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HomeMy WebLinkAbout5857 original and mod 1Public Works and Utilities Department 100 Oyster Bay Ave. N. • Bremerton, WA 98312 • (360) 473-5920 ■ FAX (360) 473-5360 August 31, 2020 Misker Arefeayne Varsity Facility Services 1502 Pike Street NW Suite #1 Auburn, WA 98001 Dear Mr. Arefeayne Work contract # 21801 for janitorial services is scheduled to expire on 08/05/2020. Under the automatic extension option, we are extending work contract # 21801 for twelve (12) months, per city PSA # 5857, Section II Term. The extension is subject to existing prices, terms, conditions and specifications, and will have a new expiration date of 09/01/2021. Should you have any questions, please call me at (360) 473-2316 or e-mail me at Chris.MottnerLa?ci.bremerton.wa.us. Thank you for your continued interest in doing business with the City of Bremerton. Sincerely, Chris Mottner Facilities/Inventory Supervisor Cc: Contract File Joe Stansbery, Lead Facilities Service Specialist Angela Hoover, City Clerk Wayne Hamilton, Utility Operations Manager AMENDMENT 1 TO CITY CONTRACT#5857 BETWEEN VARSITY FACILITY SERVICES AND CITY OF BREMERTON This is the first amendment to this Contract for janitorial services for city facilities entered into on August 6, 2018 ("the Contract"), between the City of Bremerton ("City") and Varsity Facility Services ("Vendor"). Whereas, the City and vendor entered into the Contract wherein the vendor provides janitorial services to various City facilities; and Whereas, the City and vendor wish to amend the Contract to reflect increases to Washington State's minimum wage rates, beginning January 1, 2020, that apply to janitorial services, NOW THEREFORE, the City and vendor mutually agree to amend the Contract to reflect the updated costs for janitorial services, per letter/e-mail dated December 26, 2019 as attachment "A", and will become effective January 1, 2020. This document will become a supplement to the Contract and all provisions will apply hereto. All other terms of the Contract not specifically amended herein shall remain in full force and effect. 1 IN WITNESS WHEREOF the parties hereto have executed this Amendment the date and year indicated. VARSITY FACILITY SERVICES Date 01-13-2020 Print Name Casey G. Killian Its Executive Vice President CITY OF BREMERTON Date 2.1to 1202a Greg Whitl.r, Mayor Approved as to form: Roger A. Lubovich, City Attorney Received for filing: Angela Hoover, City Clerk City Contract#5857 2 ATTACHMENT "A" Chris Mottner From: Misker Arefeayne <marefeayne@varsityfs.com> Sent: Thursday, December 26, 2019 10:10 AM To: Chris Mottner Subject: WA state minimum wage changes Hi Chris, As you know the state minimum wage changes will start on January 1St 2020. To file our affidafit with L& I and to be compliant with the state law we will increase all employees' wages by a $1.50 per hour. That will also affect our monthly contract pricing with the city. Please see below for the new pricing that will be effective on January 1st 2020. Let me know if you have any questions. 1. BKAT current price $299.50 new price$390.66 2. Police station Current price$1,688.34 New price$2,202.19 3. Public works and Utilities Current price$1,070.79 New price $1,396.69 4. SOG Current price$149.64 New price$195.19 5. Fire station Current price $244.52 New price$318.94 6. Court Current price $1,630.19 New price $2,126.81 Thank you Misker Arefeayne 1502 Pke st NW#1 Auburn, WA 98001 Office 253-218-0794, Mobile 206-369-0894 Fax 253-218-0597 marefeayne(cr�varsityfs.corn 1 AGENDA BILL CITY OF BREMERTON CITY COUNCIL 5F SUBJECT: Professional Services Agreement with Varsity Facility Services for Janitorial Services at six (6) City Facilities Study Session Date: COUNCIL MEETING Date: Department: Presenter: Phone: July 25, 2018 August 01, 2018 PW&U Wayne Hamilton (360) 473-5207 SUMMARY: The Janitorial Services Contract of Public Works & Utilities has expired. The City is seeking to accept the Washington State Contract for Janitorial Services to obtain the best available pricing for these services. The Washington State Contract is with Varsity Facility Services, Auburn Washington. The Department requests approval of the Janitorial Services Contract No. 00508 for one year from August 6, 2018 to August 5, 2019. In addition, requests authority for the Public Works Director to authorize four additional one year extensions, for a total of five one year extensions. ATTACHMENTS: 1) Professional Services Agreement for Janitorial Services; 2) State of Washington Janitorial Services Contract Summary Sheet; 3) Exhibit B Municipal Courts Facility Work Omer for Janitorial Services (typical of all other City location janitorial work contracts) FISCAL IMPACTS (Include Budgeted Amount): Funds are budgeted for the current budget year and would be budgeted for the remaining term of the contract. $66,490.367 annual cost with potential increases based on prevailing wage and minimum wage increases. STUDY SESSION AGENDA: ® Limited Presentation ❑ Full Presentation STUDY SESSION ACTION: ® Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve the Professional Services Agreement with Varsity Facility Services for City Facilities Janitorial Services; and authorize the Mayor to finalise and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION:�' "Approve ❑ Deny ElTable ❑ Continue ❑ No Action Form Updated 01/02/2018 PROFESSIONAL SERVICES AGREEMENT For Janitorial Services The City of Bremerton ("City") and Varsity Facility Services ("Vendor"), referred to collectively as the "Parties," enter into the following Agreement for professional services: I. Scope: The Vendor agrees to perform janitorial services at six City locations more specifically described in Exhibits A through F (collectively, "Scope of Work"), attached hereto and incorporated herein, including any attachments thereto. The Scope of Work may be modified only pursuant to Section VII.H of this Agreement. If the Scope of Work provides for unspecified additional services such services shall only be performed upon the express written request of the City. Vendor further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices in effect at the time such services are performed. II. Term: The City and the Vendor agree that work will begin on the tasks described in the Scope of Work on August 6th, 2018. This Agreement shall terminate one year from the date of execution, and may be renewed for four (4) additional one-year terms upon written authorization by the City's Director of Public Works and Utilities. These additional terms may be exercised at the sole discretion of the City with thirty (30) days written notice to the Vendor. The Parties agree that the work is to be completed as provided for in the work schedule included in the Scope of Work; provided however, that additional time shall be granted by the City for excusable delays or extra work as provided for in Section IKA of this Agreement. III. Compensation: In consideration of the services provided pursuant to this Agreement, the City shall pay Vendor in the amount set forth in the Scope of Work and Exhibit G — "Supply Costs," which is attached hereto and incorporated herein. Vendor's charges and bills shall conform to the fee schedule and tasks included in the Scope of Work and Exhibit G. The cost of paper and cleaning supplies and any other costs to be reimbursed by City are set forth in Exhibit G. The Vendor shall submit regular billing statements and the City shall promptly process payment. PROVIDED, HOWEVER, the City reserves the right to prioritize scoped work and accelerate and/or delay work tasks under the time frame set forth in Section II herein. Vendor shall not perform work beyond the Scope of Work, nor shall be compensated for such work, unless the Scope of Work or amount of compensation is modified pursuant to this Agreement. Vendor shall only be compensated for additional services if requested pursuant to Section I and, if not otherwise provided, such compensation shall be in accordance with the terms contained in the Scope of Work. If a billing statement does not conform to this Agreement, the City may withhold payment until the statement is brought into compliance. Such withholding does not relieve Vendor of its obligations under this Agreement. Page 1 of 7 Bremerton/KB S-VFS Janitorial Services Rev. 03/2018 Vendor supervisor costs are not separately identified in the Scope of Work and will be absorbed by Vendor, at no additional cost to the City. IV. Relationship of Parties: Vendor represents that it is skilled in the matters addressed in the Scope of Work and is performing independent functions and responsibilities within its field of expertise. Vendor and its personnel are independent consultants and not employees of the City. Vendor and its personnel have no authority to bind the City or to control the City's employees and other vendors. None of the benefits provided by the City to its employees, including, but not limited to, compensation, insurance, and unemployment insurance are available from the City to the employees, agents, representatives, or sub -contractors of the Vendor. Vendor will be solely and entirely responsible for its acts and for the acts of Vendor's agents, employees, representatives and sub -contractors during the performance of this Agreement. The City may, during the term of this Agreement, engage other independent vendors to perform the same or similar work. As an independent consultant, Vendor is responsible for its own management. The City's administration and enforcement of this Agreement shall not be deemed an exercise of managerial control over Vendor or its personnel. As an independent consultant, Vendor is responsible for payment of all taxes and licensing fees necessary to perform its obligations under this Agreement. These taxes and fees include but are not limited to State industrial insurance, Business & Occupation, State professional licensing, and City business licensing. If any taxes or fees due the City have been declared delinquent, the City may withhold the delinquent amount, plus any additional charges arising from the delinquency, from any payments due Vendor. V. Indemnification: A. Vendor 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 costs and attorney fees, arising out of or in connection with the performance of this Agreement except for that portion of the injuries and damages caused by the City's negligence, unless Vendor is conducting work pursuant to Subsection B below. The City's review or acceptance of any of the work when completed shall not be grounds to avoid any of these covenants of indemnification. B. Architects, Engineers and Any Other Professional Listed In and Performing Services Defined in RCW 4.24.115. Should a court of competent jurisdiction determine that Vendor's services provided pursuant to 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 Vendor and the City, its officers, officials, employees, agents and volunteers, the Vendor's liability hereunder shall be only to the extent of the Vendor's negligence. Page 2 of 7 Bremerton/KBS-VFS Janitorial Services Rev. 03/2018 IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'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 Agreement. VI. Insurance: The Vendor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Vendor, its agents, representatives, employees, sub -consultants or sub -contractors. Before beginning work on the project described in this Agreement, the Vendor 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 Liability 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) if applicable; and 3. Excess Liability insurance with limits not less than 1,000,000 limit per occurrence and aggregate. 4. Workers Compensation insurance as statutorily required by the Industrial Insurance Act of the State of Washington, Title 51, Revised Code of Washington and employer's liability with limits not less than $1,000,000. Any payment of deductible or self-insured retention shall be the sole responsibility of the Vendor. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which may be provided on a "claims -made" basis. The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Vendor and a copy of an endorsement that is acceptable to the City, which names the City as an additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all the required insurance policies and endorsements. The City further reserves the right to reject any unacceptable policies and/or endorsements. Page 3 of 7 Bremerton/KB S-VFS Janitorial Services Rev. 03/2018 The Vendor's Commercial General Liability 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 of the insurer's liability. The Vendor's insurance shall be primary and non-contributory insurance as respects the City and shall contain a waiver of subrogation against the City for claims arising out of any operations, liabilities and obligations to which coverage applies. It shall be an affirmative obligation upon Vendor to advise the City's Risk Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of Bremerton, Attn: Risk Management, 345 6th Street, Suite 100, Bremerton, WA 98337 within two days of the cancellation, suspension or substantive change of any insurance policy set out herein, and failure to do so shall be construed to be a breach of this Agreement. 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. VII. General Conditions: A. Work Performed at Vendor's Risk: Vendor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and sub -contractors in the performance of the work hereunder and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. B. Entire Agreement: This Agreement and its Exhibits constitutes the entire agreement between the Parties, and the Parties acknowledge that there are no other agreements, written or oral, that have not been set forth in the text of this Agreement. C. Severability: Should any part of this Agreement be found void, the balance of the Agreement shall remain in full force and effect. D. Modification: This Agreement may only be modified by written instrument signed by both Parties. E. Written Notices: All communications regarding this Agreement shall be sent to the Parties at the addresses listed below by registered or 1 st class mail, or by personal service, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. Page 4of7 Bremerton/KBS-VFS Janitorial Services Rev. 03/2018 Notices to be sent to: CITY: Attn: Chris Mottner City of Bremerton 3456 1h Street, Suite 100 Bremerton, WA 98337 Notices to be sent to: VENDOR: Attn: Misker Arefeayne Varsity Facility Services 1502 Pike Street NW Suite #1 Auburn, WA 98001 F. Waiver: Failure to enforce any provision of this Agreement shall not be deemed a waiver of that provision. Waiver of any right or power arising out of this Agreement shall not be deemed waiver of any other right or power. G. Non -Waiver of Breach: The failure of the City to insist upon strict performance of any of the covenants and agreements contained herein, or to exercise any option herein conferred in one or more instances shall not be construed to be a waiver or relinquishment of said covenants, agreements or options, and the same shall be and remain in full force and effect. H. Compliance with Laws: Vendor shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. I. Choice of Law and Venue: This Agreement shall be interpreted according to the laws of the State of Washington. Any judicial action to resolve disputes arising out of this Agreement shall be brought in Kitsap County Superior Court. J. Attorneys' Fees: In the event of litigation to enforce any of the terms or provisions herein, each Party shall pay all its own costs and attorney's fees. K. Assignment: Any assignment of this Agreement by the Vendor without the written consent of the City shall be void. VIII. Nondiscrimination: Vendor shall not discriminate in employment or services to the public on the basis of race, color, national origin, sex, religion, age, marital status, disability, or sexual orientation except for employment actions based on bona fide occupational qualification. IX. Termination: This Agreement shall remain in force until completion and acceptance of the services, terminated by written instrument upon mutual consent, or by the City of Bremerton for convenience. This Agreement may be immediately terminated for cause by a Party if the other Party substantially fails to perform through no fault of the terminating Party, and the non- performing Party does not commence correction of the failure of performance within thirty (30) days of the terminating Party's sending notice to the non-performing Party. Any Notice by Vendor shall include a report showing the status of all items listed in the Scope of Work current through the termination date. Either Party may terminate this Agreement at any time for convenience without cause, fee, or penalty by providing forty-five (45) days prior written notice to the other Party. Page 5 of 7 Bremerton/KBS-VFS Janitorial Services Rev. 03/2018 If the City receives reimbursement by any federal, state, or other source for work described in Section I herein, and that funding is withdrawn, reduced or limited in any way, or the project is cancelled or substantially reduced after the execution date of this Agreement and prior to the completion of the work, the City may summarily terminate this Agreement. A. Excusable Delay The right of Vendor to proceed shall not be terminated nor shall Vendor be charged with liquidated damages for any delays in the completion of the work due to: 1) any acts of the federal government in controlling, restricting, or requisitioning materials, equipment, tools, or labor by reason of war, national defense, or other national emergency; 2) any acts of the City, its consultants, or other public agencies causing such delay; and 3) causes not reasonably foreseeable by the Parties at the time of the execution of the Agreement that are beyond the control and without the fault or negligence of the Vendor, including, but not restricted to, acts of God, fires, floods, strikes, or weather of unusual severity. PROVIDED, HOWEVER, that the Vendor must promptly notify the City within ten (10) calendar days in writing of the cause of the delay. If, on the basis of the facts and the terms of this Agreement, the delay is properly excusable, the City shall, in writing, extend the time for completing the work for a period of time commensurate with the period of excusable delay. B. Rights Upon Termination: In the event of termination, the City shall pay for all services performed. by the Vendor to the effective date of termination, as described on a final invoice submitted to the City. After termination, the City may take possession of all records and data within the Vendor's possession pertaining to this project which may be used by the City without restriction. Any such use not related to the project which Vendor was contracted to perform shall be without liability or legal exposure to the Vendor. X. Suspension & Debarment. For contracts involving Federal funding, Vendor hereby certifies, by signing this Agreement, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Vendor shall provide immediate written notice to the City if at any time it learns that it is or has become ineligible for certification. Should Vendor enter into a covered transaction with another firm, Vendor agrees by signing this Agreement that it will verify that the firm with whom it intends to do business is not debarred, suspended, ineligible, excluded or disqualified. XI. Prevailing Wages. Vendor shall file a "Statement of Intent to Pay Prevailing Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract work. Vendor shall pay prevailing wages and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. The rates are those in effect on the date when bids are required to be submitted. The Parties recognize the potential for future variance in applicable prevailing wages. After the first year of this Agreement, the wages Vendor must pay its employees shall be altered annually according to the most recently promulgated increases in prevailing wages. The City shall bear the cost of the wage increases. Page 6 of 7 Bremerton/KBS-VFS Janitorial Services Rev. 03/2018 IN WITNESS WHEREOF, the Parties below have executed this Agreement. CITY: CITY OF BREMERTON By: CA Print Name: C pr&% W 1,,. r -r Its: Mo.-yor Ifta Date: 4,A!' z - — � -% , I.J APPROVED AS TO FORM: By:C Bremerton City (tt Mey r ( By: ( Print Name: Its: '-j "\a - Date: Y. -\'L,- \Y, ATTEST: % "W) -WAXIc'mum, P1 '# =R City Clerk (-') R-1Lega1\Lega1\FoT-msT0R,MS ON COBWEBTrofessinnal Services Agreement Rev. 03 2018.doex Page 7 of 7 Bremerton/KBS-VFS Janitorial Services Rev. 03/2018 EXHIBIT 1 Washington State Department of Enterprise Services Agency Name: City of Bremerton BKAT Agency # or ID: 121801 1 County: Kitsap Contract Life: 1 2 yrs. Original Start Date: 1 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other Estimated Square Feet: 1800 # of Floors: 1.00 Friday 6pm to Monday 7am Work to be performed at: 7266 Tibardis Road Bremerton WA 98311 on auc ® 7 -50 2 ion. rauch(cDci. bremerton.wa. us Client Contract Administrator: 100 Oyster Bay Ave. N. Bremerton I WA F98311 FW"o ner 360 R7 -33116� 0 chris. mottner(a)ci. bremerton.wa. Send billing information to: 100 Oyster Bay Ave. N. Bremerton WA 198311 aci i ies ep . 360 1473-2316 0 ch ris. mottneraci. bremerton.wa. us Page 1 Work Request Template July 2013 % of weighting applied to evaluation categories: Mandatory Site Visit Date: I 1 -May -2018 Pricing 60% 1 References: 30% 1 Standardized Q&As:l 10% Bids must be submitted on or Site Visit Time: 1:00 PM before the date of >>> 8 -May -2018 I RFQQ Bid Submissions (by Vendors) should be DESC PRMHeal Hum Serv(cDdes.wa.aov electronically sent to this email address >> Click on link to identify proper prevailing wage>>> L&I janitorial prevailing wages by job class by county 'Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. In Janitor Shampooer Waxer Window Washer Bidder to identify hourly labor rate»> 11.5 11.5 11.5 13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 a) x f Reception area tables, counters, chairs, and windows b) Q Copy room counters & tables c) Qx Lunchroom counters and tables d) Ox General hallway and corridor walls e) Ox File cabinets f) xx Glass doors g) 0 Elevator walls and hand rails h) Ox Stairwell walls and hand rails i) 0 Spot clean all smudges, stains and spills as needed on any flooring or open surface j) x Remove cobwebs k) Q Other 1) Q Other m) Q Other n) F --].Other Instructions: 1 Weekly ILJLJLJL—JI_JI xJl—J� S M T W R F S Supervisor(s) JanHor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event »> ............................................................................................................................................................................................................................................................................ ♦ Check box to activate section: a) b) C) d) e) fl g) h) i) Frequency: ❑ x Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 3 Work Request Template July 2013 i Check box to activate section: a) x Horizontal surfaces & moldings b) Q Horizontal & vertical blinds c) Q Picture Frames d) Fx Cloth panels e) �x HVAC vents, grills, and recesses f) Fx Ceiling vents, grills, and recesses g) Qx Horizontal & vertical blinds h) Q Other i) Q Other j) Q Other k) Q Other 1) 0 Other Frequency: ❑2 x a Year I I I Ix I I I I I Ix I I I Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 75 job class per event >> ♦ Check box to activate section: // a) Q Drinking Fountains b) Q Elevators c) 0 Faucets d) Q Other e)Q Other fl . Other g) Q Other Frequency:❑1 x a Week x S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 10 job class per event »> Page 4 Work Request Template July 2013 i Check box to activate section: a) X All rooms and open areas. b) Q General open areas, hallways, and corridors c) Q The following Conference Rooms: d) Q Dining / lunchroom areas e) Q Kitchen areas fl Q Reception Area g) Q Replace trash liners whenever stained, soiled, torn, and/or removed. h) Q Employee cubicle areas i) Q Other j) Q Other k) ❑X Empty smaller trash I recycle items into large receptacles at specified location 1) F� On designated day(s), take large receptacles to the specified area. instructions: Trash can liners shall be replaced whenever they become stained, soiled, or torn. Frequency: 1 1 1 x I a Week S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task perl 45 job class per event »> i Check box to activate section: a) Q Sweep within 10 feet of each entrance. b) Q Sweep sidewalks along the front of building c) Q Remove trash and debris from outside parking lot d) Q Empty all entrance ash trays e) 0 Empty outside trash cans into proper receptacle as f) 0 Other g) 0 Other h) Q Other i) Q Other j) 0 Other Frequency: x a WeekI I I I I I X 11 S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe 15 job class per event >>> Page 5 Work Request Template July 2013 4 Check box to activate section: a) b) C) d) e) 0 g) h) i) j) M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Minutes for Day Porter Services should be accordance set amount of hours for the sei * Check box to activate section: e) f) g) h) i) j) Frequency: S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event »> ...................................................................................................................................................................................................................................................... Page 6 Work Request Template July 2013 a) X Sanitize all toilets, urinals, wash basins, etc. b) QX Sweep, dry mop and/or damp mop and disinfect floors Clean mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles c) Q d) 0 fill all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. e) X Plunge and/or snake toilets as needed. f) 0 Other g) F Other h) F Other i) 0 Other j) Q Floor cleaning for bathroom is included as part of general floor cleaning duties Instructions: Frequency:11 I x a Week X u S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 45 job class per event >>> :.............................................................................................................................................................................................................................................................................................: i Check box to activate section: 10 Additional Restroom Cleaning and Disinfecting: a) 11Q x Clean and disinfect toilet stall doors and walls b) Clean and disinfect shower areas and fixtures C) Q Other d) Q Other e) Q Other f) 0 Other Frequency: 1 1 1 x M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 45 job class per event >>> .............................................................................................................................................................................................................................................................................................: Page 7 Work Request Template July 2013 ♦ Check box to activate section: 11 General Kitchen Cleanin ....................................................................................................................................................... a) Q Clean and disinfect all counters b) Q Clean and disinfect outside of all cabinets c) 0 Clean and disinfect outside of all appliances d) Qx Clean and disinfect sink and fixtures e) 0 Clean and disinfect tables and counters in lunch room / eating area. f) Q Dry mop / wet mop to remove all spills and stains on floor g) Q Clean inside of following appliances: h) Q Other i) Q Other j) .Other Frequency: 1 1 1 x M T W R F S Supervisor(s) Janitor(s) Shampoow(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event »> 4 Check box to activate section: 12 Additional Kitchen Cleaning: ....................................................................................................................... a) b) C) d) e) f) g) h) i) j) S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................................ Page 8 Work Request Template July 2013 i Check box to activate section: 13 Other Specific Rooms As Follows: ....................................................................................................... a) Q Other b) Q Other c) Q Other d) 0 r e) 0 - ther f) F-1 Other g) F—� Other h) f-7 -tom i) Q - ther j) 0 ier S M T W R F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ...........................................................................................................................................................................................................................................................................: i Check box to activate section: I] x 14 Vacuum High Traffic Carpeted Areas to Include: (Daily/ Weekly) -------------- ---------------------------------------------------- -- - a) b) C) d) e) f) g) h) i) j) eception Area eneral open areas, hallways and corridors he following Conference rooms: levator Floor mployee cubicle areas dditional Rooms &/or areas as noted in Special Instructions space below. pot clean all carpeted areas when needed rivate offices actual Frequency: 0 x a Week I I I I I I—x-1 _ S M T W R F S Estimated # of sauare feet: Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> 25 :............................................................................................................................................................................................................................................................................................. Page 9 Work Request Template July 2013 ♦ Check box to activate section: .15 Vacuum Low Traffic Carpeted Areas . . to Include:.............................................................................................................. ......................... rist�udiops-space b --tow, Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................................ ♦ Check box to activate section: X16 Clean resilient floors to include: (Daily / Weekly) Estimated # of ........................................................................................................................................................................................................................square feet:........ 300 a) P Sweep floors b) 0 Dry mop c) Q Wet mop as needed d) Q Other e) 0 Other f) 0 Other g) 0 Other h) .Other in April and October Frequency: 11 I x I a Week as noted above should be done on all noncarpeted floors unless specified otherwise. Wet mop only needs to be done twice a S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 20 job class per event >> 1 I ................................................................................................................................................................................................................................................................ Page 10 Work Request Template July 2013 i Check box to activate section: 17 Clean, Strip & Wax Resilient floors: (Monthly /Annually) Estimated # of 300 square feet:........ a) . Strip old wax and remove stains and discolorations b) Qx Re -wax the areas checked off and/or specified below. (See also special instructions for waxing requirements) c) Q All non -carpeted floors d) Q Kitchen, Lunchroom areas e) Q Restrooms f) 0 Print, Copy, Storage Rooms g) Q Stairs and Landings h) 0 Entryways i) 0 Other j) rolOther Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) ,fully complete this task per job class per event > I I 240 I I i Check box to activate section: E711 18 Shampoo Carpet As follows: ............................................................................................ a) Ox All carpeted areas b) Q Lobby / Reception area c) Q II open access areas along hallways and corridors d) Q Conference Rooms e) 0 Private offices f) 0 Employee cubicle areas g) 0 Stairs and landing h) Q Rugs i) Q Other j) Q Other Estimated # of square feet: Special instructions: Janitor to pre -vacuum all carpeted areas with an upright roller brush vacuum. Janitor to only use an approved hot water extraction process equipment. Janitor must perform cleaning early enough to allow for full drying prior to 8:00 a.m. the following work morning. Frequency:1 x a Year x Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) window Washer(s) Total MINUTES required to successfully complete this task pe 240 job class per event > Page 11 Work Request Template July 2013 i Check box to activate section: 19 Clean inside of interior/exterior windows a) 0 OfAer b) 0 Other C) 0 Other d) 0 Other e) fl F—�Other g) F� Other h) Q Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ................................................................................................................................................................................................................................................................................... i Check box to activate section: Clean (ground level) exterior windows a) ❑ Other, b) 0 Other c) 0 ether d) 0 Other e) 0 Other {) 0 Other g) Q Other h) Q Other i) Q Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> .............................................................................................................................................................................................................................................................................. Page 12 Work Request Template July 2013 i Check box to activate section: Clean (non -ground level) exterior windows Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................... i Check box to activate section: X 22 Clean additional interior windows: — Clean a) Qx Entry way Windows b) Q Private office windows c) Q Conference room windows d) Q Reception area windows e) Q Other fl 0 Other g) F Other h) F Other i) F Other j) .Other ri task is for a full window cleaning. Spot wiping of Frequency: 1 1 1 x I a Week S M T W R F S (Sizes to be determined at site visit) come Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event >> .................................................................................................................................................................................................................................................................................. Page 13 Work Request Template July 2013 ♦ Check box to activate section: a) ❑ Other b) ❑ - the -c) ❑ other- d) therd) F--1 Other e) Other f) ❑ Other g) ❑ Other h) ❑ Other i) F --]Other j) LI:—j:Jl ther S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> Check box to activate section: a) 0 Other b) ❑ Other c) ❑ . ther d) 0 ther e) ❑ Other f) 0 Other g) 0 other h) 0 Other i) ❑ Other j) ❑ Cher Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................... .............. .......................................... ............... .............................................. ........................ ...................... ............... .............................................. Page 14 Work Request Template July 2013 ♦ Check box to activate section: a) Q Other b) F Oche c) QOther Other d) F Other e) Q - ther fl 0 Other g) 0 .cher h) F Other i) F7 Other �) D Cher S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> :............................................................................................................................................................................................................................................................................... s i Check box to activate section: a) F Other b) F Other c) F Other d) F Other e) 0 Other fl F Other g) F ...Other h) F Other I) F ether j) D th,-,r Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event »> .................................. ........................................................................................ ...................... .................. .................. ................................................................................. ........: Page 15 Work Request Template July 2013 i Check box to activate section: a) Q Other b) Q - ther C) F--1 Other d) 0Other e) 0 Other f) 0 Otkwr g) 0 Other h) Q Other i) F70ther j) ❑ Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> As Needed Cleaning: ; As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. =28 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> =29 Emergency water damage cleanup Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> Page 16 Work Request Template July 2013 F=---130 Other (i.e. Chemical Spills) Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> 031 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> F —]32 Other (i.e. Bodily Fluids) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> =33 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> =34 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 17 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendors actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �<-Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES 0 36 Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper X❑ ❑ ❑ Paper Towels ❑x Deicer ❑ ❑ ❑ Toilet Seat Covers X❑ Liquid Soap ' ❑x Other (please specify) ❑ I ❑ Floor Care Products ❑X ❑ ❑ . ❑ . ❑ ❑ Glass Cleaner Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Provided by Provided by Preferred? Agency Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap ❑x ❑1X I Floor Care Products ❑X ❑ X . Garbage Bags ❑ ❑ Glass Cleaner ❑ ❑ 1X I Restroom Disinfectants &Cleaners ❑ ❑ Trash Can Liners X❑ Other (please specify) ❑ ❑ Page 18 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)E]% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 13,890 Minutes Total Labor Cost For Regularly Scheduled Services -Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $2,662.25 with prevailing wage requirement. 231.5 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo Waxer IY 1 1 Note: IF wages are reduced below prevailing wage Washer level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 35'% Total Per Unit "As Needed Cleaning" Labor Cost $0.00 -Excluded from Annual Contract Amount. Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 —Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $931.79 Total Bid Evaluation Price »> $3,594.04 Total Projected Annual Contract Price (Pre-tax)»> F $3,594.04 Price per month (Pre-tax) $299.50 Average Price per Day (Pre-tax) $9.85 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES —>—» Price per Quarter (Pre-tax) $898.51 Agency #/ID 21801 Email your completed RFQQ Worksheet reWnse to: DESCPRMHealHumServ@des.wa.gov Bid submitted by: VARSITY FACILITY SERVIC Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 19 Work Request Template July 2013 EXHIBIT B Washington State Department of Enterprise Services Agency Name: City of Bremerton (Courts) Agency # or ID: 121801 County: Kitsap Contract Life: 1 2 yrs. Original Start Date: 1 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other I Estimated Square Feet: 8000 # of Floors: FT2 Monday -Friday 6pm to 7am Work to be performed at: 550 Park Ave. Bremerton WA 98337 Dawn Williams 1473-5242 360 473-5262 dawn.williams(aDci.bremerton.w Client Contract Administrator: 100 Oyster Bay Bremerton WA 98311 IGhris Mottner 360 1473-2316 360 473.5360 chris. mottner(a)-ci. bremerton.wa Send billing information to: 100 Oyster Bay Ave. N. Bremerton WA 98311 aci i ies ep . 3601473-2316 473-5360 chris. mottner(aD-ci. bremerton.wa. us Page 1 Work Request Template July 2013 % of weighting applied to evaluation categories: "600/6pricingReferences: 30% Standardized Q&As:--H] Q% Bids must be submitted on or Mandatory Site Visit Date: 1 -May -2018 Site Visit Time: 1:00 PM before the date of »> 8 -May -2018 I RFQQ Bid Submissions (by Vendors) should be DESCPRMHeal HumServ(c�des.wa.gov I electronically sent to this email address >> Click on link to identify proper prevailing wage>>> L&I janitorial prevailing wages by job class by county Supervisor Bidder to identify hourly labor rate»> *Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. Janitor Shampooer Waxer Window Washer 11.5 11.5 11.5 1 13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 X a) ( xJ Reception area tables, counters, chairs, and windows b) Q Copy room counters & tables c) Qx Lunchroom counters and tables d) 0 General hallway and corridor walls e) Qx File cabinets i Ox Glass doors g) 0 Elevator walls and hand rails h) 0 Stairwell walls and hand rails i) 0 Spot clean all smudges, stains and spills as needed on any flooring or open surface j) x Remove cobwebs k) 0 spot clean all interior glass 1) Q Other m) 0 Other n) F --],Other s: 5 1 1 Weekly Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task per 15 job class per event > Check box to activate section: a) U Light -,,Mlic es b) Q Jaer haniles c) F--1 sending rnach;aas d) Q F4le cabinets e) Star,vills and hared ,ails 0 0 €levatar,iiafls and -ha0d. r g) 0 Other h) 0 Gth,er i) Q 9ther Frequency: n x Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................................... Page 3 Work Request Template July 2013 ♦ Check box to activate section: K4 a) x Horizontal surfaces & moldings b) 0 Horizontal & vertical blinds c) Qx Picture Frames d) Qx Cloth panels e) x HVAC vents, grills, and recesses f) Ox Ceiling vents, grills, and recesses g) Ox Horizontal & vertical blinds h) 0 Other i) Q Other j) Q Other k) Q Other 1) 0 Other Frequency: M x a Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 120 job class per event >>> ♦ Check box to activate section: El a) ® Drinking Fountains b) ® Elevators c) 0 Faucets d) 0 Other e) f) HOther Other g) Other Special Frequency:❑5 x a Week X X X X X S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event >> ........................................................................................................................................................................................................................................................................... : Page 4 Work Request Template July 2013 4 Check box to activate section: a) b) C) d) e) 0 g) h) k) 1) ns and open areas. I open areas, hallways, and corridors swing Conference Rooms: Ilunchroom areas I areas ion Area e trash liners whenever stained, soiled, torn, and/or removed. gee cubicle areas smaller trash / recycle items into large receptacles at specified location gnated day(s), take large receptacles to the specified area. Trash can liners Frequency: 1 5 1 x I a Week S M T W T F S or Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 45 job class per event >>> ............................................................................................................................................................................................................................................................................: i Check box to activate section: a) 0 Sweep within 10 feet of each entrance. b) 0 Sweep sidewalks along the front of building c) 0 Remove trash and debris from outside parking lot d) Q Empty all entrance ash trays e) QX Empty outside trash cans into proper receptacle f) 0 Other g) F Other h) F Other i) F Other j) Q Other Frequency:❑5 x a Week X X X x x S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event »> ............................................................................................................................................................................................................................................................................: Page 5 Work Request Template July 2013 ♦ Check box to activate section: a) Rcapn.s4ion 2,4 conf'--- Ge i-o`J(}, arid-rec—apt4on, area chaff, b) 0 Ps,,iase light bzf4 & 1 ght tubes, as needed c) Q -c4 and mef,,itor al!-janitarirl4 supplies d) 0 Rrw—die add 4ioriat Day Peter Services as iri S ecial �nstraet ��as e)Q-Day-poirter to also perform tu:-�,s no'er! in .; h --,paragraphs sul paragrras as stater! - fl F-1 g) h) 0 i) 0 1) S M T W T F S Supervisors) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Minutes for Day Porter Services should be accordance with set amount of hours for the service ..............................................................................................................................................................................................................................................................................: ♦ Check box to activate section: a) Q Reposition all conference room and reception area chairs b) 0 Replace light bulbs & light tubes as needed c) Ox Stock, and monitor all janitorial supplies d) Q Other e) Q Other f) Q Other g) Q Other h) Q Other i) 0 Other j) Q Other Frequency: S M T W Supervisor(s) Jandor(s) Shampooer(s) Waxer(s) Wndow Washer(s) Total MINUTES required to successfully complete this task pe 30 job class per event >> ] I Page 6 Work Request Template July 2013 9 /General Restroom Cleaning and Disinfecting a) Q Sanitize all toilets, urinals, wash basins, etc. b) Q Sweep, dry mop and/or damp mop and disinfect floors c) Q Clean mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles d) 0 fill all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. e) 0 Plunge and/or snake toilets as needed. 0 0 Other g) 0 Other h) Q Other i) 0 Other j) . Floor cleaning for bathroom is included as part of general floor cleaning duties Frequency: 1 5 1 x S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 60 job class per event »> Check box to activate section: 10 Additional Restroom Cleaning and Disinfecting: ................................................................................................................................................................................................................................................................... S M T W T F S Supervisor(s) Jan@or(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 7 Work Request Template July 2013 i Check box to activate section: 11 General Kitchen Cleanina: a) 0 Clean and disinfect all counters b) Q Clean and disinfect outside of all cabinets c) 0 Clean and disinfect outside of all appliances d) QX Clean and disinfect sink and fixtures e) 0 Clean and disinfect tables and counters in lunchroom 1 eating area. f) Q Dry mop 1 wet mop to remove all spills and stains on floor g) Q Clean inside of following appliances: h) Q Reposition kitchen furniture in an orderly manner i)FE]IOther Other j) Frequency:x a WeekIx Ix Ix Ix Ix I PI S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 35 job class per event »> ................................................................................................................................................................................................................................................................ a Check box to activate section: 12 Additional Kitchen Clean a) b) C) d) e) 9 g) h) i) j) C ro 11 21,11-C =44d gemtof(& ) S M T W T F S Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ........................................................................................................................................................................................................................................................................... Page 8 Work Request Template July 2013 ♦ Check box to activate section: 13 Other Specific Rooms As Follows: ........................................................................................................ a) F7 Qther b) er c) F Other d) F P�her e) Q 9ther f) 0 O ger g) F Other h) Q cher i) F Other Ellot4e, S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ♦ Check box to activate section: E14 Vacuum High Traffic Carpeted Areas to Include: (Daily/ Weekly) Estimated # of ......................................................................................................................................................................................................................... square feet: a) X Reception Area b) 0 General open areas, hallways and corridors c) 0 The following Conference rooms: d) 0 Elevator Floor e) X Employee cubicle areas fl 0 Additional Rooms Vor areas as noted in Special Instructions space below. g) 0 Spot clean all carpeted areas when needed h) Q Private Offices i) Q Court Rooms 1 and 2 j) n The above square footage is estimated. Vendors should confirm actual sauare footaae at site visi Frequency:❑5 x a Week X X X X X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> 60 Page 9 Work Request Template July 2013 ♦ Check box to activate section: 15 Vacuum Low Traffic Carpeted Areas to Include: :11. . .. .......... .. ... .... .. ........ ..... .. ... .... ....... ..... .. . .. ... ...... .. .. .. . ... . .. ... ... .. ............................................................................ a) b) C) d) e) f) g) h) i) j) Ub!cle-Are2s i Rearms &!s) areas as Fated ir+Spebal lnstruetiens spacce bc1o,,v. S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> ............................................................................................................................................................................................................................................................................................. : ♦ Check box to activate section: 16 Clean resilient floors to include: (Daily / Weekly) Estimated # of ........................................................................................................................................................................................................................ square feet:....... 1,000 a) Q Sweep floors b) 0 Dry mop c) Q Wet mop as needed d) Q Other e) 0 Other f) 0 Other g) Q Other h) Q Other Frequency: 1 5 1 x I a Week as notea aoove snouia oe aone on S M T W T F S unless specified otherwise. Wet mop as needed Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe 45 job class per event »> .................................................................................................................................................................................................................................................................................. Page 10 Work Request Template July 2013 ♦ Check box to activate section: �17 Clean, Strip & Wax Resilient floors: (Monthly / Annually) .........................................................................................................................................................................................................................................................................: a) F Stnp old car and r€zf'r1o`fe-S lir}s-an4 d{ sG k)'r'clfl'1S b) F Re wa x the areas checked off and/or ✓pecifieu below {See a! so special Hist u'ct )i iS for viaxing i equir@mpnts) c) Q Ali nay carpeted floors d) F Kitchen, JLunchroarn areas e) estroern s 0 Print ropy Stc age Rooms . r g) F7 Stairs, and Landings h) 0 € tryv;ays i) 0 0-ther j) F]10tt. er Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> ............................................................................................................................................................................................................................................................................................. : ♦ Check box to activate section: 718 Shampoo Carpet As follows: ............................................................................................................................................................................................................................................................................. Page 11 Work Request Template July 2013 ♦ Check box to activate section: 19 Clean inside of interiorlexterior windows a) 0 r2 b) F--] it of c) 0 ot,ger d) Q Gthea' e) 0 Other fl F � ,ther g) F Oth h) Q Other Jan Feb Mar Apr May Jun Jul Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> I I .................................................................................................................................................................................................................................................................................. a Check box to activate section: Clean (ground level) exterior windows a) F Ott er b) 0 Otr, c) Q etrie, d) 17— Gitt er e) Q Qth Qr fl F-1 OthG1 g) F-1 Other h) 0 Other i) 0 Other j) 0 0rhe, Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................: Page 12 Work Request Template July 2013 ♦ Check box to activate section: D21 Clean (non -ground level) exterior windows Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event >>> .................................................................................................................................................................................................................................................................................. i Check box to activate section: Clean additional interior windows: a) Qx Entry way Windows b) Q Private office windows c) 0 Conference room windows d) Q Reception area windows e) Q Other f) 0 Other g) Q Other h) Q Other i) F_� Other j) ■ Other Note, this task is for a full window ng (Sizes to be determined at site visit) come above.) Frequency: 1 1 I x a Week I ( X uS M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 15 job class per event >> :............................................................................................................................................................................................................................................................................................... Page 13 Work Request Template July 2013 ♦ Check box to activate section: a) `ether b) F--1 Othe( c) ❑ Other d) F-1Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> Check box to activate section: a)Q the+ b) Qth c) 0 Other d) Dath✓r e) Other othel g) O lather h) i) 0 Other j) S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> :...................................... .......................................................................................................... ............ ....................... ..............................................................------- ---- Page 14 Work Request Template July 2013 ♦ Check box to activate section: a) r--1 Other b) OOther c) 0 -the; d) 0 Otb& e) 0#e fl F--1 Other g) Q Other h) 0 Other i) 0 Oth-eT j) ❑Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task per job class per event >> .................................................. ..................... ............................................. ......... ..................................................... .................................................................... ............... ♦ Check box to activate section: a) F Other b) 0 Other C) Q Other d) Q Other e) Q Other fl 0 Other g)Other h) Q Other i) Q Other j) E Other S M T W T F S Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ........... .... .................................................................................... ........ ..................................................... .............................................. ...................................................... Page 15 Work Request Template July 2013 i Check box to activate section: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total MINUTES required to successfully complete this task job class per event :.............. ......................................... ............................................ ............. As Needed Cleaning: As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. =28 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> F--]29 Emergency water damage cleanup Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 16 Work Request Template July 2013 F --]30 Other (i.e. Chemical Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> I I F —131 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> I I 032 Other (i.e. Bodily Fluids) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> F=---133 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> F --�34 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 17 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> —Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES 0 Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper ❑ Provided by Vendor ❑ ❑ Paper Towels ❑x ❑ Deicer Toilet Seat Covers 0 ❑ ❑ 0 Other (please specify) ❑ Liquid Soap ❑ ❑X ❑ Floor Care Products ❑X ❑ Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Preferred? Provided by Agency Provided by Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap ❑X ❑ Floor Care Products ❑X ❑ Garbage Bags ❑X ❑1X I Glass Cleaner ❑X ❑ Restroom Disinfectants & Cleaners ❑ ❑ Trash Can Liners ❑X ❑ Other (please specify) ❑ ❑ Page 18 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)Fl% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 75,620 Minutes Total Labor Cost For Regularly Scheduled Services -Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $14,493.83 with prevailing wage requirement. 1,260.3 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo Waxer Washer Note: IF wages are reduced below prevailing wage level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 35% Total Per Unit "As Needed Cleaning" Labor Cost $0.00 -Excluded from Annual Contract Amount Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 -Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $5,072.84 Total Bid Evaluation Price »> $19,566.68 Total Projected Annual Contract Price (Pre-tax)»> F $19,566.68 Price per month (Pre-tax) $1,630.56 Average Price per Day (Pre-tax) $53.61 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES Price per Quarter (Pre-tax) $4,891.67 Agency #/ID 21801 Email your completed RFQQ Worksheet response to: DESCPRMHealHumServ@des.wa.gov ;Bid submitted by: VARSITY FACILITY SERVI: Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 19 Work Request Template July 2013 EXHIBIT C FIRE STATION Washington State Department of Enterprise Services Agency Name: City of Bremerton (Fire Station #1 Admin) Agency # or ID: 21801 County: Kitsap Contract Life: 2 yrs. Original Start Date: 1 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other I Estimated Square Feet: 7300 # of Floors: #1 Monday - Friday 9am to 4pm Work to be performed at: 911 Park Ave. BremertonWA 98337 ara assano ®1473-5390 360 473.5397 Sarah.tassano(a)ci.bremerton.w Client Contract Administrator: 911 Park Ave. Bremerton WA PF337 [Ta ra assano 3601473-5390 473-5397 sarah.tassano(cDci.bremerton.w Send billing information to: 100 Oyster Bay Ave. N. Bremerton WA 198311 acR R Res Dept. 3601473-2316 360 473-5360 ch ris. mottneID-ci. bremerton.wa. us Page 1 Work Request Template July 2013 % of weighting applied to evaluation categories: Pricing 60% References: 30% Standardized Q&As: Q% Bids must be submitted on or Mandatory Site Visit Date: 1 -May -2018 Site Visit Time: 1:00 PM before the date of >>> 8 -May -2018 I RFQQ Bid Submissions (by Vendors) should be DESCPRMHeal HumServ(c�des.wa.gov I electronically sent to this email address »> Click on link to identify proper prevailing wage>>> L&I janitorial prevailing wastes by iob class by county *Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. n Janitor Shampooer Waxer Window Washer Bidder to identify hourly labor rate»> 11.5 11.5 11.5 13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 �ception area tables, counters, chairs, and windows )py room counters & tables inchroom counters and tables ;neral hallway and corridor walls e cabinets ass doors :vator walls and hand rails 3irwell walls and hand rails iot clean all smudges, stains and spills as needed on any flooring or open surface !move cobwebs Total MINUTES required to successfully complete this task job class per event i Check box to activate section: a) p'IFx--1 Light switches b) Door handles c) F--] Vending machines d) 0 File cabinets e) 0 Stair walls and hand rails f) 0 Elevator walls and hand rails g) 0 Other h) 0 Other i) IE]Other Frequency: ❑1 x a Week Supervisor(s) Jandor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event »> Page 3 Work Request Template July 2013 i Check box to activate section: Frequency: ❑4 x a Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 40 job class per event >>> i Check box to activate section: X a) ® Drinking Fountains b) Q Elevators c) 0 Faucets d) 0 Other e) Q Other f) 0 Other g) Q Other Special Frequency:❑1 x a Week X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event >> ............................................................................................................................................................................................................................................................................: ♦ Check box to activate section: Page 4 Work Request Template July 2013 KI a) X All rooms and open areas. b) 0 General open areas, hallways, and corridors c) 0 The following Conference Rooms: d) Q Dining / lunchroom areas e) X Kitchen areas 9 0 Reception Area g) 0 Replace trash liners whenever stained, soiled, torn, and/or removed. h) QX Employee cubicle areas i) 0 Other j) 0 Other k) FX Empty smaller trash / recycle items into large receptacles at specified location 1) n On designated day(s), take large receptacles to the specified area. Trash can liners Frequency: 1 1 1 x I a Week S M T W T F S or Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event »> ............................................................................................................................................................................................................................................................................: i Check box to activate section: a) QX Sweep within 10 feet of each entrance. b) Q Sweep sidewalks along the front of building c) Q Remove trash and debris from outside parking lot d) Q Empty all entrance ash trays e) 0 Empty outside trash cans into proper receptacle as f) Q Other g) Q Other h) Q Other i) Q Other j) Q Other Frequency: 11 x a Week X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe] 1 5 job class per event >> Page 5 Work Request Template July 2013 i Check box to activate section: a) b) G) d) e) f) g) h) i) j) S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Minutes for Day Porter Services should be accordance with set amount of hours for the service ♦ Check box to activate section: a) 0 Reposition all conference room and reception area chairs b) 0 Replace light bulbs & light tubes as needed c) 0 Stock, and monitor all janitorial supplies d) 0 Other e) 0 Other f) Q Other g) Q Other h) 0 Other i) 0 Other D ID10ther Frequency: 1 1 1 1 a Week S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event >> ..............................................................................................................................................................................................................................................................................................: Page 6 Work Request Template July 2013 x II 9 (General Restroom Cleaninq and Disin a) Ox Sanitize all toilets, urinals, wash basins, etc. b) Ox Sweep, dry mop and/or damp mop and disinfect floors c) 0 Clean mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles d) 0 fill all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. e) x Plunge and/or snake toilets as needed. f) Q Other g) Q Other h) Q Other i)Q Other j) 0 Floor cleaning for bathroom is included as part of general floor cleaning duties Frequency: 1 1 1 x I a Week W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event »> :.................................................................................................................................................................................................................................................................................. Check box to activate section: 10 Additional Restroom Cleaninq and Disin a) b) c) d) e) 0 S M T W T F S Superviso(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> .................................................................................................................................................................................................................................................................................. Page 7 Work Request Template July 2013 i Check box to activate section: 11 General Kitchen Cleaning: ............................................................................................................................................................................................................................................. a) QX Clean and disinfect all counters b) Q Clean and disinfect outside of all cabinets c) Q Clean and disinfect outside of all appliances d) 0 Clean and disinfect sink and fixtures e) Q Clean and disinfect tables and counters in lunch room I eating area. f) 0 Dry mop 1 wet mop to remove all spills and stains on floor g) 0 Clean inside of following appliances: h) Q Other i) Q Other j) 0 Other Special Instructions: Frequency:x a WeekTX S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe 25 job class per event >>> ...............................................................................................................................................................................................................................................................................................: ♦ Check box to activate section: 12Additional Kitchen Cleaning: a) b) C) d) e) f) g) h) i) j) S M T W T F S Supervisor(s) Janhor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 8 Work Request Template July 2013 i Check box to activate section: 13 Other Specific Rooms As Follows: ........................................................................................................ a) 0 Other b) F--] Other C) Q Other d) Q Other e) Q Other fl 0 Other g) 0 Other h) OOther i) 0 Other j) .Other S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ♦ Check box to activate section: 14 Vacuum High Traffic Carpeted Areas to Include: (Daily/ Weekly) Estimated # of 5000 ........................................................................................................................................................................................................................ square feet; a) b) C) d) e) 0 g) h) i) D Reception Area General open areas, hallways and corridors The following Conference rooms: Elevator Floor Employee cubicle areas Additional Rooms &/or areas as noted in Special Instructions space below. Spot clean all carpeted areas when needed Private offices The above room Frequency:' 1' x a Week I I I I I I X I j u S M T W T F S at site visit. Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> 45 ............................................................................................................................................................................................................................................................................: Page 9 Work Request Template July 2013 ♦ Check box to activate section: 0 .15 Vacuum Low Traffic Carpeted Areas to . Include . . . . . . : .................................................................................................................................... a) Employee Oaiole Areas The followiiig-�orference rooms b) Q c) F e 0#+ses d) Q Ad6tional Rooms&/or- are-asas 4ioted-if�-Specjal 1nstruotiops! e) QOther >) 0 Other g) F-7 Other h) Q Other i) 0 Other j) n Tq --bayea e /a e ; T ted. been ear �k Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ........................................................................................................................................................................................................................................................................... : ♦ Check box to activate section: 16 Clean resilient floors to include: (Daily / Weekly) Estimated # of square feet: t: ......................................................................................t: a) x Sweep floors b) Q Dry mop c) 0 Wet mop as needed d) 0 Other e) 0 Other f) 0 Other g) 0 Other h) 0 Other instructions: Surface cleaning as noted above should be done on all noncarpeted floors unless specified otherwise. Frequency: 1 1 1 x l a Week M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 65 job class per event »> Page 10 Work Request Template July 2013 ♦ Check box to activate section: :1117 Clean, Strip & Wax Resilient floors: (Monthly /Annually) ....................................................................................................................................................... a) Q Strip -old wa-x argilem. eve sta;n- and-djscoloxatioqs b) O Re -max the areas checked off-and/t�spaoitied-bebw: -See for c) 0 At[ rioacargeted-#looms d) 0 Kitchen Lunchroom arc -as e) 0 Restroems f) Q Pfiat; Qopy;-Storage Raws g) Q Stars and Landings h) Q Ent rya,,ays i) 0 other j) F--19ther Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ........................................................................................................................................................................................................................................................................... : a Check box to activate section: —1118 Shampoo Carpet As follows: ----------------------------------------------------------------------------------- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec '- Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 11 Work Request Template July 2013 4- Check box to activate section: 19 Clean inside of interior/exterior windows a) F Other b) Q Other c) F Otter d) F Other e) 0 Other f) 0 they g) 0 Otber h) .Other Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> i Check box to activate section: 20 Clean (ground level) exterior windows a) Other b) Other C) Q Other d) Q Other e) Q Other fl Q Other g) Q Other h) 0 Other i) Q Other Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 12 Work Request Template July 2013 � ♦ Check box to activate section: II 1121 Clean (non -around level) exterior windows ♦ Check box to activate section: �22 Clean additional interior windows: a) Ox Entry way Windows b) Ox Private office windows c) Qx Conference room windows d) Fx Reception area windows e) Q Other f) Q Other g) F__] Other h) Q Other i) Q Other j) F__1 Other Special instructions: Note, this task is fora Frequency: 1 1 1 x I a Week (Sizes to be determined at site visit) come u u S M T W T F S Supervisors) Janitor(s) Shampooer(s) Wa K(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................: Page 13 Work Request Template July 2013 ♦ Check box to activate section: a) Other b) F� Ot c) F� oth d) 0 Other e) 0 Other f) F--1 Otl�e g) F--� Other h) F-1 Othe-r i) HI Other j) Other S M T Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> Check box to activate section: a) Q Other b) Ot Other c) Q Other d) Q Other e) Q Other fl Q Othe g) F-1 Other h) 0 Cther i) 0Other j) l then S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> :................................................................. ......... .............. ........................... ................ .......................... ...................................... ............................................................................. : Page 14 Work Request Template July 2013 i Check box to activate section: a) 0 Other b) 0 Other C) Q Other d) Q Other e) Q Othe; fOther) F Other 9) F Other h) F Other i) 0 Other j) ❑Other Other W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> .................................................................................................................................................................................................................................................................. ♦ Check box to activate section: a) 0 Other b) Q Other c) Q er d) Q Other e) Q Other f) Q Other g) F O} h) F Other i) QOther j) D Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> .................................................. ........... ......................................... ......................................................................................... .......................... ........................................... Page 15 Work Request Template July 2013 ♦ Check box to activate section: Total MINUTES required to successfully complete this task job class per event As Needed Cleaning: As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. =28 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> F=--129 Emergency water damage cleanup Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 16 Work Request Template July 2013 F=---130 Other (i.e. Chemical Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> F --]31 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> F --]32 Other (i.e. Bodily Fluids) Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> =7 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> =134 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 17 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> <<<Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper 0 Provided by Vendor ❑ 0 Paper Towels � ❑ Deicer Toilet Seat Covers X❑ ❑ Other (please specify) ❑ Liquid Soap ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> —Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Preferred? Provided by Agency Provided by Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap ❑ ❑ Floor Care Products ❑ Garbage Bags ❑ ❑ Glass Cleaner ❑ ❑Ix I Restroom Disinfectants & Cleaners ❑ ❑ Trash Can Liners F x] ❑ Other (please specify) ❑ ❑ ❑ ❑ ❑ Page 18 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)❑% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 11,340 Minutes Total Labor Cost For Regularly Scheduled Services -Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $2,173.50 with prevailing wage requirement. 189.0 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo Waxer ""l lmvvv Note: IF wages are reduced below prevailing wage Washer level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 36% Total Per Unit "As Needed Cleaning" Labor Cost $0.00 -Excluded from Annual Contract Amount Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 -Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $760.73 Total Bid Evaluation Price »> $2,934.23 Total Projected Annual Contract Price (Pre-tax)>>> $2,934.23 Price per month (Pre-tax) $244.52 Average Price per Day (Pre-tax) $8.04 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES Price per Quarter (Pre-tax) $733.56 Agency #IID 21801 Email your completed RFQQ Worksheet response to: DESCPRMHealHumSery@des.wa.gov i Bid submitted by: VARSITY FACILITY SERVI, Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 19 Work Request Template July 2013 EXHIBIT D POLICE STATION Washington State Department of Enterprise Services Agency Name: City of Bremerton (Police Station) Agency # or ID: 21801 1 County: Kitsap Contract Life: 2 yrs. Original Start Date: 11 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other Estimated Square Feet: 18000 # of Floors: 73 Monday - Friday 730am to 400pm Work to be performed at: 1025 Burwell Street Bremerton WA 98312 any um ®1473-5974 1 360 473.5396 randy.plumb(cb-ci.bremerton.wa. Client Contract Administrator: 100 Oyster Bay Ave. N. Bremerton WA 98311 ns o ner 3601473-2316 473-5360 ch ris. mottn e r(a)-c i. bremerton.wa Send billing information to: 100 Oyster Bay Ave. N. Bremerton I WA 98311 Facilities Dept. 360 360 473.5360 Chris.mottner(cDci.bremerton.wa.us Page 1 Work Request Template July 2013 % of weighting applied to evaluation pricing 60% categories: Mandatory Site Visit Date: 1 -May -2018 Site Visit Time: References: 30% Standardized Bids must be submitted on 1:00 PM before the date of > 10% 8 -May -2018 I RFQQ Bid Submissions (by Vendors) should be DESCPRMHeal HunnSema)_des.wa.gov I electronically sent to this email address »> Click on link to identify proper prevailing wage>>> L&I janitorial prevailing wages by job class by county "Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. n Janitor Shampooer Waxer Window Washer Bidder to identify hourly labor rate»> 11.5 11.5 11.5 T 13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 a) b) C) d) e) f) g) h) i) j) k) 1) M) n) Reception area tables, counters, chairs, and windows Copy room counters & tables Lunchroom counters and tables General hallway and corridor walls File cabinets Glass doors Elevator walls and hand rails Stairwell walls and hand rails clean all smudges, stains and spills as needed on any flooring or open surface Zemove cobwebs nterior glass Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 15 job class per event >> 1 I Check box to activate section: a) b) C) d) e) 0 g) h) i) Frequency: ❑ x Supervisor(s) Janitors) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ............................................................................................................................................................................................................................................................................................... Page 3 Work Request Template July 2013 i Check box to activate section: X a) x Horizontal surfaces & moldings b) Qx Horizontal &vertical blinds c) Qx Picture Frames d) 0 Cloth panels e) x HVAC vents, grills, and recesses f) Ox Ceiling vents, grills, and recesses g) Qx Horizontal & vertical blinds h) F Other i) 0 Other j) F Other k) F Other 1) F Other Frequency: 11 x a Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 75 job class per event >>> ..............................................................................................................................................................................................................................................................................................i i Check box to activate section: X a) ® Drinking Fountains b) ® Elevators c) FX --1 Faucets d) 0 Other e) Q Other f) Q Other g) Q Other Frequency:❑5 x a Week x x X x x S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 10 job class per event >> Page 4 Work Request Template July 2013 i Check box to activate section: X a) X All rooms and open areas. b) 0 General open areas, hallways, and corridors c) Q The following Conference Rooms: d) 0 Dining 1 lunchroom areas e) 0 Kitchen areas f) X Reception Area g) 0 Replace trash liners whenever stained, soiled, torn, and/or removed. h) Q Employee cubicle areas i) Q Other j) Q Other k) Fx] Empty smaller trash / recycle items into large receptacles at specified location 1) M On designated day(s), take large receptacles to the specified area. can liners shall be replaced whenever they become stained, soiled, or torn. Frequency: 1 5 1 x I a Week S M T W Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 35 job class per event »> ........................................................................................................................................................................................................................................................................... . i Check box to activate section: a) QX Sweep within 10 feet of each entrance. b) Q Sweep sidewalks along the front of building c) Q Remove trash and debris from outside parking lot d) QX Empty all entrance ash trays e) QX Empty outside trash cans into proper receptacle f) Q Other g) 0 Other h) Q Other i) Q Other j) 0 Other Frequency:❑5 x a Week X X x X X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event > ............................................................................................................................................................................................................................................................................: Page 5 Work Request Template July 2013 Z Check box to activate section: Check box to activate section: a) 0 Reposition all conference room and reception area chairs b) 0 Replace light bulbs &light tubes as needed c) 0 Stock, and monitor all janitorial supplies d) F Other e) Q Other f) Q Other g) 0 Other h) F Other i)Other j) FEJOther I Frequency: ❑1 a Week S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event >> ...................................................................................................................................................................................................................... .................................................. Page 6 Work Request Template July 2013 W s /General Restroom Cleaning and Disinfecting a) Q Sanitize all toilets, urinals, wash basins, etc. b) Q Sweep, dry mop and/or damp mop and disinfect floors c) Qx Clean mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles d) Q fill all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. e) Qx Plunge and/or snake toilets as needed. f) 0 Other g) F Other h) F Other i)FolFloor Other j) cleaning for bathroom is included as part of general floor cleaning duties instructions: please include mens and womens locker rooms Frequency: 1 51 x I a Week S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 55 job class per event > i Check box to activate section: x 11 10 Additional Restroom Cleaning and Disinfecting: ....................................................................................................................... a) Qx Clean and disinfect toilet stall doors and walls b) 7 Clean and disinfect shower areas and fixtures c) 0 Other d) 0 Other e) Q Other f) Q Other Frequency: 1 5 1 x I a Week S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event »> ............................................................................................................................................................................................................................................................................: Page 7 Work Request Template July 2013 i Check box to activate section: 11 General Kitchen Cleaning: .................................................................................................................................................................. a) QX Clean and disinfect all counters b) Q Clean and disinfect outside of all cabinets c) 0 Clean and disinfect outside of all appliances d) QX Clean and disinfect sink and fixtures e) QX Clean and disinfect tables and counters in lunch room I eating area. f) 0 Dry mop 1 wet mop to remove all spills and stains on floor g) 0 Clean inside of following appliances: h) 0 Reposition kitchen furniture in an orderly manner i) 0 Other j) .Other Frequency: T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task per!30 job class per event »> .................................................................................................................................................................................................................................................................................. Check box to activate section: 12 Additional Kitchen Cleaning: ............................................................................................................................................................................................................................. S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Wndow Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ................................. ........................................................................... ............................................................................................. ........................................................................ Page 8 Work Request Template July 2013 i Check box to activate section: 13 Other Specific Rooms As Follows: ........................................................................................................ a) F Other b) F Other c) F Other d) F Othe e) Q Other fl 0 Other g) F Other h) F Othier F7Other 0 Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> ♦ Check box to activate section El1 . 4 Vacuum High Traffic Carpeted Areas to Include: (Daily / Weekly).................................................................................................................................................................................... a) 0 Reception Area b) Q General open areas, hallways and corridors c) Q The following Conference rooms: d) Q Elevator Floor e) X Employee cubicle areas f) 0 Additional Rooms &lor areas as noted in Special Instructions space below. g) Q Spot clean all carpeted areas when needed h) Q Private Offices i) 0 Interview Rooms j) n The above square footage is estimated, Vendors should confirm actual Estimated # of at site Special instructions: Offices are to be done when door is open, if it is shut and locked they can be done the following scheduled day. There may be times when certain areas are off limits due to an investigation or interviews in progress, it will be made clear at the start of a shift that those areas are off limits and on those days the off limit areas can be skipped until the following scheduled day. Frequency: ❑2 x a Week I I I X I I I X S M T W T F S Supervisor(s) Janitors) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 110 job class per event >> ..............................................................................................................................................................................................................................................................................................: Page 9 Work Request Template July 2013 ♦ Check box to activate section: ::11..15 Vacuum Low Traffic Carpeted.....Areas......to...Include:............................................................................................................................. a) 0 Employee Cublde Areas b) Q The following Conference rooras;— c) 0 jvate-Offices d) F--lAdAonal Rooms&lor areas as noted in Special In tions-� e) Q Other fl 0 Other g) Q Other h) 0 Other i) Other j) rF-J S M T W T Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> ................................................................................................................................................................................................................................................................................... ♦ Check box to activate section: X 16 Clean resilient floors to include: (Daily I Weekly) Estimated # of ............................................................................................................................................................................. ............................................ square feet:.......................... a) 0 Sweep floors b) 0 Dry mop c) 0 Wet mop as needed d) Q Other e) 0 Other f) 0 Other g) 0 Other h) Q Other rl instructions: Surface cleaning as noted above should be done on all noncarpeted floors unless specified otherwise. Wet mop 2x a To include mens and womens locker rooms Frequency: 1 5 1 x I a Week M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 75 job class per event »> ..................................................................................................................................................... Page 10 Work Request Template July 2013 5,200 rs ♦ Check box to activate section: :�:11.17 Clean, Strip & Wax Resilient floors: (Monthly / Annually) ................................................................................................................................................................. a) 0 Strip old vvax and f&mose..stalns and-diseolomf# ons b) 0 Rye-vmx-the areas -c- cRed of and/,or sp ��elow; 4Seo alse-steal C) Q II-rTon-,nafp d floors d) Q Kitchen; -Lunchroom areas e) 0 € estroems Q P-nnt- Copy, Storage Roams g) Q Stairsand Larrrlings h) €n Y�,uays i) Q Qthef j) n tithe; Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WndowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> ............................................................................................................................................................................................................................................................................ ♦ Check box to activate section: :1118 Shampoo Carpet As follows: ...................................................................................... Toi Page 11 Work Request Template July 2013 a Check box to activate section: 19 Clean inside of interior/exterior windows a) 0 Other b) 0 Other c) Q Other d) Q Other e) Q 9ther f) 0 Other g) 0 Other h) Q Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) required to successfully complete this task per job class per event »> I I ♦ Check box to activate section: Clean (ground level) exterior windows a) RF --1 Other b) Other C) 0 Other d) 0 Other e) Q Other 0 OOther g) 0 Other h) Q Other i) 0 Other j) 1=10ther Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task per job class per event »> ........................................................................................................................................................................................................................................................................... : Page 12 Work Request Template July 2013 i Check box to activate section: 1 Clean (non -ground level) exterior windows a) Q mer b) r Other c) r Other d) F Other e) Q Other - f) 0 her Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> .......................................... ........................................................................................................................................................................................................................................ ♦ Check box to activate section: 22 Clean additional interior windows: a) Qx Entry way Windows b) 0 Private office windows c) 0 Conference room windows d) F__1 Reception area windows e) Q Other f) 0 Other g) Q Other h) Q Other i) � Other j) 0 Other Frequency: 1 1 1 x l a Week a run wmaow cieanmg. S M T W T F S (Sizes to be determined at site visit) smudges, fingerprints, etc., should come under above sections 1 -3 above.) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ................................................................................................................................................................................................................................................................ Page 13 Work Request Template July 2013 i Check box to activate section: a) Q sweep stars b) F1 Other c) F� Other d) Q Other e) Other f) F-1 Other g) ❑ Other h) F-� Other i) ❑Other j) rlOther S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event »> ............................................................................................................................................................................................................................................................................: Check box to activate section: a) b) c) d) e) fl g) h) i) j) S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washers) Total MINUTES required to successfully complete this task pe job class per event »> ..................... ...................... ............. ............................ ............................................. .............................. ............. ............. ................................ ................. ...................................... : Page 14 Work Request Template July 2013 ♦ Check box to activate section: a) ❑ Other b) ❑ Other c) ❑ Other d) ❑ Other e) ❑ Other 0 ❑ Other g) ❑ Other h) ❑ Other i) ❑ Other j) ❑ S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ♦ Check box to activate section: a) F Other, b) ❑ Other c) ❑ Other d) r Other e) Q Other fl ❑ Other g) ❑ Other h) F Other i) F--1 Other j) ❑ Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event »> ............................................................................................................................................................................................................................................................................: Page 15 Work Request Template July 2013 ♦ Check box to activate section: a) Q ether b) 0 Other c) 0 Other d) 0 Other e) 0 Other 0 0 Other g) Q Other h) Q Other i) F--] Other j) � Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ................................................................................................................................................................................................................................................................ As Needed Cleaning: As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. �28 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> f=29 Emergency water damage cleanup Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washe(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 16 Work Request Template July 2013 =130 Other (i.e. Chemical Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> I I =131 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> F=--132 Other (i.e. Bodily Fluids) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task per job class per event »> F ----]33 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> F —734 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washers) Total MINUTES required to successfully complete this task pe job class per event >> Page 17 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES 36 Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper ❑ Provided by Vendor ❑ ❑ Paper Towels ❑x ❑ 0 Deicer Toilet Seat Covers X❑ ❑ Other (please specify) ❑ Liquid Soap ❑ X❑ Floor Care Products X❑ ❑ ❑ ❑ Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Preferred? Provided by Agency Provided by Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap X❑ Floor Care Products X❑ Garbage Bags Fx] ❑ Glass Cleaner ❑ F Restroom Disinfectants & Cleaners X ❑ Trash Can Liners X❑ Other (please specify) ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Page 18 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)❑% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 78,300 Minutes Total Labor Cost For Regularly Scheduled Services - Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $15,007.50 with prevailing wage requirement. 1,305.0 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo waxer Washer Note: IF wages are reduced below prevailing wage level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 'Ago/ Total Per Unit "As Needed Cleaning" Labor Cost $0.00 <Excluded from Annual Contract Amount Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 <<Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $5,252.63 Total Bid Evaluation Price >> $20,260.13 Total Projected Annual Contract Price (Pre-tax)>>> $20,260.13 Price per month (Pre-tax) $1,688.34 Average Price per Day (Pre-tax) $55.51 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES —>—> Email your completed RFQQ Worksheet response to: DESCPRMHealHumServ@des.w'a.gov Price per Quarter (Pre-tax) $5,065.03 Agency #/ID 21801 'Bid submitted by: VARSITY FACILITY SERVI' Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 19 Work Request Template July 2013 EXHIBIT E PUBLIC WORKS & UTILITIES FLEET Washington State Department of Enterprise Services Agency Name: City of Bremerton (PW&U Admin & Equipment Services) Agency # or ID: 21801 County: Kitsap Contract Life: 2 yrs. Original Start Date: 1 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other I Estimated Square Feet: 110000 # of Floors: M2 Monday - Friday 6pm to 7am Work to be performed at: 100 Oyster Bay Ave. N. Bremerton WA F98312 lChris o ner oe Stansbery 1473-2316 360 473.2330 Chris. Mottner(cD-ci. bremerton.w Client Contract Administrator: 100 Oyster Bay Ave. N. Bremerton WA 98312 Chris o ner oe StansHry 3601473-2316 360 473-2330 Ch ris. mottner(aD-ci. bremerton.w Send billing information to: 100 Oyter Bay Ave. N. Bremerton WA 98312 Chris MottneRjoe Stansbery 3601473-2316 360 473-2330 Chris.mottner(cD-ci.bremerton.wa. u Page 1 Work Request Template July 2013 % of weighting applied to evaluation categories: Pricing ["7600/o References: 30% Standardized Q&As: �Q% Bids must be submitted on or Mandatory Site Visit Date: 1 -May -2018 Site Visit Time: 1:00 PM before the date of >>> 8 -May -2018 I RFQQ Bid Submissions (by Vendors) should be DESCPRMHeal HumServ(a)des.wa.gov electronically sent to this email address »> Click on link to identify proper prevailing wage>>> L&I ianitorial prevailing wages by iob class by county *Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. SUpeNISOr Janitor Shampooer I Waxer Window Washer Bidder to identify hourly labor rate>>> 11.5 11.5 11.5—F13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 a) x Reception area tables, counters, chairs, and windows b) Qx Copy room counters & tables c) QX Lunchroom counters and tables d) Qx General hallway and corridor walls e) Qx File cabinets f) 0 Glass doors g) Qx entryway windows h) Qx Stairwell walls and hand rails i) 0 Spot clean all smudges, stains and spills as needed on any flooring or open surface j) x Remove cobwebs k) Q Other 1) 0 Other m) Q Other n) F7 Other ons: 5 1 1 Weekly Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe] 1 5 job class per event >> a Check box to activate section: a) b) C) d) e) 9 g) h) i) Frequency: ❑ x Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 3 Work Request Template July 2013 i Check box to activate section: a) b) C) d) e) f) g) h) k) 1) Frequency: ❑ x a Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ♦ Check box to activate section: X a) ®Drinking Fountains b) r Elevators c) 0 Faucets d) 0 Other e) Q Other f) Q Other g) .Other instructions: Frequency:xF79 X X x x XPIS M T W ❑T S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event »> Page 4 Work Request Template July 2013 a- Check box to activate section: a) X All rooms and open areas. b) Q General open areas, hallways, and corridors c) Q The following Conference Rooms: d) 0 Dining I lunchroom areas e) QX Kitchen areas f) Q Reception Area g) Q Replace trash liners whenever stained, soiled, torn, and/or removed. h) QX Employee cubicle areas i) 0 Other j) Q Other k) F—x] Empty smaller trash / recycle items into large receptacles at specified location 1) F-1 On designated day(s), take large receptacles to the specified area. can Frequency: 1 5 1 x I a Week S M T W T F S ortorn. Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event >> i Check box to activate section: a) F—X-1 Sweep within 10 feet of each entrance. b) Q Sweep sidewalks along the front of building c) Q Remove trash and debris from outside parking lot d) Q Empty all entrance ash trays e) Q Empty outside trash cans into proper receptacle as f) 0 Other g) Q Other h) 0 Other i) Q Other j) .Other Frequency:❑5 x a Week X X X X X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event >> ............................................................................................................................................................................................................................................................................: Page 5 Work Request Template July 2013 i Check box to activate section: Min( 4 Check box to activate section: X 11 a) 0 Reposition all conference room and reception area chairs b) Q Replace light bulbs & light tubes as needed c) Q Stock, and monitor all janitorial supplies d) 0 Other e) Q Other f) Q Other g) Q Other h) Q Other i)F010ther Other j) Frequency: 1 1 1 1 a Week T W R F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 10 job class per event »> ............................................................................................................................................................................................................................................................................i Page 6 Work Request Template July 2013 x II 9 (General Restroom Cleanina and Disin a) Ox Sanitize all toilets, urinals, wash basins, etc. b) Ox Sweep, dry mop and/or damp mop and disinfect floors c) 0 Clean mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles d) 0 fill all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. e) 0 Plunge and/or snake toilets as needed. f) 0 Other g) Q Other h) Q Other i) Q Other j) 0 Floor cleaning for bathroom is included as part of general floor cleaning duties Frequency: 1 5 1 x I a Week S M Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event >> 4 Check box to activate section: 10 Additional Restroom Cleaning and Disinfecting: ............................................................................................................................................................................................ a) Ox Clean and disinfect toilet stall doors and walls b) 0 Clean and disinfect shower areas and fixtures c) 0 Other d) 0 Other e) HOther Other f) Frequency: 1 5 1 x I a Week S M T W T F Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 20 job class per event >>> ............................................................................................................................................................................................................................................................................'s Page 7 Work Request Template July 2013 i Check box to activate section: 11 General Kitchen Cleanina: ............................................................................................................................................... a) 0 Clean and disinfect all counters b) QX Clean and disinfect outside of all cabinets c) Q Clean and disinfect outside of all appliances d) 0 Clean and disinfect sink and fixtures e) 0 Clean and disinfect tables and counters in lunch room I eating area. f) 0 Dry mop I wet mop to remove all spills and stains on floor g) 0 Clean inside of following appliances: h) 0 Clean outside and fill soap dispensers i) Q Clean outside and fill paper towel dispenser j) Q Reposition kitchen furniture in an orderly manner Frequency: 1 5 1 x S M T Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event >>> ............................................................................................................................................................................................................................................................................................... i Check box to activate section: 12 Additional Kitchen Cleaning: ........................................................................................ S M T W R F S Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> .................................................................................................................................................................................................................................................................................. Page 8 Work Request Template July 2013 i Check box to activate section: 13 Other Specific Rooms As Follows: ........................................................................................................ a) 0 Other b) Q OthEr c) F Other d) OOther e) Q Other fl 0 Other g) F Other h) F Other i) F Other j) Q Other S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ..............................................................................................................................................................................................................................................................................................: i Check box to activate section: 14 Vacuum High Traffic Carpeted Areas to Include: (Daily/ Weekly) ................................................................................................................................................................................ a) b) C) d) e) f) g) h) i) 1) Reception Area General open areas, hallways and corridors The following Conference rooms: Elevator Floor Employee cubicle areas Additional Rooms Wor areas as noted in Special Instructions space below. Spot clean all carpeted areas when needed Private Offices Large Conference room and Directors conference room The above sauare footage is estimated. Vendors should confi Frequency:❑1 x a Week X S M T W R F S Estimated # of square feet: supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> 45 ..............................................................................................................................................................................................................................................................................................) Page 9 Work Request Template July 2013 ♦ Check box to activate section: 15 Vacuum Low Traffic Carpeted Areas to Include: ............................................................................................................................................................................................................................................................................... a) 0 Employee -GuN eas b) Q Tte-fs4lexiv+.—, Cop#erence rooms - — -._ —-------- ____.. '• c) Q Private Off,es -- - - - - d) Q , djtiGna4-Reems &/or areas as noted Ii Spec-ia�4nv#fuGt400s-space befaw. e) Q Other fl Q Other g) Q Other h) F--1 Other i) Q Other j) I� T;� ��Jbb 5�{3f$ iu @sif�7oforl )�onrinrSh9�#� g� aCEi!}£ f^^vac. }ie E U L V Lf-I/-I�ITC7V/ S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> ............................................................................................................................................................................................................................................................................................ : ♦ Check box to activate section: x 16 Clean resilient floors to include: (Daily / Weekly) .................................................................................................................................................... a) Q Sweep floors b) 0 Dry mop c) Q Wet mop as needed d) Q Other e) Q Other f) Q Other g) Q Other h) 0 Other Frequency: 1 5 1 x I a Week as noted above should be done on all S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxe(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 65 job class per event >>> ................................................................................................................................................................................................................................................................ Page 10 Work Request Template July 2013 ♦ Check box to activate section: FE -11 17 Clean, Strip & Wax Resilient floors: (Monthly /Annually) ....................................................................................................................................................... a) b) C) d) e) fl g) h) i) j) brvsaxing requjremer�s) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> .................................................................................................................................................................................................................................................................................. ♦ Check box to activate section: 18 Shampoo Carpet As follows: a) b) c) d) e) fl g) h) i) j) Jan Feb Mar Apr May Jun Ju Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 11 Work Request Template July 2013 ♦ Check box to activate section: 9 Clean inside of interior/exterior windows a) 0 th-er b) 0 Other c) 0 Other d) Q Other e) Q 1.thar f) F-1 Other g) QOther h) 0 Other Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> 4 Check box to activate section: Clean (ground level) exterior windows a) F—] Other b) Q Other c) Q Other d) Q Other e) Q Other fl 0 Other g) Q Other h) 0 Other i) Q Other j) Q Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ......................................................................................................................................................................----...------------------------------ Page 12 Work Request Template July 2013 i Check box to activate section: 1 Clean (non -ground level) exterior windows a) 0 Other b) F-1 Other c) 0 Other d) 0 Other, e) F__1 Other fl d Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> .................................................................................................................................................................................................................................................................................. ♦ Check box to activate section: �22 Clean additional interior windows: Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> .................................................................................................................................................................................................................................................................................. Page 13 Work Request Template July 2013 i Check box to activate section: a) F Other b) F Other c) Q Other d) F Other e) Q Other f) F Other g) ❑Other Other h) F Other i) F Other j) E Other S M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washers) Total MINUTES required to successfully complete this task pe job class per event >> ................................................................................................................................................................................................................................................................... Check box to activate section: a) 0 Other b) Q Other c) Q Other d) 0 Other e) Q Other f) 0 Other g) F Other h) F Other i) Q O#her j) E Ozer M T W R F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event > ........................................................................................................................................................................................................................................................................... Page 14 Work Request Template July 2013 i Check box to activate section: a) 0 Other b) 0 Other C) ❑ Other d) 0 Other e) ❑ Other f) ❑ Other g) ❑ Other h) ❑ Other i) ❑ Other j) ❑ Other S M T W R F S Supe"isor(s) Janitor(s) Shampooer(s) Wmer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> ................................................................................................................................................................................................................................................................ ♦ Check box to activate section: a) ❑ Other b) 0 Other C) 0 Other d) 0Qther e) Q Other f) ❑ Other g) ❑ Other h) ❑ Other () Q Other j) ❑ Other --T S M T W R F S Supewisor(s) Janitor(s) Shampooer(s) Wwer(s) Window Washer(s) Total MINUTES required to successfully complete this task perl job class per event »> ...........................................................................................................--..............................--.............................................................................................................................. Page 15 Work Request Template July 2013 ♦ Check box to activate section: a) 0 Other b) F--] Other c) I Othe d) I Otk er e) 0 Other 0 0 Other g) 0Other h) Q Other i) 0 Other j) ❑ Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> As Needed Cleaning: As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. F=728 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washers) Total MINUTES required to successfully complete this task pe job class per event >>> F=--129 Emergency water damage cleanup Page 16 Work Request Template July 2013 Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Wndow Washer(s) Total MINUTES required to successfully complete this task per job class per event >>> Page 17 Work Request Template July 2013 F=---130 Other (i.e. Chemical Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> F —131 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task per job class per event »> F=32 Other (i.e. Bodily Fluids) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> r= Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> 034 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 18 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES F=-136 Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper X Xi❑ Provided by Vendor Light Bulbs X Paper Towels X❑ Deicer Toilet Seat Covers ❑x ❑ ❑ Other (please specify) ❑ Liquid Soap ❑ � ❑ ❑ ❑ ❑ X❑ Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> <<<Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Preferred? Provided by Agency Provided by Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap � ❑ Floor Care Products X❑ Garbage Bags ❑X ❑ X❑ Glass Cleaner X❑ Restroom Disinfectants & Cleaners X❑ Trash Can Liners X❑ F Other (please specify) ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Page 19 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)❑% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 49,660 Minutes Total Labor Cost For Regularly Scheduled Services - Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $9,518.17 with prevailing wage requirement. 827.7 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo Waxer -11—v Note: IF wages are reduced below prevailing wage Washer level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 35% Total Per Unit "As Needed Cleaning" Labor Cost $0.00 -Excluded from Annual Contract Amount Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 -Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $3,331.36 Total Bid Evaluation Price >>> $12,849.53 Total Projected Annual Contract Price (Pre-tax)>>> $12,849.53 Price per month (Pre-tax) $1,070.79 Average Price per Day (Pre-tax) $35.20 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES »—> Price per Quarter (Pre-tax) $3,212.38 Agency #/ID 21801 Emell your completed RFQQ Workshee# mpopse to: DESCPRMHealHumServ@des.wa.gov i=Bid submitted by: VARSITY FACILITY SERVI� Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 20 Work Request Template July 2013 EXHIBIT F SOG Washington State Department of Enterprise Services Agency Name: City of Bremerton (Police Operations) Agency # or ID: 121801 County: Kitsap Contract Life: 1 2 yrs. Original Start Date: 1 -Jul -18 Building Type: Approved working hours Street Address: Street Address: City & Zip Point of contact Phone: Fax: Email: Work Request Number: 42170 Other Estimated Square Feet: 11900 7 # of Floors: #1 TBD - high security must be accompanied by police staff Work to be performed at: 3029 Olympus Drive Bremerton WA 98310 Barbara Forbes ®1473-5227 360 473.5787 Barbara. forbes(Wci.bremerton. Client Contract Administrator: 100 Oyster Bay Ave. N. Bremerton WA 98311 [Mr—is o ner oe SI ans ery 360 173-.2331 360 473-5360 chris.mottner@ci.bremerton.wa Send billing information to: 100 Oyster Bay Ave. N. Bremerton WA 98311 Facilities Dept. 360 360 473-5360 ch ris. mottner(ab-ci. bremerton.wa. us Page 1 Work Request Template July 2013 Information forVendors • • Site Visit, C • Submission and Evaluation weighting % of weighting applied to evaluation pricing 60% References: 3Q% Standardized Q&As: 1 U% categories: Bids must be submitted on or Mandatory Site Visit Date: 1 -May -2018 Site Visit Time: 1:00 PM before the date of >>> 8 -May -2018 RFQQ Bid Submissions (by Vendors) should be DESCPRMHealHumServa_des.wa.gov electronically sent to this email address >>> Special InstrUCtions, Conditions, Standard of VVork Requirements and/or Floor Plans Vendors must submit a completed Wage Theft Certification at the time they submit their bid or the bid will be considered non-responsive. Facility Security: Apparent Successful Bidder employees may be required to pass background check documentation for any staff member or subcontractor who will be given access to the facility. Embed any documents containing specific terms, conditions, specifications, floor plans, and/or other instructions. »»»»»> Click on link to identify proper prevailing wage>>> L&I janitorial prevailing wages by job class by county *Note: The purchasing agency may update the Work Contract based on minimum wage increases and will update the Work Contract to reflect the LNI prevailing wage changes each applicable year. In Janitor Shampooer Waxer Window Washer Bidder to identify hourly labor rate»> 11.5 11.5 11.5 13.22 NOTE: Janitorial work contracts are "performance based" contracts, and vendors must submit quotes that assure the ability to fully service all noted tasks in accordance with this agency's performance demands (which will be discussed at the site visit.) The amount of minutes bid by vendors will be calculated to measure reasonableness and quality assurance in accordance with RCW 39.26.160(2)(c) and the master contract 00508; janitorial service personnel are required to cumulatively work the amount of minutes submitted in the RFQQ and Work Contract. Page 2 Work Request Template July 2013 a) b) c) d) e) f) g) h) i) j) k) 1) M) n) m area tables, counters, chairs, and windows om counters & tables iom counters and tables hallway and corridor walls lets ors walls and hand rails walls and hand rails an all smudges, stains and spills as needed on any flooring or open surface cobwebs Instructions: 1 1 1 Weekly Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe] 1 5 job class per event >> Z Check box to activate section: a) b) c) d) e) 0 g) h) i) U 0 F Q Q Q Q QOffier Ught sw4ches Acer handles Vendlna machines File cabinets Stagy gall, and hand -rails Elevator walls and hand r Other ether Q Frequency: ❑ x Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 3 Work Request Template July 2013 i Check box to activate section: a) x Horizontal surfaces & moldings b) 0 Horizontal & vertical blinds c) 0 Picture Frames d) 0 Cloth panels e) Qx HVAC vents, grills, and recesses f) 0 Ceiling vents, grills, and recesses g) Qx Horizontal & vertical blinds h) Q Other i) Q Other j) Q Other k) Q Other 1) Q Other Frequency: 11 x a Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 45 job class per event >>> ♦ Check box to activate section: ri a) 0 Drinking Fountains b) Q Elevators c) 0 Faucets d) 0 Other e) Q Other f) Q Other g) - Other Frequency:❑1 x a Week x S M T W R �❑S Supervisor(s) Janftor(s) Shampooer(s) Waxers) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event >> Page 4 Work Request Template July 2013 ♦ Check box to activate section: a) b) C) d) e) f) g) h) k) 1) ns and open areas. open areas, hallways, and corridors )wing Conference Rooms: lunchroom areas areas )n Area trash liners whenever stained, soiled, torn, and/or removed. ;e cubicle areas maller trash / recycle items into large receptacles at specified location gnated day(s), take large receptacles to the specified area. Trash can liners shall be Frequency: 1 1 1 x I a Week M T W T F S or torn. Please include the garage area. Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 25 job class per event >> i Check box to activate section: X a) QX Sweep within 10 feet of each entrance. b) 0 Sweep sidewalks along the front of building c) Q Remove trash and debris from outside parking lot d) 0 Empty all entrance ash trays e) 0 Empty outside trash cans into proper receptacle as f) 0 Other g) 0 Other h) 0 Other i) 0 Other j) Q Other Special Instructions: Frequency:❑1 x a Week X S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 5 job class per event >> ............................................................................................................................................................................................................................................................................: Page 5 Work Request Template July 2013 i Check box to activate section: a) b) C) d) e) fl g) h) i) D M T W T F S Supervisor(s) Janitor(s) Minutes for Day Porter Services should be accordance set amount of hours for the sei i Check box to activate section: a) Q b) 0 c) Q d) 0 e) Q fl h) 0 i) j) 0 S M T W T F S Shampooer(s) Waxer(s) WiindowWasher(s) .................................................................................................: Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> ............................................................................................................................................................................................................................................................................................. . Page 6 Work Request Template July 2013 a) b) C) d) e) f) g) h) i) j) initize all toilets, urinals, wash basins, etc. weep, dry mop and/or damp mop and disinfect floors can mirrors, mirror frames, faucets, exposed pipes, dispensers, hand driers, counters, and door handles I all paper towel dispensers, toilet paper dispensers, toilet seat cover dispensers, and soap dispensers. unqe and/or snake toilets as needed. cleaning for bathroom is included as part of general floor cleaning duties Instructions: Frequency: I 1 I x I a Week W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 35 job class per event >> ............................................................................................................................................................................................................................................................................: a Check box to activate section - 10 Additional Restroom Cleaning and Disinfecting: a) 0 Clean- and disinfect toilet -stall dooFs apid-walls b) 0Olean-anddis ^f. t s", :ae� areas-and#+xtu+as c) 0 Other d) 0 Other e) 0Other 0 F- Other S M T W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ..............................................................................................................................................................................................................................................................................................s Page 7 Work Request Template July 2013 i Check box to activate section: 11 General Kitchen Cleaning: .......................................................................................................................................................................................................... a) Q Clean and disinfect all counters b) Q Clean and disinfect outside of all cabinets c) Q Clean and disinfect outside of all appliances d) 0 Clean and disinfect sink and fixtures e) QX Clean and disinfect tables and counters in lunch room I eating area. f) Q Dry mop I wet mop to remove all spills and stains on floor g) 0 Clean inside of following appliances: h) Q reposition furniture in an orderly manner i)FE]JOther Other j) Frequency:) 1 1 x S M T W T Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe 20 job class per event »> .................................................................................................................................................................................................................................................................................. ♦ Check box to activate section: 12 Additional Kitchen Cleaning: a) b) C) d) e) f) g) h) i) j) S M T W T F S Supervisors) Janftor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> ............................................................................................................................................................................................................................................................................................. : Page 8 Work Request Template July 2013 i Check box to activate section: 13 Other Specific Rooms As Follows: ........................................................................................................ a) 0 Other b) 0 Other c) 0 Other d) 0 Other e) Q - the'r fl a other g) Q Other h) Q other i) F--1 Other j) .Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ♦ Check box to activate section: 14 Vacuum High Traffic Carpeted Areas to Include: (Daily/ Weekly) .................................................................................................................................................................................. a) QX Reception Area b) Q General open areas, hallways and corridors c) 0 The following Conference rooms: d) Q Elevator Floor e) X Employee cubicle areas fl Q Additional Rooms &lor areas as noted in Special Instructions space below. g) Q Spot clean all carpeted areas when needed h) QX Private Offices i) Q Other j) F-1 The above square footage is estimated, Vendors should confi Frequency:❑1 x a Week X S M T W T F S Estimated # of 1250 ...............square feet: Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> 20 ............................................................................................................................................................................................................................................................................: Page 9 Work Request Template July 2013 ♦ Check box to activate section: 15 Vacuum Low Traffic Carpeted Areas to Include: .............................................................................................................................................. a) b) c) d) e) fl g) h) i) j) S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) ,fully complete this task pe job class per event >> ............................................................................................................................................................................................... ♦ Check box to activate section: �x 16 Clean resilient floors to include: (Daily / Weekly) Estimated # of ........................................................................................................................................................................................................................ square feet:... a)Q Sweep floors b) Q Dry mop c) 0 Wet mop as needed d) F Other e) 0 Other fl 0 Other g) F Other h) 0 Other Frequency: 1 1 1 x l a Week as noted above should be done on all noncarpeted floors unless specified S M T W T F S 700 Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe 15 job class per event >> :............................................................................................................................................................................................................................................................................................... Page 10 Work Request Template July 2013 ♦ Check box to activate section: 17 Clean, Strip & Wax Resilient floors: (Monthly / Annually) ....................................................................................................................................................... a) Q St -rip old via b) Q Re --wax the- hec) c) 0 Al-nan-earp d) 0 Kitchen , -La( e) 0 Restroonns f) 0 Print, Gepy, g) Qa+ad 6 h) 0 Entryways i) Q Other j) 00ther Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ......................................... ..................................................................................................................................................................................................................................................... : ♦ Check box to activate section: n1 g Shampoo Carpet As follows: .............................................................................................................................................................................................................................................................................. a) b) c) d) e) g) h) i) j) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxers) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> Page 11 Work Request Template July 2013 ♦ Check box to activate section: 19 Clean inside of interior/exterior windows a) Q Other b) 0 Other c) 0 Other d) 0 Other e) 0 Other f) 0 Other g) 0 Other h) 0 Other Jan Feb Mar Apr May Jun Jul Aug Sep Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >>> ............................................................................................................................................................................................................................................................................: i Check box to activate section: Clean (ground level) exterior windows a) ❑Other b) Ot Other C) 0 Other d) 0 Other e) 0 Other 0 0 Other g) Q Other h) r7 Other i) F-� Other j) 0 Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ............................................................................................................................................................................................................................................................................................... Page 12 Work Request Template July 2013 i Check box to activate section: Clean (non -ground level) exterior windows a) Q Other b) Q Other c) 0 Other d) Q Other e) 0OtherOtk fl 0 Other Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> ................................................................................................................................................................................................................................................................ ♦ Check box to activate section: 122 Clean additional interior windows: S M T W T F S Supervisors) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> .................................................................................................................................................................................................................................................................................. Page 13 Work Request Template July 2013 ♦ Check box to activate section: a) Other b) Other c) F Other d) F Other e) Other f) F Other g) ❑ Other h) ❑Other i) Other j) Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task per job class per event > .................................................. .................................. ......................... .............................................................................. ......... ............... ..................................... .................... : Check box to activate section: a) 0 Other b) 0 Other c) 0 Other d) Q Other e) Q Other f) r7 Other g) aOther h) Q Other i) Q Other j) ❑ Other S M T W T F S Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) € Total MINUTES required to successfully complete this task per job class per event »> .................. ....... ............ ....... ................ ............. ....... ............................................. ........................................................... ............................................... .................................... : Page 14 Work Request Template July 2013 ♦ Check box to activate section: a) F Other b) F Other c) F Other d) F Other e) 0 Other fl Q Other g) Q Other h) Q Other i) - Other j) ❑Other S M Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> ....................................................................................................................................................................................................................................................................... a Check box to activate section: a) =Other b) 0 Other c) Q Other d) Q Other e) Q Other 0 Other g) Q Other h) 0 Other i) Q Other j) ❑ Other W T F S Supewisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event »> ................................................................................................................................................................................................................................................................................4 Page 15 Work Request Template July 2013 i Check box to activate section: a) F-� Other b) F70ther c) Q Other d) 0 Other e) Q Other 0 0 Other g) OOther h) Q Other i) 0 Other j) InlOther Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> .................................................. ............ ............................................ .................. ......................................................... ................................... .......... .............. I............. As Needed Cleaning: As needed cleaning should only be checked if the agency/entity can provide enough upfront information on each cleaning task for the vendor to calculate the proper amount of minutes to bid to perform the function. F=-728 Out of the ordinary cleanup following special event or office function or minor construction Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> M29 Emergency water damage cleanup Page 16 Work Request Template July 2013 Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event »> Page 17 Work Request Template July 2013 F --]30 Other (i.e. Chemical Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task per job class per event »> I I F --]31 Other (i.e. Biological Spills) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >>> 032 Other (i.e. Bodily Fluids) Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) WiindowWasher(s) Total MINUTES required to successfully complete this task pe job class per event >> =33 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> =34 Other Supervisor(s) Janitor(s) Shampooer(s) Waxer(s) Window Washer(s) Total MINUTES required to successfully complete this task pe job class per event >> Page 18 Work Request Template July 2013 Absent a compelling business reason State Agencies are to utilize state contract to purchase PAPER SUPPLIES M35 Flat Monthly Fee to supply PAPER SUPPLIES (i.e. paper towels, toilet paper & covers) AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> <<<Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for PAPER SUPPLIES D Environmentally Provided by Provided by Supply Preferred? Agency Vendor Toilet Paper ❑ Provided by Vendor ❑ ❑ ❑ ' Paper Towels ❑ Toilet Seat Covers ❑ ❑ Deicer ❑ Other (please specify) ❑ ❑ ❑ F Liquid Soap ❑X ❑91 Floor Care Products ❑ Absent a compelling business reason State Agencies are to utilize state contract to purchase CLEANING SUPPLIES Flat Monthly Fee to provide all necessary CLEANING SUPPLIES AT VENDORS ACTUAL COST All monthly invoices must be accompanied with a cost break down and supporting documentation to validate vendor's actual costs are accurately reflected Bidder to propose Monthly Flat Service Fee >>> �—Bidder to identify (for market research purposes only) the estimated monthly costs the client should expect to budget for CLEANING SUPPLIES Supply Environmentally Preferred? Provided by Agency Provided by Vendor Light Bulbs ❑ ❑ Deicer ❑ ❑ Liquid Soap ❑X ❑91 Floor Care Products ❑ ❑ KI Garbage Bags ❑x ❑ 0 Glass Cleaner ❑ 1:1KI Restroom Disinfectants & CleanersEil X❑ KI Trash Can Liners E ❑ Ix I Other (please specify) ❑ ❑ F-1 F71Et7--E] 910 Page 19 Work Request Template July 2013 Important! Client Questionnaire must be filled out and submitted with RFQQ. Click here to open and fill out Client Questions! Prompt Payment Discount (PPD)M% (Maximum amount attributable to Bid Score is 5%) NOTE: A PPD % net 30 days will be applied to the bidders bid prices and thereby impact the bidders score. Total Amount of Annual Minutes/hours Bid for this project: 6,940 Minutes Total Labor Cost For Regularly Scheduled Services -Based on minutes bid. This is the minimum amount that vendor has to pay for the labor in order to remain compliant $1,330.17 with prevailing wage requirement. 115.7 Hours IF Vendor wish to pay a wage other than prevailing wage, type in the new wage below. NOTE: The contracting agency/entity may request verification of wages paid to employees. Paying wages less than prevailing wage or less than submitted in the RFQQ could be grounds for breach of any future work contract. Janitor Shampoo Waxer """ "" Note: IF wages are reduced below prevailing wage Washer level Bidder must submit a written declaration identifying how bidder is exempt from paying prevailing wage. Bidder Labor Cost/Percentage multiplier >>> Enter Monthly Added Fee The labor cost multiplier provides a mark-up to cover Vendor's non -labor related expenses and added profit margin. It can be applied as a flat Enter Annual Added Fee annual amount, a monthly amount, and/or as an additional percentage increase to the overall labor costs. Choose one, two, or all three multiplier formats you wish to use and type the proper amount in the Enter % increase to Labor Costs correct box. 35% Total Per Unit "As Needed Cleaning" Labor Cost $0.00 -Excluded from Annual Contract Amount Flat Monthly Fee for providing Janitorial Products: As noted above (§33 and §34)>>> $0.00 Prompt Payment Discount Bid Evaluation Credit>>> $0.00 -Excluded from Annual Contract Amount Annual Total Labor Cost Adjustment (from above calculations) >>> $465.56 Total Bid Evaluation Price »> $1,795.73 Total Projected Annual Contract Price (Pre-tax)>>> $1,795.73 Price per month (Pre-tax) $149.64 Average Price per Day (Pre-tax) $4.92 VENDORS USE PRE-TAX PRICE PER QUARTER & AGENCY # OR ID TO REPORT 00508 QUARTERLY SALES Price per Quarter (Pre-tax) $448.93 Agency #IID 21801 Email your completed RFQQ Worksheet response to: DESCPRMHeatHumSery@des.wa.gov Bid submitted by VARSITY ^FACILITY SERVI Bid responses must be received no later than 2:00 PM Tuesday, May 8, 2018 Late submissions will not be considered for any reason Page 20 Work Request Template July 2013 EXHIBIT G SUPPLY COSTS U�R�ICI96� � f EXHIBIT "G" SUPPLY COSTS The costs of paper supplies and cleaning supplies will be reimbursed by the City at actual costs as follows; The Vendor shall provide for the paper and cleaning supplies for all service locations as set forth in Exhibits A through F. Paper and cleaning supplies will be appropriate products for the service locations scope of work. The Vendor shall submit monthly invoices accompanied with a cost breakdown of products and supplies purchased per service location, and will provide supporting documentation to validate that the Vendor's actual costs are accurately reflected within the Vendor's invoices. The City shall promptly process invoiced payments as provided for in Section III. Compensation, of the Professional Services Agreement for Janitorial Services. A�oR CERTIFICATE OF LIABILITY INSURANCE DAT8/23/2D/YYYY) 8/23/2018 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 SilverStone Group 11516 Miracle Hills Drive Suite 100 CONTACT NAME: Sher Allen PHONENo- Ext). 402-964-5644 FAX No): E-MAIL ADDRESS: Certificates SS i.com INSURER(S) AFFORDING COVERAGE NAIC# Omaha NE 68154 INSURER A: Travelers Property & Cas Of Am 36161 n nnnnnMnTlnAl All rlr. LFc rncnrlrnrl INSURED INSURER B: St. Paul Fire And Marine Ins. INSURER C : Varsity Contractors, Inc. dba Varsity Facility Services DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 PO Box 1692 INSURERD: Pocatello ID 83204 INSURER E : INSURER F GUVtRAI3tJ %.,FF%I IIiMIL IN -l- 1. - I ---v-, 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. IN RI LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS l' A X COMMERCIALGENERALLIABILITY CLAIMS -MADE rX ] OCCUR n nnnnnMnTlnAl All rlr. LFc rncnrlrnrl TC2JGLSA1761B754 9/1/2017 9/112018 EACH OCCURRENCE $1,000;006' DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ /C PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000 00,%'� GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS $2,000,000 '"^ RO F LOC POLICY � PRO-CT A OTHER: AUTOMOBILE LIABILITY X ANY AUTO TC2JCAP1761B742 9/1/2017 �� 9/1/2018 COMBINED SINGLE LIMIT $1,000, 0 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident)$ B X UMBRELLALIAB X OCCUR ZUP21N2602417NF 9/1/2017 9/1/2018 EACH OCCURRENCE $19,00g0 ,!"' AGGREGATE $ 19,000,000 EXCESS LIAB CLAIMS -MADE $ X PER OTH- STATUTE ER A N/A TC2JUB1761B698 9/1/2017 9/1/2018 DED X RETENTION $10 nno WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ E.L. EACH ACCIDENT $ 1,000,000 j E.L. DISEASE - EA EMPLOYEE $ 1,000,utV/' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder has 30 days' Notice of Cancellation provided with respects to General Liability (Automobile Liability, Workers Compensation and/or Umbrella) as required by written contract. j j City of Bremerton is listed as add'(tiojrA insured on a primaryen¢ non-contributory basis with respect to General Liability including completed operations as required by written contract. Waiv6f of subrog idn applies in m,Vor of City of Bremerton as required by written contract. GERTIFICA It t1ULUt:K SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Bremerton 345 6th Street, Suite 100 Bremerton WA 98337�� AUTHORIZED REPRESENTATIVE ;ip n nnnnnMnTlnAl All rlr. LFc rncnrlrnrl V IJVV-GV IJ I"Ivvl�v vv.�• v..�...�... ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TC2JGLSA1761B754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED,. - (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or"personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) b) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". TniS endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: L The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring Insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible 'other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insuranc apply on a primary basis or a primary a non-contributory basis, this insurance is primary to 'other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible 'other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG 02 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii_ The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: I. Immediately record the specifies of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the Bairn or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5_ The following definition is added to SECTION V. - DEP'INtTIONS: "written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 000826 POLICY NUMBER: TC27GLSA176IB754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): Any person or entity with whom you have agreed in a written contract, executed prior to loss to name as an additional insured, but only for the limits agreed to in such contract or the limits of insurance of this policy, whichever is less. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG D411 04 08 © 2008 The Travelers Companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: TC2JGLSA176113754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insur- ance is primai4 to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All riahts reserved. Paae 1 of 1 G(2191-1 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 8/31/2018 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 CONTACT NAME: She Allen SilverStone Group PHONE 11516 Miracle Hills Drive 402-964-5644 a No E-MAIL ADDRESS: sallen@ssgi.com Suite 100 INSURERS AFFORDING COVERAG NAIC# Omaha NE 68154 INSURER A: Travelers Property Casualty Co. of America 36161 CLAIMS -MADE X OCCUR INSURED INSURERB-:- Varsity Contractors, Inc. dba Varsity Facility Services INSURERC: p INSURER D: f Bremartnir PO Box 1692 Risk INSURER E : Risk Man Pocatello ID 83204 INSURER F: COVERAGES CERTIFICATE NUMBER: 2026618640 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. INSR LTR OF INSURANCE ADDLSUBRPOLICTYPE IVSD WVD POLICY NUMBER EFF /YYYY MMIDDY POLICY EXP MM DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TC2J-GLSA1761B754-TIL18 9/1/2018 /1/2019 EACH OCCURRENCE $1,000 0 DAMAGE TO RENTED CLAIMS -MADE X OCCUR PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,00 0 POLICY � PRCOT [ LOC PRODUCTS - COMP/OP AGG $ 2,000 000. $ OTHER: A AUTOMOBILE LIABILITY TC2J-CAP1761 8742-TIL18 9/1/2018 9/1/2019 COMBINED SINGLE LIMIT $1,000; oo Ea accident BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLALIAB X OCCUR ZUP21N26024-18-NF 9/1/2018 9/1/2019 EACH OCCURRENCE $19,00 00. AGGREGATE $ 19,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 1 0000 $ I A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N TC2JUB-176113698-18 9/1/2018 9/1/2019 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,00 o0 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / HICLES (ACORD 101, Additional marks Schedule, may be attached if more space is required) City of Bremerton is listed as addoefial insuro on a primary non-contributory basis with respect to General Liability including completed operations as required by written contract. Waiver of 4ub gation applies in favor of City of Bremerton as required by written contract. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Bremerton 345 6th Street, Suite 100 Bremerton WA 98337 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TC2JGLSA1761B754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you/ agree in a "written contract requiring insurance" // to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or"personal injury'; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent ads or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and'included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible 'other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insuranc apply on a primary basis or a primary ap non-contributory basis, this insurance is primary to 'other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. bj If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit' and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the Bairn or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions, d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5_ The following definition is added to SECTION V. — DEFINtTIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and C. Before the end of the policy period Page 2 of 2 0 2005 The St, Paul Travelers Companies, Inc. CG D2 46 08 05 000eze POLICY NUMBER: TC2JGLSA176113754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons) or Organization(s): l Any person or entity with whom you have agreed in a written contract! executed prior to loss to name as an additional insured, but only for the limits agreed to in such contract or the limits of insurance of this policy, whichever is less. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "persanal injury" or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG D411 04 08 © 2008 The Travelers Companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: TC2JGLSA1761B754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE -- ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary an on -contributory basis, this insur- ance is pri ry to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. GG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Paoe 1 of 1 b) r% 4f ac4 ek p1 f1 d '?'S, 1 61 l 6b CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/30/2019 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 SilverStone Group 11516 Miracle Hills Drive RECEIVES Suite 100 CONTACT NAME: Sherry Allen PHONE FAX 402-964-5644 No): A/c E-MDRAIL ADEss: sallen@ssgi.com INSURER(S) AFFORDING COVERAGE NAIC# Omaha NE 68154 INSURER A: Travelers Property Casualty Co. of America 36161 SEP INSURED 0 3 2019 Varsity Contractors, Inc. 3605 Ocean Ranch Blvd, Ste 200 Oceanside CA 92056 CRY of Bremertorp Risk Management INSURER B: INSURER C INSURERD: INSURER E: INSURER F: PRODUCTS - COMP/OPAGG $2,0 COVERAGES CERTIFICATE NUMBER: 340693667 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � CUR TC2J-GLSA1761B754-TIL19 9/1/2019 9/1/2020 EACH -OCCURRENCE $1,000,000: DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRO- LOC OTHER: GENERAL AGGREGATE $ 2,00 PRODUCTS - COMP/OPAGG $2,0 $ A AUTOMOBILE 1X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY TC2J-CAP1761B742-TIL19 9/1/2019 9/1/2020 COMBINED SINGLELIMIT $1,0 0 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident A X UMBRELLA LIAB EXCESS LIAB X I OCCUR CLAIMS -MADE ZUP-21N26024-19-NF 9/1/2019 9/1/2020 EACH OCCURRENCE $19,00,0, 0 AGGREGATE $ 19,00 ,000 DED I X RETENTION $ in nnn $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVEF—]E.L. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A UB -3N21 0059 -1 9-51-R 9/1/2019 9/1/2020 X SPER TATUTE OERH EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,00 0 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHI ES (ACORD 101, A'Oditional RerpOks Schedule, may be attached if more space is required) City of Bremerton is listed as additionq!,insured on a pr andUprl-contributory basis with respect to General Liability including completed operations as required by written contract. Waiver oflubrogation applies in favor of City of Bremerton as required by written contract. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Bremerton 345 6th Street, Suite 100 r' Bremerton WA 98337 AUTHORIZED REPRESENTATIVE �_0� ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TC2JGLSA1761B754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART t. WHO IS AN INSURED -- (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or"personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance' applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance'. This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" anc Ancluded in the "products -completed op- erations hazard" unless the "written contract requiring insurance' specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance' requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible 'other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG 02 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; it. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: L Immediately record the specifies of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the Bairn or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a toss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5_ The following definition is added to SECTION V. — DEFINfTIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 oone2e POLICY NUMBER: TC2JGLSA1761B754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(sI or Organization(s): Any person or entity with whom you have agreed in a written contract, executed prior to loss to name as an additional insured, but only for the limits agreed to in such contract or the limits of insurance of this policy, whichever is less_ Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "persanal injury" or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG D411 04 08 © 2008 The Travelers companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. August 6, 2019 Public Works and Utilities Department 100 Oyster Bay Ave. N • Bremerton, WA 98312 • (360) 473-5920 • FAX (360) 473-5360 Misker Arefeayne Varsity Facility Services 1502 Pike Street NW Suite #1 Auburn, WA 98001 Dear Mr. Arefeayne Work contract # 21801 for janitorial services is scheduled to expire on 08/05/2019. Under the automatic extension option, we are extending work contract # 21801 for twelve (12) months, per city PSA # 5857, Section II Term. The extension is subject to existing prices, terms, conditions and specifications, and will have a new expiration date of 08/05/2020. Should you have any questions, please call me at (360) 473-2316 or e-mail me at Chris. Mottner@ci.bremerton.wa.us. Thank you for your continued interest in doing business with the State of Washington and the City of Bremerton. Sincerely, 1 Chris Mottner Facilities/Inventory Supervisor Cc: Contract File Monya Tabor, Office of State Procurement Angela Woods, City Clerk Wayne Hamilton, Utility Operations Manager POLICY NUMBER: TC2JGLSA176113754 POLICY TERM: 09/01/2017 - 09/01/2018 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE -- ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverag Part must apply on a primary basis, or a prirn�y and norV!nthbutory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All dahts reserved. Paae 1 of 1 DATE(MM/DD/Yl'YY) -� CERTIFICATE OF LIABILITY INSURANCE 04/022020 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)5 AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. us 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). CONTACT PRODUCER NAME: Aon Risk Services Central, Inc. PHONE (g66) 283-7122 FAX (800) 363-0105 Chicago IL office (ac. No. Ext): (NC. No.): 200 East Randolph ADDRESS: Chicago IL 60601 USA INSURER(S) INSURED IZCVCI Y CL varsity Contractors Inc. dba Varsity Facility Services 3605 ocean Ranch Blvd, Suite 200 APR 0 8 2020 Oceanside CA 92056 USA AFFORDING COVERAGE NAIC # INSURER A: Zurich American Ins CO 16535 INSURER B: American Zurich Ins CO 40142 INSURERC: Travelers Property Cas Co of America 25674 INSURER D: INSURER E City of Bremerton � INSURER F: 1 I COVERAGES CERTIFIF.i116i�A�F1� 6 081301712 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. Limits shown are as requested LTSRI R TYPE OF INSURANCE I SD WVD POLICY NUMBER MMJDD/YYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 5 4 04/01/2021 EACH OCCURRENCE $2 , 000 , 000 DAMAGE TO RENTED $500 , 000 CLAIMS -MADE X❑ OCCUR PREMISES Ea occurrence MED EXP (Any one person) $10 , 000 PERSONAL& ADV INJURY $2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $4,000,00000 JECT OTHER: A AUTOMOBILE LIABILITY BAP 6510032-30 04/01/2020 04/01/2021 COMBINED SINGLE LIMIT $5,000,000 Ea accident BODILY INJURY ( Per person) X ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS PROPERTY DAMAGE HIREDAUTOS NON -OWNED Per accident ONLY AUTOS ONLY C X UMBRELLALIAB X OCCUR ZUP21P2450020NF 04/01/2020 04/01/2021 EACH OCCURRENCE $1010001000 SIR applies per policy terns & conditions AGGREGATE $1010009000 EXCESS LIAB CLAIMS -MADE DED X RETENTION B WORKERS COMPENSATION AND wc651003030 04/61/2626 04/51/2021 X PER STATUTE OTTH- ER EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $1, 000, 000 OFFICERIMEMBER EXCLUDED? N N / A E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 (Mandatory In NH) If Yes, describe under E.L. DISEASE -POLICY LIMIT $1 , 000 , 000 DESCRIPTION OFOPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, City Of Bremerton AUTHORIZED REPRESENTATIVE 345 6th Street, Suite 100 d a 0 2 N r M 0 u-� i ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) AFRO CERTIFICATE OF LIABILITY INSURANCE I 04/02/2021 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 entlorsed. 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). PflODUCER t'iCl�Cl V GL� Aon Risk services Central, Inc. Chicago IL office 200 East Randolph Chicago IL 60601 USA APR 19 2021 INSURED City of Bremenon Kellermeyer Bergensons services, LLCRisk Management 3605 ocean Ranch Blvd. suite 200 Oceanside CA 92056 USA EMAIL ADDRESS: C866) 283-7122 INSURERS) AFFORDING COVERAGE INSURER A; ZUrICh AmerlCan IRS CO INSUFIERB: American zurich Ins co (800) 363-0105 NAIC # 16535 40142 INSURERC: ACE Property &Casualty Insurance Co. 20699 INSURER D: INSURER E: INSURER F: ES CERTIFICATE NUMBER: 570086840477 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 LO 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. Limits shown are as requested LTA TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY GL0651003131 EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence)$500,000 MED EXP (Any one person) $10 , 000 PERSONAL & ADV INJURY $2,0001000 GENI AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO ❑ LOC JECT00 GENERAL AGGREGATE $41000,000 PRODUCTS - COMP/OPAGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY BAP 6510032-31 04/01/202104/01/2022 COMBINED SINGLE LIMIT Ea accident $5,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED AUTOS ONLY ONLYF I BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident C X UMBRELLALIAB EXCESS LIAR JX OCCUR CLAIMS-MADE G72514117001 SIR applies per policy terns 04 01/2021 & condl 04 01/2022 ions I EACH OCCURRENCE � $10,000,000 AGGREGATE $10,000,000 DED X RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/ N ANY PROPRIETOR/ PARTNER/ EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It as, describe under DESCRIPTION OF OPERATIONS below N / A wc651003031 04 O1 2021 04 Ol 2022 X PER STATUTE OTH• ER E.L, EACH ACCIDENT $1, OOO, OOO E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 E.L. DISEASE -POLICY LIMIT $19000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) certificate Holder is included as Additional insured in accordance with the policy provisions of the General Liability policy. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of certificate Holder in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Clty Of Bremerton AUTHORIZED REPRESENTATIVE 345 6th Street, Suite 100 Brmerton wA 98337 u5A `���Y �i�� `����� ea�eSi F ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MSC#17755 Aon Risk Services PO Box 1447 Lincolnshire, IL 60069 MDG2021 00001383 01 'I�I��1�1����11'��II'�'���I����I1�1�1111�1�11�1�1���1�'11111�'I�I "'"� City of Bremerton ,; � 345 6th Street, Suite 100 Brmerton WA 98337 A DAT 0(MWD20 2YYY) CERTIFICATE OF LIABILITY INSURANCE 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, No IMPORTANT: If the cercate 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 Aon Risk services Central, Inc. Chicago IL office 200 East Randolph Chicago IL 60601 USA INSURED Kellermeyer Bergensons 3605 ocean Ranch Blvd. Oceanside CA 92056 USA [�Ti1,U�cf1eTeI�9 services, LLc suite 200 RECE�'Ef: APR 12 City ofi Bremerton Risk Management EMAIL ADDRESS: (866) 283-7122 INSURERS) AFFORDING COVERAGE INSURER A: ZUrICh American Ins CO INSURERB: American Zurich Ins co (600) 363-0105 NAIC # 35 INSURERC: ACE Property &Casualty insurance co. 20699 INSURER D: INSURER E: INSURER F: 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADUL INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EAP MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR GLO EACH OCCURRENCE $2 , 000 , 000 PREMISES Ea occurrence)$500,000 MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $290001000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $41000,000 X PRODUCTS - COMP/OPAGG $4,000,000 A AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY BAP 6510032-32 04/01/2022 04/01/2023 COMBINED SINGLE LIMIT Ea accident $5,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident C X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE XEUG72514117002 SIR applies per policy terns 04 01 2022 & conditions 04 01 2023 EACH OCCURRENCE $10,0001000 AGGREGATE $109000,000 DED X RETENTION B WORKERS COMPENSATION AND EMPLOYE RS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICERWEMBER EXCLUDED? N (Mandatory In NH) If as, describe under DESCRIPTION OF OPERATIONS below N / A WC6510 3032 04 1 2022 04 01 2023 X PER STATUTE OTRH- E,L. EACH ACCIDENT $1,0001000 E.L. DISEASE -EA EMPLOYEE $10000, 000 E.L. DISEASE -POLICY LIMIT $11000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is included as Additional insured in accordance with the policy provisions of the General Liability policy. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �' City Of BrelllertOn AUTHORIZED REPRESENTATIVE '' 345 6th street, Suite 100 v 0 2 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD