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HomeMy WebLinkAboutCP1308 BNSF Utility Crossing Contact 14-04o 9/I CONTRACT Contract No. 14 -04 THIS AGREEMENT AND CONTRACT, made and entered into, in triplicate, at Auburn, Washington, this �]'t' day of OC{+obu 2014, by and between the CITY OF AUBURN, WASHINGTON, a municipal corporation, and Pacific Civil & Infrastructure, Inc, 3450S.344 1h Way #115, Federal Way, WA 98001, hereinafter called the CONTRACTOR. WITNESSETH. That, in consideration of the terms and conditions contained in the Contract Documents entitled "CP1308, BNSF Utility Crossings," which are by this reference incorporated herein and made a part of this Contract, the parties hereto covenant and agree as follows: I. The CONTRACTOR shall do all work and fumish all tools, materials and equipment for Project CP1308, BNSF Utility Crossings — the construction of replacement of various City utilities at their crossings of Burlington Northern Santa Fe (BNSF) Railroad Rights -of -Way The following utility crossings will be constructed in auger bored casings in the BNSF rights - of -way (1) West Main Street crossing of BNSF Seattle Subdivision. 8 -inch water main; (2) 3rd Street NW crossing of BNSF Seattle Subdivision. 24 -inch sanitary sewer and 24 -inch storm drain, (3) 37th Street NW crossing of BNSF Seattle Subdivision: 12 -inch water main, and (4) Crossing of BNSF Stampede Subdivision approximately 580 feet east from the Auburn -Black Diamond Road SE crossing: 6 -inch water main. The project will also include slipline rehabilitation of a 48 -inch concrete storm drain crossing near the 37th Street NW crossing of BNSF Seattle Subdivision, as well as roadway intersection reconstruction and traffic signal modifications at the intersection of 37th Street NW and B Street NW Work will include but not be limited to traffic control, erosion and sediment control, excavation of boring pits; dewatering; installation of auger bored casings; bypass pumping; installation of gravity and pressure utilities and appurtenances; connection to existing utilities; slipline utility rehabilitation; surface and roadway restoration, roadway excavation; pavement and base course replacement; curb, gutter, sidewalk, and ADA -ramp construction, traffic signal equipment installation; and pavement markings for a unit bid price of one million, four hundred and one thousand, eight hundred and twenty -nine dollars and sixty -one cents ($1,401,829 61) and Washington State Sales Tax of one hundred and nine thousand, three hundred fifty -six dollars and seventy -three cents $109,356.73 for a total contract value of one million, five hundred and eleven thousand, one hundred eighty -six dollars and thirty -four cents ($1,511,186.34) in accordance with and as described in the Contract Documents which are by this reference incorporated herein and made a part hereof, and shall perform any alterations in or additions to the work provided under this Contract and every part thereof. This Contract shall be executed by the Contractor and returned to the City within 7 calendar days after the receipt of the dated notification of award and the Contract time shall commence within 5 working days after execution of the Contract by the City and so designated on the Notice to Proceed. Physical completion shall be within 100 working days of the date on the Notice to Proceed. If said work is not completed within the time specified, the CONTRACTOR agrees to pay liquidated damages to the CITY OF AUBURN, as specified in Section 1 -08 9 (Liquidated Damages) of the Standard Specifications. The CONTRACTOR shall provide and bear the 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 this Contract and every part thereof, except such as are mentioned in the Contract Documents to be furnished by the CITY OF AUBURN II. The CITY OF AUBURN hereby promises and agrees with the CONTRACTOR to employ, and does employ the CONTRACTOR to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the Contract Documents and the terns and conditions herein contained and hereby contracts to pay for the same according to said Contract Documents and the aforesaid proposal hereto attached, at the time and in the manner and upon the conditions provided for in this Contract. III. The CONTRACTOR for himself, and for his heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all the covenants herein contained upon by part of the CONTRACTOR. IV. It is further provided that no liability shall attach to the CITY OF AUBURN, WASHINGTON by reason of entering into this Contract, except as expressly provided herein. IN WITNESS WHEREOF the parties hereto have caused this Contract to be executed the day and year first hereinabove written. Countersigned. this �7r day of OGAob2j , 2014 ATTEST* Danielle E. Daskam, City Clerk AS TO FORM• fi CITY OF AUBURN, WASHINGTON By —"�qTB a ms, Mayor PACIFIC CIVIL & INFRASTRUCTURE, INC By Authorized Official Signature .z CONTRACTBOND CONTRACT NO 14 -04 BOND NO. 09171840 BOND TO CITY OF AUBURN, WASHINGTON KNOW ALL MEN BY THESE PRESENTS. That we, the undersigned, Pacific Civil & Infrastructure. Inc, 3450 S. 344th Way #115. Federal Way, WA 98001, as principal, and Fidelity and Deposit Company of Maryland a corporation, organized and existing under the laws of the State of Maryland 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 Auburn, Washington, in the penal sum of one million, five hundred and eleven thousand, one hundred eighty -six dollars and thirty -four cents ($1.511.186.34) for the payment of which sum we jointly and severally bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into in pursuance of the Statutes of the State of Washington and the Ordinances of the City of Auburn, Washington. Dated at Auburn, Washington, this h day of October 2014. Nevertheless, the conditions of the above obligation are such that: WHEREAS, the City of Auburn on the 6th day of October, 2014, let to the above bounden principal a certain Contract. The said Contract being numbered 14 -04, and providing for the construction of Project CP1308, BNSF Utility Crossings - replacement of various City utilities at their crossings of Burlington Northern Santa Fe (BNSF) Railroad Rights -of -Way. The following utility crossings will be constructed in auger bored casings in the BNSF rights -of -way (1) West Main Street crossing of BNSF Seattle Subdivision: 8 -inch water main; (2) 3rd Street NW crossing of BNSF Seattle Subdivision: 24 -inch sanitary sewer and 24 -inch storm drain; (3) 37th Street NW crossing of BNSF Seattle Subdivision: 12 -inch water main; and (4) Crossing of BNSF Stampede Subdivision approximately 580 feet east from the Auburn -Black Diamond Road SE crossing: 6 -inch water main. The project will also include slipline rehabilitation of a 48 -inch concrete storm drain crossing near the 37th Street NW crossing of BNSF Seattle Subdivision, as well as roadway intersection reconstruction and traffic signal modifications at the intersection of 37th Street NW and B Street NW. Work will include but not be limited to traffic control; erosion and sediment control; excavation of boring pits; dewatering; installation of auger bored casings; bypass pumping; installation of gravity and pressure utilities and appurtenances; connection to existing utilities; slipline utility rehabilitation; surface and roadway restoration; roadway excavation; pavement and base course replacement; curb, gutter, sidewalk, and ADA -ramp construction; traffic signal equipment installation; and pavement markings (which Contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, the said principal has accepted, or is about to accept, the said Contract, and undertake to perform the work therein provided for in the manner and within the time set forth: NOW, THEREFORE, if the above bounden principal shall faithfully and truly observed and comply with the terms, conditions, and provisions of said Contract in all respects and shall well and truly and fully do and perform all matters and things by them undertaken to be performed under said Contract, upon the terms proposed therein, and any and all duly authorized modifications of said Contract that may hereafter by made, and within the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and material men, and all persons who shall supply principal or subcontractors with provisions and supplies for the carrying on of said work and shall hold said City of Auburn, Washington, harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal or any subcontractor in the performance of said work, and shall in all respects faithfully perform said Contract according to law, and shall indemnify and hold the City of Auburn, Washington, harmless from any damage or expense by reason of failure of performance, as specified in said Contract, and The undersigned principal and the undersigned surety present this contract bond related to the Contract, PROVIDED that this document shall not be enforceable unless and until the City of Auburn awards and executes the Contract to the undersigned principal. No obligations under this bond, for the performance of the above - referenced contract, shall be enforceable until the City of Auburn has executed the contract to the undersigned principal. The Surety, hereby agrees that modifications and changes may be made in the terms and provisions of the aforesaid Contract without notice to Surety, and any such modifications or changes increasing the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this Contract Bond in a like amount, such increase; however, not to exceed twenty — five percent (25 %) of the original amount of this bond without the consent of the Surety. PROVIDED, however, that after the acceptance of this Contract and the expiration of the lien period, and if there are no liens pending, then the penal sum of this bond, shall be reduced to either ten percent (10 %) of the value of the improvements to the City or two thousand dollars ($2,000), whichever is greater, to warranty against defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance. Not withstanding the reduction of this bond, the principal and surety shall hold the City of Auburn harmless from all defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance, THEN and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. It is hereby expressly agreed that if any legal action is necessary to be brought under the conditions of this bond, that the decisions of the Courts of the State of Washington shall be binding. IN WITNESS WHEREOF, the above - bounden parties have executed this instrument this 9th day of October 02014 Pacific Civil & Infrastructure, Inc. Fidelitv and Deposit COmDanv of Marvland Surety G� By r Atto 601 Fact Christopher Kinyon Propellnsurance 1201 Pacific Ave. Suite 1000 Tacoma, WA 98402 (253) 759 -2200 Resident Agent's Address & Phone Number ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANI FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies "), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Eric A. ZIMMEPMAN, James B. BINDER, Karen SWANSON, Jennifer SNYDER, Julie R. TRUITT, Peggy A. FIRTH, Christopher KINVON, Jamie DIEMER, Carley ESPIRITU and Mandy KELTNER, all of Tacoma, Washington, EACH its true and lawful agent and Attomey -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice - President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 27th day of May, A.D. 2014. ATTEST: BY ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND µgaQ,� ♦a Olipj, .GNj i1LS(,.pY�•q or b% 1WB ji Y'Y�yrv,Minr ��� Assistant Secretary Vice President Eric D Burnes Thomas O. McClellan State of Maryland City of Baltimore On this 27th day of May, A D 2014, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O. MCCLELLAN, Vice President, and ERIC D. BARNES, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and smith, that he/she is the said officer of the Company aforesaid, and that die seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations IN TESTIMONY WHEREOF 1 have hereunto set my hand and affixed my Official Seal the day and year first above written 7"l jiili,Uc� 1✓ '!t �tii� "� Mana D Adamski, Notary Public My Commission Expires July 8, 2015 POA -F 180 -2849C EXTRACT FROM BY -LAWS OF THE COMPANIES "Article V, Section 8, Attomeys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomcys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company and may authorize any officer or any such attorney -m -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate, and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company " This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice- President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed, IN TESTIMONY HEREOF, I have h reunto subscribed my name and affixed the corporate seals of the said Companies, this q� day of 0&/ 0 P , 20A lo i°r" u ✓ a :m ' _ oE Sd j wo ;V,_om Geoffrey Delisio, Vice President Page 1 of 2 }t Search > FIDELITY & DEPOSIT COMPANY OF MARYLAND FIDELITY & DEPOSIT COMPANY OF MARYLAND General I Contact I Licensing I Appointments I Complaints I Orders I National Info I Ratings Back to Search General information Contact information Name: FIDELITY & DEPOSIT COMPANY OF MARYLAND Mailing address Corporate family group: Z_ URICH INS GRP ,,,,Registered address 1400 AMERICAN LN,TWR 1, trial 600 Red Brook Blvd 19TH F Organization type: PROPERTY Owings Mills, MD 21211 SCHAUMBURG, IL 50196- 1056 W AOIC: 442 NAIC: 39306 Status: ACTIVE Admitted date: 07/27/1895 Ownership type: STOCK ^ back to top Telephone 410 -539 -0800 Telephone 410 -539 -0800 Types of coverage authorized to sell b,,hat is th¢� Insurance types Casualty j Marine ----- - Ocean Marine Property _ - - -- _ Surety Vehicle......... - -- --� back to top Agents and agencies that represent this company (Appointments) What is this? View agents View agencies ^ pact to top Company complaint history What .,tb,� View complaints ^ back to top Disciplinary orders 2008 -2014 what is tnis. Year _ Order Number_ 2013 _ 13 -0223 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 -725 -7047 or email legal @oic.wa.gov Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. ^ back to rip http:/h vww. insurance.wa.goN,/consumertooIkit /Company /CompanvProfiIe.aspx? WAOIC. 10/17/2014 Page 2 of 2 National information on insurance companies Want more information about this company? The NAIC's Consumer Information page allows you to retrieve national financial and complaint information on insurance companies, plus has information and tips to help you understand current insurance issues. ^ bah m tap Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability Some of these companies charge for their services. A.M. Best Weiss Groin Ratings Standard and Poor's Corp Moody'sInvestors Service If itch _IBCA, Duff and Phelps Ratings ^ back romp http: / /cvww. insurance .wa.gov /consumertoolkil/ Company /CompanyProtile.aspx ?WAOIC 10/17/2014 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A..M cBe�s�t''sr �+� *� ^p rVi 3. (i lTeY f `i¢ig3'f�.I L4: 4i C f3 169 Member Center Log I SIgn UQ Need Coverage? How Does Your Insu;r�er �Rate? State Insurance Information Find Insurers by state or coverage type Enter A company Name seleq a elate Consumer -Hu Ime I Terms to Know I y%by a Best's Rating Is Important I Contact Us la Life & Retirement © Health 8 Disability Q Car 8 Home O Other Life Events Fidelity and Deposit Company of Maryland A Print thin pane I. —rbp,, rt zoom amen. G, ua) AM Baux 1030] NNICY as. FEIN it 13.201 Address 1400 American Lane Phone 800 -987 -3373 Schaumburg, IL 60196 -1056 Fax 877 -962 -2567 UNITED STATES Web zunchna Co. Best's Ratings View Definition Need More Information? Purchase an insurer reason, complete with Finanaal Strength Rating A+ rating history, market share and a list of Outlook Stable competitive insurers for $ 9 95 Effective Dale November 27, 2073 Affirmed ( ) View Samole Report Financial Size Category %V ($2 Billion or greater) Licensing: The company Is licensed In the District of Columbia, Guam, Northern Mariana Islands, Puerto Rico, U S Virgin Islands and all states Top Lines) of Business feneed upon Duaa a,emum Wtieem 1 surety a wear ennitio0) 2 Fidelity (vieworeelin I 3 Commercial Multiple Peril (view o fnnnun ) 4 Homeowners Multiple Peril rv�rnrui 5 Allied Lines fuiew Dannmi Top States) of Business fluxes upon pan Premiums written) 1 California 2 New York 3 Florida 4 Texas 5 Virginia Visit our NewsRoom for the latest News and Press Releases for this company and its A I Best Group, Terms of Use All Information provided on the A M Best website, Including but not United to text, data ratings, reports, Images, photos, graphics, and chains Is owned by or licensed to A M Best Company and Is protected by United States copyright laws and International treaty provisions A M Best and its licensors retain all copyright and other proprietary rights to the werbsce content Bests Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored in a database or retrieval system In any form for commercial purposes without the prior wntten permission of the A M Best Company All unauthorized use of Best's Credit Ratings or other published Information Is strictly prohibited By logging Into Best's Member Center or accessmq this site, you accept and agree to be bound by our complete 7Al of Use Customer Sarvice 1 Period Sunda I Member Center I Contact In I Careers About A M Best I Site Isla I Privacy Poso I Security I Terms gt Use I Legal 8 Licensing Copyright C 2014 A M Best Company. Inc ALL RIGHTS RESERVED A M Best Woddwide Headquarters, Arl Road Oldwick, New Jersey, orla58, U S A http: / /xvww3.ambest .com /Consumers /Coinpan),Profile.aspx' ?BL =36 &ambnum= 000387 &. 10/17/2014 i BOND IN LIEU OF RETAINAGE (Retainage Bond -RCW 60.28) Bond No. 08171841 KNOW ALL PERSONS BY THESE PRESENTS, THAT corporation organized under the laws of the State of Washington and registered to do business in the State of Washington as a contractor, as Principal, and Fldelity and Deposit Company of Maryland corporation organized under the laws of the State of Maryland and registered to transact business in the State of Washington as surety, as Surety, their heirs, executors, administrators, successors and assigns, are jointly and severally held and bound to the City of Auburn, Washington, hereinafter called CITY, and are similarly held and bound unto the beneficiaries of the trust fund created by RCW 60.28, in the sum of five percent (5 %) of all amounts earned by the Principal on the contract described below. THE CONDITIONS OF THIS BOND OBLIGATION ARE THAT WHEREAS, on the Mday of 07,40bf�2014, the Principal executed Contract No. 14 -04 with the CITY for Project Number CP1308, BNSF Utility Crossings; and WHEREAS, said contract and RCW 60.28 require the CITY to withhold from the Principal the sum of five percent (5 %) from monies earned by the Principal on estimates during the progress of the construction, hereinafter referred to as earned retained funds; and WHEREAS, the Principal has requested that the CITY not retain any earned retained funds as allowed under RCW 60.28; NOW, THEREFORE, the condition of this obligation is such that the surety is held and bound to the CITY and to the beneficiaries of the trust fund created by RCW 60.28 in the sum of five percent (5 %) of the final contract cost which shall include any increases due to change orders, increases in quantities of work, addition of new items of work, or otherwise, hereafter referred to as the final contract cost. If all purposes of RCW 60.28 and all contract obligations are fulfilled, then this obligation shall be null and void, otherwise, it shall remain in full force and effect until release is authorized in writing by the CITY. IT IS FURTHER EXPRESSLY AGREED THAT 1 The liability of the Surety under this bond shall not exceed five percent (5 %) of the final contract cost, if no monies are retained by the CITY pursuant to RCW 60.28 on estimates during the progress of construction. Retainage Bond Page 1 of 3 1 2. In the event this bond ceases to comply with CITY standards, the CITY reserves the right to resume the actual withholding of earned retained funds according to the contractor's designated option for management of retainage under RCW 60.28.011(4). In the event the CITY resumes withholding of earned retained funds, the liability of the Surety under this bond shall not exceed the actual amount of the earned retained funds which were covered by this bond and released by the CITY prior to resumption of actual withholding. 3. The Surety hereby consents to and waives notice of any extension in the time for performance of the contract, assignment of obligations under the contract, or contract alteration, amendment, or change order 4 Any suit under this bond must be instituted within the time period provided by applicable law with venue in King County, Washington. This bond and any proceeds therefrom shall be subject to all claims and liens and in the same manner and priority as set forth for retained percentages in RCW 60.28 5. Until written release of this obligation by the CITY, this bond may not be terminated or canceled by the Principal or the Surety for any reason. Any extension of time for the Principal's performance on the contract, assignments of obligations under the contract, or any amendment to the contract or change orders of any kind shall not release the Surety from its obligation under this bond. 6. The contractor shall comply with all applicable requirements of RCW 60.28. 7 RCW 60.28 requires the CITY to accept a retainage bond in lieu of withholding earned retained funds and the Surety hereby waives any defense that this bond or bond form is void or otherwise not authorized by law. 8. Any claim or suit against the CITY to foreclose the liens provided for by RCW 60.28 shall be effective against the Principal and Surety and any judgment under 60.28 against the CITY shall be conclusive against the Principal and Surety WITNESS our hands this stn day of October 2014 Retainage Bond Page 2 of 3 PRINCIPAL: Pacific Civil & Infrastructure, Inc 3450 S 344" Way #115 Federal y,//W''A 980 11/ (Signature of Authorized Representative) Print/ Type Name SURETY: Fidelity and Deposit Company of Maryland By- _ (Signatur of Attorn I act fo (Surety *) Christopher Kinyon (Typed Name of Attorney -in- Fact)" Dated October 9, 2014 Local Agent Name, Phone, & Address Propel Insurance 1201 Pacific Ave, Suite 1000 Tacoma, WA 98402 CITY OF AUBURN: Accepted By Ingrid G ub, sst. DifE for of trigineering Services /City Engineer *This bond must be accompanied by a fully executed Power of Attorney appointing the Attorney -in -Fact before it becomes effective. Retainage Bond Page 3 of 3 x } ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS. That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies "), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Eric A. ZIMMERMAN, James B. BINDER, Karen SWANSON, Jennifer SNYDER, Julie R. TRUITT, Peggy A. FIRTH, Christopher KINVON, Jamie DIEMER, Carley ESPIRITU and Mandy KELTNER, all of Tacoma, Washington, EACH its true and lawful agent and Attomcy -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as Its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New Y ork, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office In Owings Mills, Maryland, in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice- President has hereunto subscribed hisilier names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND this 27th day of May, A.D 2014. ATTEST BY %J, ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARY LAND :oil rca'°y''u n4 n3 �7 uw •� vsI Assistant Secretary Vice President Eric D Barnes Thonms O. McClellan State of Maryland City of Baltimore On this 27th day of May, A D 2014, before the subscnbeh, a Notary Public of the State of Maryland, duly colnm ssioned and qualified, THOMAS O. MCCLELLAN, Vice President, and ERIC D. BARNES, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described In and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and sauh, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were dulv affixed and subscnbed to the said instrument by the authomy and direction of the said Corporations IN TESTIMONY WHEREOF I have hereunto set my hand and affixed my Official Seal the day and year first above written POA -F 180 -2849C Maria D. Adamskh, Notary Public My Commission Expires July R, 201$ POA -F 180 -2849C EXTRACT FROM BY -LAWS OF THE COMPANIES "Article V, Section 8, Attomeys -in -Fact The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or olhei like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and 1 do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED "That the signature of the President or a Vice President and the attesting signature of a Sccrctary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company " This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED* "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice - President, Secretary, or Assistant Secretary of the Company, whether nmde heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, 1 have hereunto subscribed my name and affixed the corporate seals of the said Companies, this � day of 0"� er , 20]U n„ • p �; 'oa 86AL Geoffrey Delisto, Vice President Page I of 2 A Search > FIDELITY & DEPOSIT COMPANY OF MARYLAND FIDELITY & DEPOSIT COMPANY OF MARYLAND General I Contact I Licensing I Appantrrents I Complmnts I Orders I National Info I ratings Back to Search General information Contact information Name: FIDELITY & DEPOSIT COMPANY OF MARYLAND Mailing address Corporate family group: ZURICH INS GRP ,mat,Registered address 1400 AMERICAN LN,TWR 1, m'31 600 Red Brook Blvd 19TH F Organization type: PROPERTY Owings Mills, MD 21211 SCHAUMBURG, IL 60196- 1056 WAOIC: 442 NAIC: 39306 Status: ACTIVE Admitted date: 07/27/1895 Ownership type: STOCK oa<k to top Telephone 410 -539 -0800 Telephone 410 -539 -0800 Types of coverage authorized to sell ,baLisths? IInsurancetypes [Casualty _ Marine Ocean Marine [Property [Surety (vehicle ° book tc tap Agents and agencies that represent this company (Appointments) Shat c tN3> View agents View agencies ^ back to top Company complaint history V,hot is nns' View complaints - back m by Disciplinary orders 2008 -2014 Year (Order Number --- 2013 113 -0223 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 - 725 -7047 or email legal @oic.wa.gov Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. ^ back ro top A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M Best's`, Cons.,umerr In4wance gentep 114 Member Center Lee In l Sign uv Need Coverage? How Does Your Insurer Rate? State Insurance Information Find insurers by state or coverage type Enlera Company Name I�� Seltna5131e Consumer Hume I Terms to<Bow I Any a Best's Rating is important I Centact Us i © Life & Retirement O Health & Disability Q Car & Home O Other Life Events Fidelity and Deposit Company of Maryland Pmt this Me,B la R4mEer of oriel, Ineii.— C/ou, hil AM BesA 00]87 N4 to 139. Frills 1Y-IN1117 Address 1400 American Lane Phone 800 -987 -3373 Schaumburg, IL 60196 -1056 Fax 877- 962 -2567 UNITED STATES Web www zumi hma cam Best's Ratings View Detmiovg Need More information? Financial Strength Rating A+ M Purchase an Insurer report, complete with Outlook Stable rating history , mallet share antl a list of Effective Date November 21, 2013 (Affirmed) comJpetitive insurers for $ 995 Financial Size Category XV ($2 Billion or greater) View Sample Repo Licensing: The company Is licensed In the District of Columbia, Guam, Northern Mariana Islands, Puerto Rico, U S Virgin Islands and all states Top Line(s) of Business usuee up— Dean ammumzwrmenl 1 Surety resew oearremi I 2 Fidelity Crew Dermnnn) 3 Commercial Multiple Peril Mew Denoeionl 4 Homeowners Multiple Peril tvrew DeeeaionI 5 Allied Lines Mew Deem or I Top States) of Business Less. , -area Rrem.me vin em 1 California 2 New York 3 Florida 4 Texas 5 Virginia Visit our NeweROOm for the latest News and Press Releases tot this company and its A M Best Group Terms of Use All information provided on the A M Best website, including but not limited to text, data, ratings, reports, images, photos, graphics, and charts Is owned By or licensed to A M Best Company and Is protected by United States copyright laws and international treaty provisions A M Best and its licensors retain all copyright and other proprietary rights to the website content Best's Credit Ratings, obtained through any source, may not be reproduced distributed to Third Parties, or stored in a database or retrieval system in any form far commercial purposes without the prior written permission of the A M Best Company All unauthorized use of Best's Credit Ratings or other published information Is strictly prohibited By logging into Best's Member Center or accessing this site you accept and agree to be bound by our complete Terms of Use Customer Service I Pmdud Support I Member Center I Contact Into I Careers About AM Best l Site Map I Pnvacv pole, I S,c.r, I Temps of Use l Leoal &Lean n Copynght ® 2014 A M Beal Company, Inc ALL RIGHTS RESERVED AM Best Worldwide Headquarters, Ambest Road, Oldw¢k, New Jersey, 08858, USA http: / /evww3. ambest .com /Consumers /ConipanyProftle .asps ?BL= 36 &ambntim =0003 87 &. 10/17/2014 ACOR" CERTIFICATE OF LIABILITY INSURANCE `' D10 /14 I °DY4 10/14/2014 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(les) 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 WAN712152 1- 206 - 343 -2323 MCM Insurance Services LLC dba MGM MCM Benefits and Insurance Services, LLC, CA Lrc 110F82099 1325 Fourth Avenue, Suite 2100 CONTACT NAME PHONE FAX INC. No E.I) Cac No) E -MAIL ADDRESS INSURER(S) AFFORDING COVERAGE NAIGp Seattle, WA 98101 INSURER OHIO CAB INS CO 124074 INSURED INSURERS OHIO SECDAITY INS CO 24082 Pacific Civil & Infrastructure INSURER C SCOTTSDALE INS CO 41297 INSURER PRODUCTS DO All All 3450 S 344th Way Suite 115 INSURER $ Federal Way WA 98001 AUTOMOBILE LIABILITY L�� ANY AUTO ALL O SCHEDULED x AUUTOS S AUTOS NON -OWNED HIRED AUTOS X AUTOS X $500 COMP D$D $500 COLL DED x i� INSURER F 05/01/14 COVERAGES CERTIFICATE NUMBER: 41833823 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE iA0DL15UBR INSR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE POLICY NUMBER MMI DNYri MMIDDIYEYYY I LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR X WA Stop Gap �J X X BLS1556088758 04/21/14 04/21/151 EACH OCCURRENCE DAMAGE TO RENTED REMISES Ea occurrence $ 1,000,000 $ 1,000,000 MED ESP (Any ane person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 I USA GENERALAGGREGATE $ 2,000,000 GEN L AGGREGATE LIMIT AP-LIES PER POLICY PRO LOC PRODUCTS DO All All 52.000,000 $ B AUTOMOBILE LIABILITY L�� ANY AUTO ALL O SCHEDULED x AUUTOS S AUTOS NON -OWNED HIRED AUTOS X AUTOS X $500 COMP D$D $500 COLL DED x i� BAS1556088758 05/01/14 U4 /21/1!a COMBINED SINGLE LIMIT (Ea accident $ 11000,000 BODILY INJURY (Per Person) $ BODILY INJURY (Per accident) )$ PROPERTY DAMAGE L {P er acaden0 $ Ig C � L'- !11 UMBRELLA LIAB EXCESS LIAB I I—' I IOCCUR (CLAIMS -M ADE XLS0094838 10/14/14 04/21/151 EACH OCCURRENCE $ 9,0D0,000 AGGREGATE $ 9,000,000 I 1 I DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PROP R I ETORIPARTNE RIEXECUTIVE Y N OFFICERIMEMBEREKCWDEDn ❑ (Mandatory In NH) Ifyes, descnbe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- TORY LI 'IT' ANY E L EACH OCCIDENT $ E L DISEASE EA EMPLOYEE; $ EL DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, Additional Remarks Schedule, d more spaces v,nvd) RE Contract No 14 -04 Proect No CP1308 Project Name BNSF Utility Crossings Insurance rs considered primary non contributory and a waiver of subrogation shall apply The contracting agencyh and its officers, elected officials, employees, agents, and volunteers; Burlington Northern Santa Fe Railroad Company (BNSF) are named additional insured per the attached CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) reganhup£ 41833823 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Auburn THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN Engineering Division ACCORDANCE WITH THE POLICY PROVISIONS. 25 West Main BE AUTHORIZED REPRESENTATIVE Auburn, WA 98001 "(� I �w.,i. w' /AL -tL� I USA J ACORD 25 (2010/05) reganhup£ 41833823 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON - CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office. Inc., with its permission. Page 1 of 8 P EXTENDED PROPERTY DAMAGE Q. x Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following a. Expected Or Intended Injury 'Bodily Injury' or "property damage" expected or Intended from the standpoint of the Insured. This exclusion does not apply to 'bodily Injury" or "property damage' resulting from the use of reasonable force to protect persons or property WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US • WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work' done under a contract with that person or organization and included In the "products- completed operations hazard" provided: 1 You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 8 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided 1 It is not owned by any insured; 2. It Is hired, chartered or loaned with a trained paid crew, 3. The pilot in command holds a currently effective certificate, Issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot, and _ 4. It is not being used to carry persons or property for a charge However, the insurance afforded by this provision does not apply if there is available to the insured other ° valid and collectible insurance, whether primary, excess (other than Insurance written to apply specifically s in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is. (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1 Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply If such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not Include vehicle lifts. Vehicle lifts are lifts or hoists used In automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The Insurance afforded by this provision of this endorsement Is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1 Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability, a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days A separate limit of Insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc , with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions Is replaced by the following. Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection Sys- tems: or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions Is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included In your premises rental or lease agreement, Is not an "insured contract" E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1 Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are Incurred and reported within three years of the date of the accident: and F EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1 Under Supplementary Payments - Coverages A and B, Paragraph 1.b. Is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. Is replaced by the following. d. All reasonable expenses incurred by the Insured at our request to assist us In the Investigation or defense of the claim or "suit ", Including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1 Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional Insured but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused in whole or in part by a. Your acts or omissions, or the acts or omissions of those acting on your behalf, In the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs. or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 8 b. Premises or facilities rented by you or used by you, or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization, or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions' (1) This insurance does not apply to "bodily injury", "property damage ", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage' included within the .'completed operations hazard" (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards' (a) The existence, maintenance, repair, construction, erection, or removal of advertising —_ signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- __ sures, or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However 1 The insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by r the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organizations status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury' or "property damage" We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability- This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury' or "property damage" or the offense which caused the "personal and advertising injury", Involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily Injury" or "property damage" occurring after, (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the Injury or damage arises has been put to Its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy 3. With respect to the insurance afforded to these additional insureds, the following Is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS Is amend- ed as follows a. The following Is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making Its policy excess, and you have agreed in a written contract or written agreement to provide the additional Insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc with its permission. Page 5 of 8 b. The following Is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or (ease contract or agreement, or permit issued by a state or political subdivision between you and an additional Insured does not require this insurance to be primary or primary and non - contributory, this Insurance Is excess over any other insurance for which the addi- tional Insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance Is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional Insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional Insured under any form or endorsement under this policy a1 The following Is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional Insured under this endorsement will as soon as practicable a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us, "s — b. Tender the defense and Indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured, and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or Indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured 2. The limits of insurance applicable to the additional Insured are those specified in a written contract or written agreement or the limits of Insurance as stated In the Declarations of this policy and defined in Section III - Limits of Insurance of this policy whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured Is replaced with the following: (1) "Bodily injury" or "personal and advertising injury" (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co- "employee" while In the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business, (b) To the spouse, child, parent, brother or sister of that co- "employee" or "volunteer worker" as a consequence of Paragraph (1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above, or (d) Arising out of his or her providing or falling to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees' are Insureds for "bodily injury' or "personal and © 20131-Iberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office. Inc. with its permission Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused In whole or in part by their intoxica- tion by liquor or controlled substances The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee" K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage' that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV -Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence ", offense claim or "suit" by an agent, servant or "employee' of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1 of Section II - Who Is An Insured or a person who has been designated by them to receive reports of ..occurrences', offenses, claims or "suits" shall have received such notice from the agent, servant or .employee" N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc with its permission. Page 7 of 8 a g P EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury 'Bodily Injury' or 'property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or 'property damage" resulting from the use of reasonable force to protect persons or property Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for Injury or damage arising out of your ongoing operations or "your work' done under a contract with that person or organization and included In the 'products- completed operations hazard" provided: 1 You and that person or organization have agreed in writing In a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc with Its permission. Page 8 of 8 Page 1 of 2 A Search > OHIO CASUALTY INSURANCE COMPANY THE OHIO CASUALTY INSURANCE COMPANY THE General I Contact I Licensing I Appointments I Complaints I Orders I National Info I Ratings Back to Search General information Name: OHIO CASUALTY INSURANCE COMPANY THE Corporate family group: LIBERTY MUFF GRP what .s this, Organization type: PROPERTY WAOIC: 1001 NAIC: 24074 Status: ACTIVE Admitted date: 04/10/1926 Ownership type: STOCK ^ back to rop Contact information Registered address 62 MAPLE AVE KEENE, NH 03431 Telephone 513- 603 -2400 Types of coverage authorized to sell V /het a thu? Insurance types Disability Manne Ocean Marine Property Surety - -- ___ - -_ - - -1 Vehicle_ ^back to top - - - - -- — Agents and agencies that represent this company (Appointments) What is this' View agents View agencies ^ back to tap Company complaint history \ ^,hat ie trill View complaints ^ back to top Disciplinary orders 2008 -2014 e•,hat „th,=: Year Order Number _ d 12012 12 -0253 j Mailing address 175 BERKELEY ST BOSTON, MA 02116 Telephone 617- 357 -9500 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 - 725 -7047 or email legal @oic.wa.gov Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. ^ has to LOP http: / /www. insurance .wa.gov /consumertoolkit /Company /Compan),Profi le.asps' WAOIC. 10/17/2014 Page 2 of 2 National information on insurance companies Want more information about this company? The NAIC's Consumer Information (CIS) page allows you to retrieve national financial and complaint information on insurance companies, plus has information and tips to help you understand current insurance issues. ^ bats to top Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability Some of these companies charge for their services. A.M._Best Weiss _G rout Ratings Standard and Poor's Corp Moody's Investors Service Fitch IBCA, Duff and Phelps Ratings ^ back to top http: / /www. insurance .wa.gov /consumertoolkit/ Company /CompanyProfile.aspx "WAOIC 10/17/2014 A.M. Best's Consumer Insurance Information Center Page 1 of 1 FAN.Bests 10 Member Center Loa In lSign U2 Need Coverage? How Does Your Insurer Rate? State Insurance Information Find Insurers by state or coverage type '- Enera Cmnpany Name [�,R.�l eeletl aSlale Comumel�Hour, I Terms to know I My a Best's Paging Is Important I Contact Us Life & Retirement © Health & Disability Q Car & Home ® Other Life Events Ohio Casualty Insurance Company 19 Pnntthisoaga a memo¢, u1 Lineny Mutual Insu,an1. companieel AM Best 102378 NAltr 24074 FEINN 310398250 Address 175 Berkeley Street Phone 513603 -2400 Boston, MA 02116 Fax 513 - 603 -3179 UNITED STATES Web wwwL ry MUtuA1Grouo nom Best's Ratings VlewDourntlon Need More information? Financial Strength Rating A Purchase an msurer report, complete with rating history, market share and a list of Outlook Stable insurers for $ 9 95 pSample Effective Date September 24, 2014 (Affirmed) View Repo Financial Size Category XV (E2 Billion or greater) Licensing: The company is licensed In the District of Columbia and all states Top Lines) of Business (based upon used Premiums wraeq 1 Other Liability (Occurrence) New promisor ) 2 Surety ohn. 04enmon) 3 Commercial Multiple Peril N,ew D=Im „on) 4 Auto(Commercial)Chew Dearitrn) 5 Workers' Compensation Were Drina.nn) Top State(s) of Business (based upon Direct wemune condom 1 New Jersey 2 Washington 3 Pennsylvania 4 Texas 5 New York Visit our NeweRoom for the latest News and Press Releases for this company and Its A M Best Group Terms of Use All information provided on the A M Best websee, including but not limited to text, data, ratings, reports, Images, photos, graphics, and charts Is owned by or licensed to A M Best Company and Is protected by United States copyright laws and International treaty provisions A M Best and its licensors retain all copyright and other proprietary rights to the webste content Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored In a database or retrieval system In any forth for commercial purposes without the prior written permission of the A M Best Company All unauthorized use of Best's Credit Ratings or other published Information Is strictly prohibited, By togging mio Best s Member Center or accessing this site, you accept and agree to be bound by our complete Terms of Use Customer Sery ice I Product Forms, I Member Center I Contact Into I Careers About A M Best I Site Me I Privacy Policy I Ses� I Terms of Use I Lenal a Llcens,na Copyright ® 2014 A M Best Company, Inc ALL RIGHTS RESERVED A M Best Worldwide Headquarters, Ambest Road, Oldwmk, New Jersey, 08858, U S A http: /hvww3.ambest.com/ Consumers /CompanyProfile.asps?B L- 36 &ambnum °00237U. 10/17/2014 A Search > OHIO SECURITY INSURANCE COMPANY OHIO SECURITY INSURANCE COMPANY General I Contact I Licensing I APpomtments I Complaints I Orders I national Info I Ratings Back to Search General information Contact information Name: OHIO SECURITY INSURANCE COMPANY Registered Corporate family group: LIBERTY MUFF GRP What,,tho> address Organization type: PROPERTY 62 MAPLE AVE KEENE, NH 03431 WAOIC: 1007 NAIC: 24082 Telephone 513- 867 -3023 Status: ACTIVE Admitted date: 06/11/1974 Ownership type: STOCK ^ back to top Types of coverage authorized to sell 1hat is thr> Insurance types Casualty Marine Ocean Marine Property Surety Vehicle 7 ^ back to top Agents and agencies that represent this company (Appointments) ,,hat is this? View agents View agencies ^ back to top Company complaint history dall View complaints ^ back m top Disciplinary orders 2008 -2014 V /hat is this? Year Order Number _ 1 2012 __. 12 -0253 _--- .-- __ - -__ Page I of 2 Mailing address 175 BERKELEY ST BOSTON, MA 02116 Telephone 617- 357 -9500 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 -725 -7047 or email legal @oic.wa.gov Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. ^ bad to top http: / /www. insurance .wa.gov /consumertoolkit/ Company /CompanyProfile.aspx' ?WAOIC 10/17/2014 Page 2 of 2 National information on insurance companies Want more information about this company? The NAIC's Consumer Information (CIS) page allows you to retrieve national financial and complaint information on insurance companies, plus has information and tips to help you understand current insurance issues. ^ back to top Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability Some of these companies charge for their services. A.M. Best __ Weiss Group Ratings Standard and Poor's Corp _ Moody's Investors Service Fitch IBCA, Duff and Phelps Ratings ^ back to top http. / /www. insurance .wa.gov /consumertoolkit/ Company /CompanyProfile.aspx ?WAOIC 10/17/2014 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M.Best's QuAt#mI inglgan p q' p/� r ' 10 Member Center Loaf I$Iran UB Need Coverage? Em How Does Your Insurer Rate? State Insurance Information Find msurers by state or coverage type LiEnei a I Selea a slate Consumer Home I Terms to Know I My a Best's Rabng is Important I Contact Us QLlfe & Retirement O Health 8 Disability Q Car & Home O Other Lde Events Ohio Security Insurance Company OR Print thispaae (a member of uteri, Mutual ir.oaeoe eoay.,,sl AM Best#02379 WIC 02a092 FEIN #9t -05417'] Address 175 Berkeley Street Phone 513-603 -2400 Boston, MA 02116 Fax 513£03 -3179 UNITED STATES Web www LiberryMutual Group con Best's Ratings Vlewomfndlon Need More information? Financial Strength Rating A purchase an Insurer report , complete with Outlook Stable rating history , market share and a list of Effective Date September 24, 2014 Affirmed view S mp Insurers for $ 9 95 p ( ) view Sample fteoon Financial Sze Category. SV (S2 Billion or greater) Licensing: The company Is licensed In the District of Columbia, AL, AK, AZ, AR, G0, CT, DE, FL, GA, ID IL, IN IA, KS, BY LA, MD, MA, Ml, MN, MS, MO, MT, NE, NV NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, Wd, WI and WY Top Line(s) of Business Box. vvon o #ea ciem�oms vo meal 1 Commercial Multiple Peril M1w DriM* I 2 Auto (Commercial) Mew oebniinn 3 Workers' Compensation Now Danmboa t 4 Other Liability (Occurrence) Ivmw oabnmorii 5 Products Liability Mew Dabmban) Top States) of Business Into..pee Ii fir— onvw#veet 1 Washington 2 Texas 3 Colorado 4 Oregon 5 New Jersey Visit our NewsRoom for the latest News and Press Releases for this company and Its A M Best Group Terms of Use All information provided on the A M Best website, including but not limited to text, data ratings, reports, Images, photos, graphics, and charts Is owned by or licensed to A M Best Company and Is protected by United States copyright laws and International treaty provisions A M Best and Its licensors retain all copyright and other proprietary rights to the website content Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parries, or stored In a database or retrieval system In any form for commercial purposes without the prior written permission of the A M Best Company All unauthorized use of Best's Credit Ratings or other published Information is strictly prohibited By logging Into Best's Member Center or accessing this site, you accept and agree to be bound by our complete Terms of Use _ — Customer Service pnduct ,y Pdx1Member Center Contact Info Careers AboveAM Best ISto Flap Pnvacv Policy emberty Terms oUseI Info Seers mo J Copyright ® 2014 A M Best Company, Inc ALL RIGHTS RESERVED A M Best Worldwide Head,maners, Ambest Road. Oirl New Jersey, 08858, U S A http: / /NvNvw3.ambest.com /Consumers /CoinpatiyProfile.aspx?BL =36 &ambnum= 002379 &. 10/17/2014 List of Active Carriers Surplus Line ASSUCrahonof Washington Brokers /Canners Home . Brokers /Carriers , List of Active Garners List of Active Carriers Inclusion on this list does not Indicate that the carrier meets the requirement as an appropriate Insurer The Surplus Line Broker is solely responsible for determining the qualifications of each canter Being on this list means the carrier is recognized by the Surplus Line Association of Washington and filings by brokers for the carnet will be accepted for examination ALB_ J_ c I-qE F G HL11_I.l-]L im N O IPI QIRJS LT iUIV1WiX Y1Z i5haw Alli Inxnel Addles, BOULEVARD 11890 rnII SAVERS PROPERTY & CASUALTY II P,URAi 10E COMPANY - 10 OVFNI.4IID PARK 4S 66210 PAR 10 LIME STREET SCOR UK COMPANY, LTD LBdDUPI. UK EC3M 7AA 837711 rnP IEY CEI HER DRIVE SCUT 111SURANCE COMPAH I SCOTTSDALE, AZ 35253 8677 fl ( All IEY CENTER DRIVE 5G7TTlDALE �LIRPLl1S LINES 1P I41R 41 11 -E CiR IP AP IY SCOTTSDALE, AZ 85)59 W.4TFR STREET SE1 IECe SPECIALTY INSURANCE COC IFAl' Y NE NEW fri 10033 1641ENNURG,DAME SHIPOWNERS MUTUAL PROTECTIODI AND 11 IDEMER TY ASSOCIATION LU iEIbIROURG, LU L2240 BIRDER IAPLSGATAII 57B SIR IU` III TELL II ISURANCE SNP SRTCLI IUI NI, SE SET 13 96 ASYLUM S REST SPARTA SPECIALTY INSURANCE COf.IPArL( -I HA HART PJNI Cl 06103 385 WASHIIJGT0l1 SIREET ST PAUL SURPLUS LINES Ii 1SURa11CF COMPANY ST PAUL, FII 1 55102 STAIIDAPD HOUSE STIVJDARD CLUB EUROPE, LTD LOIJDOfI, I IF WC2R 3AA 399 PARK 4VENLIE STARR bURF'LUS TIMES INSURANCE CSi11P,tllY NE4, lONI. IJY 10022 1'100 AMERICAN LANE STEADFAST INSURANCE COMPANY SCHAUMFURO, IL 60196 39 BLLL A1 ]F. SIFANIAIR MUTUAL UNDERWRIT7I IG .13OOAT[ON, LTD UJI IDU11, Llh, E1 7LU SALVI IS HnUSE SUHDI RLAHD MARINE INSURANCE COMPANY, LTD DURIIAILI, IAK DIPI 5TS FORTE BI IILDI1 G 2A SWIb RE PITERNATIT)HAL SE LU;EMPt-AIhG, LH L1246 2 Pnw 1 of 2, 11en" 1 In 15 of 1. Copyright © 2014 Surplus Line Association of Washington, All Rights Reserved. I Mtp /Iwwwsurplushncs mg /Bmkcragc_I'irnrrCamers asp�[III'17 /2UFA 3 58 26 PNII I I i A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's C,qnrA vpgr r1p% u ncA [; q" te r 110Member Center tastoWnISign Need Coverage? How Does Your Insurer Rate? State Insurance Information Find insurers ey state or coverage type Enw a Company Name Selea a slate Consumer Home I Terms to Know I `Aby a Best's Raring is Informant I Contact Us QLife & Retirement © Health & Disability Q Car& Home O Other Life Events Scottsdale Insurance Company IR Print this page la member m Name ,ores Group) AM best %0321 NAICr 41297 FEIN sr 311024919 Address 8877 North Gainey Center Drive Phone 480- 365 -0000 Scottsdale, AZ 85258 -2108 Fax 480 -0836752 UNITED STATES Web www s.ttsd.le nB corn Best's Ratings View Definition Need More Information? Financial Strength Rating A+ Purchase an insurer report, complete with MR rating history, market share and a list of Outlook Stable competitive Effective Date April 02, 2014 Affirmed P (Affirmed Via. View $ample Reoon Report Financial Size Category %V (E2 Billion or greater) Licensing- The company is licensed In Arizona, Delaware and Ohio It also operates on a surplus lines or non - admitted basis In the District of Columbia Puerto Rim, AL, AK, AR, CA, CO, CT FL, GA, Ht, ID, IL, IN, IA, KS, KY LA, ME, MD, MA, MI, MN, MS, NO MT, NE, NV, NH, NJ, NM, NY NC, NO ON OR, PA RI, SC, SD, TN, T%, UT, VT VA, WA, WV, WI and ANY 11 also operates as an accredited remsufer and an excess lines carrier in New York Top Libels) of Business lessee upon Caen Pre some wrrenl 1 Other Liability (Occurrence) lmew Deronrn 1 2 Commercial Multiple Peril to ew D,firbirm I 3 Other Liability(Clalnuminlade) sew Dennaionl 4 Allied Lines rue. Der,ndnnl 5 Homeowners Multiple Peril lye Ce mmol Top States) of Business lessee o,ba rs em aremoms wnnanl 1 California 2 New York 3 Florida 4 Texas 5 Louisiana Visit our NewsRoom for the latest News and Press Releases for this company and Its A M Best Group Terms of Use All information provided on the A M Best Merrill mdludatg but not limited to text data ratings, reports, Images, photos, graphics, and charts Is owned by or licensed to A M Best Company and 1s protected by United States copyright laws and international treaty provisions A M Best and its licensors retain all copyright and other proprietary rights to the websne content Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or shred m a database or retrieval system in any form for commermal purposes without the prior wntten permission of the A M Best Company. All unauthorized use of Best's Credit Ratings or other published information 1s strictly prohibited By logging into Best's Member Cenrar or accepting this site you accept and agree to be bound by our complete Terms of Use Customer Sere re I Product Bur, I Member Center I Contact Info I Careers About A M Best Site Mao I Privacy Pollcv I Sew I Terms of Use I Legal a Licensor Gopynght 02014 A M Best Company, Inc ALL RIGHTS RESERVED A M Best Wondwde Headater. s, Amster Road, Cher , New Jersey, 08959, U SA http: /hvww3.ambest.com/ Consumers /Companyllroftle.aspx ?BL =36 &ambnum = 0032928.. 10/17/2014 CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 2 Contract No., Project No. and Project Title: Contract # 14 -04, CP 1308, BNSF Utility Crossings Contractor Name and Address: Pacific Civil & Infrastructure 3450 S. 344th Way, Ste 115 Federal Way, WA, 98001 The Contractor is hereby directed to make the changes to the Contract as described herein. This document and all attachments are a supplement to the contract. All work, materials and measurements for the type of construction involved shall be in accordance with the contract documents of the above named project unless stated otherwise in this change order. Summary of Proposed Changes: 1. Quantity is added to Bid Item #19, "HMA Cl. 1/2 -inch PG 64 -22 (Class B)" to account for using additional HMA Cl. 1/2 -inch in lieu of the HMA Cl. 1 -inch at Project Site #1, Main Street. 2. The Contractor shall install a 2 -inch permanent blow off assembly at Project Site #4, Black Diamond Rd. The location of the blow off assembly is to be determined in the field by the Engineer. Work shall conform to Section 7- 09.3(22) (Blowoff Assemblies) of the Contract Documents. The pay item "2 -inch Blow Off and 2 -inch Diam. Poly Carrier Pipe' is added to the Contract and will be paid per lump sum and shall include payment for all labor and materials required to famish and install the blowoff assembly. 0.5 day is added to the contract for this work. 3. The Contractor shall install a 2 -inch poly pipe within the 24 -inch water casing parallel to the tracks with capped ends, 1 foot outside of the casing at Project Site #4, Black Diamond Rd. Work shall conform to the applicable sections of Section 7 -15 (Service Connection) of the Contract Documents. The pay item "2 -inch Diam. Poly Carrier Pipe" is added to the Contract and will be paid per linear foot of pipe installed and shall include payment for for all labor and materials required to furnish and install the pipe. 0.5 day is added to the contract for this work. 4. The pay item "24 -inch Upsized Casing for Bid Item #41" is added to the Contract and will be paid per linear foot of 24 -inch casing installed instead of the 20 -inch casing specified in the Plans as directed by the Engineer and shall include payment for for all labor and materials required to famish and install the upsized casing pipe. Work shall conform to the applicable sections of Section 7 -20 (Auger Boring) of the Contract Documents. 5. The pay item "24 -inch Upsized Casing for Bid Item #42" is added to the Contract and will be paid per linear foot of 24 -inch casing installed instead of the 20 -inch casing specified in the Plans as directed by the Engineer and shall include payment for for all labor and materials required to furnish and install the upsized casing pipe. Work shall conform to the applicable sections of Section 7 -20 (Auger Boring) of the Contract Documents. 6. The pay item "Cathodic Protection Credit per Anode to Bid Item #96" is added to the Contract and will be measured per each cathodic protection anode specified in the Contract to be installed for the 36 -inch steel storm casing at Project Site #2, 3rd St. NW, that is not installed. This is a credit item to the City. 7. The pay item "Cathodic Protection Credit per Anode to Bid Item # 148" is added to the Contract and will be measured per each cathodic protection anode specified in the Contract to be installed for the 36- inch steel sewer casing at Project Site #2, 3rd St. NW, that is not installed. This is a credit item to the City. H: \Forms \FCO25.xls (Revised 05/2012) CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 2 Contract No., Project No. and Project Title: Contract # 14 -04, CPI 308, BNSF Utility Crossings 8. 3 working days are added to the Contract to account for the time needed to verify locations of existing utilities by potholing. Costs for the potholing are accounted for by the "Utility Potholing' pay items. 9:. The pay item "Casing Coating Credit to Bid Item #96" is added to the Contract and will be measured per linear foot of casing installed without the cathodic protection coating specified in the Contract for the 36 -inch steel storm casing at Project Site 42, 3rd St. NW. This is a credit item to the City. 10. The pay item "Casing Coating Credit to Bid Item # 148" is added to the Contract and will be measured per linear foot of casing installed without the cathodic protection coating specified in the Contract for the 36 -inch sewer storm casing at Project Site #2, 3rd St. NW. This is a credit item to the City. The Contract time is extended by 4 days. Item Sch. Sec. No. Item Description Quantity Units Unit Price Total Price 19 A 5 -04 HMA Cl. 1/2 -inch PO 64 -22 (Class B) 70 TON 170 $ 11,900.00 CO #2 -1 A 7 -9 2 -inch Blow Off l LS 2950.00 $ 2,950.00 C042 -2 A 7 -15 2 -inch Diam. Poly Carrier Pipe. l LS 1040.00 $ 1,040.00 CO #2 -3 _A_ 7 -20 24 -inch Upsized Casing for Bid Item 941 77 LF 20.35 $ 1,566.95 CO #2 A 7 -20 24 -inch Upsized Casing for Bid Item #42 100 LF 20.35 $ 2,035.00 CO #2 -5 B 7 -20 Cathodic Protection Credit per Anode to Bid Item #96 -20 EA 256.25 $ (5,125.00) CO #2 -6 C 7 -20 Cathodic Protection Credit per Anode to Bid Item #148 -10 EA 256.25 $ (2,562.50) CO #2 -7 B 7 -20 Casing Coating Credit to Bid Item #96 -104 LF 12.00 $ (1,248.00) CO #2 -8 C 7 -20 Casing Coating Credit to Bid Item # 148 -107 LF 12.00 $ (1,284.00) Subtotal Washington State Sales Tax (9.5 %) on applicable items TOTAL $ 9,272.45 $ 880.88 $ 10,153.33 This change order constitutes full and complete compensation for all labor, equipment, materials, overhead, profit. any and all indirect costs, and time adjustment to perform the above described changes. All other costs are non- compensable. All other terms and conditions of the contract remain unchanged. H: \Forms \FCO25.x1s (Revised 0512012) Base Amount Totals incl.Tax I. Total Cost this C/O $ 9,272.45 $ 10,153.33 2. Total Cost Previous C/O $ - $ 3. Original Contract Amount $ 1,401,829.61 $ 1,511,186.34 4. Revised Contract Amount $ 1,411,102.06 $ 1,521,339.67 This change order constitutes full and complete compensation for all labor, equipment, materials, overhead, profit. any and all indirect costs, and time adjustment to perform the above described changes. All other costs are non- compensable. All other terms and conditions of the contract remain unchanged. H: \Forms \FCO25.x1s (Revised 0512012) r t CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 2 Contract No., Project No. and Project Title: H: \Forms \FCO25.xls (Revised 0512012) Contractor: Inspector: Project Manager: City Engineer: Approved by: Contract # 14 -04, CP1308, BNSF a - /7•iS 2 -fl- /1 Dak RC- ,-C -ti3y ec%F CITY OF AUBURN n�F# SU6U9 CONTRACT CHANGE ORDER AGREEMENT NO. 1 FC 1 °zo74% Contract No., Project No. and Project Title: Contract # 14 -04, CP1308, BNSF Utility Crossings Contractor Name and Address: Pacific Civil & Infrastructure 3450 S. 344th Way, Ste 115 Federal Way, WA, 98001 The Contractor is hereby directed to make the changes to the Contract as described herein. This document and all attachments are a supplement to the contract. All work, materials,measurements and unit bid prices for the type of construction involved shall be in accordance with the contract documents of the above named project unless stated otherwise in this change order Summary of Proposed Changes: 10% of the lump sum bid price for "Mobilization" of Schedule A, B, & C will be paid upon completion of 1% of the Contract Work. No additional compensation or work day added with this change order The Contract time is extended by �_ days. Subtotal $ Washington State Sales Tax (9.5 %) on applicable items $ TOTAL $ Base Amount Total incl. Tax 1 Total Cost this C/O $ - $ 2. Total Cost Previous C/O $ - Sales Item Sch. Sec. No. Item Description Quantity Units Unit Price Total Price Tax ( +/) ($) ( +/) (Y/N) N/A N Subtotal $ Washington State Sales Tax (9.5 %) on applicable items $ TOTAL $ This change order constitutes full and complete compensation for all labor, equipment, materials, overhead, profit, any and all indirect costs. and time adjustment to perform the above All other terms and conditions of the contract remain unchanged Contractor: Inspector: Project Manager: City Engineer: Approved by: H: \Forms \FCO25.x1s (Revised 05/2012) iy Base Amount Total incl. Tax 1 Total Cost this C/O $ - $ 2. Total Cost Previous C/O $ - $ 3. Original Contract Amount 4 Revised Contract Amount $ - $ This change order constitutes full and complete compensation for all labor, equipment, materials, overhead, profit, any and all indirect costs. and time adjustment to perform the above All other terms and conditions of the contract remain unchanged Contractor: Inspector: Project Manager: City Engineer: Approved by: H: \Forms \FCO25.x1s (Revised 05/2012) iy *� L4 nI l ITY OF ��� A,', T Nancy Backus, Mayor ul ^u J,r'" �.G• %' WASHINGTON 25 West Main Street * Auburn WA 98001 -4998 * www.auburnwa.gov * 253- 931 -3000 July 21, 2015 CERTIFIED MAIL RETURN RECEIPT REQUESTED Andrew Albrecht Pacific Civil & Infrastructure 3450S344 1h Way, #115 Federal Way, WA 98001 RE: Contract No. 14 -04 Project No. CP1308 — BNSF Utility Crossings Final Pay Estimate Letter Dear Mr. Albrecht: Enclosed is your Final Payment in the amount of $61,393.27. The total contract amount for this project as shown on your Final Pay Estimate is $1,726,328.19. The one -year warranty period begins as of the date of this Final Pay Estimate Letter. We have attached a list of subcontractors shown to have performed work on this contract, as well as their Unified Business Identifier (UBI) numbers and Affidavit of Wages Paid ID number (if known). This is based on our current records, and may not be all inclusive. Please review the attached list, and return with any additions or corrections to Amanda DeSilver, Contract Administration Specialist, no later than two weeks from the date of this letter. If we do not receive a response from you regarding this list, we will assume that it is correct. Please be aware that contract completion will not be granted prior to receipt of Affidavits of Wages paid for your firm and all Subcontractors, and that incorrect information supplied to L & I may delay clearance of your retainage bond until payment of industrial insurance by all Subcontractors is verified. If you have any questions, please contact Amanda DeSilver, Contract Administration Specialist, at 253 - 876 -1980. This notification does not constitute contract completion. / I ;weetin' . PE Assistant City Engineer Community Development and Public Works Department JS /ad /mm Enclosure cc: Dani Daskam, City Clerk Todd O'Brien, Construction Inspector File 13.11 (CP1308) AUBURN * MORE THAN YOU IMAGINED List of Approved Subcontractors Project No. CP1308 Contract No. 14 -04 Project Name: BNSF Utility Crossings Prime Contractor Name: Pacific Civil & Infrastructure Prime Affidavit ID: 582524 Subcontractor UBI Number Affidavit ID Apply -a -Line 600553941 Puget Construction Services 603356329 583662 Best Parking Lot Cleaning 601901928 582938 Ground Up Road Construction 602790246 Northwest Boring Co, Inc. 179022389 Olson Brothers Pro -Vac, LLC 602170975 Advanced Government Services 602304323 582368 Pioneer Cable Contractors 600464320 584821 Miles Resources, LLC 602870349 Slead Construction 278048845 Lloyd Enterprises 171004642 584711 Speer Taps Inc 600491975 567698 HD Supply Waterworks, LTD 602456211 S£�b�Fiq Concrete Services, Inc. 601334103 Pacific International Grout Company 600033655 582451 Evergreen Concrete Cutting* 601605667 582427 ICON Materials* 601006854 Ralph's Concrete Pumping* 578085430 578638 WCCL Systems* 603278120 573061 * these subs were not appoved by the City, but Affidavits are still required before retainage can be released. FC210(09/13) CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. NO. 14 -04 BNSF Utility Crossings SCHEDULE A: Water Utility Improvements ITEM NO. ITEM DESCRIPTION I q ESTIMATE ANITY' TOTAL QUANTITY QUANTITY TYPE I UNIT COST TOTAL COST PERIOD COST PERCENT EST. CITY. 1 Minor Changes 1 2.950 Eq. Adj. 10,000.00 $ 29,503.19 $ - 295% 2 SPCC Plan 7 1 LS 1,000.00 $ 1,000.00 $ - 100% 3 Property Restoration 1 1 LS 400.00 _$ 400.00 $ _ - 100% 4 Utility Potholing 16 22 FA 460.00 $ 10.120.00 $ - 138° 5 Mobilization 1 1 LS 46,300.00 i $ 46,300.00 $ - 100% 6 Traffic Control Supervisor 1 1 LS _ 700.00 _ $ 700.00 $ - 100° 7 Traffic Control Labor (Min. Bid $38 per hour) 320 559 _ _ _ _ _- HR 40.00 $ 22,360.00 $ - 175% 8 Construction Signs Class A 200 301.5 SF 5.00 $ 1,507.50 $ - 151% 9 Portable Changeable Message Sign - 20 130 Day 62.00 $ _ 8,060.00 $ - 650% 10 Outside Agency Uniformed Police Flagging Labor 1 0 1 Eq. Adj. 1,500.00 $ - $ - 0% 11 Other Temporary Traffic Control 1 1 LS 7,000.00 $ 7,000.00 $ - 100% 12 Removal of Structures and Obstructions 1 1 LS 1,200.00 1 $ _ 1,200.00 $ - 1006/. 13 Remove Raised Pavement Markings 1 1 LS 134.00 1 $ 134.00 $ - 100% 14 Remove Flexible Pavement 140 207.57] SY 26.00 ($ 5,396.82 $ - 148% 15 Remove and Reset Fencing 20 20'1 LF 26.00 1 $ __ 520.00 $ _ - 100% 16 Shoring or Extra Excavation Class B - 1500 15001 1430 SF 11.85 i $ 17,775.00 $ 16,945.50 100% 17 1 Crushed Surfacing Top Course 70 161997 TON 24.00 1 $ 3,887.76 $ - 231% 18 Crushed Surfacing Base Course 150 01 TON 24.00 $ - $ - _ _ 0% 19 HMA Cl. 12 -inch PG 64 -22 (Class B) 85 158.59 TON 170.00 $ 26,960.30 $ - 187% 20 HMA CI. 1 -inch PG 64-22 (Class E) 70 0 TON 170.00 $ - $ - 0% 21 Planing Bituminous Pavement 105 01 SY 46.00 $ - $ _ 0% 22 Asphalt Cold Patch 20 01 TON 116.00 $ - $ - 0% 23 Pipe Foundation Material 5 63.641 TON 27.00 $ 1,718.28 $ - 1273% 24 CSTC for Select Trench Backhll and Pipe Bedding 300 706.451 TON 24.00 $ 16,954.80 $ - _ 235% 25 Removal of Contaminated Soil 1 01 Eq. Adj. 10,000.00 $ - $ 0% 26 Abandon Existing Water Main (8 In.) 135 135 LF 20.00 $ 2,700.00 $ - 100% 27 Abandon Existing Water Main (12 In.) 116 116 LF 25.00 $ 2,900.00 $ - _ 100 %< 28 Abandon Existing Water Main (21n.) 165 165 LF 6.00 $ 990.00 $ - _ 100% 29 Connect to Existing Water Main 5 5 EA 4,000.00 $ 20.000.00 $ - 100% 30 Special CI. 52 Ductile Iron Pipe for Water Main 12 In. Diam. 38 25 LF 260.00 $ 6.500.00 $ _ _ 66% 31 Special Cl. 52 Ductile Iron Pipe for Water Main 8 In. Diam. 51 51 LF 160.00 $ 8,160.00 $ _ 100% 32 Special Cl. 52 Ductile Iron Pipe for Water Main 61n. Diam. 16 16 LF 100.00 $ 1,600.00 $ - 100% 33 Gate Valve 12 In. Diam 2 2 EA 1,970.00 $ 3.940.00 $ - 100% 34 Gate Valve 8 in. Diam. 2 2 EA 1,540.00 $ 3,080.00 $ - 100% 35 Gate Valve 6 In. Diam. 1 0 EA 830.00 $ - $ - 0% 36 1 Gate Valve 2 In. Diam. 2 2 EA 391.83 $ 783.66 $ - _ _ 100% 37 Adjust Valve Box 6 4 FA 500.00 $ 2,000.00 $ - 67% 38 Service Connection 21n. 12 12 LF 75.00 $ 900.00 $ - 100% 39 12 In. Steel Casing with 2 In. Diam. Poly Carrier Pipe 68 68 LF 560.00 $ 38,080.00 $ - 100% 40 Water Service Connection Renewal 3 3 EA 1,200.00 1 $ 3,600.00 $ - 100% SCHEDULE SUBTOTAL $ Period Dates Begin: May 21, 2015 End: June 20, 2015 16,945.50 h:Iprojlpe1CP1308 PE.xls 1 of 9 629/2015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. NO.� 4 -04 BNSF Utility Crossings SCHEDULE A: Water Utility Improvements ITEM ESTIMATE I NIT U COST I TOTAL COST PERIOD COST PERCENT EST. NO. ITEM DESCRIPTION QUANTITY OTOTAL QUANTITY TYPE Auger Boring 12 In. Steel Casing with 6 In. Diann. DI Carrier 77 77 LF 780.00 $ 60,060.00 $ - 100% 41 Pipe Auger Boring 20 In. Steel Casing with 8 In. Dam. DI Carrier 42 Pipe 103 100 LF 790.00 $ 79,000.00 $ - 97% Auger Boring 241n. Steel Casing with 12 In. Diam. DI 43 Carrier Pipe 124 104 LF 800.00 $ 83,200.00 $ - 84% 44 Removing Steel Casing Obstructions 1 D Eq. Adj 5,000.00 $ - $ - Ooh 45 Temporary Water Pollution/Erosion Control 1 0.62246 Eq. Adj 2,000.00 $ 1,244.92 $ - 62% 46 ESC Lead 60 0 Day 20.00 $ - $ - 1 0°i 1 1 LS 1,000.00 $ 1,000.00 $ - 100 47 TESC Plan Preparation 0 Sy 10.00 $ - $ - 0% 48 Hydro seeding with Moderate -Term Mulch 40 49 Remove and Reinstall QWICK Curb 30 63 LF 1,512.00 Is - -210% 50 Dewatering System — Main Street 5 5.776 Eq. Adj. 15,000.00 $ 86,646.37 $ - 116% 51 Dewatering System — 371h Street NW 5.625 6.763 Eq. AtlJ. 8,000.00 $ 54,105.32 $ - 1200A 52 Dewatering System - Black Diamond 1 0 Eq. Adj. 3.000.00 $ - $ - 0% 53 Raised Pavement Marker Type 2 8 8 EA 6.00 $ 48.00 $ - 100% 54 Induction Loop Type 3, Stop Line (3x5 ft. Diam.) 1 0 EA 4,000.00 $ - $ - 0% 1 1 EA 250.00 $ 250.00 1 $ - 100° 55 Plastic Traffic Arrow 40 631 LF 11.00 $ 693.00 1 $ - 158% 56 Paint Line 4 4 EA 155.00 $ 620.00 $ - 100% 57 Plastic Traffic Letter 140 181 LF 7.00 $ 1.267.00 $ - 129% 56 Plastic Wide Line 1 1 LS 2,950.00 $ 2,950.00 $ - 100% CO2 -1 2 -Inch Blow Off 1 1 LS 1,040.00 $ 1,040.00 $ - 100% CO2 -2 2 -Inch Diameter Poly Carrier Pipe LF 20.35 $ 1,566.95 $ - 100% CO2 -3 24 -Inch Upsized Casing for 13I#41 77 77 CO2-4 24 -Inch Upsized Casing for BI#42 100 100 LF 20.35 $ 2,035.00 $ CO3 -1 Increase Bid Item 50 & 51 SCHEDULETOTAL $ Period Dates Begin: May 21, 2015 End: June 20, 2015 16,945.50 h:\prgj\pe \CP 1308 PEAS 2 of 9 62912015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. NO. 14 -04 BNSF Utility Crossings SCHEDULE B: Storm Utility Improvements ITEM NO. ITEM DESCRIPTION ESTIMATE QUANTITY TOTAL QUANTITY PERIOD QUANTITY UNIT TYPE UNIT COST TOTAL COST PERIOD COST PERCENT EST. QTY. 59 Minor Changes 1 0.075 Eq. Adj 10,000.00 $ 747.77 $ - 7% 60 SPCC Plan 1 1 LS 500.00 $ 500.00 $ - 100% 61 62 Utility Potholing Mobilization 5 1 6 1 EA LS 460.00 11,000.00 $ 2,760.00,.-$ $ 11,000.00 - $ - 120°/ 100% 63 Traffic Control Supervisor 1 1 LS 500.00 $ 500.00 $ - 100% 64 Traffic Control Labor (Min. Bid $38 per hour) 240 229 HR 40.00 $ 9,160.00 $ - 9561. 65 Construction Signs Class A 100 156.251 SF 1 5.00 $ 78125 $ - 156% 66 Portable Changeable Message Sign 20 55 Day 62.00 $ 3,410.00 $ - 2750/ 67 Outside Agency Uniformed Police Flagging Labor 1 0 Eq. Adj 1,500.00 $ _ - _' S _ _ 0% 68 Other Temporary Traffic Control 1 1 LS 3,890.00 $ 3,890.00 $ - 100% 69 Removal of Structures and Obstructions 1 1 LS 500.00 $ 500.00 $ - 100% 70 Remove Raised Pavement Markings 1 1 LS _365.00 _$ __ 365.00 -$ $ _ - 100% 71 Removal of Curb and Gutter 75 32.5 LF 4.00 130.00 $ - 43% 72 Removal of Cement Cone. Driveway 11 37.31 SY 4.00 $ 149.20 $ - 339% 73 Removal of Sidewalk 40 15 SY 4.00 $ 60.00 $ - 38% 74 Remove Flexible Pavement 135 75 SY 12.80 $ 960.00 $ - 56% 75 Removal of Cement Conc. Pavement 100 931 SY 32.00 $ 2,976.00 $ - 93% 76 Shoring or Extra Excavation Class B 1650 1650 890 SF 2.00 $ 3,300.00 $ 1,780.00 _ 100% 77 Crushed Surfacing Top Course 40 118.33 TON 17.00 $ 2.011.61 $ - 296% 78 Crushed Surfacing Base Course 55 1.421 TON 17.00 $ 1,044.14 $ - 112% 79 HMA Cl. 1/2 -inch PG 64 -22 (Class B) 30 165.961 TON 170.00 $ 28,213.20 $ _ 553% 80 RNA CI. 1 -inch PG 6422 (Class E) 20 50.09 TON 170.00 $ 8,515.30 $ - 250% 81 Planing Bituminous Pavement 225 329.4 SY 23.00 $ 7,576.20 $ - 146% 82 Asphalt Cold Patch 1 15 6.07 TON 116.00 $ 704.12 $ - 40% 83 Abandon Existing Storm Sewer (24 In.) 140 140 LF 30.00 $ 4,200.00 $ - 100% 84 Abandon Existing Storm Sewer (12 In.) 150 150 LF 5.00 $ 750.00 $ - 100% 85 Solid Wall Polyvinyl Chloride (PVC) Storm Pipe SDR 21, 24 In. Dia. 53 53 LF 300.00 $ 15,900.00 $ - _ 100% 86 Solid Wall Polyvinyl Chloride (PVC) Storm Pipe, SDR 35,12 In. Di' 122 122 LF 32.50 $ 3,965.00 $ 87 High Density Polyethylene Pipe (HOPE) Storm Pipe DR 21, 28 In. 0 10 10 LF 94.00 $ 940.00 $ - 100% 88 Storm Sewer Television Inspection 400 0 LF 6.04 $ - $ - 0% 89 Temporary Storm Sewer Bypass System (3rd St. NW) 1 0 LS 3.500.00 $ - $ - 0% 90 Manhole, Type 1, 54 In. Diam. 4 4 EA 5,525.00 $ 22,100.00 $ - 100% 91 Manhole, Type 2, 48 In. Diam. 1 1 EA 3,130.00 $ 3,130.00 $ - 100% 92 Connect to Existing Manhole 1 1 EA 1,600.00 $ 1,600.00 $ - 100% 93 94 Pipe Foundation Matedal CSTC for Select Trench Backfill and Pipe Bedding 10 175 0 426.97 TON TON 27.00 24.00 $ - $ 10,247.28 $ - $ - 0% _ 244% 95 Removal of Contaminated Soil 1 1.968 1.80992 Eq. Adj 1,500.00 $ 2,952.69 $ 2,714.88 197% 96 Auger Boring 36 In. Steel Casing with 28 In. Diam. HDPE Carrier Pipe 104 104 LF 1,120.00 $ 116,480.00 $ - 100% 97 Remove Steel Casing Obstructions 1 0 Eq. Adj 5,000.00 $ - $ - 0% 98 Slipline Storm Pipe 42 Inch Diam. 110 110 LF 420.00 $ 46.200.00 $ - 100% SCHEDULE SUBTOTAL $ Period Dales Begin: May 21, 2015 End: June 20, 2015 4,494.88 h:\projlpe \CP 1308 PE.xls 3 of 9 6/29/2015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. PO. 1^4 BNSF Utility Crossings SCHEDULE B: Storm Utility Improvements ITEM I I PERIOD UNIT UNIT COST TOTAL COST I PERIOD COST PERCENT EST. No. (ITEM DESCRIPTION QUANTITY QUANTITY ITV QUANTITY TYPE 99 TESC Plan Preparation 1 i ' LS 1,000.00 $ 1,000.00 S - 100% 100 ESC Lead 60 0 Day 20.00 $ - $ - 0% 101 Hydroseeding with Moderate -Term Mulch 60 0 SY 15.00 $ - $ - 0% 102 Biodegradable Erosion Control Blanket 60 0 SY 10.00 $ - $ - 0% 103 Temporary Water Pollution/Erosion Control 1 0.061 1 Eq. Adj. 2,000.00 $ 121.03 $ - 6% 104 Cement Cone. Traffic Curb and Gutter 75 36.5 LF 23.00 $ 839.50 $ - 49% 105 Remove and Reinstall QWICK Curb 35 35 LF 21.00 $ 735.00 $ - 100% 106— IDewatedng System –3rd Street NW 3.85 1.445 Eq. Adj. 13,000.00 $ 18,791.21 $ - 38% 107 Dewatering System – 37th Street NV 2.65 2.12205588 Eq. Adj. 17,000.00 $ 36,074.95 $ - 80 °k 108 Industrial and Commercial Driveway Apron 25 37.33 SY 70.00 $ 2,613.10 $ - 149% 109 Raised Pavement Marker Type 2 8 11 3 EA 35.00 $ 365.00 $ 105.00 138% 110 Cement Cone. Sidewalk 30 4.6 SY 50.00 $ 230.00 $ - 15% 111 Paint Line 115 411 184 LF 3.00 $ 1,233.00 $ 552.00 357% 112 Plastic Stop Bar 13 13 LF 25.00 $ 325.00 $ - 100% 113 Plastic Railroad Crossing Symbol 1 1 EA 600.00 $ 600.00 $ - 100% 114 Plastic Wide Line 12 53 LF 7.00 $ 371.00 $ - $ - $ - 442% CO2 -5 Cathodic Protection Credit per Anode for BI #96 -20 20 EA (25625) $ (5,125.00) -100% CO2 -7 Casing Coating Credit for BI #96 -104 104 EA (12.00) $ (1,246.00) -100% CO3-2 Increase Bid Items 106 8 107 h: \pro /lpe\CP1308 PEAS Period Dates Begin: May 21, 2015 End: June 20, 2015 4 o19 SCHEDULETOTAL $ 5,151.88 6129/2015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. NO. 14-04 BNSF Utility Crossings SCHEDULE C: Sanitary Sewer Utility Improvments ITEM NO. (ITEM DESCRIPTION ESTIMATE QUANTITY TOTAL I QUANTITY' PERIOD NTITY .QUA UNIT TYPE' I- UNIT COST TOTAL COST PERIOD COST PERCENT EST. I QTY. 115 Minor Changes 1 0.6215491 0.168115 Eq. Adj 10,000.00 1 $ 6,215.49 $::1,611115 62 % 116 ISPCC Plan 1 1 LS 1,000.00 $ 1,000.00 S - 1 1001/6 117 Property Restoration 1 _ __ 0. ____ - -__ .,___LS _. -- , -_ 800.00 $ - $ - 0% 118 Utility Potholing 6 8 EA 460.00 $ 3,680.00 $ - 133° 119 Mobilization 1 1 LS 11,000.00 $ 11,000.00 $ - 100% 120 Traffic Control Supervisor 1 1 LS - 500.00 $ 500.00 $ - 100% 121 Traffic Control Labor (Min. Bid $38 per hour) 240 375.5 _ _ _ _ _ HR 40.00 $ 15,020.00 $ - 156% 122 Construction Signs Class A 100 156.5 SF 5.00 1 $ 782.50 $ - 157% 123 Portable Changeable Message Sign 55 _ Day 62.00 $ 3,410.00 $ - 27591. 124 Outside Agency Uniformed Police Flagging Labor _ _20 1 _ 0 _ Eq. Adj. 1,500.00 $ - $ - 0% 125 Other Temporary Traffic Control 1 1 LS 2,100.00 $ 2,100.00 $ - 100% 126 Removal of Structures. and Obstructions 1 7 LS 500.00 $ 500.00 $ - 100% 127 Removal of Curb and Gutter 40 30 LF 1.25 $ 37.50 $ - 75% 128 Removal of Cement Conic. Driveway 25 0 SY 1.25 $ - $ - 0% 129 Remove Flexible Pavement 70 18 SY 26.00 $ 468.00 $ - 26% 130 Removal of Sidewalk 10 --- 1 30 SY 1.25 $ 37.50 $ - 300% 131 Removal of Cement Conc. Pavement 70 1 18 SY 37.00 $ 666.00 $ - 26% 132 Shoring or Extra Excavation Class B 675 675 395_ SF 10.00 $ 6,750.00 $ 3,950.00 100% 133 Crushed Surfacing Top Course 50 0 TON 17.00 $ - $ - 0% 134 Crushed Surfacing Base Course 95 29.33 TON 17.00 $ 498.61 $ - 31% 135 RNA Cl. 1/2 -inch PG 6422 (Class B) 25 94.35 _ TON _ _ 170.00 $ _ 16,039.50 $ - 377% 136 HMA Cl. 1 -inch PG 6422 (Class E) 35 52.84 TON 170.00 $ 8,982.80 $ - 151% 137 Planing Bituminous Pavement 215 281.8 SY 19.00 $ 5,354.20 $ - 131% 138 Asphalt Cold Patch 15 0 TON 116.00 $ _ - $ - _ 0% 139 Manhole, Type 1, 541n. Diam. 4 4 EA 5,670.00 $ 22,680.00 $ - 100% 140 Pipe Foundation Material 1 20 0 TON 27.00 $ - $ - 0% 141 CSTC for Select Trench Backfill and Pipe Bedding 110 267.16 TON 24.00 $ 6,411.84 $ - _ 2.43 0. 142 Removal of Contaminated Soils 1 0 Eq. Adj. 20,000.00 $ - $ - 0° 143 Abandon Existing Sanitary Sewer (241n.) 143 143 LF 31.00 $ 4,433.00 $ - 100% 144 Solid Wall Polyvinyl Chloride (PVC) Sewer Pipe, SDR 21, 241n. 35 35 LF 222.00 $ 7,770.00 $ _ - __ _ _ 100% High h Density Polyethylene (HDPE) Sewer Pipe, DR 21, 281n. 7 7 LF 95.00 $ 665.00 $ _ - 100% 146 147 148 Sanitary Sewer Television Inspection Temporary Sewage Bypass System (3rd St. NW) Auger Boring 36 In. Steel Casing with 28 In. Diam. HDPE Came 150 1 107 0 D 1 107 LF LS LF 11.00 700.00 1,030.00 $ - $ - $ 110,210.00 $ - $ - $ - 0% 0% 100% 149 Remove Steel Casing Obstructions 1 3.191 2.772 Eq. Adj. 5,000.00 $ 15,954.28 $ 13,860.00 319% 150 Temporary Water Pollution /Erosion Control 1 0 Eq. Adj. -_ 2,000.00 $ _$ _ _ __ _ _ 0% 151 TESC Plan Preparation 1 1 LS 500.00 $ 500.00 $ - 100% 152 ESC Lead 60 0 Day 10.00 $ - $ - 0% 753 Cement Conc. Traffic Curb and Gutter 40 10 LF 27.00 $ 270.00 $ - 25% 154 Dewatering System - 3rd Street NW 3.15 3.241 Eq. Adj. 13,000.00 $ 42,128.05 $ - 103% SCHEDULE SUBTOTAL $ Period Dates Begin: May 21, 2015 End: June 20, 2015 19,491.15 h:iprojlpe1CP1308 PE.xls 5 of 9 6129/2015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 8. FINAL CO. NO, 14-01r BNSF Utility Crossings SCHEDULE C: Sanitary Sewer Utility Improvments INO. ESTIMATE I UNIT COST TOTAL COST I PERIOD COST PERCENT EST. ITEM DESCRIPTION QUANTITY QUANTITY TYPE TYPE QTY. strial and Commercial umve y Apron 25 16.6 _ Sy 72.00 $ _ 1,195.20 0 66 ed Pavement Marker Type 2 4 6 EA 36 -00 $ 216.00 0 150% ent Conc. Stdevralk 10 35 SY 56.00 $ 1,960.00 0 350% nt Line 80 180 LF 3.00 $ 540.00 0 225% 415BRaised sBC Stop Bar 12 12 LF 25.00 $ 300.00 0 100% hodic Protection Credit per Anode for BI #148 AD 10 LF (256.25) $ (2,562.50) 0 - 100% ing Loafing Credit for BI #148 -107 107 LF (12.00) $ (1,284.00) 0 - 100% rease Bid It 154 SCHEDULE TOTAL $ 19,491.15 h ?proj1pe \CP1308 PE.As 6 of 9 6/292015 at 3:08 PM CITY OF AUBURN CP1308 PAY ESTIMATE #8 & FINAL CO. NO. 14 -04 BNSF Utility Crossings SCHEDULE D: 37th & B Intersection Improvements ITEM NO. ITEM DESCRIPTION ESTIMATE QUANTITY TOTAL QUANTITY I PERIOD QUANTITY I UNIT TYPE UNIT COST TOTAL COST PERIOD COST PERCENT EST. Qom, 160 Minor Changes - 1 0.1075566 0.1075566 Eq.Adj.j 15,000.00 1 $ 1,613.35 $ 1,613.35 11 161 SPCC Plan 1 1 LS 500.00 $ 500.00 $ - 100% 162 Property Restoration 1 0 LS 500.00 S - $ - 0% 163 Mobilization 1 1 LS 10,000.00 $ 10,000.00 $ - 100% 164 Traffic Control Supervisor 1 1 LS 500.00 $ 500.00 $ - 100% 165 Traffic Control Labor (Min. Bid $38 per hour) 240 443.5 HR 40.00 $ 17,740.00 $ - 185% 166 Portable Changeable Message Sign 20 80 Day 62.00 $ 4,960.00 $ - 400% 167 Outside Agency Uniformed Police Flagging Labor 1 0.56628 Eq. Adj. 1,500.00 $ 849.42 $ - 57% 168 Other Temporary Traffic Control 1 1 LS 3,600.00 $ 3,600.00 $ - 100% 169 Removal of Curb and Gutter 180 226 LF 5.00 $ 1,130.00 $ - 126"/ 170 Removal of Sidewalk 140 158.23 SY 11.00 $ 1,740.53 $ - 113° 171 Remove Flexible Pavement 1670 1670 SY 7A0 $ 11,690.00 $ - - 100% 172 Roadway Excavation Including Haul 690 690 CY 17.38 $ 11,992.20 $ - 100% 173 Gravel Base 750 608.71 TON 27.00 $ 16,435.17 $ - 810. 174 Crushed Surfacing Top Course 100 59.53 TON 1 27.00 $ 1,607.31 $ - 60% 175 HMA Cl. 112 -inch PG 64 -22 (Class B) 380 442.43 TON 89.00 $ 39,376.27 $ - 116% 176 HMA CI. 1-inch PG 64 -22 (Class E) 580 509.86 123.22 TON 84.00 $ 42,828.24 $ 10,350.48 88% 177 Asphalt Cold Patch 10 1 0 TON 116.00 $ - $ - 0% 176 Adjust Manhole 2 3 EA 600.00 $ 1,800.00 $ - 150% 179 Adjust Catch Basin 2 2 EA 370.00 $ 740.00 $ - 100°/ 180 ADA- Compliant Ring and Cover 2 2 EA 500.00 $ 1,000.00 $ - 100° 181 Adjust Valve Box 5 8 FA 500.00 $ 4,000.00 $ - 160% 182 Hydroseeding with Moderate -Term Mulch 250 0 SY 5.00 $ - $ - 0% 183 TESC Plan Preparation 1 1 LS 500.00 $ 500.00 $ 100% 184 ESC Lead 10 0 Day 10.00 $ - $ _ go/. 185 Temporary Water Pollution/Emsion Control 1 O Eq. Adj. 2,000.00 $ - $ - 0% 186 Cement Conc. Traffic Curb and Gutter 182 228.5 LF 28.00 $ 6,398.00 $ - 126% 187 Raised Pavement Marker Type 2 30 54 29 EA 36.00 $ 1,944.00 $ 1,044.00 180% 188 Monument Type B (Modified) 1 1 EA 500.00 $ 500.00 $ - 100°/ 189 Cement Conc. Sidewalk 34 61.78 SY 56.00 $ 3,459.68 $ - 182% 190 Cement Conc. Curb Ramp Type Parallel A 6 6 EA 1,800.00 $ 10,800.00 $ - 100% 191 Traffic Signal System Modifications 1 1 LS 42,000.00 $ 42,000.00 $ - 100% 192 Plastic Traffic Arrow 3 3 EA 100.00 $ 300.00 $ - 1000% 193 Paint Line 250 446 140.5 LF 2.00 $ 892.00 $ 281.00 1780 194 Plastic Crosswalk Stripe and Stop Bar (24 inch wide) 240 544 285 LF 1 9.00 $ 4,896.00 $ 2,565.00 227°% 195 Plastic Traffic Letter 12 01, EA 97.00 $ - $ - 0% 196 Plastic Wide Line 140 2101 LF 5.00 1 $ 1,050.00 $ 286.50 1 1509M. SCHEDULE TOTAL $ 15,853.83 Period Dales Begin: May 21, 2015 End: June 20, 2015 Wproppe\CP1308 PE.xls 7 of 9 6)2912015 at 3:08 PM CITY OF AUBURN PROJECT SUMMARY PAY ESTIMATE #8 & FINAL Original Contract Contract Change Amount Orders SCHEDULE A: Water Utility Improvements Contract $ 540,515.66 $ 116,491.95 $ Sales Tax ( +9.5 %) $ 51,348.99 $ 11,066.74 $ Bond in Lieu of Retainage SCHEDULE TOTAL $ 591,864.65 $ SCHEDULE B: Storm Utility Improvements 19,491.15 102% 2,294.58 Contract $ 342,852.00 $ Sales Tax ( +9.5 %) $ 32,570.94 $ Materials on Hand $ - $ Bond in Lieu of Retainage SCHEDULE TOTAL $ 375,422.94 $ SCHEDULE C: Sanitary Sewer Utility Improvments Contract $ 267,755.75 $ Sales Tax ( +9.5 %) $ 25,436.80 $ Bond in Lieu of Retainage SCHEDULE TOTAL $ 293,192.55 $ SCHEDULE D: 37th & B Intersection Improvements Contract $ 250,706.20 $ Sales Tax Not Applicable Bond in Lieu of Retainage SCHEDULETOTAL $ 250,706.20 $ TOTAL CONTRACT AMOUNT TO DATE (including Sales Tax) TOTAL PAYMENT TO CONTRACTOR PAYMENT DUE CONTRACTOR: h:\proj\pe \CP1308 PEAS 127,558.69 $ 58,627.00 $ 5,569.57 $ CP1308, BNSF Utility Crossings CO. NO. 14 -04 Total Payment This Period 673,969.86 $ 16,945.50 64,027.14 $ 1,609.82 737,997.00 $ 18,555.32 381,037.55 $ 5,151.88 36,198.57 $ 489.43 64,196.57 $ 417,236.12 $ 5,641.31 Percent/Contract 103% 95% 24,153.50 $ 297,080.27 $ 19,491.15 102% 2,294.58 $ 28,222.63 $ 1,851.66 26,448.08 $ 325,302.90 $ 21,342.81 $ 245,792.17 $ 15,853.83 98% - $ 245,792.17 $ $ 1,726,328.19 $ 1,726,328.19 $ Begin: May 21, 2015 End: June 20, 2015 8of9 15,853.83 61,393.27 61, 393.27 99.8% 629/2015 at 4:19 PM CITY OF AUBURN CO. NO. 14 -04 - CP1308 BNSF Utility Crossings PAY ESTIMATE #8 & FINAL CONTRACTOR: Pacific Civil & Infrastructure 3450 South 344th Way, Ste. 115 Federal Way, WA 98001 Phone: (253) 874 -3965 The undersigned has reviewed and approved this final pay estimate. I agree that it is a true and correct statement showing all monies due me from the City of Auburn under this contract; that I have carefully examined the final pay estimate estimate and understand it and that I hereby release the City of Auburn from any and all claims of whatsoever nature which I may have, arising out of this contract, which are not set forth in this estimate. PAYMENT DUE TO CONTRACTOR = $ 61,393.27 Signatures: Contractor Inspector, Date 3 0 1 S— Date 6/0- 3 D /� > 1 Project Manager Gr «S (✓lt z- y Date n � City Engineer Date .a.D{ h:\prolpe \CP1306 PEAS 9 of 9 6/29/2015 at 4:19 PM R A. N �r Nancy Backus, Mayor D`-.ff ' Y tL �1 -- ` WASH 1 NGTON 25 West Main Street * Auburn WA 98001 -4998 * www.auburnwa.gov * 253- 931 -3000 September 15, 2015 CERTIFIED MAIL RETURN RECEIPT REQUESTED Andrew Albrecht Pacific Civil & Infrastructure 3450S344 1h Way #115 Federal Way, WA 98001 RE- Contract No 14 -04 Project No. CP1308 — BNSF Utility Crossings Contract Completion and Acceptance Dear Mr. Albrecht: All of your obligations in regard to this project have been met in accordance with Section 1 -08.5 of the Standard Specifications. Your retainage bond will be released approximately 60 days after this date, provided all necessary releases have been received and there are no outstanding claims against the retainage. All approved Labor & Industries Affidavits of Wages Paid from your firm and all subcontractors on the project have been received. If you have any questions, please contact Amanda DeSilver, Contract Administration Specialist, at 253 - 876 -1980. Sincerely, i Asst. Director of Engineering Services & City Engineer Community Development & Public Works Department IG /ad /as Enclosure cc: Dani Daskam, City Clerk Jacob Sweeting, Assistant City Engineer File 13.11 (CP1308) AtTRTTRN# MORETHANYOIIIMAGINM oi. ...._9I' Contract um er ob Order Contracting C1111 Z, ll Original Replacement of various City utilities at their crossings of BNSF Railroad Rights -of -Way. Work includes traffic control; ❑ Revised gravity /pressure utilities, bypass pumping, etc. Federally funded transportation project? ❑ Yes LYJ No (if yes, provide Contract Bond Statement below) # hr iaev ao NOTICE OF COMPLETION OF PUBLIC WORKS CONTRACT Date: 9115/15 Contractor's UBI Number: 603 - 389 -830 ;Name'& Mailin `•Address'of Pubbc Agency Depar mend Use',Onlys+ .r City of u urn Assigned to: 25 West Main Street Auburn, WA 98001 Date Assigned: UBI Number: 171000010 Notice is herebv given relative to the conioletion of contract or uroiect described below Project Name Contract um er ob Order Contracting BNSF Utility Crossin s 14 -04 ❑ Yes b No rlc Do Description of oue Inch e Jobsite Address(es) Replacement of various City utilities at their crossings of BNSF Railroad Rights -of -Way. Work includes traffic control; erosion /sediment control; excavation of boring pits; dewatering; installation of auger bored casings and gravity /pressure utilities, bypass pumping, etc. Federally funded transportation project? ❑ Yes LYJ No (if yes, provide Contract Bond Statement below) Contractors Name E -mail Address Affidrivit ID" Pacific Civil and Infrastructure aalbrecht @paccivil.com 582524 Contractor Address Telephone 3450 South 344th Way, #115, Federal Way, WA 98001 253 -874 -3965 If Retainage is not withheld, please select one of the following and ist urety s ame & Bond Number. 56 Retainage Bond ❑ Contract/Payment bond (valid for federally funded transportation projects) Name: Fidelity & Deposit Cc of Maryland Bond Number: 09171841 Date Contract Awarded Date Work Commenced Date Worlt Completed Date Work c Accepted 10/6/14 10129/14 5/8/15 7/20/15 Were 5ubc6iitriict6s used on this project? It 'so',.plense.conipleteAddendiim A. Nflyes LJNo - Affidavit ID* -, NoL& I release will be g antedugtil all affdavits . are listed. Contract Amount Additions ( +) Reductions (- ) Sub -Total Amount of Sales Tax 9.5 (If various rates apply, please send a breakdown) TOTAL $ 1,511,186.34 $ 86,693,51 $ 1,597,879.85 $ 128448.34 $ 1.726,328,19 Liquidated Damages $ 0.00 Amount Disbursed $ 1,726,328.19 Amount Retained $ 0.00 NOTE: These two totals must be eaual TOTAL $ 1,726,328.19 Comments: Tax on schedules A, B & C, No tax applicable on schedule D. Note: The Disbursing Officer must submit this completed notice immediately after acceptance of the work done under this contract. NO PAYMENT SHALL BE MADE FROM RETAINED FUNDS until receipt of all release certificates. Submitting Form: Please submit the completed form by email to all three agencies below. Contact Name: Amanda DeSilver Email Address: adesllver @auburnwa.gov. Department of Revenue C Public Works Section (PWC@dor.wa.gov WaOilruton State DoGwnment of Labor & Industries (360) 704 -5650 Contract Release (855) 545 -8163, option 11 4 ContractRelease@LN I. W A.GOV REV 31 0020e (4/28/14) 1`215- 038 -000 04 -2014 Title: Contract Admin Specialist Phone Nwnber: 253 -676 -1980 Employment Security Department Registration, Inquiry, Standards & Coordination Unit (360) 002 -9450 publlcworks @esd.wa.gov Addendum A: Please List all Subcontractors and Sub -tiers Below This addendum can be submitted in other formats. Provide known affidavits at this time. No L &1 release will be granted until nil affidavits are listed. Subcontractor's Name: UBI Number: (Required) Affidavid ID* Advanced Government Services 602304323 582368 Apply -a -Line 600553941 589490 Best Parking Lot Cleaning 601901928 582938 Concrete Services, Inc 601334103 592062 Evergreen Concrete Cutting 601605667 582427 Ground Up Road Construction 602790246 592871 HD Supply Waterworks 602456211 586369 ICON Materials 601006854 595230 Lloyd Enterprises 171004642 584711 Mlles Resources 602870349 591918 Northwest Boring Co 179022389 589251 Olson Brothers Pro -Vac 602170975 590849 Pacific International Grout Co 600033655 582451 Pioneer Cable Contractors 600464320 584821 Puget Construction Services 603356329 583662 Ralph's Concrete Pumping 578085430 578638 Slead Construction 278048845 589060 Speer Taps Inc 600491975 567698 WCCL Systems 603278120 573061 For tax assistance or to request this document in an alternate formal, please call 1- 800 -647 -7706. Teletype (TTY) users may use the Washington Relay Scrvice by calling 711. MV 310020e Addendum (04/28/14) F215 -038 -00004 -2014