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085-21 - Public Works Board - Contract Amendment 1DocuSign Envelope ID: 86AE4E80-1B26-48A2-8FDA-A7F69B77F2E4 AMENDMENT FACE SHEET Contract Number: PE22-96103-000 PROJECT COMPLETION AMENDMENT - X PUBLIC WORKS BOARD EMERGENCY CONSTRUCTION LOANS 1. Contractor 2. Contractor Doing Business As (optional) City of Port Orchard N/A 214 Prospect St Port Orchard, WA 98366 3. Contractor Representative 4. Public Works Board Representative N/A N/A 5. Original Contract Amount 6. De -Obligation 7. Final Contract Amount $500,000.00 $246,847.50 $253,152.50 8. Amendment Funding Source 9. Amendment Start Date 10. Amendment End Date Federal: ❑ State: 0 Other: ❑ Amendment Execution June 1, 2041 N/A: ❑ Date 11. Federal Funds (as 12. Federal Agency 13. CFDA applicable): N/A N/A N/A 14. Contract Purpose The purpose of this amendment is to certify the project completion for this Public Works Board Loan. The Board, defined as the Washington State Public Works Board and Borrower/Contractor acknowledge and accept the terms of this Agreement/Contract As Amended and attachments and have executed this Agreement/Contract Amendment on the date below to start as of the date and year referenced above. The rights and obligations of both parties to this Agreement/Contract As Amended are governed by this Agreement/Contract Amendment and the following other documents incorporated by reference: Amendment Terms and Conditions, including Attachment I: Certified Project Completion Report. A copy of this Agreement/Contract Amendment shall be attached to and made a part of the original Agreement/Contract between the Board and the Borrower/Contractor. Any reference in the original Agreement/Contract to the "Agreement" or the "Contract" shall mean the "Agreement As Amended" or "Contract As Amended," respectively. FOR THE CONTRACTOR FOR PUBLIC WORKS BOARD ��p�`DocuSigned by: [DOCUSIgned by: F69E8885DOE74EF... 7245D4026B7D42E... Signature Kathryn A. Gardow, Public Works Board Chair Robert Putaansuu 7/25/2022 1 5:59 PM PDT Print Name Date Mayor APPROVED AS TO FORM ONLY This 22nd Day of March, 2013 Title 7/25/2022 1 9:28 AM PDT Bob Ferguson Attorney General Date Signature on File Kathryn Wyatt Assistant Attorney General DocuSign Envelope ID: 86AE4E80-1B26-48A2-8FDA-A7F69B77F2E4 AMENDMENT DECLARATIONS Amendment Title Amendment Number CLIENT INFORMATION Legal Name Loan Number Completion Amendment Amendment X City of Port Orchard PE22-96103-000 PROJECT INFORMATION Title Pottery Lift Station Repairs Project City Port Orchard Project State Washington Project Zip 98366 LOAN TERMS and CONDITIONS Loan Amount De -obligation Final Loan Amount Loan Term -Original Loan Term -Revised Current Interest Rate Final Interest Rate Loan Reimbursement Start Date Payment Month $500,000.00 $246,847.50 $253,152.50 20 Years 20 Years .94% .94% 9/20/21 June 1 SPECIAL TERMS AND CONDITIONS GOVERNING THIS LOAN AGREEMENT LOAN SECURITY CONDITION GOVERNING THIS LOAN AGREEMENT Revenue Obligation: This loan is a revenue obligation of the CONTRACTOR payable solely from the net revenue of the Sanitary Sewer (Wastewater) system. Payments shall be made from the net revenue of the utility after the payment of the principal and interest on any revenue bonds, notes, warrants or other obligations of the utility having a lien on that net revenue. As used here, "net revenue" means gross revenue minus expenses of maintenance and operations. The BOARD grants the CONTRACTOR the right to issue future bonds and notes that constitute a lien and charge on net revenue superior to the lien and charge of this loan agreement. SCOPE OF WORK Repairs associated with the Pottery Lift Station. Construction includes 100% piping replacement and wet well lining with air dispersion systems for both the Pottery Lift Station and the Sedgwick Lift Station, which has been found to be the major contributor to the high concentrations of hydrogen sulfide gas. The project costs may include but are not limited to: engineering, cultural and historical resources, environmental documentation, review, permits, public involvement, bid documents and construction. The project needs to meet all applicable Local, State, and/or Federal standards. DocuSign Envelope ID: 86AE4E80-1B26-48A2-8FDA-A7F69B77F2E4 AMENDMENT TERMS AND CONDITIONS Contract Number: PE22-96103-000 PUBLIC WORKS BOARD PROJECT COMPLETION AMENDMENT CONSTRUCTION CONTRACTS The purpose of this amendment is to acknowledge the project has been certified complete and the final contract amount, interest rate, and local share on the above referenced contract have been adjusted, if necessary, as reflected below. The Public Works Board, (or its successor) a department of the state of Washington and the Contractor agree to amend the above referenced contract as described below. The amount of the loan shall be the Final Loan Amount as identified on the Declarations Page. The interest rate shall be the Final Interest Rate as identified on the Declarations Page, per annum on the outstanding balance. Page 1 7/6/2022 DocuSign Envelope ID: 86AE4E80-1B26-48A2-8FDA-A7F69B77F2E4 ATTACHMENT I: CERTIFIED PROJECT COMPLETION REPORT PUBLIC WORKS BOARD -EMERGENCY CONSTRUCTION LOANS Loan Number: PE22-96103-002 Contractor: City of Port Orchard Project Name: Pottery Lift Station Repairs Address: 214 Prospect St Port Orchard, WA 98366 Original or Extended Project Completion Date: 9/20/22 Chief Executive Officer Certification The Chief Executive Officer of the Borrower/Contractor certifies that: • To the best of his/her knowledge, the financial information and data provided in this report is true and correct as of the signature date indicated below, and no project costs listed in this report incurred more than twelve (12) months before agreement/contract execution or after the date of the project completion; • Records supporting the information provided in this report are on file and will be made available by the Borrower/Contractor upon request; and E�DocuSigned by: leo(�c,v% F69E8885DOE74EF... Signature of Chief Executive Officer Robert Putaansuu Print Name Title Mayor 7/25/2022 1 9:28 AM PDT Date of Signature Project Engineer or Consultant Certification The Project Engineer or Consultant of the Borrower/Contractor certifies that: • To the best of his/her knowledge, the data provided in this report is true and correct as of the signature date indicated below; • The project was completed in accordance with the Loan Agreement/Contract's Scope of Work; and • The loan is 20 years, if performance incentive has been choose to extend the term; the engineer agrees the life of the asset 20 years. 2/25/2022 • The project was completed on (Actual Date of Project Completion) EDocuSigned by: �L �� C. C1 AVIALY A08425EC455B474... Signature of Project Engineer or Consultant Kenneth C. Hammer Print Name Title Interim Public works Director 7/25/2022 1 7:38 AM PDT Date of Signature 7/6/2022 DocuSign Certificate Of Completion Envelope Id: 86AE4E801B2648A28FDAA7F69B77F2E4 Subject: Please DocuSign: PWB Emergency Construction Completion Amd-X.doc Division: Local Government Program: Public Works Board ContractNumber: PE22-96103-000 DocumentType: Contract Amendment Source Envelope: Document Pages: 4 Signatures: 4 Certificate Pages: 5 Initials: 0 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) Record Tracking Status: Original 7/6/2022 11:52:45 AM Security Appliance Status: Connected Storage Appliance Status: Connected Signer Events Kenneth C. Hammer kchammer@cityofportorchard.us Interim Public Works Director Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 7/25/2022 7:32:55 AM ID:c097Obc3-ac66-4de9-bO22-5d727ad98eO6 Robert Putaansuu rputaansuu@cityofportorchard.us Mayor Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 7/25/2022 9:27:57 AM ID:920a6586-e484-4687-a47a-fladO8564578 Kathryn Gardow pwbgardowk@gmail.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 7/25/2022 5:58:50 PM ID:1c792228-f3c1-4a22-8f08-704855a2eefa Holder: Mark Rentfrow mark. rentfrow@commerce.wa.gov Pool: StateLocal Pool: Washington State Department of Commerce Signature DocuSig�neld by: E d wVul� RAAMmtr n08425Ec455B474... Signature Adoption: Pre -selected Style Using IP Address: 152.44.129.230 by: ED—Sign1d 6bu� Naaln SUU F69E88B5DOE74EF... Signature Adoption: Pre -selected Style Using IP Address: 152.44.129.230 Signed using mobile [DocuSigned by: 7245 D4026B7D Signature Adoption: Drawn on Device Using IP Address: 107.122.81.87 Signed using mobile Status: Completed Envelope Originator: Mark Rentfrow 1011 Plum Street SE MS 42525 Olympia, WA 98504-2525 mark.rentfrow@commerce.wa.gov IP Address: 147.55.134.112 Location: DocuSign Location: DocuSign Timestamp Sent: 7/6/2022 11:59:44 AM Viewed: 7/25/2022 7:32:55 AM Signed: 7/25/2022 7:38:38 AM Sent: 7/25/2022 7:38:39 AM Viewed: 7/25/2022 9:27:57 AM Signed: 7/25/2022 9:28:21 AM Sent: 7/25/2022 9:28:22 AM Viewed: 7/25/2022 5:58:50 PM Signed: 7/25/2022 5:59:08 PM In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/6/2022 11:59:45 AM Certified Delivered Security Checked 7/25/2022 5:58:50 PM Signing Complete Security Checked 7/25/2022 5:59:08 PM Completed Security Checked 7/25/2022 5:59:08 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 8/11/2020 4:44:12 PM Parties agreed to: Kenneth C. 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