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HomeMy WebLinkAbout2015-414-E AMS - Lomax Construction, Inc. for DSS expansion $246,600 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A [Departmental Use Only] TITLE D.S.S Expansion FY FY2015-16 NORTH CAROLINA CONSTRUCTION AGREEMENT UNDER$250,000.00 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter called"Agreement"), made as of the 7th day of August, 2015, by and between Lomax Construction, Inc., (hereinafter called the "Contractor"), and Orange County, a body politic and a political subdivision of the State of North Carolina, (hereinafter called the "Owner"). WITNESSETH: That the Contractor and the Owner, for the consideration herein named, agree as follows: 1. CONTRACT DOCUMENTS; PRIORITY The Contract Documents consist of this Agreement, the Request for Proposals, Proposal, Construction Drawings and Written Specifications. The Contract Documents form the Contract. In the event of any inconsistency between or among the Contract Documents the Contract Documents shall be interpreted in the following order of priority: a. This Agreement. b. Designer Approved Bulletins and/or Field Orders. c. Request for Proposals and addenda thereto. d. Proposal. 2. SCOPE OF WORK The Contractor shall furnish and deliver all of the materials, and perform all of the work required by this Agreement within the time period stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner and in accordance with the following enumerated documents, which are made a part hereof as if fully contained herein: a. Construction Drawings prepared by Corley Redfoot Architects (Sheet specification to follow: Architectural and Structural Sheets dated 6/12/15; Fire Protection, Mechanical, Electrical, and Plumbing sheets date 6/17/15; written specifications as prepared by Corley Redfoot Architects dated 06/12/15,and written specifications issued under Addendum 1, dated 6/15/15, Addendum 2, dated 6/17/15, Addendum 3 dated 6/23/15, and Addendum 4 dated 6/25/15. Specifications issued on the first two dates are identified in the revised Table of Contents issued under Addendum 2.) b. Written specifications prepared by the project engineer. c. Lomax Contruction, Inc. proposal dated 6/26, 2015, and the revised bid (based upon Revised 10/14 1 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A value engineering with the Designer and the Owner) dated 6/30, 2015. which fully describes the work to be performed, such work(hereinafter called the "Work"). d. Related documents listed under Section 1 above. 3. TERM AND SCHEDULING a. The Contractor agrees to commence work pursuant to the written Notice-to Proceed. b. The Contractor agrees to complete substantially all Work included by no later than 90 calendar days after the Notice to Proceed letter is issued and according to a mutually agreeable schedule between the Owner and Contractor. Assuming that the Notice to Proceed is issued on August 10, 2015, the date for Substantial Completion will be no later than November 7, 2015. c. Time is of the essence with respect to all dates specified in the Contract Documents as Completion Dates. d. The Contractor shall perform the Work in the time, manner and form required by the Contract Documents and as stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner. e. It is expressly understood that the Owner will employ other contractors to perform work as a part of the Project whose work will be performed simultaneously and sequentially with the performance of the Work by the Contractor. It shall be necessary for the Contractor to coordinate its activities with such other contractors, particularly with respect to access to work areas, storage of materials and other common facilities. f. Should the Owner determine that the Contractor is behind schedule Owner may require, at no additional cost to the Owner, the Contractor to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform the Work in accordance with the approved proj ect schedule. 4. STANDARD OF CARE a. The Contractor shall exercise reasonable care and diligence in performing the Work in accordance with the highest generally accepted standards of this type of Contractor practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Contractor is solely responsible for the professional quality, accuracy and timely completion and/or submission of all work. b. The Contractor shall not load or permit any part of the Work to be loaded with a weight that will endanger its safety, intended performance or configuration. c. Contractor shall be responsible for all errors or omissions caused by its employees, agents, contractors, or assigns in the performance of the Agreement. Contractor shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the Owner. Revised 10/14 2 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A d. Contractor is an independent contractor of Owner. Any and all employees of the Contractor engaged by the Contractor in the performance of any work or services required of the Contractor under this Agreement, shall be considered employees or agents of the Contractor only and not of the Owner, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Contractor. e. Contractor agrees that Contractor, its employees, agents and its subcontractors, if any, shall be required to comply with all federal, state and local antidiscrimination laws, regulations and policies that relate to the performance of Contractor's services under this Agreement. f. If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Contractor represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. 5. PAYMENT & TAXES a. The Owner hereby agrees to pay to the Contractor for the faithful performance of this Agreement, and the Contractor hereby agrees to perform all of the Work for a sum not-to- exceed Two hundred forty six thousand six hundred dollars Dollars ($246,600.00). Not later than the fifth (51h) day of each calendar month the Contractor shall submit to the Owner's Representative, generally the architect if an architect is retained on the Work, a Request for Payment for work done during the previous calendar month. i. The Request for Payment shall be in form of a standardized invoice or AIA Document G702-703 appropriately addressed to Owner's Representative at Orange County, Attention Jeff Thompson, PO Box 8181, Hillsborough NC 27278 and shall show substantially the value of work done during the previous calendar month. ii. The amount due for payment shall be ninety-five percent (95%) of the value of work completed since the last Request for Payment and this amount shall be paid by the Owner on or before the last business day of the month. Owner shall retain five percent (5%). 1. Upon Owner's Representative's certification that ninety percent (90%) of the Work has been satisfactorily completed retainage may be discontinued. Retainage may be discontinued, at Owner's Discretion, so long as work continues to be completed satisfactorily and on schedule. iii. Final payment shall not be due to the Contractor until thirty (30) days after one hundred percent (100%) of the Work, including punch list work, has been satisfactorily completed and an appropriate affidavit as required in Section 7(c) below has been received by Owner. b. Should Owner reasonably determine that Contractor has failed to perform the Work related to a Request for Payment, Owner, at its discretion may provide the Contractor ten (10) days to cure the breach. Owner may withhold the accompanying payment without penalty until such time as Contractor cures the breach. i. Should Contractor or its representatives fail to cure the breach within ten (10) days, or fail to reasonably agree to such modified schedule, Owner may immediately Revised 10/14 3 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A terminate this Agreement in writing, without penalty or incurring further obligation to Contractor. ii. This section shall not be interpreted to limit the definition of breach to the failure to perform the Work related to a Request for Payment. c. The Contractor has included in the Contract Price and shall pay all taxes assessed by any authority on the Work or the labor and materials used therein. It shall be the Contractor's responsibility to furnish the Owner documentary evidence showing the materials used and sales and use tax paid by the Contractor and each of its subcontractors. 6. INSURANCE AND BONDS a. Minimum requirements — Contractor shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by Owner's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http %/oi,a�� scourItvnc..�ov/ �ircl�asin ri s�zt ac s.��s ). if Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here N/A (if no additional insurance required mark N/A as being not applicable). Contractor shall not commence construction work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. b. Performance Bonds — Contractor shall furnish bonds covering the faithful performance of the Contract and payment of all obligations arising under any of the Contract Documents or related in any way to the Work. Contractor shall immediately furnish a copy of such bonds to any requesting person who appears to be a potential beneficiary of bonds covering payment obligations arising under any of the Contract Documents. This subsection 6(b) applies only to Contracts of fifty thousand dollars ($50,000.00) or more where the total cost for the project is three hundred thousand dollars ($300,000.00) or more. 7. INDEMNITY a. The Contractor shall indemnify and hold harmless to the extent permitted by law the Owner and its agents and employees from and against any and all claims, damages, losses and expenses, including attorney's fees, arising out of or resulting from the performance or nonperformance of the Work, provided that any such claim, damages, loss or expense (A) is attributable to bodily injury, sickness, disease or death or injury to, or destruction of, property, including the loss of use resulting therefrom; and (B) is caused in whole or in part by any breach of any provision of the Agreement or by any negligent or wrongful act or omission of the Contractor, any Subcontractor, or supplier of the Contractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The indemnification obligation under this paragraph shall not be limited in any way by any limitation of the amount or type of damages, compensation or benefits payable by or for the Contractor or any subcontractor under workers' compensation acts, disability benefits acts or other employee benefit acts. b. The Contractor shall indemnify and hold harmless Owner from any lien of whatever type through the purchase of appropriate bonds and insurance as designated in Section 6 above. Revised 10/14 4 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A In the event any such lien is filed against Owner's property Contractor shall, through such bonds and insurance or at Contractors expense, defend Owner against all such claims of lien. c. Upon completion of the Work the Contractor shall execute an affidavit stating there are no unpaid debts for any work that has been done or materials that have been furnished to the Project prior to and as of the date of substantial completion and further stating that Contractor shall indemnify, save and protect Owner and Owner's lender, if any, harmless from and against any and all claims, liabilities, losses, damages, causes of action, and expenses (including court costs and reasonable attorney's fees related thereto) arising out of, in connection with, or resulting from any such debts and liens. Such indemnification shall be in a form and substance acceptable to Owner. d. By executing this Agreement Contractor agrees to abide by and be bound by the indemnification provisions herein and of Section 7(c) specifically. 8. DISPUTE RESOLUTION AND GOVERNING LAW a. Owner and Contractor agree that should a dispute arise as to the terms of the Contract Documents the architect shall serve as the initial decision-maker, unless there is no architect retrained on the project related to the Work. Owner and Contractor further agree as follows: i. If there is no architect retained for the Work, Owner and Contractor agree, prior to the initiation of any civil litigation, to submit to mediation by agreeing on an individual to serve as mediator to mediate the dispute. ii. Should the Owner and Contractor fail to mutually agree on an individual to serve as mediator Owner may select a mediator to mediate the dispute. iii. Any mediator selected under this section shall be an attorney licensed to practice law in the State of North Carolina and shall be generally recognized as having experience in mediating construction disputes. iv. Owner and Contractor agree to equally share in the cost of a mediator selected under this section. b. The laws of the State of North Carolina shall apply to the interpretation and enforcement of this Agreement. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or nonperformance of, this Agreement or the Contract shall be brought in the General Court of Justice of North Carolina sitting in Orange County,North Carolina and it is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all anti-discrimination laws. c. Notice of any claim by Owner or Contractor must be initiated by written notice to the other Party within thirty (30) days of the occurrence of the event giving rise to the claim or within thirty (30) days of the discovery of the event or condition giving rise to the claim, whichever is later. i. Should any claim be made, regardless of whether such claim is made by Owner or Contractor, Contractor shall continue to faithfully and diligently perform the Work in such a manner as to meet all scheduled timelines. Any failure to faithfully and Revised 10/14 5 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A diligently perform the Work may be deemed, by the Owner, a breach of the Contract. ii. If a claim is made such claim shall be made to the initial decision maker, if applicable, who may request more supporting data, reject the claim in whole or in part, approve the claim in whole or in part or advise the parties the claim is unable to be resolved. iii. If a claim is made by the Owner the Owner may, but is not obligated to, notify the surety. 9. NON—APPROPRIATION a. Contractor acknowledges that Owner is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. b. In the event that public funds are unavailable and not appropriated for the performance of Owner's obligations under this Agreement, then this Agreement shall automatically expire without penalty to Owner immediately upon written notice to Contractor of the unavailability and non-appropriation of public funds. It is expressly agreed that Owner shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. c. In the event of a change in the Owner's statutory authority, mandate and/or mandated functions, by state and/or federal legislative or regulatory action, which adversely affects Owner's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to Owner upon written notice to Contractor of such limitation or change in Owner's legal authority. 10. NOTICES Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Owner: Contractor: Orange County Lomax Construction, Inc. Attn: Jeff Thompson Attn: Charlie Johnson P.O. Box 8181 PO Box 35169 Hillsborough,NC 27278 Greensboro,NC 27425 11. MISCELLANEOUS a. Duties and Obligations imposed by the Contract Documents shall be in addition to any Duties and Obligations imposed by state, federal or local law, rules, regulations and ordinances. b. No act or failure to act by the Owner or Contractor shall constitute a waiver of any right or duty granted them under the Contract Documents, nor shall any act or failure to act constitute any approval except as specifically agreed in writing. c. The Work shall be tested and inspected as required by the Contract Documents and as required by law. Unless prohibited by law the costs of all such tests and inspections Revised 10/14 6 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A related to state and federal codes such as ADA, Administrative, Electrical, Plumbing, Mechanical and Building Codes shall be borne by the Contractor. The costs for material and structural testing shall be conducted by an independent third party at the expense of the Owner. Delays related to any of the aforementioned tests and inspections shall not be grounds for delaying the completion of the work. If any such tests and inspections reveal deficiencies in the Work such that the Work does not comply with terms or requirements of the Contract Documents and/or the requirements of any code or law the Contractor is solely responsible for the cost of bringing such deficiencies into compliance with the terms of the Contract Documents and/or any code or law. d. Should the Architect, if an architect is retained for the project involving the Work, or Owner reject any portion of the Work for failing to comply with the Contract Documents Contractor shall immediately, at Contractor's expense, correct the Work. Any such rejection may be made before or after substantial completion. If applicable, any additional expense borne by the Architect under this section shall be paid at Contractor's expense. e. The Contractor shall not assign any portion of this Agreement nor subcontract the Work in its entirety without the prior written consent of the Owner. f. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 12. CONSEQUENTIAL AND LIQUIDATED DAMAGES a. Owner and Contractor mutually waive any claim against each other for consequential damages. Consequential Damages include: i. Damages incurred by Owner for loss of use, income, financing, or business. ii. Damages incurred by Contractor for office expenses, including personnel, loss of financing, profit, income, business, damage to reputation, or any other non-direct damages. b. Liquidated damages shall be in accord with the Contract Documents. 13. TERMINATION OR SUSPENSION a. The Owner may, without cause, order the Contractor to terminate, suspend, delay or interrupt the Work in whole or in part for such period of time as the Owner may determine. In the event of termination by the Owner under this Agreement, the Contractor shall be entitled to receive its reasonable and documented direct costs prior to termination, including the cost of materials purchased for the Work which purchases cannot be canceled or which material cannot reasonably be used by the Contractor on other work, and the cost of closing down the work in a safe and efficient manner. i. If Owner orders a delay, suspension or interruption of the Work, and such order is not due to or as a result of any fault on the part of the Contractor, the Contractor may recover a per diem amount at a rate calculated by N/A). ii. If Contractor elects to accept the amount listed in the General Conditions provision Revised 10/14 7 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A of the Construction Documents Contractor waives any right to further claims for payment of damages sustained as a result of Owner's order to delay, suspend or interrupt the Work. b. Contractor may terminate the Contract if, at the Owner's written direction, the Work is stopped for thirty (30) consecutive days through no act or fault of the Contractor, their agents or employees, or a subcontractor or their agents or employees or any other person performing work pursuant to the Contract Documents. Contractor may terminate the Contract if a Court or other Public authority having jurisdiction enters a lawful order that requires all work to be stopped and such stoppage lasts for thirty (30) consecutive days. 14. ENTIRE AGREEMENT All of the documents listed, referenced or described in this Agreement, the written Notice-to- Proceed, together with Modifications made or issued in accordance herewith are the Contract Documents, and the work, labor, materials and completed construction required by the Contract Documents and all parts thereof is the Work. The Contract Documents constitute the entire agreement between Owner and Contractor. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. If any provision of the Agreement shall be declared invalid or unenforceable,the remainder of the Agreement shall continue in full force and effect. [SIGNATURE PAGE TO FOLLOW] i t Revised 10/14 8 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the day and date first above written wholly or in a number of counterparts each of which shall, without proof or accounting for other counterparts, be deemed an original contract. ORANGE COUNTY CONTRACTOR DocuSigned by: DocuSigned by: 0637994®735E477... D,2CE24CM338'34F4— Signatu Signature County Manager John Lomax President Printed Name and Title I Revised 10/14 9 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I i FORM OF PROPOSAL Project: Orange County Deapartment of Social Services Expansion Contract: Single Prime General Construction Institution: Orange Countv lNorth Carolina Bidder: Lomax Construction, Inc. Date: June 26,2015 The undersigned, as bidder, hereby declares that the only person or persons interested in this proposal as principal or principals is or are named herein and that no other person than herein mentioned has any interest in this proposal or in the j contract to be entered into;that this proposal is made without connection with any other person,company or parties making a bid or proposal;and that it is in all respects fair and in good faith without collusion or fraud. The bidder further declares that he has examined the site of the work and the contract documents relative thereto,and has read all special provisions furnished i prior to the opening of bids;that he has satisfied himself relative to the work to be performed. The Bidder proposes and agrees if this proposal is accepted to contract with Orange County,North Carolina,in the form of contract specified below,to furnish ail necessary materials,equipment,machinery,tools,apparatus,means of transportation and labor necessary to complete the construction of I'Floor Renovation of the Richard B.Whiffed Building A,300 West Tryon Street, Hillsborough, North Carolina, in full in complete accordance with the plans, specifications and contract documents, to the full and entire satisfaction of Orange County, and Corley Redfoot Architects, Inc., with a definite understanding that no money will be allowed for extra work except as set forth in the General Conditions and the contract documents,for the sum of: SINGLE PRIME CONTRACT: Base Bid: Three Hundred Seventy Three Thousand Nine Hundred 373 900 Dollars($) Fire Protection Subcontractor: Sunland Fire Protection Lic 22924 Plumbing Subcontractor: D &L Plumbing Lic 31616 I Mechanical Subcontractor: j Comfort Engineers Lie 9342 Electrical Subcontractor: Systems Electric Lie 23955-U GS 143.123(d)requires all single prime bidders to identify their subcontractors for the above subdivisions of work. A contractor whose bid is accepted shall not substitute any person as subcontractor in the place of the subcontractor listed in the original bid,except(i)if the listed subcontractor's bid is later determined by the contractor to be non-responsible or non-responsive or the listed subcontractor refuses to enter into a contract for the complete performance of the bid work,or(ii)with the approval of the awarding authority for good cause shown by the contractor. Form of Proposal 1 of 3 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I I I I ALTERNATES- I Should any of the alternates as described in the contract documents be accepted,the amount written below shall be the amount to be "added to" or "deducted from" the base bid. (Strike out "Add" or "Deduct" as appropriate.) Alternate-1: Entrance Canopy. iSixty Thousand Nine Hundred Dollars($) 60,900 Alternate-2: Classroom 701.1. Ten Thousand Dollars($) 10,000 Alternate-3: New Rooftop Units RTU-15 and RTU-16. i Thirty Eight Thousand Nine Hundred Dollars($) 38,900 i UNIT PRICE S• f Unit Price,No. 1: Cutting and patching of concrete floor slabs $ 43.00 /C*X s/f ** Unit Price No.2: Cutting and patching of acoustical panel ceilings $ 6.50 /tAX s/f** i i **Unit prices based on Unit of Measurements as described in Unit Price Section 012200 3.1.A.2 and 3.1.13.2. ' I � Form of Proposal 2 of 3 I i i 1 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A Proposal,Signature Page The undersigned further agrees that in the case of failure on his part to execute the said contract and the bonds within ten(10) consecutive calendar days after being given written notice of the award of contract,the certified check, cash or bid bond accompanying this bid shall be paid into the funds of the owner's account set aside for the project as liquidated damages for such failure;otherwise the certified check,cash or bid bond accompanying this proposal shall be returned to the undersigned. Respectfully submitted this day of June 26,2015 Lomax Construction,Inc. (Name of firm or corporation making bid) WITNESS: By: iignattlte Name: Richard Lewis (ProprietorsWp or Partnetship) Print or type Title Vice President ' (ownedPartner/Pres,/V.Pres) Address P. O. Box 35169 ATTEST: Greensboro, NC 27425-5169 }3y; License No.. 37571 ravis Larfqrey Title: Corporate Secretary Federal I.D.No. (Corp.Sec.or Asst.Sec.only) l��tllllJlt)�� 'Iii Email Address: tlangley @lomaxconstruetion.com I Z:CU SEAL (CORPORATE SEAL): 1996 �, •O Addendum received and used in computing bid: Addendum No. 1 Addendum No.3 Addendum No.5 Addendum No.2 Addendum No.4 Addendum No.6 Form of Proposal 3 of 3 000uSign Envelope ID:4neoFon4oFoE-4Emcoonn'nFsArnnoFAnA L ot A X V1 �` �� 7� �� K� �� �� 1` K� �] ~�'0' 1 ., ^ ` 6/30/2O15 Travis Langley Lomax Construction,Inc. 8517'A Norcross Rd. Colfax,NC 27235 KeoRedfoot Corley Dedtoot Architects Inc. 222 Cloister Court Chapel Hill,NC 27514 Re: Orange County Department of Social Services Expansion Upfit Revised Bid (Revised) Dear Ken; Thank you for considering Lomax Construction for the above named project. Per our conversation following the bid results and per your request vve have revised our base bid dated 6/26/15bu the amount o<$37\90Utu the following revised amount: Two hundred forty six thousand six hundred dollars---------------------------------$246,6O0.UO The bid has been reduced tu the above amount by eliminating ozchanging scope ofwork. Items being installed by owner/others must be done in a timely manner and per the mutually agreed upon schedule aoho not hold tip the project. Lomax reserves the right torequest extended general conditions should the schedule be delayed due to work outside of this contract not being completed per the agreed upon schedule. Items tobe deleted ua follows per your request: 1. Delete the$22,000 allowance added in addendum#4 for 2"water meter and use fees. The fees will now be paid by odmm outside of this contract. 2. Delete all 064116 Casework and 123661.16 Solid Surface Countertops from the scope of work tobe done ata future time. 3. Delete all O664OU Plastic(FDP)Paneling from the scope ot work tobebyowner. 4. Delete all BIBS work from the scope of work. 5. Delete U81213I{M Frames,O81416 Flush Wood Doors,U83113 Access Doors&Frames and O87100 Door Hardware work from the scope ofwork. This includes providing and � installing all frames,doors,hardware and access doors from the scope of work,to be � installed byowner. Lomax to include bzxoiabioo and installing glass bu doors&cframes DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A 6. Delete all 092216 Metal Framing,092900 Gypsum Board and 095113 Acoustical Panel Ceilings from the scope of work to be done by owner. Note this also deletes the 500 SF quantity allowance for ACT listed in the Allowances section. 7. Delete the diamond grinding and sealing of concrete for rooms listed in the finish schedule. Owner to chemically remove remaining flooring and flooring mastic and seal concrete. 8. Delete all 099123 Interior Painting and 099600 High-Performance Coatings from the scope of the work to be done by owner. 9. Delete all plumbing"trim out"of the"Coffee Shop'area to be done at a later date. Includes rough-in only at this area for plumbing. 10. Delete all electrical"trim out"of the"Coffee Shop"area to be done at a later date. Specifically this deletes(1)type A fixture, (1)dimmer switch,(1)type D fixture,all receptacles and GRC conduits in this area. Includes installing circuits required for future "Coffee Shop"to junction boxes left above ceilings. In addition to the items discussed above the following items were also deleted to get under the budget: 11. Delete the requirement for a construction sign. 12. Change all plumbing drain and vent piping from cast iron to PVC except above plenum rated ceilings where cast iron will remain. 13. Change plumbing water piping from copper to CPVC except above plenum rated ceilings where copper will remain. 14. Delete 101100 Visual Display Boards(Chalkboard and Picture Hanging Rails)at"Coffee Shop" area. 15. Deleted 105201 Fire-Protection Specialties from the contract to be supplied and installed by owner. Note:no fire extinguishers were found on the plans but there was a specification section so I included a total of(2)fire extinguishers in the bid. Sincerely, Travis Langley VP Pre-Construction Lomax Construction,Inc. I I i DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach fo Bid Attach to Bid Identification of HUB Certified/ Minority Business Participation 1 Lomax Construction, Inc. (Name of Bidder) do hereby certify that on this project,we will use the following HUB Certified/minority business as ! construction subcontractors,vendors,suppliers or providers of professional services, Firm Name, Address and Phone# Work Type *Minority **HUB Category Certified IN j i I i i I i I "Minority categories:Black,African American(B),Hispanic(H),Asian American(A)American Indian(1), Female(F)Socially and Economically Disadvantaged(D) i HUB Certification with the state HUB Office required to be counted toward state participation goals. The total value of minority business contracting will be ($) 0.00 NIBForms 2002-Revised July 2010 DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I 1 Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid State of North Carolina AFFIDAVIT A-Listing of Good Faith Efforts County of Guilford (Name of Bidder) Affidavit of Lomax Construction,Inc. I have made a good faith effort to comply under the following areas checked: Bidders must earn at least 50 points from the good faith efforts listed for their bid to be CO sidered responsive. (1 NC Administrative Code 30 1.0101) 1—(10 pts)Contacted minority businesses that reasonably could have been expected to submit a quote and that were known to the contractor,or available on State or local government maintained lists,at least 10 days before the bid date and notified them of the nature and scope of the work to be performed. 42--(10 pts)Made the construction plans,specifications and requirements available for review by prospective minority businesses,or providing these documents to them at least 10 days before the bids are due. 3—(15 pts)Broken down or combined elements of work Into economically feasible units to facilitate minority atticipation. ? 4—(10 pts)Worked with minority trade,community,or contractor organizations identified by the Office of Historically Underutilized Businesses and included in the bid documents that provide assistance in recruitment of minority businesses. 5—(10 pts)Attended prebld meetings scheduled by the public owner. ® 6—(20 pts)Provided assistance in getting required bonding or insurance or provided alternatives to bonding r Insurance for subcontractors. 7—(15 pts)Negotiated in good faith with interested minority businesses and did not reject them as } unqualified without sound reasons based on their capabilities. Any rejection of a minority business based on lack of qualification should have the reasons documented in writing. 8—(25 pts)Provided assistance to an otherwise qualified minority business In need of equipment,loan capital,lines of credit,orjoint pay agreements to secure loans,supplies,or letters of credit,including waiving credit that is ordinarily required. Assisted minority businesses in obtaining the same unit pricing with the bidder's suppliers in order to help minority businesses in establishing credit. ® 9—(20 pts)Negotiated joint venture and partnership arrangements with minority businesses in order to increase opportunities for minority business participation on a public construction or repair project when possible. ® 10-(20 pts)Provided quick pay agreements and policies to enable minority contractors and suppliers to meet cash-flow demands. The undersigned,if apparent low bidder,will enter into a formal agreement with the firms listed in the Identification of Minority Business Participation schedule conditional upon scope of contract to be executed with the Owner. Substitution of contractors must be in accordance with GS143-128.2(d) Failure to abide by this statutory provision will constitute a breach of the contract. The undersigned hereby certifies that he or she has read the terms of the minority business commitment and is authorized to bind the bidder to the commitment herein set forth. Date: 6/26/15 Name of Authorized Officer: Travi gley ���00tmt t t A I►t j{3oa�,, Signature: Wt�l�Fl� .�� Title: V.P,and Corporate SecKdt6fy O P State of N.C. ounty of Guilford P �bCJ ti=Subscribed nd6 t e o e me t1u th y of dune 20 15 Notary Pubh My commission expires 44 ROW MBForrns 2002-Revised July 2010 I DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I STATE OF NORTH CAROLINA AFFIDAVIT ORANGECOUNTY i j I Travis Langley (the individual attesting below), being duly authorized by and on behalf of I Lomax Construction, Inc. (the entity bidding on project hereinafter"Employer")after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verif is the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies,or any successor or equivalent program used to verify j the work authorization of newly hired employees pursuant to federal law in accordance with NCGS§64-25(5). 2. Employer understands that Employers Must Use E-Verify. Each employer,after hiring an employee to work i In the United States,shall verifythe work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 3. Employer is a person,business entity,or other organization that transacts business in this State and that employs 25 or more employees in this State. (mark Yes or No) a. YES , or b. NO i 4. Employer's subcontractors comply with E-Verify,and if Employer is the winning bidder on this project Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer. This 26 day of June M.2015 -�2_ nature of Affiant Print or Type Name: Travis Langley,VP&Corporate Secretary State of North Carolina Orange County 4 Signed and sworn to(or affirmed) before me,this the 26 th Xo day of June .,=X 2015 o z My Commission Expir W April 14,2016 COUP°a° otary Public I DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A I Contractor's Safety Record Information The Contractor's safety record shall be reviewed and evaluated in addition to other quality and performance criteria as part of bid evaluation process. Failure to provide the requested i information and documentation may result in rejection of your bid as non-responsive. Accordingly, all bidders must submit the following information regarding their safety record. The following definitions shall apply to this section; "DART incident rate"—Acronym for"Days Away,Restrictions and Transfers". The DART incident rate may be used to show the relative level of injuries and illnesses within a firm compared to the industry.It is based only on those injuries and illnesses severe i enough to warrant"Days Away,Restrictions and Transfers". The DART incident rate is calculated using OSHA's Form 300 and the following formula: ((Number of entries in column H(days away from work)+column I(job transfer or restriction)x 200,000)/(Number of hours worked by all employees)=DART Incident rate. "EMR"—Acronym for`Experience Modification Rate,"is an indicator of a contractor's past safety performance,widely used by the insurance industry as an equitable means of determining premiums for workers'compensation insurance.The rating system considers the average workers'compensation losses for a given firm's type of work and amount of payroll and predicts the dollar amount of expected losses to be paid by that employer in a designated rating period,usually three years.The rating is based on comparison of firms doing similar types of work, and the employer is rated against the average expected performance in each work classification.Losses incurred by the employer for the rating period are then compared to the expected losses to develop an experience rating. "OSHA"—Acronym for the Federal Occupational Health and Safety Administration. The term"OSHA"as used in this Policy also refers to any state or local agency having jurisdictional authorization to enforce worker safety requirements and assess fines or wainings for violation of worker safety standards. 1. OSHA.DART Incident Rate. Provide the bidder's DART Incident Rate calculated from OSHA's Form 300 for the last three years and the other required information shown in the example table below. The bidder must attach all supporting documentation and calculations including certified OSHA forms. DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A Sbp��Xx�p� 15c1s`{a,�?'ih3u�. � f...-�'-°•y .�:� vv 2014 0 0 1542 f 2013 0 0 1542 2012 0 0 1542 I i 2. Experience Modification Rate(EMR). Provide the bidder's most recent Experience Modification Rate(EMR)based on insurance claims history. The bidder mustprovide the source of the EAM information and contact information of insurer entity providing the EMR. r , f �i' '� Craft Insurance Group 2014 .90 1542 Mark McLamb I 336-375-0600 ! i i I 3. Answer the following OSHA Specific Questions: (a) Within the last 2 years,has the bidder received any citations classified by OSHA as being(1)serious, (2)willful and/or(3)repeat violations where your company operates? i Yes No If yes, attach a copy of each such citation and violation. (b) Has the bidder experienced any work-related fatalities within the last five years? Yes No DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A (c) Has the bidder had any citations issued by OSHA as a result of work related fatalities within the past 5 years? Yes No I (d) Is the bidder under investigation for any work-related fatalities? Yes No (e) If your answer is"yes"to 3(b), (c)or(d),provide a copy of the citation(s), list of number(s) of fatalities and documented explanation of the fatality. 4. Safety Plan: i (a) Does the company have a written safety program that includes responsibility for all aspects of safety management? Yes Nf No (b) Does the company have a written plan for safety training of new employees and ongoing training of existing employees? Yes V No (c) Does the company have documented e vridence of safety fi aining that they have conducted? Yes No (d) If the company has employees with limited English ability,does the company have a written plan for ensuring that their employees understand the training they are being given? i Yes No (e)Do all supervisors have an appropriate documented level of OSHA training i (e.g.,a minimum of 30 hour OSHA construction safety training)? Yes No i i i DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A (f)Do employees have documented basic OSHA 10 hour construction safety training? Yes V No 1 (g)Does the company have a documented Hazard Communication Program? Yes No 5. Required Written Explanation of Safety Record. If the bidder has any of the following: (a)DART incident rate great er than its industry average,(b)an EMR greater than 1.0, (c) answered".yes"to any of the OSHA Specific Question above,or(d)answered"no"to any of the Safety Plan questions,the bidder shall provide the County,in its bid, a detailed written explanation of its safety record and the reasons why such safety history is NOT representative of its future performance and what specific actions it has taken to improve its overall safety record. Failure to provide a written explanation of its safety record pursuant to this paragraph may be deemed as non-responsive by the County. ICI 0 0 c to tom' M m 0 m OSHA's Form 300A (Reu 0112004) Year 20_14_ co Summary of ork- elate Injuries and Illnesses U.S.Department of Labor accapalronal Saroty and Hoafth Administration 0 race oppmved OMB—12111006 All establishments covered byPart 1904 must complete this Summarypage,even ifno work-related injuries orfllnesses occurred during the year Remember w review the Log n to verify that the enVJes are complete and accurate before completing Ws summary C)T Using the Log,counr the Individual entries you made for each category.Than write the totals below making sure you've added the entries from every page of the Log.Ifyou Establishment information A had no cases,write"0_' Ill Yarn natabttshmaat anmo Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have p Lomax Construction, Inc. o miled access to the OSHA 301 or o C f�' ,J �I its equlvalenL See 29 CFR Pad 1904.3$in OSHA's recordkeepinng rule,for further details on the access provisions forthese forms. 851 7-A Norcross Road W su0ct 00 cry Colfax S--Nczlp 27235 Number of Cases Total number of Total number of Total number of Total number of Ind descr tion D unity p (eq.,Mrtnu/nr[nrc ofwa(ar trsrrk lrailea) v deaths cases with days cases withjob other recordable Ge P.rcal(nntr2ctnr I Cnnstruc:tion 00 away from work transfer or restriction cases Standard lodusrrial Classification(SIC),if known(eg.,3715) 0 0 0 0 0 15- 9 D w {G) (H) (Q (J) OR D Number of NorcbtLnerictn Industrial Classification(NAILS),Kknown(eg..336212) Days Total number ofdays away Total number ofdays ofjob Employment information(I you dau'thavctht fgn¢y:ede from work transfer or restriction N/arkdted on thr bad:ofrhir page m atu,rala) 0 0 Maud w=gcnumberofemployees 20 (K) (L) Toellhoursworkcdhyalletnployees lost yctr 41,600 Injury and Illnes�s Types M Sign here Total number of... Knowingly falsifying this document may result in a free. (M) (1)Injuries 0 (4)Poisonings 0 (5)Heating loss ---0— I certify that I have wamined this document apd that to the best of my (2)Skin disorders 0 knowledge the entries are true,accurate,and complete. (6)All other illnesses (3)Respiratoryconditions Q J Aravis Langley , Corp. Secretary_ r335 992 _ 7000 12/31/14 Post this summary page fram February 1 to April 30 of the year following the year covered by the form. Puhac rnpmdaghurden for ddr oouecdan of rmatwnEac i--d w average 58 minutes prrza.pomc Including lime m review 1he;n.nr_w morchaad gather the dotaneedcd.and comprew and review lhceoBecuon orivfaraudan.Person arenas requiccd w rcopond w lhecolre as oriotouo u..aolrm itdtsplayaae dyvalid OMB eoatrd nambcultyou have any nuoeatsshoaltheca od="-aranyotbcc arpecn arlhis dots mllecdnn,co .L ilS nopotmuntorl.oboti OSHA.0al—rStodadm1 Aaalpk,R.—N-3644,2200 C—dt tloaAvenne,MAr Wuhi tg oa.DC 211210.Do notsmd the completed Tams b the oM= 0 i M 0 CD Attention:This form contains information relating to OSHA's Fofm 300 (Rev.0112004) employee health and must be used in a manner that'' p cc rotects the confidentiality of employees to the extent Year 20 14. ®� possible while the Information is being used for ° ®g of Work-Related InJuries and Illnesses occupational safety and health purposes, tf s. ry..rtment of Labor o i record (jeeup.tiom75afaty and aaal[h Admlolstratlon W You must ln/ormation about every work-related death and about every work-relaledinjury crillness that involves loss of consciousness restricted work acffvtrbrJob transfer, r',i mr uppro,'ed 0hiB no.121 M 17 days a way from work,ormedical Use tmentbeyondArst aid.You musta Isom cord signiNcantwork-releted injuries and B lnessos that atadia nosedb a ••-• - ° g y physician 4 Ilbensed healri ~' careprofessional You must also record work-refutedst Injuries and/Ansley that meet any idthespecific recording criteria listed in le 29 CFR Part 1904.8 through l9oa.12 Fes/free to Fsrahusgmonrneme Lomax Construction, Inc. 0 use two ouY loot single case if yea need to.You must complete an Injury and lUness Inc dent Report(OSHA Form 301)orequ ve/ent for toreach injury orillness recorded on this -- rn form.lfyou're not sure whethera case is recordable,cailyourlocalOSHAofrcelorhelp. c+rr`Colfax crate N� A Identify person - m (A) (al (C) Describe(D) (� F sn2or tha nurser of tF.:. "t,;' ."...... W () daya the Infused or =:2Chock thq?'(iljliry?c4lymq Cnm Employee's mme jnh ttte Date of injury Where die event occurred Describe injury or illness,parts of body iiff.a da III warkar was: -i,ehoaaa no d o%Ilinq fi.i; W na --- -- ._4 . (ag.,Weldcr) or onset (e.g.,Loodmg desk Wort!end) and ohject/substance that directly injured hr. N . -... ,, oEilhuss L'Cac, v.- E ,2:Y�- ,ae:f� r�a-.r v; tr�.2i• _ .,,.E: n'i Cn or made person ill(r g.,Second degree lnviu an g. ^r"•-a -Aemthted a1(Wark, ,. (M) t` " ' :'., -n rigkf farrm7a frmn arcIanc Lorrh '-`� 't pw�h ) ;;y�.p'r�aawas:eye.s a; niT:o,-u'•(�:,.°w='�^,� Afrwom y ereorn m i r=.h r.r 9.r'•e ese:"N-°.�'"`'?:, wry-. py ` D paath'�ljeo4airerlL::'ir. i, work�+ toatrletinn 6 'ry`3G�N°mot i^. �,P.,•!S n<. `^3`- (�: ,"`I 5p' ;`N��.Lr_,yt (J):..�n"y (ICI.... W montlJdoy ._. ._-���k�.an''isc'e.®.r'�•,1V days days ❑ Y>' y [�k'6.� r�.: TI —L x3Yr H"s.}""a;. 1 W modwday K� S5 T� �Yu —days —days ❑:,❑ ❑ LQ 7�� D monWday ., w ,,�''-s^''1•..'s `k` - � —drys dayr C): ❑t ❑.r LO t..❑, �ra+o a. monWd/ay t . rr7i —day. —days .p- ❑: [� ,( ��.4 manwdaye® ''wA da do '' ;�� —days —days '•QS put moNlVda F' ac.t. ��-Y-'�-gg yr -^�rm-•�g IN monwdoy Li> i� N'.+P,, �,k® �f: —daya _days ..)�;i.Q. GI i�D _q a / r:® y.tL+_-p.�rya r•�:k' •t°a`I"� � v'" d da monlNday b .T -'dY.,.!1:.:� '.�14...B, r:�.`. __ Ys __ Ys Q--:❑�'❑--s:,r'15:;ffiz.:.❑:r -_ni - T'f3. manor day ® .:�i r d`®cy day. —days / »:. ;ate-',;eFr.�' ,1' ""..'`l:� aiC. '• '' �'' I ®' a[� � �. s> —days _d,y, R1 UV/y 'r 5u'YM., zC7tr<tF9 .. p.t Q ya -per moNlJdsy z� �-�-, � .rtu —days &y. — / ta.�: a ,-•ra�� 1x"�j' � ar��� tr' ,. r�I^�t•�r r monlNday L`u*4.6'5,. +i'i -tS. •`�ey°.•;,ti2.0 —dam —drys '❑: •❑.- l :_ �;?�Y•ib ^"P: Page totafs>� o 0 Q O O O O O Q O O rnblu•rcpon:ng huMetaf rthiaw0rvion W'Infutnmtiun wratim;nW muw:cagr lb tnuturupnrrespmau,Md.diag lime,.rm.,, Hasurolo lranslerlhese lords to the Summerypage(Form 3ooN beforeyoupostit 2 ea a o U.c iwtruttiom,anrch mtd gaWcrUm&—dcd,are mmpien uod revicwdtc Collect{and'inronnaUon.Praa,n>arc nocrrquircd ' e m lorespandetbe m0caian nrinf rmmiouuden it d'u piaysacurrendy-Rd 0MB COaual—b.jr)—haeeany ..mcnn s5 ,� a ahaut those esUwuv,s ar any odtcr mpecu oCiLia d:ua mllminn,coataa:115 Dcparumarar1-,hor,0S11A 01fi,—'Smdaied N x dnalpie,[1oav N-9GM,200 C�.v1im8on dvmuc,NW,tP hingron,DC20210.Doao—d theeompl—d foruu ro d.0 olIIce pnae oI 2 (1) (2) (3) (4) {5} (6) 0 0 n c fn tom' m m 0 i m OSHAf s Form 300A (Rev_0912004) Note:You can type input into this form and save it. Because the forms in this recordkeeping package are"fillableiwritable" Year 20 13 6 ��t� p� A p Injuries .g / PDF documents,you can type into the input foml fields and - Summary of Work-Related Injuries aa`�ei' ®11nesseS then saveyourinputsusin the free Adobe PDF Reader. U-S.Departmenivftabor � n g 000uparfonal Safety aQSd Honlut Adminlstnrtian Focm uppro.vd OMB no.1218-0176 All establishments covered by Part 7904 must complete this Summary page,even ifno work relafed injuries orillnesses occurred during the year Rememberto review the Log to verify that the entries are complete and accurate before completing this summary. n Using the Log,count the individual entries you made for each category Then write the totals below,malting sure you've added the entries from Establishment information m every pageofthelog.lfyouhadnocases,write'0." vour�rar:rme,�caa..,. Lomax Construction,Inc. m Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have limited access o v to the OSHA Form 307 or its equivalent See 29 CFR Part 1904.35,in OSHA's recordkeepfng rule,forfurther details on the access provisions for 8517-A Norcross Road W these forms Street W City Colfax State NC Zip 27235 of cij*se,s n Industry description(e.g.,Manufacture ofrnotor truck trailers) Total number of Total number of Total number ofcases Total number of General Contractors/Construction D 0 deaths cases with days with job transferor other recordable 00 away from work restriction cases Standard Industrial Classification(SIC),if known(e.g.,3717) 0 Q Q Q Q 1542 w OR D North American Industrial Classification(NAICS),if known(e-g.,336212) Total number of days Total number of days of job Employment information(ffyou don't have these figures,see the away from work transfer or restriction Worksheet on the next page to estimate) 0 U Annual average number ofempioyees 17 (K) (L) Total hours worked by all employees Iast year 36413 njury and 171hess Types Sign here Total number of_.. Knowingly falsifying this document may result in a fine {M) (9)Injuries d (4) Poisonings D I certify th ve exa ' d this document and that to the best of my kno e e s true,accurate,and mto (2)Skin disorders a (5) Hearing loss � PB� (3)Respiratory Co pany exc ve Title conditions (6) All other illnesses b �dfj� �� 13� Phone- ,- Date 1 4PI Post this Summary page from February 1 to April 30 of the year following dw year covered by We form. 'I"`�'''' �•" ' "`Sapp p'np�ut:: Public rcponing burden farthis collection ofinfammtiaa is ostimamd 10 avenge 50 mitwms per raapoase,including time m ms•icw tiro inabuctians,snatch ami gotherthe dam needed,and _ eompicm and nvivsv au:wllection afivfannation.Person are and required to respond to the collection of iaformadon ualus it displals a ouacnily valid OMB.—I number•Ifyou have nay --u about fins-rsii--or any od—azpeets of aria dam eollcctioa,contact Its Dlpmtment oFLab.r;OSHA Cur—ofSndstiml AnaL-is,Room Nd644,200 Coostimtioa Avcnuc,NW, Washington.DC 20210.Do not send the oomplctfA foam m ibis oflfoa 0 0 c In M (D o CD CD Attention:This form contains information relating to p OSHA's Form 300 (Rem otf2oo4) employee health and must be used in a manner that protects the confidentiality of employees to the extent Year 2025 00 I ® m Log of Work-Related /i9�uries an Illnesses Possible while the information is being used for U.S.Departmenf of Labor n / [ occupational safety and health purposes. oro�,�.o,rsa/oh,ne xnana as nr t�:R H,n M,..iw��.•.-k:,. �-a- ex:._a-_a�,--„T;.x.-,.,o��cvw.a�r�.w�.,�...:..A.•a,w..,.,>:x+-r.�-�.. >,:�...._.c-�:.• You must record information about every work-related death andabout every work-related injury oriflness that involves loss of consciousness,restricted work activiryorjob transfer, r nn approved ohtb no.121 a-one 00 l days away from work,or medical treatment beyond first aid.You must also recordsigniBcant work-re/aced injuries and illnesses that are diagnosed by a physician orlicensed health care professional.You must also record work{elated injuries and Binesses that meet any of the specific recording criteria listed In 29 CFR Part 7904.8 through 1904-72 Feel free to Estabrai..fnarm GtO,'ryj lZ.Y GO}7� �7 use two lines fora single case if you need to.You must complete an Injury and fitness Incident Report(OSHA Form 307)or equivalent form for each injury orilfness mcarded on this /^ �•n_ C') form.If you're not sure whether a case is recordable,call your focal OSHA office for help. ctn, C� Stain 44/r T A M Enfor the nrrmher of (A) (8) (C) (D) (E) (F) days[ho lnJured or Ch'Sck;thq°ryK,yi cot4tnri;er W Case Employee's Warne Job title Dateofbn Wheretheeventoceurred Des¢ibe•'u .rillness, o£hod aff-w ill worker wax - W PTY rn3 a'Y 1' Y d. _ _ r6ogsotaietYTae ot'Ittriosa:. W no. (eg.,4yelder) or onset (e.S.,Loadm 8 dork nlh nd) nd o b ecUsnbstancc that direty in ud .£illness or made pe=on rill e..,Secotut de give bunu an -x tahii7 atf at-Wo'ik-: .( )` right fdrrann jmm.acdytnm tarrL) •f.; c.:":r`:tea,c ..•tom away on joh :c%Q TI N.Y.d:+r. IRq.[ nvfPr-:di ec oop from era ctor or -` °5x tt t 'tra n:wa t. rir,soco-)c!k•','e4iP:�:d..;:" work runt aton y. e.. x « D t{-G-)g•.:t tt-�{)� (L) {'1. (i) (3): '(4)r (5) (6) C) .�L1. —da3's —dris 'r❑y �: .❑.• .❑ '❑. ❑ mmw,/day �� .•'7..?• "l-.-E' ® '••... —days —da}s .4-I 0 .0 '❑ ❑ D monm!do/ ..®. �•:: ®'. " —days —drys ❑ '•q :❑, '� .❑ ❑ manthb Y �1--gp:` gyp,.: days II•':.}C� l.'1' �1 0 ❑ monlhtd y t.,,i: •..,®:.' ®i. —days —d'ys U 'l.7.'�(<'O ❑ ❑ m_� �•. : ";. _nays —days iJ .❑� -❑ ❑ ❑ mamma y ® ,drys T.Y. Cl Q II F1 ❑ ❑ mn,ama v .'.�: `® ®' _nays _days LI iJ' ❑ ❑ Q Ti mnmmd.y �. '•� - —days —` Q ,❑ II ❑ ❑ o manlh/dey �-R' .C3. �. �. —days —days 0_-.0r ❑ II 11 C1 —drys 0 u o 0 ❑ ❑ mnnwday —day: _drys ❑ ❑ ❑ [3 ❑ ❑ non Wdny �g _ � '� �. ®. - (�. _days —days II ❑ ❑ � ❑ ❑ monwdar �•a page tatats>� _ Public repontng burden for 11.collsxtion orinlormation is a C--d m av—gr LL minuw perrcpoo-ie,including time w miew 3e sure to transfer These loiats to the Sur--ypgge(F.-300F)before youpost d. the isutcvecions,smrcb atu!gather the dam needed,and mmpkm and revirn•the can«don oCinlormadom Yawns are riot fegnired ,g d respondmthecnllcaion.fintornuaon unit�s icd:splaysacurrend7•valid[h�iu mnual numbee try..have nnpmmmenu ' _ about d�ese esdmaies ur any.d—nap—.!this duo cnllcaion,—mm US Depanmwcc olLabor.OSHA air—ursutirumi daalys�,Room NSfi14,211U Consrio.don Avenue,Nw,tvashingmn,DC 2U2Ie.D.not wrd du romplacd r��mmdtis Brim Pooa,._ar_ (1) (2) (3) (4) (5) (6) �� rh /`!iY M 0 -a m OSHA's Form 30OA (Rev 0112004) Year Department Summary o Work-Relate juries � Illnesses [f 5.nepaa of Latr co DocaWrtonW SaHctiand HealHxAmvtntsr.aaion � r—.pp..•.d 0=m.LMAUG All establishments covered byPart 1903 musrcomp(ete this Summary page,even fl no work related iliUrfes orillnesses occurred during the year Remember to review the Log ICTI to verify that the entd0ss are complete and accurate before completing this sun=T.. Using the Log countthe indrveast entrees you mado preach category.Then write the totals below,maid sure Estah"Ishmertt information fll had no cases.write"0.' n9 you've added the entries from everypage of the Lag.1t you p v Employees,formeremployees.and theirrepresentatives have the right to review the OSHA Form 300 in its entirety They also have funiledaccess to the OSHA Form 301 or c'airasTaD1u 'Q1ta�Lomax Construction Inc. W its equivalent See 29 CFR Part 1904.35,in OSHA's mcordkeeping ade,torfuriherdetalls on the access provisions for these forms. W sett 8517-A NorcxQqa Road city sore NG ZIP 27235 n D Total number of Total number of 7bt2tntuaberof 'ibral number of indusayd capaa„(gp,,�rr�jm,rzn/Snnroruu,�vurs) C)w deaths cascswidt days caseswith3ob otherrecordableelleral C Ontraetors/construction 0 away rom work D Y transfer or restri xion cases Standard Iadusnial Gau;fiaflon(SIC),ifknown(eg,3715) 0 w 0 0 0 1 5 4 2 D (G) (M (il (J) Oli N—LA-6-n Indvarul Gxsificabon(NAICS7,ifkuown(cg.,3362I2) s- Total number ofdays away Total number of days ofjob Employment Information(g a dorr'rh,w lnRfg,rctserrlm from work transfer or or restriction Id"kilvet.a The 6k,dL&pgrr.vdw.) 0 0 Annualavccagcnnmbcrofgnployccs 117 (K) (L) Toll hotusworkrd byaII employees tnxtyor 36,413 ItSign here Total iturnber of... Knowin lyfal slfyixgthisdocumentmayresultina fine. (1)Injuries Q (4)poisonings 0 0 (`)Hearing loss 0 I certify that I have ned this do t and that to the best ofmy (2)Skin disorders il knowledge the te,an complete. —� (6)All other lnesses 0 (3)Respiratory conditions .. Rich Taylor Pr_ a>umnr�...w 336 992-7000 1-17-13 Post this Summary gage from February 1 to April 30 of the yoar following the year Covered by the form. PuClic p.cd.ghnrdanlirtlila.ollacttm.r;�oa�donJC e-.dmatedbavem5n 58 m5w[es pe[repumgtnd¢ding ymeea micw rhetnatmmonc,ccmrhmdsa[ha•Ihe deta�u7¢d,and �mptetc and.n,%..w the rdled:oa.fi.to�aG..�Pw.man:nouegtdn:d b mp.nd t.w.eollnnG...Ctnlorm.Go..ntesa ttdzplaya a--ay.-did OMS m.lr.t.—baerfyw brave a.y m+n..n.-alw.tthno eetLnnrn..c onv orfirracpem otthss aatamikaian,eoat>�us DTp. tnClahae.OSR&OM=ofSwUaddAnalyd,.Fo N-36f4MContimttanAvenacNw. wnsht.yt.n DC46Yla.1)on.tsmdihe.. Fkw f.— dt .nice. ' - -_-� - �� -- -_'� - � (D Attention"This;form contains information relatIng to OSHA"S Form 300 (R.0112-OG4) employee health and must be used in a manner that- (0 protects the conMenfiality of employees to the extent Year 20 12 0 pd�sible while the information is being used for ——0 n Log of Work-Related Injuries and Illnesses U.S.Department of Labor 0 occupational safety and health purposes. 00 Yourmust record Information about evoiywork-relateddeath and aboutemwy work-relatedinjug,crijiness that involves loss ofCQnsCbuShoSS,resUioted vvcdcSCUWY�wjOb transfer 321&0116 days avray hnm wczk ormedloaf treatment beland irstad-You must also fecoxfstgairicant wotk-refafed injudes and Nnessess that we dia_Onosed by aph�dan or licensed health -n cars Proressionar.Yo Lt must also tc=d work4ebted 4urias and Illnesses that me ot any of the sPOOSC lecord1n.9 Cdefia listed in 29 CFR Part 7 9 04,8 through 1904.!?-FWJ tree to Etab& 0 use&wo lines for a single case ifyou need to.Yo u must complete an 4uiy and Iffness Incident Repoit(OSHA Form,3oi)or equIvatent form fOr each 4MY OF iffnCSS�ecolced on this M form,If yo uli e n ot sure whath er a c is re cordable,call yo ur local 0 SHA o frice for help. C41 M piuryl"I wUder) Onset (e-g-L—fiTd.&—,f),end) —d-hjcct�substance that&recOy injuted akl Ai ME wit ' � � � � DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A ORANGE COUNTY DEPARTMENT OF SOCIAL SERVICES EXPANSION Rev 06/17/15 HILLSBOROUGH,NORTH CAROLINA TABLE OF CONTENTS BIDDING REQUIREMENTS Notice to Bidders Instructions to Bidders Guidelines for Recruitment and Selection of Minority Businesses BID FORMS AND SUPPLEMENTS Form of Proposal Identification of HUB Certified/Minority Business Participation Affidavit A—Listing of the Good Faith Effort Affidavit B—Intent to Perform Contract with Own Workforce Affidavit C—Portion of Work to be Performed by Minority Firms Affidavit D—Good Faith Efforts E-Verify Affidavit Contractor's Safety Record Information CONTRACT FORMS Construction Agreement Under$250,000 General Conditions Supplementary Conditions Form of Performance Bond Form of Payment Bond Sheet for Attaching Power of Attorney Sheet for Attaching Insurance Certificates DIVISION Ol - GENERAL REQUIREMENTS 011000 Summary........................................................................ 011000-1 thru 5 012100 Allowances...................................................................... - 012100 1 thru 3 012200 Unit Prices...................................................................... - ........................................ 012200-1 thru 2 012300 Alternates.................................................... ......... - 6/15/15 012300 1 thru 2 012500 Substitution Procedures....................................................... 012500-1 thru 3 012600 Contract Modification Procedures........................................... 012600-1 thru 2 012900 Payment Procedures........................................................... 012900-1 thru 5 013100 Project Management and Coordination..................................... 0 13 100-1 thru 7 013200 Construction Progress Documentation...................................... 013200-1 thru 8 013300 Submittal Procedures.......................................................... - 013300 1 thrul0 014000 Quality Requirements............................I.............I.............. 014000-1 thru 8 015000 Temporary Facilities and Controls...........................................015000-1 thru 7 016000 Product Requirements.........................................................016000-1 thru 5 017300 Execution Requirements......................................................017300-1 thru 9 017419 Construction Waste Management and Disposal........................... 017419-1 thru 7 017700 Closeout Procedures........................................................... - ....................... 017700-1 thru 6 017823 Operation and Maintenance Data............................................ 017823-1 thru 8 i TABLE OF CONTENTS TOC-i DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A ORANGE COUNTY DEPARTMENT OF SOCIAL SERVICES EXPANSION Rev 06/17/15 HILLSBOROUGH,NORTH CAROLINA DIVISION 01 -GENERAL REQUIREMENTS (continued) 017839 Project Record Documents................................................... 017839-1 thru 4 017900 Demonstration and Training..................................................017900-1 thru 4 DIVISION 02—EXISTING CONDITIONS 024119 Selective Demolition...................................... 6/15/15......... 024119-1 thru 4 DIVISION 03—CONCRETE See Structural Drawing, Sheet S 1.1,for Cast-in-Place Concrete DIVISION 04—MASONRY 042000 Unit Masonry...................................................................042000-1 thrul2 DIVISION 05—METALS 055000 Metal Fabrications..............................................................055000-1 thru 2 DIVISION 06—WOOD AND PLASTICS 061053 Miscellaneous Rough Carpentry..........................6/15/15.......... 061053-1 thru 5 06160.0 Sheathing....................................................6/15/15.......... 061600-1 thru 3 064116 Plastic-Laminate-Faced Architectural Cabinets........ 6/15/15.......... 06416-1 thru 6 066400 Plastic Paneling.............................................6/15/15.......... 066400-1 thru 4 DIVISION 07—THERMAL AND MOISTURE PROTECTION 074113.19 Batten-Seam Metal Roof Panels......................................... 174113.19-1 thrul0 077253 Snow Guards................................................ 6/15/15.......... 077253-1 thru 2 079200 Joint Sealants................................................................... 079200-1 thrul0 DIVISION 08—DOORS AND WINDOWS 081213 . Hollow Metal Frames......................................................... 081113-1 thru 6 081416 Flush Wood Doors.............................................................08'1416-1 thru 6 083113 Access Doors and Frames.................................6/17/15.......... 083113-1 thru 3 087100 Door Hardware................................................................. 087100-1 thrul3 088000 Glazing.......................................................................... 088000-1 thru 6 088813 Fire-Resistant Glazing.........................................................088813-1 thru 6 TABLE OF CONTENTS TOC.-ii DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A ORANGE COUNTY DEPARTMENT OF SOCIAL SERVICES EXPANSION Rev 06/17/15 HILLSBOROUGH,NORTH CAROLINA DIVISION 09—FINISHES 092216 Non-Structural Metal Framing............................................... 092216-1 thru 4 092900 Gypsum Board..................................................................092900-1 thru 7 095113 Acoustical Panel Ceilings..................................................... 095113-1 thru 7 096513 Resilient Base and Accessories...............................................096513-1 thru 5 096543 Linoleum Flooring............................................................... 096543-1 thru 6 096816 Sheet Carpeting............................................... ................ - 096816 1 thru 6 099123 Interior Painting............................................ 6/15/15.......... 099123-1 thru 6 099600 High-Performance Coatings.................................................. 099600-1 thru 5 DIVISION 10—SPECIALTIES 101100 Visual Display Units.......................................6/15/15.......... 101100-1 thru 6 102113.19 Plastic Toilet Compartments..............................6/15/15...... 102113.19-1 thru 5 102800 Toilet Accessories..............................................................102800-1 thru 4 105201 Fire-Protection Specialties.................................6/15/15.......... 105201-1 thru 4 DIVISION 11—EQUIPMENT 114000 Foodservice Equipment............................ ...... 6/15/15.......... 114000-1 thru 4 DIVISION 12—FURNISHINGS 123661.16 Solid-Surfacing Countertops............................. 6/15/15...... 123661.16-1 thru 4 END OF TABLE OF CONTENTS TABLE OF CONTENTS TOC -iii DocuSign Envelope ID:489DFD84-DFCE-4EO7-BB35-5F6A708DFA3A ACC>REP CERTIFICATE OF LIABILITY INSURANCE ) DATE 7/10/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the.certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mark MCLamb CIC NAME: Craft Insurance Center PHONE (336)375-0600 FAX No:x336)375-7009 823 North Elm Street E-MAIL ADDRESS:mmclamb @craftinsurance.com PO BOX 14946 INSURERS AFFORDING COVERAGE NAIC q Greensboro NC 27415 INSURERAAll America Insurance Company 0222 INSURED INSURERB:Central Mutual Insurance 20230 Lomax Construction, Inc. INSURER C:Builders Mutual Insurance 10844 PO Box 35169 INSURERD:Peerless Indemnity Insurance 18333 INSURER E: Greensboro NC 27425-5169 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300 000 PREMISES Ea occurrence $ i A CLAIMS-MADE OCCUR X Y CLP 7967877 1/1/2015 1/1/2016 M ED EXP(Any one person) $ 5,000 PERSONAL RADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccld.nl 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED X Y AP 7967876 1/1/2015 1/1/2016 BODILY INJURY(Per accident) $. AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ C XS 7967878 1/1/2015 1/1/2016 $ C WORKERS COMPENSATION Y X WCSTATU- I OTH- AND EMPLOYERS'LIABILITY Y/N I TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 0002462713 1/1/2015 1/1/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 JDBand M arine LP 7967877 1/1/2015 1/1/2016 Rental Equipment $100 000 lders Risk IM957153 1/1/2015 1/1/2016 Builders Risk $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Project: Department of Social Services Expansion in Hillsborough, North Carolina. Orange County, Owner, Designer & Designer's Consultants are Additional Insureds on the General Liability and Automobile policies if required by written contract, agreement or permits only as respects to operations of the Named Insured on a primary and non-contributory basis. Waiver of subrogation is provided in favor of the additional insureds under the General Liability, Automobile and Workers Compensation policies if required by written contract. The umbrella policy is written on "follow the CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County - ACCORDANCE WITH THE POLICY PROVISIONS. - PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Mark McLamb, CIC/RMM �'/`�`'` ?� � ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(�>ninns)m Tha Ar'r)Rr1 nnma nnri Inrrn nra ranictararl mnrlec nf.Ar-npn DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A COMMENTS/REMARKS form basis". 30 day notice of cancellation applies to all policies except 10 days notice for non-payment of premium. The workers compensation experience mod for the 2015-2016 policy term is .89. I OFREMARK COPYRIGHT 2000, AMS SERVICES INC.