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HomeMy WebLinkAbout100719_ca03 Department 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 Enginee Agenda Date: October 7, 2019 Subject: Execute Contract for the Jefferson County Transfer Station: Site Improvement Project Project # 40120403 Statement of Issue: The Execution of a Construction Contract for site improvements, including compacted fill, a cast in place concrete foundation to receive a 14'x56' modular office with canopy. Includes other work such as utility connections, concrete and asphalt paving in several locations. Analysis/Strategic Goals/Pro's Et Con's: This procurement has been done via the Competitive Sealed Bidding Process. Nordland Construction Northwest, of Nordland, WA was found to be the most responsive and responsible Bidder. This project consists of improvements to the Jefferson County Solid Waste Transfer Station site for the installation of a modular building, to be provided by the County. The site will be prepared, filled, and compacted for the construction of a cast in place concrete foundation, for the installation of the modular, with utility connections. Other elements include an emergency facewash, concrete paving, and a canopy. Site improvements such as gravel parking, asphalt paving, culvert replacement and site restoration in proximity to the Transfer Station will be installed Fiscal Impact/Cost Benefit Analysis: This project is funded with local funds. The contract amount, is ($237,620.00) tax inclusive. This project will support Transfer Station operations for the foreseeable future. Recommendation: We recommend that this Contract (three originals) for construction be signed by the Board. Please sign the three originals, retaining one for your records, and return two originals to Public Works. Department Contact: Gordon D. Ramstrom, Architectural Project Planner, 360-385-9380 R =w-d ,i,, /v-i//(-7---, ( ..a.h efr ihp Mort,y, Co ty 4dministrat Date Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 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 and the Director of Public Works under and by virtue of Title 36, R.C.W,as amended and NORDLAND CONSTUCTION NW, Inc. of Nordland, WA,98358 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: The Contractor agrees to furnish all labor and equipment and do certain work,to-wit: The scope of work is for a\\ 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: This project consists of improvements to the Jefferson County Solid Waste Transfer Station site for the installation of a modular building,to be provided by the County. The site will be prepared,filled and compacted for the construction of a cast in place concrete foundation,for the installation of the modular,with utility connections. Other elements include an emergency facewash,concrete paving,and a canopy. Site improvements such as gravel parking,asphalt paving,culvert replacement and site restoration in proximity to the Transfer Station will be installed. The site address is 325 County Landfill Rd., Port Townsend, WA 98368. for the total sum of Two hundred thirty seven thousand, six hundred twenty and 00/100 dollars ($237,620.00) in accordance with and as described in the attached plans and specifications and in the AIA Document A201 2017`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 as follows:within ninety(110)calendar days after the Notice to Proceed to the point of Substantial Completion. 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 Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 1 of 10 Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 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. Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 2 of 10 Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 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 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. Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 3 of 10 Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 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. 4.24.1 15 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 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. nLimited Small Works Project per RCW 39.04.155(3): Performance Bond and Retainage Waived INDEX OF EXHIBITS X Exhibit A: Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion Fd^I Exhibit B: Certification of Compliance with Wage Payment Statues X 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 Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 4 of 10 • Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 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 q 0 ,2019 Contractor: (Please print) By: "12-40 AA' .YGii-rdSo/V (Please print) (Signature) State of Washington,Contractor Registration Number COUNTY OF JEFFERSON BOARD OF COMMISSIONERS Kate Dean, District 1 David Sullivan, District 2 Greg Brotherton, District 3 Approved as to form only: 0 c• / /4 Philip C. Hunsucker D t✓ Chief Civil Des ' :-= utor LI Monte Rein.ers, P.E. r- Date Public Works Director/County Engineer Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 5 of 10 Jkilcrs:un Count) Public: \\ork FRANSFER S 1 .11 ION: SI FE IMPROVE v11-ti I I'RI)JN. l t{)l 20-12; 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. Oactkna CuNcruk( ‘nc,. Name of Contractor(Please print) n ri�n t1 Pia S 1 clg Name and Title of Aut orized Representative(Please print) Signature of Authorize Representative ❑ I am unable to certify to the above statement. An explanation is attached. Construction Contract, Contract F, ersion 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 6 of 10 Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 EXHIBIT B CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. The undersigned bidder hereby certifies that,within the three-year period immediately preceding the bid solicitation date August 8,2019 the bidder is not a"willful"violator,as defined in RCW 49.48.082,or any of the provisions of chapters 49.46,49.48, or 49.52 RCW 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. Bidder's Business Name Signature of Authorized Official* k k..„\41 Printed Name (e 5 >1E Title ,23n sof-Aland << D e City State Check One: Sole Proprietorship 111Partnership ElJoint Venture IT Corporation State of Incorporation, or if not a corporation, State where business entity was formed: If a co-partnership, give i name under which business is transacted: I A *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. ,Bond No. 0227049 Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 EXHIBIT C CONTRACT BOND JEFFERSON COUNTY,WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That Nordland Construction Northwest, Inc. ,of 123 Ponderosa Place, Nordland, WA 98358 ,as Principal, and Berkley Insurance Company , as Surety, are jointly and severally held and bound unto the COUNTY OF JEFFERSON,the penal sum ofTwo Hundred Thirty Seven Thousand Six Hundred Twenty&NonODoll ($237,620.00 )� 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 7th day of OctoberA.D.,2019,the said Nordland Construction Northwest, Inc. ,Principal herein,executed a certain contract with the County of Jefferson,by the terms,conditions and provisions of which contract the said Nordland Construction Northwest, Inc.,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:This project consists of improvements to the Jefferson County Solid Waste Transfer Station site for the installation of a modular building,to be provided by the County. The site will be prepared,filled and compacted for the construction of a cast in place concrete foundation,for the installation of the modular,with utility connections. Other elements include an emergency facewash,concrete paving,and a canopy. Site improvements such as gravel parking,asphalt paving,culvert replacement and site restoration in proximity to the Transfer Station will be installed. The site address is 325 County Landfill Rd.,Port Townsend,WA 98368,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 7th day of October ,2019 Nordland Construction Northwest, Inc. Berkley Insurance Company PRINCIIPPAL�- ,, ! SURETY COMPANY By: e't / ✓ By: moi. _.. ' - - es egg, Agent B 410 4.4.112.&A Attorney-in-fact.ludith C. Kaiser-Smith Address of local office and agent of surety company: PayneWest Insurance, Inc. 501 N. Riverpoint Blvd., Suite 403 Spokane,WA 99202 James Clegg,Agent 509-789-7438 Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 10 of 10 No.BI-7801i POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON,DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. -D KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly cl organized and existing under the laws of the State of Delaware,having its principal office in Greenwich,CT,has made,constituted CL) and appointed, and does by these presents make, constitute and appoint: James E. Majeskey II;Judith C. Kaiser-Smith; Thomas .F. V.A. Davis;Shanalee E. Steele;Jaclyn R. Kruse; or Melissa Wolf of Payne West Insurance,Inc. of Spokane, WA its true and ;? ? lawful Attorney-in-Fact,to sign its name as surety only as delineated below and to execute,seal,acknowledge and deliver any and c all bonds and undertakings, with the exception of Financial Guaranty Insurance,providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.S50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. cn = This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, in without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following 'o t resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010: c RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief E c Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein o y to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such o •c attorney-in-fact and revoke any power of attorney previously granted;and further ° o RESOLVED,that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, :E or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated;and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and p c further o o, RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any . power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company;and such signature and seal when so used shall have the same force and effect as E though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company,notwithstanding the fact that they may have E ceased to be such at the time when such instruments shall be issued. IIN WITNESS WHEREOF, the Com y has caused these presents to be signed and attested by its appropriate officers and its o 2 corporate seal hereunto affixed this(,"day of f'L _ O • ct Attest: Berk! Insurance Company -g (Seal) By By . Ir . ederman < Je . 9 after Executive Vice President&Secretary Se ' e ' sident cn i O .D E WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE"BERKLEY"SECURITY PAPER cn STATE OF CONNECTICUT) E ) ss: N o COUNTY OF FAIRFIELD ) tSworn to before me,a Notary Public in the State of Connecticut, this 194 day of tI7 , (1 , by Ira S. Lederman c and Jeffrey M. Rafter who are sworn to me to be the Executive Vice President ��S�ecrretaryy,, and Senior Vice vtPresident, . respectively,of Berkley Insurance Company. No VRrPuet Ict. OLX CONNECTICUT MY COMMISSION I o IEXPIRES44otary Public,State of Connecticut CERTIFICATE .E I,the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY,DO HEREBY CERTIFY that the foregoing is a C4 S' true, correct and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded 3 s and that the authority of the Attorney-in-Fact set forth therein, who executed the bond or undertakin• to which this Power of Attorney is attached,is in full force and effect as of this date. Given under my hand and seal of the Company,this 7th day of Oct• - €41,2019 . (Seal) 4 . J`►' Vincent P.Forte Please verify the authenticity of the instrument attached to this Power by: Toll-Free Telephone: (800) 456-5486; or Electronic Mail: BSGlnquiry@berkleysurety.com Any written notices, inquiries, claims or demands to the Surety on the bond attached to this Power should be directed to: Berkley Surety 412 Mount Kemble Ave. Suite 310N Morristown, NJ 07960 Attention: Surety Claims Department Or Email: BSGClaim@berkleysurety.com Please include with all communications the bond number and the name of the principal on the bond. Where a claim is being asserted, please set forth generally the basis of the claim. In the case of a payment or performance bond, please also identify the project to which the bond pertains. Berkley Surety is a member company of W. R. Berkley Corporation that underwrites surety business on behalf of Berkley Insurance Company, Berkley Regional Insurance Company and Carolina Casualty Insurance Company. Jefferson County Public Works TRANSFER STATION: SITE IMPROVEMENT PROJECT #40120423 - 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 Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 9 of 10 I Jefferson tcrsurn Count Public NA arks I RyNSFLR S I .1 t ION: SITE IMI'ROVI AI[:N f l'ROJI C I x401204 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. DateSacELAUCAci Signed /r'+. 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 Construction Contract, Contract F, Version I, Risk Legal Review Date xx/xx/xxxx(TBD) Page 10 of 10 NORDCON-02 MNEIGHBORS ,4coRl7" CERTIFICATE OF LIABILITY INSURANCE DATD/YYY' 9//17/217/2019 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 have ADDITIONAL INSURED provisions or 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 COI�ITACT NAME: Spokane Office PHONE Paynewest Insurance,Inc. (A/C,No,Ext):(509)838-3501 FAX No):(509)8384511 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:BITCO General Insurance Corp 20095 INSURED INSURER B Nordland Construction Northwest,Inc. INSURER C 123 Ponderosa PI INSURER D: Nordland,WA 98358 INSURER E: 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 CONTRACT OR 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. LTR TYPE OF INSURANCE INSD WVDR POUCY NUMBER POUCY EFF POLICY EXP UNITS (MM/DD/YYYY) IMMIDD/YYYY► A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 3682173 5/28/2019 5/28/2020 DAMAGE TO RENTED 300,000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 POLICY X Pyr LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X ANY AUTO X x CAP 3682174 5/28/2019 5/28/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTEO�S ONLY _ AUTOSBODILYBODILY INJURY(Per accident) $ _ AUTOS ONLY _ AUTOS ONLYY ��gOPERd�tDAMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS UAB CLAIMS-MADE CUP2817403 5/28/2019 5/28/2020 AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER ETH AND EMPLOYERS'LIABILITY Y/N AApNYCCPRROO/PMMRIIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ QFFICatory in NH)EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Transfer Station:Site Improvement Project/County Project#40120423-Jefferson ounty Transfer Station,325 County Landfill Rd.Port Townsend,WA 98368 Jefferson County is additional insured,on a primary/non-contributory basis,including waiver of subrogation,as per the attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, Jefferson County ACCORDANCE WITH THE POLICY PROVISIONS.NOTICE WILL BE DELIVERED IN P.O.Box 1220 Port Townsend,WA 98368 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD