HomeMy WebLinkAbout071116_ca01V1,
615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth-org
'4UM,
Consent Agenda
May 16, 2016
Public He Ith
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley,, County Administrator
FROM: Jared Keefer, Environmental Health Director
Tami Pokorny, Environmental Health Specialist
DATE: - / / f / 2 -DI
SUBJECT: Agenda Item — Amendment #1, Project Agreement with Zephyr's INC of Allyn,
WA; Upon Signature; for $1,250.00 + tax of $112.50 for a total of $1,352.50
STATEMENT OF ISSUE".
Jefferson County Public Health requests approval of Amendment #1, Project Agreement with Zephyr's INC
of Allyn, WA; Upon Signature; for $1,250.00 + tax of $112.50 for a total of $1,352.50
ANA
Zephyr's INC is retained by the county to provide �O:Nos,
removal or decommissioning of all manmade:
structures, materials, debris and on-site systems located on two properties, both of which are in either the
Duckabush or Big Quilcene Floodplains. The project locations are overbrook Lane (APN# 502171006) and
195 Rodgers St. (APN# 991200301). This is a public works project and is paid for by RCO #1.2-1384C and
#13-1221, Zephyr's INC is required to establish and maintain safe access and traffic control while
undertaking its demolition services. Zephyr's INC will remove a concrete slab totaling 160 sq. ft., and
remove approximately 40 cinderblocks. All debris will be hauled to Peninsula Topsoil in Belfair for recycling.
This project is considered essential to the long-term restoration goals for the Big Quilcene River and the
Duckabush River, and their estuaries.
FISCALIMRACI&�����
Funding for Amendment #1, Project Agreement is provided by RCO #12-1384C and #13-1221, both of
which call for restoration measures as a component of their goals. There is no impact to the Jefferson
County General Fund for this agreement and there are no match requirements.
RECOMMENDATION:
JCPH Management recommends BOCC signature of Amendment #1, Project Agreement with Zephyr's INC of
Allyn, WA; Upon Signature; for $1,250.00 + tax of $112.50 for a total of $1,352.50
77,
7377
P14or_ ministrator Date
(i,1116 U,nty Ad ......
Community Health �_ Environmental Health
Developmental Disabilities Water Quality
360-385-9400 360-385-9444
360-385-9401 (f) Always working for a safer and healthier community (f) 360-379-4487
AMENDMENT NO. 1: ZEPHYR'S, INC OF ALLYN, WA — DUCKABUSH AND BIG
QUILCENE DEMOLITION PROJECT
AMENDMENT NO. 1 TO JEFFERSON COUNTY DUCKABUSH AND BIG QUILCENE
DEMOLITION PROJECT AGREEMENT WITH ZEPHYR'S, INC.
WHERAS, Zephyr's, Inc. of Allyn, WA (Contractor) and Jefferson County (County) entered into an
agreement on April 18"', 2016 for professional services in connection with the Duckabush and Big
Quilcene Demolition Project in Jefferson County, Washington.
WHERAS, the parties desire to amend the terms of the agreement.
IT IS AGREED BETWEEN BOTH PARTIES AND NAMED HEREIN AS FOLLOWS:
1. PURPOSE: To amend the agreement between Jefferson County, hereinafter referred to as `the
County' and Zephyr's, Inc. of Allyn, WA, hereinafter referred to as `Contractor'.
2. IT IS MUTUALLY AGREED this Amendment to the agreement amends item number nine (9) to
increase the reimbursement for work performed under the terms of this contract by $1,250 plus
$112.50 in Washington State Sales Tax.
3. IT IS MUTUALLY AGREED this Amendment to the agreement amends Exhibit A, Scope of
Work: Contractor will remove a concrete slab totaling 160 square feet and approximately 40
cinderblocks from the Duckabush Wetlands Preserve. The concrete and cinderblocks are to be
hauled to Peninsula Topsoil in Belfair for recycling.
I. All other terms and conditions of the original agreement remain in full force and effect. The
effective date of this amendment is May 12, 2016.
IN WITNESS WHEREOF: the parties have signed this amendment.
JEFFERSON COUNTY
ZEPHYR'S INC,
Kathleen Kler, Chair Date Ron Griffey Date
Jefferson Board of County Commissioners Zephyr's Inc.
proved as form only
eler C, Pra:weu O Ke
David Alvarez, Chief Civil DPA
AGREEMENT
Between
JEFFERSON COUNTY, WASHINGTON
And
ZEPHYR'S INC. OF ALLYN, WASHINGTON
THIS AGREEMENT entered into this Jay of 2016, by and between Jefferson County, a
political subdivision and municipal corporation of the Starkof Washington, hereinafter referred to as
"Jefferson County," and Zephyr's, Inc. of Allyn, WA 98524, hereinafter referred to as "Contractor;" in
mutual desire of the parties hereto that Contractor should undertake and complete a certain Public Works
Project on behalf of the Jefferson County, described as follows:
Work Order: "Duckabush and Big Quilcene Demolition Project"
1 I'x1ajec,t l esi nat�iora. Contractor shall undertake the performance of the said Public Works Project in
Jefferson County, Washington. The Coniracl:or shall provide all equipmentand personnel necessary
to A) under take the work as contemplated by this Agreement and B) complete same in the time frame
contemplated by this Agreement.
2 Scope LyfS Servi es. Contractor agrees to perform the scope of work identified on Exhibit A, attached
hereto, including the provision of all labor, materials, equipment, and supplies.
Time of"Performance. Contractor shall commence the work as contemplated by this agreement upon
Notice toProceed and .shall p ursurc dicx work. diligewly and corrtinurously arratll the project is
completed, All oar-the-grouml work nauast be completed within 30 eaalendarr clays atter written Notice to
Proceed is issued, Should Jeffersca,n County l:nvironrnenta.l Hearlth deter•naine that the. site or weather
conditions are unsuitable for the performance of the Contractor's obligations under this Agreement,
then the Time of Performance will be extended in tirne by the number of days equal to the delay. The
County shall have sole discretion to determine the length of the delay and shall promptly convey to
Contractor its determination that the delay has ended.
4. �+�'I!aagriei t Pcrzl`oitinirrg-Acaalc Contractor has examined the site of work and has decided the manner
for performing all necessary labor. Contractor is aware that the work vicinity is a residential
neighborhood and care must be taken to prevent unreasonable disturbance.
5 Character acter of" Mata riarls. Contractor has examined the site of work and has recognized and determined
the character of the materials terials to be encountered, demolished and removed.
6 Q.01y Log.Contractor shall nwintain a daily report of operations ,and a time log, in as format to be
approved by Enviroimiental Health, and shall, upon request, prorarlatly provide l.,nvironineratal Health
a daily copy of such log. Among other things, such log shall precisely specify the time of
commencing work and the time of t.ermination of work. Contractor shall record the times and the
duration of all shutdowns for any purpose during the workday.
7 Permits, Contractor shall pay for, obtain, and satisfy all necessary permits to undertake the work as
contemplated by this Agreement unless specified otherwise in the bid documents.
Zephyr's, Inc. - Duckabush and Big Quilcene Demolition Project
8. A,cneo Nolilications. Contractor shall give appropriate notification to all necessary governmental
agencies of its intention to undertake the work contemplated by this Agreement, which notifications
shall be in addition to any other requirements of other said agencies. Contractor shall provide a copy
of such notices to Environmental Health.
9. Cont: act_llre. The Contractor shall be paid by the County for completed work and for services
rendered under this agreement as follows:
a. The Contractor will be reimbursed for all work performed under the terms of this contract.
Payment for the work provided by the Contractor shall not exceed $16,675.00, plus $1,500.75
Washington State Sales Tax, for the completion of this project without express written
amendment signed by both parties to this Agreement.
b. Funding for this contract will be provided by RCO grants # 12-1384C and #13-1221. If funding
from RCO is withdrawn, reduced, or limited in any way after the effective date of this agreement,
this contract may be renegotiated or terminated as provided herein. In the case that RCO grant
amounts are reduced for any reason there shall be no obligation on the part of the County to
expend its own funds or incur any expense in order to return the funding level to the amount
listed above in section a.
c. The Contractor may submit invoices to the County not more than once per month, but not less
than quarterly, during the progress of the work for work completed to date. Such invoices will be
checked by the County, and upon approval thereof, payment will be made to the Contractor in the
amount approved.
d. Final payment of any balance due the Contractor 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.
e. 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.
f. The Contractor'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 six (6) years after final
payments. Copies shall be made available upon request.
10 Ti tne or CqqI&Cion Lind I L(lu,ddw1.);iN, gg ,. The work shall be commenced immediately after
written notification to proceed by Environmental Health to the Contractor and shall be completed as
indicated in paragraph 3, Time of Performance.
Unless there shall have been an extension of time granted by Environmental Health, for each calendar
day after the above time expires, for the completion of the work that remains uncompleted, Contractor
shall pay Jefferson County the sum of one percent (1%) of the amount listed in Section 9.a above or
$60 per day, whichever amount is greater, as fixed, agreed liquidated damages, and this sum is not to
be in any sense a penalty. In the event that an extension of time is granted and completion does not
occur on or before the extended deadline, then the Contractor shall pay Jefferson County as liquidated
damages the specified amount per day for each day that the work remains uncompleted beyond the
date or time fixed by the extension of time.
Contractor does hereby authorize Jefferson County to deduct such liquidated damages from the
amount due or to become due the Contractor. Contractor further agrees that any such deduction shall
2
Zephyr's, Inc. - Duckabush and Bib _ uilcene Demolition Project
fulfillment of the entire contract or waive or nullify any other rights or privileges the County has
pursuant to this Agreement.
11.(:Documents, All documents, drawings, specifications ind other materials
produced by the Con[ractor in connection willi the services rclidered under this agreement shall be the
property of the: County whether the project for which they are made is executed or not. The
Contractor shall be permitted to retain copies, including reproducible copies, of drawings and
specifications for information, reference and use in connection with Contractor's endeavors.
12. Ct i i )lianee with Laws, Contractor slizall, in perf6i'ming flic servjccs contemplated by this agreement,
ft-lithfully (.,)bserve and comply with all federal, stale, and local law s, ordinances and regulations,
applicable to the services to be rendered under this agreement.
13. Indernnification 'I'lie Contractor agrees to indemnify, defend and hold the County and its departments,
elected amd appointed officials, employees, agents and volunteers harmless from ;ujd Igainsi any and
all claims, damages, losses and expenses, including but not limited to court costs and attorney's fees
or any alternative resolution dispute costs, for any personal injury, any bodily injury, sickness, disease
or death and for any damage to or destruction of any property to the extent caused by any act or
omission of the Contractor, its employees, agents or volunteers.
This indemnification obligation of the Contractor shall not be limited in any way by the Washington
State Industrial Insurance Act, RCW "Title 51, or by application of any odler worker's compensation
act, disabi I ity benefit act or other employee benefit act, and the Contractor hereby expressly waives
any iminunity afforded by such acts. The foregoing indeninification, obligations of the Contractor
represent a material inducement to the County to enter into this Agreement, are reflected in the
Contractor's compensation and have been mutually negotiated and agreed to by the parties. The
provisions of this section shall survive the expiration or termination of this Agreement.
14. In.5141-;ii1ce'. "Hie Conti -actor 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 RCW 48.05:
a. Worker's compensation and employer's liability insurance as required by the State of
Washington. This insurance shall have a minimum $1,000,000 liability cap.
b. 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.
c. Insurance policies and additional named insured endorsements obtained for the Contractor
shall provide primary insurance coverage. Any third party liability coverage provided to the
County by its membership or participation in a Ch. 48,62 RCW self-insurance prograrn shall
be excess and non-contributory to such insurance policies the Contractor is obligated to
obtain and retain. All Contractor's liability insurance policies must be endorsed to show this
primary coverage.
d. Contractor must comply with all insurance requirernents listed here. Failure to do so
authorizes the County to withhold compensation otherwise due to the Contractor.
Icertificates
e. The Contractor shall within 15 days of the execution of this Contract provide of
insurance narning the county as an additional insured on all policies except those listed in
Section 14.b above, and the full texts any endorsements listed there.
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
Zephyr's, Inc. - Duckahush and Bid ,uilcene Demolition Project
that the insurance policies listed above shall protect both parties and be primary coverage for any and
all losses covered by the above -listed insurance policies. It is further agreed by the parties that any
and all deductibles made part of the above -listed insurance policies shall be assumed by, paid for and
at the risk of the Contractor.
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 Contractor or any subcontractor shall procure a
bond guaranteeing payment of losses and related investigations, claim administration and defense
expenses.
Any subcontractor to the Contractor 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 Contractor or any subcontractor to take out and/or maintain any required insurance shall
not relieve the Contractor or arly subcontractor from any liability under the Agreement, nor shall the
insunince requirements be construed to conflict with or otherwise limit the obligations concerning
indemnification.
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 fr(,)m payment due., or to become
due, to the contractor or subcontractor until such time as the contr�rcjor or subcontractor 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.
15 11rreva¢lin g_Wagn . It is the sole responsibility of Contractor and subcontractors to assign the
appropriate classifications to all laborers, workmen or mechanics performing any work pursuant to
any Public Works Contract and to ascertain the applicable prevailing wage rates and fringe benefits
for each such classification. Current prevailing wage data can be obtained by Contractor frorn the
Industrial Statistician of the Department of Labor and Industries, Prevailing Wage Office, P.O. Box
44540, Olympia, Washington 98504-4540, (360) 902-5335, or go to their website at
htlpr_: 8 A h In i4+.`:r...l °.��/ I r lc ,l: rc t°rr{zir r i'¢c k arz�,;'',�Y g L�;�r,9 him
16 Performance Bond and rLabor m r., nN4ateri l..Payment Bonds. Prior to execution of the contract,
Contractor shall furnish Performance and Labor & Material Payment Bonds covering the faithful
performance of the contract, and the payment of all obligations arising thereunder in such forin
approved by the Owner and in the amount: of one hundred percent (100%) of the contract. The bidder
shall require the attorney -of -fact who executes the required bonds on behalf of the surety to affix
thereto a certified and current copy of this power -of' attorney indicating the monetary limi[ of'such
power.
For contracts under $35,000 (including sales tax), in lieu of a performance bond, Contractor may
provide writd.err and signed request to have Jefferson County retain :50% ofthe contract price for 30
days following, completion of all work or receipt, of all necessary releases frons the Department of
Revenue, the Department of Labor and Industries, and settlement of any liens filed under chapter
60.28 RCW, whichever is later.
4
Zephyr's, Inc. - Duckabush and Big ,uilcene Demolition Project
For work that has no subcontractors and is $2,499.99 or less (including WSST), Jefferson County will
file a combined Intent/Affidavit form signed by Contractor following completion of the work (this
eliminates the $80.00 filing fee). Payment will be made in a single payment following completion of
the work to Jefferson County's satisfaction and receipt of the signed combined Intent/Affidavit form.
17 lr j� ej Lident Cowractor. The Contractor and the County agree that the Contractor 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 Contractor nor any employee of Contractor 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, or otherwise assuming the duties of an
employer with respect to Contractor, or any employee of Contractor.
18 As ,iainient and ubwnyac'ting;. Contractor shall not assign this Agreement or any interest therein
nor subcontract the whole or any portion of the work contemplated by this Agreement, nor may any
interest hereunder be assigned or transferable by operation of law, or by any process or proceedings
of any court or otherwise, without the prior written consent of Jefferson County. Contractor shall,
when intending to use subcontractors, provide Jefferson County with a Payment Bond as well as the
list of the proposed subcontractors to be used to Jefferson County for approval prior to any
subcontracting.
19. Subcontractor
_13gspoq-,i biIitiy.
A. Contractor shall include the language of this section and the provisions of Section 14 above in
each of its first tier subcontracts, and shall require each of its subcontractors to include the same
language of this section in each of their subcontracts, adjusting only as necessary the terms used for
the contracting parties. Upon request, Contractor shall promptly provide documentation to
Environmental Health demonstrating that the subcontractor meets the subcontractor responsibility
criteria below and the insurance requirements imposed on the Contractor by Section 14 above. The
requirements of this section apply to all subcontractors, regardless of tier.
B. At the time of subcontract execution, the Contractor shall verify that each of its first tier
subcontractors meets the following bidder responsibility criteria:
a. Have a current certificate of registration as a contractor in compliance with chapter 18.27
RCW, which must have been in effect at the time of bid submittal;
b. Have a current Washington Unified Business Identifier (UBI) number;
c. If applicable:
i. Have Industrial Insurance coverage (workers' compensation)
coverage for the bidder's employees working in Washington
as required in Title 51 RCW;
ii. Have a Washington Employment Security Department
number as required in Title 50 RCW; and
iii. Have a Washington Department of Revenue state excise tax
registration number as required in Title 82 RCW;
iv. An electrical contractor license, if required by Chapter 19.28
RCW;
v. An elevator contractor license, if required by Chapter 70.87
RCW.
vi. Not be disqualified from bidding on any public works contract under RCW
39.06.010 or 39.12.065(3);
Zephyr's, Inc. - Duckabush and Bid , uilcene Demolition Project
20. Non-Waivero f-Bre.ach. Failure of Jefferson County to insist upon the strict performance of any of the
covenants of this Agreement or failure to exercise any option herein conferred i1,1 kiny one or more
instances shall not be construed to be a waiver or relinquishment of any other covenant of this
Agreement or any subsequent default of same covenant or condition.
21. Insolvency, If Contractor shall file a petition in Ninkruptcy, oj° if(lic (,,ontractor sliall be adjudged
bankrupt or insolvent by any court, or if a receiver ofthe property of"Contractor shall beippointed in
an hall make an assigni-nellt form
y proceeding brought by or against Contr"'Iclor, or if'Contr(tctoi- s
benefit of creditors, Jefferson County may, at its option, terminate this Agreement at any time.
22. Teni'dnalion for Defl,11111, Time is of the essence ()f this Agreement. In the event Contractor shall fail
to I<cel) and perform any of the covenants or conditions ofthis Agreement containcd, or should
Contractor for any reason be unwilling or unable to carry out said Agreement, then Jefferson County
may cancel this Agreement upon giving Contractor ten (10) days' notice in writing.
23. Notices. Notices to the County of Jefferson shall be sent to the following address:
Tami Pokorny, Project Manager
Jefferson County Environmental Health
615 Sheridan Street
Port Townsend, WA 98368
Ph: 360/379-4498
Ernail: tpokorny@cojefferson.wa.us
Notices to Consultant shall be sent to the following address:
Ronald A. Griffey, President
Zephyr's, Inc.
PO Box 35
Allyn, WA 98524
Ph: 360/275-2861
Email: rnvgi-iffey@aol.com
24. A It( 1_qlir s qLBreych. In the event of a breach of the contract by either party, the breaching party
shall be liible to the non -breaching party for all damages sustained as a result thereof; including
consequential damages, reasonable legal expenses incurred, expert witness fiees �.,,md any costs of suit.
25. DiscriminationProhibited. The Contractor, with regard to the work performed by it under this
agreement, . ...... . ..... origin, religion, creed, age,
Wi 11 not discriminate on the grounds of race, color, national oi
sex, or the presence of any physical or sensory handicap in the selection and retention of employees
or procurement of materials or supplies.
26. 1 te A g iL Lg. This Agreement represent the entire and integrated agreement between the
'n gral-od....
Counly and the Contractor and supersedes all prior negotiations, representations, or agreements
written or oral. This agreement may be amended only by written instrument signed by both the
County and Contractor.
27. A tit Contractor has authorized the person signing this Contract on its
behalfto sign this Agreement and to bind the Contractor to all the terms and conditions listed herein.
Zephyr's, Inc. - Duckabush and Bi,� ,Iuilcene Demolition Project
SIGNATURE PAGE
DATED this day of 2016
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Ronald A. Griffev. President
Name of Consultant Kath I e�il
(Signature) Phil John
UBI #601 706 026
Contractor's License #ZEPHYI — 033C0
Employment Security Department #877209003 David
Date
ler.Oiairwonuan
6ifiv"Ain. Member
)proved as to forn" Mily: 3
David Alvarez Date
Deputy Prosecuting Attorney
Zephyr's, Inc. - Duckabush and Bi�, ,,,uilcene Den7oliflon Project
Exhibit A
Scope of Work
This project involves two locations:
1. Overbrook Lane (Duckabush Floodplain) APN# 502 171 006
2. 195 Rodgers St. (Big Quilcene Floodplain) APN# 991200 301
FOR EACH PROJECT LOCATION SEPAR.4 TEL Y, establish and maintain safe access and traffic control,
dcinolisl'j, remove or decommission, and haul to an approved waste site, all maninade structi.1rcs,
and on-site systenis located on each site, scarify drive ways sand other cornaed areas,
overlay native topsoil, and re -seed and mulch while protecting the site from erosion such that:
• Reasonable access is established. Vehicle, pedestrian and nearby property owner safety is
assured. Roads are restored to original condition after work is completed.
• Any necessary permits and authorizations from Jefferson County Public Works and utility
providers are obtained. (Demolition permits will be applied for by Environmental Health.)
• All existing utility connections are safely located, discontinued, disconnected and removed.
• All buried utilities are protected from damage.
• Remains of all structures, tree house, concrete, lumber, beams, appliances and man-made debris,
household waste and all litter are removed and disposed of properly.
• Any and all roadside culverts, surface drains, and driveway entrances are removed and the ground
re-contoured to match the existing ditches.
• Any spoils from the roadside ditches are used to bring the existing grades under the demolished
or removed buildings to be level with the adjacent present grades.
• Existing trees are protected from damage to the extent feasible.
• There is no trespassing onto adjacent properties.
• Driveways, parking areas, and other areas devoid of vegetation are ripped to a depth of at least
twelve inches and overlain with adjacent topsoil to a depth of at least six inches.
• All disturbed areas are finely graded or raked in preparation for seeding.
• All disturbed areas are hand -seeded with a mixture of weed-fi-ee native grasses and overlain with
generous quantities of clean straw. Grass seed mix is to be approved in advance by Jefferson
County.
• The final project site is clean and 11- ' ce of litter " ' and manmade materials, matches existing contours,
seeded and controlled for erosion, and ready for replanting with bare root seedlings.
4D
The Contractor shall provide all labor, materials, tools, equipment, transportation and services and shall
perform all work required for executing file Conti -act in a satisfactory and professional nianner to provide
a complete project. Care shall be taken to minimize disturbance to nearby property owners while work is
in progress. Work schedules and access shall be coordinated through Jefferson County U'rivironniental
Health. Work may be suspended by the County at any time due to rain or adverse soil conditions. Vehicle
and equipment parking on-site during the project is at the owner's own risk.
Solid waste removed from the site shall be disposed of at the Jefferson County Transfer Station in Port
Townsend or Olympic View tion
anBnI n ot be dumped at the
Jefferson County transfer stalocated in Quilcene. Household hazardous waste, such as paint, solvent,
etc,, which 111USt be diSpOsed (.,)f at the Jefferson or Kilsap County Moderate Risk Waste J`acilit y, Tile
Contractor shall as proof that all materials have been disposed of in an acceptable
manner.
Zephyr's, Inc. - Duckabush and Bi,, _,uilcene Demolition Project
!q!L il)CLII-I-ed including focs at all
The Contractor shall be re
Jefferson and Kitsap County facilities. Burning of materials by the contractor (either on- or oil' site) is not
allowed by Washington State law, unless conducted by a F"ire Department as a tI-jIiIIiII
fire, subject to all
applicable permits and regulations. No such training fire will be conducled as, I)aft Of this PI-09cet.
6
Demolition Project
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION
The Contractor certifies to the best of its knowledge and belief, that it and its principals:
(l ) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency;
(2) Have not within a 3 -year period preceding this proposal been convicted of or had a civil judgment
rendered against them for commission of 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 statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen properly;
(3) 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 (2) of
this certification; and
(4) Have not within a 3 -year period preceding this contract had one or more public transactions
(Federal, State, or local) terminated for cause or default.
Where the Contractor is unable to certify to any of the statements in this certification, such Contractor
shall attach an explanation.
..
Name of Contractor (Please print)
Name and Title of Authorized Representative (Please print)
Signature oi`Authorize Re)AcMit<t.ive
I am unable to certify to the above statement An explanation is attached.
10
Zephyr's, Inc. - Duckabush and Big 2uilcene Demolition Project
CONTRACTOR'S DECLARATION OF OPTION FOR CONTRACTS FOR LESS THAN
$35,000
A. A Contract Bond will be provided as required.
Date _ Signed
B. In lieu of providing a Contract Bond, the County will withhold 50% of the Contract amount.
Date . Signed
11
Duckabush,
CONTRACT BOND
JEFFERSON COUNTY, WASHINGTON
KNOW ALL MEN BY THESE PRESENTS:
That __...... of
as Principal, and
as Surety, are jointly and severally held and bound unto the
COUNTY OF JEFFERSON, the penal sum of _.............. .--- ----- — ---.....Dollars ($), for the payment of
which we jointly and severally bind ourselves, or heirs, executors, administrators, and assigns, and successors and
assigns, firmly by these presents.
The condition of this bond is such that WHEREAS, on the day of , A.D., 2009,—the said
Principal herein, executed a certain contract with the County of Jefferson, by
the terms, conditions and provisions of which contract the said _,,,.,....y _...__. Principal herewith,
agrees to furnish all materials and do certain work, to -wit: That the said Principal herein will undertake and complete
the following described work:
mm R, in Jefferson County,
Washington, as per maps plans and specifications made a art of said cont
gt � � p p p Tact, which contract as so executed, is
hereunto attached, and is now referred to and by this reference is incorporated herein and made a part hereof as full for
all purposes as if here set forth at length.
NOW TH E' 1� 1�1 -"0 IZE, if the Princil')al herein shall f rithfully and truly observe and coinply with the tears,
conditions and provisions of said contract, in all respects and shall well sand truly and fully do and perform all matters,
and things by the said Principal undertaken to be performed under said contract, upon the terns proposed therein, and
within the time prescribed therein, and until the sane is accepted, and shall pay all laborers, i'viec:hanics, subcontractors
and materialmen, and all persons Nvlio shall supply such contractor or subcontractor wish provisions and suppliesfor
the carrying on of such work, and shall in all respects faithfully perform said contract according to law, then this
obligation to be void, otherwise to remain in full force and effect.
WITNESS our hands this day of_ ._...... .-. _ .........m....,.�, 200.
PRINCIPAL
APPROVED AS TO FORM ONLY this
day of _–- ,,,,,200_.
Prosecuting Attorney
SURETY COMPANY
Attorney-in-fact
Address of local office and agent
of surety company:
12
Zephyr's, Inc. - Duckabush and Br., uilcene Demolition Project
CONTRACTOR'S DECLARATION OF OPTION FOR MANAGEMENT OF
STATUTORY RETAINED PERCENTAGE
A. I hereby elect to have the retained percentage of this contract held in a fund by the Owner until
(30) days following final acceptance of the work.
Date Signed „Or��, "
c�
B. I hereby elect to have the Owner deposit the retained percentage of this contract in an interest
bearing account, not subject to withdrawal until after final acceptance of the work.
Date
Signed
C. I hereby elect to have the Owner invest the retained percentage of this contract from time to time
as such retained percentage accrues.
I hereby designate
said funds.
as the repository for the escrow of
I hereby further agree to be fully responsible for payment of all costs or fees incurred as a result of
placing said retained percentage in escrow and investing it as authorized by statute. The Owner shall not
be liable in any way for any costs or fees in connection therewith.
Date
Signed
13