HomeMy WebLinkAboutSANITARY SEWER CONNECTION SERVICES AGREEMENT BETWEEN AUGUSTA, GEORGIA AND UNIVERSAL PLUMBING (2) This SUMPLEMENTAL AGREEMENT,made on the --y)
day of N 1 to the
Cl 20 8
AGREEMENT,approved by the Augusta Commission on October 18,2016 negoti ed on the 14th of March
2018.
by and between
AUGUSTA,GEORGIA,BY AND THROUGH THE AUGUSTA-RICHMOND COUNTY
COMMISSION,party of the first part,hereinafter called the OWNER, and Universal Plumbing,
party of the second part,hereinafter called the CONTRACTOR.
WITNES SETH, 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 5-BID ITEM#18-168
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.
11Page
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 fmal 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 final 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 fmal 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 final payment,except that it shall not
constitute a waiver of claims.
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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
ATTEST. :w.ib.:*1,:,„,,C&7"0:..% EAL
*$
9.1/4-
By: B : lii!'I _ .�4 ! I'111��',
The Honorable Hardie Davis,Jr. Lena J. ontlier',:':i-Pi -':2:`
'��' , `
:% ,11t,- S
tYw' t i
Mayor Clerk o �ommi Zo
Date: 5 f �2 � ' Date: i 1 Arai /
i 4 4 i e de'444 toctor, .1eJt.
APPROVED AS TO FORM: DEPARTMENT APPROVAL:
By: 4, / / ' 7 ' Y.
Thomas D. Wiedmeier
Attorney Director,Augusta Utilities Department
Date: 5-0/Ig Date: 3"7(op eb
CONTRACTOR:
'� ATTEST: SEAL
H4Arillialrill.. -
BY: CI QaJls.tkA V4'14-0
Name: Lai' L J11PF Name:C) Q.t l Gt L 0._ /or-5
Title: �ir-IG4--nt Title: CO fp atf '
Date: .S J7 J16S Date: 517/IS
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PERFORMANCE BOND
(NOTE: THIS BOND IS ISSUED SIMULTANEOUSLY WITH PAYMENT BOND ON PAGE 6,
IN FAVOR OF THE OWNER CONDITIONED FOR TIIF PAYMENT OF LABOR
AND MATERIAL)
KNOW ALL MEN BY THESE PRENSENTS:
That Universal Plumbing Co. as Principal, hereinafter called
Contractor,and Travelers Casualty_&Surety Co.of America ,a corporation organized and existing under the
laws of the State of Connecticut y,with its principal office in the City of Hartford ,State of
Connecticut , as Surety, hereinafter called Surety, are held and firmly bound unto AUGUSTA,
GEORGIA BY ANI)'Ii tROUGH T11E AUGUSTA COMMISSION as Obligee,herein after called the Owner,
in the penal amount ofThiny-three thousandfourhundredninety-4 ollars (533,495.00 ) for the payment whereof
Contractor and Surety hind themselves,their heirs,executors,administrators,successors,and assigns,jointly
and severally,firmly by these presents for the faithful performance of a certain written agreement.
WHEREAS,Contract has by said written agreement dated entered in to a contract
with Owner for the Sanitary Sewer Connection Services Task Order Program in accordance with the
drawings and specifications issued by the Augusta Utilities Department and the Augusta-Richmond County
Commission, which contract is by reference made a part hereof, and is hereinafter referred to as the
CONTRACT.
NOW,IllFRFFORE,the condition of this obligation is such that,if Contractor shall promptly and faithfully
perform said CONTRACT,then this obligation shall be null and void;otherwise it shall remain in fill force
and effect.
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Bond 106828768
***Sanitary Sewer Connection Service Phase 2-Group 5
4
Whenever Contractor shall be, and declared by Owner to be in default under the
CONTRACT, the Owner having performed Owner's obligations thereunder, the Surety may
promptly remedy the default, or shall promptly
(1) Complete the CONTRACT in accordance with its terms and conditions, or
(2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions,
and upon determination by Surety of the lowest responsible bidder,or,if the Owner elects,
upon determination by the Owner and the Surety jointly of the lowest responsible bidder,
arrange for a contract between such bidder and Owner, and make available as Work
progresses(even though there should be a default a succession of defaults under the contract
or contracts of completion arranged under this paragraph)sufficient funds to pay the cost of
completion less the balance of the contract price; but not exceeding, including other costs
and damages for which the Surety may be liable hereunder,the amount set forth in the first
paragraph hereof. The term "balance of the contract price,"as used in this paragraph, shall
mean the total amount payable by Owner to Contractor under the Contract and any
amendments thereto, less the amount properly paid by Owner to Contractor
Any suit under this bond must be instituted before the expiration of two(2)years from the date on which final
payment under the CONTRACT falls due.
No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner
named herein or the heirs, executors, administrators or successors of the Owner.
Signed and sealed this 50w1 day of A?ri 1 A. D. 20d
4att_ .
/ 1111L'moi
Witness � f.LlO� 1►' .0 WW ' 'i- (Seal)
ntractor)
Attest Ca&GUI Ca Jorie By f�-j L. 002°5 (Seal)
J
(Title)-?(C.)i cttrit,
Witness (Seal)
(Surety)
Witness By (Seal)
(Title)
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LABOR AND MATERIAL PAYMENT BOND
(NOTE: THIS BOND IS ISSUED SIMULTANEOUSLY WITH PERFORMANCE BOND ON
PAGE 4, IN FAVOR OF THE OWNER CONDITIONED FOR THE PAYMENT OF
LABOR AND MATERIAL.)
KNOW ALL MEN BY THESE PRENSENTS:
That Universal Plumbing Co. as Principal, hereinafter called
Contractor,and Travelers Casulty&Surety Co.of America a corporation organized and existing under the
laws of the State of Connecticut ,with its principal office in the City of Hartford ,State of
Connecticut , as Surety, hereinafter called Surety, are held and firmly bound unto AUGUSTA,
GEORGIA BY AND THROUGI I THE AUGUSTA COMMISSION as Obligee,herein after called the Owner,
for the use and benefit of claimants as herein below defined in the amount of Thirty-three thousand four hundred ninety-five Dollars
($33,495.00--------- ) for the payment whereof Contractor and Surety bind themselves, their heirs, executors,
administrators,successors,and assigns,jointly and severally, firmly by these presents.
WHEREAS,Contract has by written agreement dated entered in to a contract with
Owner for the Sanitary Sewer Connection Services Task Order Program in accordance with the drawings
and specifications issued by the Augusta Utilities Department and the Augusta-Richmond County
Commission, which contract is by reference made a part hereof, and is hereinafter referred to as the
CON TR ACT.
NOW, THEREFORE, the condition of this obligation is such that, if the Contractor shall promptly make
payment to all claimants as hereinafter defined,for all labor and material used or reasonably required to use in
the performance of the CONTRACT,then this obligation shall be void;otherwise it shall remain in full force
and effect, subject,however, to the following conditions:
(I) A claimant is defined as one having a direct contract with the Contractor or with a
subcontractor of the Contractor for labor,material,or both, used or reasonably required for
use in the performance of the contract, labor and material being construed as to include that
part of water.gas,power, light,heat,oil, gasoline.telephone service or rental of equipment
directly applicable to the CONTRACT.
(2) The above named Contractor and Surety hereby jointly and severally agree with the Owner
that every claimant as herein defined,who has not been paid in full before the expiration of a
period of ninety(90)days after the date on which the last of such claimant's work or labor
was done or performed,or materials were furnished by such claimant,may sue on this bond
for the use of such claimant,prosecute the suit to final judgment for such sum or sums as may
be justly due claimant, and have execution thereon. The Owner shall not be liable for the
payment of any costs or expenses of any such suit.
6 I ..
Bond: 106828768
(3) No suit or action shall be commenced hereunder by any claimant,
(a) Unless claimant, other than one having a direct contract with the Contractor, shall
have given written notice to any two of the following:The Contractor,the Owner,or
the Surety above named, within ninety (90) days after such claimant did or
performed the last of the work or labor, or furnished the last of the materials for
which said claim is made,stating with substantial accuracy the amount claimed and
the name of the party to whom the materials were furnished,or for whom the work or
labor was done or performed. Such notice shall be served by mailing the same by
registered mail or certified mail,postage prepaid, in an envelope addressed to the
Contractor,Owner or Surety,at any place where an office regularly maintained for
the transaction of husiness,or served in any manner in which legal process may be
served in the state in which the aforesaid project is located, save that such service
need not he made by a public officer.
(h) After the expiration of one(1)year following the date on which Contractor ceased
work on said CONTRACT, it being understood, however, that if any limitation
embodied in this bond is prohibited by any law controlling the construction hereof,
such limitation shall be deemed to he amended so as to he equal to the minimum
period of limitation permitted by such law.
(c) Other than in a state court of competent jurisdiction in and for the county or other
political subdivision of the state in which the project,or any part thereof,is situated,
or in the United States District Court for the district in which the project,or any part
thereof,is situated,and not elsewhere.
(4) The amount of this bond shall he reduced by and to the extent of any payment or payments
made in good faith hereunder,inclusive of the payment by Surety of mechanics'liens which
may be filed of record against said improvement,whether or not claim for the amount of such
lien he presented under and against this bond.
Signed and sealed this 30th day of April A. D. 2(118 .
Witness Universal Plumbing Co. (Seal)
(Contractor)
Attest By $
• 'V/'vo
eiattaLar Jt le
Witness Travelers Casualty&Surety Co.of America(Seal)
(Surety)
Witness y )
A. ley L.S aVTle) Attorney-In-Fact
7 „ L
Bond: 106828768
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
.A► POWER OF ATTORNEY
TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. 230060 Certificate No. 00654 401 6
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
Morris H. Moss,Preston A. Moss,and Ashley L. Smith
of the City of Augusta ,State of Georgia ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 20th
day of October 2015
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
rsu
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State of Connecticut By:
, ' "x'.�,(�/�ej./�
City of Hartford ss. Robert L.Raney, eniS or Vice President
On this the 20th of October 2015
Y , ,before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
to•Ter44_
/�In Witness Whereof,I hereunto set my hand and official seal. `� ��(/�+ l� . `1
My Commission expires the 30th day of June,2016. „.,PUBU�,* Marie C.Tetreault,Notary Public
58440-8-12 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
.A. POWER OF ATTORNEY
TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. 230060 Certificate No. 006544 011
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
Morris H. Moss,Preston A. Moss,and Ashley L. Smith
of the City of Augusta ,State of Georgia their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 20th
day of October 2015
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
N
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Z -. 4r = co; 'E E ._ .n a HARTFORD + 'S HARTFORD.
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State of Connecticut %= �
By:
City of Hartford ss. Robert L.Raney, enior Vice President
On this the 20th dayof October 2015
, ,before me personally appeared Robert L.Raney.who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
TETVIn Witness Whereof,I hereunto set my hand and official seal. ft.
.'1;M Nc( W 4eC
•My Commission expires the 30th day of June,2016. CpM"G *Marie C.Tetreault,Notary Public
1
NY
58440-8-12 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
APPENDIX
1. Bid Document of Awarded Lots
2. Property Owner Acceptance
Wage
UNIVERSAL-SSCP PHASE 2
GROUP 5 ADDRESS BID PRICE
1 3831 Highpointe Dr, Hephzibah,GA, 30815 $2,900.00
2 3704 Beacon Hill Dr, Hephzibah, GA, 30815 $2,920.00
3 2615 Anthony DeJuan Parkway, Hephzibah, GA 30815 $2,875.00
4 3610 Karleen Rd, Hephzibah, GA, 30815 $3,000.00
5 3614 Karleen Rd, Hephzibah, GA, 30815 $2,800.00
6 4224 White Pine Ct,Augusta, GA, 30906 $1,600.00
7 4315 White Pine Ct,Augusta, GA, 30906 $1,800.00
8 4321 White Pine Ct,Augusta, GA, 30906 $2,200.00
9 4417 Elk Grove TrI,Augusta, GA, 30906 $1,800.00
10 4430 Elk Grove TrI,Augusta, GA, 30906 $3,500.00
11 3815 Crest Dr, Hephzibah, GA, 30815 $2,700.00
12 3861 Crest Dr, Hephzibah, GA, 30815 $2,800.00
13 2012 Westfield Drive,Augusta GA 30909 $2,600.00
14
15
16
17
18
19
20
TOTAL AMOUNT AWARDED: $33,495.00
UTILITIES DEPARTMENT
—/ -
Tom Wiedmeier P.E. Marie Corbin,P.E.
...........,..4...4G ' O R C 1 -1..
< A Director Assistant Director
Sanitary Sewer Connection Program
Final Liability Waiver and Release
Address of.ropert for which consent for entr and access being granted:
Relationship to property:
(i.e., owner, owner's representative, tenant, etc.)
OWNER NAME:
MAILING ADDRESS:
PHONE NUMBER&E-mail:
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( ) gee 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.
j CERTIFY THAT I HAVE READ THIS DOCUMENT. AND I FULLY UNDERSTAND
ITS 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
Janice Allen Jackson
Printed Name Printed Name
Signature Signature
Date Date
Engineering Division
452 Walker Street, Suite 200
Augusta, GA 30901
Phone: (706) 312-4154
www.augustaga.gov