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PK16-198 - Original - Charon Drilling Inc - Contract - 4/29/16
% ce--% rds M �,A""`;'`�; t❑,. KE,N❑ WASH 1 N GT'O N „ I Document 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: Charon Drilling Inc Vendor Dumber 34610 JD Edward's Number Contract dumber: (LP'V This is assigned by City Clerk's Office Project Name: Riverbend Irrigation Well Description: ❑ Interlocal Agreement ❑ Change Order ❑' Amendment ® Contract ❑ Other: Contract Effective Date: 04/ .9/16 Termination Date: 09/30/16 Contract Renewal Notice ([lays'): 0 Cumber of days required notice for termination or renewal or amendment Contract Manager: Melanie Manning/Pete Petersen Department: Parks - Riverbend Golf Comdex. Contract Amount: $135,106.00 Approval Authority: Z Department Director ZMayor ZCity Council Detail: (i.e. address, location, parcel number, tax id, etc.): Charon Drilling Inc intends to drill an irrigation well to provide water, to the Riverbend Go'If Complex. The new well will be located near the existing well which was drilled in 1988. The drilling site is in the southwest corner of the golf complex within the fenced area north of Meeker Street and west of the Meeker Bridge crossing the Green River. �.obiristr❑-Noble will be directing this proaect. adccW10877_8_14 PARKS, RECREATION AND COMMUNITY SERVICES Jeff Watling, Director Phone: 253-856-5100 KENT xE�c�a Fax: 253-856-6050 x.s�.+o-c.. Address: 220 Fourth Avenue S. Kent, WA. 98032-5895 DATE: March 25, 2016 TO: Mayor Cooke and Kent City Council FROM: Jeff Watling, Parks, Recreation and Community Services Director RE: Riverbend Irrigation Well Project - Bid Tab The bid opening for the Riverbend Irrigation Well Project was held on Friday, March 25, 2016 with one bid received. The lowest responsible and responsive bid was submitted by Charon Drilling, Inc. in the amount of $135,106.00. The Engineer's estimate was approximately $150,000.00. The Parks, Recreation and Community Services Director recommends awarding this project to Charon Drilling, Inc. and entering into a public works agreement. Bid Summary (bids do not include WSSD O1. Charon Drilling, Inc. $135,106.00 Engineer's Estimate: approximately $150,000.00 WKENls� T Agenda Item: Bids TO: Kent City Council DATE: March 25, 2016 SUBJECT: Riverbend Irrigation Well - Award MOTION: Move to award the Riverbend Irrigation Well Project and enter into an agreement with Charon Drilling, Inc. in the amount of $135,106.00 and authorize the mayor to sign all necessary documents, subject to final terms and conditions acceptable to the city attorney and parks director. SUMMARY: This project is to drill the new irrigation well in proximity to the existing well with specific location determined by the requirements of the drilling equipment and the appropriate setbacks. The plan is to land a 12-inch well casing at a depth of 450 feet and complete a sand-packed well in a sand aquifer encountered between 400 and 450 feet in the existing well. Flowing artesian conditions may be encountered. Therefore, a flow seal must be set into the first confining layer encountered beneath the site. This is expected to result in a seal set at about 90 feet below land surface. The precise position of the flow seal will be determined in the field once the geologic conditions are known. The well will be drilled with cable- tool methods using 12-inch casing after the 16-inch flow seal casing has been cemented in place. A temporary 20-inch casing must be set to accomplish the required sealing. EXHIBITS: Bid Tab RECOMMENDED BY: Parks, Recreation and Community Services Director YEA: n/a NAY: n/a BUDGET IMPACT: No Budget Impact - Authorize expenditure from Riverbend Capital budget !0 City of Kent P ubl c Works KENT Bid Opening A'Xr010NC.70k Project: Riverbend Irrigation Well Bid O enin Project :: Date: March 25 2016 Due / Open: i P.M. Location: Council Chambers Addenda Issued. 0 Bidders Bid Amount Bid Bond Engineer's Estimate 0 The apparent low bidder is: �� � PROPOSAL To the City Clerk City Hall Kent, Washington 98032 The undersigned hereby certifies that r iQ ��� ((h Inc has examined the job site and construction details of the work outlined on the plans and described in the specifications for the project named Riverbend Irrigation Well for the City of Kent, Washington, and has read and thoroughly understands the plans and specifications and contract governing the work embraced in this improvement and the method by which payment will be made for that work and hereby proposes to undertake and complete the work embraced in this improvement in accordance with the bid and contract, and at the following schedule of rates and prices: NOTE TO BIDDERS: 1) All bid items are described in the Kent Parks Special Provisions and/or the current version of the WSDOT Technical Specifications. Reference the Section in this proposal document where the bid item is described. 2) Proposal items are numbered in sequence but are non-continuous. 3) Unit prices for all items, all extensions, and total amount of bid must be shown. 4) Should bid items with identically worded bid item descriptions appear in more than one schedule of the proposal, the bidder must bid the same unit price. The City shall use the lowest unit price submitted by the bidder for the items in question in each schedule where identical bid item description appears. Bid items with identically worded descriptions which appear in more than one schedule are denoted with an asterisk (*). 5) The Washington State Department of Revenue has issued special rules on the state sales tax. Sections 1-07.2(1) through 1-07.2(3) are meant to clarify those rules. The Contractor shall contact the Contract Payment section of the Division of Accounting and Financial Services of the Department of Transportation, Olympia, Washington, for questions regarding sales tax. The Contracting Agency will not adjust its payment if the Contractor bases a Bid on a misunderstood tax liability. The Contractor shall include all Contractor-paid taxes in the unit Bid prices or other Contract amounts. In some cases, however, state retail sales tax will not be included. Section 1-07.2(2) describes this exception. BID SUMMARY TOTAL BID AMOUNT L3 5 . /ab, Uc- The undersigned Bidder hereby verifies that these listed bid prices are true and correct in all respects. BIDDER: DATE: (signature) By: Q ut e bo&r) Title: (print name) Company Name: s Address: FoS City/State/Zip: 6Kaliom, LA Phone: CaS S! 7 5-7 c?4 GENERAL CONTRACTOR'S REFERENCES RIVERBEND IRRIGATION WELL: L6 I TInc, 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 Riverbend Irrigation Well. At least two of the references should be from a public agency. ` Agency Name Address, city, state, zip d 5 Phone I(l-0 �wt 4h Contact Name Pk6ltC+JIPU Name of Project I oo Amount of Contract (approx.) and Year c S V a-11' A IQY; I- I is-T 1C-E Agency Name SSb� (SSU � cat 5� �)mhon4jiA Address, city, state, zip Phone i A Contact Name l� : Name of Project C), wo , Amount of Contract (approx.) and Year I Agency Name 11014 q Address, city, state, zip (�)alq 570 0 Phone CQ_K�� ++od,, 9fa, • 5 700 Contact Name Name of Project .• ,L, _ �' Amount of Contract (approx.) and Year Note: This form must be included with your bid. u I have worked for the City of Kent in 2012, 2013, 2014, or 201S. Name of Project: CONTRACTOR'S QUALIFICATION STATEMENT (RCW 39.04.350) THE CITY WILL REVIEW THE CONTRACTOR'S RESPONSES TO THIS FORM TO DETERMINE WHETHER THE BIDDING CONTRACTOR IS RESPONSIBLE TO PERFORM THE CONTRACT WORK. THIS FORM REQUIRES CRITERIA ESTABLISHED BY STATE LAW AS WELL AS SUPPLEMENTAL CRITERIA ESTABLISHED BY THE CITY THAT ARE APPLICABLE TO THIS PUBLIC WORKS PROJECT. THE BIDDER SHOULD READ AND RESPOND TO THIS FORM CAREFULLY. Indicia of contractor's responsibility inherently involve subjective determinations as to the contractor's ability to perform and complete the contract work responsibly and to the owner city's satisfaction. The city has an obligation and a duty to its citizens and its taxpayers to administer its budgets and complete its projects in a businesslike manner. Accordingly, it has a duty to exercise the type of inquiry and discretion a business would conduct when selecting a contractor who will be responsible to perform the contract work. The city's supplemental criteria are based, in large part, on the qualification statement form used by the American Institute of Architects. The city provides these criteria so as to provide the most objective framework possible within which the city will make its decision regarding the bidder's ability to be responsible to perform the contract work. These criteria, taken together, will form the basis for the city's decision that a bidder is or is not responsible to perform the contract work. Any bidder may make a formal written request to the city to modify the criteria set forth in this qualification statement, but that request may only be made within 48 hours of the date and time that the bidder first obtains the bid documents or three (3) business days prior to the scheduled bid opening date, whichever occurs first. If the city receives a modification request, it will consider any information submitted in the request and will respond before the bid submittal deadline. If the city's evaluation results in changed criteria, the city will issue an addendum establishing the new or modified criteria. If the city determines that, based on the criteria established in this statement, a bidder is not responsible to perform the contract work, the city will provide written notice of its determination that will include the city's reason for its decision. The bidder has 24 hours from the time the city delivers written notice to the bidder that the bidder is not responsible to perform the contract work to appeal the city's determination. No appeals will be received after the expiration of this 24 hour appeal period. The city may deliver this notice by hand delivery, email, facsimile, or regular mail. In the event the city uses regular mail, the delivery will be deemed complete three days after being placed in the U.S. Mail. The bidder's right to appeal is limited to the single remedy of providing the city with additional information to be considered before the city issues a final determination. Bidder acknowledges and understands that, as provided by RCW 39.04.350, no other appeal is allowed and no other remedy of any kind or nature is available to the bidding contractor if the City determines that the bidder is not responsible to perform the contract work. If the bidder fails to request a modification within the time allowed, or fails to appeal a determination that the bidder is not responsible within the time allowed, the city will make its determination of bidder responsibility based on the information submitted. COMPLETE AND SIGN THIS FORM AS PART OF YOUR BID. FAILURE TO PROPERLY COMPLETE THIS FORM MAY ALSO RESULT IN A DETERMINATION THAT YOUR BID IS NON-RESPONSIVE AND THEREFORE VOID. THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES: CONSULTATION WITH AN ATTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION. The undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED BY: �k NAME: 'DQ lx ADDRESS: I T719, St fS-± PRINCIPAL OFFICE: ffidg ��f jl.rnti I/?C ADDRESS: zv c), PHONE: 47,5-7q'F FAX: 1. STATUTORY REQUIREMENTS 1.1 Provide a copy of your Department of Labor and Industries certificate of registration in compliance with chapter 18.27 RCW. Q -hd2e C642016 ; 13 3 A(F 1.2 Provide your current state unified business identifier number. &00.5&t(-7$X 1.3 Provide proof of applicable industrial insurance coverage for your employees working in Washington as required in Title 51 RCW, together with an employment security department number as required in Title 50 RCW, and a state excise tax registration number as required in Title 82 RCW. Providing a copy of a state of Washington "Master License Service Registration and Licenses" form is�typjcalix�fficient evidence of the requirements of this subsection. ��1r! �J' C-�n��oy��i�r�Seccca ; 57516(0Ua 3 L �1--519,0 z16 -3 1.4 Provide a statement, signed by a person with authority to act and speak for your company, that your company, including any subsidiary companies or affiliated companies under majority ownership or under control by the owners of the bidder's company, are not and have not been in the past three (3) years, disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065 (3). 2. ORGANIZATION 2.1 How many years has your organization been in business as a Contractor? 2.2 How many years has your organization been in business under its present business name? olgyl�S 2.2.1 Under what other or former names has your organization operated? "SJkn -CVK.(be�{� � 'I U Ul� (06t -9 ) 2.3 If your organization is a corporation, answer the following:: 2.3.2 Date of incorporation: •l987 2.3.2 State of incorporation: bA N 2.3.3 President's name:uvp Q wC IfA -6e\00'1�. 2.3.4 Vice-president's name(s`: none. 2.3.5 Secretary's name:(e- echaK 11 2.3.6 Treasurer's name: �)Mll f (O&CS011 2.4 If your organization is a partnership, answer the following: 2.4.1 Date of organization: 2.4.2 Type of partnership (if applicable): 2.4.3 Name(s) of general partner(s): 2.5 If your organization is individually owned, answer the following: 2.5.1 Date of organization: 2.5.2 Name of owner: 2.6 If the form of your organization is other than those listed above, describe it and name the principals: 3. LICENSING 3.1 List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate license numbers, if ap licable. DOG--URIue/' -=llao L*�-h�rn_p��-�rjGc�1 #�lh�ROD*93(nJ5 9-'3yC 3.2 List jurisdictions in which your organization s partnership or trade name is filed. �LA 4. EXPERIENCE 4.1 List the categories of work that your organization normally performs with its own forces. l (L+r we. t drl U t� ; ��r(ueu pe(ond J iol'06 l reh'?b/ w� d-CWh1m 1SSja)`15 ) 9u M VeMow Q aro Ins+C( 4.2 Claims and Suits. (If the answer to any of the questions below is yes, please attach details.) 4.2.1 Has your organization ever failed to complete any work awarded to it? 4.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers? No 4.2.3 Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years? No 4.3 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.) N 0 4.4 On a separate sheet, list major construction projects your organization W(Jd(d has in progress, giving the name of project, owner, architect or design engineer, contract amount, percent complete and scheduled completion date. 4.4.1 State total worth of work in progress and under contract: �,4.5 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 a+' 1([ ed percentage of the cost of the work performed with your own forces. 4.5.1 State average annual amount of construction work performed during the past five years: 0 '1oo(U.o , V4.6 On a separate sheet, list the construction experience and present �dl� commitments of the key individuals of your organization. ✓4.7 On a separate sheet, list your major equipment. I S. REFERENCES 5.1 Trade References: (,-KeJ 5.2 Bank References: K ( k ©CuS� 5.3 Suret Y U jj� IU p�11 5.3.1 Name of bonding company: K&Uetees (tisc rmna 5.3.2 Name and address of agent: Q �wwl<aocc 6. FINANCING [[ �� �X a-�40 0 �Tc�c `18401 6.1 Financial Statement. Cas���ts t , aac o 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. 6.1.1 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). .1®2 Name and: address of firm preparing attached financial statement, and date thereof: 6.1.3 Is the attached financial statement for the identical organization named on page one? 6.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent- subsidiary). 6.2 Will the organization whose financial statement is attached act as guarantor of the contract for construction? 7. SIGNATURE 7.1 Dated at this day of 2016. Name of Organization: C kjoY,C)V1 Dr(' 11;" IVIC 4,1 9 By: f 3 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 �V" day of Marc 1,, 2016. Notary Public: - <k My Commission Expires: CITY OF KENT SUBCONTRACTOR LIST (Contracts over $100,000) List each subcontractor, from any tier of subcontractors, that shall perform subcontract work amounting to more than 10% of the total bid contract price. List each bid item to be performed by each designated subcontractor in numerical sequence. If no subcontractors will be performing 10% or more of the work, indicate this by writing "None" and signing this form at the bottom of the page. Failure to submit a fully completed and signed subcontractor list after the time set for bid opening may disqualify your bid. Riverbend Irrigation Well Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers Subcontractor Name Item Numbers CONTRACTOR'S SIGNATURE oj_l4�r-\ SUBCONTRACTOR LIST (Contracts over 1 million dollars) Name of Bidder: 1 Project Name: Project Number: Pursuant to RCW 39.30.060, Bidder shall list the names of the subcontractors with whom the Bidder, if awarded the contract, will subcontract for performance of the work of heating, ventilation, and air conditioning; plumbing; and electrical, or to name itself for the work. 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. Heating, Ventilation, and Air Conditioning Subcontractor Name: Plumbing Subcontractor Name: `C Electrical Subcontractor Name: Signature of Bidder Date o BID BOND FORM KNOW ALL MEN BY THESE PRESENTS: That we, Charon Drilling, Inc. as Principal, and Travelers Casualty and qEet- Coma of America as surety, are held and firmly bound unto the CITY OF KENT, as Obligee, in the penal SUM of Five Percent(5%)of Bid Amount 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 Riverbend Irrigation Well According to the terms of the proposal or bid made by the Principal thereof, 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 invitation to bid, 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 damaged, the amount of this bond. SIGNED, SEALED AND DATED THIS 25th DAY OF March 2016. Charon Drilling, Inc. PRI CIPA Travel rs Casualty,and Surety Company of America CM �ez "SURETY 6hristopher KNy-oii',--,-\ftorney-in-Fact 20 ft;� Received return of deposit in the sum of JWNhNwiwvuutigv�,tdaH�O v��uu�y�r:���y» �mu�u an�mnu��uxrm�a�uaun� rdnum, ,nmi+vvao asren,�u pnuc.irY IS INVALID W�YHifJI,�T THE Flfx �n � �tirvimao�mmmwau-✓rvwramnuur�um�amsaxi _ws�w��w�w��rvru�r%rwr�nm��v�n��nwr�rvumauunuur��mmua�muouwu�a�u WARNING:THIS POWER OF ATTORNEY a BORDER POWER OF ATTORNEY VELE S,J Farmington Casualty Company St Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers C,asualty and Surety Company Fidelity and C,,uaranty Insurance Underwriters,Inc. Travelers Casualty and Surely Company of America 5t.Paul'hurt,and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company 1 i Attorney-In Fact Noa Certificate No. 006675214 i y 230535 d fj KNOW ALL MEN 13Y THESE PRESENTS: That Farruington Casualty Cora7pamy°, St. Paul Fire ainci Marine. Insurance' Company, St. Paul Guardian 111SUrance 1 'I i Paul C a m run St. 1.aul Mercury insan-itnee Company,Travelers Casualty 1 �, , Travelers , � ., .. „ ,.C< t.lt and Surety Company. Casualty and Sroaty C.aaaaapaaig tat t1nucrrca.and Clnrta,ci States II jFidelity yid Csuaranty Company are corporations duly organrred tinder the laws of''the State of Connecticut, that Fidelity and Girmnanty Insurance Company is a cara'Iroa-aatiarn duly ai1ganveti under the laws of the State of Iowa,and than Fidelity and Guaranty Insurance Underwriters,Inc,.,as ar corporation citaly orb>amietl tmds:r the. 1 y lures of the State of Wisconsin(herein collectively called the"Companies").and that the Companies der hereby make,constitute and appoint Karen C.Swanson, Brent E. 1-luilr sett,Pctcr J.Comfort,Julie R.Troia,Christopher K inyon,Jamic Diemer,Carley Espiritu,Jennifer L.Snyder', ,AnneLes M. Richie.and Kyle.loseph 1larwat , oi'tile City of w� Sta2c of ,... . _...,_- their true and lawful Attorne s)-in-Fact, each i their separate capacity if"more.than one is named above,to sign,execute,sc'ai and t ack w l7 rt Tacoma u,. I p ' � .' � acknowledge any and all fronds sec ogaair races,crtnaldtoial undertakings and �f other rwriting's obligatory in the nature thereof on behalf'of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performaince of contracts,and executing or guaranteeing bonds and undertakings required orper'i7:aittud in any actions or proceedings allowed by law, r ; 29th j IN NVITNE'SS WHEREOF,lire Companies have caused this instrument to he signed wid their corporate seals to be beroto affixed,this f February 016 day of f Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and C uaranty Insurance Company D-avelcrs Casualty and Surety Company Fidelity and(Aiaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United,;"states Fidelity and Guaranty Company St.Paul Guardian Insurance Company 9 1 9 1 ,W6W,�Y ftitiE a�'r b �9 7t+6� 4tir 4,y .�. (49� �vw oa �pu=��'`°� F)S1YA/y�. l '� 4� �a�` iaSRYFtliin, � a wcaswaaraaa�. n, a' coati. n auata. r: N t895 ch it � 1 Sh AG>o, a SEldL k y Tyd• f II State of Connecticut 13y: City of}hiriford sS. Ruben 1"itany.,cniorVice President I ii Oil this the. 29th day of FebrUary_____ 20 16 before me personally appeared Roberti L.Raney,who aackno Medged himself to ' be the Senior Vice President of Farmington.Casualty Company. Fidelity and Guaranty Insurance Company.Fidelity and Civaarauty Insurance Underwriters,]lie.,St.Patel Fire and Marine Insurance Company,St.Paul Gtlan'dia❑111SUra'nce Company,St.Paul Nfci'cury Insurance Company,TravclerS Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,aid that Ile,as Such,being.authorised so to do,executed the foregoing �I instrument for the purposes therein contained by signing on behalf of the coi-poratians by himself as as drily authorized officer. 'Cr M Commission expires the 3tlth day of June,2016, �Mrii \i� f N, In Witness hereof' I.hereunto set my hand and official seal, dr t,J r Y I Y �i a C Ieirem li,Notary I u1 lic �I 58440-8-12 Printed in U.S.A. u i �iiu ii WARNING THIS POWER OFu ATTORNEY AISry INVALID WITHOUT THE uRED BORDER PROPOSAL SIGNATURE PAGE The undersigned bidder hereby proposes and agrees to start construction work on the Contract, if awarded to him/her, on or before ten (10) calendar days from the date of the Notice to Proceed, and agrees to complete the Contract within (120) working days after issuance of the City's Notice to Proceed. The undersigned bidder hereby agrees to submit all insurance documents, performance bonds and signed contracts within ten (10) calendar days after City awards the Contract. The City anticipates issuance of the Notice to Proceed on the day of the preconstruction meeting. No bidder may withdraw his/her bid for a period of sixty (60) calendar days after the day of bid opening. The required bid security consisting of a bid bond, cashier's check or cash in an amount equal to 5% of the total amount is hereto attached. 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 I, to the plans and/or specifications is hereby acknowledged. Failure to a knowledge receipt of the addenda may be considered an irregularity in this proposal. SI0f�(p �L By signing this Proposal Signature Page, the undersigned bidder agrees to accept all contract forms and documents included within the bid packet and to be bound by all terms, requirements and representations listed in the bid documents whether set forth by the City or by the Bidder. DATE: 3 (�' (C� O 'boum-bgAbhA NAME OF BIDDER BY: ajlat.�-� Signature tutue,e ty"Zon • �aes'idt°ut (Print Name and Title) Inl9 , D44 Ev&+ Address 6&ahant mq%3m. Department of Labor and Industries CHARON DRILLING INC PO Box 44450 .Olympia, WA 98504-4450 Reg: CC CHARODI133NF UBI: 600-564-782 Registered as provided by Law as: Construction Contractor (CCO1) - GENERAL 331 CHARON DRILLING INC Effective Date: 8/6/1987 12719 E 224TH ST Expiration Date: 6/1/2017 GRAHAM WA 98338 cmD rw w. eFxm ree*^ r l�';"M^ +'mnfruPY"'°'"`MF;7Nwr�b�af, „y �G7"'NN�nu4N1 ?�5?'T.�;r'" ,'� ,,,. P';Nuw:dV4 Ini ">�'a:Yr"w7^*�""""Argmi TM' y""7?711hFw.w y iv+>riN' Pr1 wnM^In"'y"ly-T+ :G r na mzm a a n m xiim r x r h m� m /!P 'ram -, x C 9 1 �vM ,.. " �, ... ., , buy„,,,,, as a 4a .£ x map g gw NSE ° 9-lmP l C�< d- ',w 1' Unified Business ID 600 56 782 Hwy Domestic Profit Corporation Business ID I k Location: 1 7 Expires: - D-- 017 p CHARON DRILLING, INC. � �uJ r'J 127191 224TH ST E . GRAHAM WA 98338 789 w ' TAX REGISTRATION UNEMPLOYMENT INSURANCE �f N INDUSTRIAL INSURANCE a d1 MINOR WORK PERMIT ,7 ms a � 1 CITE LICENSES/REGISTRATIONS: MILTON GENERAL BUSINESS BUCKLEY GENERAL BUSINESS 1 PORT ORCHARD GENERAL BUSINESS SUMNER GENERAL BUSINESS r TUMWATER GENERAL BUSINESS 4 uk DUTIES Sweep shop, clean tools, wash trucks etc. �. p LICENSING RESTRICTIONS: Minors employed in maintenance and repair work must be at leek 16 years " of age.ru,rJ �aJ NAC 916-125-0330)G ) ' Court errrmis ion and a variance from L&I is required to hire minors �^p ty% under the age of 14 in non-agriculture jobs. Cell 360-9 -5316 or F email 1 teen efe @Lni. e.Daaar for information. a� h' xe� r h All t , a, k� o++ 'rbis document a tn namedr the business above.By li urorcepnv,,Ihisduc:u.drnene,ts the rqkl rations, lth�c,6lcr�nsero eer�alwa.smlle-Infoltr iocan`the�applisc•atio�n � X' I f� was complete,true,and accurate to the best of his car her knowledge,and that haaas nes's wiII be f",di crand ucted in c f)rnpH an c wmmh all applicable Washinit,lon smatp er uniy,and city rc gul atucans Nra r uor m Deanne nu nt .. if State of Washington Office of the Secretary of State Business Licensing Service Corporations Division y LEGAL ENTITY REGISTRATION Unified Business ID B: 600 564 782 Business ID #: 1 Expires: 02-28-2017 CHARON DRILLING, INC. 12719 224TH ST E GRAHAM WA 98338 r� ;f Domestic Profit Corporation Renewed by Authority of Secretary of State F F e ' y L accepting this document the licensee certifies that information vided on the renewal was complete,true,and accurate to the st of his or her knowledge,and that the company will stay in mpliance with all applicable Washington State regulations. Secretary of s a , DEPARTMENT OF LABOR& INDUSTRIES Certified as provided by Law as: Plumber/Electrician Combo (PI-03)-PUMP& �RRIG TCON (EL0 )-THUMP& IRRIGATION PL CMAR D* 36J EL C A bD*93QT6 "s 4 Eff Da4 :4/2 (2007 Exp Cate: 412412016 Cb DAVID 12719 224TH ST C GRAHAM,WA 98338 Department of Labor and Industries PO Box 444 0 CHAROi , DA�VID O?ynipia, 'WA 8504-44 () C+ 'l AD R1 *934C C6-flil4as,p livid d by Law as: v Adninis atr Mil . IRRIGATION EIf 6t,iV�,- at 4/26/2007 IIR C , DAVITS `Ep.tJ24J20 1 GRAHAM WA: 98338 w,w� CHA. RONDRILLING INC. 12719 224th STREET E. GRAHAM,WA 98338 PHONE(253)847-5794 FAX(360)893-6718 Charon Drilling, Inc. is not and never has been disqualified, in the past twenty-nine (29)years of business, from bidding on any public works contract under RCW 39.06.010 or 39.12.065 (3). 1541��Zm-(RYAZ�n_ -� ,a2 I(P Dave Charon, President Charon Drilling, Inc. C,,'H A R 0 NDRILLING INC. 12719 224th STREET E. GRAHAM,WA 98338 PHONE(253)847-5794 FAX(360)893-6718 PROJECTS IN PROGRESS Kitsap County PIED#1 South Bainbridge Well#9 Contact: Bill Whiteley (360) 626-7704 Drill 12"well—est 200 ft Hydrologist—Marty Sebren $55,000 -25%completed Ckd CY) CHARON DRILLING INC. 12719 224th STREET E. GRAHAM,WA 98338 PHONE(253)847-5794 RECENT MAJOR PROJECTS FAX(360)893-6718 All work performed in entirety by Charon Drilling, Inc. no subcontactors City of Sumner(2010) Central Well Drilling at the Fle5ichmann Site Contact: Charles Ted Hill (253) 299-5703 Robinson-Noble, Inc. Drill 1 "well—499 ft $170,000 City of Turnwater(2011) Palermo Wellfield Redevelopment Project Contact: Dan Smith (360)754-5855 Pacific Groundwater Group Decommission existing Well 2, drill new 12"well—100 ft $75,000 City of Turnwater(2012) Palermo Wellfield Redevelopment- Phase 4 Contact: Dan Smith (360)754-5855 Pacific Groundwater Group Drill 20" well—117 ft $85,000 City of Buckley(2013) Trail Well Drilling&Testing Contact: Dave Schmidt (360) 829-1921 Gray&Osborne, Inc. Drill 12"well —163 ft $94,000 WA Dept of Veterans Affairs (2014) WA Soldiers Home, Orting, Well Replacement Contact: Yelena Semenova (360) 507-1003 Contracted by Nordic Construction, Inc. Pacific Groundwater Group Decommission exiting well, drill new 16" well 119 ft $45,000 Cross Valley Water District(2014) Well 7B Contact: Gary Hajek(360) 668-6766 Robinson-Noble, Inc. Drill 20" well—211 ft $111,000 r,HARON L)RILLING INC. 12719 224th STREET E, GRAHAM,WA 98338 PHONE(253)847-5794 FAX(360)893-6718 Licensed Drillers Dave Charon—licensed since 1981 (DOE#1190) Todd Mickelsen—licensed since 1986(DOE#1476) Major Equipment Two 72 Star Cable-Tool Drilling Rigs w/tools One 71 Star Cable-Tool Drilling Rig w/tools Boom Truck F-600 Service Trucks Backhoe,Trackhoe 6-yd Dump Truck Hydraulic Jacks Submersible Pumps Line-Shaft Turbine Pumps Grout Mixer& Pump Perforators (Mills Knife) Down-Hole Casing Cutters C11,ARONDRILLING INC. 12719 224th STREET E. GRAHAM,WA 98338 PHONE(253)847-5794 FAX(360)893-6718 TRADE REFERENCES Preferred Pump 9605—261h Ave S Tacoma,WA 98444 (253) 548-1252 PQ Products, Inc. 927 Farwell Rd Spokane,WA 99208 (800) 624-6820 Mitchell Lewis&Staver Co. 2624--112'h St S Lakewood, WA 98499 (253) 589-2141 PCB Best&Company, Inc. 3414 West Lake Samrnamish Pkwy CAE Redmond, WA 98052 (425) 882-1000 Bond No. 106490203 PAYMENT AND PERFORMANCE BOND TO CITY OF KENT KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Charon Drilling, Inc. as Principal, and Travelers Casualty and Surety Company of America a Corporation organized and existing under the laws of the State of tftow,*as a Surety Corporation, and qualified under the laws of the State of Washington to become Surety upon bonds of Contractors with Municipal Corporations, as Surety, are jointly and severally held and firmly bound to the CITY OF KENT in the penal sum of $135,106.00 , 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. *Connecticut This obligation 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 Riverbgnd Irrigation Well (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 pay all laborers, mechanics, subcontractors and material men, 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 in 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. Bond No. 106490203 TfC WITNS: Charon Drilling, Inch PRINCIPAL (e nLer principal',,, name abovc) m Bya _ :.. TITLE: ' '� LP .: PRINT NAPE DATE: DATE: XOL w CORPORATE SEAL: &za__�z — PRINT NAME Travelers Casualty and Surety a E; °- Company of America AT � _ _ _._... SURETY: P� l w CORPORATE SEAL, BY ®r._.... ,,_ � `� a... .. GATE: 04/27/2016 TITLE: Christopher!!�igr n,_Attc�rn.,,.,_ y-i.n-E�kct ADDRESS:1501 Fourth Ave., Suite 1000 ._....__.__ Seattle, WA 95101 CERTIFICATE AS TO CORPORATE SEAL I hereby certify that I am the Assistant) 'Secretary of the Corporation named as Principal in the within Bend; that 2(1 f2 L-w- Who signed the said band on behalf of the Principal � � ��� � Ill°✓rv1� � . 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" CAR A S.I:STANT SECRETARY WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER POWER OF ATTORNEY TRAVELERS,l Farmington Casualty CompanySt.Paul Mercury Insurance Company F idelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 230,535 Certificate No. 006675304 KNOW AIA MEN 13Y THESE PRESENTS: That Farmington Casualty Company, St, Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury 111SUI-ance Company.Travelers Casualty and Surely Company, Travelers Casualty and Surely Company ol'America, and United States Fidelity and Guaranty Company are, corporations duly 01-ganiMl Under the laws of the State of Connecticut. that Fidelity and Guaranty Insurance Company is a corporation duly organized Under the laws of the State Of lowa,and that f,idehty and Guaranty hisurance underwriters.Inc.,is a corporation duly organized under the laws of the State of Wisconsin(hercin collectively called the"ComIxinies").and that the Companies do hereby make,constitute and appoint ii Karen C. Swanson,Brent E. Heilesen, Pctct .1.Comfort.Julie R.Tillitt,Christopher Kinyon,Jamie Diener,Carley Esphiftl,Jennifer L.Snyder, Annelics M. lZichic,and Kyle Joseph Flowat sj of'the City of Tacoma washillotolliU State of their tree and lawful Anorney(s)-in-Fact, each fit then-separate capacity if more than one is named above,to sil-ii,execute,seal andacknowicd-c any and all bonds,recognizances,conditional undertakings and oilier writings obligatory in the nature thereof on behalf of the Companies in then-bUSineSS of guaranteeing the fidelity ofpersons,guaranteeing the performance of contracts and executim-,or"Llaranteeim,bonds and L111dCrtakil1j_',S required oi-Permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Colapaflies have Caused this instrument ko he si.ned and their Corporate seal"to be hcrcto affixed.this 29111 t. day of February -, 2016 Farmington Casualty Company St.Patil Mercury Insurance Company Fidelity and Guaranly Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guarmtv Company St.Paul Guardian Insurance Company 8v 61 St ate of conilect i cu t Bv: City ofHailf'ord ss, Robeil L.Raney.,.C/Ilior Vice President 01,this the 29th day of' l"el-M-11"lly 2016 before me personally appeared Robert I_Raney,whoacknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty 11I.S1.11-anCe COMPally,Fidelity and Guaranty 1115UI-1111CC Underwriters,Inc.,St.Paul Fire and Marine Inma-ance Company,St,Paul Guardian Insurance Comparly,st,Pat[]Mercury Insurance COmpany.Travelers Casualty and Surety Conipany,'Fravelers Casualty and Surety Company of America,and United Staites Ftdelity and Guaranty Company.and LIMI he,a,such,being authorized SO to CIO.executed the foregoing instrument f0l'111C l)LlrI)OSeS therein contained by Signing on behalf of the corporations by himself as UdUly al.111106/Cd OfFICCT, 'Ter In Witness Whereof,I hereunto set my hand and official seal. My Commission expires the 30th day ofJunc,2016. 00 *LI Mahe C.'reti%-,ault,Noiai-y Public 58440-8-12 Printed in U.S.A. WA �mwf ,:,vTwH I., WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER ']'his power o[Attoruey is 1,,ramcd ouder and by the authority of,tile following resolutions adopted by the Boards of Directors of Farmington Casually Company,Fidelity -in(] Guaranty IuSLII-a1ICC C0111flany, Fidelity and Guaranty laskirance Underwriters, Inc., St. Paul fire and Marine Insurance Company, St. Paul Guardian Insurance C0111f)ally, St. Paul N4CT-CLIIy 111SUrarICC Company,Travelers Casualty and Surety Company,Travelers Casualty anal Surely Company ofAinefica,and United Suales Fidefily and Guaranty Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,ally Vice Chairman, any Executive Vice President,all), Senior Vice President,any Vice Plesidern,ally Second Vice President,the'ri-easurer,anv AsistantTreasurer,the Corporate Secretary or any Assistant Secretary may oppoint Auorneys-in-Flacl and A'Clas to Zict for and on behalf of the Company and may give such app0nIICC SLICII authority as his or her certificate of authority Inay prescribe to sh-'11 with tile Company's liallic and seal with the Company's seal bonds,reco'o ill'Za[ices,contracts of indemnity,and other w6tings obligwory ill the nature ol'a bond,icC0gruZa11CC,01-COnditiOlutl undertakirw,afid any of said officers or the Board all'Directors at any time may reniove any SLICII apl)Oilltee Mld I-CVokc the power given him or her;and it is FURTIJER RESOINEI),that tile Chairman,the president,my Vice Chairman,any Executive Vice President,any Senioi-Vice President or any Vice President may delegate all or any part of the.foregoing authority to one(u.more officers ofemployees of daisCompally.provided that each such delegation is in writing and a copy thereof,is filed in the office of[lie Secretary;and it is FURTHER RESOIATI),that any bond,recognizance,contract of'indellillity,or wrifing, obli"atory in the nature ol'a horld,recognizance,or conolitional undonakiii- shall be valid all([binding,upon the Company when(a)signed by the President,any Vice Chiji-man,any Executive Vice President,any Senior Vice President or any Vice President,aatty Second Vice president,the Treasurer, illy Assistant'I'rctJS JILCT"the Corporate Secretary or any Assistant Secretary and duly attested and scaled With the Compally's seal by a Secretary or Assistant Secreta o-ry; r(b)cluly executed(under seal,if required by OM Ot inme Attorneys-in-Fact and Agents pulsitaill to)tile power po-cscribed it) his or her cerLificlac or their certificates of authority m by one or more Company officers pursuant to a written dcle,liholl of authority; alld it is FURTHER RESOLVED,that the signature of each Of the f0110MMI officers; President,anv 1-1*xectllive Vice I'lVSidCIlL any Senior Vice President,Ltily Vice I'l-CSiLICTIt. ,lily Ass.islaw Vice President,any Secretary, any Assistant Secretary,and file ,cal of the Company Illay be affixed by facsimile 10 :ffly Power of Attorney or to any certificate relating therclo)appointing;Resident Vice presidents,Resident Assistant Secretaries or Attorneys-in-Friel for purposes only of oxecining and attesting horlds and undertakin-,and rather writilu's obligatory ul the nature thereof"and Lilly Such Power of Al(orney or certificate bearing such facsimile signature or facsimile seal shall he valid and binding upon the Company and away such power so executed and certified by such facsirvule Signature and facsimile sea]shall be.valid and hindin"oil the Company in the future with respect to any bond or understandim,to which it is attached. I 1,Kevin E.lfu,ghes,the tanclersignecl,Assisttult Sccretary.(it'Farninn'toll Casualty Coltipally.Fidelity and Guaranty insurance Company.Fi(leliiv and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine insurance C'Oillpafly.St.Paul&Wldiull Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Cam paIIyj'raVCICI-',Casualty and Somy Company ofAmcrica,mid Unned States Fidelity and Cillarlinly Company do hereby certify that tile abow and forqoing is a true and correct Copy of the power of Attorney executed by said Companies,which is in ftill force and effect and has 1101 bean revoked. 2-79 'lay of ,IN TESTIMONY NVIJERF�'OF,[have hereunto set my hand and affixed tile scals ofsaid Companies this 20/(K 1*711 cvin l IN ighes.Assistant Sect mry Ewe -vp z SEJM Cwt,'Ile TY a I 6i� k ........... To verify the authenticity of fill,,, KiweT elf Attorney,call 1-800 421 3880 or conlact its at Please refer to [lie Atlowney-fit-pact number,the above-halted individuals and the cletaik of tile bond to which Gic,power is attached. r r, WARNING:THIS POWER OF ATTORNEY IS INVALID MTHOUT THE RFD BORDER CITY OF KENT KING COUNTY, WASHINGTON Riverbend Irrigation Well ADDENDUM No. 1 March 21, 2016 FROM: City of Kent Parks Department, Riverbend Golf Complex, Robinson-Noble, Inc. Kent Washington TO: Charon Drilling, Inc., Hokkaido Drilling, Inc., Holt Services, Inc. This addendum forms a part of the Contract documents and modifies the Technical Specifications: ALL CHANGES ARE SHOWN IN BOLD, ITALICS TECHNICAL SPECIFICATIONS FOR THE DRILLING OF City of Kent Riverbend Golf Complex Irrigation Well March, 2016 1. General The City of Kent, herein referred to as the Owner, intends to drill an irrigation well to provide water to its Riverbend Golf Complex. The new well will be drilled near an existing well which was drilled in 1988 to a total depth of 451 feet. The successful bidder, herein called the Contractor, will drill the new well in proximity to the existing well with the specific location determined by the requirements of the drilling equipment and the appropriate setbacks. The plan is to land a 12-inch well casing at a depth of 450 feet and complete a sand-packed well in a sand aquifer encountered between 400 and 450 feet in the existing well. Flowing artesian conditions may be encountered. Therefore, a flow seal must be set into the first confining layer encountered beneath the site. This is expected to result in a seal set at about 90 feet below land surface. The precise position of the flow seal will be determined in the field once the geologic conditions are known. The drilling site is in the southwest corner of the golf complex within the fenced area north of Meeker Street and west of the Meeker Bridge crossing the Green River. The site is in the NE 1/4 of the SE 1/4 of section 22, Township 22 North, range 4 East very near the section line with section 23 (latitude 47.378236, longitude 122.270908). A map of the area and an aerial photo of the site are attached. The well will be drilled with cable-tool methods using 12-inch casing after the 16-inch flow-seal casing has been cemented in place. A temporary 20-inch casing must be set to accomplish the required sealing. Robinson Noble, Inc., herein called the Geologist, shall direct work for the Project and act as the Owner's representative in all activities associated with the drilling, design, construction, development, and testing of the well. General project management will be provided by the Owner. The Owner will prepare the site prior to mobilization. Cuttings may be disposed of on site along the undeveloped Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 1 of 7 margin of the property at a place to be arranged between the Owner and the Contractor. During construction, the Contractor must take reasonable precautions to contain cuttings and water associated with the drilling process, prevent erosion, and avoid becoming a nuisance to the Golf Complex operations. 2. Scope of Work The intent of this contract is to drill a 12-inch irrigation well using cable-tool drilling methods to a depth of 450 feet in material that may exhibit flowing artesian conditions. Before 12-inch drilling can proceed, a 16-inch flow-seal casing must be cemented into a 20-inch hole (estimated to be 90 feet). The 20-inch temporary casing will be removed during the placement of the seal material. It is expected that flow issuing from the 16-inch by 12-inch annulus during drilling will be of sufficiently low turbidity to allow disposal on the property along the undeveloped margin of the property. The seal will require drilling 20-inch casing to a depth of approximately 90 feet (as appropriate to advance the seal into the confining clay unit) and cementing in a 16-inch steel casing to serve as both a surface seal and a flow-control seal. Following completion of the drilling, the Geologist will determine the required well design and observe construction and development procedures and the appropriate test pumping. The conditions encountered in the existing well suggest that completion will be accomplished using gravel-packed screen methods. It is anticipated that a specialty glass-bead pack material will be used. Well drilling, construction, testing, and completion shall be performed in accordance with the requirements of Washington Administrative Code (WAC) 173-160, and the requirements of these specifications. Where the requirements of these specifications are more stringent, the requirements of the specifications shall prevail, provided that nothing in these specifications shall be construed to require work in violation of the WAC. 3. Equipment and Materials 3.1 Drillinq Machine. Drilling shall be accomplished by cable-tool methods only. The rig proposed for the work must be appropriate to drill the specified well and place the required casings and screens. All appurtenant equipment including, but not limited to, bailers, jacks, and casing cutters are to be considered as part of the rig, available to the project as needed, and delivered to the site as a function of job mobilization. 3.2 Test Pump. The test pump shall have the capability of up to 500 gallons per minute from a - 250-foot setting in a 12-inch pumping chamber. The test pump shall be run in with two, 1-inch I.D. sounding tubes that can be either PVC or galvanized steel. The sounding tubes shall be strapped to the pump column at regular intervals and run to within 10 feet of the top of the pump. If the bottom of the sounding tube is sitting on the shoulder of the pump so as to prevent instruments from exiting the tube, no cap on the sounding tube is required. Otherwise, the sounding tube will be capped and sufficient holes or cuts will be made in the tube wall to facilitate water entry. Pump accessories shall also include means of varying the discharge and accurately measuring the discharge rates. Orifice plates and manometer tubes shall be provided to measure discharge rate as part of the pumping equipment. It may be necessary to escort the pumped water as much as 100 feet during testing to avoid complications to golfing surfaces. Such discharge pipe is to be provided as part of the test pump standard equipment. No extra payment is due for its provision, installation or removal. 3.3 Drive Shoes. All permanent casings shall have drive shoes which are forged or cast and of an industry-approved manufacturer. A shoe or armor plate on any temporary casing shall be of sufficient strength to allow that casing to be driven to required depth. 3.4 Surface Casing. The temporary 20-inch surface casing shall meet the requirements of holding an oversized hole to the required depth (estimated to be 90 feet) and sustain roundness until extracted at flow-seal/surface-seal completion. This casing remains the Contractor's property. Riverview Park Trail Relocation Addendum#1 to Bid Documents Page 2 of 7 3.5 Permanent Casing. The drill casing shall be new, or equal, with a minimum wall thickness of 0.25-inch for the 16-inch flow-seal casing and 0.375-inch for the 12-inch drill casing. 3.6 Riser and Spacer Casings. If used, any riser or spacer casings shall be new, or equal, and have a wall thickness as directed. 3.7 Extra Materials. Any extra materials such as gravel pack or special fabrications shall be provided by the Contractor as specified by the Geologist during the course of the work. It is anticipated that a special order glass-bead pack material will be used. This will be part of the extra materials item. The Geologist will assist in the definition of the glass-bead materials and the arrangements for ordering in the event that the screen design requires such materials 3.8 Well Screen and Fittings. The well screen shall be specified by the Geologist and provided by the Contractor as directed. 3.9 Wellhead Completion. The final wellhead configuration shall consist of a 12-inch flanged T with blind flanges and fittings bolted to them. Additional fittings shall be installed as appropriate to provide access for monitoring shut-in pressure and instrumentation as the Owner requires for the completed well. A similar horizontal discharge port shall be provided on the 16-inch casing whereby the annular flow can be diverted while an annular ring is welded between the 16-inch casing and the 12-inch casing at the conclusion of drilling. This discharge port on the 16-inch casing shall be equipped with an appropriately sized gate valve to control the flow when work on the well is required (we anticipate a 3-inch valve will be sufficient).This will also provide a mechanism for working on the well throughout the operational life of the well should that become necessary. The wellhead shall be completed with a square concrete pad 8-inch or greater in thickness and at least 5 feet on a side and protected by three bollards that extend to no less than three feet above the pavement. A schematic drawing of the intended wellhead facility is attached. 4. Execution of Work 4.1 Completion Time. The contract shall be completed within 120 calendar days of starting for the specified work. The project starting time shall be no later than the date indicated on the Bid Proposal. There shall be no work performed on holidays or weekends, unless approval for such work is granted by the Owner and Geologist. Requests for extended work hours or days shall be made at least 24 hours prior to that requested time. Exceptions may be granted in emergency situations where it is clear and agreed to by all parties that project progress would be significantly threatened by a holiday/weekend delay or to allow the contractor to affect repairs on his equipment in order to ensure continued project progress on the next regular workday. 4.2 Surface Seal/flow Seal. The surface seal/flow seal shall consist of 16-inch casing cemented into a 20-inch temporary cased hole. Cement shall be placed into the 20-inch/16- inch annulus from the bottom up as the 20-inch casing is extracted. Care must be taken to protect against the cement migrating into the 16-inch casing. This may be accomplished by setting the 16-inch casing substantially into the underlying confining material and filling the 16-inch casing with sand. Alternative approaches will be considered provided they reliably address the need to protect the 16-inch hole and are provided to and approved by the Geologist prior to execution. The seal must be completed and allowed sufficient time to set before the 12-inch drilling begins. All sealing work must be in accordance with WAC 173-160- 221 and 173-160-231. Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 3 of 7 4.3 Drilling. All drilling shall be by churn-drill or drive-and-bail methods, and cuttings are to be removed with a sand-pump bailer unless otherwise authorized by the Geologist. Casing shall be kept within 5 feet of the bottom of the previously drilled hole at all times. The hole shall be drilled in such a manner that any over-excavation is held to a minimum. The Geologist shall have the authority to stop progress immediately if there is apparent over-excavation, and drilling shall not resume until procedures have been taken to remedy the problem. All cuttings must be controlled on the site but may be disposed of on the undeveloped margin of the site near the drilling site and agreed to by both the Owner and the Contractor. Typically, this means the drill cuttings would need to be spread across a flat-lying area and allowed to become part of the soils on the property. If the contractor prefers, the cuttings can be collected and disposed of offsite at the contractor's expense. Water generated as part of the drilling operation can be allowed to run off to the undeveloped margin of the property provided it does not become a nuisance to the use of the property or represent a threat to surface waters on or in proximity to the site. During the course of the work, the Contractor shall have on hand a supply of chlorine solution or dry chlorine at all times. Chlorination shall be done on occasion as directed by the Geologist or as desired by the Contractor such that disinfection of the drill string and materials is accomplished. No extra payment is authorized for normal chlorination. Drilling shall be performed by an experienced and licensed well driller and a helper. Only competent workmen shall be employed on the job. 4.4 Permanent Casing. All casing utilized in the drilling of the well shall be new, or equal, with a minimum wall thickness as noted in Item 3.5 above. 4.5 Refusal of Casing. During the drilling process, casing refusal is a condition that might occur before the required depth is reached. To justify a call of "refusal," the Contractor shall state to the Geologist, to the best of their knowledge, the basis for the assertion of refusal. Such reason(s) will be the basis for contract consideration of the claim. The assertion of refusal shall include alternative plans and any change of prices. Economics related to slower-than- expected drilling progress shall not be accepted as a reason for refusal. 4.6 Sampling. The Contractor shall ensure that representative samples of formations drilled are collected during the drilling process. They shall be taken at least every 5 feet or at formation changes, and at least every 3 feet in water-bearing zones or as directed by the Geologist. Samples of water-bearing materials shall be collected from the entire contents of the sand-pump bailer. The bailer load shall be collected on a clean, 4' x 8', 3/4-inch thick (minimum) plywood board (or equivalent) provided by the Contractor and the sample taken from a mix obtained therefrom. Samples shall be placed into a competent container and labeled with the project name, date and time collected, and true depth below ground. If questions arise as to the true nature of the materials being penetrated, the Geologist, at his sole discretion, may require that a Dames and Moore driven sample be retrieved. This will be accomplished at the rig hourly rate as defined in item 7.9. 4.7 Records. The Contractor shall keep a daily written log of operation, including formations drilled; size and length of the casing placed; tools used; depth to water at the beginning and end of the shift; location, size and length of screen; and progress of development work. A duplicate copy of the daily log shall be furnished to and approved by the Geologist no later than the beginning of the following day's work. A sealing plan for dealing with flowing conditions must be developed by the Contractor before moving onto the site per WAC 173-160-251 4.8 Scheduling and Communication. Prior to mobilization to the project site, the Contractor will provide the Owner and Geologist with a schedule for site work, including anticipated daily arrival and departure times and any foreseeable schedule conflicts. The Contractor is Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 4 of 7 responsible for notifying the Geologist, in advance, of any conditions resulting in a delayed arrival to or early departure from site or if the Contractor will not be on site during a scheduled work day. To facilitate communication with the Owner and Geologist, the Contractor and crew will have a working cellular phone or other means of communication on-site at all times. 4.9 Welding. All steel casings, risers and liners shall be joined by arc welding using standard procedures. The Contractor assumes full responsibility for any breakage of casing, drive shoe failing, or weld failing during the course of the work. Stainless steel screens shall be welded with stainless steel welding rod according to manufacturer's specifications (see UOP Johnson Groundwater and Wells, Third Edition, 2007, Appendix A - on the accompanying CD). 4.10 Alignment. The basic alignment requirement is that all casings, liners, risers, screens, and tools can be freely run through the well, and that a test pump and permanent pump can be freely set in the well. Other alignment tests will not be required unless doubt arises during the work. If the Geologist or Owner requires an alignment test, the Contractor will be required to conduct a test as specified by the AWWA Standard for Water Wells publication (AWWA/ANSI A100-97, Appendix D: Plumbness and Alignment—Procedure for Testing). The bid hourly rig rate shall be paid for this test, unless the results of the test show alignment does not meet the above-specified conditions, in which case the Contractor shall bear the expense of the test and the expense of correcting or otherwise mitigating the misalignment. 4.11 Screen Setting and Pullback. The screen assembly shall be lowered into the fully cased well by methods approved by the Geologist. The casing shall be extracted by use of hydraulic jacks to the depth specified on the well completion diagram provided by the Geologist. No other pullback method shall be used without express authorization from the Geologist. Both the screen position and the level of filter-pack material, if used, shall be constantly checked by the Contractor during pullback. The Contractor assumes full responsibility for the accuracy of casing extraction measurements and the successful retraction of the casing as required. 4.12 Drive Shoe Cut. Unless otherwise directed, the Contractor will cut off the drive shoe to allow easier pulling and to avoid further disturbance of the drill-hole wall. Cuts shall be accomplished with an internal rotation-type cutter assembly and the cut shall be verified to the satisfaction of the Geologist prior to continuation of the project. 4.13 Development. The well screen will be developed as directed by the Geologist. Development shall consist of bailing and surging with surge discs on the drill stem or other means (e.g. water jetting, air-lift pumping) as deemed appropriate by the Geologist. 4.14 Test Pumping. The day prior to setting the test pump the water column in the well shall be chlorinated and shut in. The test pump shall be run at variable rates to prove both the capacity of the well and to determine if the water is free from sand and sufficiently stable to run a constant-rate test. The test pump shall then be run at a constant discharge for a period of up to 24 hours. Constant-rate tests must have discharge rates kept to within 5% of the specified discharge, and, if pumped over eight hours, must be run uninterrupted for the first eight hours. Following the first eight hours, brief shutdowns of no more than six minutes each 12 hours shall be allowed. If longer shutdown occurs, the results of the test could be nullified and, if so, testing would have to be repeated at the Contractor's expense. 4.15 Capping. At all times during the progress of the work, the Contractor shall protect the well in such a manner as to effectively prevent either tampering with the well or entrance of foreign matter into it. The completed well shall have a gasket sealed blind-flange plate bolted to the top flange and the horizontal flange (downstream of the valve) on the "T" fitting required to be welded to the casing. A horizontal port and plug shall be installed to facilitate subsequent installation of a pressure gage. A steel ring shall also be firmly welded between the 16-Inch seal casing and the well casing such that the annulus cannot leak. An appropriately sized horizontal port shall be installed on the 16-inch casing at a position practical to construction and operation of the well. At the conclusion of the project this port shall be Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 5 of 7 equipped with a valve to provide control of the annular flow should access to the annulus be required during the operational life of the well. At this time, a 3-inch valve is expected to be adequate. 4.16 Well Abandonment. In the event that the Contractor shall fail to complete the well because of lost tools, misalignment, or any reason determined to prevent the reasonable expected scope of the Contract, the well shall be abandoned in accordance with well decommissioning procedures in WAC 173-160-381. In such case, no payment will be due the Contractor for work performed to abandon the well. In the event that the well is abandoned by direction of the Owner, procedures must also meet the requirements of WAC 173-160-381, and the payment for the decommissioning procedures will be due. 5. Submittals 5.1 Project Invoices. The Contractor will provide the Geologist with a copy of each invoice prior to submittal to the Owner. The Geologist will review the invoice for accuracy. The Contractor will allow sufficient time for this review such that the Owner's schedule for submittal of invoices can still be met. 5.2 Well Screen and Fittings. Prior to screen installation, the Contractor will provide to the Geologist a copy of the screen manufacturer's technical specifications for the screen as ordered/built. 5.3 Water Well Report. At the conclusion of the project, the Contractor will provide a copy of the Washington State Water Well Report as submitted to the Department of Ecology as required by 18.104.050 RCW. 5.4 Safety Plan. The Contractor shall have on site a safety plan suitable for the operation of the equipment intended for the work. 6. Measurement and Payment 6.1 Mobilization and Demobilization shall be billable at the rate of 70% of price bid when drilling starts and the final 30% when all equipment and materials are removed from the site and the site is left in a clean and orderly state. This item includes all compensation for site preparation and the fee for the Washington Department of Ecology Notice of Intent. 6.2 Flow Seal/Surface Seal payment shall be paid per foot for a seal which consists of a 16- inch casing cemented into a 20-inch temporarily-cased hole. Price bid includes all labor and materials to drill the oversized hole, provide temporary use of casing, maintain proper sealing procedures according to WAC 173-160-231(2), and to provide and place the seal. The price also includes provision and installation of a fitting and valve affixed to the side of the 16-inch casing to facilitate control of the flow of water from the annulus between the 16-inch seal and the drill casing. 7.3 Drive Shoe payment shall be for shoes welded to permanent casings and successfully driven to depth. 7.4 Drilling Hole For Casing shall be paid per lineal foot of hole drilled below the bottom of the flow seal (estimated to be 90 feet) which is capable of being cased with the specified 12- inch casing. 7.5 Casing shall be paid for per lineal foot of permanent 12-inch casing set below land surface, plus two feet of final stickup. Price bid shall include labor for installation of casing, including the seal overlap casing, and any overlap casing should casing reduction be required. Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 6 of 7 7.6 Shoe Cut shall be paid on a lump sum basis for a successful separation of the drive shoe from the permanent casing. The price bid shall include all costs for the provision of the cutter assembly, as well as running in, cutting, and removing the cutter assembly. 7.7 Commercial Well Screens and Fittings, delivered to the site, shall be paid for at the manufacturer's published price plus actual cost of freight. The screen order shall be made at the direction of the Geologist. 7.8 Extra Materials not otherwise herein specified shall be provided only as directed and shall be paid for at documented cost plus 15% handling. Extra materials include, but are not limited to, risers, spacers for well screen assemblies, and gravel pack material (anticipated material is glass beads). 7.9 Authorized Rig Work shall be paid for any directed work that requires a fully operating rig and a minimum of a two-person crew and is not otherwise covered by unit prices herein. No extra payment for hourly work shall be made when equipment being used is not in good working condition. 7.10 Test Pumo shall be paid for at the price bid, such payment to include provision, installation and final removal, and pumping for four (4) hours to verify that the equipment is operating properly, to provide initial definition of the well capacity and to verify that well development is adequate and the well is stable for testing. Specified accessories are part of the pump unit. Unless otherwise authorized, this item is to be used only once per well. Interim removal and resetting in the same well would be covered under Item 7.9. Price bid includes provision of an accepted discharge method for water pumped and any cost for additional eductor pipe to escort discharge water to the point of disposal. Payment for this item will not be made if representative water level measurements cannot be obtained from the installed sounding tube(s). 7.11 Operate Pump-beyond four (4) hours shall be paid at the hourly rate bid. Only one operator is required during pump operation. Payment for this item will not be authorized in situations where the pump is not operational, representative water level measurements cannot be obtained from the installed sounding tube, or when the pump operation is below the requirements set forth in Items 3.2 and 4.14 unless otherwise agreed to by the Geologist. This item includes monitoring water level and production rate during the test when the geologist is not on site to accomplish those tasks 7.12 Authorized Stand-by/Shop Time shall be paid for any directed work not otherwise covered by unit prices herein, which does not require a fully operating rig. Stand-by/Shop Time shall also be paid per hour for time lost during a single 8-hour working shift while geophysical logging is delaying work, or for time required for one employee to fabricate shop items. During geophysical logging, the Contractor will provide one employee for assistance as directed by the Geologist. 7.13 Salvage Credit at the price bid shall be deducted for all permanent casing that is recovered and reusable in lengths of 5 feet or more, and as agreed upon by the Contractor and Geologist. Such recovered casing becomes the Contractor's property. Labor for salvage is paid at the rate bid for rig work (Item 7.9). 7.14 Wellhead completion shall be paid for as a lump sum item once the wellhead is completed to the satisfaction of the Owner. This item includes all materials necessary to fabricate the wellhead, the concrete pad and the protective bollards. It also includes all labor required in fabrication and installation of the wellhead components. Riverview Park Trail Relocation Addendum #1 to Bid Documents Page 7 of 7 CONTRACTOR COMPLIANCE STATEMENT (President's Executive Order #11246) Date 3 , f 2 -I Q This statement relates to a proposed contract with the City of Kent named RIVERBEND IRRIGATION WELL I am the undersigned bidder or prospective contractor. I represent that - 1. I have, _ 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. LOP JX 16 1 ((h/A- In(, NAME OF BIDDER BY: SIGNATURE/TITLE 6KQ (110C U4 TLIA ADDRESS (Note to Bidders: The information required in this Compliance Statement is informational only) A. BASE BID: RIVERBEND IRRIGATION WELL I. BASE BID: Irrigation Well Drilling, construction, testing, wellhead completion etc: /315), 0 0 (figures) 617e (Written in dollars) II. PROJECT TOTAL- DO NOT INCLUDE SALES TAX TOTAL LUMP SUM BID Lump Sum $DQe&(&&2 7hi& -ice /'lh6&y-nd Ore �ap&fdl' L1�L�/ (dollars) (Written in dollars) DO NOT INCLUDE SALES TAX B. UNIT PRICE BIDS (Unit prices include all labor, materials, and equipment necessary to provide and/or execute and/or place Item noted.) DO NOT INCLUDE SALES TAX Price Per Estimated Total Item Description Units Unit Cost for Bid Comparison 1 Mobilization and demobilization One Lump Sum5 t� 2 Place and complete surface/flow 90 feet ft seal ` / 3 12-inch drive shoe One Each 4 Drill hole for 12-inch casing 360 feet -je-1 ft 5 Provide and install 12-inch casing 452 feet ft `it Provide well screen and fittings 6 (Estimating 50 feet). $ 8,000 For bid estimate, use $8,000 7 Extra materials. Cost plus 15%. $ 3,000 For bid estimate, use: $3,000 8 Authorized rig work 150 hours a 37r ate 9 Authorized stand-by/shop time 10 hours �- Provide, install & remove test 10 One Lump Sum dp pump; (and pump 4 hours), �15+ •- 11 Operate pump 24 hours dd 00 a5z• -, &t dUD. 12 Salvage Credit for 12-inch casing 50 feet D) ( W! 13 Wellhead Completion One Lump Sum Base Bid Total Proposed Date to Begin Drilling Activities: obi j� Firm Name: �,�at<,On 2 Date: -01�T`1 10 CITY OF KENT COMBINED DECLARATION FORM: NON-COLLUSION, MINIMUM WAGE NON-COLLUSION DECLARATION I, by signing the proposal, hereby declare, under penalty of perjury under the laws of the United States that the following statements are true and correct: 1. That the undersigned person(s), firm, association or corporation has (have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the project for which this proposal is submitted. 2. That by signing the signature page of this proposal, I am deemed to have signed and to have agreed to the provisions of this declaration. AND MINIMUM WAGE AFFIDAVIT FORM I, the undersigned, having duly sworn, deposed, say and certify that in connection with the performance of the work of this project, I will pay each classification of laborer, workman, or mechanic employed in the performance of such work not less than the prevailing rate of wage or not less than the minimum rate of wage as specified in the principal contract; that I have read the above and foregoing statement and certificate, know the contents thereof and the substance as set forth therein is true to my knowledge and belief. Riverbend Irrigation Well NAME OF PROJECT 0 I'l i I r"YA �ac, NA�%( B DDER'S FIR SIGNATURE OF AUTHORIZED REPRESENTATIVE OF BIDDER 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 all sensory, mental or physical disability. 3. During the time of this contract 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 hiring and promotion of women and minorities. 5. Before acceptance of this contract, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. For: DC, Title: A Date: m R.10 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. Notice of Intent to Construct Notification Number - m ater ell This form and required fees MIDST BE RECEIVED by the Department of Ecology WE23834 DEPARTMENT OF 72 FLOURS BEFORE you construct a well. ECOLOGY This is not a permit, certificate, or application for a water right. Suite of Washington This is notice to Ecology that you intend to construct a water well in compliance with all applicable laws and regulations and, for licensed well drillers, the conditions of your current license. This Notice of Intent does not represent approval or permission to use water from the well. Submit one form and the required fee (check or money order)for each well that you intend to construct. Mail completed form to: Department of Ecology, Cashiering Unit, PO Box 47611, Olympia„ WA 98504-761'1. NOTE: Please print. Processing your Notice of Intent may be delayed if all fields are not filled in completely. 1. Property Owner City Of Kent Phone Number (253)856-5725 Mai'YM-%'rRvss eenue South City Kent StateVVA dip Code 98032 2. Agent (if different from above) Phone Number Mailing Address City State dip Code 3. Well Location Tax Parcel Number, Township, Range, Section,'/4,and 1/41/4 are Required. Latitude and longitude(if available). County Name Project Name King- 17 Riverbend Irrigation Well Well Site Street Address City State Jip Code 2019. West Meeker St Kent WA 98032 Tax Parcel Number Township Range Section 4/ (within 160 acres) '/-'f4(within 40 acres) 22N 4E 22 SE NE 4. Type of Well Construction New Municipal 5. Is use of water from this well Permit Exempt? No 6. Estimated Start Date 7. Number of Homes to be Served 4/27/2016 12:00:00 AM 1 8. Professional's License Number 9. Well Drilling Company Name Phone Number Charon Drilling Inc None Supplied 10. Well Driller Name Driller License Number DAVE CHARON 1190 11. Send the entire form. Phase copy the notification number(located in the upper and lower right corners) and keep in a safe place. Use this reference number when communicating with the Department of Ecology. Well Size: Provide a copy of this Notice of Intent to the well owner. 1. New Well less than 12"in diameter-$200.00 2. New Well 12"in diameter or larger- $300-00 WE23834 Amount Enclosed$ $3 0 0 This notification number must be provided to your driller: charondrilling@hotmail.com Yot,lr Notice of Intent has been processed as of 4/27/2016, Your Gash Journal Validation Number is 461T1200. This message being sent at (4/26/2016) Water Well Notice of Intent page 1 of 2 CONTRACT THIS AGREEMENT, made in duplicate, is entered into between the CITY OF KENT, a Washington municipal corporation ("City"), and Charon Drilling Inc, organized under the laws of the State of Washington, located and doing business at 12719 224th St. East, Graham, Washington 98338 ("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: Riverbend Irrigation Well in accordance with and as described in the Contract and shall perform any alterations in or additions to the work provided under the Contract and every part thereof. The Contract shall include all project specifications, provisions, and plans; the City's general and special conditions; the 2016 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. The Contractor is responsible to obtain copies of the 2016 WSDOT Standard Specifications including the latest amendments issued by WSDOT as of the date of bid opening. 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 120 working 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 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 and the terms and conditions herein contained and hereby contracts to pay for the same according to the Contract 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. 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 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. CITY OF KENT BY: S TT OKE, MAYOR A , ATTE T RZNALD F. OOR -CITY CL K APPR ED AS TO,,FORM:. r .. KENT LAW DEPARTMENT CONTRACTOR BY: C� PRINT NAME: TITLE:?- d2, ,A r 0 vl- VD r-!Ulf, DATE: rrx CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the contract. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contract for the contract known as Riverbend Irrigation Well that was entered into on the Day of 20 , between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned contract. By: For: Title: Date: EXHIBIT B 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. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 or its equivalent, with minimum limits of $3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. The Commercial General Liability insurance shall be endorsed to provide the Aggregate per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an Additional Insured under the Contactor's Commercial General Liability insurance policy with respect to the work performed for the City. All endorsements adding Additional Insureds shall be issued on form CG 20 10 11 SS or a form deemed equivalent, providing the Additional Insureds with all policies and endorsements set forth in this section. 2. 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. 3. 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. Commercial General Liability insurance shall be written with minimum limits of $3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. EXHIBIT B (Continued) 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 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. EXHIBIT B (Continued) 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. Client#: 68161 CHARDRIL3 DATE(MM/DD/YYYY) ACORD,, CERTIFICATE OF LIABILITY INSURANCE 4126/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ICONTACT E: NAME: Christina McMullen Propel Insurance PHONE INC,No Ft): AIC,No 800 499-0933 nx 866.577.1326 Tacoma Commercial Insurance E-MAIL ADDRESS: christina.mcmullen@propelinsurance.com christina.mcmullen ro elinsurance.com 1201 Pacific Ave,Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC 0 Tacoma,WA 98402 INSURER A:American States Insurance Co. 19704 INSURED INSURER 8:AIG Specialty Insurance Company 26883 Charon Drilling Inc. INSURER C:American Economy Insurance Co. 19690 12719 East 224th Street INSURER D: Graham,WA 98338 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE 1ADOL,SUBR POLICY EFF POLICY EXP LIMITS LTR 'IN WVD= POLICY NUMBER MMIDDfYYYY i MMIDDIYYYY A GENERAL LIABILITY j X X 01C13857476 6/0112015106/0112016 EACH 1 OCCURRENCE 00$ , X COMMERCIAL GENERAL LIABILITY I REMA,GS RENcTuErrence ........... $200 OOO CLAIMS-MADE C OCCUR ! MED EXP(Any one person) $10 000 i PERSONAL 8 ADV INJURY S 1 000,000 GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY X JECT LOC Is C AUTOMOBILE LIABILITY X X ',OICI5980444 6101/2015�06/01/2016(E..dentswGLEUMIT (S1,000,000 X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE S AUTOS (Per accident) S A X UMBRELLA LIAB X [OCCUR X 01 SU43014130 610112015;06/01/2016 EACH OCCURRENCE s2,0001000 EXCESS LIAB CLAIMS-MADE!. AGGREGATE s2,000,000 DED I X RETENTION S10 000 $ WORKERS COMPENSATION 7WC STATU- !OTH- TOR1 AND EMPLOYERS'LIABILITY YIN I A ANY PROPRIETOR/PARTNER/EXECUTIVE OIC13857476 6101/2015 06/01/2016 E.L.EACH ACCIDENT $1 000 000 OFFICERIMEMBEREXCLUDED? NIA i (Mandatory In NH) WA Stop Gap ',E.L.DISEASE-EA EMPLOYEE S1,000,000 If yyes,describe under EE DESCRIPTtON OF OPERATIONS below I !E.L.DISEASE-POLICY LIMIT S1 000,000 B Pollution CP05030885 6101/2015106/0112016 $1,000,000 Limit A Leased&Rented OIC13857476 06/0112015 06/01/2016 $25,000 Limit Equipment i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE: Riverbend Irrigation Well Additional Insured status as respects General Liability applies per attached form(s). CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2019 West Meeker Street ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S21822761M1981337 AMROO This page has been left blank intentionally. { ""REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS "" Liberty Mutual. COMMERCIAL GENERAL LIABILITY INSURANCE CG 24 04 05 09 POLICY NUMBER: 01-CI-385747-6 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: CITY OF SUMNER CITY OF KENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of damage arising out of your ongoing operations or Rights Of Recovery Against Others To Us of "your work" done under a contract with that person Section IV — Conditions: or organization and included in the We waive any right of recovery we may have against "Products-completed operations hazard". This waiver the person or organization shown in the Schedule applies only to the person or organization shown in above because of payments we make for injury or the Schedule above. o Insurance Services Office, Inc., 2008 CG 24 04 05 09 EP AFP-META2.22-PRINT001.0210-0009-B ....REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS .... Liberty Mutual. CG 76 80 10 02 INSURANCE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: any person or organization for whom you are required by written contract, agreement or permit to provide a primary and noncontributory additional insured endorsement (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION 11 — WHO IS AN INSURED is amended you. Coverage shall be limited to the extent of your to include as an additional insured the person or negligence or fault according to the applicable princi- organization shown in the Schedule subject to the pies of comparative fault. following provisions: 1. The additional insured is an insured but only for The insurance provided will not exceed the lesser of: liability directly resulting from: a. The coverage and/or limits of this policy, or a. your ongoing operations for the additional in- b. The coverage and/or limits required by the sured whether the work is performed by you contract, agreement or permit. or for you; or With respect to the insurance afforded the additional b. the general supervision of your ongoing op- insured, paragraph 4. of SECTION IV — COMMER- erations by the additional insured. CIAL GENERAL LIABILITY CONDITIONS is de- 2. This insurance does not apply to: leted and replaced by the following: a. "Bodily injury" or "property damage" arising 4. Other Insurance Out of any act or omission of, or for defects a. This insurance is primary and noncontrib- in design furnished by or for, the additional utory, and our obligations are not affected by insured or any other insurance where the additional in- b. "Bodily injury" or "property damage" in- sured is the Named Insured, whether pri- cluded within the "products-completed oper- mary, excess, contingent, or on any other ations hazard." basis; however, the defense of any claim or "suit" must be tendered as soon as practi- A person's or organization's status as an additional cable to all other insurers which potentially insured under this endorsement ends when your op- provide insurance for such claim or "suit". erations for that insured are completed. b. This additional provision applies only to the additional insured shown in the Schedule No coverage will be provided if, in the absence of this and the coverage provided by this endorse- endorsement, no liability would be imposed by law on ment. CG 76 80 10 02 EP AFP•META2.22•PRiNT001-0210.0011•B '••"REPRINTED FROM THE ARCHIVE.THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS •.. Liberty Mutual. CU 22 94 02 10 INSURANCE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT. OF OTHER INSURANCE - DESIGNATED PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT, AGREEMENT OR PERMIT TO PROVIDE A PRIMARY AND NONCONTRIBUTORY ADDITIONAL INSURED ENDORSEMENT. The following is added to Condition E. Other Insurance under SECTION IV — CONDITIONS: However, with respect to a person or organization shown in the Schedule, that qualifies as an additional insured under paragraph G. of SECTION II — WHO IS AN INSURED, if a written contract in which you have agreed to provide insurance for that person or organization expressly requires that this insurance ap- plies on a primary or a primary and non-contributory basis, this insurance will apply as if other insurance available to that person or organization which designates that person or organization as a Named Insured does not exist, and we will not share with that other insurance. Regardless of the written contract between you and the person or organization shown in the Schedule, this insurance is still excess over any other valid and collectible insurance available to that person or organization, whether such insurance is primary, con- tributing, excess, contingent or otherwise, as respects "automobiles" or when that person or organization is an additional insured under such other insurance. All other terms and provisions remain the same. 2010 Liberty Mutual Insurance Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CU 22 94 02 10 EP AFP•META2.21•PRINT001.0391-0009•A *-REPRINTED FROM THE ARCHIVE, THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS Liberty Mutual. C U 24 99 04 92 INSURANCE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US AMENDMENT SECTION IV - CONDITION J. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US IS AMENDED TO INCLUDE THE FOLLOW: THIS INSURANCE WILL NOT BE INVALIDATED SHOULD THE "INSURED" WAIVE IN WRITING PRIOR TO LOSS ANY AND ALL RIGHTS OF RECOVERY AGAINST ALL SUBSIDIARY AND AFFILIATED ORGANIZATIONS OF THE NAMED INSURED FOR LOSS OCCURRING TO ANY AND ALL COVERAGES PROVIDED BY THIS POLICY. THIS ENDORSEMENT DOES NOT CHANGE ANY OTHER PROVISION OF THE POLICY. CU 24 99 04 92 EP AFP-META2.21-PRINT001.0391.0011-A '...REPRINTED FROM THE ARCHIVE.THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS - Lib e Mutual. COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 INSURANCE POLICY NUMBER: 01-CI-385747-6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All projects of the named insured unless Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally Construction Project General Aggregate obligated to pay as damages caused by Limit for that designated construction project. "occurrences" under Section I — Coverage A, Such payments shall not reduce the General and for all medical expenses caused by acci- Aggregate Limit shown in the Declarations dents under Section I —Coverage C, which can nor shall they reduce any other Designated be attributed only to ongoing operations at a sin- Construction Project General Aggregate gle designated construction project shown in the Limit for any other designated construction Schedule above: project shown in the Schedule above. 1. A separate Designated Construction Project 4. The limits shown in the Declarations for General Aggregate Limit applies to each Each Occurrence, Damage To Premises designated construction project, and that Rented To You and Medical Expense con- limit is equal to the amount of the General tinue to apply. However, instead of being Aggregate Limit shown in the Declarations. subject to the General Aggregate Limit 2. The Designated Construction Project Gen- shown in the Declarations, such limits will be eral Aggregate Limit is the most we will pay subject to the applicable Designated Con- for the sum of all damages under Coverage struction Project General Aggregate Limit. A, except damages because of "bodily B. For all sums which the insured becomes legally injury" or "property damage" included in the obligated to pay as damages caused by "products-completed operations hazard", "occurrences" under Section I — Coverage A and for medical expenses under Coverage and for all medical expenses caused by acci- C regardless of the number of: dents under Section I — Coverage C, which a. Insureds; cannot be attributed only to ongoing operations at a single designated construction project shown b. Claims made or "suits" brought; or in the Schedule above: c. Persons or organizations making claims 1. Any payments made under Coverage A for or bringing "suits". damages or under Coverage C for medical 3. Any payments made under Coverage A for expenses shall reduce the amount available damages or under Coverage C for medical under the General Aggregate Limit or the expenses shall reduce the Designated Products-completed Operations Aggregate Limit, whichever is applicable; and o Insurance Services Office, Inc., 2008 CG 25 03 05 09 Page 1 of 2 EP AFP-META2-08-PRINT001-0322-0011-J --REPRINTED FROM THE ARCHIVE.THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS "-' 2. Such payments shall not reduce any Desig- Aggregate Limit nor the Designated Construction nated Construction Project General Aggre- Project General Aggregate Limit. gate Limit. D. If the applicable designated construction project C. When coverage for liability arising out of the has been abandoned,delayed,or abandoned and "products-completed operations hazard" is pro- then restarted, or if the authorized contracting vided, any payments for damages because of parties deviate from plans, blueprints, designs, "bodily injury" or "propery damage" included in specifications or timetables, the project will still the "products-completed operations hazard" will be deemed to be the same construction project. reduce the Products-completed Operations Aggregate Limit, and not reduce the General E. The provisions of Section III — Limits of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 AFP-ME7rA2a-PRINT001-0322-DD12,1 ""REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS Liberty Mutual. CG 86 72 10 02 4� INSURANCE POLICY NUMBER: 01-CI-385747-6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for whom you are required by written contract, agreement or permit to provide Completed Ops . coverage. Location and Description of Completed Operations: Your work on all jobs at all locations for the named person or organization. Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION tl — WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only to the extent you are held liable due to "your work" at the location designated and described in the schedule of this endorsement for that insured and included in the "product-completed operations hazard". Includes Copyrighted Information of ISO Properties, Inc., 2001 with permission CG 86 72 10 62 EP AFP-M ETA2a-P R I NT001-0322-0015-J I Page 1 of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Document Received Intent Id: Affidavit Id: Status: Approved On Date: 4/25/2016 757973 4/27/2016 Company Details CHARON DRILLING INC UBl#: 600564782 12719 E 224TH ST Reg#: CHARODII 33NF GRAHAM, WA 98338 E-mail: charondrilling@hotmail.com 253-847-5794 Industrial Insurance Account Id: 51903400 Filed By Charon, Penelope Prime Contractor Company Name CHARON DRILLING INC Contractor Registration No. CHAROD1133NF WA UBI Number 600564782 Phone Number 253-847-5794 Project Information Awarding Agency KENT, CITY OF 220 - 4TH AVE S KENT, WA - 98032-5895 Awarding Agency Contact Melanie Manning Awarding Agency Contact Phone Number 253-856-5192 https://secure.Ini-wa.gov/pwiaNiewlntent.aspx 4/28/2016 Page 2 of 3 Contract Number Project Name Riverbend Irrigation Well Bid due date 3/25/2016 Award Date 4/5/2016 Project Site Address or Directions 2019 West Meeker St Kent, WA Intent Details Does your company intend to hire No subcontractors to perform all work? Does your company intend to hire any No subcontractors? Will your company have employees perform Yes work on this project? Do you intend to use any apprentices? No (apprentices are considered employees.) Will this project utilize American Recovery No and Reinvestment Act (ARRA) funds? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? How many owner/operators performing 1 work on the project own 30% or more of the company? What is the estimated contract amount? Or is $135,106.00 this a time and materials estimate? Expected project start date: (MM-DD-YYYY) 5/2/2016 In what county (or counties) will the project King be done? In what city (or nearest city) will the project Kent be done? Journey Level Wages https:Hsecure.ini.wa.gov/pwiaNiewlntent.aspx 4/28/2016 Page 3 of County Trade Occupation Wage Fringe Workers King Well Drillers & Oiler $22.00 $3.68 1 Irrigation Pump Installers !-1 Show/Hide Existipc j_L�l qLt e r, i,�Io note! e 1J,'-�t,-'" littps:Hsecuie.Ini.wa.gov/pwi�iNiewlntent.aspx 4/28/2016 / , r / 1 I / / J / l 1 I � 1 � f / J f r � l f I J/ f I � f I � r 1 1 rl r ,I I , r r I r , I I I r r r � r I I II, rl 1 J / I r r f f I 1� � I r r I 1 I r f t J / � I I , I I r / I r , I � � I , f 1 1 I � � r r �I r r 1 I � f r r t r I I L I f I r r 1 f J I 1 I � � , 1 I � I � 1 I 1 1 I � I I I 1, r MINIM!' �r � J � J 11 I I ,1 r 1 J � I�I r 1 f / / r �J I / r r No�, Ii III 1 I � � 11�>1 ��1,��1,1 l f l I I 1 r! ,r � I I , r� I I r J I � r l r rr r r , I/ s 1 la r 1/ l 1 J � r 1 r 1 I I r J I r , , r r r/ I / o r / r r r I >J, 11 1 r rr J 1 J I . / 1 I f Fr r J �rl t 1 I � f >/ 1 I r J I I r , I J � � 1 / l J 1 i 1 I I 1 .l I � r I � � I J 1 � I 1 � I 1 � � I I t r I / I 1 � I I � 1 � I J 1I � t � r I Jf i I I � / 1 1 r 1� 1 � 11 t I I I 1 I JI , r 1. I ,� r r / J r J r 1 1 I� J r 1 � J� J , � 1 �I I � I l r�I f r r 1 I J /� J r J fl I 1 I I I I / � J f r I V r , , r I / I / � 1 1r � � I I I I / I � J I, r 1 , J l ® � J / l 1 1 �J . l ,ll1 1 s, r , 1 r I I , d J I s I � Ir 1,, r , , I I f } r � J II IIIIIII IIII� I I f I / f / /( I J J , ,I � 1 I r , I / / i r I / I I r 1 � I I r I, I I/ I i r t I JI i J , l , r I r r/ / / I , i I 1 y 1! 1 I r 1 1 I I 1 I / J J I f � I I I I J J rI � 111 J f I � J /� I I � I 1 I � I � f / r � 1 / � � I / r J � I f J � 1 l 1 I 1 , I / I I 1 rl, � 1 11 � � � r I 1 1 f � J � 1 � 1 1 1 J � r � r � J f � 1- � r I ; JI I 1 1- r