HomeMy WebLinkAbout058-25 - Source Electric, LLC - Contract Exhibit APROPOSAL
CITY OF PORT ORCHARD
LIFT STATION CONTROLS UPGRADE
PW2025-014
To: Mayor and City Council
City of Port Orchard, Washington
Contractor: Source Electric, LLC
State License No.: SOURCE*876QD
Date: 6/05/2025
Month/Day/Year
Bidder's Declaration and Understanding
The Bidder declares that s/he has carefully examined the Contract Documents for the
construction of the project, that s/he has personally inspected the site, that s/he has satisfied
her/himself as to the quantities involved, including materials and equipment, and conditions of
work involved, including the fact that the description of the quantities of work and materials, as
included herein, is brief and is intended only to indicate the general nature of the work and to
identify the said quantities with the detailed requirements of the Contract Documents, and that
this Proposal is made according the provisions and under the terms of the Contract Documents,
which Documents are hereby made a part of this Proposal. The Bidder further declares that s/he
has exercised her/his own judgment regarding the interpretation, of subsurface information and
has utilized all data, which s/he believes pertinent from City and other sources and has made
such independent investigations as the Bidder deems necessary in arriving at her/his conclusions.
Bidder understands that any bid response documents may be subject to release under the Public
Records Act Chapter 42.56 RCW and the City may be required to disclose bid responses upon a
request. Bidder acknowledges that s/he has been advised to mark any records believed to be
trade secrets or confidential in nature as "confidential." If records marked as "confidential" are
found to be responsive to the request for records, the City as a courtesy to the Bidder may elect
to give notice to Bidder of the request so as to allow Bidder to seek a protective order from a
Court. Bidder acknowledges and agrees that any records deemed responsive to a public records
request may be released at the sole discretion of, and without notice by, the City.
Contract Execution
The Bidder agrees that if this Proposal is accepted, s/he will, within fourteen (14) calendar days after
Notice of Award, complete and sign the Contract in the form annexed hereto, and will at that time
deliver to the City executed copies of the Performance Bond, Labor and Material Payment bond, the
Certificate of Insurance, and other documentation required by the Contract Documents, and will, to
the extent of her/his Proposal, furnish all machinery, tools, apparatus and other means of
construction and do the work and furnish all the materials or services necessary to complete all work
as specified or indicated in the Contract Documents.
Rev 3%18'22
Cih% of Port Orchard
Lrft Station Controls Upgrade Project #PW2025-014
Page -12
Start of Construction and Contract Completion
The Bidder further agrees that within 14 calendar days of CONTRACT START DATE, s/he will meet
with engineering personnel and begin work no later than September 1, 2025, and complete the
construction within 342 working days of START DATE.
Lump Sum and Unit Price Work
The Bidder further proposes to accept as full payment for the work proposed herein the amounts
computed under the provisions of the Contract Documents and based on lump sum and unit price
amounts, it being expressly understood that the unit prices are independent of the exact
quantities involved. The Bidder agrees that the lump sum prices and the unit prices represent a
true measure of the labor, services, and materials required to perform the work, including all
allowances for overhead and profit for each type and unit of work called for in these Contract
Documents.
If any material, item, or service required by the Contract Documents has not been mentioned
specifically, the same shall be furnished and placed with the understanding that the full cost to
the City has been merged with prices named in the proposal.
Rev 3,18'72
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
Page -13
BID PRICE FORM
Lift Station Controls Upgrade
PROJECT NO. PW2025-014
NOTE: The Project must be bid in its entirety, including all bid alternate items as specifically listed
in the Proposal, in order to be considered a responsive bid. The Contracting Agency reserves the
right to award all work, or any combination of the base bid and bid alternates, according to the
lowest qualified responsive bid tendered, available funds, and as it best serves the interest of the
Contracting Agency. All work awarded will be made to the same Contractor/bidder. Bidder shall
make no stipulation on the Bid Form, nor qualify the bid in any manner.
Source Electric, LLC
Bidders Name:
SALES TAX
Retailing/Retail Sales Tax Rule WAC 458-20-170 and its related rules, apply to this project for the
constructing and repairing of existing buildings, or other structures, upon real property. The Contractor
shall collect from the City retail sales tax on the full contract price. The City will automatically add this
sales tax to each payment to the Contract. The Contractor shall not include the retail sales tax in the unit
bid item prices, with the following exception: The City will not add in sales tax for a payment the
Contractor or a subcontractor makes on the purchase or rental of tools, machinery, equipment, or
consumable supplies not integrated into the project. Such sales taxes shall be included in the unit bid item
prices or in any other contract amount.
All Work is described in the Project Manual and shown on plans and described in the specifications for
Project No. PW2023-004 for the City of Port Orchard City Hall Renovations, 216 Prospect Street, Port
Orchard, WA 98366. Refer to Sheet A10.01 for a breakdown of the Base Bid and Bid Alternates.
The bidder agrees the lump sum and unit prices entered for the various bid items included in the Bid
Schedule include all use taxes, overhead, profit, bond premiums, insurance premiums and all other
miscellaneous and incidental expenses as well as all costs of materials, labor, tools and equipment
required to perform and complete the work.
LUMP SUM BASE BID AMOUNT
Five Hundred Twenty Eight Thousand Three Hundred and Forty Six Dollars Dollars
(amount in words)
$ 528,346.00
(amount in numbers)
LUMP SUM BID ALTERNATE #1: Tremont Lift Station
One Hundred Seventy Two Thousand Four Hundred and Fifteen Dollars Dollars
(amount in words)
Rev 3i18.2?
City of Port Orchard
Lift Station Controls Upgrade Project # PW2025-014
Page -1 d
S 172,415.00
(amount in numbers)
LUMP SUM BID ALTERNATE #2: Golden Pond Lift Station
One Hundred Twenty Nine Thousand One Hundred and Forty Dollars
Dollars
(amount in words)
$ 129,140.00
(amount in numbers)
LUMP SUM BID ALTERNATE #3: Cedar Heights Lift Station
One Hundred Forty Two Thousand Eight Hundred and Twenty Five Dollars Dollars
(amount in words)
$ 142,825.00
(amount in numbers)
TOTAL OF BASE BID AND ALL BID ALTERNATES
Nine Hundred Seventy Two Thousand Seven Hundred and Twenty Six Dollars Dollars
(amount in words)
$ 972,726.00
(amount in numbers)
Rev 3118122
Cin' of Port Orchard
Lift Station Controls Upgrade Project #PTf2025-014
Page -IS
The undersigned Bidder hereby agrees to start construction on this project, if awarded, no later
than fourteen (14) calendar days after Notice to Proceed and to complete the project within the
time stipulated in the Contract. By signing below, Bidder acknowledges receipt of the following
Addenda to the Bid Documents:
CITY OF PORT ORCHARD
Lift Station Controls Upgrade
NONE
Addendum No.
Date of Receipt Addendum No. Date of Receipt
Addendum No. Date of Receipt Addendum No. Date of Receipt
NOTE: Failure to acknowledge receipt of Addenda may be considered as an irregularity in the Bid
Proposal and Owner reserves the right to determine whether the bid will be disqualified.
By signing below, Bidder certifies that s/he has reviewed the insurance provisions of the Bid
Documents and will provide the required coverage.
The undersigned Bidder hereby certifies that, within the three-year period immediately
preceding the bid solicitation date for this Project, the Bidder is not a "willful" violator, as defined
in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a
final and binding citation and notice of assessment issued by the Department of Labor and
Industries or through a civil judgment entered by a court of limited or general jurisdiction.
OFFICIAL AUTHORIZED TO SIGN FOR BIDDER:
"I certify (or declare) under penalty of perjury under the laws of the State of Washington that
the foregoing is true and correct."
Signature:
Printed Name and Title:
Ryan Stewart Member
Business Address:
Date:
6/05/2025
Location or Place Executed (City, State):
Port Orchard, WA
Business Telephone:
7045 Banner Rd SE, Port Orchard Wa 98367 1 360-620-4844
NOTES: If the Bidder is a co -partnership, give firm name under which business is transacted;
proposal must be executed by a partner. If the Bidder is a corporation, proposal must be executed
in the corporate name by the president or vice-president (or any other corporate officer
accompanied by evidence of authority to sign).
Rev 3%18%22
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
Page -16
STATE OF ____
)ss.
COUNTY OF
I certify that I know or have satisfactory evidence that 1C..A c5+ AAXA ( c signed
this proposal, on oath stated that he/she was authorized to execute the proposal and
acknowledged it as the MR.mb e,( (title) of
SpUCC'Q 9c)%-S%C (name of party on behalf of whom proposal was
executed) and acknowledged it to be his/her free and voluntary act for the uses and purposes
mentioned in this proposal.
Dated this day of jort
CASSNDRA MCBLAIN-EDELMAN
Notary Public
State of Washington
Commission Number 25013836
My Commission Expires
04/25/2029
Rev 3/18/22
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
My Commission Expires:
Gg1/c L o q
Page -17
BIDDER'S QUALIFICATION FORM
CITY OF PORT ORCHARD
LIFT STATION CONTROLS UPGRADE
PW2025-014
1. Name of Contractor:
Source Electric, LLC
Address:
7045 Banner Rd SE. Port Orchard WA 98367
2. Telephone No.( 360 ) 620-7525 Fax No.: (
Email Addressestewart@source-electric.com
3. Washington State Dept. of Labor and Industries Worker's Compensation Account No.:
283, 131-00
4. Washington State Dept. of Licensing Contractor's Registration No.: SOURCE'876QD
Expiration Date: Oct 31st 2025
5. Washington State Uniform Business Identifier No.: 603-340-974
(Must have UBI number before the contract is awarded.)
6. Does the Contractor have a City of Port Orchard Business License Yes: x No:
(A City of Port Orchard Business license is required prior to commencing work pursuant to a written Notice to
Proceed)
7. Number of years engaged in contracting business under above name: 12
8. At the time of bid submits did the contractor have a certificate of registration in
compliance with Chapter 18.27 RCW? Yes ________-
9. Does the contractor have industrial insurance coverage for its employees working in
Washington as required in Title 51 RCW? (Provide number.) 283, 131-00
10. Does the contractor have an employment security department number as required in
Title 50 RCW? (Provide number): 496979 00 0
11. Does the contractor have a state excise tax registration number as required in Title 82 RCW?
(Provide number): 603-340-974 _
12. Has the contractor been disqualified from bidding on any public works contract under
RCW 39.06.010 or 39.12.065(3)? No
Rev 3118122
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
Page -18
13. If project includes Federal funding. Is the Contractor registered in Sam.gov? Yesa No
Enter Unique ID No. (UEI)KYQEKUILVJN5
14. Has the contractor received training on the requirements related to public works and
prevailing wage under chapters 39.04 and 39.12 RCW, as required in RCW 39.04.350(1)(f)
Yes
15. Within the three-year period immediately preceding the date of the bid solicitation, was the
contractor (determined by a final and binding citation and notice of assessment issued by the
department of labor and industries or through a civil judgment entered by a court of limited
or general jurisdiction) to have willfully violated, as defined in RCW 49.48.082, any provision
of chapter 49.46, 49.48, or 49.52 RCW? No
16. Has the contractor violated the "Off -site Prefabricated Non -Standard Project Specific Items"
reporting requirements more than one time as determined by the department of labor and
industries? No
17. Particular types of construction performed by your company: Water and Wastewater electrical &
controls. Lift station upgrades including controls and SCADA upgrades. Treatment plant SCADA & electrical
& controls improvements. Generator replacements
18. Gross amount of contracts now on hand: $ 9,371,870.80
19. List similar recent construction projects that your firm has done in the last 5 years (i.e., water
and storm and sanitary sewer main construction, road reconstruction, excavations, extensive
dewatering, etc.):
Amount Type Owner's Name Phone
$679,800.00 SCADA & Telemetry Improvements City of Fife (253) 896-8214
$756,668.00 SCADA & Telemetry Improvements City of Auburn (253) 204-0842
$474,694.00 Telemetry [Upgrades Cedar River Water & Sewer District (425) 255-6370
$809,121.00 SCADA & Security Upgrades Cascade Water Alliance (206) 930-0211
Rev 3%1822
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
Page -19
20. What is the construction experience of the principal individuals to be assigned to this project?
Years of
Construction
Name Title Experience Availability
Erik Stewart
Zach Cook
Executive Manager
30 Yes
Superintendent 25
Yes
Pursuant to RCW 39.06.020, the contractor further agrees to verify responsibility criteria for each
of its subcontractors and to require each of its subcontractors to both verify responsibility criteria
as described herein for its subcontractors and include instant condition for verification
requirement.
By:
(Authorized Signature)
Title: Member
Date: 6/05/2025
NOTE: Any bidder having current outstanding litigation with the City will not be considered
responsible and will be rejected by the City.
Rev 3118122
City of Port Orchard
Lift Station Controls Upgrade Project # PW2025-014
Page -20
BID SECURITY
CITY OF PORT ORCHARD
LIFT STATION CONTROLS UPGRADE
PW2025-014
Bid Deposit:
The undersigned Principal hereby submits a Bid Deposit with the City of Port Orchard in the form of
a cash deposit, certified or cashier's check, or postal money order in the amount of
Dollars ($ y.
Bid Bond:
KNOW ALL MEN BY THESE PRESENTS: That we, Source Electric LLC__________________________________, as Principal and
=1,0Corporate 5o ;t,,sn as Surety, are held firmly bound unto the City of Port Orchard,
Washington, as Obligee, In the penal sum of Five Percent (5%) of Total Bid Amount Dollars, for the
payment of which the Principal and the Surety bind themselves, their heirs, executors, administrators,
successors and assigns, jointly and severally by these presents.
The conditions of this obligation are such that if the Obligee shall make any award to the Principal for
Lift Station Controls Upgrade PW2025-014 . Port Orchard, Washington, according to the terms of the
Proposal or Bid made by the Principal therefore, and the Principal shall duly make and enter into a contract
with the Obligee in accordance with the terms of said Proposal or Bid and award and shall give bond for
the faithful performance thereof, with Surety or Sureties approved by the Obligee, or if the Principal shall,
in case of failure to do so, pay and forfeit to the Obligee the penal amount of the deposit specified in the
call for bids, then this obligation shall be null and void; otherwise it shall be and remain In full force and
effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated damages,
the amount of this Bond.
Signed, Sealed and Dated this 5th day of June 20 25
Source Electric LLC Swiss Re Corporate Solutions America Insurance Corporation
Principal Surety
Signature of Authorized Official Signature of Authorized Official
t__ j'.7 By: Thomas P. Hentschell, Attorney -in -Fact
Primed Name and Title Attorney -in -Fact (Attach Power of Attorney)
Name and address of local office of
Agent and/or Surety Company:
Acrisure
1436 S. Union Ave. Suite 101
Tacoma, WA 98405
Surety companies executing bonds must appear on the current Authorized Insurance List in the State of
Washington per Section 1-02.7 of the Standard Specification.
Rev 3/18/22
City ofPor70rcho,d
Lift Station Conbols Upgrade Project #PW2025-014
Page -21
Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal
SWISS RE CORPORATE SOLUTIONS
SWISS RE CORPORATE SOLUTIONS AMERICA INSURANCE CORPORATION ("SRCSAIC")
SWISS RE CORPORATE SOLUTIONS PREMIER INSURANCE CORPORATION ("SRCSPIC")
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT SRCSAIC, a corporation duly organized and existing under laws of the State of Missouri, and
having its principal office in the City of Kansas City, Missouri, and SRCSPIC, a corporation organized and existing under the laws of the State of
Missouri and having its principal office in the City of Kansas City, Missouri, each does hereby make, constitute, and appoint:
THOMAS P. HENTSCHELL, BRADLEY A. ROBERTS. JOANNE REINKENSMEYER, KRISTIN JACKSON,
DAPHNE ROBERTS. DANIELLE BRYANT and BAILEY BEACH
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of:
FIFTY MILLION ($50,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both SRCSAIC and SRCSPIC at meetings duly called and held on the 9s' of May 2012:
"RESOLVED, that any two of the President, any Managing Director, any Senior Vice President, any Vice President, the Secretary or any Assistant
Secretary be, and each or any of them hereby is, authorized to execute a Power of Attorney qualifying the attorney named in the given Power of
Attorney to execute on behalf of the Corporation bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to
attest to the execution of any such Power of Attorney and to attach therein the seal of the Corporation; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to
any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Corporation when so affixed and in the future with reeard to any bond, undertaking or contract of surety to which it is attached."
• R�'•.,
1 NS R ,N4c•'
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D3avid Satory, Senior Vice President SRCSAIC & Senior Vice President
jo -
of of SRCSPIC
:SEAL'
'SEAL'
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gy
!ssou�`
p•`•
Gerald Jagrowsld, Vice President of SRCSAIC & Vice President of SRCSPIC
IN WITNESS WHEREOF, SRCSAIC and SRCSPIC have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized
officers this 25TH day of SEPTEMBER 20 24
Swiss Re Corporate Solutions America Insurance Corporation
State of Illinois Swiss Re Corporate Solutions Premier Insurance Corporation
County of Cook
On this IL day of SEPTEMBER 20 24 , before me, a Notary Public personally appeared David Satory. Senior Vice President of SRCSAIC
and Senior Vice President of SRCSPIC and Gerald Ja row�ski , Vice President of SRCSAIC and Vice President of SPCSPIC, personally known to mc, who
being by me duly sworn, acknowledged that they sigh ned the above Power of Attorney as officers of and acknowledged said instrument to he the voluntary act
and deed of their respective companies.
VMNM62Y,EDA
mrtnarc M.r d 4 .'I
raa�•io NY.Y
res aisbiA fMnw n Poll
Karen S nicdit_ Notary
I, Jeffrey Goldberg the duly elected Senior Vice President and Assistant Secretary of SRCSAIC and SRCSPIC, do hereby certify that the above and foregoing
is a true and correct copy of a Power of Attorney given by said SRCSAIC and SRCSPIC, which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this day of , 20
Jeffrey Goldberg, Senior Vice President &
Assistant Secretary of SRCSAIC and
SRCSPIC
Failure to return this Declaration as part of the bid proposal package
will make the bid nonresponsive and ineligible for award.
NON -COLLUSION DECLARATION
I, by signing the proposal, hereby declare, under penalty of
perjury under the laws of the United States that the following
statements are true and correct:
That the undersigned person(s), firm, association or corporation has
(have) not, either directly or indirectly, entered into any agreement,
participated in any collusion, or otherwise taken any action in restraint of
free competitive bidding in connection with the project for which this
proposal is submitted.
2. That by signing the signature page of this proposal, I am
deemed to have signed and to have agreed to the provisions
of this declaration.
NOTICE TO ALL BIDDERS
To report rigging activities call;
1-800-424-9071
The U.S. Department of Transportation (USDOT) operates the above toll -free
"hotline" Monday through Friday, 8:00 a.m. to 5:00 p.m., eastern time. Anyone
with knowledge of possible bid rigging, bidder collusion, or other fraudulent
activities should use the "hotline" to report such activities.
The "hotline" is part of USDOT's continuing effort to identify and investigate
highway construction contract fraud and abuse and is operated under the
direction of the USDOT Inspector General. All information will be treated
confidentially and caller anonymity will be respected.
A DOT Form 272-036H EF
Revised 5/06
Rev 3,182?
City of Port Orchard
Lift Station Controls Upgrade Project #PW2025-014
Page -22
CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES
The bidder hereby certifies that, within the three-year period immediately preceding the bid
solicitation date May 9, 2025, the bidder is not a "willful" violator, as defined in RCW 49.48.082,
of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding
citation and notice of assessment issued by the Department of Labor and Industries or through a
civil judgment entered by a court of limited or general jurisdiction.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is
true and correct.
Source Electric, LLC
Bidder's Business Name
Signature of Authorized Officer/Representative*
Ryan Stewart
Printed Name
Title
6/05/2025
Date
Check One:
Sole Proprietorship O
Port Orchard
City
Washington
Partnership El Joint Venture El Corporation/LLC 0
State
State of Incorporation, or if not a corporation, State where business entity was formed:
Washington
If a co -partnership, give firm name under which business is transacted:
*If a corporation or limited liability company, this certificate must be executed in the entity's
name by the president or vice-president (or any other corporate officer accompanied by
evidence of authority to sign). If a co -partnership, this certificate must be executed by a partner.
Rev 3'1822
Ciiv of Port Orchard
Lift Station Controls Upgrade Project # P W2025-01 #
Page -23
SUPPLEMENTAL CRITERIA INFORMATION FORM
As evidence that the Bidder meets the mandatory and supplemental responsibility criteria, the
apparent two lowest Bidders must submit to the Owner by 12:00 p.m. (noon) of the second
business day following the bid submittal deadline, this Supplemental Criteria Information Form
verifying that the Bidder meets the Mandatory Criteria under RCW 39.04.350(1) and the
Supplemental Bidder Criteria stated below. The two lowest Bidders shall also submit supporting
documentation including but not limited to that detailed below (sufficient in the sole judgment
of the Owner) demonstrating compliance with all mandatory and supplemental responsibility
criteria. The Owner reserves the right to request such documentation from other Bidders as well,
and to request further documentation as needed to assess Bidder responsibility. The Owner also
reserves the right to obtain information from third parties and independent sources of
information concerning a Bidder's compliance with the mandatory and supplemental criteria,
and to use that information in their evaluation. The Owner may (but is not required to) consider
mitigating factors in determining whether the Bidder complies with the requirements of the
supplemental criteria.
The basis for evaluation of Bidder compliance with these mandatory and supplemental criteria
shall include any documents or facts obtained by Owner (whether from the Bidder or third
parties) including but not limited to: (i) financial, historical, or operational data from the Bidder;
(ii) information obtained directly by the Owner from others for whom the Bidder has worked, or
other public agencies or private enterprises; and (iii) any additional information obtained by the
Owner which is believed to be relevant to the matter.
If the Owner determines the Bidder does not meet the bidder responsibility criteria and is
therefore not a responsible Bidder or the bid is not responsive, the Owner shall notify the Bidder
in writing, with the reasons for its determination. If the Bidder disagrees with this determination,
it may appeal the determination within two (2) business days of the Owner's determination by
presenting its appeal and any additional information to the Owner. The Owner will consider the
appeal and any additional information before issuing its final determination. If the final
determination affirms that the Bidder is not responsible (or the bid is not responsive), the Owner
will not execute a contract with any other Bidder until at least two business days after the Bidder
determined to be not responsible (or the bid not responsive) has received the Owner's final
determination.
Request to Change Supplemental Bidder Responsibility Criteria Prior to Bid: Bidders with
concerns about the relevancy or restrictiveness of the Supplemental Bidder Responsibility
Criteria may make or submit requests to the Owner to modify the criteria. Such requests shall be
in writing, describe the nature of the concerns, and propose specific modifications to the criteria.
Bidders shall submit such requests to the Owner no later than five (5) business days prior to the
bid submittal deadline and address the request to the Project Engineer or such other person
designated by the Owner in the Bid Documents.
Rev 3/18'22
City of Port Orchard
Lift Station Controls Upgrade Project # PW2025-014
Page -_J
For criteria with check boxes, the bidder will check either "Yes" or "No." For each "Yes" answer
on the form, the Bidder shall provide a signed and dated statement providing the project
information requested and explaining the extenuating circumstances.
Project Name: Lift Station Controls Upgrade
Part A. General Company Information
Company Name: Source Electric, LLC
Address: 7045 Banner Rd SE Port Orchard WA 98367
Contact Phone: 360-620-7525
Years in business as a Prime Contractor: 12
Years in business under Present Name: 12
Contact E-mail: estewart@source-electric.com
Years in business as a subcontractor: 12
List any former company names under which the company, its owners, and/or its principals
has operated in the past five (5) years.
Explain reason for name change(s) in the past five (5 years)
I Part B. Delinquent State Taxes
Is the bidder listed on the Washington State Department of Revenue's "Delinquent
Taxpayer List" website:
http://dor.wa.gov/content/filea ndpaytaxes/latefil ing/dtlwest.aspx
Yes ❑ No X❑
If "Yes" attach a copy of the written payment plan approved by the Department of
Revenue.
Part C. Federal Debarment
The bidder shall not be listed as a current debarred or suspended bidder on the Federal
"System For Award Management" website www.sam.gov. Is the bidder listed as debarred
or suspended?
Yes ❑ No X❑
Sam.gov Unique Entity ID No. KYQEKUILVJN5
Rev 3,18122
City of Port Orchard
Lift Station Controls Upgrade Project # PW2025-01 #
Page -25
Part D. Subcontractor Responsibility
Does the bidder's standard subcontract form include the subcontractor language required
by RCW 39.06.020? Does the bidder have an established procedure which it uses to
validate the responsibility of each of its subcontractors? Does the subcontract form require
that each of the bidder's subcontractors have and document a similar procedure for sub -
tier subcontractors?
Yes ® No ❑
If "Yes" or "No", provide a copy of its standard subcontract form and a copy of the
procedures used to validate the responsibility of subcontractors.
Part E. Prevailing Wages
In the last five (5) years, has the bidder had prevailing wage complaints filed against it or
received violations as determined by the applicable state or federal government agency
monitoring prevailing and/or Davis -Bacon wage compliance?
Yes ❑ No
If "Yes," attach a separate signed/dated statement listing the prevailing wage violations,
along with an explanation of each violation and how it was resolved. The City shall
evaluate these explanations and the resolution of each violation to determine whether the
violations demonstrate a pattern of failure to pay prevailing wages to workers unless there
are extenuating circumstances acceptable to the City.
Part F. Claims Against Retainage and Bonds
Does the bidder have a record of any claims filed against the retainage or payment bonds
for public works projects during the previous three (3) years?
Yes ❑ No
If "Yes", attach a separate signed / dated statement for each project with claims which
includes the following: 1) Owner and contact information for the owner; 2) a list of claims
filed against the retainage and/or payment bond for the project; and 3) a written
explanation of the circumstances surrounding the claim and the ultimate resolution of the
claim. The City may contact previous owners to validate the information provided by the
Bidder. The City shall evaluate the information to determine if it demonstrates a lack of
effective management by the bidder of making timely and appropriate payments, unless
there are extenuating circumstances acceptable to the City in its sole discretion.
Rev 318/22
Cit)- of Port Orchard
Lift Station Controls Upgrade Project # PW2025-01 #
Page -26
Part G. Public Bidding Crime
Has the bidder been convicted of a crime involving bidding on a public works contract
within the last five (5) years?
Yes ❑ No X❑
Part H. Termination for Cause/Termination for Default
Has the bidder had any public works contract terminated for cause by any government
agency during the previous five (5) years?
Yes❑ No
If "Yes", attach a separate signed / dated statement listing each contract terminated, the
government agency terminating the contract and the circumstances involving the
termination for cause. The City will determine if there are extenuating circumstances
acceptable to the City in its sole discretion.
Part I. Lawsuits
Has the bidder been involved in lawsuits (or arbitrations for those instances where
arbitration is completed in lieu of a lawsuit) with judgments entered against the bidder for
failure to meet terms on contracts in the previous five (5) years?
Yes ❑ NoIII
If "Yes", attach a list of lawsuits and/or arbitrations with judgments / arbitration awards
entered against the bidder along with a written explanation of the circumstances
surrounding each lawsuit and/or arbitration.
Part J. Work Experience
List at least three construction projects on the attached Work Experience Form, each of
which meet all of the following criteria:
• Successfully completed at least three (3) electrical and controls improvements for
wastewater facilities in the past ten (10) years.
• Contract value exceeding $100,000.00.
Rev 3,18,22
Cih- of Port Orchard
Lift Station Controls Upgrade Project # PW2025-01 #
Page- 27
Part K. Signature
I hereby certify, warrant and declare under penalty of perjury that the information included
herein is correct and complete. Failure to disclose requested information or submitting false
or misleading information may result in rejection of my bid, termination of my contract, and
may impact my firm's ability to bid on future projects.
ISignature of Authorized Representative Date
Pr�Name of Authorized Representative
Ryan Stewart
Title
Member
$679,800.00 SCADA & Telemetry Improvements City of Fife
$756,668.00 SCADA & Telemetry Improvements City of Auburn
$474,694.00 Telemetry Upgrades Cedar River Water & Sewer District
$809,121.00 SCADA & Security Upgrades Cascade Water Alliance
Rev 3/18/22
City of Port Orchard
Lift Station Controls Upgrade Project 4PW2025-014
(253) 896-8214
(253) 204-0842
(425) 255-6370
(206) 930-0211
Page -28
SUBCONTRACTOR LIST
Per RCW 39.30.060, the bidder is required to submit as part of the bid the names of the
subcontractors with whom the bidder will subcontract for performance of the work of HVAC
(heating, ventilation, and air conditioning), plumbing as described in chapter 18.106 RCW, and
electrical as described in chapter 19.28 RCW, or to name itself for the work and is also required
to list the names of subcontractors with whom the bidder will subcontract for performance of
the work of structural steel installation and rebar installation. The bidder shall not list more than
one subcontractor for each category of work identified, unless subcontractors vary with bid
alternates, in which case the bidder must indicate which subcontractor will be used for which
alternate.
The work to be performed is to be listed below the subcontractor(s) name. The requirement to
name the bidder's proposed HVAC, plumbing, electrical, structural steel installation, and rebar
installation subcontractors applies only to proposed HVAC, plumbing, electrical, structural steel
installation, and rebar installation subcontractors who will contract directly with the bidder
submitting the bid to the public entity.
Failure to list subcontractors who are proposed to perform the work of HVAC (heating,
ventilation and air conditioning), plumbing, and electrical, or to name itself to perform such
work, or failing to name subcontractors who are proposed to perform structural steel
installation or rebar installation, or naming more than one subcontractor to perform the same
work will result in your bid being non -responsive and therefore void.
Subcontractor Name Source Electric LLC
Work to be Performed Electrical (Self perform)
Subcontractor Name
Work to be Performed
Subcontractor Name
Work to be Performed
Rev 3/'1&22
City of Port Orchard
Lift Station Controls Upgrade Prgject #PW2025-014
Page -29
Subcontractor Name
Work to be Performed
Subcontractor Name
Work to be Performed
Rev 3118/22
City of Port Orchard
LiifStation Controls Upgrade Project #PW2025-011
Page -30