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Home My WebLink About4761 Contract Number: Vendor: Subject: Department: File Class: Begin Date: End Date: Review Date: Vault Date: Comments: 4761 SEALEVEL BULKHEAD BUILDERS 26th Street Landslide Repair Engineering LEG 12-1 09/15/2008 11/30/2008 02/15/2011 01/01/2011 ACCEPTANCE OF COMPENSATION & RELEASE OF ALL CLAIMS City of Bremerton - 26th Street Landslide Repair Proje~t #819 Notice to Proceed: September 22, 2008 I . Substantial Completio~ date: October 6, 2008 Sealevel Bulkhead Builders, Inc., (CONTRACTOR), hereby indicates agreement with, and acceptance of, the final Contract Payme~t of $4,455.37, the total Contract Price of ~$82,937.71, which includes Washington State sales and/or use taxes, and the fmal Contract Time of 45 days, as full and final compensation for all Work performed in I connection with this contract, and does hereby release the City of Bremerton (OWNER) from all claims, liability, demands, damages land actions of any kind whatsoever, arising from performance of that Contract. ' Sealevel Bulkhead Builders, By: !.' Title~ Date: / 'P 01:- STATE OF WASHINGTON ) ) SS. COUNTY OF KITSAP ) On this ~ day of t-Jov-em \1.e(l . 20d before me,' the undersigned, a Notary Public in and for the State of Washington, duly commissioned and ~orn, personally appeared: Sandy Powell, to me known as the individual(s) described in andwho executed theforegoing instrument, and acknowledged to me that he/she/they signed and seal~d the said instrument, as his/her/their free and voluntary act and deed for the uses and purposes therein mentioned, and on oath stated that he/she/they I , was (were) authorized to execute said instrument. WITNESS My HAND AND OFFICIAL SEAL, hereto affIXed the day and year in this certificate above written. ~\\,\"If""111. ~,\\ ~C?:(.~. ii'~ S" ~...~t-A'SSIO... Z, ~ ~ .'c,o ""~..'< ~ ::: >-\. '0" "+.. ~ft ~ ':..t. :~., \.}. '4h ~..".... _ ~ " '7 L 'PO' :: -, -c:-:::;> ~ mo _ _, .. ... fit: = :: cp .. c, ';'()(j, .......~. '" :..-\ ....., 'Ellie · ...--. "'-"A;, · ... ~,..... '>C ~...... .,. /' . '~ . ~ ' <z ~o...,!,8ER ,.'l..O':.t\+~ ~ ,;:-... ..... e'-'*' '/1111 WASH\~ \\\,,,, 1111111111\\\\\ ;Notary Pub Ie in and for the State of Washington ~esidingat ~ ~y appointment expires: q III :JOCf/ I I 545 5th Street. P.O. Box 259 Bremerton, Washington 98337 (360) 377-3711 1-888-377-3711 Fed. 1.0. # 31-1260530 .', "'/",BILLlNGPERIOD'/ , " .' ',', ADVERTISER/CUENT:NAME>:'c ',';0,<,0" 21,::.: CURRENTNET MOUNT DUE.'.... DA }, ER 90"DAYS " ADVERTISING INVOICE and STATEMENT "PAGE#.: ,) 5 . BILUNG'DATE 8 ,"BILLED'ACCOJJNT,NAME 'AND'ADDRESS :", '9 . REMITTANCE ADDRESS,' .'" 1, 1, 1, / ;J n / n 8 ,'BliLEDACCOUNTNUMBER 'Y\"':'" . CITY OF BREMERTON DEPT OF PUBLIC CITY OF BREMERTON DEPT OF PUBLIC 3027 OLYMPUS DR BREMERTON WA 98310 KI\TSAP SUN PO BOX 34688 S REC;EI NOV 252008 15554 " " . ,',',:ADVERTISERlCLlENT NUMBER' , ENGINEERING DIVISION 020053703700000053509 ~~"~, "', ". ,~ ,'" '. ) 'S!t'~l DATE .......pLEAsE DEfACHANoREfURN'uPPER 'poFiffbNWifHVoURREMltfANcE" :1 l~i:~:~{;~~R(jNifs};~,. 1~ 1.9 11/20 241661 11/20 NOTICE OF COMPLETION 3310 20079894 BILL DAVIS 2x 4 2 53.50 Project # Initials_ Date Ok'd. 53.50 -. K 't.:.:~\,i,\~,W*,;M.!;;. 0,'.,', III ':.; ,'YIO ~~.~__l_sap~ un kitsapsun.com 545 5th Street. P.O. Box 259 Bremerton, Washington 98337 (360) 377-3711 1-888-377-3711 Fed.I.D. # 31-1260530 'UNAPPLlED AMOUNTS ARE INCLUDED IN TOTAL AMOUNT [ All accounts are due upon receipt. ALL MAJOR CREDIT CARDS ACCEPTED I ; ,,\; INVOICE. NtlMBER. '. ,f 25 ,. " ,~ "" "c ",> '~ ',"J " .;'ADVERTtSER;INFORMATION' , , l '.,\,~ ~"..Y", <f '.....c, "" . -"'.:" " '''', , ..t, :c,"'" , " ..; ,11(,,: :.-, ).. BILl'ING'PERIOD" _ . ,. .;". '-BIELED.ACCOUNT'NUMBEW:/ '''' q'~" "ADVERTISER/CLIENT NUMBER ,." 2- ,',' . ,. ; '\ADVEBTISERlCLlENl' NAME 537037 11/20/08 - 11/20/08 15554 CITY OF BREMERTON DE BILLING INQUIRIES: (360) 792-3333 " Washington State '(;)0"1'1''' pi Department of Revenue ~, EiPr I' : ',~ PO Box 47474 Olympia, WA 98504-7474 602 087 185 Certificate of Payment of State Excise Taxes by Public Works Contractor SEALEVEL BULKHEAD BUILDERS INC PO BOX 375 KINGSTON WA 98346 0375 CITY OF.BREMERTON PUBLI~ WORKS M,H VELLEGAS 3027 OLYMPUS DR BREMERTON WA 98310 4799 We hereby certify that taxes, increases and penalties due or to become due from the above-named contractor under Chapter 180, Laws of 1935, as amended, with respect to the following public works contract: , CITY OF BREMERTON PUBLIC WORKS 819, 26TH ST LANDSLIDE REPAIR together with all other taxes, increases and penalties due from such contra,ctor, 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 II fijp I p./IOr . at Olyni.pia, Washington, S tate of Washington Department of Revenue ~~/~~' Certifyinb1fficer . '... .' . . . .. To inquire about the availability of this document in an alternate format for the visually impaired or in a language other than English, please call (360) 486-2342, TTY users may call 1-800-451-7985. REV 310028 (10-01-02) ROUTING: Disbursing Officer, Contractor, File, Special File ,:-- Employment Security Department - WASHINGTON STATE POBox 9046 · Olymplo WA 98507-9046 CONTRACTOR: SEALEVEL BULKHEAD BLDRS PO BOX 375 KINGSTON, W A 98347 ) CERTIFICATE OF ) PAYMENT OF CONTRIBUTIONS ) PENALTIES AND INTEREST ON ) PUBLIC WORKS CONTRACT ES Reference No. 151829-00 4 TO: CITY OF BREMEROTN PUBLIC WORKS 3027 OL YMPUS DR BREMERTON, W A 98310 The Employment Security Department hereby certifies those 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: 819 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 certificate 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 December 11, 2008. COMMISSIONER LOYMENT SECURITY DEPARTMENT Original-Disbursing Officer Duplicate--Employer Triplicate--Central Office Files EMS 8449 760 R3-98 ~10 o Verify Workers' Comp Premium Status - Employer Liability Certificate https://fortress.wa.gov/1ni/crpsi/ AcctInfoPrint.aspx? AccountId=48057... Washington State Department of Labor and Industries Employer Liability Certificate Department of Labor and Industries Employer Liability Certificate Date: 01/15/2009 UBI #: 602 087 185 Legal Business Name: SEALEVEL BULKHEAD BUILDERS INC Account #: 480,570-02 'Doing Business As' Name: SEALEVEL BULKHEAD BUILDERS INC Estimated Workers Reported: Quarter 3 of Year 2008 "7 to 10 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: SEALEBB993L 7 Expire Date: 8/21/2009 Account Representative: T7 / ROBERT SCRIBNER (360)902-4679 - Email: SCRR235@lni.wa.gov What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). 10f1 1/15/20094:35 PM Contract Number: Vendor: Subject: Department: File Class: Begin Date: End Date: Review Date: Vault Date: Comments: 4761 SEALEVEL BULKHEAD BUILDERS 26~ Street Landslide Repair Engineering LEG 12-1 09/15/2008 11/30/2008 11/01/2008 I I I I I I I I I I I I I I I I I I I AGREEMENT CITY OF BREMERTON, KITSAP COUNTY, WASHINGTON THIS AGREEMENT, made and entered into this tf{ day of ~ ,20~ between the City of Bremerton under and by virtue of Title 35 RCW (cities) as a nded, and . <PdAwe1 ~~ ISlA ;{{Jur~.. (VLC- . (contractor name) 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: I. The Contractor shall do all work and furnish all tools, materials and equipment for the 26TH Street landslide Repair, in accordance with and as described in the attached Plans and Specifications, and the Standard Specifications of the Washington State Department of Transportation which are by this reference incorporated herein and made part hereof and shall perform any changes in the work in accord with the Contract Documents. 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 these Contract Documents except those items mentioned therein to be furnished by the City of Bremerton. II. The City of Bremerton hereby contracts with Contractor and Contractor hereby agrees to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with 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 schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this Contract. III. The Contractor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Contractor shall secure at its expense, and shall be responsible for all payments of income tax, social security, state industrial insurance compensation, unemployment compensation, and all other payroll deductions for the Contractor, officer, agents, employees and sub-contractors. The Contractor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Contractor's officers, agents, employees and subcontractors. IV. The Contractor for himself/herself, and for his/her heirs, executors, administrators, successors, assigns, does hereby agree to the full performance of all the covenants herein contained upon the part of the Contractor. V. It is further provided that no liability shall attach to the City of Bremerton by reason of entering into this Contract, except as provided herein. 26TH STREET LANDSLIDE REPAIR MAY 2008 AGREEMENT FORMS Page AF-1 of AF-10 VI. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits including all legal cost and attorney fees, arising out of or in connection with the performance of this agreement, except for injuries and damages solely caused by the City's negligence. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE. TITLE 51 RCW, SOLELY FOR THE PURPOSE OF THIS INDEMNIFICATION. THE PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration of termination of this agreement. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year first below written and the Local Agency Approving Authority has caused this instrument to be executed by and in the name of said City of Bremerton the day and year first above written. Executed by the Contractor this 7Pt ~ ~ f;t~1Ad ibu~s, ~. q"~-G~'- Executed by the Local Agency this 15t/r...) day of 0 ~ day of ,20 O'lS (SEAL) ~ B(J~ftl~ H~tJy ity of Bremerton Appr Ing Authonty City of Bremerton Attorney 26TH STREET LANDSLIDE REPAIR MAY 2008 AGREEMENT FORMS Page AF-2 of AF-10 - -j " I ~ ~ I I ;J . I I I I I I I I I ,I I