HomeMy WebLinkAbout082619_ca10615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
Public Healt consent Agenda
March 5, 2019
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Stuart Whitfield, Environmental Public Health Director
Tami Pokorny, Natural Resources Program Coordinator
DATE: atjttot 2J -e, Z,0 l�
SUBJECT: Agenda Item — Project Agreement with F.S. and G.S. Services, Inc.; Upon
Signature — 30 days from Notice to Proceed; for $5,975 + tax of $537.75 for a
total of $6,512.75
STATEMENT OF ISSUE:
Jefferson County Public Health requests approval of Project Agreement with F.S. and G.S. Services, Inc.;
Upon Signature — 30 days from Notice to Proceed; for $5,975 + tax of $537.75 for a total of $6,512.75.
ANALYSIS STRATEGIC GOALS PRO'S and CON'S:
F.S. and G.S. Services, Inc. is retained by the County to remove and properly dispose of all asbestos -
containing materials from the 1,000 square -foot house located at 231 Rodgers St. in Quilcene, WA that
were identified in the inspection report by NWA Northwest Environmental dated September 25, 2018.
FISCAL IMPACT COST BENEFIT ANALYSIS:
Funding for the Project Agreement is provided by RCO #15-1189, Big Quilcene River Floodplain Key
Pieces project matched with the Public Works Quilcene Floodplain Acquisition Account #5533Q.61.000.
There is no impact to the Jefferson County General Fund for this agreement.
RECOMMENDATION:
JCPH Management recommends BOCC signature of the Project Agreement with F.S. and G.S. Services, Inc.;
Upon Signature — 30 days from Notice to Proceed; for $5,975 + tax of $537.75 for a total of $6,512.75.
/_� ///7
Philip Orley, Cqu Administratoor Date
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
CONTRACT
JEFFERSON COUNTY, WASHINGTON
THIS AGREEMENT, made and entered into this day of , 2019, between the
COUNTY OF JEFFERSON, acting through the Jefferson County Commissioners under and by virtue of Title 36,
R.C.W, as amended and F.S. and GS. Services, Inc. of Puyallup, WA hereinafter called the Contractor.
WITNESSETH:
That in consideration of the terms and conditions contained herein and attached and made a part of this agreement,
the parties hereto covenant and agree as follows:
1. The Contractor agrees to furnish all labor and equipment and do certain work, to -wit: That the Contractor
herein will undertake and complete the following described work: Remove and properly dispose of all asbestos -
containing materials from the 1,000 square -foot house located at 231 Rodgers St. in Quilcene, WA that were
identified in the inspection report by NWA Northwest Environmental dated September 25, 2018. Disposal must be
at the Kitsap County Olympic View Transfer Station. Thoroughly clean up all areas affected by the work. The house
may be offered for sale, moved to a new location and re -occupied. The certified abatement contractor shall comply
with all federal, state and local regulations when performing any work.
The work schedule is to be coordinated with the project manager to reduce impacts of activities to surrounding
property owners. The Contractor will be reimbursed for all work performed under the terms of this contract in an
amount not exceed six -thousand five hundred twelve dollars and seventy-five cents ($6,512.75). All work will be
performed in accordance with and as described in the AIA Document A201 2007 `General Conditions of the Contract
for Construction' which are by this reference incorporated herein and made a part hereof. The Contractor shall
perform any alteration in or addition to the work provided in this contract and every part thereof.
The Contractor shall complete the described work within 30 days after the Notice to Proceed.
The Contractor shall provide and bear the expense of all equipment, work and labor of any sort whatsoever
that may be required for the transfer of materials and for constructing and completing the work provided for in this
contract and every part thereof.
2. The County of Jefferson hereby promises and agrees with the Contractor to employ, and does employ the
Contractor to furnish the goods and equipment described and to furnish the same according to the attached
specifications and the terms and conditions herein contained, and hereby contracts to pay for the same according to
the attached specifications and the schedule of unit or itemized prices hereto attached, at the time and in the manner
and upon the condition provided for in this contract. The County further agrees to employ the Contractor to perform
any alterations in or additions to the work provided for in this contract that may be ordered and to pay for the same
under the terms of this contract and the attached specifications at the time and in the manner and upon the conditions
provided for in this contract.
3. The Contractor for himself, and for his heirs, executor, administrators, successors, and assigns, does hereby
agree to the full performance of all the covenants herein contained upon the part of the Contractor.
4. Prior to commencing work, the Contractor shall obtain at its own cost and expense the following insurance
from companies licensed in the State with a Best's rating of no less than A: VII. The Contractor shall provide to the
County Risk Manager certificates of insurance with original endorsements affecting insurance required by this clause
prior to the commencement of work to be performed.
The insurance policies required shall provide that thirty (30) days prior to cancellation, suspension, reduction
or material change in the policy, notice of same shall be given to the County Risk Manager by registered mail, return
receipt requested, for all of the following stated insurance policies.
If any of the insurance requirements are not complied with at the renewal date of the insurance policy,
payments to the Contractor shall be withheld until all such requirements have been met, or at the option of the County,
the County may pay the renewal premium and withhold such payments from the moneys due The Contractor.
All notices shall name the Contractor and identify the agreement by contract number or some other form of
identification necessary to inform the County of the particular contract affected.
A. Workers Compensation and Employers Liability Insurance. The Contractor shall procure and
maintain for the life of the contract, Workers Compensation Insurance, including Employers Liability
Coverage, in accordance with the laws of the State of Washington.
B. General Liability(1) - with a minimum limit per occurrence of one million dollars ($1,000,000) and
an aggregate of not less than two million dollars ($2,000,000) for bodily injury, death and property damage
unless otherwise specified in the contract specifications. This insurance coverage shall contain no limitations
on the scope of the protection provided and indicate on the certificate of insurance the following coverage:
1. Broad Form Property Damage with no employee exclusion;
2. Personal Injury Liability, including extended bodily injury;
3. Broad Form Contractual/Commercial Liability including completed operations (contractors only);
4. Premises - Operations Liability (M&C);
5. Independent Contractors and Subcontractors; and
6. Blanket Contractual Liability.
(1) Note: The County shall be named as an additional insured party under this policy.
C. Automobile (2) - with a minimum limit per occurrence of $1,000,000 for bodily injury, death and
property damage unless otherwise specified in the contract specifications. This insurance shall indicate on
the certificate of insurance the following coverage:
1. Owned automobiles;
2. Hired automobiles; and,
3. Non -owned automobiles.
(2) Note: The County shall be named as an additional insured party under this policy.
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 shall procure a bond guaranteeing payment of losses and related
investigations, claim administration and defense expenses.
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 to take out and/or maintain any required insurance shall not relieve The Contractor
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 Contractor.
It is agreed by the parties that judgments for which the County may be liable, in excess of insured amounts
K
provided herein, or any portion thereof, may be withheld from payment due, or to become due, to the Contractor until
such time as the Contractor 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 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 Contractor must provide in
order to comply with this Agreement.
If the proof of insurance or certificate of coverage indicating the County is an "additional insured" to a
policy obtained by the Contractor 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 Contractor to obtain the full text of that endorsement and
forward that full text to the County within 30 days of the execution of this Agreement.
The County may, upon the Contractor's failure to comply with all provisions of this contract relating to
insurance, withhold payment or compensation that would otherwise be due to the Contractor.
5. The Contractor shall comply with all Federal, State, and local laws and ordinances applicable to the work to
be done under this Agreement. This Agreement shall be interpreted and construed in accord with the laws of the
State of Washington and venue shall be in Jefferson County, WA.
The Contractor shall indemnify and hold the County, and its officers, employees, and agents harmless from
and shall process and defend at its own expense, including all costs, attorney fees and expenses relating thereto, all
claims, demands, or suits at law or equity arising in whole or in part, directly or indirectly, from the Contractor's
negligence or breach of any of its obligations under this Agreement; provided that nothing herein shall require a
Contractor to indemnify the County against and hold harmless the County from claims, demands or suits based
solely upon the conduct of the County, its officers, employees and agents, and; provided further that if the claims or
suits are caused by or result from the concurrent negligence of: (a) the Contractor's agents or employees; and, (b)
the County, its officers, employees and agents, this indemnity provision with respect to claims or suits based upon
such negligence, and/or the costs to the County of defending such claims and suits, etc., shall be valid and
enforceable only to the extent of the Contractor's negligence, or the negligence of the Contractor's agents or
employees.
Claims against the County, shall include, but not be limited to assertions that the use and transfer of any
software, book, document, report, film, tape, or sound reproduction of material of any kind, delivered hereunder,
constitutes an infringement of any copyright, patent, trademark, trade name, or otherwise results in an unfair trade
practice or an unlawful restraint of competition.
The Contractor specifically assumes potential liability for actions brought against the County by
Contractor's employees, including all other persons engaged in the performance of any work or service required of
the Contractor under this Agreement and, solely for the purpose of this indemnification and defense, the Contractor
specifically waives any immunity under the state industrial insurance law, Title 51 R.C.W. The Contractor
recognizes that this waiver was specifically entered into pursuant to provisions of R.C.W. 4.24.115 and was subject
of mutual negotiation.
6. The Contractor's relation to the County shall be at all times as an independent Contractor, and nothing
herein contained shall be construed to create a relationship of employer-employee or master -servant, and any and
all employees of the Contractor or other persons engaged in the performance of any work or service required of the
Contractor under this Agreement shall be considered employees of the Contractor only and any claims that may
arise on behalf of or against said employees shall be the sole obligation and responsibility of the Contractor.
7. The Contractor shall not sublet or assign any of the services covered by this contract without the express
written consent of the County or its authorized representative. Assignment does not include printing or other
3
customary reimbursable expenses that may be provided in an agreement.
8. Nothing in the foregoing clause shall prevent the County, at its option, from additionally requesting that the
Contractor deliver to the County an executed bond as security for the faithful performance of this contract and for
payment of all obligations of the Contractor.
For contracts of $150,000 or less, the County and the Contractor may agree that in -lieu of the Contract
Bond; the County will withhold 10% of the Contract amount in accordance with R.C.W 39.08.010. If applicable,
the Contractor will indicate this option on Exhibit D.
9. The Contractor will declare a management option of the statutory retained percentage on Exhibit E.
Limited Small Works Project per RCW 39.04.155(3): Performance Bond and Retainage Waived
INDEX OF EXHIBITS
X71
^ I Exhibit A: Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion
X1 Exhibit B: Certification of Compliance with Wage Payment Statues
Exhibit C: Contract Bond, Jefferson County, Washington
Exhibit D: Contractor's Declaration of Option for Contracts for Less Than $150,000
X� Exhibit E: Contractor's Declaration of Option for Management of Statutory Retained Percentage
4
IN WITNESS WHEREOF, the Contractor has executed this instrument on the day and year first below written, and
the Board of County Commissioners has caused this instrument to be executed by and in the name of said County of
Jefferson the day and year first above written.
Executed by the Contractor 2019
Contractor:
(Please print)
By:
(Please print)
(Signature)
State of Washington Certified Asbestos Abatement Contractor
#ABCN00001022 Exp. 07/06/2019
COUNTY OF JEFFERSON
BOARD OF COMMISSIONERS
Kate Dean, Chair
David W. Sullivan, Member
Greg Brotherton, Member
Approved as to form only:
1?liila}rhmsrr er - w�; k, I Date
Cbaef Civil Deputy Prosecutor
Carolyn Gallaway, Deputy Clerk of the Board
5
EXHIBIT A
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION
The Contractor certifies to the best of its knowledge and belief, that it and its principals:
(1) 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 property;
(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 of Authorize Representative
❑ I am unable to certify to the above statement. An explanation is attached.
EXHIBIT B
CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES
The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date
), the bidder is not a "willful" violator, as defined in R.C.W 49.48.082, of any provision of chapters 49.46, 49.48, or
49.52 R.C.W, as determined by a final and binding citation and notice of assessment issued by the Department of
Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.
Bidder's Business Name
Signature of Authorized Official*
Printed Name
Title
Date City State
Check One:
Sole Proprietorship ❑ Partnership ❑ Joint Venture Corporation ❑
State of Incorporation, or if not a corporation, State where business entity was formed:
If a co -partnership, give firm name under which business is transacted:
* If a corporation, proposal must be executed in the corporate name by the president or vice-president (or any
other corporate officer accompanied by evidence of authority to sign). If a co -partnership, proposal must be
executed by a partner.
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EXHIBIT C
CONTRACT BOND
JEFFERSON COUNTY, WASHINGTON
KNOW ALL MEN BY THESE PRESENTS:
That
and
'of , as Principal,
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., 20 the said
Principal herein, executed a certain contract with the County of Jefferson, by
the terms, conditions and provisions of which contract the said , 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:
in Jefferson County,
Washington, as per maps, plans and specifications made a part of said contract, 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 THEREFORE, if the Principal herein shall faithfully and truly observe and comply with the terms,
conditions and provisions of said contract, in all respects and shall well and truly and fully do and perform all matters and
things by the said Principal undertaken to be performed under said contract, upon the terms proposed therein, and within
the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and
materialmen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for 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 , 20
PRINCIPAL
I
SURETY COMPANY
By:
By:
Attorney-in-fact
Address of local office and agent
of surety company:
EXHIBIT D
CONTRACTOR'S DECLARATION OF OPTION FOR CONTRACTS FOR LESS THAN $150,000
A. A Contract Bond will be provided as required.
Date _ Signed
B. In lieu of providing a Contract Bond, the County will withhold 10% of the Contract amount.
Date Signed
m
EXHIBIT E
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
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 _ as the repository for the escrow of said funds.
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
D. I hereby elect to provide a Retainage Bond in accordance with R.C.W 60.28.011.
Date Signed
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Quilcene Floodplain Asbestos Abatement Project
Jefferson County Environmental Public Health
Project No. 2019-0118
BID FORM
BIDDER: rs. 6LI14 G J S S IM. I U2_14 5 rl Ave E S+f A , PVA allu f INA °I $%
(name, address, telephone number of bidder) 253` 54 -01 1
SCOPE:
Remove and properly dispose of all asbestos -containing materials from the 1,000 square -foot house
located at 231 Rodgers St. in Quilcene, WA that were identified in the inspection report by NWA
Northwest Environmental dated September 25, 2018. Disposal must be at the Kitsap County Olympic
View Transfer Station. Thoroughly clean up all areas affected by the work. The house may be offered for
sale, moved to a new location and re -occupied. The certified abatement contractor shall comply with all
federal, state and local regulations when performing any work under the resulting contract.
To: Jefferson County Environmental Public Health Dept.
Attn: Tarni Pokorny
615 Sheridan St.
Port Townsend, WA 98376
The Undersigned, having examined the site of the proposed work and related documents, being fully
qualified and certified to abate asbestos, including the availability of materials, services, and equipment
required in connection with or incidental to said construction in strict conformance with the above
mentioned documents, for the Bid Amount including all Addenda:
(Write Out) T Iyt d UsU of mint YbKnd waimm hw Mat ~/4o
5.,1-45.°o — -
5 3T *4s
(Dollars)
Washin-ton State Sales Tax (9.0%)
Total Bid (Including Sales Tax)
ADDENDA
Receipt of Addenda numbered_ N are hereby acknow ledued and all cost of Addenda work
ha\ e been included in the Total Bid cost of this proposal.
Quilcene Floodplain Asbestos Abatement Project
Jefferson County Environmental Public Health
Project No. 2019-0118
BID GUARANTEE
BID GUARANTEE
The undersigned furnishes herewith bid guarantee in the amount of 5% of the total of the base bid
proposal. This bid guarantee warrants that the undersigned will not withdraw his proposal for a period of
thirty (30) days after the scheduled closing time for the receipt of proposals. That if this proposal is
accepted, the undersigned will enter into a fon-nal contract prepared by Jefferson County and that the
required perforniance bond and payment bond will be given, In the event of the withdrawal of this
proposal within the period stipulated above, or the failure of the undersigned to enter into a contract and
give the required bonds within the ten (10) days after the undersigned has received notice of the
acceptance of this proposal, the undersigned shall be liable to the Owner for the full amount of the bid
guarantee as liquidated damages on account of the default of the undersigned.
A bid guarantee in an amount of five percent (5%) of the base bid total, in the form as indicated below, is
attached hereto:
CASH
POSTAL MONEY ORDER
CASHIER'S CHECK
CERTIFIED CHECK
PROPOSAL BOND xIf this option is taken, use the form on the next page
If a proposal bond is used, it shall be submitted on a form furnished or approved by the County and
signed by the bidder and his surety company. The surety's attorney in fact must be registered with the
Washington State Insurance Commission.
Bidder FS and GS_ SeVVU5, IKe.
By ��I S OhStreet address 'address J ty 2 I q+ Ave . E. Sfe.. A
City State Zip
- 253.548' 10 1 Telephone Number
1022 41 U /ILII
State of kk as hineton. .-\sbestos Abatement Contractor Certification Expiration Date
Quilcene Floodplain Asbestos Abatement Project
Jefferson County Environmental Public Health
Project No. 2019-0118
CONTRACT TIME OF COMPLETION c€ LIQUIDATED DANTAGES FORM
ABILITY OF CONTRACTOR TO MEET OWNER'S SCHEDULE:
1. Submit plan to abate the asbestos, including timeline, within 14 calendar days of the Notice to
Proceed to JCEPH.
2. Allow two weeks for review, revision and approval by JCEPH.
3. Complete Contract Work within thirty (30) days from the acceptance of the asbestos abatement
plan.
4. Ve agree to perforin the work according to the above requirements.
Bidder: flSv1 rlAt-J"X5. t Gg.&V.4s Date:
LIQUIDATED DAMAGES
In the event that the Contract Work is not completed at said time, the Contractor agrees to forfeit to the
Owner as liquidated damages the sum of One hundred Dollars ($100.00) for the first calendar day and
One Hundred Dollars ($100.00) for each and every additional day the work remains uncompleted.
10
F.S.& GS.
Services Inc.
February 20, 2019
Jefferson County Environmental Public Health
Attn: Ms. Tami Pokorny
615 Sheridan Street
Port Townsend, WA 98368
RE: Asbestos Abatement at 231 Rodgers Street, Quilcene, WA.
Scope: Remove and dispose of the identified asbestos materials as noted in the Northwest
Environmental AHERA Good Faith Survey, dated 9-25-2018. Materials and approximate
quantities to be removed are as follows: Bathroom tile and vinyl, 45 SF and Upstairs floor tile,
320 SF.
Dear Tami,
Following is our quote for the above noted project.
Bid Amount for Asbestos Abatement ......................................... $5,975.00
Notes: Quote includes Notification to Labor and Industries, Prevailing Wages, 5% Bid Bond,
Payment and Performance Bond, travel time, labor, abatement, rental (if needed), air monitoring
and disposal. Includes disposal at Kitsap County Olympic View Transfer Station. Insurance is per
standard policy limits-G/L $2M per occurrence. Additional policy limits are available at a
premium.
Not Included In This Quote:
• Washington State Sales Tax
Demolition/Moving the structure
• Notification to ORCAA
This quote is based on acceptance of mutually agreed upon contract terms. All work will be
performed in compliance with Federal, State, and Local regulations. Where job specifications are
more stringent, specifications will prevail. This quote is valid for 45 days. Thank you for giving
F.S. & GS. Services, Inc. the opportunity to furnish a quote for this project, Any questions please
contact Jason Kanar.
e ect fu lly
Jaso Kanar
V.P. f Operations
16214 57" Ave East, Suite A Phone: 253-548-1011
Puyallup, WA 98375 Fax: 253-536-8488
Quilcene Floodplain Asbestos Abatement Project
Jefferson County Environmental Public IIealth
Project No. 2019-0118
PROPOSAL BOM) FORM
PROPOSAL BOND
KNOW ALL MEN BY THESE PRESENTS, That+� , F.S. & GS Services, Inc.
of Puyallup, WA
and Insurance Company
principal, and the Contractors Bonding
a corporation duly organized under the laws of the state of Illinois _
and authorized to do business in the State of Washington, as surety, are held and firmly bound unto the
County of Jefferson in the full suns of five (5) percent of the total amount of the base bid proposal of said
principal for the work hereinafter described, for the payment of which, well and truly to be made, we bind
our heirs, executors, administrators and assigns, and successors and assigns, firmly by these presents.
The condition of this bond is such, that whereas the principal herein is herewith submitting his or its
sealed proposal for the following construction, to wit:
UUILCI N E FLOODPLAIN ASBESTOS ABA'1'EMEItT PROJECT— JCLPH Project No. 2019-0118`
said bid and proposal, by reference thereto, being made a part hereof. `T
NOW, THEREFORE, 11 the said proposed bid by said principal be accepted, and the Contract be awarded
to said principal, and if said principal shall duly make and enter into and execute said Contract and shall
furnish bond as required by Jefferson County within a period of ten (10) days from and after said award,
exclusive of the day of such award, then this obligation shall be null and void, otherwise it shall remain
and be in full force and effect.
IN TESTIMONY WHEREOF, The principal and surety have caused these presents to be signed and
sealed this _ 25th day of February 2019..
F.S.tr Serv�1�snr2' IS- toy
(Princip
Contractors Bonding and Insurance Compa(ly,%wilmol
ISurety) `aaa°� flili3ikQ rr�r'
•' • •i �. 'jri
COP .
0 q .
� • m Y
(Attorney-in-fact) J ie Craker t
',��r�ti� ��lttaal'a`aaao
11
POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: 800-645-2402
Know All Men by These Presents:
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and
together, the "Company") do hereby make, constitute and appoint:
Thomas l' 1jentschell. 11rarl Rnirertti Julio [Taker, Joanne Reinkensme yer ointly or severally
in the City of Tacoma -, State of Washington its true and lawful Agent(s) and Attomey(s) in Fact, with
full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all
bonds and undertakings in an amount not to exceed Twentv Five Million Dollars
( $25,000,000.00 1 for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been
executed and acknowledged by the regularly elected officers of the Company.
RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of
the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board
of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate
seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal may be printed by facsimile."
IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this 12th day of
April 2018 .
,'oNvn
a.
OpPOq,*
State of Illinois
SS
County of Peoria )))
On this _ 121h day of April . 2al8 , before me, a Notary Public,
personally appeared Bion W. Davis _ who being by me duly xwnrn,
acknowledged that he signed the above Powcr of Attorney as the aforesaid
officer of the ILLI Insurance Campan)• andlor Contractors Bonding and
Insurance Company and acknowledged said instrument to be the voluntary
act and deed of said corporation.
By: tV
Gretchen L. Jolmigk �7 Notary Public
■„■....... rWry rrrrrrrrrrrwr�
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1: 'OFFICIALSEAL'
Mey 26.
a0. • a ■
RLI Insurance Company
Contractors Bondingg and
,/
Insurance Company
By:
I-V
/ r /(/ ” y i
Barton W. Davis Vice President
CERTIFICATE
I, the undersigned officer of RLI Insurance Company and/or
Contractors Bonding and Insurance Company, do hereby certify
that the attached Power of Attorney is in full force and effect and is
irrevocable; and furthermore, that the Resolution of the Company as
set forth in the Power of Attorney, is now in force. In testimony
whereof, I have hereunto set my hand and the seal of the RLI
insurance Compimy and/or C2ptraccto 'y�ont�{ i a3 Insurance
i._ wnpjllky thi,j,, — day of r-->rj L— A19 LA��� iw3rrrrrr
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RLI Insurance Company Contractors Bonding and Insurance CW ay ��y CO4, ��4
By:
Jean M tephenson �,f ��, CtplroralG S� • !a[y
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4673779020212 A0058817