HomeMy WebLinkAbout040113_ca08Department of Public Works
O Consent Agenda
Page 1 of 2
Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Philip Morley, County Administrator
From: Frank Gifford, Public Works Director ~~
Agenda Date: April 1, 2013
Subject: Standard Consultant Agreement with Exeltech Consulting, Inc.
Queets Bridge Painting
Co. Rd. No. 107508, CR1881
M.P. 0.60 to M.P. 0.76
BHOS-16WA(001)
Statement of Issue:
The issue is requesting execution of the Standard Consultant Agreement with Exeltech
Consulting, Inc. of Lacey, WA. for providing Construction Engineering Project
Administration services for the Queets Bridge Painting, CR1881 project.
Analysis/Strategic Goals/Pro's B: Con's:
This project is included in the officially adopted 2013-2018 Transportation Improvement
Program as Item No. 11. This project is also included in the adopted 2013 Annual
Construction Program as item No. 11. The purpose of this project is to repaint the steel
girders and bracing members of the Queets Bridge.
This agreement will provide Construction Engineering Project Administration services by
Exeltech Consulting, Inc., for the construction engineering phase. The required
engineering services for this project consist of: pre-construction, construction, and post-
construction project administration services. Public Works staff used a consultant selection
process to select this consultant from the 2012 Professional Services Roster as the most
highly qualified consultant.
Fiscal Impact/Cost Benefit Analysis:
The maximum amount payable for consultant services under this Consultant Agreement is
$186,237.33. This project has grant funding in the amount of $2,969,652 from the Federal
Highway Administration Bridge Replacement Off System funds, administered via the
Washington Department of Transportation. These consultant services will be eligible for
reimbursement from the FHWA BHOS funding at the rate of 100%.
Department of Public Works
O Consent Agenda
Page 2 of 2
Recommendation:
The Board is asked to execute the three (3) originals of the Professional Services
Consultant Agreement with Exeltech Consulting, Inc., and return two (2) signed originals
to Public Works (attn. John Wayand).
Department Contact: John Wayand, Project Manager, 385-9377
Revi ed B ,
ip Morley C u ty Administrat Date
1!
,~
Local Agency
Standard Consultant
Agreement
®Architectural/Engineering Agreement
^ Personal Services Agreement
Agreement Number
Queets 2013-1
Federal Aid Number
BHOS-16WA(001)
Agreement Type (Choose one)
^ Lump Sum
Lump Sum Amount $
^ Cost Plus Fixed Fee
Overhead Progress Payment Rate
Overhead Cost Method
^ Actual Cost
^ Actual Cost Not to Exceed
^ Fixed Rate
Fixed Fee $
® Specific Rates Of Pay
® Negotiated Hourly Rate
^ Provisional Hourly Rate
^ Cost Per Unit
Consultant/Address/Telephone
EXELTECH CONSULTING, INC.
8729 Commerce Place Drive NE, Suite A
Lacey, WA. 98516
360-357-8289
Project Title And Work Description
Queets Bridge Painting, Bridge No. 8W, CR1881
Clearwater Road, M. P. 0.60 to M. P. 0.76
Co. Rd. No. 107508
DBE Participation
^ Yes ®No
Federal ID Number or Social Security Number
91-1491880
Do you require a 1099 for IRS . Completion Date
~ Yes ^No March 31, 2014
Total Amount Authorized $186,237.33
Management Reserve Fund 0.00
Maximum Amount Payable $186,237.33
Index of Exhibits (Check all that apply}:
® Exhibit A-1 Sco a of Work ^ Exhibit G-2 Fee-Sub S ecific Rates
^ Exhibit A-2 Task Order Agreement ^ Exhibit G-3 Sub Overhead Cost
^ Exhibit B-1 DBE Utilization Certification ® Exhibit H Title VI Assurances
® Exhibit C Electronic Exchan a of Data ® Exhibit I Payment U on Termination of A Bement
^ Exhibit D-1 Payment - Lum Sum Exhibit J Alle ed Consultant Desi n Error Procedures
^ Exhibit D-2 Pa ment -Cost Plus ® Exhibit K Consultant Claim Procedures
® Exhibit D-3 Payment - Hourl Rate ^ Exhibit L Liabili Insurance Increase
^ Exhibit D-4 Payment -Provisional ® Exhibit M-1 a Consultant Certification
® Exhibit E-1 Fee -Consultant Fee ® Exhibit M-1 b A ency Official Certification
® Exhibit E-2 Fee -Specific Rates ® Exhibit M-2 Certification -Prim
® Exhibit F Overhead Cost ® Exhibit M-3 Lobbyin Certification
^ Exhibit G Subcontracted Work ^ Exhibit M-4 Pricin Data Certification
^ Exhibit G-1 Subconsultant Fee ^ A .31.910 Sup lemental Si nature Pa e
THIS AGREEMENT, made. and entered into this day of ,
between the Local Agency of Jefferson County , Washington, hereinafter called the "AGENCY", and the
above organization hereinafter called the "CONSULTANT"
DOT Form 140-089 EF
Revised 3/2008
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013
Page 1 of 33
WITNESSETH THAT:
WHEREAS, the AGENCY desires to accomplish the above referenced project, and
WHEREAS, the AGENCY does not have sufficient staff to meet the .required commitment and therefore
deems it advisable and desirable to engage the assistance of a CONSULTANT to provide the necessary
services for the PROJECT; and
WHEREAS, the CONSULTANT represents that he/she is in compliance with the Washington State Statutes
relating to professional registration, if applicable, and has signified a willingness to furnish Consulting services
to the AGENCY,
NOW THEREFORE, in consideration of the terms, conditions, covenants and performance contained herein,
or attached and incorporated and made a part hereof, the parties hereto agree as follows:
I General Description of Work
The work under this AGREEMENT shall consist of the above described work and services as herein defined
and necessary to accomplish the completed work for this PROJECT. The CONSULTANT shall furnish all
services, labor, and related equipment necessary to conduct and complete the work as designated elsewhere in
this AGREEMENT.
II Scope of Work
The Scope of Work and projected level of effort required for this PROJECT is detailed in Exhibit "A" attached
hereto and by this reference made a part of this AGREEMENT..
III General Requirements
All aspects of coordination of the work of this AGREEMENT with outside agencies, groups, or individuals
shall receive advance approval by the AGENCY. Necessary contacts and meetings with agencies, groups,
and/or individuals shall be coordinated through the AGENCY. The CONSULTANT shall attend coordination,
progress and presentation meetings with the AGENCY and/or such Federal, State, Community, City or County
officials, groups or individuals as may be requested by the AGENCY. The AGENCY will provide the
CONSULTANT sufficient notice prior to meetings requiring CONSULTANT participation. The minimum
required hours or days notice shall be agreed to between the AGENCY and the CONSULTANT and shown in
Exhibit "A."
The CONSULTANT shall prepare a monthly progress report, in a form approved by the AGENCY, which will
outline in written and graphical form the various phases and the order of performance of the work in sufficient
detail so that the progress of the work can easily be evaluated.
The CONSULTANT, and each SUBCONSULTANT, shall not discriminate on the basis of race, color,
national origin, or sex in the performance of this contract. The CONSULTANT, and each
SUBCONSULTANT, shall carry out applicable requirements of 49 CFR Part 26 in the award and
administration of USDOT-assisted contracts. Failure by the CONSULTANT to carry out these requirements is
a material breach. of this AGREEMENT that may result in the termination of this AGREEMENT.
Participation for Disadvantaged Business Enterprises (DBE), if required, per 49 CFR Part 26, or participation
of Minority Business Enterprises (MBE), and Women Business Enterprises (WBE), shall be shown on the
heading of this AGREEMENT. If D/M/WBE firms are utilized, the amounts authorized to each firm and their
certification number will be shown on Exhibit "B" attached hereto and by this reference made a part of this
AGREEMENT. If the Prime CONSULTANT is a DBE firm they must comply with the Commercial Useful
Function (CUF) regulation outlined in the AGENCY'S "DBE Program Participation Plan". The mandatory
DBE participation goals of the AGREEMENT are those established by the WSDOT'S Highway and Local
Programs Project Development Engineer in consultation with the AGENCY.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 2 of 33
All Reports, PS&E materials, and other data furnished to the CONSULTANT by the AGENCY shall be
returned. All electronic files, prepared by the CONSULTANT, must meet the requirements as outlined in
Exhibit "C."
All designs, drawings, specifications, documents, and other work products, including all electronic files,
prepared by the CONSULTANT prior to completion or termination of this AGREEMENT are instruments of
service for this PROJECT, and are the property of the AGENCY. Reuse by the AGENCY or by others, acting
through or on behalf of the AGENCY of any such instruments of service, not occurring as a part of this
PROJECT, shall be without liability or legal exposure to the CONSULTANT.
IV Time for Beginning and Completion
The CONSULTANT shall not begin any work under the terms of this AGREEMENT until
authorized in writing by the AGENCY.
All work under this AGREEMENT shall be completed by the date shown in the heading of this
AGREEMENT under completion date.
The established completion time shall not be extended because of any delays attributable to the
CONSULTANT, but may be extended by the AGENCY in the event of a delay attributable to the AGENCY,
or because of unavoidable delays caused by an act of GOD or governmental actions or other conditions
beyond the control of the CONSULTANT. A prior supplemental agreement issued by the AGENCY is
required to extend the established completion time.
V Payment Provisions
The CONSULTANT shall be paid by the AGENCY for completed work and services rendered under this
AGREEMENT as provided in Exhibit "D".attached hereto, and by reference made part of this AGREEMENT.
Such payment shall be full compensation for work performed or services rendered and for all labor, materials,
supplies, equipment, and incidentals necessary to complete the work. The CONSULTANT shall conform to all
applicable portions of 48 CFR Part 31.
A post audit may be performed on this AGREEMENT. The need for a post audit will be determined by the
State Auditor, WSDOT External Audit Office and/or at the request of the AGENCY' S PROJECT Manager.
VI Sub-Contracting
The AGENCY permits sub-contracts for those items of work as shown in Exhibit "G" attached hereto and by
this reference made part of this AGREEMENT.
Compensation for this sub-consultant work shall be based on the cost factors shown on Exhibit "G."
The work of the sub-consultant shall not exceed its maximum amount payable unless a prior written approval
has been issued by the AGENCY.
All reimbursable direct labor, overhead, direct non-salary costs and fixed fee costs for the sub-consultant shall
be substantiated in the same manner as outlined in Section V. All sub-contracts shall contain all applicable
provisions of this AGREEMENT.
With respect to sub-consultant payment, the CONSULTANT shall comply with all applicable sections of the
Prompt Payment laws as set forth in RCW 39.04.250 and RCW 39.76.011.
The CONSULTANT. shall not sub-contract for the performance of any work under this AGREEMENT
without prior written permission of the AGENCY. No permission for sub-contracting shall create, between the
AGENCY and sub-contractor, any contract or any other relationship. A DBE certified sub-consultant is
required to perform a minimum amount of their sub-contracted agreement that is established by the WSDOT
Highways and Local Programs Project Development Engineer in consultation with the AGENCY.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 3 of 33
VII Employment
The CONSULTANT warrants that they have not employed or retained any company or person, other than a
bona fide employee working solely for the CONSULTANT, to solicit or secure this contract, and that it has
not paid or agreed to pay any company or person, other than a bona fide employee working solely for the
CONSULTANT, any fee, commission, percentage, brokerage fee, gift, or any other consideration, contingent
upon or resulting from the award or making of this contract. For breach or violation of this warrant, the
AGENCY shall have the right to annul this AGREEMENT without liability or, in its discretion, to deduct from
the AGREEMENT price or consideration or otherwise recover the full amount of such fee, commission,
percentage, brokerage fee, gift, or contingent fee.
Any and all employees of the CONSULTANT or other persons while engaged in the performance of any work
or services required of the CONSULTANT under this AGREEMENT, shall be considered employees of the
CONSULTANT only and not of the AGENCY, and any and all claims that may arise under any Workmen's
Compensation Act on behalf of said employees or other persons while so engaged, and any and all
claims made by a third party as a consequence of any act or omission on the part of the CONSULTANT'S
employees or other persons while so engaged on any of the work or services provided to be rendered herein,
shall be the sole obligation and responsibility of the CONSULTANT.
The CONSULTANT shall not engage, on a full- or part-time basis, or other basis, during the period of the
contract, any professional or technical personnel who are, or have been, at any time during the period of the
contract, in the employ of the United States Department of Transportation, or the STATE, or the AGENCY,
except regularly retired employees, without written consent of the public employer of such person.
VIII Nondiscrimination
During the performance of this contract, the CONSULTANT, for itself, its assignees, and successors in
interest agrees to comply with the following laws and regulations:
Title VI of the Civil Rights Act of 1964
(42 USC Chapter 21 Subchapter. V .Section 2000d through 2000d-4a)
Federal-aid Highway Act of 1973
(23 USC Chapter 3 Section 324)
Rehabilitation Act of 1973
(29 USC Chapter 16 Subchapter V Section 794)
Age Discrimination Act of 1975
(42 USC Chapter 76 Section 6101 et seq.)
Civil Rights Restoration Act of 1987
(Public Law 100-259)
American with Disabilities Act of 1990
(42 USC Chapter 126 Section 12101 et. seq.)
49 CFR Part 21
23 CFR Part 200
RCW 49.60.180
In relation to Title VI of the Civil Rights Act of 1964, the CONSULTANT is bound by the provisions of
Exhibit "H" attached hereto and by this reference made part of this AGREEMENT, and shall include the
attached Exhibit "H" in every sub-contract, including procurement of materials and leases of equipment,
unless exempt by the Regulations or directives issued pursuant thereto.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 4 of 33
IX Termination of Agreement
The right is reserved by the AGENCY to terminate this AGREEMENT at any time upon ten (10) days written
notice to the CONSULTANT.
In the event this AGREEMENT is terminated by the AGENCY other than for default on the part of the
CONSULTANT, a final payment shall be made to the CONSULTANT as shown in Exhibit "I" for the type of
AGREEMENT used.
No payment shall be made for any work completed after ten (10) days following receipt by the
CONSULTANT of the Notice to Terminate. If the accumulated payment made to the CONSULTANT prior to
Notice of Termination exceeds the total amount that would be due when computed as set forth herein above,
then no final payment shall be due and the CONSULTANT shall immediately reimburse the AGENCY for any
excess paid.
If the services of the CONSULTANT are. terminated by the AGENCY for default on the part of the
CONSULTANT, the above.formula for payment shall not apply.
In such an event, the amount to be paid shall be determined by the AGENCY with consideration given to the
actual costs incurred by the CONSULTANT in performing the work to the date of termination, the amount of
work originally required which was satisfactorily completed to date of termination, whether that work is in a
form or a type which is usable to the AGENCY at the time of termination, the cost to the AGENCY of
employing another firm to complete the work required and the time which may be required to do so, and other
factors which affect the value to the AGENCY of the work performed at the time of termination,
Under no circumstances shall payment made under this subsection exceed the amount, which would have been
made using the formula set forth above.
If it is determined for any reason that the CONSULTANT was not in default or that the CONSULTANT'S
failure to perform is without the CONSULTANT' S or its employee's default or negligence, the termination
shall be deemed to be a termination for the convenience of the AGENCY. In such an event, the
CONSULTANT would be reimbursed for actual costs in accordance with the termination for other than
default clauses listed previously.
In the event of the death of any member, partner or officer of the CONSULTANT or any of its supervisory
personnel assigned to the PROJECT, or dissolution of the partnership, termination of the corporation, or
disaffiliation of the principally involved employee, the surviving members of the CONSULTANT hereby
agree to complete the work under the terms of this AGREEMENT, if requested to do so by the AGENCY.
This subsection shall not be a bar to renegotiation of the AGREEMENT between the surviving members of the
CONSULTANT and the AGENCY, if the AGENCY so chooses.
In the event of the death of any of the parties listed in the previous paragraph, should the surviving members of
the CONSULTANT, with the AGENCY' S concurrence, desire to terminate this AGREEMENT, payment
shall be made as set forth in the second paragraph of this section.
Payment for any part of the work by the AGENCY shall not constitute a waiver by the AGENCY of any
remedies of any type it may have against the CONSULTANT for any breach of this AGREEMENT by the
CONSULTANT, or for failure of the CONSULTANT to perform work required of it by the AGENCY.
Forbearance of any rights under the AGREEMENT will not constitute waiver of entitlement to exercise those
rights with respect to any future act or omission by the CONSULTANT.
X Changes of Work
The CONSULTANT shall make such changes and revisions in the complete work of this AGREEMENT as
necessary to correct errors appearing therein, when required to do so by the AGENCY, without additional
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 5 of 33
compensation thereof. Should the AGENCY find it desirable for its own purposes to have previously
satisfactorily completed work or parts thereof changed or revised, the CONSULTANT shall make such
revisions as directed by the AGENCY. This work shall be considered as Extra Work and will be paid for as
herein provided under Section XIV.
XI Disputes
Any dispute concerning questions of fact in connection with the work not disposed of by AGREEMENT
between the CONSULTANT and the AGENCY shall be referred for determination to the Director of Public
Works or AGENCY Engineer, whose decision in the matter shall be final and binding on the parties of this
AGREEMENT; provided, however, that if an action is brought challenging the Director of Public Works or
AGENCY Engineer's decision, that decision shall be subject to de novo judicial review. If the parties to this
AGREEMENT mutually agree, disputes. concerning alleged design errors will be conducted under the
procedures found in Exhibit "J", and disputes concerning claims will be conducted under the procedures found
in Exhibit "K".
XII Venue, Applicable Law, and Personal Jurisdiction
In the event that either party deems it necessary to institute legal action or proceedings to enforce any right or
obligation under this AGREEMENT, the parties hereto agree that any such action shall be initiated in the
Superior court of the State of Washington, situated in the county in which the AGENCY is located. The parties
hereto agree that all questions shall be resolved by application of Washington law and that the parties to such
action shall have the right of appeal from such decisions of the Superior court in accordance with the laws of
the State of Washington. The CONSULTANT hereby consents to the personal jurisdiction of the Superior
court of the State of Washington, situated in the county in which the AGENCY is located.
XIII Legal Relations
The CONSULTANT shall comply with all Federal, State, and local laws and ordinances applicable to the
work to be done under this AGREEMENT. This contract shall be interpreted and construed in accordance with
the laws of the State of Washington.
The CONSULTANT shall indemnify and hold the AGENCY and the STATE and its officers and employees
harmless from and shall process and defend at its own expense all claims, demands, or suits at law or equity
arising in whole or in part from the CONSULTANT'S negligence or breach of any of its obligations under this
AGREEMENT; provided that nothing herein shall require a CONSULTANT to indemnify the AGENCY or
the STATE against and hold harmless the AGENCY or the STATE from claims, demands or suits based solely
upon the conduct of the AGENCY or the STATE, their agents, officers and employees; and provided further
that if the claims or suits are caused by or result from the concurrent negligence of (a) the CONSULTANT' S
agents or employees, and (b) the AGENCY or the STATE, their agents, officers and employees, this indemnity
provision with respect to (1) claims or suits based upon such negligence (2) the costs to the AGENCY or the
STATE of defending such claims and suits shall be valid and enforceable only to the extent of the
CONSULTANT'S negligence or the negligence of the CONSULTANT S agents or employees.
The CONSULTANT' S relation to the AGENCY shall be at all times as an independent contractor.
The CONSULTANT shall comply with all applicable sections. of the applicable Ethics laws, including RCW
42.23, which is the Code of Ethics for regulating contract interest by municipal officers. The CONSULTANT
specifically assumes potential liability for actions brought by the CONSULTANT'S own employees against
the AGENCY and, solely for the purpose of this indemnification and defense, the CONSULTANT specifically
waives any immunity under the state industrial insurance law, Title S 1 RCW.
Unless otherwise specified in the AGREEMENT, the AGENCY shall be responsible for administration of
construction contracts, if any, on the PROJECT. Subject to the processing of a new sole source, or an
acceptable supplemental agreement, the CONSULTANT shall provide On-Call assistance to the AGENCY
during contract administration. By providing such assistance, the CONSULTANT shall assume no
responsibility for: proper construction techniques, job site .safety, or any construction contractor's failure to
perform its work in accordance with the contract documents.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 6 of 33
The CONSULTANT shall obtain and keep in force during the terms of the AGREEMENT, or as otherwise
required, the following insurance with companies or through sources approved by the State Insurance
Commissioner pursuant to Title 48 RCW.
Insurance Coverage
A. Worker's compensation and employer's liability insurance as required by the STATE.
B. Commercial general liability and property damage insurance in an aggregate amount not less than two
million dollars ($2,000,000) for bodily injury, including death and property damage. The per
occurrence amount shall not exceed one million dollars ($1,000,000).
C. Vehicle liability insurance for any automobile used in an amount not less than a one million dollar
($1,000,000) combined single limit.
D. Professional liability (Errors and Omissions) policy in an amount of not less than one million dollars
($1,000,000.00) combined single limit if any employee, agent or representative of the CONSULTANT
undertaking work in furtherance of or pursuant to this Agreement holds or is required to hold a
professional license issued by the State of Washington or any other state.
Excepting the Worker's Compensation Insurance and any Professional Liability Insurance secured by the
CONSULTANT, the AGENCY will be named on all policies as an additional insured. The CONSULTANT'S
insurance required by this Section shall be in all circumstances primary to any insurance available to the
AGENCY. The CONSULTANT shall furnish the AGENCY with verification of insurance and endorsements
required by the AGREEMENT. The AGENCY reserves the right to require complete, certified copies of all
required insurance policies at any time.
All insurance shall be obtained from an insurance .company authorized to do business in the State of
Washington. The CONSULTANT shall submit a verification of insurance as outlined above within fourteen
(14) days of the execution of this AGREEMENT to the AGENCY.
No cancellation of the foregoing policies shall be effective without thirty (30) days prior notice to the
AGENCY.
The CONSULTANT'S professional liability to the AGENCY shall be limited to the amount payable under
this AGREEMENT or one million ($1,000,000) dollars, whichever is the greater, unless modified by Exhibit
"L". In no case shall the. CONSULTANT'S professional liability to third parties be limited in any way.
The AGENCY will pay no progress payments under Section V until the CONSULTANT has fully complied
with this section. This remedy is not exclusive; and the AGENCY and the STATE may take such other action
as is available to it under other provisions of this AGREEMENT, or otherwise in law.
XIV Extra Work
A. The AGENCY may at any time, by written order, make changes within the general scope of the
AGREEMENT in the services to be performed.
B. If any such change causes an increase or decrease in the estimated cost of, or the time required for,
performance of any part of the work under this AGREEMENT, whether or not changed by the order,
or otherwise affects any other terms and conditions of the AGREEMENT, the. AGENCY shall make
an equitable adjustment in the (1) maximum amount payable; (2) delivery or completion schedule, or
both; and (3) other affected terms and shall modify the AGREEMENT accordingly.
C. The CONSULTANT must submit any "request for equitable adjustment", hereafter referred to as
"CLAIM", under this clause within thirty (30) days from the date of receipt of the written order.
However, if the AGENCY decides that the facts justify it, the AGENCY may receive and act upon a
CLAIM submitted before final payment of the AGREEMENT.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 7 of 33
D. Failure to agree to any adjustment shall be a dispute under the Disputes clause. However, nothing in
this clause shall excuse the CONSULTANT from proceeding with the AGREEMENT as changed.
E. Notwithstanding the terms and conditions of paragraphs (A) and (B) above, the maximum amount
payable for this AGREEMENT, shall not be increased or considered to be increased except by specific
written supplement to this AGREEMENT.
XV Endorsement of Plans
If applicable, the CONSULTANT shall place their endorsement on all plans, estimates, or any other
engineering data furnished by them.
XVI Federal and State Review
The Federal Highway Administration and the Washington State Department of Transportation shall have the
right to participate in the review or examination of the work in progress.
XVII Certification of the Consultant and the Agency
Attached hereto as Exhibit "M- 1 (a and b)" are the Certifications of the CONSULTANT and the AGENCY,
Exhibit "M-2" Certification Regarding Debarment, Suspension and Other Responsibility Matters -Primary
Covered Transactions, Exhibit "M-3" Certification Regarding the Restrictions of the Use of Federal Funds for
Lobbying and Exhibit "M-4" Certificate of Current Cost or Pricing Data. Exhibit "M-3" is required only in
AGREEMENTS over $100,000 and Exhibit "M-4" is required only in AGREEMENTS over $500,000.
XVIII Complete Agreement
This document and referenced attachments contain all covenants, stipulations, and provisions agreed upon by
the parties. No agent, or representative of either party has authority to make, and the parties shall not be bound
by or be liable for, any statement, representation, promise or agreement not set forth herein. No changes,
amendments, or modifications of the terms hereof shall be valid unless reduced to writing and signed by the
parties as an amendment to this AGREEMENT.
XIX Execution and Acceptance
This AGREEMENT may be simultaneously executed in several counterparts, each of which shall be deemed
to be an original having identical legal effect. The CONSULTANT does hereby ratify and adopt all statements,
representations, warranties, covenants, and agreements contained in the proposal, and the supporting material
submitted by the CONSULTANT, and does hereby accept the AGREEMENT and agrees to all of the terms
and conditions thereof.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2Q13 Page 8 of 33
L
.; In witness whereof, the parties hereto have executed this AGREEMENT as of the day and year shown in the
"Execution Date" box on page one (1) of this AGREEMENT.
Exeltech Consultin ,Inc.
Consultant (Please print)
~Ja~bsh -
Consultant's Na (Please print
Consultant ture
Date
COUNTY OF JEFFERSON
BOARD OF COMMISSIONERS
John Austin, Chair
Phil Johnson, Member
David W. Sullivan, Member
A roved as to form ly: ~ 1~
David Alvarez Date
Deputy Prosecutin Attorney
~ ZS /.~
Frank Gifford Date
Public Works Director
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 9 of 33
EXHIBIT A-1
SCOPE OF WORK FOR
CONSTRUCTION ENGINEERING
PROJECT ADMINISTRATION SERVICES
QUEETS BRIDGE PAINTING
Bridge No. 8W
Clearwater Road M.P. 0.60 to M.P. 0.76
County Road Project CR1881
County Road Number 107508
OBJECTIVES:
The objective of the proposed work is to provide Project Administration for the Construction Engineering phase
of Jefferson County's Queets Bridge Painting project.
Queets Bridge is located on the Clearwater Road between M.P. 0.60 and M.P. 0.76, approximately 45 miles from
Forks, WA. and 65 miles from Aberdeen, WA., in Section 29, Township 24 North, Range 12 West, W.M. The
bridge is 844 feet long and 37 feet wide, out-to-out. The superstructure is comprised of steel plate girders, cross-
bracing, and a concrete deck. The girders are made from weathering steel which were painted when the bridge
was constructed in 1988. The painting is planned for 2013. All work is to be performed per the WSDOT Local
Agency Guidelines, the WSDOT Standard Specifications for Road, Bridge, and Municipal Construction, the
AASHTO Standard Specifications for Highway Bridges, and the Steel Structures Painting Council (SSPC)
Painting Manuals.
The scope of work for this project includes:. Construction Engineering Project Administration.
In this agreement the Consultant providing on-site Construction Engineering Administration (Exeltech
Consulting, Inc.) is designated as the Consultant Construction Engineering Administrator (C.E.A.). The
Consultant (Integrity Structural Engineering, PLLC) is designated as the Consultant Engineer of Record
(E.O.R.). The Consultant E.O.R.'s Subconsultant (Greenman -Pedersen, Inc.) is designated as the Subconsultant
Construction Inspector. The contractor performing the actual construction work is designated as the Contractor.
The contracting agency (Jefferson County Public Works Department) is designated as the Agency.
The Consultant C.E.A, will be responsible for providing all work, materials, and equipment necessary to provide
the project administration for the construction engineering phase of this project. The Consultant C.E.A.'s work
effort shall be to complete the tasks as specified in this scope to the satisfaction of the Agency.
AGENCY'S RESPONSIBILITIES:
a. Provide oversight of all construction engineering administration activities.
b. Provide review comments for all Consultant C.E.A.'s deliverables.
c. Provide readily available project information and examples from previous projects to the
Consultant C.E.A.
d. Provide right of entry and access to the project for all required services.
CRITERIA:
a. WSDOT Local Agency Guidelines Manual, current edition
b. WSDOT Standard Specifications for Road, Bridge, and Municipal Construction, current edition
c. AASHTO Standard Specifications for Highway Bridges, current edition
d. Steel Structures Painting Council (SSPC) Painting Manuals, current edition
e. WSDOT Construction Manual, current edition
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 10 of 33
ASSUMPTIONS:
1. The level of consultant services for the C.E. Administrator is based on an estimated 103 on-site working
days during construction. Additional days are provided for during the pre-construction and post-
construction time periods for preparation for construction and for the project close-out process. The
estimated hours required for the level of services specified in the scope of work is shown in the cost
estimate included Exhibit E-1.
2. The Contractor's work is anticipated to take place during an 8 hour period between 7:00 am. and 6:00
pm. each working day. The .Contractor may request permission to work longer than an 8 hour day/40
hour week, but permission to work longer is subject to the Agency's approval. The Agency has provided
for overtime hours that may be needed by the E.O.R.'s Subconsultant Construction Inspector under a
separate agreement. The Agency has assumed that the C.E. Administrator will work 8 hour days, and
Exhibit E-1 has provided for 20 hours of overtime if necessary.
3. Consultant services will be performed in accordance with the WSDOT Local Agency Guidelines (LAG)
Manual, and the WSDOT Construction Manual.
4. The Consultant's construction management team is assumed to include the following labor resources:
one part time Project Manager, one full time Construction Engineering Administrator, one part time
Document Engineer, one part time QA/QC Engineer, one part time Administrative Support.
Professional consultant services will be limited to the assumed hours/costs established in Exhibit E-1,
unless additional consultant services are authorized by the Agency.
5. Engineer-o~Reeord{~~R.~~~erviees-Willie-provided-by another--oorrsuitant (Consultant~.C~~.j unzler-~ ------_
separate agreement with the Agency. The Consultant E.O.R. will review contractor submittals as
specified by the agreement.
6. Bridge preparation and painting construction Inspection services will be provided by a Subconsultant
Construction Inspector under separate agreement with the Consultant E.O.R.
7. The C.E. Administrator will be responsible for the inspection of all contract items except the bridge
preparation and painting items, as specified in Subtask 2.4.
8. All project direction from the Agency will be channeled through the Consultant C.E. Administrator, who
will also serve as the primary point of communication with the Consultant E.O.R. and the Contractor.
Exeltech's C.E. Administrator will report directly to, and communication flow will be directly to and
from the Agency's Project Manager.
9. The Project documentation will be maintained in the Consultant's project office in Port Angeles, WA.
and filed in accordance with standard filing protocol. The original project documentation will be
transferred to the Agency at the completion of the project.
10. The Consultant C.E. Administrator will coordinate and schedule with the WSDOT Fabrication Dept. for
the performance of fabrication inspection of the added girder web stiffeners and with the WSDOT
Materials Lab for the performance of the required paint testing. The Agency will pay the WSDOT
inspection and testing invoices directly.
11. The Contractor will be providing the blast waste material testing, as required in the specifications.
12. The existing paint on the bridge is known to be lead based, per testing done during the preliminary
engineering phase.
13. No archeological conditions are known to exist at the .project site, but will be properly dealt with if
encountered.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 11 of 33
TASKS
TASK 1: PROJECT MANAGEMENT
This task includes management of the Consultant C.E.A.'s scope, schedule, and budget, coordination of the
Consultant C.E.A.'s activities with the Agency and other Consultants, and submittal of project progress reports
and invoices.
This work includes monitoring monthly progress and the status of individual work elements, and work planned
for the following month. The Consultant C.E.A. will document the current project status and provide projections
for remaining work and expenditures. This work includes preparation of project correspondence, submittals,
transmittals, management of Consultant C.E.A.'s personnel, and record keeping as required for FHWA funded
projects.
The Consultant C.E.A. will be required to coordinate the work effort involved in all tasks under this agreement
with the Agency. Prior to beginning any work, the Consultant C.E.A. will establish a project manager dedicated
to this project, who will be the Consultant C.E.A. contact for the Agency.
Provide monthly written progress reports submitted with the monthly project invoice, which shall include the
following information for the Consultant C.E.A.:
a. Progress-to-date for that month. Provide description of the work completed by each employee.
b. Progress compared to original schedule and anticipated progress for the next month.
c. Anticipated problems and delays for the Consultant C.E.A.'s work.
d. Updated schedule of the individual work elements.
Provide invoices for accomplished work at a frequency not to exceed one per calendar month. The Agency will
disallow all or part of any claimed cost, which is not adequately supported by documentation. Invoices shall
include the following information for the Consultant C.E.A.:
a. Name of each employee that worked on the project in the billing period
b. Each employee's job classification.
c. Each employee's hours worked.
d. Each employee's regular and overtime hourly wage rates.
e. The total wages paid each employee.
f. Each invoice will also include all direct non-salary costs and copies of supporting invoices or bills.
g. All mileage charges will be supported by departure and arrival odometer readings for all vehicles used
for the work. Mileage charges will be paid at the current IRS standard mileage rate.
h. Copies of invoices from any Subconsultants used on this project, with copies of associated invoices for
non-salary costs.
i. Per diem rates will be paid per the current published State of Washington, Office of Financial
Management (www. ofm. wa. gov/resources/travel. asp).
Deliverables: Monthly progress reports, updated schedules, and monthly project invoices.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 12 of 33
TASK 2: CONSTRUCTION ENGINEERING ADMINISTRATION
• Pre-Construction Administration
This work includes review and familiarization of the project Contract Provisions and Plans, project
administration setup, communications with the Agency, the Consultant E.O.R., the Subconsultant Construction
Inspector, and the Contractor. This work includes an initial project meeting with the Agency, apre-construction
visit to the project site, and a formal Pre-construction meeting. This work also includes preparation of required
pre-construction documentation. The anticipated pre-construction engineering documentation and the primary
responsible party for each .item are provided in the list at the end of the scope of work.
Subtask 2.1: Project Meetings
The Consultant C.E.A. shall attend an initial project meeting with the Agency at the Agency's office in Port
Townsend. The purpose of the meeting will be to review the project, discuss all of the tasks as specified in this
scope of work, discuss submittals, record keeping, identify project issues, develop solutions, and discuss
coordination with the Agency, other Consultants and the Contractor. The Consultant E.O.R. and the
Subconsultant Construction Inspector may also attend the initial project meeting. The meeting shall be scheduled
to occur prior to the formal pre-construction meeting and require approximately 2 hours.
The Consultant C.E.A. will prepare and distribute the meeting agenda to the Agency, a minimum of two working
days prior to the initial project meeting. This work includes the preparation for and facilitation of the meeting.
The Consultant C.E.A. will prepare and distribute post-meeting notes with required actions to all meeting
participants within 4 working days of the meeting.
Subsequent additional project meetings may be held at the Agency's Port Townsend office or at the project site,
and may be scheduled by either the Consultant C.E.A. or the Agency. This Subtask also includes the preparation,
facilitation, preparation and distribution of the follow-up documentation of all subsequent project meetings.
Deliverables: Meeting agendas, post- meeting minutes with required actions
Subtask 2.2: Project Site Visit
The Consultant C.E.A. shall visit the project site prior to the beginning of construction. The purpose of the
project site visit is for the Consultant C.E.A. to become familiar with the bridge site, the associated County road,
the construction staging area and access, and the adjacent properties.
The Consultant C.E.A. shall review the Provisions and Plans as the site visit is conducted. The Consultant
C.E.A. is to inform the Agency of any potential problems that are discovered during the site visit. The Consultant
E.O.R., the Subconsultant Construction Inspector, and the Agency's Project Manager may accompany the
Consultant C.E.A. during the site visit. The project site visit duration will be approximately 2 hours.
Deliverables: Summary of the project site visit.
Subtask 2.3: Pre-construction Meeting
The Consultant C.E.A. shall schedule, prepare, and facilitate one formal Pre-construction meeting with the
Agency and the Contractor at the Agency's office in Port Townsend. The purpose of the Pre-construction
meeting will be to discuss the Contractor's work to be done for this project and review all project bid items and
tasks. The meeting will cover: Contractor's order of work and time schedules, utilities, subcontractors, traffic
control, safety, environmental requirements, records, submittals, inspections, and discussion of specific
project/contract issues.
Other Sub-contractors, Consultants, or parties that are critical to the project may also attend the meeting. The
pre-construction meeting duration will be approximately 2 hours.
Deliverables: Pre-construction meeting agenda, submittal of post-meeting minutes with required actions, and
distribution of meeting minutes to meeting attendees.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 13 of 33
• Construction Administration
This work consists of the Consultant C.E.A. acting as the Agency's on-site representative during the construction
engineering phase of this project, inspection, and being responsible for all daily project operations and
documentation requirements.
Subtask 2.4: Construction Administration
The Consultant C.E.A. shall manage the project scope, schedule, and budget, and provide updates to the Agency
once per month or as requested by the Agency.
The Consultant C.E.A. shall provide oversight and coordination of the work to be done by the Consultant E.O.R.
and the Subconsultant Construction Inspector. This work also includes communicating with the Agency's
Project Manager on a daily basis or as directed by the Agency's Project Manager.
The Consultant C.E.A. shall communicate on a daily basis with the Contractor and provide a written record of
communication for all Contractor communications.
All Contractors' plans, programs, or materials submittals .from the Contractor shall be submitted to the
Consultant C.E.A., who will then forward the information to the Consultant E.O,R. for approval when necessary.
The Consultant C.E.A. shall ensure that Contractor submittals are routed to the Consultant E.O.R. for review in a
timely manner. All communication concerning approval of Contractor's plans, programs, or materials shall be
provided by the Consultant E.O.R. to the Consultant C.E.A., who will forward the information to the Contractor.
The Consultant C.E.A. shall provide copies of all Contractor submittals and the Consultant E.O.R. approvals, to
the Agency for review.
The Consultant C.E.A shall review the Record of Materials (ROM) prepared by the WSDOT Materials
Laboratory. If modifications are necessary, the Consultant E.O.R. shall assist the Consultant C.E.A in revising
the ROM to correspond with the project materials requirements. The Consultant C.E.A shall maintain the ROM
throughout the construction process and modify it as necessary for coordination with any materials changes and
confirmation of testing.
The Consultant C.E.A. shall review and approve all Requests for Approval of Materials (RAM) submitted by the
Contractor. The Consultant E.O.R. will assist in the review and approval of RAMS.
The fabrication of the Added .Girder Web Stiffeners is required to be inspected by the WSDOT Fabrication
Inspection Dept. The Consultant C.E.A. shall coordinate the scheduling of this inspection at the fabrication site.
The Consultant E.O.R. shall assist the Consultant C.E.A. in reviewing and approving the WSDOT Fabrication
Inspection Dept. report. If inspection results are not within the tolerances stated in the specifications, the
Consultant C.E.A. will require the Contractor to make the necessary corrections, re-inspect, and resubmit the
inspection results for approval.
The Consultant C.E.A. shall review and approve all blast waste material test results of the samples submitted by
the Contractor. The Consultant E.O.R. shall assist the Consultant C.E.A. in determining the appropriate blast
waste disposal method based on the test results.
The Consultant C.E.A. shall review and approve all paint material test results of the samples submitted by the
Contractor. The Consultant E.O.R. shall assist the Consultant C.E.A. in determining if the test results are within
the tolerances stated in the specifications. If the test results are not satisfactory, the Consultant C.E.A will require
the Contractor to re-test and resubmit test results for approval. It is anticipated that the paint sample testing will
be done by the WSDOT Materials Lab.
If testing of the previously taken existing soil samples becomes necessary due to environmental concerns, the
Consultant C.E.A. will coordinate the testing by an appropriately certified materials laboratory per the Agency's
direction. The Consultant E.O.R. shall assist the Consultant C.E.A. in reviewing and evaluating the materials test
results, and providing recommendations to the Consultant C.E.A. concerning the existing soil samples test
results.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 14 of 33
The Consultant C.E.A. shall coordinate the inspection of all Contractor work and provide oversight of the
Subconsultant Construction Inspector's work of ensuring the Contractor's compliance with the project Contract
Provisions and Plans.
• The Subconsultant Construction Inspector shall be responsible for the inspection of the following contract
items: Added Girder Web Stiffeners, Cleaning and Painting -Queets River Bridge 8W, Containment of
Abrasives, and Testing and Disposal of Containment Waste. The Consultant C.E.A. will assist the
Subconsultant Construction Inspector with the inspection of these items if requested.
• The Consultant C.E.A. shall be responsible for the inspection of all contract items except: Added Girder
Web Stiffeners, Cleaning and Painting -Queets River Bridge 8W, Containment of Abrasives, and Testing
and Disposal of Containment Waste.
Inspection shall consist of monitoring the Contractor's compliance with the project Contract Provisions and
Plans, collection of delivered materials tickets, Bill of Ladings, Manufacturer's Certificates of Compliance,
Certificates of Materials Origin documentation, tracking of materials quantities (Field Note Records}, tracking
the Contractor's equipment, and other inspection documentation.
The Consultant C.E.A. shall be responsible for the documentation of the Contractor's use of proper materials and
techniques, with assistance from the Subconsultant Construction Inspector.
The Consultant C.E.A. shall provide review of and ensure that the Contractor submits the Contractor's Daily
Traffic Reports on a daily basis.
The Consultant C.E.A. shall track and document the Contractor's Working Days. The Consultant C.E.A. shall
provide a Weekly Statement of Contractor's Working days to the Contractor each week. A signed Weekly
Statement will be obtained from the Contractor indicating receipt of the statement.
Requests for Information will be made by the Contractor to the Consultant C,E.A., who will forward the request
to the Consultant E.O.R. The Consultant E.O.R.'s responses will be forwarded to the Consultant C.E.A, and the
Contractor. The Consultant E.O.R.'s responses to requests. for information will be used by the Consultant C.E.A
and the Agency to help direct construction activities for the project.
The Consultant C.E.A. shall monitor the Contractor's schedule and progress and work with the Contractor to
correct any schedule or progress problems.
The Consultant C.E.A. shall take an active role in ensuring that any deficiencies identified in the Contractor's
operations are corrected as soon as possible. If unsuccessful, the C.E.A. will immediately notify the Agency's
Project Manager.
The Consultant C.E.A. shall prepare the initial and final scope and cost estimate for all required change orders
and negotiate the change orders with the Contractor and obtain approvals from the Agency.
The Consultant C.E.A. shall prepare Monthly Pay Estimates, with assistance from the Consultant C.E.A.
monthly Pay Estimates will be provided to the Agency for review, approval, and payment to the Contractor.
The Consultant C.E.A. shall take all appropriate action to minimize the potential for claims by the Contractor.
The Consultant C.E.A. shall perform and document Minimum. Wage Compliance Surveys by interviewing the
Contractor's employees.
The Consultant C.E.A. shall document in the Daily Inspection Reports all project site visitors and
communications with the visitors.
The Consultant C.E.A. shall document in the Daily Inspection Reports and with photos if possible any work
place injuries or traffic accidents.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 15 of 33
The Consultant C.E.A. shall prepare and process all construction engineering documentation and reporting
required by the Agency, WSDOT, and the FHWA. The anticipated construction engineering documentation and
the primary responsible party are provided in the list at the end of the scope of work. The Consultant C.E.A.
shall provide copies of all Contractor submittals and the Consultant E.O.R.'s approvals to the Agency for review.
The Consultant C.E.A. shall accompany the Subconsultant Construction Inspector on the Pre-final and Final
project inspections. The Consultant C.E.A. shall assist the Subconsultant Construction Inspector with the
inspections and provide written inspection notes to the Subconsultant Construction Inspector for both
inspections.
The Consultant C.E.A. shall coordinate, facilitate, and provide meeting documentation for all project meetings
and/or conference phone calls with the Consultant E.O.R., the Contractor, and the Agency during the
construction phase.
Deliverables: All schedules, budgets, Consultant C.E.A. communications, Contractor communications records,
construction engineering documentation, meeting documentation, Inspector's Daily Reports (WSDOT form 422-
004 and 422-004A), project photos, delivered materials tickets, Bill of ladings, manufacturer's Certificates of
Compliance, Certifications of Materials Origin, ROM, RAMS, Field Note Records, test results, Requests for
Information, Daily Traffic Reports, Weekly Statements of Contractor's Working Days, Change Order
documentation, Minimum Wage Compliance surveys, daily quantities spreadsheets (MS Excel format), monthly
quantities spreadsheets for monthly pay estimates, and Monthly Pay Estimates.
• Post-Construction Administration
This work includes final inspections, preparation, and processing of the required project close-out documentation.
Subtask 2.5: Post-Construction Administration
This Subtask includes participation in the final inspections for the Substantial Completion and Physical
Completion levels of completion. The Consultant C.E.A. will assist the Subconsultant Construction Inspector
during all on-site final inspections and preparation of the list of work items to be completed (punch list). This
work includes providing the punch list to the Contractor and confirmation that all remaining items of work have
been completed by the Contractor.
This subtask includes finalizing and preparation of all construction engineering documentation and submittal of
the documentation to the required agencies. The anticipated post-construction engineering documentation and the
primary responsible party are provided in the list at the end of the scope of work.
This subtask includes preparation for all funding agency reviews. This includes but is not limited to a WSDOT
Project Management Review, a WSDOT Documentation Review, and a State Auditor Financial Aid Compliance
Audit. The project files shall be organized and indexed so as to provide readily accessible documents for
reviewers. The Consultant C.E.A. shall meet with the Agency's Project Manager to review the project files prior
to WSDOT and FHWA reviews. The Consultant C.E.A. shall participate in all funding agency review meetings.
Deliverables: All final construction engineering documentation in organized bound project folders.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 16 of 33
Construction En~ineerin~ Documentation
The Consultant C.E.S. shall prepare and process the required construction engineering documentation.
Processing includes distribution to the Agency for review and submittal to the appropriate governmental agency
where required. The construction engineering documentation is anticipated to include, but is not limited to, the
items in the following list. Each item is followed by the Consultant who is primarily responsible for completing
the documentation, either the Consultant C.E.A. [C.E.A.] or the Consultant E.O.R. [E.O.R.].
General Construction Documentation:
1. Daily Construction Project Diary (WSDOT form 422-014 notebook)[C.E.A.]
2. Inspector's Daily Reports (WSDOT form 422-004 and 422-004A)[C.E.A.]
3. Daily Coatings Inspection Report [E.O.R.]
4. Weekly Statement of Working Days. [C.E.A.]
5. Documentation of coordination with Utility Companies. [C.E.A.]
6. Documentation of coordination of temporary traffic closures. [C.E.A.]
7. Project updates to the Quinault Indian Nation, the general public, and the emergency services. [C.E.A.]
8. Documentation of correspondence with Agency Project Manager (phone calls, emails). [C.E.A.] and
[E.O.R.]
9. Documentation of oversight of inspection work. [C.E.A.]
10. Documentation of oversight of quality control. [C.E.A.]
11. Documentation of Requests for Information from Contractor. [C.E.A.]
12. Documentation of resolution of construction problems with the Consultant E.O.R. and Contractor.
[C.E.A.]
Contractor Submittals:
1. Request to Sublet, State L&I form 421-012 EF. [C.E.A.]
2. Contractor and Subcontractor or Lower Tier Subcontractor Certification .for Federal-Aid Certification
forms, WSDOT form 420-004 EF. [C.E.A.]
3. Statement of Intent to Pay Prevailing Wages, State L&I form F700-029-000. [C.E.A.]
4. Quarterly Reports of Amounts Credited as DBE Participation, WSDOT form 422-102 EF. [C.E.A.]
5. Federal-Aid Highway Construction Contractors Annual EEO Report, FHWA form 1391. [C.E.A.]
6. Federal-Aid Highway Construction Summary of Employment Data, FHWA form 1392 (from Agency).
[C.E.A.] and [Agency]
7. Monthly Employment Utilization Report, WSDOT form 820-010. [C.E.A.]
8. Employee Interview Report, Minimum Wage Compliance Survey, WSDOT form 424-003 EF.[C.E.A.]
9. Certified payrolls. [C.E.A.]
10. Contractor Schedules. [C.E.A.]
11. Breakdown of the cost of Lump Sum Items. [E.O.R.]
12. Daily Traffic Control Reports. [C.E.A.]
13. Review and approval of Contractor bridge painting submittals: [E.O.R.] [C.E.A. assist]
a. Construction Schedules
b. Health and Worker Safety plan
c. Emergency Response plan
d. Spill Prevention and Response plan
e. Construction Site Work plan (includes equipment and material staging)
f. Work Force Qualifications
g. Quality Control Program
h. Paint System Manufacturer and Paint System Information
i. Cleaning and Surface Preparation Equipment plan
j. Hazardous Waste Containment, Collection, Testing, and Disposal plan
k. Paint Application Equipment and Operations plan
1. Added Girder Web Stiffeners: field measured locations, field measurements, shop drawings, and
installation plan
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/1 4/12 0 1 3 Page 17 of 33
Materials:
1. Maintain the Record of Materials (ROM) (WSDOT Materials Laboratory to prepare original ROM).
[C.E.A.]
2. Request for Approval of Materials (RAM), WSDOT form 350-071. EF. [C.E.A.][E.O.R. assist]
3. Certification of Materials Origin, WSDOT form 350-109 EF. [C.E.A.][E.O.R. assist]
4. Coordination with WSDOT Fabrication Inspection Dept. and Contractor for the Added Girder Web
Stiffener inspection. [C.E.A.] [E.O.R. assist]
5. Monitor the Contractor's testing of the blast waste material. [C.E.A.] [E.O.R. assist]
6. Monitor paint materials test results. [C.E.A.][E.O.R. assist]
7. Materials testing of existing soil samples (if testing is necessary): [C.E.A.][E.O.R. assist]
a. Coordinate materials sampling and testing with the Consultant Engineer of Record.
b. Review materials test results and determine required action.
Change Orders:
1. Prepare Independent Agency, Change Order Document (Scope and Cost Estimate). [C.E.A.]
2. Review Contractor's cost estimate for proposed change. Negotiation of Scope and Cost with Contractor.
[C.E.A.][E.O.R. assist]
3. Preparation of Final Agency Change Order document. [C.E.A.]
4. Submittal to Agency for approval. [C.E.A.]
5. Send executed change order to Contractor. [C.E.A.]
6. Provide Contractor signed Change Order to Agency for approvals. [C.E.A.]
Pay Estimates:
1. Assemble, review, and prepare Inspector's daily quantities notes into monthly quantity totals. [C.E.A.]
2. Prepare monthly Pay Estimate spreadsheet. [C.E.A.] [E.O.R. assist]
3. Submittal to Agency for review and approval. [C.E.A.]
4. Submittal to Contractor for review and signature. Reconciliation of any quantity discrepancies. [C.E.A.]
5. Submittal to Agency for payment to Contractor. [C.E.A.]
6. Payment of Pay Estimate to Contractor [Agency]
Project Completion:
1. Pre-final inspection and punch-list preparation and submittal to Contractor.[E.O.R.] [C.E.A. assist]
2. Prepare and issue to Contractor Notice of Substantial Completion. [C.E.A.]
3. Final inspection, preparation, and submittal to Contractor, a punch list of final remaining items to be
corrected or completed.[E.O.R.] [C.E.A. assist]
4. Prepare and issue to Contractor Notice of Physical Completion. [C.E.A.]
5. Submit copy of Notice of Physical Completion to WSDOT Local Programs and request inspection and
acceptance. [C.E.A.]
6. Finalize and process execution of all uncompleted Change Orders, process final project change order if
necessary. [C.E.A.][E.O.R. assist]
7. Finalize all uncompleted Certified Payrolls. [C.E.A.]
8. Finalize all materials acceptance documents. [C.E.A.][E.O.R. assist]
9. Prepare Comparison of Preliminary and Final Quantities and submit to Agency for approval. [C.E.A.]
10. Prepare Material Certification form and submit to agency for approval. [C.E.A.]
11. Prepare Final Contract Voucher, submit to Agency for review and approval, submit to Contractor for
signature. [C.E.A.]
12. Prepare Final Pay Estimate, submit to Agency for review and approval. Send to Contractor for review
and signature. [C.E.A.][ E.O.R. assist]
13. Verify all required DBE documents received from Contractor. [C.E.A.]
14. Establish Contract Date of Completion, notify Contractor. [C.E.A.]
15. Affidavit of Prevailing Wages Paid, State L&I form F700-007-00, approval for Contractor and all Sub-
contractors received from L&I. [C.E.A.]
16. Submit Notices of Completion to Dept, of Revenue, Employment Security Dept., L&I. [C.E.A.]
17. Receive releases from Dept.. of Revenue, Employment Security Dept., L&I. [C.E.A.]
18. Prepare As-Built Plans (if required), submit to Consultant C.E.A. for approval. [E.O.R.]
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 18 of 33
19. Review As-Built Plans (if required), submit to Agency for approval. [C.E.A.]
20. Prepare project files for WSDOT Project Management Review and. Documentation Review.
[C.E.A.] [E.~.R. assist]
21. Prepare project files for Financial Aid Compliance Audit (State Auditor) [C.E.A.]
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 19 of 33
Exhibit C
Electronic Exchange of Engineering and Other Data
In this Exhibit the agency, as applicable, is to provide a description of the format and standards the
consultant is to use in preparing electronic files for transmission to the agency. The format and
standards to be provided may include, but are not limited to, the following:
I. Construction Engineering Documentation
A. All Construction Engineering Administration and Construction Engineering
Documentation listed in, but not limited to, Exhibit A-1, Scope of Work.
B. The Agency has the right to review documentation with the Consultant and request
revisions.
II. Methods to Electronically Exchange Data
A. All submitted electronic documentation shall be in the Microsoft Office electronic file
formats, AutoCAD file formats, or Adobe .pdf format.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 20 of 33
Exhibit D-3
Payment (Negotiated Hourly Rate)
The CONSULTANT .shall be paid by the AGENCY for completed work and services rendered under this
AGREEMENT as provided hereinafter. Such payment shall be full compensation for work performed or
services rendered and for all labor, materials, supplies, equipment, and incidentals necessary to complete the
work. The CONSULTANT shall conform to all applicable portions of 48 CFR 31.
1. Hourly Rates: The CONSULTANT shall be paid by the AGENCY for work done, based upon the
negotiated hourly rates shown in Exhibits "E" and "F" attached hereto and by this reference made part of
this AGREEMENT. The rates listed shall be applicable for the first twelve (12) month period and shall
be subject to negotiation for the following twelve (12) month period upon request of the CONSULTANT
or the AGENCY. If negotiations are not conducted for the second or subsequent twelve (12) month
periods within ninety (90) days after completion of the previous period, the rates listed in this
AGREEMENT, or subsequent written authorization(s) from the AGENCY shall be utilized. The rates
are inclusive of direct salaries, payroll additives, overhead, and fee. The CONSULTANT shall maintain
support data to verify the hours billed on the AGREEMENT.
2. Direct Non-Salary Costs: Direct Non-Salary Costs will be reimbursed at the Actual Cost to the
CONSULTANT. These charges may include, but are not limited to the following items: travel, printing,
long distance telephone, supplies, computer charges, and sub-consultant costs.
a. Air or train travel will be reimbursed only to economy class levels unless otherwise approved by the
AGENCY. The CONSULTANT shall comply with the rules and regulations regarding travel costs
(excluding air, train, and rental car costs) in accordance with the AGENCY' S Travel Rules and
Procedures. However, air, train, and rental car costs shall be reimbursed in accordance with 48CFR
Part 31.205-46 "Travel Costs."
b. The billing for Direct Non-Salary Costs shall include an itemized listing of the charges directly
identifiable with the PROJECT.
c. The CONSULTANT shall maintain the original supporting documents in their office. Copies of the
original supporting documents shall be supplied to the AGENCY upon request.
d. All above charges must be necessary for the services provided under this AGREEMENT.
3. Management Reserve Fund: The AGENCY may desire to establish a Management Reserve Fund to
provide the Agreement Administrator with the flexibility to authorize additional funds to the
AGREEMENT for allowable unforeseen costs, or reimbursing the CONSULTANT for additional work
beyond that already defined in this AGREEMENT. Such authorization(s) shall be in writing and shall
not exceed the lesser of $100,000 or 10% of the Total Amount Authorized as shown in the heading of
this AGREEMENT. The amount included for the Management Reserve Fund is shown in the heading of
this AGREEMENT. This fund may not be replenished. Any changes requiring additional costs in
excess of the Management Reserve Fund shall be made in accordance with Section XN, "Extra Work."
4. Maximum Total Amount Payable: The Maximum Total Amount Payable by the AGENCY to the
CONSULTANT under this AGREEMENT shall not exceed the amount shown in the heading of this
AGREEMENT. The Maximum Total Amount Payable is comprised of the Total Amount Authorized,
and the Management Reserve Fund. The Maximum Total Amount Payable does not include payment
for Extra Work as stipulated in Section XIV, "Extra Work." No minimum amount payable is guaranteed
under this AGREEMENT.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 21 of 33
Monthly Progress Payments: Progress payments may be claimed on a monthly basis for all costs
authorized in 1 and 2 above. The monthly billings shall be supported by detailed statements for hours
expended at the rates established in Exhibit "E", including names and classifications of all employees,
and billings for all direct non-salary expenses. To provide a means of verifying the billed salary costs for
the CONSULTANT' S employees, the AGENCY may conduct employee interviews. These interviews
may consist of recording the names, titles, salary rates, and present duties of those employees performing
work on the PROJECT at the time of the interview.
6 Final Payment: Final Payment of any balance due the CONSULTANT of the gross amount earned will
be made promptly upon its verification by the AGENCY after the completion of the work under this
AGREEMENT, contingent upon receipt of all PS&E, plans, maps, notes, reports, electronic data and
other related documents which are required to be furnished under this AGREEMENT. Acceptance of
such Final Payment by the CONSULTANT shall constitute a release of all claims for payment, which
the CONSULTANT may have against the AGENCY. unless such claims are specifically reserved in
writing and transmitted to the AGENCY by the CONSULTANT prior to its acceptance. Said Final
Payment shall not, however, be a bar to any claims that the AGENCY may have against the
CONSULTANT or to any remedies the AGENCY may pursue with respect to such claims.
The payment of any billing will not constitute agreement as to the appropriateness of any item and at the
time of final audit, all required adjustments will be made and reflected in a final payment. In the event
that such final audit reveals an overpayment to the CONSULTANT, the CONSULTANT will refund
such overpayment to the AGENCY within thirty (30) days of notice of the overpayment. Such refund
shall not constitute a waiver by the CONSULTANT for any claims relating to the validity of a finding by
the AGENCY of overpayment. The CONSULTANT'has twenty (20) days after receipt of the final
POST AUDIT to begin the appeal process to the AGENCY for audit findings.
7. Inspection of Cost Records: The CONSULTANT and their. sub-consultants shall keep available for
inspection by representatives of the AGENCY, STATE, and the United States, for a period of three (3)
years after receipt of final payment, the cost records and accounts pertaining to this AGREEMENT and
all items related to or bearing upon these records with the following exception: if any litigation, claim or
audit arising out of, in connection with, or related to this contract is initiated before the expiration of the
three (3) year period, the cost records and accounts shall be retained until such litigation, claim, or audit
involving the records is completed.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 22 of 33
Exhibit E-1
Consultant Fee Determination -Summary Sheet
(Specific Rates of Pay)
Project: Queets Bridge Painting, CR1881
DIRECT SALARY COST (DSC):
Classification
Pro'ec~ t Manager
Document Engineer
QA/QC Engineer
CE Administrator (red)
CE Administrator (O.T.) (2)
Clerical
REIMBURSABLES:
Man Hours (1) Rate = Cost
148.0 x 156.04 X3,093.92
170.0 x 107.48 18 271.60
48.0 x 111.93 5 372.64
968.0 x 119.14 $115,327.52
20.0 x 178.71 3 574.20
49.0 x 84.65 4147.85
TOTAL DSC = $169x787.73
Reproduction/Communication = $ 250.00
Daily Travel Stipend (3): 103 on-site work days x $145.00 per on-site work daX = $14,934.00
Mileage -- 1265.60
Reimbursables Subtotal = 16 449.60
GRAND TOTAL = $186,237.33
PREPARED BY: John Wayand, Proiect Manager DATE: March, 2013
Jefferson County Public Works
Notes:
(1) Estimated hours are based on the detailed cost estimate breakdown dated 3/11/2013.
(2) Overtime rate applies after 40 hours per week. Travel time shall not be included in the 40 hour
calculation.
(3} Daily Travel Stipend includes all charges for daily travel to and from the project site for the C.E.
Administrator. No other travel charges are allowed for daily travel. Hourly rates do not apply when the
C.E. Administrator is travelling to and from the project site daily.
PW_Fonms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Fage 23 of 33
Exhibit E-2
Consultant Fee Determination -Summary Sheet
(Specific Rates of Pay)
Fee Schedule
Hourly Overhead Profit Rate
Discipline or Job Title Rate @ 183.52% @ 30% Per Hour
Proiect Manager $49.77 $91.34 14.93 $156.04
Document Engineer $34.28 X62.91 10.28 $107.48
QA/QC Engineer $35.70 $65.52 10.71 $111.93
CE Administrator (reg_,) $3 8.00 $69.74 11.40 $119.14
CE Administrator (O.T.) X57.00 $104.61 17.10 $178.71
Clerical $27.00 $49.55 $8.10 $84.65
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 24 of 33
Exhibit F
Breakdown of Overhead Cost
Account Title $ Beginning Total % of Direct Labor
Direct Labor $1,059,211 100%
Overhead Expenses:
FICA $199,565 18.84%
Retirement $37,810 3.57%
Health/Accident Insurance $84,660 7.99%
Medical Aid & Industrial Insurance
Holiday/Vacation/Sick Leave $213,448 20.15%
Commission/Bonus/Pension
Total Fringe Benefits $535,483 50.55%
General Overhead:
State B&O Taxes $63,135 5.96%
Insurance $85,257 8.05%
Administration & Time Not Assignable $635,010 59.95%
Printing, Stationery & Supplies $30,554 2.89%
Professional Services $16,280 1.54%
Travel Not Assignable $51,035 4.82%
Telephone & Telegraph Not Assignable $57,448 5.42%
Fees, Dues & Professional Meetings $46,711 4.41%
Utilities & Maintenance $7,911 0.75%
Professional Development $7,007 0.66%
Rent $271,974 25.68%
Equipment Support $17,735 1.67%
Office, Miscellaneous & Postage $108,810 11.1
Total General Overhead $1,408,355 132.997%
Total Overhead (General + Fringe) $1,943,838
Overhead Rate (Total Overhead /Direct Labor) 183.52%
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 25 of 33
Exhibit H
Title VI Assurances
During the performance of this AGREEMENT, the CONSULTANT, for itself, its assignees, and successors in
interest agrees as follows:
1. Compliance with Regulations: The CONSULTANT shall comply with the Regulations relative to non-
discrimination in federally assisted programs of the AGENCY, Title 49, Code of Federal Regulations,
Part 21, as they may be amended from time to time (hereinafter referred to as the "REGULATIONS"),
which are herein incorporated by reference and made a part of this AGREEMENT.
2. Non-discrimination: The CONSULTANT, with regard to the work performed during the
AGREEMENT, shall not discriminate on the grounds of race, color, sex, or national origin in the
selection and retention of sub-consultants, including procurement of materials and leases of
equipment. The CONSULTANT shall not participate either directly or indirectly in the discrimination
prohibited by Section 21.5 of the REGULATIONS, including employment practices when the
AGREEMENT covers a program set forth in Appendix B of the REGULATIONS.
3. Solicitations for Sub-consultants, Including Procurement of Materials and Equipment: In all
solicitations either by competitive bidding or negotiations made by the CONSULTANT for work to be
performed under asub-contract, including procurement of materials or leases of equipment, each
potential sub-consultant or supplier shall be notified by the CONSULTANT of the CONSULTANT'S
obligations under this AGREEMENT and the REGULATIONS relative to non-discrimination on the
grounds of race, color, sex, or national origin.
4. Information and Reports: The CONSULTANT shall provide all information and reports required by
the REGULATIONS or directives issued pursuant thereto, and shall permit access to its books,
records, accounts, other sources of information, and its facilities as may be determined by AGENCY,
STATE or the Federal Highway Administration (FHWA) to be pertinent to ascertain compliance with
such REGULATIONS, orders and instructions. Where any information required of a CONSULTANT
is in the exclusive possession of another who fails or refuses to furnish this information, the
CONSULTANT shall so certify to the AGENCY, STATE or the FHWA as appropriate, and shall set
forth what efforts it has made to obtain the information.
5. Sanctions for Non-compliance: In the event of the CONSULTANT' Snon-compliance with the non-
. discrimination provisions of this AGREEMENT, the AGENCY shall impose such AGREEMENT
sanctions as it, the STATE or the FHWA may determine to be appropriate, including, but not limited
to:
• Withholding of payments to the CONSULTANT under the AGREEMENT until the
CONSULTANT complies, and/or;
• Cancellation, termination, or suspension of the AGREEMENT, in whole or in part
6. Incorporation of Provisions: The CONSULTANT shall include the provisions of paragraphs (1)
through (S) in every sub-contract, including procurement of materials and leases of equipment, unless
exempt by the REGULATIONS, or directives issued pursuant thereto. The CONSULTANT shall take
such action with respect to any sub-consultant or procurement as the AGENCY, STATE or FHWA
may direct as a means of enforcing such provisions including sanctions for non-compliance.
Provided, however, that in the event a CONSULTANT becomes involved in, or is threatened with,
litigation with asub-consultant or supplier as a result of such direction, the CONSULTANT may
request the AGENCY and the STATE enter into such litigation to protect the interests of the
AGENCY and the STATE and, in addition, the CONSULTANT may request the United States enter
into such litigation to protect the interests of the United States.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14/12013 Page 26 of 33
Exhibit I
Payment Upon Termination of Agreement
By the Agency Other Than for
Fault of the Consultant
(Refer to Agreement, Section IX)
Lump Sum Contracts
A final payment shall be made to the CONSULTANT which when added to any payments
previously made shall total the same percentage of the Lump Sum Amount as the work completed at
the time of termination is to the total work required for the PROJECT. In addition, the
CONSULTANT shall be paid for any authorized extra work completed.
Cost Plus Fixed Fee Contracts
A final payment shall be made to the CONSULTANT which when added to any payments
previously made, shall total the actual costs, plus the same percentage of the fixed fee as the work
completed at the time of termination is to the total work required for the Project. In addition, the
CONSULTANT shall be paid for any authorized extra work completed.
Specific Rates of Pay Contracts
A final payment shall be made to the CONSULTANT for actual hours charged at the time of
termination of this AGREEMENT plus any direct non salary costs incurred at the time of
termination of this AGREEMENT.
Cost Per Unit of Work Contracts
A final payment shall be made to the CONSULTANT for actual units of work completed at the time
of termination of this AGREEMENT.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 27 of 33
Exhibit K
Consultant Claim Procedures
The purpose of this exhibit is to describe a procedure regarding claim(s) on a consultant agreement.
The following procedures should only be utilized on consultant claims greater than $1,000. If the
consultant's claim(s) are a total of $1,000 or less, it would not be cost effective to proceed through
the outlined steps. It is suggested that the Director of Public Works or Agency Engineer negotiate a
fair and reasonable price for the consultant's claims} that total $1,000 or less.
This exhibit will outline the procedures to be followed by the consultant and the agency to consider
a potential claim by the consultant.
Step 1 -Consultant Files a Claim with the Agency Project Manager
If the consultant determines that they were requested to perform additional services that
were outside of the agreement's scope of work, they may be entitled to a claim. The first
step that must be completed is the request for consideration of the claim to the Agency's
project manager.
The consultant's claim must outline the following:
• Summation of hours by classification for each firm that is included in the claim;
• Any correspondence that directed the consultant to perform the additional work;
• Timeframe of the additional work that was outside of the project scope;
• Summary. of direct labor dollars, overhead costs, profit and reimbursable costs
associated with the additional work; and
• Explanation as to why the consultant believes the additional work was outside of the
agreement scope of work.
Step 2 -Review by Agency. Personnel Regarding the Consultant's Claim for Additional
Compensation
After the consultant has completed step 1, the next step in the process is to forward the
request to the Agency's project manager. The project manager will review the consultant's
claim and will meet with the Director of Public Works or Agency Engineer to determine if
the Agency agrees with the claim. If the FHWA is participating in the project's funding,
forward a copy of the consultant's claim and the Agency's recommendation for federal
participation in the claim to the WSDQT Highways and Local Programs through the
Region Local Programs Engineer, if the claim is not eligible for federal participation,
payment will need to be from agency funds.
If the Agency project manager, Director of Public Works or Agency Engineer, WSDOT
Highways and Local Programs (if applicable), and FHWA (if applicable) agree with the
consultant's claim, send a request memo, including backup documentation to the
consultant to either supplement the agreement, or create a new agreement for the claim.
After the request has been approved, the Agency shall write the supplement and/or new
agreement and pay the consultant the amount of the claim. Inform the consultant that the
final payment for the agreement is subject to audit. No further action in needed regarding
the claim procedures.
If the Agency does not agree with the consultant's claim, proceed to step 3 of the
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 28 of 33
r
procedures.
Step 3 -Preparation of Support Documentation Regarding Consultant's Claim(s)
If the Agency does not agree with the consultant's claim, the project manager shall prepare
a summary for the Director of Public Works or Agency Engineer that included the
following:
• Copy of information supplied by the consultant regarding the claim;
• Agency's summation of hours by classification for each firm that should be included in
the claim;
• Any correspondence that directed the consultant to perform the additional work;
• Agency's summary of direct labor dollars, overhead costs, profit and reimbursable costs
associated with the additional work;
• Explanation regarding those areas in which the Agency does/does not agree with the
consultant's claim(s);
• Explanation to describe what has been instituted to preclude future consultant claim(s);
and
• Recommendations to resolve the claim.
Step 4 -Director of Public Works or Agency Engineer Reviews Consultant Claim and Agency
Documentation
The Director of Public Works or Agency Engineer shall review and administratively
approve or disapprove the claim, or portions thereof, which may include getting Agency
Council or Commission approval (as appropriate to agency dispute resolution procedures).
If the project involves federal participation, obtain concurrence from WSD4T Highways
and Local Programs and FHWA regarding final settlement of the claim. If the claim is not
eligible for federal participation, payment will need to be from agency funds.
Step S -Informing Consultant of Decision Regarding the Claim
The Director of Public Works or Agency Engineer shall notify (in writing} the consultant
of their final decision regarding the consultant's claims}. Include the final dollar amount
of the accepted claim(s) and rationale utilized for the decision.
Step 6 -Preparation of Supplement or New Agreement for the Consultant's Claim(s)
The agency shall write the supplement and/or new agreement and pay the consultant the
amount of the claim. Inform the consultant that the final payment for the agreement is
subject to audit.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 29 of 33
r
Exhibit M-1(a}
Certification of Consultant
Project No. CR1881
Local Agency
I hereby certify that I am ~. I ~ and
duly authorized representative of the firm of Exeltech Consultin ,Inc. whose address
is 8729 Commerce Place Drive NE, Suite A, Lacey, WA. 98516 and that neither I nor the above
firm I here represent has:
(a) Employed or retained for a commission, percentage, brokerage, contingent fee, or
other consideration, any firm or person (other than a bona fide employee working
solely for me or the above CONSULTANT) to solicit or secure the AGREEMENT;
(b) Agreed, as an express or implied condition for obtaining this contract, to employ or
retain the services of any firm or person in connection with carrying out this
AGREEMENT; or
(c) Paid, or agreed to pay, to any firm, organization or person (other than a bona fide
employee working solely for me or the above CONSULTANT} any fee, contribution,
donation, or consideration of any kind for, or in connection with, procuring or
carrying out this AGREEMENT; except as hereby expressly stated (if any);
I acknowledge that this certificate is to be available to the Washington State Department of
Transportation and the Federal Highway Administration, U.S. Department of Transportation in
connection with this AGREEMENT involving participation of Federal-aid highway funds, and. is
subject to applicable State and Federal laws, both criminal and civil.
3 ~ 2v~3
Da e
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 30 of 33
/~
fv
Exhibit M-1(b)
Certification Of Agency Official
I hereby certify that I am the AGENCY official of the Local Agency of Jefferson County Public
Works, Washington, and that the consulting firm or its representative has not been required, directly
or indirectly as an express or implied condition in connection with obtaining or carrying out this
AGREEMENT to:
(a) Employ or retain, or agree to employ to retain, any firm or person; or
(b) Pay, or agree to pay, to any firm, person, or organization, any fee, contribution,
donation, or consideration of any kind; except as hereby expressly stated (if any):
I acknowledge that this certificate is to be available to the Washington State Department of
Transportation and the Federal Highway Administration, U.S. Department of Transportation, in
connection with this AGREEMENT involving participation of Federal-aid highway funds, and is
subject to applicable State and Federal laws, both criminal and civil.
Name Frank Gifford, Public Works Director
(please print)
Si ature ~ ~ Date /Z ~~/~ 3
~ ~ 1
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 31 of 33
r-
;,
w
Exhibit M-2
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters-Primary Covered Transactions
I. The prospective primary participant certifies to the best of its knowledge and belief, that it and its
principals:
A. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or agency;
B. Have not within athree-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission or fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (federal, state, or
local) transaction or contract under a public transaction; violation of federal or state
antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
C. Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (federal, state, or local) with commission of any of the offenses enumerated in
paragraph I( B) of this certification; and
D. Have not within a three (3) year period preceding this application/proposal had one or
more public transactions (federal, state, or local) terminated for cause or default.
II. Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Consultant (Firm}: Exeltech Consulting Inc._
Name ~GU~~OS~ ~• ~ UVf ~ ~ G~
(please pr'
,~ .~a/3
Signature: Pre r Au ized Official of Consultant ate
PW_Fonns/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 32 of 33
n
r rv
,~ Exhibit M-3
Certification Regarding The Restrictions
of The use of Federal Funds for Lobbying
The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his
or her knowledge and belief, that:
No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any Federal agency, a member of Congress, an officer or employee of
Congress, or an employee of a member of Congress in connection with the awarding of
any Federal contract, the making of any Federal grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any Federal
agency, a member of Congress, an officer or employee of Congress, or an employee of a
member of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is a prerequisite
for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code.
Any person who fails to file the required certification shall be subject to a civil penalty. of
not less than $10,000 and not more than $100,000 for each such failure,
The prospective participant also agrees by submitting his or her bid or proposal that he or
she shall require that the language of this certification be included in all lower tier
subcontracts which exceed $100,000 and that all such sub-recipients shall certify and
disclose accordingly.
Consultant (Firm): Exeltech Consultin ,Inc.
Name ~~~-~b ~ ~ ~ ~-l~tl~
(please
Signature: Pres
official of Consultant
~`~
Date
PW_Forms/Standard Consultant Agreement with Exhibits Revised 2/14//2013 Page 33 of 33