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Home My WebLink About4405+Enter Search Criteria, Press Esc Key to Transmit IPress Del Key to Terminate Delete Mode CHANGE Contract Transactions Contract Number 4405 Name T BAILEY INC ~Vendor RESERVOIR 19 STANDPIPE TANK REPAIR/SEISMIC UPGRADE iSubject Department PW&U Status Code CON Amount $48721.00 Begin Date 11/25/2003 Insurance End Date 01/31/2004 Type Amount Review Date 02/15/2006 GL $2000000.00 AL $1000000.00 Insurance Total $3000000.00 Insurance Review Date 09/01/2004 VAULT 01/01/2006 · ~.~ Stat~ of Washington .~."~ .D~partment of Revenue ~/~NU£ Olympia WA 98504-7474 Contractor's Registration No. (UBI No.) NOTICE OF COMPLETION OF PUBLIC WORKS CONTRACT From: ~ - ~- ~ ..... Assigned To ;~ · :' , ,: Date Assigned Notice is hereby Liven relative to the completion of contract or project described below Description of Contract Contract Numb? =,-...-, / <. ... .. .z/So Contractor's Name " ,' ' . Telephone Number Contractor s Address ? ' $' Date Work Commenced Date Work Completed . Date Work Accepted Sur~t~ ~or Bonding Company / . ..--: . ~ ..~ ~ /:: .' ~, ,". Agent's Add~:~ss0 / Contract Amount $ ~2 Amount Disburs~ $2,~..~.- .... .... Additions,-'7,~:",~";-~ ~c?..~ . ,5'-; Amount Retained ~'~- ¥"%.v. ;,=~:~ '~' Reductions r3. O~ TOTAL ./',-'/, ~ c/~- · $ '.? , , _c~ Amount of Sales Tax Paid at fl', ~ % -~-'~ .... " (If various rates appb7, please send a breakdown.) TOTAL ." g~ /"~:::,: ature / r' -: ' ~ Type or Print Name "~/' : ' ?' :/;//-':. :: Phone Number : c.' = .- The Disbursing Officer must complete and mail THREE copies of this notice to the Department of Revenue, P.O. Box 47474, Olympia, WA 98504-7474, immediately after acceptance of the work done under this contract. NO PAYMENT SHALL BE MADE FROM RETAINED FUNDS until receipt of Department's certificate, and then only in accordance with said certificate. To inquire about the availability of this document in an alternate format for the visually impaired or a language other than English, please call (360) 753-3217. Teletype (TTY) users may call (800) 451-7985. You may also access tax information on our Interact home page at http://dor.wa.gov. REV 310020 (7-13-99) ORIGINAl. ~ NO'~CE,OF FINA~ COMPLETION Notice of'final completion has.been filed with the Cty ~>f Bre~neAon on Wedr~sd~y February 11, 20Q4 by T Bailey, Inc., A~acgites, Wash- [ogton~ for c6ntract 4405- Reservoir. 19 - Standpipe Tan~ Re'pair~ & Seismic Upgrade lc- cared at 2628 Ash Street.~ Brem~Aon. Wash- ington · A~y part[es having a claim fqr materials, labor or damages with refenced tdthis ~ohBact have thir[y 30) d~ys from the date of firat public~ tioh of [hid nbtic~ to fie a c~aim William Eiey Purcha~ihg Managgr 239 4th Street Bremer~on, WA 98337 February 13. 2004 #100D.,~.~_631 Wasl'dngton State Department of Revenue PO Box 47474 Olympia, WA 98504-7474 601 351 925 Certificate of Payment of State Excise Taxes by Public Works Contractor T BAILEY INC CITY OF BREMERTON PUBLIC WORKS 12441 BARTHOLOMEW PdD DAN MILLER ANACORTES WA 98221 9327 3027 OLYMPUS DR NE BREMERTON WA 98310 4799 RECEIVED APR 0 5 200~ DEPT OF PUBLIC We hereby certify that taxes, increases and penalties due or to become due :on~I!I~ItI~t~vA~I~ILITIES contractor under Chapter 180, Laws of 1935, as amended, with respect to the foil-owing pu~-works contract: CITY OF BREMERTON PUBLIC WORKS 4405 RESERVOIR 19-STANDPIPE TAIqK REPAIR/SEISMIC UPGR together with ail other taxes, increases and penalties due from such contractor, have been paid in full or that they are, in the Department's opinion, readily collectible without recourse to the state's lien on the retained percentage. This certificate is issued pursuant to the provision of Chapter 60.28 Revised Code of Washington for the sole purpose of informing the state, county, or municipal officer charged with the duty of disbursing or authorizing the payment of public funds to said contractor that the Department of Revenue hereby releases the state's lien on the retained percentage provided by this Chapter for excise taxes due from said contractor. This certificate does not release said contractor from liability for additional tax that may be later determined to be due with respect to the above-mentioned contract or other activities. Dated i~/~[/~00¢ at Olympia, Washington, / '/ State of Washington Depart¢, ent of Revenue Certifying Offic4er "- - To inquire about the availability of tNs document in an alternate lo.at for the visually impaired or in a language other than English, please call (360) 753 3217 ~ users may call I 800 451-7985 REV 31 0028 (10-01-02) ROUT~G~~nuactor, File, Special Pile ~ RECEIVED STATE OF WASHINGTON EMPLOYMENT SECURITY DEPARTMEN- I'IAR 1 8 200~ PO Box 9046 e Olympia, WA 98507-9046 DEPT OF PUBLIC WORKS AND UTILITIES CONTRACTOR: T Bailey Inc. ) CERTI:FICATE OF 12441 Bartholomew Rd. ) PAYMENT OF CONTRIBUTIONS Anacortes, WA 98221-9327 ) PENALTIES AND INTEREST ON ) PUBLIC WORKS CONTRACT ES Reference No. 860375-000 TO: City of Bremerton Public Works & Utilities - Atto: Dan Miller 3027 Olympus Dr. Bremerton, WA 98310 The Employment Security Department hereby certifies that contributions, penalties and interest due from the above named contractor under the Employment Security Act have been paid in full or provided for with respect to the following public works contract: 4405 The Employment Security Department hereby certifies that it has no claim pursuant to RCW 50.24.130 against the public body named above for tax attributable to service performed for said public body by the above named contractor on the above described contract. The Employment Security Department releases its lien on the retained percentage which is provided by RCW 60.28.040 for contributions, penalties and interest due from said contractor. This cc~rtificate does not release said contractor from liability for additional contributions, penalties and interest which may be later determined to be due with respect to the above mentioned contract. Dated at Olympia, Washington on March 17, 2004. COMMISSIONER EMPLOYMENT SECURITY DEPARTMENT Representative) Origlnal~isbursing Officer Duplicate Employer Triplicate~entral Office Files EMS 8449 760 R3-98 CITY OF BREMERTON CHANGE ORDER CONTRACT CHANGE ORDER NO: 01 PROJECT NAME: RESERVOIR '19 - STANDPIPE TANK REPAIR & SEISMIC UPGRADE PROJECT NO: 458 CONTRACTOR: T Bailey, Inc. ORIGINAL CONTRACT AMOUNT: $48,721.00 DAYS: 60 cai-days PREVIOUSLY APPROVED CHANGES: 0.00 DAYS: 0 THIS CHANGE: $82,460.00 DAYS: 5 cai-days REVISED CONTRACT AMOUNT: $131,181.00 DAYS: 65 cai-days This Change Order covers changes to the subject contract as described herein. The Contractor shall construct, furnish equipment and materials, and perform all work as necessary or required to complete the Change Order Items. The increase or decrease in contract pdce shown below includes any applicable taxes. DESCRIPTION OF CHANGES INCREASE IN (DECREASE) IN CONTRACT o ,-- CONTRACT CONTRACT TIME ','- ,- AMOUNT AMOUNT EXTENSION '~ '5 ($) ($) (CAL.-DAYS) n~ n, XI Provide all labor, materials, and equipment, to remove and disposal of coal tar lining on the intedor floor and shell and apply new interior coating system as follows: Full field blast of floor and interior shell surfaces to near-white (SP-10) condition and remove and proper disposal of the existing coal tar lining; and Apply TNEMEC intedor paint system for potable water tanks (primer and finish coats) .................................................... $82,460.00 Time Extension of five (5) calendar days from the originally established completion date of January 15, 2004. The new completion date is January 20, 2004 ..................................... 5 Complete the installation of the closed cell backer rod and continuous sealant per Detail 1/S2.0 and Specifications 07900; and disinfect tank upon completion of the work per AWWA Standard for Disinfection of Water-Storage Facilities ................$0.00 $0.00 NET CHANGE IN CONTRACT AMOUNT (Increase) $82,460.00 g LJec.t ~. ?UU3 :~:3[5PM I BAILEY INC 36[} 293-3893 N0.645[~ P. 3/4 CONTRACT CHANGE ORDER NO: O1 PROJEC-f NAME: Reservoir 19-Standpipe Tank Repair & Seismic Upgrade Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, on-site or home office overhead, or lost profits. Nothing in this Change Order shall limit the City's right to bdng a claim for past per[ormance. The undersigned Contractor approves the foregoing Change Order as to the changes, if any, in the contract pdce specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Change Order. This document will become a supplement of the contract and all provisions will apply hereto. It is undemtoed that this Change Order shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a change order that is binding on the parties of this contract. In addition, Contractor warrants that it has or will infon'n the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. C~ 7~//DOate~ RECOMMENDED: ! ~ DIRE O~KS & UTILITIES .... RECOMMENDED: ~-~'~ 1,2-~-0.~ MANAGER, WATER RESOURCES DIVISION Date CON~CTOR, T Bailey, Inc. ~ T~ ,~ Date APPROVED: ~YOR I Date Bremerton City Attorney .... Page 2 of 2 Project No. 458 :Press Esc Key to Insert new record, Ctrl-Z to Clear form ·Press Del Key to Terminate Insert Mode INSERT Contract Maintenance Contract Number 4405 Vendor Name T BAILEY INC :Subject RESERVOIR 19 STANDPIPE TANK REPAIR/SEISMIC UPGRADE ~Department PW&U :Status Code CON Amount $48721.00 Begin Date 11/25/2003 Insurance End Date 01/31/2004 Type Amount Review Date 02/15/2006 Press F1 for GL $2000000.00 valid insuranceAL $1000000.00 type codes Insurance Total $3000000.00 Insurance Review Date 09/01/2004 Comments VAULT 01/01/2006 + CONTRACT RESERVOIR 19 STANDPIPE TANK REPAIR & SEISMIC UPGRADE (Page I of 4) This agreement, made and entered into this /~. day of ~/~',o~ , 20 ~9~J~ by and between the City of Bremerton, bereinafier called the City, and "~ ~-~/~ I L2~,"~, I Sk.~(~'~ ~ , herein~er called the Contractor: W'anesseth: That in consideration of the t.eqm and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and agree as follows: I. The Contractor shall perform all work and furnish all labor, tools, materials and equipment for the Reservoir No. 19, Standpipe Tank Repair & Seismic Upgrade. All parties agree that the State of Washington shall be and is hereby, named as an expressed third-party beneficiary of this Contract, with full rights as suck All work shall be in accordance with and as described in the Plans, General Provisions, Specifications, and the 2002 Standard Specificatiom for Road, Bridge and Municipal Construction (English), which are by reference incorporated herein and made a part hereof. Contractor shall begin the work within ten ( I 0) calendar days after the date that written NOTICE TO PROCEED is issued to the Contractor. The Contractor shall complete the work no later than sixty (60) calendar days after the date that NOTICE TO PROCEED is issued. If said work is not completed within the time specified, the Contractor agrees to payto the City an mount in accordance with the General Provisions, Section 1-2.06(E) of these Contract Documents for each calendar day said work remains incomplete after expiration of the specified times as liquidated damages. The Contractor shall provide and bear the expense of all equipment, tools, material and labor of any sort whatsoever that may be required for the transfer of materi~ds and for construction and completing the work provided for in this Contract and every part thereot~ except such as are mentioned in the specifications to be furnished by the City. 458-BREMERTON-RESERVOIR No. 19 Bidders Checklist & Bid/Contract Forms Standpipe Tank Repair & Seismic Upgrade 00300-17 CONTRACT (Page 2 of 4) II. The City hereby promises and agrees with the Contractor to employ and does employ the Contractor to provide the materials and to do and cause to be done the above descn'hed work to complete and finish the same according to the attached plans and specifications and the terms and conditions herein contained and hereby contracts to pay for the same according to the attached specifications and the approved bid as attached hereto incorporated by reference, at the time and in the manner and upon the conditions provided for in this Contract. III. The Contractor for himselt~ and for his heirs, executors, administrators, successors, and assigns, does hereby agree to fulfill the performance of all covenants herein contained upon the part of the Contractor. IV. It is fia'the~ provided that no liability shall attach to the City of Bremerton by reason of entering into this Contract, except as expressly provided herein. V. INDEMNIFICATION Contractor shall defend, indemnify and hold the City, its officers, officials, employees, agents, volunteers and assigns harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this contract, except for injuries and damages caused by the sole negligence of the City. The City' s inspection or acceptance of any of Contractor's work when completed shall not he grounds to avoid any of these covenants of indemnifieatimz Should a court of competent jurisdiction determine that this contract is subject to RCW 4.24.115, then, in the event of liab'flity for damages arising out ofhodily in'jury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall he only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this contract. 458-BREMERTON-RESERVOIR No. 19 Bidders Checklist & Bid/Conb*act Forms Stendp~ee Tank Repair & Seismic Upgrade 00300-18 CONTRACT (Page 3 of 4) VI. INSURANCE The Contractor shall procure ard maintain, during the term of construction and throughout the speciried term of maintenance, insurance of the types and in the amounts descn'bed below against claims for injuries to persons or damage to property that may arise from or in connection with the performance of the work hereunder by the Contractor, its agents, representatives, employees, mb-consultants and/or subcontractors. Before beginning work on the project desen'bed in this contract, the Contractor shall provide a Certificate of Insurance evidencing: 1. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General L'mb'flitg insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and general aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanket contractual; products/completed operations/broad form property damage; explosion, collapse and underground (XCU); and employer's liability. 3. Excess Liab'diW insurance with limits not less than $1,000,000 pex occurrence and aggregate. The insurance must refer to the project name, project location and contain a brief description of the project. Any payment of dednct~le or seffinsured retention shall be the sole responsib'flity of the Contractor. The City, its officers, officials, employees, agents and volunteers shall be named as an additional insured on the insurance policy, as respects work performed by or on behalf oftbe Contractor and a copy oftbe endorsement naming the Cay as additional insured shall be attached to the Certificate of Insurance. The Contractor's insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits oftbe insurer's liability. The Contractor's insurance shall be prknary insurance as respects the City, and the City shall be given thirty (30) calendar days prior written notice by certified mail, return receipt requested, of any cancellation, suspemion or material change in coverage. 458-BREMERTON-RESERVOIR No. f9 Bidders Checklist & Bid/Contract Forms S~andp~e Tank Repair & Seismic Upgrade 00300-19 CONTRACT (Page 4 of 4) The City also reserves its unqualified right to require, at any time and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. Proof of coverage shall be provided to the City in the form of a Certificate of Insurance and shall include additional insured endorsements as evidence of coverage. The City also reserves its unqualified right to require, at anytime and for any reason, proof of coverage in the form ora duplicate of the insurance policy with all endorsements as evidence of coverage. Approval of required insurance is a condition precedent to the execution of this contract. In witness wbereof the parties hereto have caused this agreement to be executed the day and year first herein above written. Title: ~__ Date: ?/ ~/~ o,~ APPROVED: City Attorney 458-BREMERTON.RESERVOIR No. 19 Bidders Checklist & Bid/Contract Forms Standpipe Tank Repair & Seismic Upgrade 00300-20