Request for Tender No Supply and Installation of Mosaic Floor Tile at the Nanaimo Ice Centre (NIC)

Transcription

1 Request for Tender No Supply and Installation of Mosaic Floor Tile at the Nanaimo Ice Centre (NIC) Issue Date: November 12, 2014 Tender Closing Location Purchasing Department 2020 Labieux Road Nanaimo, BC V9T 6J9 Tender Closing Date and Time Tenders must be received at the Purchasing Department prior to: 3:00 p.m. (15:00 hrs) Pacific Time, November 25, 2014 City Contact Person for all Enquiries Chris Wood, Supervisor of Facilities Maintenance Phone: Mandatory Site Meeting A mandatory site meeting will commence at 9:00 a.m., November 18, 2014 at Nanaimo Ice Centre, 750 Third Street, Nanaimo, B.C., convening in the main lobby. Only those Bidders attending the mandatory site visit will be eligible to submit a Tender. Tenders will not be opened in Public

2 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC SECTION 1.0 PROJECT SUMMARY 1.1 The City of Nanaimo (the City ) is seeking qualified Contractors to supply, prepare and install 2 x2 mosaic tile in the showers in various rooms at the Nanaimo Ice Centre, 750 Third Street, Nanaimo, B.C. 1.2 The general workscope includes the following: Supply and install 2 x2 mosaic floor tile and base for shower bases. Fibreglass grating to cover trench drains. ColourMax stain resistant urethane grout. Grind floors to remove paint. Render floor slope. 1.3 Areas of Work: All dressing room showers Referee s room Flex room 1.4 It is the responsibility of the Bidder to take accurate measurements, ask questions and be familiar with the site to determine the existing conditions, layouts and limitations. 1.5 The successful Contractor will be responsible for scheduling and coordinating the installation work with the Owner on a room by room basis. Although, the completion date is flexible, the work should be performed within a reasonable time upon award notification. 1.6 All required materials, equipment, removal, disposal etc. are the sole responsibility of the Contractor. 1.7 In the event of a multiple employer workplace, the Bidder is to be designated as the Prime Contractor for this project per WorkSafe BC OH&S Regulations Sections 20.2 Notice of Project and 20.3 Coordination of Multiple Employer Workplaces and Workers Compensation Act, Section 118 Coordination of Multiple-Employer Workplaces (1) and (2). The Bidder should also understand the general duties of the City as defined in the Workers Compensation Act, Section 119 General Duties of City. The Bidder should have the necessary qualifications and be willing to accept the responsibilities as Prime Contractor for the project. Refer to Prime Contractor forms in the Appendix. The Prime Contractor will be required to coordinate the safety of all workers on the work site including their employees, subcontractors, City workers and the general public. SECTION 2.0 INSTRUCTIONS TO BIDDERS 2.1 Mandatory Site Meeting A mandatory site visit will commence at 9:00 a.m., November 18, 2014 at Nanaimo Ice Centre, 750 Third Street, Nanaimo, B.C., convening in the main lobby. Bidders must sign the attendance sheet. 2

3 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC The purpose of the mandatory site visit is for Bidders to determine the existing conditions, layouts, limitations and to take accurate measurements and ask any questions relevant to providing a Tender. Questions posted by Bidders and answered at the facility site meetings may not be further documented or disseminated. Questions which are taken under advisement at the meeting will be documented and responses shall be distributed to the Bidders recorded as attending the meeting. 2.2 Closing Time and Delivery Instructions Tenders must be received by the Purchasing Department prior to 3:00 p.m., local time, November 25, Tenders may be delivered by one (1) of the following three (3) methods: i. By hand/courier delivery to the only acceptable address and department: Purchasing Department, 2020 Labieux Road, Nanaimo, BC V9T 6J9. The Tender should be enclosed in a sealed envelope, clearly marked RFT 1585 Supply and Installation of Mosaic Tile and should include one (1) hard copy of the Tender. ii. Electronically submitted at the only acceptable address: purchasinginfo@nanaimo.ca Please note: Maximum file size limit is 8MB, or less. Iii Via Facsimile at the only acceptable fax number of Tenders received after the closing date & time will not be considered. It is the Bidder s sole responsibility to ensure they allow themselves enough time to submit their Tender to the Purchasing Department. The wall clock in the Purchasing Department Office is the official time piece for the receipt of all Tenders. 2.3 Mandatory Requirement Tenders not clearly demonstrating that they meet the following mandatory requirements will be excluded from further consideration during the evaluation process. Item # Mandatory Requirements 1. Tender(s) must be received at the closing location specified prior to 3:00 p.m. (15:00 hr) Pacific Time on November 25, Bidders must attend the mandatory site meeting and signed the attendance sheet. 3. Tender Form 1585 must be submitted and signed by an authorized person in a position to legally bind the Bidder to statements made in response to this Request for Tender. 2.4 Tender Form 1585 The Tender Form 1585 must be submitted and signed by an authorized person in a position to legally bind the Contractor and Bidder to statements made in response to this Request for Tender. Tender Forms that do not contain a signature will be disqualified. 3

4 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC 2.5 Receipt Confirmation Form For any further distributed information about this Request for Tender, please return this form by fax to or to The City will attempt to send information directly to Bidders that have returned the Receipt Confirmation Form, but it is the responsibility of the Bidders to ensure that all information has been received. Addendums will also be available on the City website under the Business tab, then Bid Opportunities tab, then tender 1585 tab. 2.6 Examination of RFT Tender Documents The Bidder shall carefully examine the RFT and the site of the proposed works and is solely responsible for making allowance in the Tender for any conditions likely to be encountered. 2.7 Liability for Errors The City and its employees and agents shall not be held liable or accountable for any error or omission in any part of this Request for Tender or response to Bidder questions. While the City and/or its employees and agents have made efforts to ensure an accurate representation of information in this RFT, the information contained in the RFT is supplied solely as a guideline for Bidders. The information is not guaranteed or warranted to be accurate by the City and/or its employees or agents, nor is it necessarily comprehensive or exhaustive. Nothing in this RFT is intended to relieve Bidders from the responsibility of conducting their own investigations and research and forming their own opinions and conclusions with respect to the matters addressed in this RFT. Bidders will be solely responsible to ensure their Tender meets all requirements of the RFT, to advise the City immediately of any apparent discrepancies or errors in the RFT and to request clarification if in doubt concerning the meaning or intent of anything in the RFT. 2.8 Bidders Costs for Tender All costs associated with the preparation and submission of the Tender, including any costs incurred by the Bidder after the Closing Time, will be borne solely by the Bidder. 2.9 Questions Questions are to be sent to the attention to the contact person below. Chris Wood, Supervisor of Facilities Maintenance chris.wood@nanaimo.ca Phone: Information obtained from any other person or source is not official and is not to be relied upon. Inquiries and responses will be recorded and may be distributed to all Bidders in the form of written addenda issued by the Purchasing Department. If the City determines that an addendum is required to this RFT, the City s Purchasing Department will issue an addendum to Bidders who have returned the Receipt Confirmation Form. It is the sole responsibility of the Bidder to check the City Website for addendums prior to submitting their Tender. 4

5 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC 2.10 Addenda Each addendum will be incorporated into and become part of the RFT document. No addendum of any kind to the RFT is effective unless it is contained in a written addendum issued by the City s Purchasing Department Tender Revisions Prior to the closing date & time, revisions to a Tender that has already been submitted may be made by submitting the changes to the Purchasing Department in writing Withdrawal of Tender The Bidder may withdraw their Tender at any time prior to the Tender closing time by contacting the Purchasing Department in writing Currency and Taxes All prices are in Canadian Dollars exclusive of all applicable taxes. Applicable taxes are to be shown as a separate line item Litigation Clause The City may, in its absolute discretion, reject a Tender submitted by Bidders if the Bidder, or any officer or director of the Bidder is or has been engaged either directly or indirectly through another corporation in a legal action against the City, its elected or appointed officers and employees in relation to: (a) Any other Contract for works or Services; or (b) Any matter arising from the City s exercise of its powers, duties or functions under the Local Government Act for another enactment within five years of the date of this Request for Tender. In determining whether to reject a Tender under this clause, the City will consider whether the litigation is likely to affect the affect the Bidder s ability to work with the City, its consultants and representatives and whether the City s experience with the Bidder indicates that the City is likely to incur increased employees and legal costs in the administration of this Contract if it is awarded to the Bidder Acceptance of Tender The lowest or any Tender will not necessarily be accepted The City s Discretion (a) Tenders that contain qualifying conditions or otherwise fail to conform to the Instructions to Bidders may, at the sole discretion of the City, be disqualified or rejected. (b) In the event that all Tenders received are over budgetary expectations, the City reserves the right to cancel the Request for Tender process and negotiate with the lowest priced or any Bidder, or with any firm whether or not it submitted a Tender. (c) Preference will be given to Contractors within the Regional District of Nanaimo where quality, service and price are equivalent Conflict of Interest By submitting a Tender, the Bidder warrants that neither it nor any of its officers or directors, or any employee with authority to bind the Bidder, has any financial or 5

6 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC personal relationship or affiliation with any elected official or employee of the City or their immediate families which might in any way be seen by the City to create a conflict Ownership of Tender and Freedom of Information and Privacy Protection Act All documents, including Tenders, submitted to the City become the property of the City. They will be received and held in confidence by the City, subject to the provisions of the Freedom of Information and Privacy Protection Act (FOIPPA) Tender Validity Tenders shall be irrevocable and shall remain open for acceptance by the City for thirty (30) calendar days after the closing date and time. SECTION 3.0 SPECIFICATIONS 3.1 To supply delivery and install 2 x2 mosaic tile in accordance to the Manufacturer s installation instructions at the Nanaimo Ice Centre. The work includes preparation of floor as well as the supply and installation of bases, fibreglass grating and floor slope rendering. General workscope: Supply and install 2 x2 mosaic floor tile and base for shower bases. Fibreglass grating to cover trench drains. ColourMax stain resistant urethane grout. Grind floors to remove paint. Render floor slope. Areas of Work: All dressing room showers Referee s room Flex room 3.2 Installations are to be scheduled and co-ordinated with the Arenas Manager or authorized representative on a room by room basis dependent on availability. 3.3 Hours of Work Nanaimo Ice Centre: 5:00 a.m. 1:00 a.m. Monday to Friday, excluding statutory holidays. 3.4 All materials must be new. 3.5 Preparation and installation will be in accordance to the Manufacturer s instructions. 3.6 All required materials, equipment, removal, disposal etc. are the sole responsibility of the Contractor. 3.7 The Contractor must only employ skilled and qualified tradesmen to perform the Work. 3.8 Inspection (a) All materials and installation will be subject to inspection and will meet the approval of the City and the City s decision will be final and binding upon all parties. 6

7 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC (b) Should materials or installation be defective in quality of workmanship or otherwise fail to conform within the specifications set forth, the City will have the right to reject them or require their immediate correction. (c) Materials or installation requiring correction will be removed or re-installed for correction at no expense to the City. (d) If the Contractor fails to take proper action promptly when requested by the City, the City may replace or correct materials as necessary and charge the cost of such replacement to the Contractor, or the City may terminate the contract. 4.0 GENERAL TERMS AND CONDITIONS 4.1 Acceptance of Terms All the terms and conditions of this RFT are assumed to be accepted by the Bidder and incorporated in its Tender, except those revisions that are proposed or requested in the Tender and accepted by the City. 4.2 Contract and Contract Documents The City s preferred form of Contract is the City of Nanaimo s official Purchase Order and the Contract documents will include and consist of: Tender Submission; All amendments and attachments; City of Nanaimo Business License; General Commercial Liability Insurance; WorkSafe BC Clearance Letter; The City s official purchase order; and If applicable, Prime Contractor forms The City is not obligated to any Bidder in any manner until a City of Nanaimo Purchase Order has been issued and signed by an authorized person of the City. 4.3 Payment Terms Payment Terms will be Net thirty (30) days from invoice date. 4.4 Holdback This work will be subject to a ten percent (10 %) holdback in accordance with the British Columbia Builders Lien Act. The holdback shall not be released until the expiry of fiftyfive (55) days after substantial completion of the project, or as required by the Act. 4.5 No Additional Payment Except as otherwise provided in this Contract, no payment for extras shall be made unless such extras and prices have the City s prior written consent 4.6 Laws, Permits and Regulations (a) This RFT will be governed by the laws of the Province of British Columbia. (b) The Contractor is responsible for complying with all applicable laws, bylaws, and other statutory regulations including obtaining and paying for all necessary permits, licenses and approvals, in order to perform the Work. 4.7 Assignment The Contractor shall not assign any of its obligations without the City s prior written consent. 7

8 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC 4.8 Insurance Requirements (a) The Contractor shall be required to carry not less than two (2) million dollars Commercial General Liability Insurance, naming the City of Nanaimo as an additional insured, Automobile Liability Insurance on all vehicles operated or licensed in the name of the Contractor in an amount not less than (2) million dollars per occurrence for bodily injury, death and property damage, Contractors Equipment insurance in an all risks form covering construction machinery and equipment used for the performance of the project from insurers licensed in the Province of British Columbia and in forms and amounts acceptable to the City. (b) All insurance must be primary; and not require the sharing of any loss by an insurer of the City. (c) The Contractor shall provide, maintain, and pay for, any additional insurance which it is required by law to carry, or which it considers necessary to cover risks not otherwise covered by insurance specified in this Section in its sole discretion. (d) The Contractor shall place and maintain, or cause any of its sub-contractors to place and maintain, such other insurance or amendments to the foregoing policies as the City may reasonably direct. (e) The Contractor hereby waives all rights of recourse against the City for loss or damage to the Contractor's property. 4.9 WorkSafe BC The Contractor and any of its sub-contractors shall be required to provide proof of good and active standing with the Workers Compensation Board of B.C. Such compliance shall be maintained for the duration of the Contract otherwise the City may terminate the Contract without penalty or liquidated damages being assessed by the Contractor against the City City of Nanaimo Business License The Contractor shall be required to obtain a City of Nanaimo or Inter-Municipal Business License prior to Contract award. No Contract will be awarded to any Company who cannot obtain a City of Nanaimo Business License. The costs shall be borne by the successful Contractor Sub-Contracting The Contractor will preserve and protect the rights of the City with respect to any Work performed under sub-contract and incorporate the terms and conditions of this Contract into all sub-contracts as necessary to preserve the rights of the City under this Contract. The Contractor will be as fully responsible to the City for acts and omissions of subcontractors and of persons directly or indirectly employed by them as for acts and omissions of persons directly employed by the Contractor Indemnity The Contractor shall indemnify and save harmless the City of Nanaimo including without limitation, the City of Nanaimo Mayor, its Council Members, agents, servants and employees from and against all claims, demands, losses, damages, costs and expenses made against or incurred, suffered or sustained by the City at any time where the same are based upon or arise out of anything tortuously done or omitted to be done by the Contractor or the designated employees. 8

9 Request for Tender No Supply & Installation of Mosaic Floor Tile at NIC 4.13 Minimum Rate of Pay Minimum rate of pay for work performed under this Contract or under sub-contract shall be as classified in the current Agreement between the City of Nanaimo and the Canadian Union of Public Employees, Local No Default (a) The City may by notice of default to the Contractor, terminate in whole or in part the Contract if the Contractor fails to make delivery of the goods or to perform any provision of this Contract within the time specified, or within a reasonable time if no time is specified. In the event the City does terminate the Contract in whole or in part as specified above, the City may procure goods or services similar to those so terminated and the Contractor will be liable to the City for any excess costs for such similar goods or services. (b) The Contractor will not be liable for any excess costs if failure is due to strike, lockout, or Acts of God. The City will not be liable where delivery sites are not available due to strike, lockout, or Acts of God Dispute Resolution In the event of a dispute arising between the City and the successful Bidder as to their respective rights and obligations under the Agreement, both parties agree to resolve the dispute by: (a) Frank and open negotiations whereby both parties use their best efforts to resolve the dispute by mutual agreement including the most Senior Management of both parties. (b) If, after thirty (30) calendar days, the dispute is not resolved, both parties agree to appoint a mediator to resolve the dispute. All costs to be split equally. (c) If, after the mediation process is complete and the dispute is not resolved, the parties shall proceed to arbitrations following the rules of procedures as per the British Columbia International Commercial Arbitration Centre located in Vancouver, BC. All costs, with the exception of legal fees, shall be borne equally. 9

10 TENDER 1585 NIC SHOWER TILE INSTALLATION PROJECT TENDER FORM Page 1 of 1 The undersigned has examined Tender 1585 and having full knowledge of the requirements of the City, do hereby agree to be bound by the Terms, Conditions, Statements and Representations contained herein. PRICING LUMP SUM PRICE GST Total Contract Price $ $ $ MATERIALS & WORKMANSHIP WARRANTY ACCEPTANCE Company Name & Mailing Address: Address: Authorized Signature: Printed Name: Date:

11 Prime Contractor General Information Form This document does not replace the Workers Compensation Act or OH&S Regulations Sections 118 of the Workers Compensation Act: multiple employer workplace means a workplace where workers of 2 or more employers are working at the same time. Note: Workers of one employer do not necessarily have to come in contact with workers of the other They do not have to be in the same place at the same time Workers activities could affect the health and safety of another employer s workers. This is true even if the workers at the workplace are workers of the owner or contractor. prime contractor means, in relation to a multiple-employer workplace, (a) the directing contractor, employer or other person who enters into a written agreement with the owner of that workplace to be the prime contractor for the purposes of this Part, or (b) if there is no agreement referred to in paragraph (a), the owner of the workplace. The prime contractor of a multiple employer workplace must Ensure that the activities of all employers, workers (including the owners), and other persons at the workplace relating to occupational health and safety are coordinated and Do everything that is reasonably practicable to establish and maintain a system or process that will ensure compliance with the WC Act and the Regulation in respect of the workplace Each employer of workers at a multiple employer workplace must give to the prime contractor the name of the person the employer has designated to supervise the employer s workers at that workplace. For the sake of clarity, the following apply in determining whether there is a multiple-employer workplace: Two or more adjacent workplaces do not constitute a multiple-employer workplace, even though the activities at one place might affect the health and safety of workers at an adjacent workplace. In contrast, the workplace will generally be a multiple-employer workplace in the following situations: -Workers of different employers are present at the same time working on the different projects; or -Workers of different employers are present at the same time working on the same project. In either case the workplace would be considered a multiple-employer worksite. -1-

12 Prime Contractor General Information Form Page 2 of 3 In determining whether workers of 2 or more employers are working at the same time, the phrase at the same time will be given such fair, large and liberal construction as may best attain the objectives of section 118. At the same time does not mean that, at any precise point in time, there are workers of 2 or more employers present in the workplace. Rather, it means that, over an appropriate interval, there are workers of 2 or more employers present in the workplace, whether or not the 2 or more groups of workers are actually present together in the workplace at any precise point in time at all. The duration of the interval of time to be considered will depend upon the circumstances of the individual workplace. Whether the workers of the one employer come into actual contact with the workers of the other employer does not generally affect the determination of whether the workplace is a multiple-employer workplace. An employer, the employer s workers and their activities could well affect the health and safety of another employer s workers who come into the workplace later in the day or on another day, even though there may be no actual contact between the two groups of workers. However, the degree to which the activities of the first employer and its workers affect the health and safety of the second employer s workers will generally affect the determination of the responsibilities of the prime contractor and of the two employers under Part 3 and the regulations Virtually all workplaces will be visited by workers of other employers. For example, workers may deliver or pick up mail, goods or materials or enter to inspect the premises. Short term visits of this type, even if regular, do not make the workplace a multiple-employer workplace for purposes of section 118(1). The written agreement referred to in section 118(1) of the Act must be made available within a reasonable time if requested by a Board officer. There can be only one "prime contractor" at a workplace at any point in time. If an owner enters into more than one agreement purporting to create a "prime contractor" for the same period of time, the owner is considered to be the prime contractor. -2-

13 Prime Contractor General Information Form Page 3 of 3 Section 119 of the Workers Compensation Act: Every owner of a workplace must (a) provide and maintain the owner's land and premises that are being used as a workplace in a manner that ensures the health and safety of persons at or near the workplace, (b) give to the employer or prime contractor at the workplace the information known to the owner that is necessary to identify and eliminate or control hazards to the health or safety of persons at the workplace, and (c) comply with this Part, the regulations and any applicable orders. Prime Contractor Qualified Coordinator OH&S Regulations 20.3: If a work location has overlapping or adjoining work activities of 2 or more employers that create a hazard to workers, and the combined workforce at the workplace is more than 5, (a) the owner, or if the owner engages another person to be the prime contractor, then that person must (i) appoint a qualified coordinator for the purpose of ensuring the coordination of health and safety activities for the location, and (ii) provide up-to-date information as specified in subsection (4), readily available on site, and (b) each employer must give the coordinator appointed under paragraph (a)(i) the name of a qualified person designated to be responsible for that employer's site health and safety activities. (3) The duties of the qualified coordinator appointed under paragraph (2)(a)(i) include (a) informing employers and workers of the hazards created, and (b) ensuring that the hazards are addressed throughout the duration of the work activities. (4) The information required by subsection (2)(a)(ii) includes (a) the name of the qualified coordinator appointed under subsection (2)(a)(i), (b) a site drawing, which must be posted, showing project layout, first aid location, emergency transportation provisions, and the evacuation marshalling station, and (c) a set of construction procedures designed to protect the health and safety of workers at the workplace, developed in accordance with the requirements of this Regulation. -3-

14 Prime Contractor Preconstruction Meeting Form Date: Meeting Location: Firm Name: Contract #: Prime Contractor: Prime Contractor s Superintendent: City s Contract Representative: AGREEMENT The Prime Contractor: Acknowledges appointment as Prime Contractor defined by WorkSafe BC OH&S Regulations Sections 20.2 and 20.3, and in the Workers Compensation Act, Sections 118 Clauses 1 and 2. Understands the Owners duties as defined in the Workers Compensation Act, Section 119. Understands for any discrepancy establishing health and safety protocol, WorkSafe BC OH&S Regulation and/or the Workers Compensation Act (Part 3) shall prevail. Acknowledges being informed of any known workplace hazards by the owner or owner s delegate, by signing attached Existing Known Hazard Assessment form. Shall communicate known hazards to any persons who may be affected and ensure appropriate measures are taken to effectively control or eliminate the hazards. Shall ensure all workers are suitably trained and qualified to perform the duties for which they have been assigned. Shall ensure or coordinate first aid equipment and services as required by WorkSafe BC OH&S Regulation. Shall coordinate the occupational health and safety activities for the project. Assumes responsibility for the health and safety of all workers and for ensuring compliance by all workers with the Workers Compensation Act (Part 3) and WorkSafe BC OH&S Regulation. Understands any WorkSafe BC violation by the Prime Contractor may be considered a breach of contract resulting in possible termination or suspension of the contract and/or any other actions deemed appropriate at the discretion of the City. Understands any penalties, sanctions or additional costs levied against the Prime Contractor will be the responsibility of the Prime Contractor. Confirms the Prime contractor s safework procedures and risk assessments were prepared by, or approved by a Qualified Person as defined by WorkSafe BC OH&S Regulations. Accepts the following required documents shall be maintained and made available upon request from the City and/or WorkSafe BC Prevention officer at the workplace.

15 The documents required to be maintained and available by the Prime Contractor will include, but not be limited to: All notices which the Prime Contractor is required to provide to WorkSafe BC as per WorkSafe BC OH&S Regulation. Any written summaries of remedial action taken to reduce occupational health and safety hazards within the area of responsibility. All directives and inspection reports issued by WorkSafe BC. Records of any incidents and accidents occurring within the Prime Contractor s area of responsibility. Completed accident investigations for any incidents and accidents occurring within the Prime Contractor s area of responsibility. On a construction workplace, these additional documents are required to be maintained and available by the Prime Contractor: Records of all orientation and regular safety meetings held between contractors and their workers, including topics discussed, worker names and companies in attendance. Written evidence of regular inspections within the workplace. Occupational first aid records. Worker training records. Current list of the name of a qualified person designated to be responsible for each subcontractor (employer s) site health and safety activities. Diagram of the emergency route to the hospital. The following information must be provided to the City Contract Representative: WorkSafe BC Notice of Project WorkSafe BC Clearance Letter Prime Contractor s OH&S Safety Program Prime Contractor s OH&S Safety Program Document First Aid Attendants: Safety Supervisor: Location of First Aid Station: Signature of Prime Contractor: Signature of City Contract

16 Representative: EXISTING KNOWN HAZARD ASSESSMENT Discussion between the Prime Contractor and the City Contract Representative Date: Meeting Location: Prime Contractor: Prime Contractor Representative: City Contract Representative to make the Prime Contractor aware of any known extraordinary pre-existing hazards peculiar to the contract. It is recognized the known pre-existing hazards identified may not be a comprehensive list and due caution is always required. Use additional pages if necessary. Comment: Identified Extraordinary Hazards Action required to eliminate or control hazards and ensure worker safety Comment: Comment: Prime Contractor Representative (signature) City Contract Representative (signature) Prime Contractor Representative (printed) City Contract Representative (printed)

17 RECEIPT CONFIRMATION FORM City of Nanaimo Request for Tender No Supply and Installation of Mosaic Floor Tile at the Nanaimo Ice Centre Closing Date & Time: Prior to 3:00 P.M. (15:00hrs) Pacific Time, November 25, 2014 For any further distributed information about this Request for Tender, please return this form by fax or as soon as possible to: or Fax: COMPANY NAME: STREET ADDRESS: CITY/PROVINCE: POSTAL CODE: PHONE NUMBER: FAX NUMBER: PHONE NUMBER: CONTACT PERSON: TITLE: ADDRESS: