2010-049FILE REFERENCE FORM 2010-049
X Additional File Exists
Additional File Contains Records Not Public, According to the Public Records Act
Other
Date Initials
Order Number Three - Ordinance No. 2010-313 1 12/07/10 1 )R
oRDINANCE NO. 10~0~~
AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORDS
CONTRACT FOR THE CONSTRUCTION OF A 4~~INCH WATER TRANSMISSION MAIN
FROM SCRIPTURE STREET NORTH ALONG BONNIE BRAE TO NEST WINDSOR DRIVE
AND OVER TO LOOP ZSS; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR;
AND PROVIDING AN EFFECTIVE DATE BID 4466-AWARDED TO THE LOWEST
RESPONSIBLE BIDDER MEETING SPECIFICATION, SJ LOUIS CONSTRUCTION OF
TEAS, LTD IN THE AMOUNT OF $4,67a,7I0}.
WHEREAS, the City has solicited, received and tabulated competitive bids for the
construction of public works or improvements in acco~•dance with the procedures of State law and
City ordinances; and
WHEREAS, the City Manager or a designated employee has received and recommended that
the herein described bids are the lowest responsible bids for the construction of the public works or
improvements described in the bid invitation, bid propasals and plans and specif cations therein;
NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS,
SECTION I. The following competitive bids for the construction of public works or
improvements, as described in the "Bid Invitations", "Bid Proposals'" or plans and specifications on
file in the Office of the City's Purchasing Agent filed according to the bid number assigned hereto,
are hereby accepted and approved as being the lowest responsible bids:
BID
NUMBER CONTRACTOR AMOUNT
4466 SJ Louis Construction of Texas, LTD $4,670,7I0
SECTION 2. The acceptance and approval of the above competitive bids shall not constitute
a contract between the City and the person submitting the bid for construction of such public works
ar improvements herein accepted and approved, until such person shall comply with all requirements
specified in the Notice to Bidders including the timely execution of a written contract and furnishing
of performance and payment bonds, and insurance certificate after notification of the award of the
bid.
SECTION 3. The City Manager is hereby authorized to execute all necessary written
contracts far the performance of the construction of the public wanks or improvements in accordance
with the bids accepted and approved herein, provided that such contracts are made in accordance
with the Notice to Bidders and Bid Proposals, and documents relating the~4eto specifying the terms,
conditions, plans and specifications, standards, quantities and specified sums contained therein,
SECTION 4, Upon acceptance and approval of the above competitive bids and the execution
of contracts for the public works and improvements as authorized herein, the City Council hereby
authorizes the expenditure of funds in the manner and in the amount as specified in such approved
bids and authorized contracts executed pursuant thereto,
SECTION 5. This ordinance shall become effective immediately upon its passage and
approval,
PASSED AND APPROVED this the day of ~ ,2010,
i
MA A. U G ,MAYOR
f
ATTEST:
JENNIFER WALTERS, CITY SECRETARY
BY.
APPROVED AS TO LEGAL FORM;
ANITA BURGESS, CITY ATTORNEY
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CONTRACT AGREEMENT
STATE OF TEXAS
§ COUNTY OF DENTON §
THIS AGREEMENT, made and entered into this 16 day of February A.D., 20103
by and between City of Denton of the County of Denton and State of Texas, acting through
George C. Campbell thereunto duly authorized so to do, hereinafter termed
"OWNER," and
S J Louis Construction of Texas Ltd.
520S.6 1h Avenue.
Mansfield TX 76063
of the City of Denton, County of Denton and State of Texas , hereinafter termed
"CONTRACTOR."
WITNESSETH: That for and in consideration of the payments and agreements hereinafter
mentioned, to be made and performed by OWNER, and under the conditions expressed in the bonds
attached hereto, CONTRACTOR hereby agrees with* OWNER to commence and complete
performance of the work specified below:
Bid 4466-North-South 42-Inch Water Transmission Main
in the amount of $4,670,710 and all extra work-in connection therewith, under the terms as stated in
the General Conditions of the agreement; and at his (or their) own proper cost and expense to
furnish all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance, and
other accessories and services necessary to complete the work specified above, in accordance with
the conditions and prices stated in the Proposal and the Performance and Payment Bonds, attached
hereto, and in accordance with all the General Conditions of the Agreement, the Special Conditions,
the Notice to Bidders (Advertisement for Bids), and Instructions to Bidders, as referenced herein
and on file in the office of the Purchasing Agent, and in accordance with all local, state and federal
laws; and plans, which includes all maps, plats, blueprints, and other drawings and printed or
written explanatory matter thereof, and the Specifications therefore, as prepared by:
Freese and Nichols Inc.
all of which are referenced herein and made a part hereof and collectively evidence and constitute
the entire contract.
CA-1
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Independent Status
It is mutually understood and agreed by and between City and Contractor that Contractor is
an independent contractor and shall not be deemed to be or considered an employee of the City of
Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or sick
leave benefits, worker's compensation, or any other City employee benefit. City shall not have
supervision and control of Contractor or any employee of Contractor, and it is expressly understood
that Contractor shall perform the services hereunder according to the attached specifications at the
general direction of the City Manager of the City of Denton, Texas, or his designee under this
agreement.
Indemnification
Contractor covenants and agrees to and does hereby indemnify, hold harmless and defend, at
its own expense, Owner, its officers, servants and employees, from and against any and all claims or
suits for property loss or damage and/or personal injury, including death, to any and all persons, of
whatsoever kind or character, whether real or asserted, arising out of the Work and services to be
performed -hereunder by Contractor, its officers, agents, employees, subcontractors, licensees or
invitees, whether or not caused, in whole or in part, by the alleged negligence of the officers,
servants, employees, of the Owner. Contractor likewise covenants and agrees to, and does hereby,
indemnify and hold .harmless Owner during the performance of any of the terms and conditions of
this Contract, whether arising out of in whole or in part, any and all alleged acts or omissions of
officers, servants, or employees of Owner. The provisions of this paragraph are solely for the
benefit of the parties hereto and not intended to create or grant any rights, contractual or otherwise,
to any other person or entity.
Choice of Law and Venue
This agreement shall be governed by the law - of the State of Texas and venue for its
construction and enforcement shall lie in the courts of Denton County, Texas.
The CONTRACTOR hereby agrees to commence work on or after the date established for
the start of work as set forth in written notice to commence work and complete all work within the
time stated in the Proposal, subject to such extensions of time as are provided by the General and
Special Conditions.
The OWNER agrees to pay the CONTRACTOR in current funds the price or prices shown
in the Proposal, which forms a part of this contract, such payments to be subject to the General and
Special Conditions of the Contract.
CA-2
Right to Audit
The OWNER shall have the right to audit and make copies of the books, records and computations
pertaining to this agreement. The CONTRACTOR shall retain such books, records, documents and
other evidence pertaining to this agreement during the contract period and five years thereafter,
except if an audit is in progress or audit findings are yet unresolved, in which case records shall be
kept until all audit tasks are completed and resolved. These books, records, documents and other
evidence shall be available, within 10 business days of written request. Further, the
CONTRACTOR shall also require all Subcontractors, material suppliers, and other payees to retain
all books, records, documents and other evidence pertaining to this agreement, and to allow the
OWNER similar access to those documents. All books and records will be made available within a
50 mile radius of the City of Denton. The cost of the audit will be borne by the OWNER unless the
audit reveals an overpayment of 1% or greater. If an overpayment of 1% or greater occurs, the
reasonable cost of the audit, including any travel costs, must be borne by the CONTRACTOR
which must be payable within five business days of receipt of an invoice.
Failure to comply with the provisions of this section shall be a material breach of this contract and
shall constitute, in the OWNER'S sole discretion, grounds for termination thereof. Each of the
terms "books", "records", "documents" and "other evidence", as used above, shall be construed to
include drafts and electronic files, even if such drafts or electronic files are subsequently used to
generate or prepare a final printed document.
CA - 3
IN WITNESS WHEREOF, the parties of these presents have executed this agreement in-the
w;
year and day first above written.
ATTEST:
City of Denton T
BY:
(SEAL)
ATTEST:
S.J. Louis Construction--of=Texas,=Ltd.
CONTRACTOR
Michelle.Baker, Admin. Assistant 520 S. 6th Ave.
Mansfield, TX 76063
MAILING ADDRESS
817-477-0320
PHONE NUMBER
817-477-0552
FAX NUMBER
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Les V. Whitman, General Manager
APPROVED AS TO FORM: PRINTED NAME
(SEAL)
A BURGESS, Cl ATTORNEY
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ourselves.:our ..he>rs, .executors,; admuustrators;:.successors,..and: assigns; :Joint l y.. a n all
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firrnl .:b ::these: resents... This.:Bond";shall::automaticallybe:.~ncrease by.:: the amount o any
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entered into .a certain :Contract; identified: byOrdinance:=:Number :010=049; vv~th: e :City=.:of
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DeiAon;:the.O :wner dated the::16 - o f February A.D::: 2010 or:Bid #4466 North=Sou#hA2
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accordance ::wit3i::the: Plans; .:Specifications:::and::Contract::Documents::during :the :origin.:.term
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: thereof .and any extension thereof .which: maybe granted.by. the :Owner, :with: or:vvithout notice :to.:::.. ;
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LIMITED PARTNERSHIP ACKNOWLEDGMENT
STATE OF TEXAS
COUNTY OF TARRANT
On this 16th day Of February, 201o before me personally appeared Les V. Whitman
to me known, who being by me duly sworn, that he/she is the General Manager
of the S. J. LOUIS CONSTRUCTION OF TEXAS LTD. the Limited Partnership described in and
which executed the foregoing instrument; that he/she signed his/her name thereto by
order of the Board of Governors of said Limited Partnership.
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MICHELLE S.BLAIR Notary Public
MY COMMISSION EXPIRES
,lanuary27,2014 (Notary Seal)
•.T~ of
ACKNOWLEDGMENT OF CORPORATE SURETY
STATE OF MINNESOTA
COUNTY OF HENNEPIN
On. this 16th day of February, 201o before me appeared AMY M. BURNS to be known, who being
by me duly sworn, did say that s(he) is the aforesaid Attorney-in-Fact of the LIBERTY MUTUAL
FIRE INSURANCE COMPANY, a corporation; that the seal affixed to the foregoing instrument is
the corporate seal of said corporation, and that said instrument was signed and sealed on
behalf of said corporation by the aforesaid officer, by authority of its Board of directors; and
the aforesaid officer acknowledged said instrument to be the free act and deed of said
corporation.
Notary Public,
(Notary Sea
04 cga`ir'rs '
TODD A. KELSEY
~6 y1 Notary Public-Minnesota
My Commission
Expire
,_s Jan 31, 2014
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-THIS:POWER:OF,"ATTORNEY .IS NOT:VALID_UNLESS:IT:IS:PRINTED ON.RED.:BACKG,ROUND - _ - _
This Rower_of:Att:" * , aim its the.act§ of:;those:named herein=-.and-the have rid authori`• -to:bind-the. Co. m an exec t:in'the:manner'and to the
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WAUS AU WISCONSIN
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KNOW ALL; PER SON -THESE-'PRESENTS _
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That bb 'rt Mutual Fire. - th m n :Wi con in stocK insurance tco hr ou h its Assi s tant Secreta
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_authorih! ;-ofa -he Bo of=Directors hereinaft erset foith;:does: ereb name;,constitute and:ap'P olnt _--KATHLEEN:SORENSON TODD.A. KELSEY _
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AMY M13URNS LL_OF.=THE=CITY'~OF_-':BLO.OMINGTON;:STATE::O.F=MINNESOTA .
_ , each-:individually if-th6r6be-morethan:one namedj.its,true:antlaawful`attorney=in:=fact to:rriake; execute;,seal;:acknowtedge and deliver,:for and on_ its.behalf as_=
surety and ,_as- :its act and deed, any -:and all.: tidertaki ' - bonds, recognizances :and.-ot e • -surety:- obl gatons - t e pe . a _ su ot__e c ed
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- undertakings;:bonds; ~ecogrnzances and:other-suretyoblig_6dns;in:pursuahb6ofatiese:presents, shall-be as:binding:uponahe,Company asrf,theyhad been duly signed,
h - p 6sidenand att f h ro n -'in eir-own- "ro-~er- ` rsons - - - - -
:by t e pre t ested by thesesr- . - - o t e - pa . y_ th - p pe - _ -
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. That this pbWbi is"rnade and.ezecuted ursuant'.to.and',b :authori of the followin" Unanimous.Consent"and Vote:of: fie l3oard :of Di ectors`dated.Ju e 8 - - - - - - - _ -
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V - OTED- : that the Secreta :-and each: Assistant Secr'eta -be and:each":`of them is~authorized ,to. execute. •owers'.of attorneY 4uali in .the attor- "
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amed m`the; iven over, of-attorne to=execute=on:behalf_ofahe Gm an sure undertakin "s bonds - reco nizances:and. other: cur -et" =:'N
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.vi~ =.:obligations;=-and: that the,.Sec~etary :and .each Assistant Secretary be;-and=each: or any-of-,them-hereby: is;: authorized-to-attest to the execution M :
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That:;tl e Resolutionsef forth:_abo- is a.true-co . the--reof andJs now rn full-force .and effect . - - - -
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IN: WITNESS-:WHERE- Fthis Power:'.of-Attorne~ .has been-subscribed:b an.-authorized off icer o~-:off icial:of i Com an =and:"the--.cor orate .seal: N -
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- - _ Gamet 11V; Elliott; Assistant Secretary _ - ,
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:C :d_ COMMONWEALTH -PENNSYLVANIA ss - _ - - _ - - _ _ - - a -
COUNTY..OF MONTGQMERY _ - _ - _ - - _ _ _ - _ - - y~.o_ .
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AM` W'': =0n this: -:14th,:: a~_of_ :`.:Jul - 2009 -=:;=before _me, a=:Notar Public, ersonall - came: Garnef W.:Elliott;` to me =known;: and- _
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-0) acknowledged_thi t--:he ii-Asststant:.Secretary of :Liberty Mutual Fi(e:-Insurance: Company .that:knows the-_sai :of said=corporation.;-and-.that=;h-' 4)
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executed-the:above.=Power-of.•Attorne" and aff ized:ahe cor "orate seal of:-Elbe Mutual;fire Insurance: Corn` an ftiereto -with the authori and`at-the
E: direction:of said corporation _ - - - y
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G~ 'IN:TESTIMONY:'WHEREOF v" die a to. subscribed :m _ name and_aff i, ` , y v notarial-seal-=at::Pl mouth-:Meetin ; .Penn_sv lyania;_on the .da :and-- ear: o :
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:C,. , ; , ~g I - ~ ~t ~O Ah1oNt `EALTf{.oF PENNSdLVAN1r1: - - _ -~i
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-++.;L-; _ - - _Teiesa = Pastelta; testa-Y P7 i_ - - -
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Teresa Pastell t ublic
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- , _ :der: Petrsy~varua F,4scciatioii of I:~tarie - - . -
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CERTIFICA
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- that t - . x h
i mal.:power of attorney_of whic the= -
:1,_the_ undersi he'd nt sErreta: of-. .-Ubeit :Mutual:Fire:Insurance: Com an „do hereb certi _
:foregoing _is_a:full;_true and correct copy;:-;s~-in_full=foree;::and-:effect ors the date :of this certificate; and:a"'do furt -e -ertrfy that_the-officer or official who.
_ .
- - - _ - - - - - rn in=facf:as
ezecu_ted_the: said-power= of',attorney,-was: one=of the,b icers_ or officials specially, authorized-by the Board=of =Directors to _ appomt atto_ _ eys
- rovided=in the Unanimous.Consent.and:Vote=ofthe-Board of-Dire ctors,of--Libert Mutual Fire-lnsurbyi - Com an -dated.June 28; 2006
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•f:tfh-~ Boa
es under and:b-..aut hori, t o e
This:certificate=arf( the aboJe "owes of-attorn_e :ma eam ned tifacsimile: & mechani= catl -re -roduced`simatur-
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of:,Directors of Libe Mut- (A,e Insurance::Com an =evidenced:b ;the;Unan'im. Consent and;:Vofe bf the Board of Directors dated Ju- e, 8 2
=--wherein-it:W. . - - _ . - _ , _ - - = - - - - - - - - _ - _ - _
as. - - -
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uch_-power.::of attorneyor-_to .any.certficate_. aIatm•_ g .
VOTED thatahe si - gnatures of such=offi:, cers and-he`seaf of the_Company-may_ be:_affixed to any,s - r
- - - _ - - - - - -i
- tt ereto by, _fac- simile ,an-.-..-:--
antl an . sub - h: ~'ower-of:atforne _o -r. certificate:bearin such.facsimile si nature and ;facsimile seal shall be valid and bind- n
n _ h - orn pan =_w. n_so::affixed. and.Jh theJfjtuie -iniith-yes ect-_to~any :suref ' undertaking s :bonds- reco nizances.-and: other=suret~• _
: upo . t., C_ P _..Y . e_-- - - - . _P. .Y-, Y. _ . 9 , . . .9. - - - Y
obti" -attons .t o:which it is'attached _ _ - - - - - - - _ - -
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- _ - - - - - - - - - - - - - - - -.-.f-.
INTEST:I_MONY WHEREOF; T ,'ha' my name an_d affixed the .corporates L of the said company, this . t `d_o
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YMENT. OND.:- .
. . . - N.. 190 0:18 .810:: . .
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= : : STATE OF.TEXAS:_:.:_;.:..:.:
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UNTY OF: DE T
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OW ALL.MEN BY. THESE PRESENTS::That S J Loi is Co ' ction--~of:Texas;
Ltd.,:whose address as .520 S. 6 ..'AV: : nue :Mansfie 1'X :76063. here. er. called:PrinciP an
al a -
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:::::.::.-::Liberty. , i.F:Ire #nsurance Company.::
a atio . gamzed and.existing under the:laws : .
: .
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:.of.the:State°of_:Wisconsin : .,.and..ful~y::authorized .:to:transact:;
, ' : .
:::::.`business : in :the :.State of :Texas;:: as:. Surety; are heldNand.:firmly: bound unto -the: City: of Denton, : a
:
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municipal corp.... . ..organized and existing under the laws'of tbe-:State.:of::Texas; hereinafter- .
,
: ::::called:.Owner;. and :unto. aIi'persons; firms, 'and 'corpoiaEons :litho: may.:furnish::niatenals fo:. i, or : ;
.
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: p .e... rm labor - uP o -Ihe..buridrng or.: im royements hereinafter referred ao ° .in :the.- -~::e - -'um "of
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Four`: Million;:: .Hundred'; Seventy :~~T'housand. Seven:' Hun : dred ::Ten
: ' and' .:0110..: OLI;"
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. Colin.. Te xas -'forthe . :
- 670 71 .la. ,inU riioney of the United.States , 'to :be-pai d in :Denton. : ,
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a
p ym ent o:f :.w::: :hich :sum well-: and tiuly:to::be made, vye hereb :y:. .bi .nd..: ourselves our heirs; .executors; : .
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admmistrators;:-$uccessors,__and:assigns,:lomtly.:.and severally;::frmlybyahese:pi-esents. =.TYiis: = .
:Bond: shall .automatically be:. increased: b
Ythe ':ainount:.of .:any:: Change 'O r' er : or: - Su lemental
: :
: _ : . .
Agreement;.:which::increases :the:Contract :price, :but: in::no event::: shall: a -.Chan ge :Orde
. r.:or
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upp _gtnq, : : greernent w ch:re uces the Contract price::decrease: the.penal sum ofthis-Bond.-:. :
_
. - ° THE ATZO diti ::..al
OBLIG N. TO PAY: -SAlv1E :"is 'con oned : as fo ow s. - . Wher ' s the Princi 'al : ',pa . .
:...;..p-:....
entered into a.certain.Conttact; identified by ordinance Number.: - 10 049 ;-::with :.the.: City : of :
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:-'_:Dento : ahe.:Owne .r :dated the`: 16 of February.-. or::Bid #4466. Nortli-South 42
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: Inc ViTater Tr ion : : :
h ansmiss Main:Y r:......:
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` . :;NOW;:;THEREFORE ::if the:Pruici al `sj'..: all:well; truly :and:faithfully erform its: duties::::.'..:.-:_
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f.:.. :.:and.::make..prompt-payment to :all;:persons ; s `.`subcontract .:ors; . :corporati ons-:and claimants ~ -ii : : : : . .
; ::supplying` labor. andlor material m .the:prosecutio.-....L... f the: Work:provided°for :in:.said:Con tract::and . ' :
: ::..any::and all:duly..authorized niodificatlons: of said Contract that:may.her : . eaftei:be niade;:iiotice: of : :
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which modificatzons`to the Surety., e' bereb a ress l ' Y..vvalyed,::then:this;obl ption:shall be
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void;-:atherwise it shall remain in full force: and.effect: . . :
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: ::::.:PROVMED .FURTHEF that-:if. any:legal -act : ion :be.-filed.:on this .Bond; ~ eXClusive'.-ve .nue` -
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-shall lie in Denton:County~ .Texas::...:: ` :
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. . AND . PROVIDED. F.[TRTHE that the said: Sure ° foi .value::received bereb sti ulaies : =
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: ::::::.and agrees. Ghat no: change;. exten- sion ofaime, alteration or :addition to the terms of the: Contract, ,
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:or: to; the: Woik .to: be performed ;thereunder, of to .the ::Plans; ..Specifications; .Dravviiigs; etc.: ~ .
accomp, an the same shall :in ail se :affect its'. obligation.:on this .Bond and it does . heieb
- 1n . Y g . . ..y
waive notice: of. any such change;: exctension :of time; alteration-or `addition ao the terrine:of :the . -
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Contract, :onto the.:Wor.k to be erformed thereunder `or to-the Plans, S ecifications; Drawin s, .
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..;hi sBond is': .ven.ursuant #o
: . . T P.: .the proylsions:of = Chapter, 225" .of the Texas :Govern . : ment : -
.Code:, .as.:amended, and an other..a li cable statutes of the State T e*
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::':;:.The .undersigned and:design' ted agent.-is .hereby.- desi . ated b :the 'Sure ::herein :as the
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" Resldent.A ent in Denton Coup to
- . g;. :..........:.:..':,.::w :om any: requisite notes maybe: delivered 'aaci on vvhoai
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. service :of:process may. be had: in matters an sinout.of:such sure~. ' : as -roNrl ed:b ' :Article':7: 1 ' -
: . .
. g ..............:...:.......`.Y?.:: - ....:.:....:...Y.......- ::19:...
of.the Insurance C . ode,: ' VeMon's:~Aiiaotated.Cii Statutes.:of the State:of Texas.::.:.
' :..:...:.....::::IN:::WITNESS '~REOF -
this uistrument is executed in four co r : es;:each: he.-of w66bh: . .
:ahall be.deeed an :on al this the :16th :.da of Februa ::20:10 :
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P CIPAL
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LQU:IS CONSTRU:CTIQ.N:.QF.TE, . -::LTD.;:.:
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BY:
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: SURETY
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MPAN ":'I
....LIBERTY M A:L.FIRE INSURANCE ...,..:Y.- ".Y ;
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`":Am •.`M.•-~ urns:.:.'; - :
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.::__:.-.The. Resident Agent of .the .:Suretyin::Denton: County, ;Te ..:.xas:f .
or;dehvery.of notice. and s. erviceTgfr,.:,.4=«°:
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Corporaboh Service: Company:d/pla:CSC-Lawyers Incorporation:Servic. Company:
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: . ::.STREET :.2:11 East Tth Sfreet` cite:620 ° Austin TX:28701:
.ADDRESS. S.. ,
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(1VO1'E:::,Date:•.of:Payment::Bona::::nz .ust...be::daFe.'of:;Contr ct :;If:'Resider?t1 gent;. .is: °not: a
. cor oratron ct ersons. : : .
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V
LIMITED PARTNERSHIP ACKNOWLEDGMENT
STATE OF TEXAS
COUNTY OF TARRANT
On this 16th day of February, 201o before me personally appeared Les V. Whitman
to me known, who being by me duly sworn, that he/she is the General Manager
of the S. J. LOUIS CONSTRUCTION OF TEXAS LTD. the Limited Partnership described in and
which executed the foregoing instrument; that he/she signed his/her name thereto by
order of the Board of Governors of said Limited Partnership.
"Y Nota Publi
p:'nk MICHELLE S. BLAIR ry MY COMMISSION EXPIRES (Notary Seal)
January 27, 2014
ACKNOWLEDGMENT OF CORPORATE SURETY
STATE OF MINNESOTA
COUNTY OF HENNEPIN
On this 16th day of February, 201o before me appeared AMY M. BURNS to be known, who being
by me duly sworn, did say that s(he) is the aforesaid Attorney-in-Fact of the LIBERTY MUTUAL
FIRE INSURANCE COMPANY, a corporation; that the seal affixed to the foregoing instrument is-
the corporate seal of said corporation, and that said instrument was signed and sealed on
behalf of said corporation by the aforesaid officer, by authority of its Board of directors; and
the aforesaid officer acknowledged said instrument to be the free act and deed of said
corporation.
Notary Public,
00fi gT~ TODD A. KEFLSEf
:j Notary Public-Minnesota
°1 a;: k iy/ Niy Commission EXDir(S Jan 31, 2014
~^^yw. r„r a v+ a f!A F :n q nrh,'S°~?.~,`~`t`Y.~iiii i,"V'-;
- ~ _ - - - - -2607976 -
.-=:-;-=THIS-POWERAF"ATTORNEY IS::NOTVALID_UNCESS:~IT:IS PRINTED ON;RED:BACKGROUND.~-. ~ _ - - - = - - -
- -',._Thi~":P~ w f~Atto~ .:Lmi--:•:; h - - - _ "-__~-.r - .h v ~ n :~bincJ t .X-:: - - - - - - -
_ _ s o ,e- o - ney.. i, •ts"a, a acts_of those named, e,em';and~they_ a e o .authority to he Company a cept-,in #he`manner ands-#o the: -
;-.:,,-extent.,herem_Stafed.-:; _ _ _
" L'IBERTY;MUTUAL FIRE,INSURANCE CO.MPANYv _ - -
_ - W SAID, WISCONSIN _
AU
, ' -•..OWERAF;ATTORNEY - - - -
KNOW~AL'L~P_ERSONS:,BY THESE~FRESENTS-:::;-:::~:.-.-:-:. _ . - _ - - -
T a be u a Fir .In urance:Com ~~n _ - m ~an :-Wi--- n m ``t" ck-i ' • r ~ :•~_'m an r •.'..~-it -rAssistant S `r t ursuant to,•
. h t-Li -"rt :M 'tu I~ - - - - - th - - - -
. -Y_ s - - Pa .YK?r!e:-.Co . P _ Y-),_a sco . s ..s o nsu ance:co , P. _ .Y,.-...Dug, s. - ec a ary, f? d by
- _~authontyof~ttieBoar :of.Directors:hereinafter~~set_forth;-does.iierebyname;: constitute and-:appoint= "~.KATHLEEN~SORE.NSON-TODD-AKELSEY; :
-~=:~=-AMY~M:-BURN LL`:OF~THE=CIT.Y OF~~BLOOMINGTON`-:STATE:OF~MINNESOTA..:.~::::::.-:::::..:::.: - - - = -
_;:each:individually.~if there,be more;tlan one-named;: its•true;an__d~lawful,attorney-iri=factrto:make;:execute,-seal;-:acknowledge:and=deliver, for:.and on its;behalf as_
_ ~.-sure .:.and ~as=; its=act _and=:,deed;:. ari ~=-.and-. all dertakin "~s; . bonds;;,~eco -nizances::and :other: sure " obli atio_ ns - the enal sum :not: exceedin ~ -
- ~~.FIFTY•:MILLION:AIVD:~00%100************** - . DOLLARS-~ =50"000=-000:00*****************~********* ::::each- Viand tlie~-executiori: of-;such- -
-
="undertakings,-:bonds;,recogrnzances and:other"surety obligations; in put5_uarice of thes_ a presents, shall_be as bnding~upon tfie Company:as~'rf they had;been dulysigried::
b tithe-~residenta d ecreta~~ ~f h m n~~~in=ttr ii•-~~~ ~n~~r - "-r•-~ ~-on -
_ _ - y_ p_ attested~by the s , ry.o t e Co pa y- a ow .p.ope pe s s. - _ _ -
- - - - - = - - - - - - - - -
That tb-s po e _ s , tide and executed:pu, suantto~arid:by autfionty of:4hefollowing-Unanimous Conse• t.a . d Vote of tle~Boa d o -Directors:dated.Ju a 28; 2006_:
: wherein, among~other"things, _it was". _ - - - - - - _ - _ : N_
: -VOTED, :=that the=Secrets ,:=and-each":AsSistarif Secrets :-fje =and=each":of-them. is-=authorized:toy-executes ~owers-:of attorne = •uali in ~ the~•atforne =
- =named=iSecre iven ower of attome to:ezecute on=.behalf_of-the=Corn an `sure undertakin s bonds :'reco nizances.ah-:other:-suret' :~rn-
N: _ ::^obli ations=Nand=that the Secrets arid.each Assistant Sec~eta : ,be -arid each o~ an" unert =he_ reb : t o -authorized to:attest to:the-execution
=e ; = ~~.-of-an -sueh~.- ower-of attorne ~ -and to.."affizahereto the=cor orate: seal-of the:Corn 'an : : - ~ - - -
. P
:ca, That the Resolution seYforth'above:is a true copythereof and-isnow r taly.- o'-,-a d effect - :._c-
-1N~::WITNESS:WHEREOF;-this-Power of-Attorney-ha"s_.been-subscribed; by an: authorized-..officer or:official:-of the-:Companyand:ttie .corporate: seal: of=:,v:~-
Line :Mutual:Fire-trisurance:Com an =-has been: affixed:the`refo rn Pl mouth:Meetin :Penns Ivania this: 14th. da of - July -
2009 - _ - - _ - : ~ - _ - - - ~=a
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" -a - _ - _ _ _ ~ : LIBERTY MUTUAL FIRE INSURANCE-COMPANY - ~:M-
• ca
- - _ _ _ - _ ' Garnet W Elliott, Assistant Secretary
COMMONWEALTH OF; PENNSYLVANIA ss - - - - - - - - C -
a~
0... : _ _ _ -
C .c~:000NTY;'.OF MONTGOMERY= - = - _ = - - - - - -
' - vt•v~.~ :On3his.-:: - da _of_ . l`~ ~ _ _ :=before _me ,-a Notar : Putilic~-. ~-ersorialf _ came :Garnet W::Elliott ~`to _~ine -Rnown~ and w~
..14th y .July 2.009 ..Y._,.... P.,..-_ ,..Y , -
acknowled ed :,that::he is_ an' Assistarif:Secreta of .Libe Mutual F}re Insurance Gom an that tie: knows the, seal of :said coy oration; and=_that :he_ a~ .
=executed=the:-above= Rower: ~of:~Attorne ands affixed she="cor orate: se_ aF Hof:.Elbe Mutual :Fires Insurance:_Corii ~ari .thereto- with~.the- authori _ and:: at the::.
direction:of, said:cor ,oration - - - - - -
-0=~ca: IN:TESTIMONY::WHEREOF-` ~ ve e e :~to~ subscribed :ni•~:-naiime and_affixed::m'notarial--seal at-~ PI mouth- Meetin ~Penhs` Ivania• on, the "da :-and:- ear- -:O .
first above_written -5.: _ - - - - = - Z~N
- ~ C` - - - _ - ~ . _ ~ P . CO: h10N1R`EALTI-E O PE S f N _ _ _
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!F+. ;L• _ _ _ _ _ - _ erz5a FaSt~JTa; t~atan Rii:r.,c - - - - - - - - - -
T
- - - °}yittou;h-ri~.chto~~mery-Cot.'r[cy _
Z.',e~• _ " - - a `.Corii,-iii55+tsri Ex •°res,A.larth2B 2w.t3:+ - - - - =Q _O
. - - - ~ - • - Teresa Rastella Not , ublic -
- - - _ _ - _ -Ph~.~er,' REnrsKvania fs.cc,ati~i, of k~r}e`s' _ _ _ - , _ _ O_ '
CERTIFICATE:'- - - - - - - - - _ - - - -
1 the undersi ned an Assis' nt; :ecreta of Elbert Mutual Fire:"Insurance Gorri an do hereb :certi that the. on inal-: ower of-attorne -of-which the -
~'fore "Din ~ is a-full-true and:correct:~co~••=-is~in:full=force:and~effecton-the date~of=this-certifieate~ _and•-:I:-do"fuittier cerfi. =that the~officer-or-official who - -
- -~=executed.the=said- ower-of.~,attorne ~was~one~of~alie~bfficers--or=officials-a•~-ec'iall ,authorizedb .ahe~:Board~.of-Di~ecfors;toa omt~attorre-~s=iri-fact~as~
rovided m,the :Unanimous, Gonse"nt.and:'Vote ~of-the_Board_of-Directors:•of:Gtiert ;Mutual Fire _Insurarice-;Compan dafed-June -28;_2006 _
P Y Y
Thiscertificate`and the above ower of"attome ~•ma • tie si ned ti- facsimile or.mechanicall~ re ~ roduced-si natures-under_and b ~:aut or t o the Boa d
- of~Directors of= Libe - ~ Mutual Fire= lnsuran_ce- Com an =evid_enced.:b she':Unanimous=:bonsent:and: Vote_of:the. Board_of=Directors daf ed. Ju ..e 28, ;2006~_~ =
-wh r m..it-wasp=- : _ _ _ _ - _ _ _ - _ _ _ _ _ _ _ ' _ _
_ n ~ ~ "w • r f` `rn" ~r_ = n fcert ca ~ 1 in ~ ~ _
VOTED. "":~that_the signatures of such officers;:and the-seal of the~Gompany_may pe::affixed_to a •y sucFi po e_ o ,atto•_ ey. o to a _y - to .,eat, g_
ther"eto~b `facsimite';and:an":such: ow_ er-ofattorrie `orcertificate bearin" =such;facsimile•si-nsture-and:facsimile seal=_shall:6e val_id:and bindin "
u on the Com "an ;:when so affixed: and, n she=future with: res ect, to an suret ,:undertakinower-onds, eco nizanees,a- d._otfiebi uret- _ -
ob i n - ~v►ihi~h ifis'a~- ~~h` ~ -
_ at o s to c ttac ed ~~e9 - _ - -
9 - -
" IN:~TEST"IMO.NY 1NHEREOF:I:haye he~eurito_subscribed=rriy.,.name andaffixed the corp""Drat.-'seal,of~the:said company; this 16th:=-. ~~.day of ~ -
~Eebruar" 2010• - _ _ - -f~t~ - - - - - - -
_ _ X' - _ -
1' ~ 1
4id M..Ca
- - _ - - rey,.A§sistantSecretary.. -
SJL71780
CORD CERTIFICATE OF LIABILITY INSURANCE FE °ti22o,0
PRODUC \3MarketPointe rcial Lines - (952) 830-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF I ORMATION
ONLY AND CONFERS NO RIGHTS UPON THE C TIFICATE
rgo Insurance Services USA, Inc. HOLDER. THIS CERTIFICATE DOES NOT AME , EXTEND OR
ALTER THE COVERAGE AFFORDED BY TH OLICIES BELOW.
Drive, Suite 600
gton, MN 55435-5455 INSURERS AFFORDING COVERAGE NAIC #
INSURED S.J. Loui Construction of Texas, LTD INSURER A- AIU Insurance Company
520 South Ave. INSURER B:
INSURER C:
P O Box 834
INSURER D:
Mansfield TX 76 3 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LIS D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE P LICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CO ITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOW CH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFF DED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE ERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOW AY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSU CE ~Ss POLICY N BER POLICY EFFECTIVE POLI EXPIRATION LIMITS
DATE MM/DD D MM/DD
A GENERAL LIABI 4807560 11/1/09 11/1/10 EACH OCCURRENCE $ 1,000,000
100000,
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 PREMISES (Ea occurrence)
CLAIMS MADE Fx ]OCCU MED EXP (Any one person) $ 10,000
X Contractual PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 10,000,000
[~EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
RO- X LOC
POLICY X P
JE
A AUTOMOBILE LIABILITY LOOOO' 6505622 11/1/09 11/1/10 COMBINED SINGLE LIMIT
X ANY AUTO / (Ea accident) $ 1,000,000
c/
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY $
(Per accident)
X NON-OWNED AUTOS
x $2,500 Comp
,500 COII PROPERTY DAMAGE $
X $2 (Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESS/UMBRELLA LIABILITY 5427865 11/1/09 11/1/10 EACH OCCURRENCE $ 20,000,000
X OCCUR F ]CLAIMS MADE AGGREGATE $ 20,000,000
DEDUCTIBLE $
X RETENTION s 10,000 $
WORKERS COMPENSATION AND / 1591766 11/1/09 11/1/10 X WC STATU- oTH-
A EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $ 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS / LO TIONS /VEHICLES/ EXCLUSIONS ADDED BY END RS mriS ECIAL PROVISIO
Project: North-South 42-In Water Transmission Main, Bi - TheCity of nPntnn, its o c s, age ts, employees & volunteers are named additional
insured o>Za primary basi with respect to General Liabilit r the above referenced project
lrt~ r`- 5u610
CERTIFICATE H LDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED P ICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL EAVOR TO MAIL 301 DAYS WRITTEN
C/nTX V NOTICE TO THE CERTIFICATE HOLDER NAMED TO LEFT, BUT FAILURE TO DO SO SHALL
9treet IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND U N THE INSURER, ITS AGENTS OR
D209 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 1203994 0 ACORD CORPORATION 1988
CITY OF DENTON
INSURANCE REQUIREMENTS FOR CONTRACTORS
Bidder's attention is directed to the insurance requirements below. It is highly recommended
that bidders confer with their respective insurance carriers or brokers to determine in advance
of Bid submission the availability of insurance certificates and endorsements as prescribed
and provided herein. If an apparent low bidder fails to comply strictly with the insurance
requirements, that bidder may be disqualified from award of the contract. Upon bid award, all
insurance requirements shall become contractual obligations, which the successful bidder
shall have a duty to maintain throughout the course of this contract,
STANDARD PROVISIONS:
Without limiting any of the other obligations or liabilities of the Contractor, the Contractor shall
provide and maintain until the contracted work has been completed and accepted by the City of
Denton, Owner; the minimum insurance coverage as indicated hereinafter.
As soon as practicable after notification of bid award, Contractor shall file with the Purchasing
Department satisfactory certificates. of insurance, containing the bid number and title. of the
project. Contractor may, upon written request to the Purchasing Department, ask for
clarification of any insurance requirements at any time; however, Contractors are strongly
advised to make such requests prior to bid opening, since the insurance requirements may not be
modified or waived after bid opening unless a written exception has been submitted with the bid.
Contractor shall not commence any work or deliver any material until he or she receives
notification that the contract has been accepted, approved, and signed by the City of Denton.
All insurance policies proposed or obtained in satisfaction of these requirements shall comply
with the following general specifications, and shall be maintained in compliance with these
general specifications throughout the duration of the Contract, or longer, if so noted:
• Each policy shall be issued by a company . authorized to do business in the State of
Texas with an A.M. Best Company rating of at least A.
• Any deductibles or self-insured retentions shall be declared in the bid proposal. If
requested by the City, the insurer shall reduce or eliminate such deductibles or
self-insured retentions with respect to the City, its officials, agents, employees and
volunteers; or, the contractor shall procure a bond guaranteeing payment of losses and
related investigations, claim administration and defense expenses.
• Liability policies shall be endorsed to provide the following:
• Name as additional insured the City of Denton, its Officials, Agents,
Employees and volunteers.
CI-9
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• That such insurance is primary to any other insurance available to the
additional insured with respect to claims covered under the policy and that this
insurance applies separately to each insured against whom claim is made or
suit is brought. The inclusion of more than one insured shall not operate to
increase the insurer's limit of liability.
• Cancellation: The City requires 30 day written notice should any of the
policies described on the certificate be cancelled or materially changed
before the expiration date.
• Should any of the required insurance be provided under a claims-made form,
Contractor shall maintain such coverage continuously throughout the term of
this contract and, without lapse, for a period of three years beyond the contract
expiration, such that occurrences arising during the contract term which give
rise to claims made after expiration of the contract shall be covered.
• Should any of the required insurance be provided under a form of coverage that
includes a general annual aggregate limit providing for claims investigation or
legal defense costs to be included in the general annual aggregate limit, the
Contractor shall either double the occurrence limits or obtain Owners and
Contractors Protective Liability Insurance.
• Should any required insurance lapse during the contract term, requests for
payments originating after such lapse shall not be processed until the City
receives satisfactory evidence of reinstated coverage as required by this contract,
effective as of the lapse date. If insurance is not reinstated, City may, at its sole
option, terminate this agreement effective on the date of the lapse.
CI - 10
a
SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS:
All insurance policies proposed or obtained in satisfaction of this Contract shall additionally
comply with the following marked specifications, and shall be maintained in compliance with
these additional specifications throughout the duration of the Contract, or longer, if so noted:
[X] A. General Liability Insurance:
General Liability insurance with combined single limits of not less than $1,000,000.00
shall be provided and maintained by the Contractor. The policy shall be written on an
occurrence basis either in a single policy or in a combination of underlying and
umbrella or excess policies.
If the Commercial General Liability form (ISO Form CG 0001 current edition) is used:
• Coverage A shall include premises, operations, products, and completed
operations, independent contractors, contractual liability covering this contract
and broad form property damage coverage.
• Coverage B shall include personal injury.
• Coverage C, medical payments, is not required.
If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and
ISO Form GL 0404) is used, it shall include at least:
• Bodily injury and Property Damage Liability for premises, operations, products
and completed operations, independent contractors and property damage
resulting from explosion, collapse or underground (XCU) exposures.
• Broad form contractual liability. (preferably by endorsement) covering this
contract, personal injury liability and broad form property damage liability.
[X] Automobile Liability Insurance:
Contractor shall provide Commercial Automobile Liability insurance with Combined Single
Limits (CSL) of not less than $500,000.00 either in a single policy or in a combination of
basic and umbrella or excess policies. The policy will include bodily injury and property
damage liability arising out of the operation, maintenance and use of all automobiles and
mobile equipment used in conjunction with this contract.
Satisfaction of the above requirement shall be in the form of a policy endorsement for:
• any auto, or
• all owned, hired and non-owned autos.
CI - 11
n
v 5
~s
[X] Workers Compensation Insurance
Contractor shall purchase and maintain Worker's Compensation insurance which, in addition
to meeting the minimum statutory requirements for issuance of such insurance, has
Employer's Liability limits of at least $100,000 for each accident, $100,000 per each
employee, and a $500,000 policy limit for occupational disease. The City need not be
named as an "Additional Insured" but the insurer shall agree to waive all rights of
subrogation against the City, its. officials, agents, employees and volunteers for any work
performed for the City by the Named Insured. For building or construction projects, the
Contractor shall comply with the provisions of Attachment 1 in accordance with §406.096
of the Texas Labor Code and rule 28TAC 110.110 of the Texas Worker's Compensation
Commission (TWCC).
[ ] Owner's and Contractor's Protective Liability Insurance
The Contractor shall obtain, pay for and maintain at all times during the prosecution of the
work under this contract, an Owner's and Contractor's Protective Liability insurance policy
naming the City as insured for property damage and bodily injury which may arise in the
prosecution of the work or Contractor's operations under this contract. Coverage shall be on
an "occurrence" basis, and the policy shall be issued by the same insurance company that
carries the Contractor's liability insurance. Policy limits will be at least combined bodily
injury and property damage per occurrence with a aggregate.
[ ] Fire Damage Legal. Liability Insurance
Coverage is required if Broad form General Liability is not provided or is unavailable to the
contractor or if a contractor leases or rents a portion of a City building. Limits of not less
than each occurrence are required.
[ ] Professional Liability Insurance
Professional liability insurance with limits not less than per claim with
respect to negligent acts, errors or omissions in connection with professional services is
required under this Agreement.
[ ] Builders' Risk Insurance
Builders' Risk Insurance, on an All-Risk form for 100% of the completed value shall be
provided. Such policy shall include as "Named Insured" the City of Denton and all
subcontractors as their interests may appear.
CI - 12
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r
[ ] Commercial Crime
Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside
the premises, burglary of the premises, and employee fidelity. The employee fidelity
portion of this coverage should be written on a "blanket" basis to cover all employees,
including new hires. This type insurance should be required if the contractor has access to
City funds. Limits of not less than each occurrence are required.
[ ] Additional Insurance
Other insurance may be required on an individual basis for extra hazardous contracts and
specific service agreements. If such additional insurance is required for a specific contract,
that requirement will be described in the "Specific Conditions" of the contract specifications.
CI - 13
ATTACHMENT 1
[X] Worker's Compensation Coverage for Building or Construction Projects for
Governmental Entities
A. Definitions:
Certificate of coverage ("certificate ")-A copy of a certificate of insurance, a certificate
of authority to self-insure issued by the commission, or a coverage agreement (TWCC-
81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation
insurance coverage for the person's or entity's employees providing services on a
project, for the duration of the project.
Duration of the project - includes the time from the beginning of the work on the project
until the contractor's/person's work on the project has been completed and accepted by
the governmental entity.
Persons providing services on the project ("subcontractor" in §406.096) - includes all
persons or entities performing.-all or part of the services the contractor has undertaken to
perform on the project, regardless of whether that person contracted directly with the
contractor and regardless of whether that person has employees. This includes, without
limitation, independent contractors, subcontractors, leasing companies, motor carriers,
owner-operators, employees of any such entity, or employees of any entity which
furnishes persons to provide services on the project. "Services" include, without
limitation, providing, hauling, or delivering equipment or materials, or providing labor,
transportation, or other service related to a project. "Services" does not include
activities unrelated to the project, such as food/beverage vendors, office supply
deliveries, and delivery of portable toilets.
B. The contractor shall provide coverage, based on proper reporting of classification codes
and payroll amounts and filing of any overage agreements, which meets the statutory
requirements of Texas Labor Code, Section 401.011(44) for all employees of the
Contractor providing services on the project, for the duration of the project.
C. The Contractor must provide a certificate of coverage to the governmental entity prior to
being awarded the contract.
D. If the coverage period shown on the contractor's current certificate of coverage ends
during the duration of the project, the contractor must, prior to the end of the coverage
period, file a new certificate of coverage with the governmental entity showing that
coverage has been extended.
E. The contractor shall obtain from each person providing services on a project, and
provide to the governmental entity:
CI - 14
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1) a certificate of coverage, prior to that person beginning work on the project, so the
governmental entity will have on file certificates of coverage showing coverage for
all persons providing services on the project; and
2) no later than seven days after receipt by the contractor, a new certificate of coverage
showing extension of coverage, if the coverage period shown on the current
certificate of coverage ends during the duration of the project.
F. The contractor shall retain all required certificates of coverage. for the duration of the
project and for one year thereafter.
G. The contractor shall notify the governmental entity in writing by certified mail or
personal delivery, within 10 days after the contractor knew or should have known, of
any change that materially affects the provision of coverage of any person providing
services on the project.
H. The contractor shall post on each project site a notice, in the text, form, and manner
prescribed by the Texas Workers' Compensation Commission, informing all persons
providing' services on the project that they are required to be covered, and stating how a
person may verify coverage and report lack of coverage.
I. The contractor shall contractually require each person with whom it contracts to provide
services on a project, to:
1) provide coverage, based on proper reporting of classification codes and payroll
amounts and filing of any coverage agreements, which meets the statutory
requirements of Texas Labor Code, Section 401.011(44) for all of its employees
providing services on the project, for the duration of the project;
2) provide to the contractor, prior to that person beginning work on the project, a
certificate of coverage showing that coverage is being provided for all employees of
the person providing services on the project, for the duration of the project;
3) provide the contractor, prior to the end of the coverage period, a new certificate of
coverage showing extension of coverage, if the coverage period shown on the current
certificate of coverage ends during the duration of the project;
4) obtain from each other person with whom it contracts, and provide to the contractor:
a) certificate of coverage, prior to the other person beginning work on the project;
and
b) a new certificate of coverage showing extension of coverage, prior to the end of
the coverage period, if the coverage period shown on the current certificate of
coverage ends during the duration of the project;
CI - 15
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•
5) retain all required certificates of coverage on file for the duration of the project and
for one year thereafter;
6) notify the governmental entity in writing by certified mail or personal delivery,
within 10 days after the person knew or should have known, of any change that
materially affects the provision of coverage of any person providing services on the
proj ect; and
7) contractually require each person with whom it contracts, to perform as required by
paragraphs (1) - (7), with the certificates of coverage to be provided to the person for
whom they are providing services.
J. By signing this contract or providing or causing to be provided a certificate of coverage,
the contractor is -representing to the governmental entity that all employees of the
contractor who will provide services on the project will be covered by workers'
compensation coverage for the duration of the project, that the coverage will be based on
proper reporting of classification codes and payroll amounts, and that all coverage
agreements will be filed with the appropriate insurance carrier or, in the case of a self-
insured, with the commission's Division of Self-Insurance Regulation. Providing false
or misleading information may subject the contractor to administrative penalties,
criminal penalties, civil penalties, or other civil actions.
K. The contractor's failure to comply with any of these provisions is a breach of contract by
the contractor which entitles the governmental entity to declare the contract void if the
contractor does not remedy the breach within ten days after receipt of notice of breach
from the governmental entity.
Cl - 16
i
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY
This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a Date Received
person doing business with the governmental entity.
By law this questionnaire must be filed with the records administrator of the local government not
later than the 7th business day after the date the person becomes aware of facts that require the
statement to be filed. See Section 176.006, Local Government Code.
A person commits an offense if the person violates Section 176.006, Local Government Code. An
offense under this section is a Class C misdemeanor.
1 Name of person who has a business relationship with local governmental entity.
N/W
2
Check this box if you are filing an update to a previously filed questionnaire..
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 71' business
day after the date the originally filed questionnaire becomes incomplete or inaccurate.)
TName of local government officer with whom filer has an employment or business relationship.
Name of Officer
This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the filer has an employment or other business
relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the
filer of the questionnaire?
Yes ® No
B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the
local government officer named in this section AND the taxable income is not received from the local governmental entity?
F-1 Yes 91 No
C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer
serves as an officer or director, or holds an ownership of 10 percent or more?
0 Yes ® No
D. Describe each affiliation or business relationship.
/1111 1
4
Signature of person doing business wi the governmental entity Date.
Adopted 06/29/2007
CIQ - I
C
Bid No. 4466
ORIG.INAL
PROPOSAL
TO
THE CITY OF DENTON, TEXAS
FOR THE CONSTRUCTION OF
NORTH - SOUTH 42-INCH
WATER TRANSMISSION MAIN
IN
DENTON, TEXAS
The undersigned, as bidder, declares that the only person or parties interested in this
proposal as principals are those named herein, that this proposal is made without collusion
with any other person, firm, or corporation; that he has carefully examined the form of
contract, Notice to Bidders, specifications and the plans therein referred to, and has
carefully examined the locations, conditions, and classes of materials of the proposed
work and agrees that he will provide all the necessary labor, machinery, tools, apparatus,
and other items incidental to construction, and will do all the work -and furnish all the
materials called for in the contract and specifications in the manner prescribed herein and
according to the requirements of the City as therein set forth. The bidder further declares
that the bidder has a minimum of 5 projects with direct experience with the installation of
water pipeline 36" diameter or greater and of similar materials to the 42" pipeline on this
project. Bidder agrees that failure to have the aforementioned experience may constitute a
non-responsive bid, and the City may disqualify the bid. Bidder agrees to provide
experience records and references to the City upon request by the City.
It is understood that the following quantities of work to be done at unit prices are
approximate only, and are intended principally to* serve as a guide in evaluating bids.
It is agreed that the quantities of work to be done at unit prices and material to be
furnished may be increased or diminished as may be considered necessary, in the opinion
of the City, to complete the work fully as planned and contemplated, and that all quantities
of work whether increased or decreased are to be performed at the unit prices set forth
below except as provided for in the specifications. Bid. forms must be completed in ink.
The official total bid amount will be determined by multiplying the unit bid prices shown
in the hand written bid forms by the respective estimated quantities shown in the proposal
P-1
and totaling all of the extended amounts. Hand written unit prices must also include a unit
price in word for each item. In' cases of conflict, unit prices in words shall govern over
the numeric price given.
It is further agreed that lump sum prices may be increased to cover additional work
ordered by the City, but not shown on the plans or required by the specifications, in
accordance with the provisions to the General Conditions. Similarly, they may be
decreased to cover deletion of work so ordered.
It is understood and agreed that the work is to be completed in full within the number of
calendar days shown on the bid tabulation sheet.
Accompanying this proposal is a certified or cashier's check or Bid Bond, payable to the
Owner, in the amount of five percent of the total bid.
It is understood that the bid security accompanying this proposal shall be returned to the
bidder, unless in case of the acceptance of the proposal, the bidder shall fail to execute a
contract and file a performance bond and a payment bond within fifteen days after its
acceptance, in which case the bid security shall become the property of the Owner, and
shall be considered as a payment for damages due to delay and other inconveniences
suffered by the Owner on account of such failure of the bidder. Owner reserves the right
to reject any and all bids. Owner may investigate the prior- performance of bidder on
other contracts, either public or private, in evaluating bid proposals. Should bidder alter,
change, or qualify any specification of the bid, Owner -may automatically disqualify
bidder.
The undersigned hereby proposes and agrees to perform all work of whatever nature
required, in strict accordance with the plans and specifications, for the following sum or
prices, to wit:
P-2
SECTION A - WATER LINE PIPE ALTERNATES
Item Description* -'Estimated : Uriit
No. (Price to be Written in Words) Quantity 'Price Total-Price : '
1. 42-inch diameter Bar Wrapped
Concrete Cylinder Pipe AWWA C-
303, Furnish and install the water line 16,500 L.F.'gc~ s-° 3p~.~~ Zsd
pipe and fittings, complete and in
place as specified in the drawings for
the unit price of:
Coe qm bacto. EtbNTV Nuk dollars and
F, FTy cents [02614]
2. 42-inch diameter Mortar Coated
Steel Pipe AWWA C-200, Furnish
and install the water line pipe and 16,500 L.F. jjq 3,Z057 9 ~D
fittings, complete and in place as
specified in the drawings for the unit
price of:
paE 4 ,1141 2y tooR dollars and
cents [02626]
* Bidder shall provide a bid for Item I or Item 2.
P-3
G
SECTION B - WATER LINE BASE BID ITEMS
Item Description -Estimated ' .::.',Unit . Total Price
No. (Price to be Written in Words) Quantity Price
3. 8-inch diameter PVC C-900 DR 18 Pipe,
Furnish and install the water line pipe,
complete and in place as specified in the 100 L.F. 4-90.
drawings for the unit price of:
rHlKry dollars and
t,) o cents [02622]
4. 12-inch diameter PVC C-900 DR 14
Pipe, Furnish and install the water line
pipe, complete and in place as specified 25 L.F. CO
~in the drawings for the unit price of:
FoitTy dollars and
QO cents [02622]
5. 12-inch diameter PVC C-900 DR 18
Pipe, Furnish and install the water line oo
pipe, complete and in place as specified 200 L.F.
in the drawings for the unit price of:
&&R dollars and
iJo cents [02622]
6. 16-inch diameter Thickness Class 52
Ductile Iron Pipe, Furnish and install the
water line pipe, complete and in place as 100 L.F. l10 ,~5 LOCO.
specified in the drawings for the unit price
of:
OME 40awteb T" dollars and
►Jo cents [02615]
7. 20-inch diameter Thickness Class 52
Ductile Iron Pipe, Furnish and install the
water line pipe, complete and in place as 225 L.F. 92. specified in the drawings for the unit price
of:
Olt4c-2y Iwo dollars and
No cents [02615]
P-4
e ,
SECTION B - WATER LINE BASE BID ITEMS
Item Description. Estimated Unit :
No. (Price to be Written in Words) Quantity Price Total.:Price
8. 24-inch diameter Thickness Class 52
Ductile Iron Pipe, Furnish and install the
water line pipe, complete and in place as 900 L.F.93
specified in the drawings for the unit price
of:
Q, tJ6Ty TWREE dollars and
O cents [02615]
9. 30-inch diameter Bar Wrapped
Concrete Cylinder C-303 or Mortar
Coated Steel C-200 Pipe (Must match 65 L.F. 174. I CP
pipe material used for Bid Item 1 or 2),
Furnish and install the water line pipe,
complete and in place as specified in the
drawings for the unit price of:
NE qu oREb 5E. wjX ROK dollars and
1,~1o cents [02614] [02626]
10. 20" Diameter x 318" Thick Steel
Encasement by Bore, furnish and install,
work fully performed, including bore pits, 50 L.F.. Zoo °-o - lotCr~
shoring, grouting,"clean-up (water pipe
not included):
Two gvr4baab dollars and
r,~ o cents [02314]
11. 32" Diameter x 1/2" Thick Steel
Encasement by Bore, furnish and install,
work fully performed, including bore pits, 90 L.F. 3og`'o 7-7, 7ZO.00
shoring, grouting, clean-up (water pipe
not included):
T KF_ IAWbub 1 &wr dollars and
PJo cents [02314]
12. 36" Diameter x 1/2" Thick Steel
Encasement by Bore, furnish and install,
work fully performed, including bore pits, 30 L.F.
shoring, grouting, clean-up (water pipe
not included):
TA?xf, 1 D2Et,> Et&wTy Two dollars and
r~ cents [02314]
P-5
SECTION B -WATER LINE BASE BID ITEMS (CON'T)
Item Description Estimated : Unit- Total'. rice
No. (Price to be Written in Words) Quantity :.Price
13. 48" Diameter x 1/2" Thick Steel
Encasement by Bore, furnish and install,
work fully performed, including bore pits, 50 L.F. ~S410 - Z2,8~0.`-°
shoring, grouting, clean-up (water pipe
not included):
FuR Mb1ZE6 REly Six dollars and
~Jo cents [02314]
14. 60" Diameter x 112" Thick Steel
Encasement by Bore, furnish and install, CO
work fully performed, including bore pits, 1010 L.F. 723 730 7-30.
shoring, grouting, clean-up (water pipe
not included):
SEA azEe> TwF.rrty ?FREE dollars and
rho cents [02314]
15_ 60" Diameter x 112" Thick Steel
Encasement by Hand Tunnel, furnish
and install, work fully performed, including 40 L.F. 4 7Z.Va 2-OZ0 -°O-
bore pits, shoring, grouting, clean-up
(water pipe not included):
E~ pSb 7vJgA1 TH9" dollars and
iJo cents [02314]
16. Bermuda Hydromulch Seeding, furnish
and install complete in place, including co
topsoil, fertilizer, and water to establish 13,500 L.F. D= - 10th.
growth:
r~10 dollars and
cl&yr-e cents [02202]
17. Bermuda Grass Sod, furnish and install
complete in place, including topsoil, O°
fertilizer, and water to establish growth: 3,700 L.F. -
GLcV6r•1 dollars and
E i t=HTy cents [02202]
18. Concrete Encasement, Furnish and
install concrete encasement, complete
and in place as specified in the drawings 100 L.F. ~sS3.- Si -
for the unit price of:
FiFry I'HRcF_ dollars and
rJo cents [03301)
P-6
SECTION B -WATER LINE BASE BID ITEMS (CON'T)
Item Description -'Estimated Unit P
No. (Price to be Written in Words) Quantity Price Total:Price
19. Asphalt Pavement Repair, furnish and
install asphalt pavement repair per detail,
including curb and gutter repair, complete 600 S.Y. 33
and in place as specified in the drawings
for the unit price of:
TNI R7V TKO dollars and
n1o cents [02601]
20. Gravel Pavement Repair, furnish and
install gravel pavement repair per detail,
complete and in place as specified in the 240 S.Y. ~`~0.°-°
drawings for the unit price of:
5~ z dollars and
r`1o cents [026011
21. Concrete Pavement Repair, furnish and
install concrete pavement repair per
detail, induding curb and gutter repair, 30 S.Y. 000 c~~{°O-
complete and in place as specified in the
drawings for the unit price of:
F-oRtv F-I&HT dollars and
tJo cents [02601] [03301]
22. Concrete Sidewalk and Driveway
Repair, remove and replace existing
concrete sidewalk and driveway, 30 S.Y. 442 complete and in place as specified in the
drawings for the unit price of:
FO&jY TWO dollars and
00 cents [02601] [03301]
23. Trench Safety, Furnish and install trench
safety, complete and in place for the unit
price of: 17,000 L.F. C> 0
3 SIO
rQo dollars and
THREE cents [02220]
24. 4" Combination Air and Vacuum
Release Valve & Meter Box, Furnish and
install complete in place, including valve, 7 EA. g~SQO.- 59 &O.,
corp stop and fittings:
F_wN Fije NuN6REt> dollars and
Ob cents [15117]
P-7
SECTION B -WATER LINE BASE BID ITEMS (CON'T)
Item Description Estimated . Unit :Total Price
No.. Price to be Written in Words Quantity Price
25. 8" Blowoff Valve, Furnish and install
complete in place including valve, piping,
and vault: 6 EA. 3,SoD,~ 4 .Z 11CCO.
TNi2 Five H%)NOFF-b- dollars and
rJo cents [01130] [151011
26. 42-inch Butterfly Valve with EPDM
Seats and Seals, Furnish and install
water line valve with EPDM seats and 9 EA. 22~ 000 ZoS1 ZQD.'
seals, complete and in place as specified
in the drawings for the unit price of:
T~E~,7• T v -14b05A&)J 61!*• I11)AJO'Vollars and
cents [15103]
27. 8-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals, 3 EA. $ ~,3~.- 3 9oo.O0
complete and in place as specified in the
drawings for the unit price of:
-1tR-MCa NjNbAgb dollars and
~Jc cents [15101 ]
28. 12-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals, 5 EA. 21 CO,- ~Z#MO.
complete and in place as specified in the
drawings for the unit price of:
T„x-o Foo HvNbaF-b. dollars and
►Jo cents [151011
29. 16-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals, 1 EA. (s00,- (90D,°~
complete and in place as specified in the
drawings for the unit price of:
1=iF y Six WtJoReb. dollars and
10 o cents [15101 J
P-8
r~.
SECTION B - WATER LINE BASE BID ITEMS CON'T
Item Description - :Estimated:..: Unit
:Total Price
No. (Price to be Written in Words) Quantity., Price
30. 20-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals, 3 EA. 113c~, - 33,9 Co.
complete and in place as specified in the
drawings for the unit price of:
TH 6 1-ripec N,JAb."b dollars and
1Jo cents [15101]
31. 24-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals,
1 EA. ~ IS ZOO- [S2o0, .
complete and in place as specified in the
drawings for the unit price of:
RFT TNoosaab. Two Hor4tPRFo dollars and
N o cents [15101
)
32. 30-inch Gate Valve with EPDM Seats
and Seals, Furnish and install water line
valve with EPDM seats and seals, 1 EA. Z~~txb- Z~~ooo °-o
complete and in place as specified in the
drawings for the unit price of:
Tt-4&-s 6ija TA oysAua dollars and
1Jo cents [15101 ]
33. 16" X 12" Tapping Sleeve with 12"Gate
Valve, Furnish and install water line
tapping sleeve and valve with EPDM 1 EA. tpp~
seats and seals, complete and in place as
specified in the drawings for the unit price
of:
R%)E TNoos 46 ot3c 4046"6- dollars and
~Jo cents [15101)
34. Ductile Iron Fittings, Furnish and install
complete in place: 10 TON [D 40
complete
E dollars and
t 10 cents [02615]
35. Check Dams, Furnish and install 100
-complete in place: 2 EA. I,bco
0,NE l4uNDRE6 dollars and
00 cents [02202] [02253]
P-9
n
w-
SECTION 13' WATER LINE BASE BID ITEMS CON'T
Uriit
Item Description :Estimated
No. (Price to be Written in Words) Quantity Price Total. Price:
36. Fire Hydrant Assembly, Furnish and
install complet in place: 1 EA. 3 ~Op - 3 °O .
-NAM TH yb &c*r kWb9Gb dollars and
+Jo cents [02719]
37. 18-inch Thick Rock Rip-Rap with 6"
bedding, Furnish and install rock rip-rap,
complete and in place as specified in the 200 S.Y.
drawings for the unit price of:
F-OQT~e si (-r►iT dollars and
Flo cents [02271]
38. Connection to Existing 16-inch Water
Line at Scripture Street, Labor to make
connection to existing water line, 1 EA. - 21Cp.- +21 complete and in place as specified in the
drawings for the unit price of:
"Fu)O T A06 4:6A HjA6"es dollars and
N)O cents [01130]
39. Connection to Existing 16-inch Water
Line at McKenna Park, Labor to make co
connection to existing water line, 1 EA. +
complete and in place as specified in the
drawings for the unit price of:
Iwo TN Aaaa dollars and
4 o cents [01130]
40.
Connection to Existing 20-inch Water
Line at STA 41+33.02, Labor to make
connection to existing water line, 1 EA. $ 2,100°° 21gO0
complete and in place as specified in the
drawings for the unit price of:
-Two THE Aot> Fcva- 404c2Eb dollars and
rJo cents [01130]
P-10
R .
r' .
SECTION B - WATER LINE BASE BID ITEMS CON'T
Item Description Estimated ..Unit_
Total Price
No. (Price to be Written in Words) Quantity Price`
41. Connection to Existing 12-inch Water
Line at STA 47+04.36, Labor to make
connection to existing water line, 1 EA. - m - (nOp,`°-
complete and in place as specified in the
drawings for the unit price of:
51 rEro Noa tea C-& dollars and
Qo cents [01130]
42. North Connection to 36" Water Line,
Labor to make connection to existing
water line, complete and in place as 1 EA. ~~ooo°°
specified in the drawings for the unit price
of:
PooR 'FRo%IsANt~, dollars and
rJo cents [01130]
43. Remove and Replace Storage Trailer
and Fencing (STA 106+50), Remove and o0
replace fence and storage trailer prior to 1 L. S. 3000,- 31000,°-°
construction and replace when
construction is finished, complete and in
place as specified in the drawings for the
unit price of:
TKO TiiousAa6 dollars and
tJo cents [01130]
44. Corrosion Protection, materials and
work fully performed as per specifications,
complete in place.
Fm Ei bN r THoOSA0b dollars and
1`1 o cents [160611'[160621
[16640]
45. Erosion Control and Preparation
Implementation, and Maintenance of Do DO
SWPPP, Furnish and install erosion 1 L.S. ISrCx.~- $ ISrWO. -
control devices for the unit price of:
Fi TEEiJ TrioysAws, dollars and
rJo cents [01568]
46-. Performance and Payment Bond
Acquisition, Furnish proper bond ca
documents for the unit price of: 1 L. S. -~~D OOD - CIO OOD,°D
FosLT4 1400SAaa dollars and
. rJo cents [01130] [Contract
Documents]
P-11
a
47. Miscellaneous Park Repairs, for repairs
deemed necessary through the Park Area co
from STA 81 +00 to STA 105+00, 1 L. S. + 3,cm,
complete in place for the unit price of:
THZM T-4005PO(D. dollars and
Q0 cents [01130]
48. Miscellaneous Utility Repairs, for
repairs deemed necessary by City,
complete and in place for the unit price of: 1 L. S. $50,000 $50,000.00
Fifty Thousand dollars and
No cents [01130]
TOTAL BID, SECTION B - WATER LINE BASE BID ITEMS
OME Mi"100 61x AvAbRE0- -rWEa-ry S1x
in the amount of -p ousAae FovR 9013b"a stxry dollars 00
and n10 cents. - 1677-
(Items'3 to 48)
P-12
BID SUMMARY . .
TOTAL BASE BID (Items 3-48), SECTION B IN WORDS:
ONE A111a, "513( dU4Dr2Efl TWEaTy SAX THouSfl►JD ouR 4NDRED
SI~CTy 1J0(JA2S PtNN tJo CFaJ'tS
TOTAL BASE BID (Items 3-48) + PIPE ALTERNATE 1 IN WORDS:.
Fouts l~~ L4 S))( 4vtjbPF-t> S~JF- ar- THoVSAOt> 56460 40NWQSI~>
~0\IAQs AtJb No CCATS
TOTAL BASE BID (Items 3-48) + PIPE ALTERNATE 2 IN WORDS:
FpOR A1104 EI&HT ~-MbQZC-b THIR -rw0 _rHaVS40D FM)
~VNOeE~ TES D096126 Poao 00 e€t.J~'s
Base bid and pipe alternate options: The Bidder must submit a bid for either Item 1 or 2.
The Bidder may bid only one of the pipe material alternates, more than one, or all of the
pipe material alternates. The Bidder must submit a Bid for Items 3-48. The award of the
contract will be based on the base bid items in the project and the selected pipe material
altemate, the decision on which pipe material alternate to award will be solely at the
discretion of the City. The lowest responsive proposal for purposes of award shall be the
conforming responsible Bidder offering the lowest cost for the base bid option plus the
pipe material alternate selected by the City.
In the event of the award of a contract to the undersigned, the undersigned will furnish a
performance bond and a payment bond for the full amount of the contract, to secure
proper compliance with the terms and provisions of the contract, to insure and guarantee
the work until final completion and acceptance, and to guarantee payment for all lawful
claims for labor performed and materials furnished in the fulfillment of the contract.
The work shall be accepted when the Engineer is satisfied that the proposed work was
fully completed, to the best of his knowledge, in accordance with the plans and
specifications.
The undersigned certifies that the bid prices contained in this proposal have been carefully
checked and are submitted as correct and final.
Unit and lump sum prices as shown for each item listed in this proposal shall control over
extensions.
P-13
a
The undersigned agrees to substantially complete all work covered by these Contract
Documents within Three hundred and sixty (360) consecutive calendar days from the day
established for the start of the work in a written Notice to Proceed. Final completion of
all work shall be reached within sixty (60) consecutive calendar days from date of
substantial completion. The date established for the start of work will be not less than ten
(10) days and not more than thirty (30) days after the date of the Contract Agreement,
except by mutual agreement of the Owner and the Contractor.
Receipt is hereby acknowledged of the following addenda to the plans and specifications:
Addendum No. 1 dated 1 12'1 Ito Received 2.1 4 o
Addendum No. 2 dated z/z f o Received i Z /10
Addendum No. 3 dated -l Received
Addendum No. 4 dated Received
Addendum No. 5 dated Received
Uet.
CONTRACTOR
BY Y G f
_~Mafl , -
5Za S. CVi::t-\ RVOla-e-,
Street Address
y -ales -4-Cr ocr.3
City and State
Seal & Authorization l
(If a Corporation) Z 0 _
Telephone
P-14
s
. i
i
i
VENDOR COMPLIANCE TO STATE LAW
The 1985 Session of the Texas Legislature passed House Bill 620 relative to the award of
contracts to non-resident bidders. This law provides that, in order to be awarded a
contract as low bidder, non-resident bidders (out-of-state contractors. whose corporate
offices or principal place of business are outside of the State of Texas) bid projects for
construction, improvements, supplies or services in Texas at an amount lower than the
lowest Texas resident bidder by the same amount that a Texas resident bidder would be
required to underbid a non-resident bidder in order to obtain a comparable contract in the
state in which the non-resident's principal place of business is located. The appropriate
blanks in Section A below must be filled out by all out-of-state or non-resident bidders in
order for your bid to meet specifications. The failure of out-of-state or non-resident
contractors to do so will automatically disqualify that bidder. Resident bidders must check
the blank in Section B.
A. Non-resident bidders in (give state), our principal place of
business, are required to be _percent lower than resident
bidders by state law. A copy of the statute is attached.
Non-resident bidders in (give state), our principal place of
business, are not required to underbid resident bidders.
B. ur principal place of business or corporate offices are in the State of Texas: Tew
BIDDER:
(PAI~ULJ_i uv-x -gas [A
COMPANY
Y
BY
LCS, Whii-num,GSA a ni lavtco
Street Address 4 (-V o~~ 3
City and State
P-15
THIS FORM MUST BE RETURNED Wn H YOUR BID.
CONTRACTOR COMPLIANCE TO TEXAS SALES TAX CODE
Comply with all requirements of the Texas Sales Tax Code. The Contractor hereby
certifies that the Contract Amount is divided as follows:
00
Materials incorporated into the Project $ '317--7o -1tO,-
(resold to the Owner as defined in Tax Code)
All other charges and costs $ ►~g00,000.
Total $ ,070;? to,00
The total must equal the total amount of the Contract.
a
CONTRACTOR:
T l ou i s ~ov~~~ rug o~ 04- gaS) .
COMPANY
BY
US
5o s,
Street Address
Tws ob
City and State
THIS FORM SHALL; BE EXECUTED AT THE TLME OF EXECUTION OF TIC
CONTRACT AND SHALL BE MADE A PART OF THE CONTRACT.
P-16
SJL71780
ACORD. CERTIFICATE OF LIABILITY INSURANCE 3/1DATE (MM/20IYYYY)
7/2010
PRODUCER Commercial Lines - (952) 830-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Wells Fargo Insurance Services USA, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4300 MarketPointe Drive, Suite 600
Bloomington, MN 55435-5455 INSURERS AFFORDING COVERAGE NAIC #
INSURED S.J. Louis Construction of Texas, LTD INSURER A: AIU Insurance Company
520 South Sixth Ave. ,D INSURER B:
P O Box 834 ~1 INSURER C:
INSURER D:
Mansfield TX 76063 [INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ""J TYPE OF INSURA POLICY NU ER POLICY EFFECTIVE POLICY EXPIRATION
LTR NSR DATE MM/DD DATE MM/DD/Y LIMITS
A GENERAL LIABILITY 4807560 11/1/09 11/1/10 EACH OCCURRENCE S 1,000,000
X COMMERCIAL GENERAL LIABILITY PREM SESOEa occurrrence S 300,000
CLAIMS MADE ~ OCCU MED EXP (Any one person) S 10,000
X Contractual PERSONAL & ADV INJURY S 1,000,000
GENERAL AGGREGATE S 10,000,000
FEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000
POLICY X JERCOT LOC
A AUTOMOBILE LIABILIT 6505622 11/1/09 11/1/1 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) S 1,000,000
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS
BODILY INJURY S
X NON-OWNED AUTOS (Per accident)
x $2,500 Comp
x $2,500 Coll PROPERTY DAMAGE S
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S
ANY AUTO
OTHER THAN EA ACC S
AUTO ONLY: AGG S
A EXCESS/UMBRELLA LIABILITY 5427865 11/1/09 11/1/10 EACH OCCURRENCE S 20,000,000 Umbrella
X OCCUR CLAIMS MADE AGGREGATE S 20,000,000 Umbrella
S
R XDEDUCTIBLE 5
RETENTION $ 1 0 STATU _-_1 S
WORKERS COMPENSATION AN / X 1 WC LIMIT OTH-
A EMPLOYERS' LIABILITY 1591766 11/1/09 11/1/10 Y
E.L. EACH ACCIDENT S 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S 1,000,000
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Project: North-South 42-Inch Water Transmission Main, Bid 4466 - The City of Denton. its officials, agents, employees & volunteers are named additional
insur, ed on a primary basis with respect to Genera Uiabil y and Additional U-~t~tred with spect to Auto Liability for the above referenced project. ,workers
Compensation policy includes waiver of subrogationn_fzvor of the City of Dentore
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE IHE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 DAYS WRITTEN
City of Denton NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
901 B Texas Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Denton TX 76209 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 1265392 9 ACORD CORPORATION 1988
(This certificate replaces certificate# 1203994 issued on 2/23/2010)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (2001/08) 2 of 2 #S915260/M915043