HomeMy WebLinkAbout052813_ca01Department of Public Works
O Consent Agenda
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Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Philip Morley, County Administrator
From: Frank Gifford, Public Works Director ~~
Agenda Date: May 28, 2013
Subject: Standard Consultant Agreement with Johnston Land Surveying for
Dowans Creek Road Relocation, County Project No. X01799, FEMA
Disaster No. 1734-DR-WA
Statement of Issue: Standard Consultant Agreement with Johnston Land Surveying of
Port Angeles, Washington for surveying services for the Dowans Creek Road
Relocation.
Analysis/Strategic Goals/Pro's l't Con's: The consultant selection process was used to
select Johnston Land Surveying for this work. The work will consist of preparing a
Record of Survey and a Right of Way Plan for the road relocation, and performing field
staking for a timber cruise.
Fiscal Impact/Cost Benefit Analysis: The maximum amount payable under this
agreement is $15,575. Funding for this project is 75% FEMA, 12.5% Washington State,
and 12.5% Jefferson County.
Recommendation: The Board is requested to sign all three originals of the Standard
Consultant Agreement with Johnston Land Surveying, and return two originals to
Public Works.
Department Contact: Mark Thurston, P.E., Project Manager, 385-916D.
Reviewed By:
ip Mor ejr; ounty Admin trator
s/Zz//3
Date
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Local Agency
Standard Consultant
Agreement
®Architectural/Engineering Agreement
^ Personal Services Agreement
Agreement Number
JLS - 2013
Federal Aid Number
FEMA Disaster No. 1734-DR-WA
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
Johnston Land Surveying
540 W. 8~h Street
Port Angeles, WA 98362
(360) 452-0237
Project Title And Work Description
Dowans Creek Road Relocation
Dowans Creek Rd. MP 0.75 to MP 1.55
County Project No. X01799
DBE Participation
^ Yes ®No
Federal ID Number or Social Security Number
201765875
Do you require a 1099 for IRS. Completion Date
® Yes ^No June 1, 2014
Total Amount Authorized $15,575.00
Management Reserve Fund $0.00
Maximum Amount Payable $15,575.00
Index of Exhibits (Check all that apply):
®
^ Exhibit A-1 Sco e of Work
Exhibit A-2 Task Order Agreement ^
^ Exhibit G-2 Fee-Sub Specific Rates
Exhibit G-3 Sub Overhead Cost
^ Exhibit B-1 DBE Utilization Certification ® Exhibit H Title VI Assurances
®
^ Exhibit C Electronic Exchange of Data
Exhibit D-1 Pa ment -Lump Sum ®
® Exhibit I Pa ment Upon Termination of A reement
Exhibit J Alle ed Consultant Desi n Error Procedures
^ Exhibit D-2 Pa ment -Cost Plus ® Exhibit K Consultant Claim Procedures
®
^ Exhibit D-3 Pa ment -Hourly Rate
Exhibit D-4 Payment -Provisional ^
® Exhibit L Liability Insurance Increase
Exhibit M-1 a Consultant Certification
^
® Exhibit E-1 Fee - Lum /Fixed/LJnit
Exhibit E-2 Fee -Specific Rates ®
® Exhibit M-lb A ency Official Certification
Exhibit M-2 Certification -Prima
®
^ Exhibit F Overhead Cost
Exhibit G Subcontracted Work ^
^ Exhibit M-3 Lobb ing Certification
Exhibit M-4 Pricin Data Certification
^ Exhibit G-1 Subconsultant Fee ^ A .31.910 Sup lemental Signature Page
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 3/20/2013
Page 1 of 22
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/1VI/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".
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."
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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 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.
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
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 3 of 22
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.
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.
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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
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 XN.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 5 of 22
_~
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 51 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.
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.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 6 of 22
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.
The Consultant shall include all subcontractors as insured under its insurance policies or shall furnish separate
certificates and endorsements for each subcontractor. All insurance policies provided by or on behalf of any
subcontractor of the Consultant shall comply with all terms and conditions of this "Legal Relations" section.
All contracts between the Consultant and their subcontractors for work to be performed in furtherance or
implementation of this contract shall contain the insurance provisions found herein.
Failure of the Consultant to take out andlor maintain any required insurance shall not relieve The Consultant
from any liability under the Agreement, nor shall the insurance requirements be construed to conflict with or
otherwise limit the obligations concerning indemnification.
It is agreed by the parties that insurers shall have no right of recovery or subrogation against the County,
including its employees and other agents and agencies. It is further agreed by the parties that insurance
companies issuing the policy or policies required by this Agreement shall have no recourse against the County
(including its employees and other agents and agencies) for payment of any premiums or for assessments
under any form of policy. It is further agreed by the parties that any and all deductibles in the above described
insurance policies shall be assumed by and be at the sole risk of the Consultant.
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.
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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.
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 Emergency Management Agency and the Washington State Department of Emergency
Management 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.
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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 (I) of this AGREEMENT.
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Consultant (Please print)
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Consultant's Name~(P~lea^se prtntJ
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Consult 's Signature
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Date
COUNTY OF JEFFERSON
BOARD OF COMMISSIONERS
John Austin, Chair
Phil Johnson, Member
David W. Sullivan, Member
Ap roved as o form on
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David Alvarez Date
Deputy cutmg rney
Zo
Fran ord Date
ublic Works Director
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 9 of 22
EXHIBIT A
SCOPE OF WORK
Dowans Creek Road Relocation
County Project No. X01799
The objective of this Agreement is to provide professional services necessary for the preparation of a
Record of Survey and a Right of Way Plan for the Dowans Creek Road Relocation Project.
Additional work will include staking portions of the right of way alignment for purposes of a timber
cruise.
The Consultant will perform all services and furnish all materials necessary to accomplish the
following tasks. Work will be authorized by the Agency by written notice to proceed for specific
tasks.
TASK 1 -- RECORD OF SURVEY
Task 1 will consist of the following items of work:
1) Review the Topographic Survey of Dowans Creek Road MP 0.75 to MP 1.55, prepared by
Johnston Land Surveying in 2007.
2) Review the preliminary road construction plans prepared by Jefferson County which depict
right of way needed for the relocation of Dowans Creek Road. The plans were developed using
the topographic survey prepared by Johnston Land Surveying. The road relocation consists of
two contiguous portions. The first portion, from Station 10+00.00 to Station 33+78.39, lying
primarily in Parcel 713013001, consists of an existing logging road. The second portion, from
Station 33+78.39 to Station 49+91.10, lying primarily in Parcel 713013003, consists of new
road construction. At the time that the topographic survey was prepared by Johnston Land
Surveying, Parcel 713013001 was owned by Rayonier Forest Resources, but since that time
DNR has acquired this parcel.
3) Perform field work necessary to tie the southwest corner of Section 1.
4) Perform necessary research to establish the existing right of way and adjacent ownerships for
roadway Station 10+00.00 to Station 33+78.39. The Agency will provide Lot Book reports
(preliminary title reports) from a local title company as necessary.
For roadway Station 33+78.39 to Station 49+91.10, a preliminary Record of Survey has already
been prepared by Johnston Land Surveying, so no additional research should be necessary.
5) Utilizing the preliminary Record of Survey that has already been prepared for roadway Station
33+78.39 to Station 49+91.10, prepare one, unified Record of Survey for the entire road
relocation, Station 10+00.00 to Station 49+91.10, that meets the requirements of Title 58 RCW
and Chapter 332-130 WAC and complies with DNR standards and requirements. Said survey
will be used for easement /right-of--way purchase and shall include legal descriptions for the
individual parcels to be acquired from DNR, and for preparing aright-of--way plan for the new
alignment.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 10 of 22
6) Respond to questions/comments from DNR as necessary during DNR's review of the Record of
Survey.
Deliverables:
Draft Record of Survey, to be submitted to the County within 45 days after the Notice to
Proceed
• Final Record of Survey
TASK 2 -RIGHT OF WAY PLAN
The Consultant will prepare a Right of Way Plan and legal descriptions for the road relocation, Station
10+00.00 to Station 49+91.10. The Right of Way plan shall be prepared in general accordance with the
WSDOT Plans Preparation Manual.
Deliverables:
• Draft Right of Way Plan and legal descriptions, to be submitted to the County within 45 days
after the Notice to Proceed
• Final Right of Way Plan and legal descriptions
TASK 3 -- STAKING FOR TIMBER CRUISE
The Consultant will stake the right of way centerline and the right of way boundary between roadway
Station 32+69.92 and Station 49+91.10, as depicted on the Roadway Plan and Profile sheets provided
by the County. The centerline will be staked at a maximum of 50 ft. intervals using 3 ft. lath and
flagging. The right of way boundary will be staked at a maximum of 50 ft. intervals and at all corners,
and shall be inter-visible. The right of way boundary shall be staked using 3 ft. lath and flagging. The
staking of the centerline and right of way boundary will be used by the County and/or DNR to perform
a timber cruise.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 11 of 22
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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. Surveying, Roadway Design & Plans Preparation Section
A. Survey Data: cadastral, topographic, and construction surveying: ASCII format
or Land XML containing point numbers, coordinates in Washington Coordinate
System Grid, point descriptions.
B. Roadway Design Files: Agency's current Engineering computer program file
format or Land XML format.
C. Computer Aided Drafting Files: Autocad file format in the Agency's current
version or older.
D. Specify the Agency's Right to Review Product with the Consultant: The Agency
shall have the right to review the submitted files with the Consultant at the
Agency's dicretion.
E. Specify the Electronic Deliverables to Be Provided to the Agency: All Surveying
data, maps and plans; Preliminary engineering studies, calculations, computer
program results, analyses reports, correspondence, reviews, and photos;
Preliminary, intermediate and final Permits, Cross-sections, Profiles, Plans,
Specifications, Estimates, Schedules, Contract Documents: and Construction
engineering and management documents.
F. Specify What Agency Furnished Services and Information Is to Be Provided: The
Agency will review all submittals from the Consultant, provide direction on
project issues when required, and provide access to all available Agency resources
relating to the applicable projects.
II. Any Other Electronic Files to Be Provided: as needed.
III. Methods to Electronically Exchange Data
A. Agency Software Suite: Microsoft Office (2007 or older) programs, Autodesk
Autocad 2012 and/or Civi12012 programs, Eagle Point design programs.
B. Electronic Messaging System: Microsoft Outlook
C. File Transfers Format: ASCII, Microsoft Office programs formats, Autodesk
program formats, Eagle Point program formats.
D. Physical media: Transfer all data to the Agency on optical media: CD or DVD
format.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 12 of 22
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.
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.
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 XN, "Extra Work." No minimum amount payable is guaranteed
under this AGREEMENT.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 13 of 22
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.
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 3/20/2013 Page 14 of 22
a
i, ~ ,
T OHNSTON
Zand ~urveying
April 18, 2013
Jefferson County Public Works
PO Box 2070
1322 Washington Street
Port Townsend, WA 98368-1927
Attn: Mark Thurston, P.E.
Mr. Thurston,
Please consider this letter to be a statement of rates for Johnston Land Surveying. It covers
Surveying services for:
Dowans Creek Road Relocation, County Project No. X01799.
Johnston Land Surveying is afour-person firm with no audited calculated overhead rate. We
charge a flat hourly fee for services that is all-inclusive of direct salary, overhead and fee.
The hourly fees offered for this contract are the lowest fees we offer for preferred clients. I
also confirm that all direct nonsalary costs will be invoiced without markup.
• Rob Johnston, Principal - $155.10
• Jessica Wagner, Senior Technician - $39.48
• Paul Brown, Technician - $36.66
• Renee Johnston, Administration - $56.40
• 2-person Crew $76.14
• GPS Crew - $231.24
Johnston Land Surveying will comply with the rules and regulations regarding travel
costs in accordance with Washington State Department of Transportation Accounting
Manual M13-82, Chapter 10 Travel Rules and Procedures, and revisions thereto.
Sincerely,
~~~I~
Rob Johnston, PLS
o~ I OHNSTO
~. ~~~ of wnsy~ o~
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o
~~, ~(+F 37531 ~p ~,'
~JJ, ClST~~
j~~'AL [.A~ S
^ 540 W. Eighth Street, Port Angeles, WA ~ 360.385.2506 ^ 360.452.0238 fax ^ 360.452.0237 ^
www.johnstonlandsurveying.com
Exhibit H
Title VI Assurances
During the performance of this AGREEMENT, the CONSULTANT, for itself, its assignees, and successors in
interest agrees as follows:
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.
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 (FEMA) 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 FEMA as appropriate, and shall set
forth what efforts it has made to obtain the information.
Sanctions for Non-compliance: In the event of the CONSULTANT'S non-compliance with the non-
discrimination provisions of this AGREEMENT, the AGENCY shall impose such AGREEMENT
sanctions as it, the STATE or the FEMA 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
Incorporation of Provisions: The CONSULTANT shall include the provisions of paragraphs (1)
through (5) 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 FEMA
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 3/20/2013 Page 15 of 22
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 3/20/2013 Page 16 of 22
Exhibit J
Alleged Consultant Design Error Procedures
The purpose of this exhibit is to establish a procedure to determine if a consultant's alleged design
error is of a nature that exceeds the accepted standard of care. In addition, it will establish a uniform
method for the resolution and/or cost recovery procedures in those instances where the agency
believes it has suffered some material damage due to the alleged error by the consultant.
Step 1 -Potential Consultant Design Error(s) is Identified by Agency's Project Manager
At the first indication of potential consultant design error(s), the first step in the process is
for the Agency's project manager to notify the Director of Public Works or Agency
Engineer regarding the potential design error(s). (Note: The Director of Public Works or
Agency Engineer may appoint an agency staff person other than the project manager, who
has not been as directly involved in the project, to be responsible for the remaining steps in
these procedures.)
Step 2 -Project Manager Documents the Alleged Consultant Design Error(s)
After discussion of the alleged design error(s) and the magnitude of the alleged error(s),
and with the Director of Public Works or Agency Engineer's concurrence, the project
manager obtains more detailed documentation than is normally required on the project.
Examples include: all decisions and descriptions of work; photographs, records of labor,
materials and equipment.
Step 3 -Contact the Consultant Regarding the Alleged Design Error(s)
If it is determined that there is a need to proceed further, the next step in the process is for
the project manager to contact the consultant regarding the alleged design error(s) and the
magnitude of the alleged error(s). The project manager and other appropriate agency staff
should represent the agency and the consultant should be represented by their project
manger and any personnel (including sub-consultants) deemed appropriate for the alleged
design error(s) issue.
Step 4 -Attempt to Resolve Alleged Design Error with Consultant
After the meeting(s) with the consultant have been completed regarding the consultant's
alleged design error(s), there are three possible scenarios:
It is determined via mutual agreement that there is not a consultant design
error(s). If this is the case, then the process will not proceed beyond this point.
It is determined via mutual agreement that a consultant design error(s) occurred.
If this is the case, then the Director of Public Works or Agency Engineer, or their
representatives, negotiate a settlement with the consultant. The settlement would
be paid to the agency or the amount would be reduced from the consultant's
agreement with the agency for the services on the project in which the design
error took place.
There is not a mutual agreement regarding the alleged consultant design error(s).
The consultant may request that the alleged design error(s) issue be forwarded to
the Director of Public Works or Agency Engineer for review.
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 17 of 22
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 claim(s) 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 Agency project manager, Director of Public Works or Agency Engineer 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
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
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 18 of 22
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).
Step 5 -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 claim(s). 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 3/20/2013 Page 19 of 22
Exhibit M-1(a)
Certification Of Consultant
Project No.
Local Agency
I hereby certify that I am ~~ Y~ ~~ C~ ~Y U`~'~vG~~ and
~~ 1h~~ ~kG1 ~~ ~ i'~
duly authorized representative of the firm of ~ ~1)~Vey wlydse address
is ~ ~ (~~ ~ /~~(r~~5 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);
~ (~ 13
Date ~ Signature
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 20 of 22
Exhibit M-1(b)
Certification Of Agency Official
I hereby certify that I am the AGENCY Official of the Local Agency of Jefferson County,
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):
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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): ~~J ~ ~ ~ 'v`~ ~ h ~ ~~~ ~J ~ ~ ~
Name ~f~ ~E`Y 1 ~l ~~'~'`1
( lease print)
=~ S
Signature: President Authorized Official of Consultant Date
PW_Forms/Standard Consultant Agreement with Exhibits Revised 3/20/2013 Page 22 of 22