HomeMy WebLinkAboutAgreements/Contracts - Public WorksK19-037
CONTRACT
THIS AGREEMENT, between the Board of County Commissioners of Grant County, State
of Washington, acting under and by virtue of Chapter 36.77 of the Revised Code of Washington,
as amended, hereinafter called the County, and _-r - -rz r f=<< , I for itself, its
heirs, executors, administrators, successors and assigns, hereinafter called the Contractor.
WITNESSETH:
That in consideration of the payments, covenants, and agreements, hereinafter
mentioned, and attached and made a part of this agreement, to be made and performed by the
parties hereto, and the parties hereto covenant and agree as follows:
DESCRIPTION OF WORK:
1. The Contractor shall do all work and furnish all tools, materials, and equipment
necessary to improve and complete Horizontal Curve Signs, Phase 3, CRP 18-06, located in
Grant County, Washington, as proposed in a bid opened 1:30 P.M., Tuesday, February 19, 2019
in accordance with and as described in the herein attached plans and standard specifications,
and in full compliance with the terms, conditions, and stipulations herein set forth and
attached, now referred to any by such reference incorporated herein and made part hereof as
fully for all purposes as if here set forth at length, and shall perform any alterations in or
additions to the work covered by this contract and every part thereof and any force account
work may be ordered as provided in this contract and every part thereof.
2. The Contractor shall provide and be at the expense of all materials, labor, carriage,
tools, implements and conveniences and things of every description that may be requisite for
the transfer of materials and for constructing and completing the work provided for in this
contract and every part thereof.
3. The County hereby promises and agrees with the Contractor to employ, and does
employ the Contractor to provide the materials and to do and cause to be done the above
described work and to complete and finish the same according to the attached plans and
specifications and the terms and conditions herein contained, and hereby contracts to pay for
the same according to the attached specifications and the schedule of unit or itemized prices
hereto attached, at the time and in the manner and upon the conditions provided for in this
contract and every part thereof. The County further agrees to employ the Contractor to
perform any alterations in or additions to the work covered by this contract and every part
thereof and any force account work that may be ordered and pay for same under the terms of
this contract and the attached plans and specifications.
4. The Contractor for himself, and for his heirs, executors, administrators and assigns, and
successors and assigns, does hereby agree to the full performance of all the covenants herein
contained upon the part of the Contractor.
5. it is further provided that no liability shall attach to the County by reason of entering
into this contract, except as expressly provided herein.
Horizontal Curve Signs, Phase 3 CRP 18-06 Contract - Page 1
IN WITNESS WHEREOF, the said Contractor has executed this instrument, and the said
Board of County Commissioners of Grant County has caused this instrument to be executed by
and in the name of said Board by its Members, duly attested by its Clerk, the day and year
below written, and the seal of said Board to be hereunto affixed on said date.
EST:
erk 0the Board
0
i'
APPROVED AS TO FORM:
c(tkday of iA,(,- C 4V 2019
— )/ /n /-��
Deputy Pios cu g Attorney
'qday of 019
Signature
V.( l L 1, 12 Ct t'Aik-" i_ E,02-
Print
iiLPrint Name
Firm Name
PCS 13�X I,9ZS)
Address
City State Zip
Phone
BOARD OF COUNTY COMMISSIONERS
OF GRANT COUNTY, WASHINGTON
Done this �' day of -4 2019
Chair
Member
Member
rionzontai curve Signs, Nnase 3 cKN 18-Ub Contract — Page
Liberty
Mutual.
SURETY
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
Certificate No: 8200306-023049
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Holli
Albers, Heather L. Allen, James B. Binder, Brandon K. Bush, Carley Espiritu, Jacob T. Haddock, Diane M. Harding, Brent E. Heilesen, kyle Joseph Howat, Cynthia L.
Jay. Aliceon A. Kellner, Christopher Kinvon, Michael S. Mansfield, Jamie L. Marques, Annelies M. Richie, Sara Sophie Sellin, Donald Percell Shanklin, Jr., Karen C.
Swanson, Misti M. Webb, Eric A. Zimmerman
all of the city of Tacoma state of Washington each individually if there be more than one named, its true and lawful attorney-in-fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 15th day of January 2019
Liberty Mutual Insurance Company
P� 1NSURq P�tv INS&q tNSu p The Ohio Casualty Insurance Company
�J P°R4 Yn yJ `000RyT 92 VQ G°aPo�lgy� West American Insurance Company
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(�! rdJl9s'T4CHUS��.da y�y F/AMPS��.AsO !S �N010"'' .aa� I l
9j� * tev Hyl * tP �H * >� By: 3
c David M. Carey, Assistant Secretary �
N State of PENNSYLVANIA @
:3 County of MONTGOMERY ss
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a V/
L) a)On this 15th day of January , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
p Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes — CU N
> therein contained by signing on behalf of the corporations by himself as a duly authorized officer. w
3 IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. c n
oC
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N FyAoNWF r$< COMMONWEALTH PENNSYLVANIAQ
O L 4� Oak 9o1 f Notarial Seal 0
ai p= y Teresa Pastella, Notary Public
OF
0 upper MenonTwp., MonOgomery County By: CD
4JP�3G My Commission Expires March 28,2021Teresa Pastella, Notary Public o N
�? Member. Pennsylvania Association of Notaries Notary
ARY t'� N o
a) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
o .� Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: aa)
r
i ARTICLE IV – OFFICERS: Section 12. Power of Attorney.
o m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the Q
a >, President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety > o
CU Cany and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall a) N
> ` have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such "0O
Z� instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the ,- M
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. o 0
U —
ARTICLE XIII – Execution of Contracts: Section 5. Surety Bonds and Undertakings. o co
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, F–
shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation – The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fad as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization – By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 28th day of February , 2019
% SU �SY INS& � %NS(IR4
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l% 9SSA CNUS��y a y� Z��NA MPSa`4`! �N°IANP' D By.
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a �, a s a Renee C. Llewellyn, Assistant Secretary
LMS -12873 LMIC OCIC WAIC Multi Co_062018
CONTRACT BOND #023209975
KNOW ALL MEN BY THESE PRESENTS:
That we, the undersigned, Shamrock Traffic, Inc. as
principal, and Liberty Mutual Insurance Company a
corporation organized and existing under the laws of the State of Massachusetts as
surety corporation, and qualified under the laws of the State of Washington to become surety
upon bonds of contractors with municipal corporations, as surety, are jointly and severally held
and firmly bound to Grant County, Washington, in the penal sum of
Four Hundred Forty Seven Thousand Four Hundred Forty Seven and No/100ths
($ 447.447.00 ) for the payment of which sum on demand we bind ourselves and our
successors, heirs, administrators or personal representatives, as the case may be.
This obligation is entered into in pursuance of the statutes of the State of Washington,
the Ordinances of Grant County, Washington.
Dated at Seattle , Washington, this 28th day of February , 2019.
The conditions of the above obligation are such that:
WHEREAS, on February 19, 2019, the Board of County Commissioners of said Grant
County has let or is about to let to the Principal, a certain contract, the said contract providing
for the improvement of 2019 County Road Safety, Horizontal Curve Signs, CRP 18-06, located
in Grant County, Washington, (which contract is referred to herein and is made a part hereof as
though attached hereto), and
WHEREAS, the said Principal has accepted, or is about to accept, the said contract, and
undertake to perform the work therein provided for in the manner and within the time set
forth;
NOW, THEREFORE, if the said Principal shall faithfully perform all of the provisions of
said contract in the manner and within the time therein set forth or within such extensions of
time as may be granted under said contract, and shall pay all laborers, mechanics,
subcontractors and material men, and all persons who shall supply said Principal or
subcontractors with provisions and supplies for the carrying on of said work, and shall hold said
Grant County harmless from any loss or damage occasioned to any person or property by
reason of any carelessness or negligence on the part of said Principal, or any subcontractor in
the performance of said work and shall indemnify and hold Grant County harmless from any
damage or expense by reason of failure of performance as specified in said contract or from
defects appearing or developing in the material or workmanship provided or performed under
said contract, and until the same is accepted, then and in that event this obligation shall be void
but otherwise it shall be and remain in full force and effect.
Countersigned:
Liberty Mutual Insurance Company
Licensed Agent/Surety Co.
Propel Insurance
01 Union Street, Suite 3400, Seattle, WA 98101
(206 ) 676-4200
Firm, Street Address (No P.O. Box), Phone of Local Office of Agent
Shamrock.Traffi
Principal
Rx �-
Cynthia L. Jay Attorney -in -Fact, Surety
Approved as to form:
t/l 2019
��Ryt Prosec ttorney
Deputy Prosecuting Attorney
unty Road Satety, Horizontal Curve Signs CRP 18-Ub Contract — Page
GRANT COUN
PUBLIC WORKS DEPARTME
Jeff Tincher, P.E.
Director of Public Works and
County Road Engineer
Ephrata (509) 754-6082
Jerome Wawers
Assistant Director of Public Works
t
Ephrata (509) 754-6082
Bob 8ersanti
Design/Construction Engineer
..._
Ephrata (509) 754-6082
#.
Jason Collings, Supervisor
Solid Waste
Ephrata (509) 754-4319
PROPOSAL
FOR
BIDDING PURPOSES
For Construction of:
Horizontal Curve Signs, Phase
CRP 18-06
TA -6458
Sealed Bids will be Opened on
February 19, 2019 4the'
at
1:30 P.M.
at the Office of
Board of County Commissioner
Grant County Courthouse
P.O. Box 37
35 C Street NW, Room 207
Ephrata, Washington 98823
Ed Lowry
Supervisor
Road District #1
Ephrata (509) 754-6586.
Mike DeTrolio, Supervisor `y
Road District #2
Moses Lake (509) 765-4172
John Brissey, Supervisor
Road District #3
Quincy (509) 787-2321
Andy Booth, Supervisor
Bridges
Ephrata (509) 754-6082
PROPOSAL
To: Board of County Commissioners Date: February 19 , 2019
Grant County, Washington
This certifies that the undersigned has examined the location of Horizontal Curve Signs, Phase
3, CRP 18-06, in Grant County, Washington, and that the plans, specifications and contract
governing the work embraced in the improvement, and the method by which payment will be
made for said work is understood. The undersigned hereby proposes to undertake and
complete the work embraced in this improvement, or as much thereof as can be completed
with the money available in accordance with said plans, specifications and contract and at the
following schedule of rates and prices.
Horizontal Curve Signs, Phase 3
Note: Unit prices for all items, all extensions, and total amount must be shown. Please type or
nca ink PlaacP initial all rhan¢Ps.
Item
Plan
Item Description
Price per Unit*
Total Amount
No.
Quantity
$3,300.00
Dollars. Cents
Dollars.. Cents
PRFPA R ATIr)N
1
1
Mobilization
At
Per Each ��_
_
Lump Sum
$3,300.00
/////////•/////
$40,000.00
Support Type ST -2 Per Each
Per Lump Sum
2 1 Notification
Lump Sum
TRAFFIC
At ._
111111111.1/111
Per Lump Sum
$750.00
3
53 Remove Existing Warning Sign & At
Each Post $20.00
$11060.00
At
Per Each ��_
_
4
_ 11
36"x42" 17-701 Primitive Road No At _
At
Each
Warning Sign with Steel Sign $300. 00
$3,300.00
$230.00
$2,300. 00
Support Type ST -2 Per Each
5 151 30" Warning Sign with Steel Sign At
Each Support Type ST -2 $230.00
Per Each
$34,730-00
6
10
W1-6, Large Arrow 48" x 24" with
At
Each
Steel Sign Support Type ST -2
$230.00
$2,300. 00
Per Each
7 I Each
Curve Signs,
W1-7,Double Large Arrow 48" x
24" with Steel Sign Support Type
ST -2
At
$230.00 ; $230.00
Per Each j
Item
1WOlan
Item Description Price per Unit*
Total Amount
No.
Quantity
Dollars. Cents
Dollars. Cents
8
1,124
W1-8, Chevron 18" x 24" with
At j
Each
j Steel Sign Support Type ST -2
$175.00 $196,700.00
-$1.00
-$1.00
Pl__ e� Each
Per Each
9
144
W13-11) Speed Plaque At
At
Each
i $50.00
i
$7,200.00
-$1.00
-$1.00
Pl__ e� Each
10
1
Project Temporary Traffic Control At _
At
Lump Sum
/J///////./////
$160,178. 00
-$1.00
-$1.00
Per Lump Sum
OTHER ITEMS
11 1 Spill Prevention, Control, and At
Lump Sum Countermeasure (SPCC) Plan //J//////.1111/ $1,000-00
Per Lump Sum
12
Calculated
Minor Changes _
At
-$1.00
-$1.00
Calculated
H&Irz- ntal Curve Signs, Pose 3 CRP 19-06
(Contract Total $447,447.00
L^.__ i
_—! --- Proposal - Page 2
Certification of Compliance with Wage Payment Statuteshrt
The bidder hereby certifies that, within the three-year period immediately preceding the
bid solicitation date (7/3/2018), the bidder is not a "willful" violator, as defined in RCW
49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a
final and binding citation and notice of assessment issued by the Department of labor
and Industries or through a civil judgment entered by a court of limited or general
jurisdiction.
I certify under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Shamrock Traffic, Inc.
Bidder's Business Name
� ! c
Signature of Authorized Official*
--_._ -sG
Printed Name
Title
m February 19, 2019 Spokane WA
`Date City State
Check One:
Sole Proprietorship ❑ Partnership ❑ Joint Venture ❑ Corporation KI
State of Incorporation, or if not a corporation, State where business entity was
formed:
If a co -partnership, give firm name under which business is transacted:
* if a corporation, proposal must be executed in the corporate name by the president or
vice-president (or any other corporate officer accompanied by evidence of authority to
sign). if a co -partnership, proposal must be executed by a partner.
Horizontal Curve Signs, Phase 3 CRP 18-06 - Proposal -
Failure to return this Declaration as part of the bid proposal package
will make the bid nonresponsive and ineligible for award.
NON -COLLUSION DECLARATION
I, by signing the proposal, hereby declare, under penalty of perjury under the laws of the
United States that the following statements are true and correct:
1. That the undersigned person(s), firm, association, or corporation has (have) not,
either directly or indirectly, entered into any agreement, participated in any
collusion, or otherwise taken any action in restraint of free competitive bidding in
connection with the project for which this proposal is submitted.
2. That by signing the signature page of this proposal, I am deemed to have
and to have agreed to the provisions of this declaration. is
To report rigging activities call:
Notice to All Bidders
1-800-424-9071
The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline'"1�on-day
through Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of possible bid
rigging, bidder collusion, or other fraudulent activities should use the "hotline" to report such
activities.
The "hotline" is part of USDOT's continuing effort to identify and investigate highway
construction contract fraud and abuse and is operated under the direction of the USDOT
Inspector General. All information will be treated confidentially and caller anonymity will be
respected.
.—.__
Proposal –Page 4
Proposal — Signature Page
The bidder is hereby advised that by signature of this proposal he/she is deemed to have
acknowledged all requirements and signed all certificates contained herein.
A proposal guaranty in an amount of five percent (5%) of the total bid, based upon the
approximate estimate of quantities at the above prices and in the form as indicated below, is
attached hereto:
Cash ❑ In the Amount of
Cashier's Check ❑ Dollars
Certified Check O ($ ) Payable to the Grant County Treasurer
Proposal Bond ® In the Amount of 5% of the Bid
Receipt is hereby acknowledged of addendum(s) No.(s) &
Signature of Authorized Official(s)
Proposal Must Be Signed
Firm Name
Address
Please Print Name of Authorized Official
mrock Traffic. Inc.
PO Box 19281
Spokane, WA 99219
State of Washington Contractor's License No. SHAMRT1811CN
Federal ID No. 91-0598512
Note:
(1) This proposalform is not trans era can any d teration`enterea ereon-wlt OUYpr—pepermission froIte
Engineer will be cause for considering the proposal irregular and subsequent rejection of bid
(2) Please refer to section 1-02.6 of the standard specifications, re•"Preparation of Proposal" or "Article 4" of the
instructions to bidders for building construction jobs
(3) Should it be necessary to modify this proposal either in writing or by elect is e s pl a e ake a erencE
following proposal number in your communication:
-
Revised 8/95
urve Signs, Phase 3 CRP 18-06 Proposal — Pa
0
Statement of Contractor Qualifications
To: Board of County Commissioners Date: February 19 , 2019
Grant County, Washington
RE: Horizontal Curve Signs, Phase 3, CRP 18-06
I hereby maintain that I am a responsible bidder as contemplated by the policies of the State of
Washington and Chapter 36.77 of the Revised Code of Washington.
1. My permanent business name and address is , Shamrock Traffic, Inc. in-.Ssppkana- W,
which I have maintained for 1 years. My phone is( Q) 244-2800 Fax (_SQ,Q)344_2g4A
2. 1 have adequate plant equipment to expeditiously and properly perform the work contemplated
for Grant County, Washington. Description of work: This contract provides for the installation
of Traffic Control Devices, County Wide, on two lane county roads in Grant County, WA, and
includes removing existing signs, installation of signs, project temporary traffic control and other
work, all in accordance with the attached Contract Plans, these Contract Provisions and the
Standard Specifications. (Please list equipment to be used on this project. Attach list if
necessary.)
Trucks Message Boards Sions- other traffic tnntml davines,,etp, and .-- liatina
of permanent signs
3. 1 have adequate funds to promptly meet obligations incident to this work (Provide bank,
contact & phone.) a) Washington Trust Bank
b) Attn • Dave Dolla_rhide c) Fna ns.781 i
4. 1 have adequate experience in this class of work and I am thoroughly familiar with the
specifications used in this project. I have constructed the following similar improvements:
(Provide project name, contact & phone.)
a) 2012 County Rd Safety Horizontal Curve Signs lefF Inchnr -Ana 7-r,"n82
b) 2015 County Rd Safety Horizontal Curve Signs - Jeff Tincher - 509 754-6082
c)SR 291 Chad esRd to uncrest aving - Tom Brasch - 509 323-8411
S. 1 have submitted and maintain annually a "Standard questionnaire and Financial Statement" to
the Washington State Department of Transportation (WSDOT): Yes ❑ No ® Region:
WSDOT has determined: a) I am prequalified to
in the amount of
b) I have failed to be prequalified for the following reasons: —
SPA Atiarrhad_ I altar
The Contracting Agency may determine a prospective Bidder who is not prequalified to perform
certain types of work within the financial and experience constraints determined by WSDOT to
be not responsible and refuse to award a contract.
The Board of County Commissioners shall proceed to award the contract to the lowest and best
bidder but may reject any or all bids if in its opinion good cause exists therefor. (RCW 36.77.040)
1 hereby certify that the above statements are true and accurate.
Ve ly ,
BY: r
(Print Name)
Company Name: Shamrock Traffic lnc
Address: PO Box 19281
City, State, Zip: Spokane, WA 99219
Washington State Contractor's License No.: SHAMRT1811CN
Revised 4/02
I&,- _ ,-
Horizontal Curvegns
Si, Phase 3 CRP 18-06 roposal - Page
Bid Bond
KNOW ALL MEN BY THESE PRESENTS:
That we, Shamrock Traffic, Inc.
. as
Principal, and _ Liberty Mutual Insurance Company
as
Surety, are held and firmly bound unto Grant County, Washington, as Obligee, in the penal sum
of Five Percent (5%) of Bid Amount
Dollars
($ 5% of Bid Amt ) for the payment of which the Principal and Surety bind themselves,
their heirs, executors, administrators, successors and assigns, jointly and severally, by these
presents.
The condition of the obligation is such that if the Obligee shall make any award to the
Principal for Horizontal Curve Signs, Phase 3, CRP 19-06, located in Grant County, Washington,
according to the terms of the proposal or bid made by the Principal therefor, and the Principal
shall duly make and enter into a contract with the Obligee in accordance with the terms of said
proposal or bid and award and shall give bond for the faithful performance thereof, with the
Surety or Sureties approved by the Obligee; or if the principal shall, in case of failure so to do,
pay and forfeit to the Obligee the penal amount of the deposit specified in the call for bids,
then this obligation shall be null and void, otherwise it shall be and remain in full force and
effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated
damages, the amount of this bond.
SIGNED, SEALED AND DATED THIS 19th DAY OF February , 2019
Principal Shamrock Traffic, Inc.
Surety Liberty Mutual Insurance ompany
Attorney -in -Fact -- ✓2 t c <'
Cy;i I L. Jay
Horizontal Curve Signs, Phase 3
Liberty
Mutual.
SURETY
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
Certificate No: 8200306-023049
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Holli
Albers- Heather L. Allen. James B. Binder, Brandon K Bush, Carley Espiritu, Jacob T. Haddock, Diane M. Harding, Brent E. Heilesen, Kyle Joseph Howat, Cynthia L.
Swanson, Misti M. Webb, Eric A. Zimmerman
all of the city of Tacoma state of Washington each individually if there be more than one named, its true and lawful attomey-fn-fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attomey has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 15th day of January , 2019 .
Liberty Mutual Insurance Company
1NSUq ,ZV INS& a \NSL/,q The Ohio Casualty Insurance Company
�JP�°aP°Rgfq'L� yJP4°aPo�iq� `9y °oa°O�+afn West American Insurance Company >
Fo m
1912 ° 1919 ° 1991 0�� N
N d�'S4cttu5`�.da3 o
By:
David M. Carey, Assistant Secretary
State of PENNSYLVANIA
M County of MONTGOMERY ss
jc
On this 15th day of January , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o
Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes —
therein contained by signing on behalf of the corporations by himself as a duly authorized officer. W
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
yr, PAS
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OF Tensa Pasteda, Notary Public
Upper Meson Twp Montgomery County By:
Mir Commis n Exprres March 28, 2021 Teresa Pastella, Notary Public
aRy P�� Member Pe msyb . Asst- of Notaries
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
6 ARTICLE IV - OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
s >, President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
3 Nany and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attomey, shall
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such
vinstruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the
- provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, reoognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization - By unanimous consent of the Companys Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF. I have hereunto set my hand and affixed the seals of said Companies this 19th day of February 2019
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Washington State
Underutilized Disadvantaged Business
WAt Department of Transportation Enterprise (UDBE) Written
Confirmation Document
See Contract Provisions. UDBE Document Submittal Requirements
Disadvantaged Business Enterprise Participation
THIS FORM SHALL ONLY BE SUBMITTED TO A UDBE THAT IS LISTED ON THE CONTRACTOR'S
UNDERUTILIZED DISADVANTAGED BUSINESS ENTERPRISE UTILIZATION CERTIFICATION.
THE CONTRACTOR SHALL COMPLETE PART A PRIOR TO SENDING TO THE UDBE.
PART A: To be completed by the bidder
The entries below shall be consistent with what is shown on the Bidder's Underutilized Disadvantaged Business
Enterprise Utilization Certification. Failure to do so will result in Bid rejection.
Contract Title: HORIZONTAL CURVE SIGNS, PHASE 3
Bidder's Business Name: SHAMROCK TRAFFIC, INC
UDBE's Business Name: CARLENE YACINICH, DBA CHANGING DIRECTIONS
Description ofUDBE's Work: TRAFFIC CONTROL SERVICES
Dollar Amount to be Applied Towards UDBE Goal: $23,000.00
Dollar Amount to be Subcontracted to UDBE*:
'Optional Field
PART B• To be completed by the Underutilized Disadvantaged Business Enterprise
As an authorized representative of the Underutilized Disadvantaged Business Enterprise, I confirm that we
have been contacted by the Bidder with regard to the referenced project for the purpose of performing the Work
described above. If the Bidder is awarded the Contract, we will enter into an agreement with the Bidder to
participate in the project consistent with the information provided in Part A of this form.
Name (printed):
Signature:
Title:
Address:
DOT Form 422-031 U
Revised 02/2018
r'mrlcnn Vorinirh
Owner
PO Box 288
Entiat, WA 98822
Date: February 18, 2019
Wro1N3shingtan StaW Underutilized Disadvantaged Business
Depa't"'ent of Tmnsp°rtatian Enterprise Utilization Certification
To be eligible for Award of this Contract the Bidder shall fill out and submit, as a supplement to its sealed Bid Proposal, an
Underutilized Disadvantaged Business Enterprise (UDBE) Utilization Certification. The Contracting Agency shall consider
as non-responsive and shall reject any Bid Proposal that does not contain a UDBE Utilization Certification which properly
demonstrates that the Bidder will meet the UDBE participation requirements in one of the manners provided for in the
proposed Contract. Refer to the instructions on Page 2 when filling out this form or the Bid may be rejected. An
example form has been provided on Page 3. The successful Bidder's UDBE Utilization Certification shall be deemed a
part of the resulting Contract.
Box 1: SHAMROCK TRAFFIC INC certifies that the UDBE firms listed below have been contacted
regarding participation on this project. If this Bidder is successful on this project and is awarded the Contract, it shall
assure that subcontracts or supply agreements are executed with named UDBEs. (If necessary, use additional sheets.)
Box 2: HORIZONTAL CURVE SIGNS PHASE 3
Column 1
Name of UDBE
(See instructions)
Column 2
Project Role
(See instructions)
Column 3
Description of Work
(See instructions)
Column 4
Dollar Amount
Subcontracted
to UDBE
(See instructions)
Column 5
Dollar Amount
to be Applied
Towards Goal
(See instructions)
CARLENE YACMCH
DBA CHANGING DIRECTIONS
SUBCONTRACTOR
TRAFFIC CONTROL SERVICES
$23,000.00
$23,000.00
Underutilized Disadvantaged Business 5% Total UDBE Commitment Dollar Amount $23,000.00
Enterprise Condition of Award Contract Goat Box 3 Box 4
5 nBy checking Box 5 the Bidder is stating that their attempts to solicit sufficient UDBE participation to meet
the OA Contract goal has been unsuccessful and good faith effort will be submitted in accordance with
Section 1-02.9 of the Contract
DOT Form 272-056U
Revised 02/2018
February 13, 2019
110 N. Hayford Rd.
P.O Box 19263
Spokane, WA 99219
509-244-2800
FAX 509-244-2949
Grant County Public Works Department
Grant County Courthouse
35 C Street NW, Room 207
Ephrata, WA 98823
Re: Horizontal Curve Signs, Phase 3
CRP 18-06
Shamrock Paving, Inc. and Shamrock Traffic, Inc.
Dear Sir/Ma'am:
Contractors REG ##
SHAMR13099LM
This letter is to explain that although Shamrock Traffic, Inc is a new entity, it is a division of Shamrock
Paving, Inc. and the work that is completed through Shamrock Traffic, Inc., is with the same employees
and equipment as with Shamrock Paving, Inc.
With this being said, projects shown on the Statement of Contractor Qualifications were completed by
Shamrock Paving, Inc. We are bidding this project under Shamrock Traffic, Inc. and will utilize the same
employees and equipment as previous projects note.
Please let me know if you have any questions or need any additional information. We look forward to
working with you on this project.
Respectfully,
Scott Willms
General Manager
cc: File
"An Equal Opportunity Employer"