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O Consent Agenda
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Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Philip Morley, County Administrator
From: Monte Reinders, Public Works Director /County Engineer
Agenda Date: October 6, 2014
Subject: Standard Consultant Agreement with Van Alter 5urveying
Paradise Bay Road, Phase II
Co. Rd. No. 503608, CR1873
M. P. 0.37 to M. P. 1.53
Statement of Issue:
Standard Consultant Agreement with Van Alter Surveying of Carlsborg, WA. for providing surveying
services for the Paradise Bay Road, Phase II, CR1873 project.
Analysis /Strategic Goals /Pro's & Con's:
This project is included in the officially adopted 2014 -2019 Transportation Improvement Program as Item
No. 9. This project is also included in the adopted 2013 Annual Construction Program as item No. 5. The
purpose of this project is to construct 11 foot lanes, 4 foot wide paved shoulders, drainage
improvements, asphalt paving, signing, striping and other work, for this segment of Paradise Bay Road.
This agreement will provide surveying services by Van Alter Surveying, for the Pre- construction and
Construction Engineering phase. The required surveying services for this project consist of: drainage
easement preparation, right of way plan preparation, construction centerline staking, roadway
construction staking, re- setting disturbed property corner monuments, installing roadway monuments, as-
built mapping, and as -built plan preparation. Public Works staff used a consultant selection process to
select this consultant from the 2014 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 $58,061.48.
This project has grant funding from the Rural Arterial Program (R.A.P.) administered via the State of
Washington County Road Administration Board. These consultant services will be eligible for
reimbursement from the R.A.P. funding at the rate of 90 %.
Recommendation:
The Board is asked to execute the three (3) originals of the Professional Services Consultant Agreement
with Van Alter Surveying, and return two (2) signed originals to Public Works (attn. John Wayand).
Department Contact: John Wayand, Project Manager, 385 -9377
Revi !,B ,
i
Morley, o ty Adrrlinistra or Date
R`.
Local Agency
Standard Consultant
Agreement
® Arch itectural /Engineering Agreement
❑ Personal Services Agreement
Agreement Number
PBR II SURVEYING 2014 -1
Federal Aid Number
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
Index of Exhibits (Check all that apply):
Consultant /Address /Telephone
Van Aller Surveying
P.O. Box 757
Carlsborg, WA. 98362
360 - 683 -3438
360 - 683 -3241 fax
Project Title And Work Description
Professional Surveying Services for:
Paradise Bay Road, Phase II, CR1873
M.P. 0.37 to M.P. 1.53
Co. Rd. No. 503608
DBE Participation
❑ Yes ®No %
Federal ID Number or Social Security Number
602035817
Do you require a 1099 for IRS1 Completion Date:
❑ Yes ®No December 31, 2015
Total Amount Authorized $58,061.48
Management Reserve Fund $0.00
Maximum Amount Payable $58,061.48
®Exhibit A -] Scope of Work
❑Exhibit G -2 Fee -Sub Specific 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 Exchange of Data
®Exhibit I Payment Upon Termination of Agreement_
❑Exhibit D -1 Payment — Lump Sum
®Exhibit J Alleged Consultant Design Error
Procedures
❑Exhibit
D -2 Payment — Cost Plus
®Exhibit
K Consultant Claim Procedures
®Exhibit
D -3 Payment — Hourly Rate
❑Exhibit
L Liability Insurance Increase
❑Exhibit
D -4 Payment — Provisional
®Exhibit
M -I a Consultant Certification
❑Exhibit
E -1 Fee — Lump/Fixed/Unit
®Exhibit
M -1 b Agency Official Certification
®Exhibit
E -2 Fee — Specific Rates
®Exhibit
M -2 Certification — Primary
®Exhibit
F Overhead Cost
❑Exhibit
M -3 Lobbying Certification
®Exhibit
G Subcontracted Work
❑Exhibit
M -4 Pricing Data Certification
❑Exhibit
G -I Subconsultant Fee
EJApp.
31.910 Supplemental 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 12/30/2013
Page I of 29
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 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.
All Reports, PS &E materials, and other data furnished to the CONSULTANT by the AGENCY shall be
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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.
VII Employment
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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 r 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.
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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
compensation thereof. Should the AGENCY find it desirable for its own purposes to have previously
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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 decisionishall 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. .
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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.
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 and /or 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. Furthermore, any insurance provided to the AGENCY by any joint self - insurance liability policy
or Risk Pool under Ch. 48.62 RCW of which the AGENCY is a member or participant shall be non-
contributory. 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 (3 0) 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.
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J
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.
Any insurance coverage for third party liability claims provided to the County by a "Risk Pool" created
pursuant to Ch. 48.62 RCW shall be non - contributory with respect to any policy of insurance the Consultant
must provide in order to comply with this Agreement.
If the proof of insurance or certificate indicating the County is an "additional insured" to a policy obtained by
the Consultant refers to an endorsement (by number or name) but does not provide the full text of that
endorsement, then it shall be the obligation of the Consultant to obtain the full text of that endorsement and
forward that full text to the County.
The County may, upon the Consultant's failure to comply with all provisions of this contract relating to
insurance, withhold payment or compensation that would otherwise be due to the Consultant.
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.
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.
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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 (1) of this AGREEMENT.
VAA1 A1. l SA SvR vF_ �rw
Consultant (Please print)
8R.fA^.l VAn/ Azt94,
Consultant's Name (Please print)
&- ,I, AR,
Consultant's Signature
Date
COUNTY OF JEFFERSON
BOARD OF COMMISSIONERS
John Austin, Chair
Phil Johnson, Member
David W. Sullivan, Member
A roved as to fib" only: Il
0.j at.
Y
David Alvarez Date
Deputy Prosecuting Attorne
Mon Date
Public Works Director /County Engineer
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 10 of 29
EXHIBIT A -1
SCOPE OF WORK FOR
SURVEYING SERVICES
PARADISE BAY ROAD, PHASE II
M.P. 0.37 to M.P. 1.53
County Road Project CR1873
County Road number 503608
OBJECTIVES:
The objective of the proposed work is to provide surveying services for Jefferson County's Paradise Bay Road, Phase II
improvement project.
The Paradise Bay Road, Phase II project is located in the Port Ludlow area on Paradise Bay Road, between Ludlow Creek
and Teal Lake Road, and in Sections 17 & 16, T28N, RI E, W.M. The existing road is approximately 22 feet wide and the
proposed roadway project is approximately 6,175 feet long. This project will preserve & rehabilitate the asphalt roadway
surface, widen and pave the shoulders to 4 feet, and improve the drainage, signing, striping, and guardrail facilities.
The proposed scope of work for this project includes: administration and coordination, drainage easement preparation, right
of way plan preparation, construction centerline staking, roadway construction staking, re- setting disturbed property corner
monuments, installing roadway monuments, as -built mapping and as -built plan preparation.
The Consultant will be responsible for any and all work and materials necessary to provide the required surveying for this
project. The Consultant's work effort shall be sufficient to complete the tasks as specified in this scope to the satisfaction of
Jefferson County Public Works (Agency).
All methods and materials will be in accordance with Washington State Department of Transportation ( WSDOT) standards
and the WSDOT Highway Surveying Manual except as modified by the Agency. All work shall be relative to Washington
State Plane Coordinate System.
The Consultant shall provide all data used in performing the work in this scope in both hard copy format and digital format
as specified later in this scope of work.
The Consultant may be considered for additional surveying services during and after the construction phase, depending upon
the Consultant's satisfactory performance of the current work scope, upon the Consultant's interest in providing additional
surveying services, and upon negotiation of a Supplemental Agreement per Section XIV Extra Work.
ADMINISTRATION AND COORDINATION
This work includes management of the Consultant's work effort, management of project scope and budget, management of
schedule and delivery dates, coordination of the Consultant's activities with the Agency, and submittal of progress reports
and invoices.
Provide monthly written progress reports submitted with the monthly project invoice, which shall include the following for
the Consultant and any Subconsultants:
a. Progress -to -date for that month. Provide detailed description of the work completed by each employee.
b. Progress compared to original schedule and anticipated progress next month.
c. Anticipated problems and delays for the Consultant's work.
d. Updated schedule of individual work elements.
e. Critical path schedule for the Consultant's work.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 11 of 29
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. Consultant invoices shall include the
following information:
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 hourly wage rate.
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.
PRE - CONSTRUCTION
TASK 1: EASEMENT PREPARATION RIGHT OF WAY PLAN PREPARATION AND CENTERLINE
STAKING
A. Calculate and prepare a stormwater drainage maintenance easement for one proposed stormwater culvert near sta.
77 +00.
B. Prepare right of way plans showing all existing right of way and the proposed stormwater drainage maintenance
easement. Right of Way plans shall be on 22 "04" sheets and use the standard Jefferson County Public Works
border /title block. Submit the 90% level of completion on paper sheets for review and comment. Submit the final
right of way plans on Mylar and in AutoCAD ".dwg" file format.
C. Calculate and set construction centerline stations (P.K. nails or spikes) at 25 foot intervals and intermediate stations
as needed. The Agency will provide a list of intermediate stations to be "set.
CONSTRUCTION
TASK 2: CONSTRUCTION STAKING
This work consists of providing construction surveying for the items identified in this scope of work for the construction of
the project. The Consultant shall perform the necessary surveying to establish horizontal and vertical control of the roadway,
to ensure that the project is staked and constructed at the proper location and grades. The Consultant shall coordinate work
with the Agency to ensure meeting the Contractor's schedule. The Consultant shall provide professional guidance on
procedures and methods involved in this work to the Agency when necessary. It is anticipated that the construction staking
for this project will require the following work:
A. Review of proposed project construction plans and AutoCAD drawings provided by the Agency. Calculation and
preparation of roadway points for construction staking. Uploading of field staking data to surveying equipment.
B. Establish additional surveying control for construction staking as needed.
C. Temporary elevation Bench Marks for construction staking shall be set and clearly marked in the field, referenced
by swing -ties to project centerline, shown on the plan and be as permanent as practical. The number and location of
elevation bench marks shall be determined by the Consultant and approved by the Agency. All elevation
benchmark notes shall be provided to the Agency.
D. Clearing and grubbing lines will be marked with white surveyors ribbon per WSDOT construction flagging color
coding standards. The clearing and grubbing line will be marked at the silt fence /high visibility silt fence locations
and at 5' outside of the catchlines as shown on the Plans or as directed by the Engineer
E. Re -set construction centerline stations (P.K. nails or spikes) at 25 foot intervals and intermediate stations as needed.
F. Slope staking of the project per the; Plans in areas of large excavation or embankment (25 foot intervals).
Additional slope stakes as required at roadway intersections and at intersecting approaches. Reference slope stakes
to be set at 5 foot offset from all prit nary slope stakes (or as requested by the contractor).
G. Roadway subgrade elevation staking (blue tops) per the Plans, at 25 foot intervals. Additional subgrade stakes as
required at roadway intersections and at intersecting approaches.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 12 of 29
H. The horizontal and vertical locations of all storm drainage structures: storm sewer pipes, culvert pipes, catch basins,
and inlets, shall be staked per the Plans. Parallel offset lines shall be staked if requested by the contractor.
1. Roadway crushed surfacing top course elevation staking (yellow tops) per the Plans at 25 foot intervals. Additional
surfacing stakes as required at roadway intersections and at intersecting approaches.
J. Mark all asphalt pavement saw - cutting locations and asphalt pavement milling limits per the Plans and as directed
by the Engineer.
K. Staking for asphalt paving operations shall consist of lath or paint marks with stations at 100 foot intervals along
one side of the roadway project.
L. Stake or mark all pavement markings (striping) per the Plans; to be coordinated with the Agency and the
Contractor.
M. Stake all guardrail locations per the Plans.
N. Assemble and provide copies to the Agency of all construction staking notes for all completed roadway staking.
TASK 3: MONUMENTATION
A. Prepare and submit the "Application for Permit to Remove or Destroy Survey Monument" to the Washington Dept.
of Natural Resources (D.N.R.), for the property corner monuments which have been re -set or moved during
construction.
B. The Consultant shall re -set all property corner monuments that have been disturbed by construction of this project.
The property corners shall be re -set with rebar and caps marked with the surveyors name and license number.
Corners will be re -set according to the existing location measurements previously made.
C. Prepare "Record of Survey" plan for Agency to record if new property corners are set with rebar and surveyor's
cap. Submit copy of Record of Survey to the D.N.R.
D. Prepare and file" Completion Report for Monument Removal or Destruction" for all re -set property corners with
the D.N.R.
E. Reference existing roadway centerline monuments (approximately 9 monuments). Re -set existing or set new
roadway monuments on the right of way centerline per the Agency's direction. Monument locations shall be staked
and referenced sufficiently to enable accurate recovery of monuments in the future.
F. New monuments to be 2" galvanized pipe and brass cap set in concrete and set in a monument case with cover.
The 2" galvanized pipe and the concrete shall be supplied by the Consultant. Brass caps, monument cases with
covers to be supplied by the Agency. Monuments to be set.after final asphalt concrete pavement has been placed
and per the Agency's direction.
POST - CONSTRUCTION
TASK 4: AS -BUILT MAPPING
A. The Consultant shall field measure both horizontal and vertical locations of catch basins, culverts, and all other
constructed stormwater structures, as a means of documenting any differences between the constructed location and the
Plans.
B. The Consultant shall field measure both horizontal and vertical locations of other roadway items not installed per the
Plans at the direction of the Agency.
C. Elevations shall be taken at every 50 feet along the completed project centerline to establish a record of the roadway
profile as constructed.
D. Prepare As -built plans and profile based on the Agency's construction plans and profile using the as -built mapping
information. The Consultant shall add the new as -built measurements onto the Agency's Plans and profile in AutoCAD
format for all affected sheets. Preliminary As -built plans will be plotted on 22 "04" paper and submitted to the Agency
PW_Forms /Standard Consultant Agreement with Exhibits kevised 12/30/2013 Page 13 of 29
for review. Final As -built plans will be plotted on 22 "04" Mylar and submitted to the Agency along with the AutoCAD
files.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 14 of 29
PARADISE BAY ROAD, PHASE II CONSTRUCTION ENGINEERING PHASE
LK115 /S ESTIMATED
SCHEDULE OF SURVEYING
TASKS
TASKS
DAYS
2014
2015
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
Mar.
Apr.
May
June
July
Aug.
Sept.
Oct.
Notice to Proceed
e
PRE - CONSTRUCTION
TASK 1- EASEMENT PREPARATION, R/W PLANS & CL STAKING
Prepare drainage easement for culvert
1
Prepare Right of Way Plans
4
s
Construction centerline staking
2
e
CONSTRUCTION
TASK 2- CONSTRUCTION STAKING
Establish project control for const. staking.
1
e
Set TBM's for construction staking
1
Re -set const. centerline staking as needed
1
a
Staking for clearing and grubbing
3
Slope staking with offset stakes
3
0
Staking for roadway subgrade
3
Staking for drainage structures /pipes
2
Staking for roadway CSTC
3
0
Staking for ACP saw - cutting and ACP milling
1
Staking for roadway asphalt paving
1
a
Staking for guardrail
1
Staking for pavement marking
2
0
TASK 3- MONUMENTATION
Prepare /submit "Application for permit to destroy survey
monument" to DNR
1
Re -set all destroyed or moved property corners
1
Prepare Record of Survey -
1
Reference exist. roadway monuments, set new mons., or adjust to
grade
2
POST- CONSTRUCTION
TASK 4 -AS -BUILT MAPPING
As -built field measurement of drainage structures
1
As -built field measurement of roadway features and profile
2
Prepare as -built plans and centerline profile
2
0
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:
Surveying, Roadway Design & Plans Preparation Section
A. Survey Data: cadastral, topographic, and construction surveying: ASCII format or
Land XML containing point numbers, coordinates (x,y,z) in Washington Coordinate
System Grid, and point descriptions.
B. Roadway Design Files: Autodesk's Civil 3D computer program file format
or Land XML format.
C. Computer Aided Drafting Files: AutoCAD drawing file format in the Agency's
current version or an agreed upon older version.
D. Agency's right to review the product with the Consultant: The Agency shall have the
right to review the submitted files with the Consultant at the Agency's discretion.
E. Electronic Deliverables to be provided to the Agency: All surveying data, maps, and
plans; Preliminary surveying studies, calculations, computer program results,
analyses, reports, correspondence, reviews, and photos; cross - sections, profiles, plans,
estimates, construction staking notes, and schedules.
II. Any Other Electronic Files to Be Provided: As needed.
III. Methods to Electronically Exchange Data
A. Agency Software Suite: Microsoft Office (2007 or newer) programs, Autodesk's
AutoCAD program and Civil 3D program.
B. Electronic Messaging System: Microsoft Outlook
C. File Transfers Format: ASCII, Microsoft Office programs formats, Autodesk program
formats, and Land XML format.
D. Physical media: Transfer all data to the Agency on optical media: CD or DVD format.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 15 of 29
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 atthorization(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.
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 X1V, "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 12/30/2013 Page 16 of 29
Monthly Progress Payments: Progress payments may be claimed on a monthly basis for all costs
authorized in I 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 12/30/2013 Page 17 of 29
DIRECT NON - SALARY COST:
Mileage: $0.56 /mile
Reproduction costs Actual cost
Materials Actual cost
Note: Exhibit E -2 continues on next sheet.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 18 of 29
Exhibit E -2
Van Aller Surveying
Consultant Fee
Determination — Summary Sheet
;(Specific
Rates of Pay)
Fee Schedule
DIRECT SALARY COST:
Hourly
Overhead
Profit
Rate
Discipline or Job Title
Rate
@ 125%
@ 30 %
Per Hour
Professional Land Surveyor
$45.00
$56.25
$13.50
$114.75
Survey Tech. II
$24.06
$30.07
$7.22
$61.35
Survey Tech I
$18.00
$22.50
$5.40
$45.90
2 Man Survey Crew
$69.06
$86.32
$20.72
$176.10
DIRECT NON - SALARY COST:
Mileage: $0.56 /mile
Reproduction costs Actual cost
Materials Actual cost
Note: Exhibit E -2 continues on next sheet.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 18 of 29
VAN ALLER EST. COUNTY ROAD PROJECT CR1873
Paradise Bay Road Phase II
IE %HIBIT E -2 CONTINUE['
Total:
$ 58,061.48
M.P. 0.37 to M.P. 1.53, 20 +75 to 82 +50, 6,175 feet_ -!
9-3.2014
I
JEFFERSON COUNTY PUBLIC WORKS
_
_ _IDA_TE',
I{{I
_
_
COST ESTIMATE
SURVEYING FOR PRE- CONSTRUCTION, CONSTRUCTION, AND POST- CONSTRUCTION
I-
__________
LICENSED
1 SURVEY _1
2MAN
ESTIMATED
ROUND
TASKS
SURVEYOR
I TECH
FIELD CREW
HOURS/
TRIPS
-_ -_ - -- - - - - -- - - - - -�-
$114.751
$61.35
$176.10
1 DOLLARS
-- -
_ _ ___�
Per Hour
I Per Hour
Per Hour
_
ADMINISTRATION AND COORDINATION
I
MEETINGS WITH AGENCY STAFF
2
0
0
2.00
1.00
_ _
I
_
_I
MONTHLY PROGRESS REPORTS / INVOICE PREPARATION
1_ 3
0
1 0
1 3.00
0.00
_
TRAVEL TIME 111 trips x 1.5 hrs. /R.T. =1.5 hrs.]
1.5 -1
I 0
�-
_ 1.00
SUB -TOTAL ADMINISTRATION AND COORDINATION HOURSF
6.50
1 0.00
1 0.00
1 6.50
_
DOLLARSI
$745.881
1 $D.00
1 $0.00
1 $745.88
_
PRE - CONSTRUCTION
1- EASEMENT PREPARATION AND CENTERLINE STAKING
_TASK
COORDINATE TASK 1 WORK WITH AGENCY
1
0
0
1.00
0.00
_ _I
CALCS. 8 PREPARE DRAINAGE MAINTENANCE EASEMENT FOR STORMWATER CULVERT STA. 77 +24 RT�
6
0
1 11.00
0.00
-
_
_ -I
-_
I -_ _
_
PREPARE RIGHT OF WAY PLANS
8
16
0
24.00
0.00
_
1 --
_
CALCS. 8 STAKE CONSTRUCTION CENTERLINE IN FIELD (AT 25' STATIONS SET ELEV EVERY 1001)_
0
0
24
24.00
3.00
I
_ _I
TRAVEL TIME 13 trips x 1.5 hrs. /R_T_= 4.5 hrs.)_
1 0
i 0_
1 4.5
I 4.50
_
SUB -TOTAL EASEMENT PREPARATION, RAV PLANS, AND CENTERLINE STAKING HOURS
I_ 14.00-
22.00
28.50
164.50
DOLLARSI
$1,606.50
I $1,349.70
1 $5,018.85
1 $7,975,05
_
CONSTRUCTION
TASK 2- CONSTRUCTION STAKING
COORDINATE TASK 2 WORK WITH AGENCY -- - -_ - -- _�_-- - - -_
-� 2
- - -_ D - _�-
- - -_ -0 -- _I
-- 2.00 - -__
- 0.00 - _
REVIEW OF PROJECT CONSTRUCTION PLANS. PREPARE 8 CALCULATE DESIGN DATA FOR ROADWAY
STAKING
I 8
0
0
8.00
0.00
ESTABLISH ADDITIONAL PROJECT CONTROL FOR CONSTRUCTION STAKING.
0
1 0
1 4
1 4.00
0.00
_!
SET TEMPORARY ELEVATION BENCH MARKS FOR CONSTRUCTION STAKING.
1 0
)
0
4
I
1 4.00
I
1.00
CLEARING AND GRUBBING LINE STAKING. (PULL CLEARING FROM CL, SITE SPECIFIC)
0
0
24
24.00
3.00__
_I
-(
I
RE -SET CONSTRUCTION CENTERLINE STAKING AS NEEDED
0
r- 0
4
1 4.00
0.00
_
_
_ SLOPE STAKING WITH OFFSET STAKES (only in areas of large excavation or ent ankment)_ _ -�0
` 0 _
24
24.00
3.00
ROADWAY SUBGRADE STAKING (BLUE TOPS}
1- 0!yI
0
24 -�
24.00
3.00
STORM DRAINAGE STRUCTURES / PIPES STAKING _
I 0
1 0
I 10
10.00
_ 1 -00
ROADWAY CSTC STAKING (YELLOW TOPS). _4
0 -I_
0
I_ 24
I 24.00_
3.00
_MARK ASPHALT PAVEMENT SAW- CUTTING AND ASPHALT PAVEMENT MILLING LIMITS
I 0
1_ 0
18
6.00
1.00
ROADWAY ASPHALT PAVING OPERATIONS STAKING
0
1 0
8
T 6.00
1.00_,_
_ _
]_-_
_
_
_ PAVEMENT MARKING STAKING (STRIPING)
0
1 _ 0
12
12.00
_ 2.00
GUARDRAIL STAKING
I0
0
I 8
I 6.00
1.00
_
ASSEMBLE AND PROVIDE COPIES OF ALL CONSTRUCTION STAKING NOTES TO AGENCY
! 8
I 0
0
1 8.00
0.00
1
I
_
71
TRAVEL ME 119 trips x 1.5 hrs. /R.T =28.5 hrs.J _
1 0
1 0
28.5
28.50 _
1900 . _
_ _
SUB -TOTAL CONSTRUCTION STAKING HOURS
18.00
I 0.00
182.50
I
200,50
DOLLARSI
_
$2065.50
1 $000
_ _
1 $32138.25
$3420175
TASK 3 - MONUMENTATION -
I_
I
I
I
COORDINATE TASK 3 WORK WITH AGENCY -
1 1
I 0
1 0
_
1 1.00
0.00
PREPARE AND SUBMIT "APPLICATION FOR PERMIT TO DESTROY SURVEY MONUMENT"
1 4
I 4
I 0
1 8.00
0.00
TO D, N, R. FOR ANY MOVED OR RE -SET PROPERTY CORNERS
RE -SET ALL DESTROYED OR MOVED PROPERTY CORNERS
(- -01-
1 0
1 6
I 6.00
1.00
PREPARE "RECORD OF SURVEY' PLAN FOR AGENCY TO RECORD. SUBMIT COPY OF R.O.S. TO D.N.R.
( 8
18
0
24.00
0.00
PREPARE / FILE "COMPLETION REPORT FOR MONUMENT REMOVAL OR DESTRUCTION" WITH D.N.R
I 1
0 -1
0
11,00
_ PROVIDE COPIES OF ALL SUBMITTED PERMITS AND PLANS TO AGENCY
_I
__
_
_0.00_
REFERENCE EXIST. ROADWAY INTERSECTION MONUMENTS (2), SET NEW MONUMENTS
0
I 0 1
16
1 16.00
2.00
OR ADJUST EXIST. MONUMENTS TO GRADE.
_
PROVIDE COPIES OF MONUMENTATION PLAN AND REFERENCES TO AGENCY
1
TRAVEL TIME 13 trips x 1_5 hrs_ /R.T= 4_5 hrs.J
0
1 0 1
4.5 i
4.50
3.00
_ _j
_
SUB -TOTAL MONUMENTATION HOURSI
14.00
1 20.00 126.50
�
60.50
DOLLARSI
$1.606.50
I $1,227.00 1
$4.666.65
$7,500.15
POST - CONSTRUCTION I
TASK 4 - AS -BUILT MAPPING
_COORDINATE TASK 4 WORK WITH AGENCY_ i
0
-
I 0
--
0 i
0.00
0.00
AS -BUILT FIELD MEASUREMENT OF DRAINAGE STRUCTURES 1
0
0 I
B
8.00
1.00
_
_
AS -BUILT FIELD MEASUREMENT OF ROADWAY FEATURES AND PROFILE 1
__ -
0
1 0 1
16
16 .00
2.00
- --
_ -__-
- -_-
-.
__-
__-
PREPARE AS =BUILT PLANS AND CENTERLINE PROFILE 1
4 1
8
0 1
0.00_
PROVIDE COPIES OF AS -BUILT PLANS AND PROFILE TO AGENCY
_ _1
_TRAVEL TIME 13 trips x i_5 hrs. /R.T. =4.5 hrs.J (
0
0 !
4.5 1
4.50
3.00
_
_ _ I
SUB -TOTAL AS -BUILT MAPPING HOURS I__
4.00
8.00
28,50 I
4050
DOI TARSI
_
$459.00 -1
____
$49
$5.018.85 i
$5,968.65
VAN ALLER EST. COUNTY ROAD PROJECT CR1873
Paradise Bay Road Phase it
IEXHIBITE4 CONTINUE[I
TOtBI:I
$ 58,061.48
M.P. 0.37 to M.P. 1.53.20+75 to 82+50,6,175 feet
DATE'. 9 -3 -2014
-_
JEFFERSON COUNTY PUBLIC WORKS
-
COST ESTIMATE__
I_
_
SURVEYING FOR PRE- CONSTRUCTION, CONSTRUCTION, AND POST- CONSTRUCTION
I
LICENSED SURVEY
2 MAN
ESTIMATED
ROUND
_
TASKS
SURVEYOR TECH
1 FIELD CREW
HOURS/
TRIPS
$114.75 $61,35
I $176.10
DOLLARS
Per Hour Per Hour
Per Hour
TASK SUBTOTALS
_ _
SUB -TOTAL ADMINISTRATION AND COORDINATION HOURS
. 6.50 0.00
1 0.00
1 6.50
DOLLAR81
$745.88 $0.00
I $0.00
1 $745.08 -
K 1: SUB -TOTAL EASEMENT PREPARATION, RIGHT OF WAY PLANS. AND CENTERLINE STAKING HOURS
14.00 22.00
28.50
I 64.50
1
DOLLARSI
$1606,50 1 $1349,70
1 $5018.85
1 $7975.05
1
TASK 2: SUB -TOTAL CONSTRUCTION STAKING HOURS
18.00 1 0_00
182.50
20050
DOLLARS
_
$2055 50 1 $0.00
$32.138.25
1 $34,203,75
TASK 3: SUB - TOTAL MONUMENTATION HOURS
_ 14.00 20.00
26.50
1 60,50
DOLLARS
$160650 1 $1227.00
1 $4666.65
1 $7500,15
TASK 4: SUB -TOTAL AS -BUILT MAPPING HOURS
1 4.00 8.00
I 28.50
I_ 40.50
1
_ --
DOLLARS
_I_
I $459.00 1 $490.80
1 $5,018,85
1 $5,968,55
_
1
HOURS
I I
56.50 50.00
I 266. D0
I __
I 372.50
1 29.00
SUBTOTAL
$6,483.38 $3,067.50
1 $46,842.60
$56,393.48
NOTE: (1 way trip = 0.75 hour, 1 round trip = 1.5 hours per man)
_
DIRECT NON - SALARY COST:
a. __Mileage Survey Vehicle 29 ROUND TRIPS x 75 miles R/T x.56/mile $1,218.00 $1,218.00
b. Reproduction i$0.00
_
c. Materials: Stakes, Spikes, Pipes, Caps, Concrete, Etc. _ I $450.00
L�
-
ISub -Total $1,668.001
Exhibit F
Breakdown of Overhead Cost
Account Title
$ Beginning Total
% of Direct Labor
Direct Labor
$54,361
100.0
Overhead Expenses:
FICA
$5,433
10.0
Unemployment
$76
0.1
Health/Accident Insurance
$4,094
7.5
Medical Aid & Industrial Insurance
$560
1.0
Holiday /Vacation /Sick Leave
$2,180
4.0
Commission /Bonus /Pension
$560
1.0
Total Fringe Benefits
$12,903
23.6
General Overhead:
State B &O Taxes
$2,102
3.9
Insurance
$4,035
7.4
Administration & Time Not Assignable
$4,320
7.9
Printing, Stationery, & Supplies
$7,798
14.3
Professional Services
$2,420
4.5
Travel Not Assignable
$14,125
26.0
Telephone & Telegraph Not Assignable
$4,338
8.0
Fees, Dues & Professional Meetings
$600
1.1
Utilities & Maintenance
$2,318
4.3
Professional Development
$290
0.5
Rent
$4,800
8.8
Equipment Support
$4,552
8.4
Office, Miscellaneous & Postage
$3,420
6.3
Total General Overhead
$55,118
101.4
Total Overhead (General + Fringe)
$68,021
125.0
Overhead Rate (Total Overhead / Direct Labor)
125.0
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 19 of 29
Exhibit G
Subcontracted Work
The AGENCY permits subcontracts for the following portions of the work of this AGREEMENT:
None, unless authorized by the Agency.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 20 of 29
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.
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 a sub - 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.
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 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
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 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 a sub - 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 12/30/2013 Page 21 of 29
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 12/30/2013 Page 22 of 29
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 I - 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). For federally funded projects, the Region
Highways and Local Programs Engineer should be informed and involved in these
procedures. .(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. The agency is to provide H &LP, through the Region Local
Programs Engineer, a summary of the settlement for review and to make
adjustments, if any, as to how the settlement affects federal reimbursements. No
further action is required:
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
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 23 of 29
the Director of Public Works or Agency Engineer for review. If the Director of
Public Works or Agency Engineer, after review with their legal counsel, is not
able to reach mutual agreement with the consultant, proceed to Step 5.
Step 5 - Forward Documents to Highways and Local Programs
For federally funded projects all available information, including costs, should be
forwarded through the Region Highways and Local Programs Engineer to H &LP for their
review and consultation with the FHWA. H &LP will meet with representatives of the
agency and the consultant to review the alleged design error(s), and attempt to find a
resolution to the issue. If necessary, H &LP will request assistance from the Attorney
General's Office for legal interpretation. H &LP will also identify how the alleged error(s)
affects eligibility of project costs for federal reimbursement.
If mutual agreement is reached, the agency and consultant adjust the scope of
work and costs to reflect the agreed upon resolution. H &LP, in consultation with
FHWA, will identify the amount of federal participation in the agreed upon
resolution of the issue.
If mutual agreement is not reached, the agency and consultant may seek
settlement by'al bitration or by litigation.
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 24 of 29
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 I - 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 WSDOT 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 12/30/2013 Page 25 of 29
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 WSDOT 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 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_I-orms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 26 of 29
Exhibit M -1(a)
Certification of Consultant
Project No.: CR1873
Local Agency: Jefferson County
I hereby certify that I am BRIAN VAN ALLER and
duly authorized representative of the firm of VAN ALLER SURVEYING whose address
is P.O. BOX 757, CARLSBORG, WA. 98362 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.
Date Signature
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 27 of 29
Exhibit M -I(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):
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
(please print)
Signature
cG
Date as`^- / j :
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 28 of 29
Is Exhibit M -2
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters - Primary Covered Transactions
1. 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 a three -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 1( 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.
11. 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):VAN ALLER'SURVEYING
Name: BRIAN VAN ALLER
(please print)
X'� x__ 9 - 2 `f - /V
Signature: President or Authorized Official of Consultant . Date
PW_Forms /Standard Consultant Agreement with Exhibits Revised 12/30/2013 Page 29 of 29