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PK10-082 - Original - Clements Brothers, Inc. - Turnkey Park Improvements - 03/29/2010
ecords M _ -_� eme KEN T a� WA DocumentNIF � - CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Clements Bros. Inc Vendor Number: 69572 ID Edwards Number Contract Number: Pk(a- 08A This is assigned by City Clerk's Office Project Name: Turnkey Park Improvements Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 3/29/10 Termination Date: 10/1/2010 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Bran Levenhagen Department: Parks Detail: (i.e. address, location, parcel number, tax id, etc.): CM3/16/10 S Pubhc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 l sr CONTRACT THIS AGREEMENT, made in triplicate, is entered into between the CITY OF KENT, a Washington municipal corporation ("City"), and Clements Bros. Inc., organized under the laws of the State of Washington, located and doing business at PO Box 7964, Bonney Lake, WA 98391 ("Contractor"). WITNESS: In consideration of the terms and conditions contained herein and attached and made a part of this Agreement, the parties agree as follows: 1. The Contractor shall do all work and furnish all tools, materials, and equipment for: Turnkey Park Improvements in accordance with and as described in the Contract Documents and shall perform any alterations in or additions to the work provided under the Contract Documents and every part thereof. The Contract Documents shall include all project specifications, provisions, and plans; the City's general and special conditions; the 2006 Standard Specifications for Road, Bridge, and Municipal Construction, as prepared by the Washington State Department of Transportation and the Washington State Chapter of the American Public Works Association, including all published amendments issued by those organizations, if applicable ("Standard Specifications"); the City's bid documents; and the Contractor's response to the City's bid. Unless otherwise directed by the City, work shall start within ten (10) days after the City issues its Notice to Proceed and be completed within 180 calendar days. The Contractor shall provide and bear all expense of all equipment, work, and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in the Contract Documents and every part thereof, except as mentioned in the specifications to be furnished by the City. 2. The City hereby promises and agrees with the Contractor to employ, and does employ, the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the Contract Documents and the terms and conditions herein contained and hereby contracts to pay for the same according to the Contract Documents and the schedule of unit or itemized prices provided by Contractor in its response to the City's bid, at the time and in the manner and upon the conditions provided for in the Contract Documents. 3. The Contractor for itself, and for its heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all covenants herein contained upon the part of the Contractor. 4. It is further provided that no liability shall attach to the City by reason of entering into this contract, except as expressly provided herein. 5. Contractor shall defend, indemnify, and hold the City, its officers, officials, employees, agents, volunteers and assigns harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this contract, except for injuries and damages caused by the sole negligence of the City. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this contract is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this contract. 6. Contractor agrees, upon the City's written demand, to make all books and records available to the City for inspection, review, photocopying, and audit in the event of a contract related dispute, claim, modification, or other contract related action at reasonable times (not to exceed three (3) business days) and at places designated by the City. 7. The Contractor shall procure and maintain, during the term of construction and throughout the specified term of maintenance, insurance of the types and in the amounts described in Exhibit A attached and incorporated by this reference. 8. Contractor is responsible for locating any underground utilities affected by the work and is deemed to be an excavator for purposes of RCW L Ch. 19.122, as amended. Contractor shall be responsible for compliance with RCW Ch. 19.122, including utilization of the "one call" locator service before commencing any excavation activities. 9. Contractor shall fully cover any and all loads of loose construction materials, including but not limited to sand, dirt, gravel, asphalt, excavated materials, construction debris, etc, to protect said materials from air exposure and to minimize emission of airborne particles to the ambient air environment within the City. IN WITNESS WHEREOF the parties hereto have caused this agreement to be executed the day and year first hereinabove written. CITY OF KENT BY: U ETT COOKE, MAYOR DA 2g—i a ATTEST: --X�,e-e6 Q�� BRENDA JACOBER, CP CLERK IPR E AS TO FORM: LA DEPARTMENT RA OR BY: PRINT NAME: ,I►. YE ;rs TITLE: I" u"�► DATE: WITNESS, if INDIVIDUAL OR PARTNERSHIP: STATE OF WASHINGTON) ) ss COUNTY OF KING ) M On this day of 2010, before me personally appeared and to me known to be and of the corporation/individual that executed the within and foregoing instrument, and acknowledged said Instrument to be free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that they were authorized to execute said Instrument and that the seal affixed is the corporate seal of said corporation. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written. NOTARY PUBLIC, in and for the State of Washington, residing at My appointment expires Notary Public State of Washington SHANE E SMITH My Appointment Expires Dec 3,2013 CONTRACTOR'S COMPLIANCE STATEMENT (President's Executive Order #11246) Date: :V,//0 This statement relates to a proposed contract with the City of Kent named Turnkey Park Improvements. I am the undersigned bidder or prospective contractor. I represent that I (please circle one response) aye or have not, participated in a previous contract or subcontract subject to the President's Executive Order #11246 (regarding equal employment opportunity) or a preceding similar Executive Order. BIDDER: u��5 Corwa4 Name By: dff4ewz� Contractor or ontra r s Representative Signature Its: DATE: 9 ILIv ADD ES`S: �x 7,7&y �N 9�3-LI l For information about your previous contracts or subcontracts, consult httg://envirotext.eh.doe.gov/data/eos/Johnson/196509.24.html. BID PROPOSAL To The City Clerk City Hall 220 Fourth Avenue South Kent, Washington 98032 The undersigned hereby certifies that has personally examined the job site and construction details of the work as outlined on the Plans and described in the Contract Documents for Turnkey Park Improvements for the City of Kent, Washington, and has read and thoroughly understands the Plans and Contract Documents, specifically including all specifications, governing the work in this project and the method by which payment will be made for said work and hereby proposes to undertake and complete the work embraced in this improvement in accordance with said Plans and all Contract Documents and at the following schedule of rates and prices: NOTE TO BIDDERS: (1) , Unit prices for all items, all extensions and total amount of bid must be shown. Show unit prices in both words and figures and, where conflict occurs, the written or typed words shall prevail. * It is the intention of the City to award the entire contract to one contractor. (2) Washington State Department of Revenue Special Rule 170, and its related rules, applies to this contract. Under these rules, the City will automatically add retail sales tax to each payment made to the Contractor. Accordingly, the Contractor should not include retail sales tax in the Unit Bid Item (s) or Lump Sum Prices, subject to certain limited exceptions. See WSDOT Standard Specifications, Section 1-07.2. e , A. BASE BID:TURNKEY PARK IMPROVEMENTS I. BASE BID (A) — PERVIOUS ASPHALT: 00 $ 177, y7/ (fig res) dollars) (Writt n in dollars) With 5,500 square feet of pervious asphalt. Base bid amount should include all overhead, labor, materials, and equipment necessary to complete the work. Work noted as "not in contract" abbreviated N.I.C. is not included in Base Bid. 11. BASE BID (B) — REGULAR ASPHALT: oa Owe A&Aa (Written in dollars) With 5,500 square feet of regular asphalt. Base bid amount should include all overhead, labor, materials, and equipment necessary to complete the work Work noted as "not in contract' abbreviated N.I.C. is not included in Base Bid. Ill. TRENCH EXCAVATION SAFETY PROVISIONS (LUMP SUM) If the contract contains any work which requires trenching exceeding a depth of four (4) feet, all costs for adequate trench safety systems shall be identified as a separate bid item in compliance with Chapter 39.04 RCW. The purpose of this provision is to ensure that the bidder agrees to comply with all the relevant trench safety requirements of Chapter 49.17 RCW. If trench excavation safety provisions do not pertain to this project, put N/A for dollar amount. Failure to complete this requirement shall be considered as non-responsive to the bid solicitation. 1. Trench Excavation Safety Provisions Lump Sum $ ' Z.I-KO (dollars) IV. PROJECT TOTALS (2) — DO NOT INCLUDE SALES TAX TOTAL LUMP SUM BID, ITEMS I and III TOTAL LUMP SUM BID, ITEMS 11 AND III Qcd Lump Sum $ IV7Z ew Lump Sum ; 17Z.5 45 OIvP—' Y*WbX" NMut 7libtWs 10A1t riw�All 7wc. us e (dollars) F(AE ' t I %VF—Wllars) (Written in dollars) (Written in dollar ) B. UNIT PRICE BIDS ce, 1. Import Fill PER C.Y. $ 30 — � (dollars) (The price includes all labor, materials, and equipment necessary to provide and place on site imported fill in accordance with Section 02210 of the Technical Specifications.) as 2. Export Fill PER C Y. $ -r-i tt5nn 4PLue- (dollars) (The price includes all labor, materials, and equipment necessary to excavate and remove from site unsuitable soil in accordance with Section 02210 of the Technical Specifications ) a.. 3. Topsoil PER C Y. $ (dollars) (The price includes all labor, daterials, and equipment necessary to provide and install topsoil as detailed and in accordance with Section 02820 of the Technical Specifications.) 4. Drainage Rock PER C.Y. $ 2-4� --V - %_1 N-1 1 (dollars) (The price includes all labor, ma erials, and equipment necessary to provide and install drainage rock as detailed and in accordance with Section 02510 of the Technical Specifications.) 5. Concrete PER &WS`y $ 3� t4-1 c4C-- cep"^ (dollars) (The price includes all labor, materi s, and equipment necessary to provide and install cubic yards of concrete flatwork as detailed and in accordance with Section 03300 of the Technical Specifications.) ... 6. Concrete Curb & Gutter PER L.F. $ 30-- N-, car-- (dollars) (The price includes all labor, materials, and equipment necessary to provide and install concrete curbing as detailed and in accordance with Section 03300 of the Technical Specifications.) 7. Asphalt PER SIFT $ (dollars) (The price includes all labor, materials, and equipment necessary to provide and install asphalt as detailed and in accordance with Section 02630 of the Technical Specifications.) 8. Pervious Asphalt with Gravel Base PER SIFT , $ ��- (dollars) (The price includes all labor, materials, and equipment necessary to provide and install pervious asphalt as detailed and in accordance with Section 02630 of the Technical Specifications, and the Geotechnical Report.) DO NOT INCLUDE SALES TAX The undersigned Bidder hereby verifies that these listed bid prices are true and correct in all respects. BIDDER: DATE: 3 (signature) By: Title: (print name) Company Name i Address: NCP City/State/Zip: Phone: �zs3 �sz-o373 GENERAL CONTRACTOR'S REFERENCES PROJECT NAME: TURNKEY PARK IMPROVEMENTS If you have not worked for the City of Kent in the past three years: Please provide three references for work performed similar in size and scope to the Turnkey Park Improvements Project. At least two of the references should be from a public agency. Agency Name Address, city, state, zip Phone Contact Name Name of Project Amount of Contract (approx.) and Year Agency Name 9 Y Address, city, state, zip Phone Contact Name Name of Project Amount of Contract (approx.) and Year Agency Name Address, city, state, zip Phone Contact Name Name of Project Amount of Contract (approx.) and Year Note: This form must be included with your bid. ❑ I have worked for the City of Kent in 2007, 2008, or 2009. Name of Project: GENERAL CONTRACTOR'S QUALIFICATION STATEMENT ALL BIDDERS MUST COMPLETE THIS STATEMENT AND INCLUDE WITH BID. THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES: CONSULTATION WITH AN ATTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION. The City will use information offered by the Bidder in this Statement as a significant factor in determining whether the Bidder is responsible and able to perform the contract work. The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED BY: /,;/1C,01V( i NAME: 1 ADDRESS: �' &>c cc Ai PRINCIPAL OFFICE: sgi /}t VIE_ A. Contractor Qualification Requirements This project calls for the laying of 5,500 square feet of pervious asphalt within an existing community park in Kent, Washington. In order to be qualified to bid for this project, the city shall require the following qualifications of bidders: ■ The bidder shall have experience laying pervious asphalt. 1. ORGANIZATION 1.1 How many years has your organization been in business as a Contractor? 51 t4 ce /qs-0 6 0 79-,*Zs 1.2 How many years has your organization been in business under its present business name? Zo ye,"4-- 1.2.1Under w at other or former names your organization operated? 1.3 If your orgalnization is a corporation, answer the following: 1.3.1 Date of incorporation: f yA.L 1.3.2 State of incorporation: 1.3.3 President's name: 1.3.4 Vice-president's nam (s): 1.3.5 Secretary's name: At*WP— 0r4*W&.__A7 1.3.6 Treasurer's name: 1.4 If your organization is a partnership, answer the following: 1.4.1 Date of organization: 1.4.2 Type of partnership (if applicable): 1.4.3 Name(s) of general partner(s): 1.5 If your organization is individually owned, answer the following: 1.5.1 Date of organization: 1.5.2 Name of owner: 1.6 If the form of your organization is other than those listed above, describe it and name the principals: 2. LICENSING 2.1 List jurisdictions and trade categories in which your organization is legally qualified P-�e-_oGbrf- CC" an ind ate licet--rr— Cis, iff a is ble. 2.2 List jurisdictions in which your organization's partnership or trade name is filed. 3. EXPERIENCE 3.1 List the categories of work that your organization normally performs with its own forces. `.�-ry�cfr r-, �1�r� ``'�2/C S Pit-PG. co c2.Ic. P#Z t- r-u� 3.2 Claims and Suits. (If the answer to any of the questions below is yes, please attach details.) 3.2.1 Has your organization ever failed to complete any work awarded to it? /X v 3.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your or its officers? /le'U 3.2.3 Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years? /Vv 3.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.) NO c o 3.4 On a separate sheet, list mayor construction projects your organization has in progress, giving the name of project, owner, architect or design engineer, contract amount, percent complete and scheduled completion date. cow* COlAoI41t- � T ` 9- qlflof 7001c— K �4 / , f�f_yy.4y LfI MIX Cot V ^ Y �Ytr G7 3.4.1 State total worth of work in progress and under contract: #MiC-C,cAJ 3.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect or design engineer, contract amount, date of completion and perce tage of the cost of the rk performed with your own forces. 3.5.1 State aGerage a�nual amount of construction work performed during the past five years: / ovitwoA) 3.6 On a separate sheet, list the construction experience and present commitments of the key individuals of your organization. 7/oo'� V. Cr,o,*oa*PrS , �jc�,�,�S `9` `8. f'ScE m79 J6F� 3.7 On a separate sheet, list your major equipment. j-n,% �KcA�Ft�R- 4. REFERENCES r- ��U 4.1 Trade References: iLEs S�G 0.� , '�w4.2 Bank References: ' 4.3 Surety: ► 4.3.1 Name of bonding company: Au$ L- 4.3.2 Name and address of agent: p .v pso 3a16 S. FINANCING +,�� 5.1 Financial Statement. After bid opening, the City may require the following financial information from any of the three apparent low bidders. If so required, the selected bidder(s) must respond with this financial information within 24 hours of the City's request for that information. The City's request for this information shall not be construed as an award or as an intent to award the contract. A bidder's failure or refusal to provide this information may result in rejection of that bidder's bid. 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income' statement showing the following items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses); Net Fixed Assets; Other Assets; Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: 5.1.3Is the attached financial statement for the identical organization named on page one, Section one? 5.1.4If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent- subsidiary). 5.2 Will the organization whose financial statement is attached act as guarantor of the contract for construction? Y� 6. SIGNATURE D 6.1 Dated at this day of 41r,-Y-Cl , 2010. Name of Organization: LE --7-ti1C By: Title: /► 6.2 /�rK NA (-G>F 75 being duly sworn, deposes and says that the information provided herein is true and sufficiently complete so as not to be misleading. Subscribed and sworn before me this � day of , 2010. Notary Public: My Commission Expires: Zu 06*6twow vim" h1�1NC MAJOR SUBCONTRACTOR LIST List each subcontractor, as indicated below, that shall perform subcontract work on the project in compliance with RCW 39.30.060., Bids on public works—When Subcontractors must be identified. This form must be submitted to the Owner within one (1) hour of the bid opening for the three apparent low bidders. Failure of the bidder to submit as part of the bid the names of such subcontractors or to name itself to perform such work or the naming of two or more subcontractors to perform the same work shall render the bidder's bid non-responsive and, therefore, void. PROJECT NAME: TURNKEY PARK IMPROVEMENTS CONTRACTOR'S SIGNATURE Subcontractor Name U W Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers GREATER THAN 3% SUBCONTRACTOR LIST (Due within five working days after Bid Opening) List each subcontractor, from any tier of subcontractors, that shall perform any subcontract work amounting to greater than 30/c of the total bid contract price. Subcontractors listed on the Major Subcontractor list may be omitted from this form. Least each bid item to be performed by each designated subcontractor in numerical sequence. If no subcontractors will be performing the specified percentage of the work, indicated this by writing "None" and signing this form. This document must be completed by the three apparent low bidders and submitted to the Owner within five (5) working days after bid opening; the City will reject all late submissions of this form. Your failure to name these subcontractors or yourself shall render your bid non-responsive and void. If additional space is required, copies of this form or similar type forms are acceptable. PROJECT NAME: TURNKEY PARK IMPROVEMENTS CONTRACTOR'S SIGNATURE . Subcontractor Name V6AT AX/NCB Item Numbers All 'P19y/Ar& Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Bond # 10-02298—BID BID BOND FORM Herewith find deposited to the City of Kent in the form of a cashiers check, cash, or bid bond in the amount of $ an amount equal to five percent of the total bid. BID BOND KNOW ALL PERSONS BY THESE PRESENTS: That we Clements Brothers Inc. , as Principal, and First Sealord surety, Inc. , as Surety, are held and firmly bound unto the CITY OF KENT, as Obligee, in the penal sum of Five Percent (s%) of Total Amount Bid Dollars, for the payment of which the Principal and the Surety bond themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, by these presents. The condition of this obligation is such that if the Obligee shall make any award to the Principal for Turnkey Park Improvements. According to the terms of the proposal or bid made by the Principal, and the Principal shall duly make and enter into a contract with the Obligee in accordance with the terms of said proposal or bid and award and shall give bond for the faithful performance thereof, with Surety or Sureties approved by the Obligee; or if the Principal shall in case of failure so to do, pay and forfeit to the Obligee the penal amount of the deposit specified in the call for bids, then this obligation shall be null and void; otherwise it shall be and remain In full force and effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated damages, the amount of this bond. SIGNED, SEALED AND DATED THIS 9th DAY OF march , 2010. PRINCIPAL: Cl m f is Brothers, Inc. by its,- SURETY; Filyst Sealord S {efy, nc. by _ //l( � 0 its: Theresa A. Lamb Attorney-in-Fact 1 " ' First Sealord Surety, Inc. Power No. PAC-0726-09-19169 Power of Attorney KNOW ALL MEN BY THESE PRESENTS,That First Sealord Surety Inc,a corporation QUIlhe 06mmonwealt1h';'pf Pennsylvania,(herettttfter the "Company")has made,constituted and appointed,and by these presents does make,congt'itute and appoint Andy D.Prdl,Jim W Doyle,Steve Wagner,Julie M Glover,Darlene Jakielski,Jim S Kutch and/or Theresa A.Lamb all of Bothell,Washington its true and lawful Attorney-in-Fact,to make,execute and deliver on its behalf insurance policies,surety bonds,undertakings and other instruments of a similar nature as follows Not To Exceed Five Million Dollars--------------------»---($5,000,000 00) Such insurance policies,surety bonds, undertakings and instruments for said purposes,when duly executed by the aforesaid Attorney-in-Fact,shall be binding upon the said Corporation as fully and to the same extent as if signed by the duly authorized officers of the Corporation and sealed with its corporate seal,and all the acts of said Attorney-in-Fact,pursuant to the authority hereby given, are hereby ratified and confirmed This appointment is made pursuant to the following By-Laws which were duly adopted by the Board of Directors of the said Corporation on April 7,2003 with all Amendments thereto and are still in full force and effect "Article XII Policies, Bonds, Recognitions,Stipulations, Consents of Surety,Underwriting Undertakings,and Instruments Relating Thereto Section 12-1.Insurance policies,bonds,recognitions,stipulations,consents of surety and underwriting undertakings of the Corporation,and releases, agreements and other writings relating in any way thereto or to any claim or loss thereunder,shall be signed in the name and on behalf of the Corporation a)by the Chairman of the Board,the President or a Vice President, and by the Secretary or an Assistant Secretary,or b)by ail Attorney- in-Fact for the Corporation appointed and authorized by the Chairman of the Board the President,or a Vice President to make such signature, or c)by such attheroffurs or representatives as the Board may from time to time determine The seal of the Corporation shall if appropriate be affixed thereto by any such officer,Attorney-in-Fact or representative The authority of such Attorney-in-Fact and Agents shall be as prescribed in the instrument evidencing their appointment Any such appointment and all authority granted thereby may be revoked at any time by the Board of Directors or by any person empowered to make such appointment" IN WITNESS WHEREOF,First Sealord Surety, Inc has caused these presents to be duly signed and its corporate seal to be hereunto affixed and duly attested this 20th day of January,2004 ^�toys First Sealord Surety,Inc (Seal) Attest By y i~1 of u Gary L Bragg,Secretary Joel D Cooperman,Vice President Commonwealth of Pennsylvania j County of Montgomery On this 20th dayof January,20 4 r ry, 0 ,before me personally appeared Joel D Cooperman,Vice President of First Sealord Surety Inc,with whom I am personally acquainted,who, being by me duly sworn, said that he resides in the Commonwealth of Pennsylvania,that he is Vice President of First Sealord Surety, Inc,the corporation described in and which executed the foregoing instrument,that he knows the corporate seal of the said Corporation, that the seal affixed to said instrument is such corporate seal,that it was so affixed by order of the Board of Directors of said Corporation, and that he signed his name thereto as Vice President of said Corporation by like authority COMWNwEALTH OFPENNSYLVANIA T. NOtiYI20 S" s• ° f4 9> ,��'(��f�� / Aritt"T.Stewart,Notary Riblic (Seal) Notary Public Low MedonT'wp.,MordW"County My C.pmmiasm154*ee Aug.5,21110 6 .b�yLyP <�P c?;• CERTIFICATE Mem bar,PennsylvaruaAssodatonofNotarlm I,the under!i'ig led Secretary of First Sealord Surety, Inc do hereby certify that the original Power of Attorney of which the foregoing is a full,true and correct copy, is in full force and effect on the date of this Certificate and I do forther certify that the Off cer who eyecu'ed the said Power or Attorney was one of the Officers authorized by the Board of Directors to appoint an Attorney-in-Fact as provided in Section 12-1 of the By-Laws of First Sealord Surety, Inc This Certificate may be signed and sealed by facsimile under and by authority of the following provisions of the By-Laws of First Sealord Surety, Inc "Section 12-2 The use of a printed facsimile of the corporate seal of the Corporation and of the signature of the Secretary or an Assistant Secretary on any certification of the correctness of a copy of an instrument executed by an authorized person pursuant to Article XII,Section 12-1 of the By-Laws appointing and authorizing an Attorney-in-Fact to sign in the name and on behalf of the Corporation surety bonds, underwriting undertakings, or other instruments described in said Section 12-1 with like effect asif such-seal and such signature had been manually affixed and made" In Witness Whereof, I whave hereunto set my hand and affixed the corporate seal of the Corporation to these presents this 71' day of i h arcti ,20fM This power of attorney is void unless the Bond number is inserted in this paragraph(insert so-id 4 QL� the bond number is the same number as on the original bond, d the bond number has been insF,rtc,'by a^ot'i r or e,rink,yee of the Company or by the agent (seal) _ Ga L Brag?,5ecretary it rust Sealord Surer% PO N dui, 0 d 01/20/20041 City of Kent Combined Affidavit & Certification Form: Non Collusion, Anti-Trust, Minimum Wage (Non Federal Aid) and Certification of Lawful Employment NON-COLLUSION AFFIDAVIT Being first duly sworn, the undersigned deposes and says, that they are 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/herself 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 overcharges 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 each of her/his suppliers and 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, depose, say and certify that in connection with the performance of the work of this project, I will pay each classification of laborer, worker, 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 wage as specified in the principal contract; that I have read the above and foregoing statement and certificate, and that I know the contents thereof and the substance as set forth therein is true to my knowledge and belief. AND CERTIFICATION OF LAWFUL EMPLOYMENT The Contractor hereby certifies that he/she has complied with all provisions of the Immigration and Nationality Act, now or as hereafter amended, 8 USC Section 1101 et. seq., and that all employees, including subcontractor employees, are lawfully permitted to perform work in the United States as provided in this agreement with the City of Kent. FOR: NON COLLUSION AFFIDAVIT, ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER, MINIMUM WAGE AFFIDAVIT AND CERTIFICATION OF LAWFUL EMPLOYMENT NAME OF PROJECT TURNKEY PARK IMPROVEMENTS NAME OF BIDDER'S FIRM 1 r SIGNATURE OF MTH 'RERESENTATIVE OF BIDDER (Notarization Required) [CORPORATE/PARTNERSHIP ACKNOWLEDGMENT] STATE OF WASHINGTON) ) ss. COUNTY OF K I N G ) I certify that _I know or have satisfactory evidence that is the person who appeared before me, and said person acknowledged that he/she signed this instrument, on oath stated that he/she was auth zed to execute the instrument, and acknowledged it as the ; • of the Partnership/Corporation to be the free and voluntary act of such Partnership/Corporation for the uses and purposes mentioned in the instrument. DATED: NOTARY PUBLIC in and for the State of Washington, residing at SVM)Uf'f' I VJA- My commission expires J)4,A) 2`IT 0L 3 �l Co w MIr AgPQYrhnAnt lft 29,201 T SIGNATURE OF AUTHO IZED R ENTATIVE OF BIDDER (Notarization Required) (INDIVIDUAL ACKNOWLEDGMENT] STATE OF WASHINGTON) ) ss. COUNTY OFKING ) I certify that _ I know or have satisfactory evidence that is the person who appeared before me, and said person acknowledged that he/she signed this instrument, on oath stated that he/she was authorized to execute the instrument, and acknowledged it to be his/her free and voluntary act for the uses and purposes mentioned in the instrument. DATED: 3(612ola NOTARY PUBLIC 1n and for the State of Washington, residing at SOMA-, '�'A My commission expires T*tj FWft OW LIE*+w 1 i DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such, all contractors, subcontractors and suppliers who perform work with relation to this contract shall comply with the regulations of the City's Equal Employment Opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific contract to adhere to. An affirmative response is required on all of the following questions for this contract to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlined, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the contract. The questions are as follows: 1. I have read the attached City of Kent Administrative Policy Number 1.2. 2. During the time of this contract I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of any sensory, mental or physical disability. 3. During the time of this contract I, the prime contractor, will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the contract I, the prime contractor, will actively consider the hiring and promoting of women and minorities. S. Before acceptance of this contract I, the prime contractor, will sign an adherence statement that the requirements as heretofore outlined were complied with. By signing below, I agree to fulfill the five requirements referenced above. Dated this day of N/I 7rz-14" 2010. By: Company: S �� Title: .3 • CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. CITY OF KENT CERTIFICATION OF NONSEGREGATED FACILITIES The undersigned certifies that s/he does not maintain or provide for her/his employees any segregated facilities at any of her/his establishments, and that s/he does not permit her/his employees to perform their services at any locations under her/his control where segregated facilities are maintained. The undersigned certifies further that s/he will not maintain or provide for her/his employees to perform their services at any location under her/his control where segregated facilities are maintained. The undersigned agrees that a breach of this certification will be in violation of the Equal Opportunity Clause set forth in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation and housing facilities provided for employees which are segregated by explicit directive, or are in fact segregated on the basis or race, color, religion, or national origin, because of habit, local custom, or otherwise. The undersigned agrees that except where s/he has obtained identical certifications from subcontractors prior to the award of subcontracts exceeding $101000, which are not exempt from the provisions of the Equal Opportunity Clause, that s/he will obtain identical certifications from subcontractors and that s/he will retain such certifications in her/his files. Signature: 177 Title: r?, It { Company: ey� 75 Address: 1�'�� gd X 794? City/State/Zip jr/N LC 3�� Date: �� G PROPOSAL SIGNATURE PAGE The undersigned bidder hereby proposes and agrees to start construction work on the Contract, if awarded to him or her, on or before ten (10) calendar days from the date of issuance of the Notice to Proceed, and further agrees to complete the Contract within approximately six months (180 days) days after issuance of the City's Notice to Proceed. No bidder may withdraw her/his bid for a period of sixty 60 days after the day of bid opening. The required bid security consisting of cash, bid bond, or cashier's check in an amount equal to 5% of the total amount is included. Notice of acceptance of this bid or request for additional information shall be addressed to the undersigned at the address stated below. Receipt of Addendum No.'s to the plans and/or specifications is hereby acknowledged. By signing this proposal Signature Page, the undersigned bidder agrees to be bound by all terms, requirements and representations listed in the bid documents whether set forth by the City or by the Bidder. NAME OF BIDDER: o str , tion Company Signature: Date: U Printed Name; ��+�► J l AfG&4 � Title: Address: �� L�dX 7/ C r a�tJ C b 3 5 Phone: ( Z531 �Z D 373 EXHIBIT s INSURANCE REQUIREMENTS FOR CONSTRUCTION PROJECTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Contactor's Commercial General Liability insurance policy with respect to the work performed for the City. 3. Excess Liability insurance covering both the Commercial General Liability and Automobile policies. 4. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products- completed operations aggregate limit. 3. Excess Liability insurance shall be written with limits no less than $1,000,000 per occurrence in excess of both the CGL and Auto Liability policies cited above. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Contractor's Insurance For Other Losses The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Contractor's employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. E. Waiver of Subrogation The Contractor and the City waive all rights against each other any of their Subcontractors, Sub-subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. G. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the Automobile Liability and Commercial General Liability insurance of the Contractor before commencement of the work. H. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. A ORD CERTIFICATE OF LIABILITY INSURANCE C E sl =DATOE /22/10CLEME-2 22 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hub International Northwest HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 3018 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Bothell WA 98041-3018 Phone. 425-489-4500 Fax:425-489-4501 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Alaska National Insurance Co INSURER B Clements Brothers Inc INSURER C PO BOX 7 964 INSURER D Bonney Lake WA 98390 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS 7GEN TYPE OF INSURANCE POLICY NUMBER DATEYM / DlYY EFFECTIVE I POLICY MDlYY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 X COMMERCIAL GENERAL LIABILITY 09HPS32159 08/29/09 08/29/10 PREMISES(Ea occurence $)�50000 CLAIMS MADE j] OCCUR MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $ 1000000 X Per Pro?/Per Loc GENERAL AGGREGATE $2000000 'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2000000 17 POLICY X ECT 7 LOC Emp Ben. 1000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A X X 'ANYAUTO 09HAS32159 08/29/09 08/29/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG I $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $2000000 A X X7 OCCUR CLAIMSMADE 09HLU32159 08/29/09 08/29/10 AGGREGATE $2000000 $ DEDUCTIBLE $ X RETENTION $10000 $ WORKERS COMPENSATION AND TORY LIMITS X ER A EMPLOYERS'LIABILITY 09HPS32159 08/29/09 08/29/10 ELEACHACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (EMPLOYERS LIABILITY) EL DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under EL DISEASE-POLICY LIMIT $ 1 000 000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS IT IS AGREED THE CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. WAIVER OF SUBROGATION APPLIES. SEE ATTACHED ENDORSEMENTS. RE: TURNKEY PARK IMPROVEMENTS CERTIFICATE HOLDER CANCELLATION CIKENT1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL CITY OF KENT IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 220 4TH AVENUE SOUTH KENT WA 98032 REPRESENTATIVES AUTHORIZED REPRESENTA /y�/ / ACORD 25 (2001108) //( '�/}/(�©ACORD CORPORATION 1 Alaska National INSURANCE COMPANY ADDITIONAL INSURED (CONTRACTORS) - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Who Is An Insured (Section II) is amended to n supervisory, inspection, or engineering include as an insured any person or organization services (herein referred to as an additional insured), but only if you are required to add that person or c The insurance provided to the additional organization as an insured to this policy by a insured, referred to in paragraph 1 of this written contract that is in effect prior to the"bodily endorsement, does not cover"bodily injury"or injury', "property damage", or 'personal and property damage' caused by your negligent adven ising injury". acts and omissions in the performance of "your work" that occurs within the 'products- 2 The insurance provided to the additional insured completed operatons hazard," urless the is Lmited as follows written contract, refened to in paragraph 1 of this endorsement, contains a specific a That person or organization is only an requirement that you procure completed additional insured if, and only to the extent operations coverage or coverage within the that, the Injury or damage is caused by °products-completed o7eranons hazard" for negligent acts or omissions of you cr your the add,uona! insured However, even if subcontractor in the performance of "your coverage within the "products-completed work" to which the written contract applies operations hazard" is required by b-ie writ+en The person or organization does not qualify contract, such coverage is available to the as an additional insured with respect to injury additional insured only if the "bodily injury" or or damage caused in whole or in part by "property damage" occurs prior to the end of independent jegii-ant acts o, omissions of the time candid during which you are required such person or organization by the vvnttein contract to provide such coverage or the expiration date of the policy, b. The insurance provided to the additional whichever comes first. insured does not apply to "bodily injury", property damage or "personal and 3 If other valid and collectible insurance, wnether on advertising injury" arising out of an architect's, a primary, excess, contingent or any other basis, engineer's, o• surveyor's rende"ing of or is available to the additional insured for a loss we failure to render any professional services cover under this endorsement, then the insurance including provided by this endorsement is excess over that other insurance However,the insurance provided 1 the preparing, approving, or fading to by this endorsement will be primary to ctner prepare or approve maps, drawings, insurance on which the additional insured is a opinions, repors, surveys, change orders, named insured for`ne covered loss, if the written design or specifications, and contract, referred to in paragraph 1 of this ANIC GL 1061 03 03 All Docs Copy Page 1 of 2 . Alaska National INSUPANCE COMPANY endorsement, contains a specific requirement that this insurance be primary or primary and non- contributory In that case we will not share with that other insurance on a pro-rata or other basis, If the other insurance available to the additional insured, whether on a primary, excess, contingent or any other basis, is coverage for which it has been named as an additional insured, then the coverage provided by this endorsement is excess over that other insurance This endorsement changes the policy to which it is attached and, unless otherwise stated, is effectica on the date issued at 12 01 A M standard time at your mailing address shown in the policy The information below is required only when this endorsement is issued subsequent to cam.,`iencament of the policy, Endorsement Effectrv= Policy No Insured Endorsement No 16 Countersigned By ANIC GL 106103 08 All Docs Copy Page 2 of 2 BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of"your work" done under a written contract with that person or organization The waiver applies only to the person or organization you contracted with and then only if the contract requires you to obtain this agreement from us This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12 01 A M standard time at your mailing address shown in the policy The information below is required only when this endorsement is issued subsequent to commencement of the policy. 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( § , ! , |) {§ ( ) \ § § § Br � (/ � ■ , ! ! � ) § j . ,= ; ; ■ , , , ,! ■ ,, , l , l , ■ , , , ,, , { *! ! ] - ee@. e@@„! ■ , . ! _ , M. mMmmmrvrvmn2■ ! � ! u ........ z � , , � . 09 . L) ; 0 � § ! | / 7 § \ | /E ; !a § ■ - ` _ - § � WTEW , \ ! | ! ƒ B \ - ) E § 0 | k ) § ( § \ ( § (� \ z | | mom ( ! § §, §. , § ,¥ ° wB � | ; § ( § || | § | . | E� -§ � §]� §� �4 �4 �4 „ |, °| . § ! , § � rl � � - . � � � , l .( §§ §\ § ; B ! ■)« .w |� `_ § : °lam , .|; § ■ ■ = , GlW ; | , , 0jj � � �z | , § -` : : - ` � � � � - - � °| °- §� ° � ;Z � Z � , D � - ° , W : # ; § - _ _ : � �� , ;\E! ( / ) § )§ ; (; §) )) f \ (j §) \ ! ( § § § § § j ( \ \ § § / w / / \ Bond NO. I�r -4� ✓" L4 5-P• PAYMENT AND PERFORMANCE BOND TO CITY OF KENT KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Clements Brothers, Inc. as Principal, and First Sealord Surety, Inc. a Corporation organized and existing under the laws of the State of Washington, as a Surety Corporation, and quahf:ed 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 KENT in the penal sum of $ 196,520.75* , together with any adjustments, up or down, in the total contract price because of changes in the contract work, for the payment of which sum on demand we bind ourselves and our successors, heirs, administrators or personal representatives, as the case may be. *one Hundred Ninety-Six Thousand Five Hundred Twenty Dgllars and 75/100 obl 1 Fits igation is entered into in pursuance of the statutes of the State of Washington, and the Codes and Ordinances of the CITY OF KENT, Nevertheless, the conditions of the above obligation are such that: WHEREAS, under and pursuant to a motion, duly made, seconded and passed by the City Council of the City of Kent, King County, Washington, the Mayor of the City of Kent has let or is about to let to the above bounden Principal, a certain contract, the said contract providing for construction of Turnkey Park Improvements (which contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, 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: NOW, THEREFORE, for non-FHWA projects only, if the Principal shall faithfully perform all the provisions of said contract in the manner and within the time herein set forth, or within such extensions of time as may be granted under the said contract, and shall Day all laborers, mechanics, subcontractors and and all persons who shall supply the Principal or subcontractors with provisions and supplies for the carrying on of said work and shall indemnify and hold the CITY OF KENT harmless from any damage or expense by reason of failure of performance as specified in said contract or from defects appearing or developing in the material or workmanship provided or performed under said contract, then and to that event this obligation shall be void; but otherwise it shall be and remain in full force and effect IN WITNESS WHEREOF, the above bounden parties have executed this instrument under their separate seals. The name and corporate seal (if required by law) of each corporate party is hereto affixed and duly signed by its undersigned representatives pursuant to authority of its governing body. Clements Brothers, Inc. TWO WITNESSES: PRINCIPAL e(entinpApal's name above) 'i.r/ )4AwdAAI BY: TITLE: DATE: 3 ►o DATE: 3/ZS//c, �q, C.1te+h�rcks CORPORATE SEAL: PRINT NAME DATE: iG First Sealord Surety, Inc. 3/23 SURETY n o,. }�G3ATE SEAL: BY: .••.... Theresa A. Lamb v ; .` � . ?P,_ .> •':.� DATE: TITLE• Attorney-in-Fact r .r '�. .• ADDRESS: 1st Way South, Suite 102 ., Federal Way, WA 98003 CERTIFICATE AS TO CORPORATE SEAL I hereby certify that I am the (Assistant) Secretary of the Corporation named as Principal In the within Bond; that �tjt^t y, GLEwtE-`S Who signed the said bond on behalf of the Principal ciemnnts Rrothers. Inc, Of the said Corporation; that I know his signature thereto is genuine, and that said Bond was duly signed, sealed, and attested for and in behalf of said Corporation by authority of Its governing body. SECRETARY OR A-1;<31STANrr SECRETARY F rst Sealord Surety, Inc, Power No: MQG 0720il-03308 Power of Attorney KNOW ALL MEN BY THESE PRESENTS That First Sealord$,urety„Inc;.,a t;orporation,of the CommonWealt,I Pennsylyat(loy(00raiiIiaI l 'Company')has made,constituted and appointed,a"d,by these presents does make; constitute and appoint Washington l Andy D Prdl,Jim W Doyle,Steve Wagner,Juhe'M Glover,Darlene Jakielski,Jiro*,wish andifobof o eundertakings 1 and oft instruments of a i its true and lawful Attorney-in-Fact,to make,execute and deliver on its behalf insurance similar nature as follows ********** Not To Exceed Five Million Dollars-----------------------—----05,000,000 00) Such insurance policies,surety bonds, undertakings and instruments for said purposes,when duly executed by the aforesaid Attorney-in-Fact, shall be binding upon the said Corporation as fully and to the same extent as if signed by the duly authorized officers of the Corporation and sealed with its corporate seal, and all the acts of said Attorney-in-Fact,pursuant to the authority hereby given, are hereby ratified and confirmed This appointment is made pursuant to the following By-Laws which were duly adopted by the-Board of Directors of the said Corporation on April 7,2003 with all Amendments thereto and are still in full force and effect "Article XII Policies,Bonds, Recognitions,Stipulations,Consents of Surety,Underwriting Undertakings,and Instruments Relaturg Tbereto Sectl4n 12-1 Insurance policies, bonds'regogV itidn$$;',stioplatipns,consents of surety a'dif,underwriting undertakings of thip tW,oirporq(Mpn,and releases, agreements and other writings relating in any way thereto or to any claim or loss thereundei�,'shall be signed in the name';" '(Yd on 4���''�If pf,jh,p Corporation a)4y the Chairman of the Board,the President or a Vice President, and by the Secretary or an Assistant 8044rr'Y etary q'pj'll, � Y11e(i+"Attorney- in-Fact for the Corporation appointed and authorized by the Chairman of the Board,the President, or a Vice President to 'a'ko'Suc h"''o1�'Ih'atute, or c)by such other officers or representatives as the Board may from time to time determine The seal of the Corporation shall if appropriate be affixed thereto by any such officer,Attorney-in-Fact or representative The authority of such Attorney-in-Fact and Agents shall be as prescribed in the instrument evidencing their appointment Any such appointment and all authority granted thereby may be revoked at any time by the Board of Directors or by any person empowered to make such appointment" IN WITNESS WHEREOF,First Sealord Surety, Inc has caused these presents to be duly signed and its corporate seal to be hereunto affixed aria d ily attested this 20th day of January,2004 cam' First Sealord Surety,Inc °a= 199", (Seal)ti �mc r Attest By Gary L Bragg,Secretary Joel D Cooperman,Vice President CommonWLalth of Pennsytvahla County of Montgomery On this 20th day of January,2004, before me personally appeared Joel D Cooperman,Vice President of First Sealord Surety, Inc,with whom I am personally acquainted,who,being by me duly sworn said that he resides in the Commonwealth of Pennsylvania,that he is Vice President of First Sealord Surety, Inc,the corporation described in and which executed the foregoing instrument,that he knows the corporate seal of the said Corporation,that the seal affixed to said instrument is such corporate seal that it was so affixed by order of the Board of Directors of said Corporation, and that he sip tined his name thereto as Vice President of said Corporation by like authority COMMONWEALTH OF PENNSYLVANIA a+tst A F �4r'��j� J/ t' Baal a, y, /'���^��,= Anthony T.Stovwrl,Notary Public (Seat) �;� ,r € Notary Public Wow MW1*n7Wp,MoNgar"Couniy MyOomm isialEVIMAug 5,2010 ;Qar r�G-�•+ CERTIFICATE Member,Pannsylvarde Association of Notaries I the unders`i�'1 Secretary of First Sealord Surety,Inc do hereby certify that the original Power of Attorney of which the foregoing Is a full,true',and it correct co In full force and effect on the date of this Certificate and I do further certify that the Officer who executed the said Power of A Ry;,1+q fY one of the Offkors authorized by the Board of Directors to appoint an Attorney-in-Fact as provided in Section 12-1 of the By-Laws of First Sett,a;I;r Ord Surety,Inc This'Certificate may be signed and sealed by facsimile under and by authority of the following provisions of the By-Laws ofFirst Sealord Surety Inc "Section 12-2 The use of a printed facsimile of the corporate seal of the Corporation and of the signature of the Secretary or an Assistant Secretary on any certification of the correctness of a copy of an instrument executed by an authorized person pursuant to Article XII,Section 12-1 of the By-Laws appointing and authorizing an Attorney-in-Fact to sign in the name and on behalf of the Corporation surety bonds underwriting undertakings or other instruments described in said Section 12-1,with like effect as if such seal and such signature had been manuatljraffixed Ardl made" In Witness Whereof, I have hereunto set my hand and affixed the corporate seal of the Corporation to these presents this on.Iday of 1" (1r5 20 This,powen'of attorney,is valIless the Bond number is inserted in this paragraph{insert Bond#here r✓�, ✓" ! ),the bond number is the same number as on the original pond, d the bond number has been inser�"(1'Iby an officer or employee of the Company or by the ageni'jII�;'I;";�'j�'l�l (seal) Ga6Bragg, Secretary I ir�t_',calmd tiwo� N)ldo, (I d Dl 'I)'0041 REQUEST FOR MAYOR'S SIGNATURE /'�•' Please Fill in All Applicable Boxes KENT Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Originator: Brian Levenha en Phone (Originator): 253-856-5116 Date Sent: 3/23/10 Date Required: 3/31/10 Return Signed Document to: Tony Donati CONTRACT TERMINATION DATE: 10/1/10 VENDOR NAME: Clements Bros. Inc. DATE OF COUNCIL APPROVAL: 3/16/10 Brief Explanation of Document: The bid opening for this project was held on March 9, 2010, with seven bids received. The low bid was submitted by Clement Bros Inc. in the amount of $179,471 00, excluding Washington State Sales Tax (WSST). The Engineer's estimate is $224,788.45, excluding W SST. Requesting authorization for the Mayor to enter into an agreement with Clement Bros. Inc for the amount of $179,471.00 to complete the Turnkey Park Improvements Project. All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: II.� b� �- �,A ?� -emu s;�- - Approval of Law Dept.: �s `� ' cl P Law Dept. Comments: Date Forwaf,;jed to Ma or: �LL � I ik,�t tv1 9�t Shaded Areas To Be Completed By Administration Staff Received: r— ,,Recommendations and Comments: Disposition: L31'�_ Date Returned: C17) GF 4�4T ("T) CLE';r,