To verify the authenticity of this Power of ;please call us at 1-800-421-3880.
P/ease refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached.
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
This form must be submitted with the Bid Proposal
CERTIFICATE OF REGISTRATION
DEPARTMENT OF LABOR & INDUSTRIES
INFORMATION FORM
PRV STATION 1 REHABILITATION PROJECT
CAG-26-096
WTR-27-4321
Name on Registration: �Qu 4#i 6Lt Sh GGti AWOv�S LLCM
Registration Number: R4c1OEEL78 alr
Expiration Date: 5/2 /ZoZ8
Note:A copy of the certificate will be requested as part of contract execution when
project is awarded.
7 PROPOSAL AND COMBINED AFFIDAVIT&CERT.FORM:NON-COLLUSION,ANTI-TRUST CLAIMS,MINIMUM WAGE
1 PRV STATION 1
APRIL 2026 REHABIUTATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
Show price per unit in figures only. Figures written to the right of the decimal in the price per unit
column shalt be interpreted as cents.
See Section 1-09.14 of the Special Provisions for information on Bid Items.
ITEM # ITEM DESCRIPTION UNIT QTY UNITTOTAL
PRICE
Mobilization and Demobilization
1 (Maximum bid 10%of Total Bid) LS 1 Lit/0W L{(� 000.
2 Construction Surveying,Staking,&As- LS 1
Built Drawings 7�god. 7 900.
3 Clearing and Grubbing LS 1 ZOrGi2O. ZO,Orb.49-
4 Removal and Replacement of TON 10
Unsuitable Foundation Material �S°� gs�'
5 Remove and Replace Concrete Curb LF 20 z.5V °� ci Otto, 49'
and Gutter
6 Remove and Replace Concrete SY 11 cqS o S99S"°—
Sidewalk
7 Abandon Existing Water Main LS 1 4/,$bi0,2412 N,400. `'0
Decommission and Abandon Existing °p
8 PRV 1 Station LS 1 4000.�° /0,000.
9 Concrete for Thrust Blocking and Dead CY 10
Man Anchors 350.°•— 3,500.°=
Quarry Spalls for Extension of Ditch TON 20
Line ISO. " °-3,0°0.
10
11 Connect to Existing Water Main EA 5 6,SOO. °-e- 32, S&D.
12 12"x10"Tapping Tee and Valve
Assembly EA 1 i 7s(,b ISSQO,
13 Fire Hydrant Complete Assembly EA 1 SOO.42 !/,COO. de-
Pressure Reducing Vatve(PRV 1)
Station 8"x 3" LS 1 /5'$,0Qo.e/S$"OOD.e
DI Pipe for Water Main,8-tn. Diam.
15 Class 52,Restrained Joint-Fittings with LF 80 07 °a
Polywrap
DI Pipe for Water Main, 10-In. Diem.
16 Class 52,Restrained Joint-Fittings with LF 110 385. e° LZ,350.aQ
Polywrap
17 8"Gate Valve Assembly EA 3 3,50o.° . d 0,S00.�°
18 10"Gate Valve Assembly EA 2 5000. lO,o00.
19 Extra DI Fittings LBS 1,000 y y t o. g2
20 Crushed Surfacing Top Course TON 31 90.°L Z,7q0,°=
21 Gravel Borrow for Trench Backfill TON 72 SO, cV 3,boo.es
22 HMA CL 1/2-Inch PG 58H-22 for Final TON 60 L$b /S'QOp°°
Trench Patch
23 g '-
1/2-Inch PG 58H-22 for TON 62 do verlay W90 Zy,:00 `—
10 SCHEDULE OF PRICES
1 PRV STATION 1
APRIL 2026 REHABIUTATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
ITEM # ITEM DESCRIPTION UNIT QTY UNIT TOTAL
PRICE
24 Erosion and Sedimentation Control LS 1 6 5-v0. 02 4 Soo. °"
25 Traffic Control LS 1 /45OO.‘: - /61 .`'2'
26 Trench Safety Systems LS 1 f7o00.OO 5;e07,o0
27 Site Specific Utility Potholing EA 5 750. •—" 3,750.
28 Pavement Marking Restoration LS 1 75a,. v- 7,silo.
29 General Restoration&Cleanup LS 1 3,SOO.°R 3,SoO.el?
30 Minor Changes FA 1 $25,000 $25,000
SUBTOTAL 5 91(135.°
WASHINGTON SALES TAX: 10.5% 51,,S'o. 4
TOTAL BID 513,g75 67
10 SCHEDULE OF PRICES
PROPOSAL&AFFIDAVIT CERTIFICATE 2 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
This form must be submitted with the Bid Proposal
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA
PRV STATION 1 REHABILITATION PROJECT
CAG-26-096
WTR-27-4321
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA
NO. DATE:
NO. DATE:
NO. DATE:
NO. DATE:
NO. DATE:
—
SIGNED: o
TITLE: Owner.
NAME OF COMPANY: €R-etflGfi t 4l4S-4 E 6htvDr'ks
ADDRESS: /310& /5-5. -4-" �/ SC
CITY/STATE/ZIP: riZ4i r i e- , w, [ 8s 7L
TELEPHONE: (364 qqq— 3 o 10
11 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA
PROPOSAL&AFFIDAVIT CERTIFICATE 1 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON
G\1 Y O��t +
This form must be submitted with the Bid Proposal �F N T o`.
CERTIFICATION OF COMPLIANCE WITH
WAGE PAYMENT STATUTES FORM
This form must be submitted with the Bid Proposal.
The bidder hereby certifies that,within the three-year period immediately preceding the bid
solicitation date,the bidder is not a "willful"violator, as defined in RCW 49.48.082,of any provision
of Chapters 49.46,49.48,or 49.52 RCW, as 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.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
A Mien tcb Lurb`works CCC-
Bidder's Business Name •
Signature of Authorized Official*
its
7 ,e_
Printed Name
(9�vr er
Title
6,7/8/zpZ 4. el i Q.tr Gt/4
Date City State
Check One:
Sole Proprietorship Partnership I vl Joint Venture n Corporation n
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.
12 CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES TEMPLATE UPDATED 2-12-19
1 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
CITY OF RENTON SUBMITTAL FORMS:SUBMITTED WITH BID
This form must be submitted with the Bid Proposal
SUBCONTRACTOR LIST
PRV Station 1 Rehabilitation Project
CAG-26-096
WTR-27-4321
In accordance with RCW 39.30-060 as amended:
For all public works contracts exceeding$1,000,000 the bidder shall submit with the bid the names
of the licensed subcontractors and proof of license by providing subcontractors license number
with whom the bidder, if awarded the contract,will subcontract for the following work or to name
itself for the work, if it is licensed to perform the work for which it has named itself.:
• All structural steel installation, rebar installation, heating,ventilation and air conditioning,
and plumbing work as described in chapter 18.106 RCW, and electrical work as described
in chapter 19.28 RCW(this also includes the control system integrator subcontractor as
well as other electrical subcontractors)shall be submitted as part of the bid.
If the work does not apply to this contract,check the box"Not Applicable". If the work will be self-
performed by the bidder, check the box"Self-Performed".
If the subcontractors'names are not submitted with the bid OR if two or more subcontractors
are named to perform the same work,the bid shall be considered nonresponsive and,
therefore,void.
If subcontractors vary with bid alternates, please complete a separate form indicating which
subcontractors will be used for which bid alternate.
Complete the following: ��
If awarded the contract, aueizavSL t *#✓ iVvrkS will contract with the
following subcontractors for the performance of heating,ventilation and air conditioning,
plumbing,electrical(including automatic controls)work,structural steel installation, and
rebar installation:
The following list of subcontracts is due with the bid. Errors identified by the contracting agency
in the proof of license information must be corrected by the bidder within 48 hours of bid
submission.
13 SUBCONTRACTORS LIST APPROVED CLB 4-2-26
1 PRV STATION 1
APRIL 2026 REHABILITATION PROJECT
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
SUBCONTRACTOR LIST
To Be Submitted with the Bid Proposal
In accordance with RCW 39.30-060 as amended:
For all public works contracts exceeding$1,000,000 the bidder shall submit with the bid the names of the
licensed subcontractors and proof of license by providing subcontractors license number with whom the
bidder, if awarded the contract,will subcontract for the following work or to name itself for the work, if it is
licensed to perform the work for which it has named itself.
• All structural steel installation, rebar installation, heating, ventilation and air conditioning, and
plumbing work as described in chapter 18.106 RCW,and electrical work as described in chapter 19.28
RCW (this also includes the control system integrator subcontractor as well as other electrical
subcontractors)shall be submitted as part of the bid.
If the work does not apply to this contract, check the box "Not Applicable". If the work will be self-
performed by the bidder, check the box"Self-Performed".
If the subcontractors' names are not submitted with the bid OR if two or more subcontractors are
named to perform the same work,the bid shall be considered nonresponsive and,therefore,void.
If subcontractors vary with bid alternates, please complete a separate form indicating which
subcontractors will be used for which bid alternate.
Complete the following: / [ /
If awarded the contract, /�A.444�7/n�S �o/l�s will contract with the following
subcontractors for the performance of heating,ventilation and air conditioning, plumbing,
electrical(including automatic controls)work,structural steel installation,and rebar installation:
The following list of subcontracts is due with the bid. Errors identified by the contracting agency in the
proof of license information must be corrected by the bidder within 48 hours of bid submission.
Category of Work Heating,Ventilation&Air Conditioning(HVAC) Not Applicable Et
Subcontractors Name Self-Performed 0
Address
Subcontractor's WA License
Phone No. No.
Bid Item Numbers
Description of Work
Approved CLB 4-2-26
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
SUBCONTRACTOR LIST
To Be Submitted with the Bid Proposal
Category of Work Plumbing(per RCW 18.106) Not Applicable ,r
Subcontractors Name Self-Performed 0
Address
Phone No. Subcontractor's WA License
No.
Bid Item Numbers
Description of Work
Category of Work Electrical(per RCW 19.28) Not Applicable 5
Subcontractors Name Self-Performed 0
Address
Phone No. Subcontractor's WA License
No.
Bid Item Numbers
Description of Work
Category of Work Structural Steel Not Applicable .&f
Subcontractors Name Self-Performed 0
Address
Subcontractor's WA License
Phone No. No.
Bid Item Numbers
Description of Work
Category of Work Rebar Installation Not Applicable 0
Subcontractors Name 1 ?t. 1.tn.4i-, Ei.r4LworKS (..L . Self-Performed '
Address (3i0t l5'S'r -&) S& Pawlr e- we a8S?6
360 Subcontractor's WA License
Phone No. 919-3810 No./ FVDE5L.7$`J
Bid Item Numbers
Description of Work (Reipor , . .o l lo.r&
2 Approved CLB 4-2-26
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal