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HomeMy WebLinkAbout102615_ca09Department of Public Works O Consent Agenda Page 1 of 1 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 2015 Subject: Civil Engineer Professional Services Agreement for Quilcene Complete Streets Project Statement of Issue: Professional Services Agreement with SCJ Alliance, WA, for providing Civil Engineer Professional Services for the Quilcene Complete Streets Project. Analysis /Strategic Goals /Pro's & Con's: This project is included in the officially adopted 2015 -2020 Transportation Improvement Program as Item No. 14 as well as in the 2015 Annual Construction Program as Item No. 12. This project is funded through a WSDOT Pedestrian & Bicycle program whose objective is to improve the transportation system so as to enhance safety and mobility for people who choose to walk or bike. This agreement will provide Civil Engineer Professional Services by SCJ Alliance, for the Preliminary Engineering, Pre - Design phase. The required services for this project consist of: Review of previously gathered community input and completed ROW /topographic survey; Attendance to both community design charrettes with consultation provided as part of the Design Team; Coordination with the Design Team to strategically develop appropriate presentation strategy for the first community design charrette; Construction Cost Estimates preparation; Design consultation to facilitate schematic level design development. Fiscal Impact/Cost Benefit Analysis: This Professional Services Agreement, for Civil Engineering services, is for $8,430. This project is funded by an $884,165 WSDOT Pedestrian & Bicycle Program grant. Recommendation: The Board is asked to execute the three (3) originals of the Professional Services Agreement with SCJ Alliance, and return (2) signed originals to Public Works (attn. Eric Kuzma). Department Contact: Eric Kuzma, Project Manager, (360) 385 -9167 Reviewed By: le z�� 0+611p Morley, Count Administrat r Date PROFESSIONAL SERVICES AGREEMENT FOR CIVIL ENGINEERING SERVICES THIS AGREEMENT is entered into between the County of Jefferson, a municipal corporation, hereinafter referred to as "the County ", and SCJ Alliance, hereinafter referred to as "the Consultant ", in consideration of the mutual benefits, terms, and conditions hereinafter specified. Project Designation. tion. The Consultant is retained by the County to provide Civil Engineer Professional Services for Jefferson County's Quilcene Complete Streets Project, funded by the WSDOT Pedestrian and Bicycle Program. The Quilcene Complete Streets Project is located in Quilcene, Washington, along US Hwy. 101, approximately between Center Road and the Quilcene Community Center. The intent of this project is to improve pedestrian and bicycle safety along this portion of US Hwy. 101. 2. Scope of Services. Consultant agrees to perform the services, identified on Exhibit "A" attached hereto, including the provision of all labor. 3. Time for Performance. Work under this contract shall commence upon the giving of written notice by the County to the Consultant to proceed. Consultant shall perform all services and provide all work product required pursuant to this agreement on the dates listed on Exhibit "A" 4. Payment. The Consultant shall be paid by the County for completed work and for services rendered under this agreement as follows: a. Payment for the work provided by Consultant shall be made as provided on Exhibits "E -1 ", "E -2 ", and "F ", attached hereto, provided that the total amount of payment to Consultant shall not exceed $8,430.00 without express written modification of the agreement signed by the County. b. The consultant may submit itemized invoices to the County once per month during the progress of work for payment of project costs. Such vouchers will be checked by the County, and upon approval thereof, payment will be made to the Consultant in the amount approved. C. Final payment of any balance due the Consultant of the total contract price earned will be made promptly upon its ascertainment and verification by the County after the completion of the work under this agreement and its acceptance by the County. d. Payment as provided in this section shall be full compensation for work performed, services rendered and for all materials, supplies, equipment and incidentals necessary to complete the work. e. The Consultant's records and accounts pertaining to this agreement are to be kept available for inspection by representatives of the County and state for a period of three (3) years after final payments. Copies shall be made available upon request. CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets\Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 1 of 16 5. Ownership and Use of Documents. All documents, drawings, specifications and other materials produced by the Consultant in connection with the services rendered under this agreement shall be the property of the County whether the project for which they are made is executed or not. The Consultant shall be permitted to retain copies, including reproducible copies, of drawings and specifications for information, reference and use in connection with Consultant's endeavors. 6. Compliance with laws. Consultant shall, in performing the services contemplated by this agreement, faithfully observe and comply with all federal, state, and local laws, ordinances and regulations, applicable to the services to be rendered under this agreement. 7. Indemnification. Consultant shall indemnify, defend and hold harmless the County, its officers, agents and employees, from and against any and all claims, losses or liability, or any portion thereof, including attorney's fees and costs, arising from injury or death to persons, including injuries, sickness, disease or death to Consultant's own employees, or damage to property occasioned by a negligent act, omission or failure of the Consultant. 8. Insurance. The Consultant shall obtain and keep in force during the terms of the Agreement, policies of insurance as follows: If and only if the Consultant employs any person(s) in the status of employee or employees separate from or in addition to any equity owners, sole proprietor, partners, owners or shareholders of the Consultant, Worker's Compensation Insurance in an amount or amounts that are not less than the required statutory minimum(s) as established by the State of Washington or the state or province where the Consultant is located. Commercial Automobile Liability Insurance providing bodily injury and property damage liability coverage for all owned and non -owned vehicles assigned to or used in the performance of the work for a combined single limit of not less than $500,000 each occurrence with the COUNTY named as an additional insured in connection with the CONSULTANT'S performance of the contract. General Commercial Liability Insurance in an amount not less than a single limit of one million dollars ($1,000,000) per occurrence and an aggregate of not less than two (2) times the occurrence amount ($2,000,000.00 minimum) for bodily injury, including death and property damage, unless a greater amount is specified in the contract specifications. The insurance coverage shall contain no limitations on the scope of the protection provided and include the following minimum coverage: a. Broad Form Property Damage, with no employee exclusion; b. Personal Injury Liability, including extended bodily injury; C. Broad Form Contractual /Commercial Liability — including completed operations; d. Premises — Operations Liability (M &C); e. Independent Contractors and subcontractors; f. Blanket Contractual Liability. The County shall be named as an additional insured party under this policy. CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets\Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 2 of 16 Such insurance coverage shall be evidenced by one of the following methods: • Certificate of Insurance; • Self - insurance through an irrevocable Letter of Credit from a qualified financial institution. Certificates of coverage as required by this section shall be delivered to the County within fifteen (15) days of execution of this agreement. Any deductibles or self - insured retention shall be declared to and approved by the County prior to the approval of the contract by the County. At the option of the County, the insurer shall reduce or eliminate deductibles or self - insured retention or the Consultant shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. The Consultant shall include all subcontractors as insured under its insurance policies or shall furnish separate certificates and endorsements for each subcontractor. All insurance provisions for subcontractors shall be subject to all of the requirements stated 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 being the intention of the parties that the insurance policies so affected shall protect both parties and be primary coverage for any and all losses covered by the above described insurance. It is further agreed by the parties that insurance companies issuing the policy or policies 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. It is agreed by the parties that judgments for which the County may be liable, in excess of insured amounts provided herein, or any portion thereof, may be withheld from payment due, or to become due, to the Consultant until such time as the Consultant shall furnish additional security covering such judgment as may be determined by the County. The County reserves the right to request additional insurance on an individual basis for extra hazardous contracts and specific service agreements. 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. CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 3 of 16 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. 9. Independent Contractor. The Consultant and the County agree that the Consultant is an independent contractor with respect to the services provided pursuant to this agreement. Nothing in this agreement shall be considered to create the relationship of employer and employee between the parties hereto. Neither Consultant nor any employee of Consultant shall be entitled to any benefits accorded County employees by virtue of the services provided under this agreement. The County shall not be responsible for withholding or otherwise deducting federal income tax or social security or for contributing to the state industrial insurance program, otherwise assuming the duties of an employer with respect to Consultant, or any employee of Consultant. 10. Covenant Against Contingent Fees. The Consultant warrants that he has not employed or retained any company or person, other than a bonafide employee working solely for the Consultant, to solicit or secure this contract, and that he has not paid or agreed to pay any company or person, other than a bonafide employee working solely for the Consultant, any fee, commission, percentage, brokerage fee, gifts, or any other consideration contingent upon or resulting from the award or making of this contract. For breach or violation of this warranty, the County shall have the right to annul this contract without liability or, in its discretion to deduct from the contract price or consideration, or otherwise recover, the full amount of such fee, commission, percentage, brokerage fee, gift, or contingent fee. 11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this agreement, will not discriminate on the grounds of race, color, national origin, religion, creed, age, sex or the presence of any physical or sensory handicap in the selection and retention of employees or procurement of materials or supplies. 12. Assignment. The Consultant shall not sublet or assign any of the services covered by this agreement without the express written consent of the County. 13. Non - Waiver. Waiver by the County of any provision of this agreement or any time limitation provided for in this agreement shall not constitute a waiver of any other provision. 14. Termination. a. The County reserves the right to terminate this agreement at any time by giving ten (10) days written notice to the Consultant. b. In the event of the death of a member, partner or officer of the Consultant, or any of its supervisory personnel assigned to the project, 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 County. This section shall not be a bar to renegotiations of this agreement between surviving members of the Consultant and the County, if the County so chooses. CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 4 of 16 15. Notices. Notices to the County of Jefferson shall be sent to the following address: Jefferson County Public Works 623 Sheridan Street Port Townsend, WA 98368 Notices to Consultant shall be sent to the following address: SCJ Alliance 2102 Carriage St SW, Suite H Olympia, WA 98502 16. Integrated Agreement. This Agreement together with attachments or addenda, represents the entire and integrated agreement between the County and the Consultant and supersedes all prior negotiations, representations, or agreements written or oral. This agreement may be amended only by written instrument signed by both County and Consultant. CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 5 of 16 DATED this SIGNATURE PAGE 5eJ A///4^6e SIGNATURE PAGE day of , 20 Consultant Firm (Please print) �Cd $ultant's Name ( lease print) ::Consultant's Signature i6/1q // Date { JEFFERSON COUNTY BOARD OF COMMISSIONERS David Sullivan, Chair Phil Johnson, Member Kathleen Kler, Member Approved as to form only: 4, David Date lJ Monte ders 6a Public Works Director /County Engineer CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets''Troject Management \Consultants \Civil EnginecrSC1 Alliance '�Contract`,Prolcssional Services Agreemcnt.docx rev. 3/31/2014 Page 6 of 16 Exhibit A Scope of Work for Civil Engineering Services for Quilcene Complete Streets Project Overview The project is located in Quilcene, Washington, along US Highway 101 (approximately from the US Bank to the Community Center). The goal is to create a streetscape within the available project budget which will lower vehicle speeds, address safety concerns, establish a sense of place, and spur economic development. Per the grant scope, the project development phase includes two charrette -style workshops that offer the opportunity for design visualization and consensus - building among residents, adjacent business owners, and WSDOT, utilizing Context Sensitive Solution strategies. Improvements may include: Sidewalks and bike lanes; Medians /pedestrian refuge areas; Pedestrian activated signals at crosswalks; Traffic signs and beacons; Utility Relocation; Pedestrian lighting; Transit stops and bike racks; and Landscaping and street furniture. The following document outlines the SCJ Alliance scope of work for this first pre - design stage of the project. This stage is intended to conceptually define the scope of improvements based on community input, design charrettes, and concept cost estimating. This stage of work will consist of a Project Management phase and a Charrette Support Phase as described below. Assumptions The project is funded by the WSDOT Pedestrian and Bicycle Program. The State funds will be administered by WSDOT Local Programs, but Federal Aid requirements do not apply since the grant program is State funded. 2. The County is contracting separately with a Fischer Bouma Partnership to lead the pre- design /charrette stage of the project. SO is providing support as directed by the County to the limits of the budget assumed. 3. The Design Team is comprised of Jefferson County, Fischer Bouma Partnership, and SO Alliance. Phase 1 Project Management This phase includes tasks to plan, manage, and administer the work; attend project meetings and Town Council study sessions; and provide quality assurance /quality control. Task 1 Project Management 1) Management: Manage the project by directing and supervising staff and reviewing work for the duration of the project. This management is for the overall work rather than specific tasks. 2) Progress Billings: Prepare a monthly progress bill with weekly progress reports attached. Bills will show staff hours for each phase (i.e., Phase 1: Project Management). CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets\Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract\Professional Services Agreement.docx rev. 3/31/2014 Page 7 of 16 Phase 1 Understanding • Project management will be provided over a 4 -month time frame. • Progress billings will be submitted monthly to the County. • Weekly progress reports will be attached to monthly progress billings. Progress billings will be deemed incomplete and subject to non - payment if progress report is not included. Phase 1 Deliverables • Progress billings, together with weekly project reports, submitted monthly via US Mail. Phase 2 Charrette Support Task 1 Charrette Support 1) Data Review: Review past community input to be provided by the County. Review topographic survey data to be provided by the County and set up base files in AutoCAD Civil 3D. 2) Kick off Design Team meeting and Quilcene site visit. 3) Community Charrettes: Participate in two (3 hour) community design charrettes as part of Design Team. 4) Design Team Coordination: Coordinate with the Design Team as directed by the County. 5) Concept Cost Estimate — Charrette 1: Prepare a concept -level project cost estimate for possible improvements, as provided by the County, in preparation for the first community charrette. 6) Design Consultation: Provide support to the Design Team as directed by the County to facilitate development of a refined conceptual level design of proposed improvements. 7) - Concept Cost Estimate — Charrette 2: Prepare a refined conceptual -level project cost estimate for proposed improvements as provided by the County in preparation for the second community charrette. Phase 2 Understanding • SO is not responsible for developing conceptual designs. The County will provide conceptual designs and SO will prepared cost estimates based on the conceptual designs provided. • SO is responsible for tracking proposed conceptual design components and providing consultation on economic feasibility as well compliance with applicable WSDOT and FHWA requirements. • Support for subtasks 3 and 5 will be as directed by the County, and the support is limited to the budget provided herewith. Phase 2 Deliverables • Conceptual level design cost estimate for the first community design charrette. • Refined conceptual level cost estimate for the second community design charrette. Future Tasks For Which Consultant May Be Retained For: • Full PS &E Preparation Contract Completion Date Shall Be: 12/31/17 END OF SCOPE OF SERVICE CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 8 of 16 Exhibit E -1 SCJ Alliance Consultant Fee Determination Perry Scott Josh Matt Alissa Maddie Task Task Description Principal Assoc Project Senior Project Project Total No. Principal Eng.1 Designer Coord.I Acct. Phase 1 - Project Management Task Management 01 1 Management 2.0 2.0 2.0 6.0 Total Hours All 2.0 2.0 2.0 6.0 Tasks: Total Direct $139.42 $49.46 $54.00 $242.88 Labor Estimate Phase 2 - Charrette Support Task Charette Support 01 1 Data Review 2.0 2.0 2 Community Charrettes 10.0 10.0 3 Design Team Coordination 12.0 12.0 4 Concept Cost Estimate - 1.0 5.0 1.0 7.0 Charrette 1 5 Design Consultation 4.0 4.0 6 Concept Cost Estimate - 1.0 5.0 1.0 7.0 Charrette 2 Subtotal Hours: 28.0 12.0 2.0 42.0 Total Hours All 30.0 12.0 2.0 2.0 2.0 48.0 Phases Total Direct Labor Estimate $2091.30 $453.12 $67.98 $49.46 $54.00 $2,715.86 All Phases CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 9 of 16 SALARY COST Discipline Hours Rate Amount Principal 0.0 $87.26 0 Assoc. Principal 30.0 69.71 $2091 Project Engineer 1 12.0 37.76 453 Senior Designer 2.0 33.99 68 Project Coordinator 1 2.0 24.73 49 Project Accountant 2.0 27.00 54 Subtotal: 40.0 Direct Salary Cost $2,715 OVERHEAD Overhead Rate: 165.37% Direct Salary Cost: $2,715 Overhead Cost $4,490 FIXED FEE Fixed Fee Rate: 32.00% Direct Salary Cost: $2,715 Fixed Fee Cost 869 TOTAL SALARY COST Total Sala Cost 8,074 SUBCONSULTANTS Subconsultant Fee 0 Subconsultant Markup: 0% 0 Total Subconsultants 0 REIMBURSABLES Copies, Re productions, etc: 2.5% 68 Mileage: 500 miles at $0.575 288 Total Expenses: 356 SUBTOTAL SALARY, SUBCONSULTANTS AND EXPENSES Subtotal (Salary, Subconsultants and Expenses) 8 430 MANAGEMENT RESERVE FUND MRF Management Reserve 0.0% of Subtotal 0 Total Estimated Bud et $8,430 CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets\Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 10 of 16 Exhibit E -2 SCJ Alliance Specific Rates of Pay Invoiced hourly billing rates may be less than the rate shown per job classification, but may not exceed the NTE rate. CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 11 of 16 zDired .Labor', `- -'-0 verhead' 'fee °` '� "Total Hourly,' Job Classifications Rate Ranges ' 165.37% a' 32 00 %, :: Billing Rates , _.,._. �• . NTE �_�_._ w , . _ _ NTE ANTE �.� ._�. _ _._ ANTE Principal Engineer $90.00 $148.83 $28.80 $267.63 Principal Planner $81.00 $133.95 $25.92 �, $240.87 Principal Landscape Architect $55.00 $90.95 $17.60 ~; $163.55 Associate Principal $72.00 $119.07 $23.04E $214.11 Senior Consultant $71.00 $117.41 $22.72 $211.13 �l Senior Project Manager , n $67.75 $112.04 $21.68 $201.47 Project Manager $49.50 $81.86 j $15.84 $147.20 Project Engineer II $44.00 $72.76 $14.08 j $130.84 Project Engineer 1 $39.00 $64.49 i $12.48 $115.97 Senior Designer $39.00 $64.49 ; ; $12.48 $115.97 Design Engineer $32.50 $53.75 ,x� $10.40 $96.65 z Landscape Architect $42.00 � $69.46 w� $13.44 i $124.90 Landscape Designer $30.00 $49.61 I $9.60 $89.21 Senior Planner $49.00 $81.03 $15.68 ,' $145.71 Planner $39.00 $64.49 $12.48 $115.97 Sr. Transportation Planner $49.50 $81.86 $15.84 $147.20 Transportation Planner 1 $39.00 $64.49 $12.48 $115.97 Traffic Analyst $36.00 $59.53 $11.52 $107.05 Environmental Scientist $49.00 $81.03 $15.68 $145.71 Environmental Planner $38.00 i $62.84 $12.16 $113.00 Engineering Tech II $29.00 $47.96 $9.28 $86.24 Project Coordinator II `k $33.00 a $54.57:M $10.56 $98.13 Project Coordinator 1 $26.00 $43.00 $8.32 $77.32 Administrative Assistant $20.00 i $33.07 $6.40 $59.47 Project Accountant ', ° $53.50; $88.47 $17.12 $159.09 Information Technology Manager I $42.00 ) $69.46 "W $13.44 $124.90 Information Technology Specialist $37.00 $61.19 $11.84 $110.03 Senior Marketing Coordinator 4. ";� $35.00 „s $57.88 $11.20 j $104.08 Communications Director ,; $45.00 $74.42 ��. $14.40: $133.82 Li Invoiced hourly billing rates may be less than the rate shown per job classification, but may not exceed the NTE rate. CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 11 of 16 Exhibit F (SCJ Alliance) Breakdown of Overhead Cost AMIL Washinglon State Department a : Transportation t_yrin P'ti±r± on .;.+?t Ii7i ".r ,�i i�ci31 j:)3`ti1Sl?;rtil j tine i ti_ 201- SCJ Alliance " 30 `ratlon Lone. NE., Suite 200 Lacey, WA 98 16 -66e 2 Transpc�rtatk)n f3uildint: 3 t i' P,•t;aole tArl viu n ue S, F. F.U. BO �r Subject: AcCCTtance F4`E 201=1 lCR - At:dit Office RevicW Dear N-Is. Lisa Hicks: Transmitted herewith is the WSDO'l' Audit 011ic.o's memo of "Aceptance." of your Iirin's F'YE 2014 hidirect Cost Rate ([CZ) of 165.3 -." %- Your 1CIZ acceptance is in accordance with 23 C: ".FR 1 �2_" and Must be Updated on an annUal basis, This rate will be applicable for; 11 =SD0`I' -A1 q-Cemcnts ® Local Agency Ct ?nt.racts in Wi5iiiii�!on State oni Costs hilted to agrc€ incnttif'contracts will still be subject to Midit ol'rae €t(ztl costs, based on the te;rnis and conctinons of the respective a <2reclnet3t''c(intract. 'l'his was not a covplzant review, Any other entity contractiltg with your firth is responsible Cot- determining the acceptability of the It_R. If VOU have any questions; feel fTCC 10 a;ontaet OLIr oFfieC at (360") '705 -7104 or via email 1131eltlil3ltTitf 5`':i 41 r� LR,IK 1. JON SC -'G l°'tna,,er, Consultant Serf iUe,s Office. EK1:rck CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 12 of 16 Washington State Department of Transportation June 12, 2015 TO: - Erik Jonson, WSDOT Contracts Administrator Memorandum FROM: Sehariie Harvey, Agreement ComplianLeAudit Manager T& 'rnftrSq SUBJECT: Shea, Carr & Jewell, [tic. Indirect Cost Ratty for fiscal year end December 3132014 We have completed our desk review of Slica, Carr & Jewell. Ine. -s Indirect Cost Rate for the above referenced fiscal year. We review cd the docu=mentation supporting the rate for compliance with criteria contained in the Federal Acquisition Regulations (FAR), Subpart 31 _ Based on our review we are issuing this memo establishing Shea, Carr & Jewell, Inc. is Indirect Cost Rate for fiscal year en=ding December 31, 2014, at 165.37% of direct labor. Shea, Carr & Jewell, Inc, provided a FHWA Certificate of Final Indirect CoStS indicating all costs included in the indirect cost rate schedule are in compliance with Federal Acquisition Regulations (FAR), Subpart 31. Costs billed to agreements will still be subj;,ct to audit of actual costs, based tm the terms and conditiuns of the respective agreement. This was not a coaizwii review. Any other entity contracting with the firm is responsible for determining the acceptability of the Indirect Cost Rate, If you have any questions, feel free to call me at (360) 705 -7006 or via email at haa-�•eys(�e!.!���rft�t.tiva. ���E, Cc: Steve McKerney File CONSULTANT AGREEMENT PAEric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.docx rev. 3/31/2014 Page 13 of 16 Ceftification of Final Indirect Casts Firm Name, Shca, Carr E JaweJI_ Inc. dba SCj Allian * Indirect Cost Rate Proposal, 165.37 Cate & PJQP E21 Preparadon (mm1ddlyyy ;,): cs.sr2015 Fiscal Period Covered �mm /ddlyyyy to rnmlddlyyyy): 0110IJ2014 to 1MY2014 1, the undersigned, {:ertitl that 1 have revici,ed the proposal to establish final indirect cast rates for the fiscal per ad' as specified above and to thl~ best of my knowledge and belief_{ I j All Costs inc!uded in this PrOPOsal t`o establish final indirtct cost rates am afloNable !n accordance with the cost principles of the Federal Acqursitlon Regulaftns (FAR) of title 48, Cade of Fe,dera; Regulations (CPR), part 31. 2.1 This proposal does not include any costs which are expressly unallowable under the cast princaples of the FAR of 48 CFR 31, Aff knDvIn rnatoriat transactions orevents IhW have occurred affecting the firths ownership, organization and indirect cast rates have been disclosed. Signature: Name of Certifying Offici6f (Print); Perry P., Shea, PE Title; Principal Date of Certification (mm!dd/y °ryy): star m -Tile "Certifying Offlclal° must be an Individual executive cr financial of cer of the firm at a level no lower than a Vice President or Chief Financial Officer, or equivalent, who has the authority to represent the financial information utilized to establish the indirect cost rate for use under Aqency conlrarts. Ref: FFNVA Directive 447G. 1A available on line at: h il),va.dot.gay e_g reosldireut 'lveslarders /r44701a_htrr CONSULTANT AGREEMENT P: \Eric K \(A) Projects \Quilcene Complete Streets \Project Management \Consultants \Civil Engineer \SCJ Alliance \Contract \Professional Services Agreement.doex rev. 3/31/2014 Page 14 of 16 0 Shea Carr & Jewell, Inc dba S(:'j Alliance Indirect Cost Rate Schedule For the Year Ended December 31, 2014 Financial Statement AmVptv-d Description Amount S(J WSDOT Adj. 14cf, Atnomit % Direct Lahor I ivdirc-ct C*oits, Fringe Benefits Vaca6elli PTO PayTol I Taxes HE�alt,)t Isisuralice 'Workers'Conip. fiisurance Profit Sharing (401-k) At0oAIk-)war,ce Total Fringe Benefits General Overhead Indirect Labor Labor Variari,�.e (Uncornp 0-F) Bid & Proposal Labor Advertising Labor �,-Mpil?YCQ BOM1S RL-ni Maintenance & Rcpairs, Automobile T;ravei heals and J'tnertaiwnent Lis uruncc Lilo Insurzincv Uti litres Taxes & Licenses Depmciari(m & Api(iTti7AiiOT1 Dueq & Sul scriptiowi Employee Traiti:Rocruit Advuil ising Professional Fcc-s Interest Computur ContrihLlfi(MS Bad Dcbt Supplies & Miscellaneous Total C-cue-rol Overhead 52;219: $279,NS-2 115,025 1 16' 3,463 0+1;),567) 292,059 1-1,594 113,093 9.200 $ 1386,316 1 j ?67'i Stl S2 1 2 19. 1 M I 279:R! . - 12, 6 V#'o 1115.02S 5.18% 35',`196 (14,897.) �, 12 2- 21 )2,059 12.16 13,594 0 61114 113,093 (2,1Q6211 C., U R 0 0 0 0 ? 39.6-.49 52 5 II S1.1741.052. 52.901%, (174,507) 0 365:60.4 (14,897.) �, 12 2- 108.2316 ($108.716) F 239.741 (6-:054) � 4 ($69,950'1 N, S 792,402 11.136 (2,1Q6211 C., U 2,690 52.901%, 43,426 (29,084) 79,589 (14,897.) �, 12 2- 83,W6 (74.139) 5 2.2 4) 9 4.63% LOU (21,083) 2,;Z,�..76 ().12% 39.6-.49 0.65% 1311,884 15013'.1 295,463 (16IJ35) 35,506 (9746 1) 64,90*2 (8,831) 38,437 f38,4317j 47,481 (21,542) t 5,86() (15.,860) 38,191 6-11J56'Q 25,061 (25,061) 642 (1 ,642) 92,667 0.00114 53,190361 f S '79:6136) 43 3) NT F, T Cr 31 1), Q F F K A, 11 I S 1. 174,0521 52.901%, (1°4,301'3 -7.8611!110 1. 65.608 16,47% 102,74() 4.63% 275 8 76 12,43"/,, 2 680 ().12% I , t. 3, 4' 0.65% 55,570 15013'.1 1•1967 0, i 8 5-209 2.35% 0.110% 6. 39.6N 1.79) % 111,884 5.94":�, 134,328 6-11J56'Q 27,045 1,22-)) 56,071 2 - 5 0 0.00114 26,339 1 19% 0 0-00% 19 1 ) �9 7% 0 0-00% 0 (),W% 6t."11 418% S-1.5133.321 I 12. 80% CONSULTANT AGREEMENT P:\Etic K\(A) Projects\Quilcene Complete StreetsTroject Management\Consultants\Civil Engineer\SCJ Alliance\Contract\Professional Services Agreement.docx rev. 3/31/2014 Page 15 of 16 Shea Carr & Jewell, Inc dha SCJ Alliance Indirect Cost Rate Schedule For the Year Ended Decernher 31, 21114 Financial Statement Accepted De.wription Amount SC WSDOT Adj. Ref, Amount % To(al Indirect Costs & ()K�erhead S4,,376,677 W99.3734) —($l()7,433) 3.6C.t 7 ifr5.37% Indirect Cost Rate 19 -1-22% 170.211 !/'� 165.37% .Vzea Carr & Jewell. Inc. - R"iesswd and Accepted by JE- 6q1/1 5 "Indirect Gest Rate still subject to WSW T Audit" References SCJ Adjustments: A Rct -ainer costs ($4 7 7 ' 55) u nal I o wab le per 48 CFR 31.205- 33(f). 13 Key pursur; I ibe insurance (5211,083) una I lo%vablc Per 48 CFR 31.'05 -19(e) 21)(Vy C ConliMyr, Comrol Rent Calculation (S 1 17S'361 per 48 CTR 31.'2115- 36(b)Q); D Amortization of 2.(R)dvvill ($81390.) unallowable per 48 CFR 31.205.49. E Costs of memberships in civic and community organization ($3,461) unallowable per 48 CFR 31,2G5- 1(1)1;7). F Public relations and advertising Sa!aricsi'Wa-e,.,,, ($10,8216), Travel (S 14.89'1): and Eniployee'MR ($5,8311 unallowable Per 48 CFR 31.205 -1 and 48 CFR 31.'205 -461. G Meals and Enterwininent (,S7'(1: 139) unailowable per 48 CFR 31-205-14. H Legal Costs in rclaric. n to organ i 7,a(i CTj 1.1+(6.717;1 una I lowable per 48 CPR 3 7 I Interest, ('315,460) unalloviable per 4£i CFR 3l 205 -M J Coniribution, (S25,06 l'i unallowable per 48 CFR I K Prorno;ional N-larkeLing ($30,874) and klark-cting Sup-plies ($7,563) unallowuh1v pzr 48 CFR 31-205-1 and 31,205-38, L Fringe Beatfil adju,4mcnt-, direv-11Y associated cost w anallowabIcAdver6sing (S10,567) unallowable per 4 8 Cl -R 31 :201,.- •5(a). N•1 Associated co-its for vehicle unallow:61c per 48 CFR 31.205-46(d) and 31-205-6(ni)(12). Associated costs incitick-- Unallowable Vehicle Costs ($25,(142) D(-p-rcc.:4at:!ot-, (537242)- N Bonus -,iayrnc-,rns unallowable per 4.4 (T-R 31-205-6, 0 Unc�nipensated Safary idjust-nunt per 48 CFR 31.201-47 37.115, ()C.k-k 5-910 & 6 -410. P Bad Debi ($1,642) unallowailc per 11,203-3, Q Tax I )4prvciiitiou ad.j us Lcd tbr 13C.-ok-Straight Line 14]5?245) per 4� CFR 31.205 -11. R Auu�.- Allowance ($9,200) unallovvable per 48 CPR 11-2105-6(m)(2). WSDOT Adjustments S Per 49 CFR 3 1.205-6f a'1(16)f. ii)i B), distribtatica of prof its ($691950) is rot an allowable contract cosi. T Travel costs umillowablic per 48 CFR 31.205-46 ($9,121), U Common Como! Rcilu Calculalion per 48 CFR 31.205 -361 1))(3'17 ($16,526) her [be offlice at 2 102 CaffikVL Dr.: no adjustment necessary for office, al 5730 Tallon Lane NE. CONSULTANT AGREEMENT P:\Eric K\(A) Projects\Quilcene Complete StreetsTroject Management\Consultants\Civil Engineer\SCJ Alliance\ContractTrofessional Services Agreement.docx rev. 3/31/2014 Page 16 of 16 JEFFERSON COUNTY CENTRAL SERVICES DEPARTMENT I Jefferson County Jail Fire Alarm Replacement Project — CHANGE ORDER — Sheet 1 of I Change j Order �i 2 Date: 19- Oct -15 Number Ordered by County Engineer under teens of _Contract documents j Contract No. 1301 594 1901 j ❑Change proposed by Contractor ! To: _ _f North Shore Electric, Inc. ATTN: Isaac Conrad -- 14590 Cavalll Rd. SE -- Olalla, WA 98359 Endorsed by: 'North Shore Electric, Inc. Contractor Firm Name _ ' — ]Signature Date j Title Consent given by Surety: (when required) Project Title: Jefferson County Jail - Fire Alarm Replacement Project Bya j I- - Attorney -in -fact Date I You are directed to perform the following described work upon receipt of an approved copy of this change order: COP #4 Contractor Costs Mark -ups Guardian (GS) =- J Design (GS) $ 2,500.00; Material (GS) 1 $ 1,953.88 Labor (GS) $ 8,280.001 ! � $ 12,733.88 Enertec -BAS $ 5,009.89 North Shore (N SE) $ 5,000.001 I Sub -total $ 22,743.771 1 ! Mark up at 15% $ 3,411.57] $ 26,155.34! — i -- WSST @ 9% $ 2,353.98 TOTAL ADD $ 28,509.32 I i I I I I I i t All work materials and measurement to be in accordance with the provisions of the specifications and special provisions for the type of construction involved. a f ;fie, ' ,, „; ORIGINAL CURRENT ESTIMATED ESTIMATED °r a y ¢ ., w n �,,bf�,,,c4 � �' df� •"�, � � ,'.i er t N t{ CONTRACT CONTRACT NET CHANGE CONTRACT TOTAL AMOUNT AMOUNT THIS ORDER AFTER CHANGE $134,615.00 $140,228.33 28,509.32 $168,737.65 ORIGINAL CONTRACT CURRENT CONTRACT TIME EXISTING CONTRACT COMPLETION DATE 14- Aug -15 CONTRACT TIME 90 calendar days CHANGE (Add/Del) No Change COMPLETION DATE' 20- Aug -15 APPROVAL RECOMMENDED APPROVAL RECOMMENDED Project Manager: I Date i Central Services Director i I Date APPROVAL RECOMMENDED APPROVED l Facilities Lead I Date Chair, Jefferson County Commissioners Date JEFFERSON COUNTY CENTRAL SERVICES DEPARTMENT CE Jefferson County Jail Fire Alarm Replacement Project CHANGE ORDER Sheet 1 of Change Order Number Date: 1 19-Oct-15 T-1 Ordered by County Engineer under terms of _Contract -1 documents Contract No. 1301 594 1901 F1Change proposed by Contractor To: North Shore Electric, Inc. ATTN: Isaac Conrad 14590 Cavalli Rd. SE 01alla, WA 98359 I Endorsed by: North Shore Electric, Inc. Contractor Firm Name Signature I Date Title Consent given by Surety (when required) Project Title: 'Jefferson County Jail - Fire Alarm j Replacement Project By: 'Attorney-in-jhct Date You are directed to perform the following described work upon receipt of an approved copy of this change order: COP #4 Contractor Costs Mark-ups Guardian (GS) 1 $ 2,500.06 Material (GS) 1,953.88! ,Labor (GS) $ 8,280.001 $ 12,733.88 Enertec-BAS $ 5,009.89 North Shore (NSE) 5,000.W Sub-total $ 22,743.771 Mark up at 15% j $ 3,411.571 $ 26,155.341 WSST 9 $ 2,353.98 —TOTAL ADD j $ 28,509.32 All work materials and measurement to be in accordance with the provisions of the specifications and special provisions for the type of construction involved. ORIGINAL CURRENT ESTIMATED ESTIMATED CONTRACT CONTRACT NET CHANGE CONTRACT TOTAL I I Q� , 1v AMOUNT AMOUNT THIS ORDER AFTER CHANGE $134,615.00 $140,228.33 28,509.32 $168,737.65 ORIGINAL CONTRACT CURRENT CONTRACT TIME EXISTING CONTRACT COMPLETION DATE CONTRACT TIME CHANGE (Add/Del) COMPLETION DATE l4- Aug -15 90 calendar days No Change 20- Aug -1S APPROVAL RECOMMENDED APPROVAL RECOMMENDED -Fx-] El -!- - Project Manager: Date Central Services Director _ Date APPROVAL RECOMMENDED APPROVED F-1 Facilities Lead Date I I Chair, Jeftrson County Commissioners Date JEFFERSON COUNTY CENTRAL SERVICES DEPARTMENT Jefferson County Jail Fire Alarm Replacement Project 1 - — CHANGE ORDER Sheet I ofl Change Order 2 — ---------- Number— Date: 19- Oct -15 Ordered by County Engineer under terms of MContract documents Contract No. : 301 594 1901 Change proposed by Contractor TO: North Shore Electric, Inc. ATTN: Isaac Conrad 14590 Cavalli Rd. SE 01alla, WA 98359 Endorsed by: jNorth Shore Electric, Inc. Contractor Firm Name Signature Date Title Consent given by Surety (when required) Project Title: Jefferson County Jail - Fire Alarm Replacement Project — By.1 Attorney -in fact Date You are directed to perform the following described work upon receipt of an approved copy of this change order: COP #4 Contractor Costs Mark-ups Guardian (GS)--- Design (GS) $ 2,500.00i Material (GS) $ 1,953.881 Labor (GS) $ 8,280.001 $ 12,733.88 Enertec: -BAS $ 5,009.89 North Shore (NSE) 5,000.00 Sub-total 22,743.7711 Mark up at 15% $ 3,411.57, $ 26,155.34( WSST @ 9% 2,353.98 11 TOTAL ADD $ 28,509.32 All work materials and measurement to be in accordance with the provisions of the specifications and special provisions for the type of construction involved. ORIGINAL CURRENT ESTIMATED ESTIMATED V, air CONTRACT CONTRACT NET CHANGE CONTRACT TOTAL 0- W, AMOUNT AMOUNT THIS ORDER AFTER CHANGE $134,615.00 $140,228.33 28,509.32 $168,737.65 ORIGINAL CONTR-ACT1 CURRENT CONTRACT TIME EXISTING CONTRACT COMPLETION DATE CONTRACT TIME CHANGE (Add/Del) COMPLETION DATE 14-Aug-15 90 calendar days No Change 20-Aug-15 APPROVAL RECOMMENDED APPROVAL RECOMMEN DED Project Manager: Date Central Services Director Date APPROVAL RECOMMENDED APPROVED Facilities Lead Date' Chair, Jefferson County Commissioners !Date JEFFERSON COUNTY CENTRAL SERVICES DEPARTMENT 1 Jefferson County Jail Fire Alarm Replacement Project CHANGE ORDER — _ Sheet 1 of 1 Change _ Order 21 Number Date: 19- Oct -15 Ordered by County Engineer under terms of _Contract documents — Contract No.: 1301 594 1901 Change proposed by Contractor I To: I I I _ North Shore Electric, Inc. ATTN: Isaac Conrad 14590 Cavalli Rd. SE Olalla, WA 98359 —!,- I i Endorsed by: !North Shore Electric Inc. Contractor Firm Name _ Signature !Date – Title —_�- Consent given by Surety: (when required) !Project Title: Jefferson County Jail - Fire Alarm Replacement Project By:l, ;Attorney -in Jact Date You are directed to perform the following described work upon receipt of an approved copy of this change order: I COP #4 Contractor Costs Mark -ups f_ I i (Guardian (GS) Design (GS) j $ 2,500.001 Material (GS) i $ 1,953.88' _ Labor (GS) $ 8,280.001 f $ 12,733.88 j Enertec -BAS $ 5,009.89 j North Shore (N SE) $ 5,000.001 Sub -total $ 22,743.771 11 Markup at 15% ^II $ 3,411.571 _ I _ S 26,155.341 WSST @ 9% $ 2,353.98 TOTAL ADD $ 28,509.32 j All work materials and measurement to be in accordance with the provisions of the specifications and special provisions for the type of construction involved. r, ;< x� ' { ORIGINAL CURRENT ESTIMATED ESTIMATED - i ;'7' a , i x g' s CONTRACT CONTRACT NETCHANGE CONTRACTTOTAL AMOUNT AMOUNT THIS ORDER AFTER CHANGE $134,615.00 ORIGINAL CONTRACT $140,228.33 CURRENT 28,509.32 CONTRACT TIME $168,737.65 EXISTING CONTRACT COMPLETION DATE CONTRACT TIME CHANGE (Add/Del) COMPLETION DATE" 14- Aug -15 90 calendar days No Change 20- Aug -15 APPROVAL RECOMMENDED APPROVAL RECOMMENDED Project Manager: Date Central Services Director Date APPROVAL RECOMMENDED APPROVED Facilities Lead Date Chair, Jefferson County Commissioners Date Client #: 116497 SHEACARR ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) ADDL TYPE OF INSURANCE 10/08/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER I CONTACT Sandy Kulseth Propel Insurance PHONE 360.252.2368 ' FAx 866.577.1326 A /C, No, Ext : A /C, No Olympia Commercial Insurance ADDRESS: sandy.kulseth @propelinsurance.com P.O. Box 2007 INSURER(S) AFFORDING COVERAGE NAIC # Olympia, WA 98507 INSURER A: American Casualty Co of Reading 20427 INSURED INSURER B: Continental Casualty Company 20443 Shea,Carr &Jewell Inc dba SCJ Alliance INSURER C: Beazley Insurance Company, Inc. 37540 8730 Tallon Lane NE, Suite 200 INSURER D: Continental Insurance Company 35289 Lacey, WA 98516 INSURER E GENERAL AGGREGATE INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADDL TYPE OF INSURANCE SUBR WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY)_ POLICY EXP (MM /DD /YYYY)_ LIMITS _ A GENERAL LIABILITY Y XI COMMERCIAL GENERAL LIABILITY j CLAIMS -MADE OCCUR j Y _ 2090667295 06/15/2015 06/15/2016 EACH OCCURRENCE $2,000,000 PREMISESOERENTED r nce 000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY aX J CT LOC PRODUCTS - COMP /OP AGG $4,000,000 _ $ D AUTOMOBILE XI LIABILITY Y ANY AUTO ALL OWNED SCHEDULED HIRED ED AUTOS S X NON -OWNED AUTOS Y 4012152794 6/15/2015 06/15/201 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ _ $ B j, XI UMBRELLA LIAB EXCESS LIAB X OCCUR Y CLAIMS -MADE Y 4016829451 06/15/2015 06/15/201 EACH OCCURRENCE s3,000,000 AGGREGATE s3,000,000 DED RETENTION$ �'� $ A WORKERS COMPENSATION AN EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE( -- OFFICER /MEMBER EXCLUDED? N! i N/ A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WA State Fund 2090667295 (WA Stop Gap NA 6/15/2015 NA 06/15/201 X I WC STATU- ll OTH- TORY LIMITS_' ER_ E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional Liability V1OBC2150601 6/17/2015 06/17/201 Limit:$1,000,000 Aggregate:$2,000,000 Deductible: $60,000 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: P1766.01 JCPW Quilcene Complete Streets I t r1ULUtH Jefferson County Dept of Public Works 623 Sheridan Street Port Townsend, WA 98368 ACORD 25 (2010/05) 1 of 1 #S1900254/M1762898 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M @ 1988 -2010 ACORD CORPORATION. All rights reserved. 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