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HomeMy WebLinkAboutCONTRACT WITH SOUTHERN SERVICES: SANITARY SEWER PHASE 2 GROUP 8 ty)14 This SUMPLEMENTAL AGREEMENT,made on the day of eELL ,20 « ,to the AGREEMENT, approved by the Augusta Commission on October 18, 2016 negotiated on the 27th of December, 2018 by and between AUGUSTA, GEORGIA, BY AND THROUGH THE AUGUSTA- RICHMOND COUNTY COMMISSION, party of the first part, hereinafter called the OWNER, and Southern Services,party of the second part,hereinafter called the CONTRACTOR. WITNESSETH,that the Contractor and the Owner,for the considerations hereinafter named, agree as follows: ARTICLE I-SCOPE OF THE WORK- The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work shown on the plans and described in the specifications for the project entitled: SANITARY SEWER CONNECTION SERVICE—PHASE 2—GROUP 8-BID ITEM#18-318 and in accordance with the requirements and provisions of the Contract Documents as defined in the General and Special Conditions hereto attached,which are hereby made a part of this agreement. ARTICLE II-TIME OF COMPLETION The work to be performed under this Contract shall be commenced within 5 business days after the date of written notice by the Owner to proceed.All work shall be substantially completed within 30 calendar days with all such extensions of time as are provided for in the General Conditions. Substantial completion shall be defined as all lots awarded connected to the city sewer system, all septic tanks abandoned. Final completion shall be 10 days after substantial completion. Final completion shall be defined as a representative of each property has signed off on the completeness and acceptance of work, example included. It is hereby understood and mutually agreed,by and between the Contractor and the Owner,that the date of beginning, rate of progress and the time for completion of the work to be done hereunder are ESSENTIAL CONDITIONS of this contract. Contractor agrees that said work shall be prosecuted regularly, diligently,and uninterruptedly at such rate of progress as will ensure full completion thereof within the time specified.It is expressly understood and agreed by and between the Contractor and the Owner,that the time for completion of the work described herein is a reasonable time for completion of the same, taking into consideration the average climatic range and construction conditions prevailing in this locality. 1IPage ARTICLE III—PAYMENT (A)The Contract Sum The Owner shall pay to the contractor for the performance of the Contract the amount as stated in the BID FORM and Schedule of Items. No variations shall be made in the amount except as set forth in the specifications attached hereto. (B)Progress Payment On no later than the fifth day of every month,the Contractor shall submit to the Owner's Engineer an estimate covering the percentage of the total amount of the Contract which has been completed from the start of the job up to and including the last working day of the preceding month,together with such supporting evidence as may be required by the Owner and/or the Engineer.This estimate shall include only the quantities in place and at the unit prices as set forth in the Bid Schedule.On the vendor run following approval of the invoice for payment,the Owner shall after deducting previous payments made,pay to the Contractor 90%of the amount of the estimate on units accepted in place.The 10%retained percentage may be held by the Owner until the final completion and acceptance of all work under the Contract. ARTICLE IV-ACCEPTANCE AND FINAL PAYMENT (A) Upon receipt of written notice that the work is ready for final inspection acceptance,the Engineer shall within 10 days made such inspection, and when he finds the work acceptable under the Contract and the Contract fully performed,he will promptly issue a final certificate,over his own signature,stating that the work required by this Contract has been completed and is accepted by him under the terms and conditions thereof. The contract shall then submittal a fmal payment request for the entire balance found to be due the Contractor including the retained percentage. This payment shall be paid to the Contractor by the Owner within 30 days after the date of the receipt of the final payment request. (B) Before final payment is due,the Contractor shall submit evidence satisfactory to the Engineer that all payrolls,material bills, and other indebtedness connected with work have been paid,except that in case of disputed indebtedness of liens of evidence of payment of all such disputed amounts when adjudicated in cases where such payment has not already been guaranteed by surety bond. (C) The making and acceptance of the final payment shall constitute a waiver of all claims by the Owner, other than those arising from unsettled liens,from faulty work appearing within 12 months after final payment, from requirements of the specifications,or from manufacturer's guarantees.It shall also constitute a waiver of all claims by the Contractor except those previously made and still unsettled. (D) If after the work has been substantially completed, full completion thereof is materially delayed through no fault of the Contractor,and the Engineer, so certifies, the Owner shall upon certification of the Engineer,and without terminating the Contract,make payment of the balance due for that portion of the work fully completed and accepted. Each payment shall be made under the terms and conditions governing fmal payment,except that it shall not constitute a waiver of claims. 2fPage IN WITNESS WHEREOF,the parties hereto have executed this Agreement in three(3)counterparts, each of which shall be deemed an original,in the year and day first mentioned above. OWNER: AUGUSTA,GEORGIA , ..._ r :A' 't skill bl) A 1 1,EST:- ,-.4''"*"."'"N.„-- IA SEAL. 1111P IF d ,70° A i By 'f Bi:•- of ° * 1 The llonorabIejdwDavis,Jr. LenaJ.Bonnet ' e I ' . if • iv Mayor Clerk of • - CoL • ••- :ion a' ; ir" t Date: Date: al if hI . i APPROVED AS TO FORM: , DEPARTMENT APPROVAL: f By: B Ali ikdd/(04 (.4-4511A . y. re Thomas D.Wiedmeier Attorney Director,Augusta Utilities Department Date:_______ Date: 'Z. Iq 1 CONTRACTOR: N. r --N\ ATTEST: SEAL 11111L 1 - - —........c By: 4---4 Name: 6a-t>" 'A **e C.. .k.V.C4 ) V IQ. Name: ilet-cet- Title: 1 Title: A/ 1 k C- Date: I - 0.8—ic\ Date: ., \e ...... -. ... ..cy ,.. - ~ :'• ‘Aotar.i. (1-; or- :33: S S\1.0 .• 0'ft 0.C3: lb ..". 1 .Z.0 * ......:.... % "ilistiii‘t0 Wage Premium Based on Final Contract price. Bond No:SB 0611049 -PERFolittaNetriOlkm- KM; is soiz;is issu §-AWL, TOV , qE6; IN FAVOR OF THE OWNER_CONDITIONED FOR 11th PAYMENT OF-LABOR AND I4; IAL) KNOW ALL MOT Hy:THESE RENRINTS: That ,George E.Petrea,Jr., Inc. DBA Southern Series _ Principal, hereinafter called Contractor,and Pennsylvania National Mutual Casualty Insurance Company,i'ccgporatiOn organized and existing ainder the laws of the State of Pennsylvania withittprin4a1 05.1**-tho City of Harnsburg _ •Stateof Pennsylvania as-Surety, ttereihafter called Surety, are held and rfninly bound-unto_AUGUSTA, GEORGIA BY-jtNall'IROUGIT THE AUGUSTA COMMISSION:as Obligee,:hereinaftercalledtheOwner, in the penal atnettut of RftFeurihaMand•TWentY Sev" Dollars ($54,027.00***) for. the payment--whereof Contractor and Stirety bind ther.P.sellfOS,their11043,*_011441i Oavioigratorgiauc4eStors,lind tisSigns,16intly and severally,fa wly-by thesepresents for theraithfiil-performance of a certain writtenagreetnelif, WHEREAS,-Contract hasby-said writtenta-greenientdated _ _ _ _ entered in to azontract with owitefr the Sanitifir Sewer Ceinfeetiimi Servieet-TaskOrder Progrant in accordance* drawings and specifications issued by the-AninstaPtilities:Department and,the Augusta4ichniondCounty- C onirnission, which contract is by reference blade a part berect -and is hereinafter refenzd to as the CONTRACT. NOW,THEREFORE,the tenditibn nbligtt*IniS such that if Contractor shall promptly and 1i4thfitilY Teiforanaajd CONTRACT,theit-thisObligation shall be null and ifojct 0.tiktv.404:441i##00610altforcP aid fiL The:Surety-hereby waives-notice of any alteration-or extension oftfine made-by the .411? :Whenever Contractot shall he, and declared 'hy Owner to he in default -under ,,the CONTIZACT, rha OwUfif :-.1uitinit terfortried Owner's ulifinktiortS th *mdr ihe 'Surety may txkinirlykeipt*th4 defAik.oi-kii-aft promptly .0.) :ComPlate the CONTRACT-in accordance willtift terms andeonditionsfor c2) -Obtain a bid otbids foroomplotin" g.the Conine:tin acoonirmcembitits terms and=aka* and uport_detenninationby Surety of the lowestrevonsiblebidderf.or;ifthe:Ovinerelecist upon by thnOwner anti:the Surety joindynt tholowest rosponaibletiddtr, arrange for 41,contract between.such:bidder and.Owner;-and.make available as Work 13rrinreaaea(even touglrthereihould he adefaults succession of defhultsimderthe.toriiract occontracts orcompletionerrangertunder this paragrapVnifficient fimdatopaythe(toad completion-less,the heance;of the contraaprics-huinotexceedineeinoluding otheroosts allttdairiagcs:forwhiclithe Sizety may beliableberetmdche amountsetfortb in thcabt- paragraph bereot.The term Thalance ofthecontractprice;transact in this paragraph,matt mean the stital-amount payable by-Owner to.-Contractor =der=the Contract:and any arnendreeets iterate;less tlie,emountyropeitypaid'iy:rivnierio'Conirsetor AW:sni -10:tist be titubod b.titere:AkkOmittkOtiPtt*glii-YfaMjcstiliiit01*-64--W*rWali payment under-theCONTRACT-faas due., No-tation-sil 4-eifO:i.eoitAtikhOinfteivi:fottlIkiikebit itrtyfikkano4gotliotutibq Oh*:then the6-.v.: nenactl:b:ercia-,w tlxclicirs,,executors,gdininistratomcrancc_essompf-the Owner. Signedpo,se.A.R.4--:Op 3gth. tortif January A DA019 . : /....¢, '• s-'On .-.:- ,,A ; Ns:'''' •e 0. ':: , ...‘ „ ... -,,, ,__. George E.Petrea,Jr.,kw MA Southern Services 1-8d0) — ' • ... •••••"'' i 0): ' • teontrackrr —•• p \c, i )--z. ••.:, / : ub 0.... 1".."0.\•If rii 2 9,252.2"....62'%'*'*'. 441110 likl Oil Ain - Attest ,_ ,., 00,7 *******NA,” - :. -...._1 •:116,A,:. 0116., Jet /I'liticifutto‘‘‘ — zittje) *Atte= -W TO' At idp...4•1 ifPeonsrumia NalattallilluloalCasualky insuiaaceCcelPint - :•.; -'777-.---------' Kathy S.Sm 1 ,Witness ,_§-ki_eth r. • . _ r - ) AP . ' limas, 119 A A i Rena Moss,Witness ititle)-- _ _.-- ;___ Robert M.Hrehor,Amey-ii ., . . $1144 Premium Based on Final Contract Price. - Bond No:SB 0611048 LABOR ATM MATERIAL PAYMENT BOND (NOTE: THIS BOND IS ISSUED SIMULTANEO LY :Pk OI CE.BO.FtD ON PAGE 4,. N FAVOR OF I Ub OWNER CO DiTIONED FORVTHEPAYMENI`OF LABOR:AND MATE .): KNOW ALL MEN-BY THESE PRENSENTS: That George E. Petrea,Jr., Inc. DBA Southern Services as Principal, hereinafter called . Contractor,and Pennsylvania National Mutual Casualty Insurance company-,a corporatiaaorganized and existing-under the lawsofthe state-of Pennsylvania .,withitsprimcipaloffioe: tve-City.Of'Harrisburg „-S'tatcof Pennsylvania , as Surety,hereinafter:called Surety,are held and:firmly bound oto AUGUSTA, GEORGIA.BY-AND THROUGIITHE AUGUSTA_.COMNII'SSIG$!Ls Obligesberein after:called the Owner for the use andbenefit of claunanis asberem below deflnedmthe amount of Fey Four Thousand,Twenty Seven O .Do - 0 54,027:00"'" _)for 1'te payment Nifncrcok-COntraOtorf and Surety bind themselves,.their yrs,executor`s, ;administrators,successors,and assigns,jointly-and severally;fi.rml. yby these• ts- -WHEREAS,contract Thylkritten'ajgeOrnent dated._. - ---.__ entered into a contract with Owner for theSanitary sewer Connection-Services TaskOrder Pr-on ram in accordance-with the drawings and apecifieations .ed bj the Augusta. Utilities Di em and the Auigusta It climtiriid Cf:410 :Commission;which contract is by=t reference made a part.hereof, and is hereinafter-referred to.as the 0011 BA.C1 ,NOW4-THEREFORE!the conditiono€-this;obligation is suchilii.Ofihe Contractor shaltptum.PRy-> e payutenttoallclaiman .aaberematferdefined,forall.laboraudtnatotiat l-orreasoualZlpTequuedtabu the performance of*pwritAcTiltatlijol4ligation ll be- oid;other d:Otallrentakin full force .and ems,subject;li©wcczer to thel`olidwing Conditions:: (1) A claimant is..define as_one having:a duct nontraet-with the Contractor or witlr.a subcontractor of the Contractorfor--labor;material,or Whinged or reasonably for usein theperformance.ofthec conked"labor andmaterialbeing construed as to°incjnde'that ;part of water,.,gas:?ower,iii t, heat,ml;- soline;telephone service or rental of equipment. directlyappl cable to,the CONTRACT (2) Tho above named Contractor and Surety hereby jerntly and severally agree with the OST4 _r- who_as-a tbeen.paithnfull before#he that everyrlainant WI**defined, exglicahpn afa VON-of nlmt ty f 90)1days the-date on which the last 044 claimant's wort or labor was-done or.IerLbrin_ed, r matenafs'were sht _liysueh claimant; ,ysue WO*togilf, for the_use-ofsch clasmaatprosecute_the sitt final jtugumentfor sum.-orsnmsas may be justly true claimiai t,-and:iave:ejeemtio thereon,The Owner Si*not be liable for the payment of any costa or expenses ofanysneb suit, •(3) No*lit or action tirP c9101n00.0.he.M14derl).Y:A4Y (a) Unless OVItnitfut.otherthan,911.q..:114174 a:4iO4P9P4:ra4-30t4 the Contractor,shalt have given written notice to twoc0.heffOgowing:-.The tunfractor,theCiwner;or theSurety above named, within Ininety (90) days after such claimant did or Pdformi*the last eft*work or:100; rAintiihg4 the of*-:A114cvials:fOr which said claim is Inocle,:ste:ft-wirli*bStorttiel.accuracy the aMonnteiainied and the namleo/tbeflaTtYkitithersflic-matenala-wet*41tnishekt5tfa-r7:41anili -ntkcir. labor was done tiellOrfettired,$1141**ice shalt be setved.bPSitiht ti*Stfr.*e,ki registered ntiailUrcertiOed mail,ricistitgenrepaiii,in an envelope iaddressed to the Contractor,Owner OrzaUTPtyl at auyillace*hexe.411-04cP-Tegrt44V41*"flif4 for the transaction of business,or served inmanner i**1300licilaiigrPflaYli‘c- setired in the stateinthe**sold tirsiAct oetted,save that such gen4ce. need not be:markby a pihflcodftcep (b) After the expiration of one(i):-year following the-dateonWhich:Contractor ceased work on.544 CONTRACT,it beingunderstood..INtwWer; thatif my limitation. embediedin thi bona is prohibited the 51)0a.ilittit.410,shall be-deemed tobe amended so as to be equal totheinmimum POO of fittliAtIPAIStwittgcl f;Y-$401.141Y- 1.0 Other than in.a.stat000tntottorvetenktaiiaafction in and:fOr the county or other pohtical subdivision of the gat iovi.414 diewpiept.#:Tatiy-pqrt 02P0.4 issiiustedi or-in:01e United$tateg:Oialikt Ciwg-f9r*-8istilet**461111Ad Ig9iPctig.rtitnrPflrt ttietilOt iS Aitn-40,111(11.19(-OseOttO, (4) The amount of this boitsa4-wvf)61,01.1pdfl hyena to the extent of any-Ftyntent.-cit_paypents made in gnadraiditereMidetrineinsA*eut-die pay :1;47$ lift* *11 imay be filed ategoA-4:agliiiikto44 lotovoitoot*ihqttoroot diain14-410:4631titufsorwrit. bt-prwelit.41 Under and agitinst*IS Onnd,„ Sii01.0.1Aaktitethille3011dayf January ,o° ta Witco A _511k/6. ••-• Gfotve E.Pelted,Jr,Inc.Dim Southern Services"Ittedy Pubv‘o (L)- (Contractor) Olt • .??:. \ 1\ Attest /I' • C ; • , Witness int' 41.1, 411411or Pennsylvania Nahum!Mutual Casa*Insurance Conemany 4 Kathy S.Smith,Witness (SuretY) - OF .W4 A -- ( / 4.44 Orgiimie Ren C.Moss,Witness (Title} P-a r_ Robert M.Hrehor,Attorney-in-Fact PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY Harrisburg,Pennsylvania ` POWER OF ATTORNEY Know All Men By these Presents,That PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY,a corporation of the Commonwealth of Pennsylvania,does hereby make,constitute and appoint Robert M.Hrehor ,of L€lburn,GA its true and lawful Attorney-in-Fact to make,execute,seal and deliver for and on its behalf,as surety,as its act and deed: ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING EXCEEDS THE SUM OF TEN MILLION DOLLARS (510,000,000.00). BondNtmaber:SB 0611149 Principal:George E. Petrea,Jr., Inc. DBA Southern Services Obligee Augusta, Georgia by and through The Augusta Commission AIL POWER AND AUTHORITY HEREBY CONFERRED SHALL HERESY EXPIRE AND TERMINATE WITHOUT NOTICE AT MIDNIGHT ON OCTOBER 31,2020,AS RESPECTS EXECUTION SUBSEQUENT THERETO. And the execution of such bonds in pursuance of these presents shall be as binding upon said Company as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its officein Harrisburg, Pennsylvania,in their own proper persons. This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on October 24,1973 at Harrisburg,Pennsylvania which is shown below and is now in full force and effect. RESOLVED,that(1)the President,any Vice President,the Secretary,or any Department Secretary shall have power to appoint,and to revoke the appointments ot;Atto neys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney,and to execute on behalf of the Company,and affix the Company's seal thereto,bonds,wings,recognizance's,contracts ofindemnity and other written obligations in the nature thereof or related thereto;and(2)any of such Officers of the Company may appoint and revoke the appointments ofjoint-control custodians, agents for acceptance of process,and Attorneys-in-Fact with authority to execute waivers and consents on behalf of the Company;and(3)the signature of any such Officer or of any Assistant Secretary or Department Assistant Secretary and the Company seal may be affixed by facsimle to any power of attorney or certification given for the execution of any bowl,undertaking,recognizance,contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seal when so used whether heretofore or hereafter,being hereby adopted by the Company as the original signature of such Officer and the original seal of the Company,to be valid and binding upon the Company with the mine force and effect as though manually affixed. In Witness Whereof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these presents to be signed and its corporate seal to be hereto affixed on November 1,2016. PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY 141.'1)4) sir Mark F yr ' d,Vice President-Surety Commonwealth of Pennsylvania,County of Dauphin—ss: On November 1,2016,before me appeared Mark Fitzgerald to me personally known,who being by me duly sworn,did say that he resides in the New Jersey,that he is the Vice President—Surety of PENNSYLVANIANATIONAL MUTUAL CASUALTY INSURANCE COMPANY,that he is the individual described m and who executed the preceding instrument,and that the seal affixed to said instrument is the corporate seal of said Company,and that said instrument was signed and sealed on behalf of said Company by authority and direction of said Company,and the said office acknowledged said instrument to be the free act and deed of said Company. TH OF PENNSYLVANIA • - a Macula Saar •ffionnipu®W Traci AMunich,Notary PublicLel, . a.• • ' tmyOf� t% h iltjrCoem 31,3020 NotmyPublic Member,Pennsylvania Assoda ion of Notaries 1,Mark Fitzgerald,Vice President—Surety of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY,a corporation of the Commonwealth of Pennsylvania,do hereby certify that the above and foregoing is a true and correct copy ofaPower ofAttomey, executed by the said Company,which is still in fall force and effect. 616161/4444, In Witness Whereof;I have hereunto set my hand and affixed the corporate seal of said Company on January 30,201-9 ' vice -:,,,:,r/,, : . eft 78-190e(Rev 10/2012) APPENDIX 1. Bid Document of Awarded Lots 2. Property Owner Acceptance 8 ( Page Southern Services SSCP, Phase 2 Group 8 y3x .Y a #3d s, a tinyzr t .a3`c - '�h' "' � A „a' 1 2573 Anthony DeJuan Pkwy, Hephzibah, GA 30815-5932 $ 2,484.00 2 1128 Azalea Dr, Augusta, GA 30904 $ 3,791.00 3 3915 Barlow Rd, Hephzibah, GA 30815 $ 3,232.00 4 2027 Boykin Rd, Augusta, GA 30906 $ 3,524.00 5 3517 Bullock Ave, Augusta, GA 30906 $ 3,020.00 6 3782 Fairington Dr, Hephzibah, GA 30815 $ 3,815.00 7 3790 Fairington Dr, Hephzibah, GA 30815 $ 2,290.00 8 3914 Grape Ave, Augusta, GA 30909 $ 3,398.00 9 2504 Inverness Dr, Hephzibah, GA 30815 $ 2,489.00 10 1922 Murphey Rd, Augusta, GA 30904 $ 3,280.00 11 3746 Pinnacle Place Dr, Hephzibah, GA 30815 $ 6,348.00 12 3914 Ruth St, Augusta, GA 30909 $ 3,800.00 13 2118 Sibley Rd, Augusta, GA 30909 $ 2,589.00 14 3220 Ware Rd, Augusta, GA 30909 $ 4,998.00 15 4232 White Pine Ct, Augusta, GA 30906 $ 4,969.00 16 17 18 19 -■ 20 PO # TOTAL AMOUNT AWARDED: $ 54,027.00 UTILITIES DEPARTMENT Tom Wiedmeier,P.E. Marie Corbin,P.E. G OR 0 1 A Director Assistant Director Sanitary Sewer Connection Program Final Liability Waiver and Release Address of property for which consent for entry and access being granted: Relationship to property: (i.e., owner, owner's representative, tenant, etc.) OWNER NAME: MAILING ADDRESS: PHONE NUMBER: The undersigned is (are) the owner(s), their representative(s), or otherwise control the real property at the location described above. I, the property owner listed above, participated in the Augusta, Georgia Sanitary Sewer Connection Program, and as such, consented to and authorized employees and authorized representatives of the Augusta Utilities Department, and employees and authorized representatives of Universal Plumbing, Southern Services Stark Plumbing, and/or Earl Babbitt Plumbing to access my property in order to perform the required actions to complete the following: 1. verify location and depth of my sewer service;verify 2. location and depth of my septic tank; 3 survey my property for the sole purpose of collecting the necessary data to determine if or how I could be connected to the Augusta sewer; abandonment of Septic Tank; 4. rerouting of plumbing to connect to Augusta,Georgia's sewer system;restoration of 5. landscaping and property to original state; and; 6. (Other) 7. I understand and acknowledge that Sanitary Sewer Connection Program (SSCP) is a program through which the Augusta Utilities Department (AUD) engaged plumbers pursuant to RFQ 16- 205 to abandon my septic tank and reroute the plumbing to connect to Augusta's sewer system; I acknowledge that the cost I paid, or have been invoiced and agree to pay, to participate in the SSCP was a flat rate of Ten Dollars ($10.00) to be paid by the property owner, and further that thereafter, the property owner/occupant will receive and be responsible for paying a monthly sewer bill; I understand and acknowledge that the improvements shall remain with the property thus belonging to the property owner and therefore shall become the responsibility of the property owner to maintain. The work will be guaranteed by a one (1) year warranty between the plumber (Universal Plumbing, Southern Services, Stark Plumbing, and/or Earl Babbitt Plumbing) and the homeowner. Augusta shall not be responsible for the maintenance or repair of the private sewer I acknowledge that I was provided the opportunity to review the work for the SSCP and have executed a Final Inspection form and provided any and all concerns and issues related to work done to my property in regards to the SSCP has been satisfactorily completed, and there are no remaining issues at this time; Therefore, I agree to the following as it relates to the following entities or persons: Augusta, Georgia, its Mayor, its Commissioners and their directors, officers, employees, contractors, representatives, and agents; Universal Plumbing, Southern Services, Stark Plumbing,and/or Earl Babbitt Plumbing, their officers, employees, directors, contractors, representatives, and agents, (collectively referred RELEASEES): I (we) understand, agree, and acknowledge that Augusta, Georgia, its Mayor, its Commissioners and their directors, officers, employees, representatives, and agents are NOT responsible for the errors, omissions, acts, or failure to act to any party or entity as it relates to injury or property damage in regards to the above listed services in accordance with the AUGUSTA, GEORGIA SANITARY SEWER CONNECTION PROGRAM; I (we) WAIVE, RELEASE, AND DISCHARGE RELEASEES from any and all liability, including, but not limited to liability arising from the negligence or fault of the entities or persons releases, for personal injury, property damage, property theft, or actions of any kind which may hereafter occur in regards to the performing of the services as it relates to the; I (we) agree to HOLD HARMLESS AND PROMISE NOT TO BRING LEGAL ACTION against the RELEASEES from any and all liabilities or claims made as a result of participation in the Sanitary Sewer Connection Program; I (we) ASSUMED ALL OF THE RISKS OF PARTICIPATING IN THE AUGUSTA, GEORGIA SEWER CONNECTION PROGRAM; This release and waiver of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND JETS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. In witness thereof, this agreement has been executed on the date and place so written. PROPERTY OWNER AUGUSTA, GEORGIA Jarvis Sims Printed Name Printed Name Signature Signature Date Date Engineering Division 452 Walker Street,Ste 200-Augusta,GA 30901 Phone(706)312-4154 Fax(706)312-4123 or(706)312-4148 W W W.AUGUSTAGA.GOV