CONTRACT ACCEPTANCE AND EXECUTION. The City Council of Fernley, Nevada, at their publicly noticed meeting of , 20 , approved the acceptance of this Contract. Further, the City Council authorizes the Mayor of Fernley, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. FERNLEY: XXX XXXXXXXXX XX, MAYOR DATED this day of , 20 . ATTEST: XXX XXXXXXX, CITY CLERK DATED this day of , 20 . , being first duly sworn, deposes and says: That is the Contractor; that has read the foregoing Contract; and that understands the terms, conditions, and requirements thereof. CONTRACTOR BY: TITLE: FIRM: BUSINESS LICENSE #: Address: City: State: Zip Code: Telephone: / Fax #: E-mail Address: _ (Signature of Contractor) DATED this day of , 20 . STATE OF ) ) ss County of ) On this day of , in the year 20 , before me, / Notary Public, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowledged that he executed it. WITNESS my hand and official seal. Notary's Signature
CONTRACT ACCEPTANCE AND EXECUTION. The Board of Supervisors for Carson City, Nevada at their publicly noticed meeting of August 15, 2019 approved the acceptance of the attached Contract hereinbefore identified as CONTRACT No. 19300022. Further, the Board of Supervisors authorizes the Mayor of Carson City, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. CARSON CITY, NEVADA ATTEST: XXXXXX X. XXXXXXX, MAYOR DATED this 15th day of August, 2019. XXXXXX XXXXXXX, CLERK-RECORDER
CONTRACT ACCEPTANCE AND EXECUTION. The City Council of Fernley, Nevada, at their publicly noticed meeting of , 20 , approved the acceptance of this Contract. Further, the City Council authorizes the Mayor of Fernley, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. FERNLEY: XXX XXXXXXXXX, MAYOR DATED this day of , 20 . ATTEST: XXX XXXXXXX, CITY CLERK DATED this day of , 20 . , being first duly sworn, deposes and says: That is the Contractor; that has read the foregoing Contract; and that understands the terms, conditions, and requirements thereof. CONTRACTOR BY: TITLE: FIRM: BUSINESS LICENSE #: Address: City: State: Zip Code: Telephone: / Fax #: E-mail Address: (Signature of Contractor) DATED this day of , 20 . STATE OF ) ) ss County of ) On this day of , in the year 20 , before me, / Notary Public, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowledged that he executed it. WITNESS my hand and official seal. Notary's Signature My Commission Expires: ATTACHMENT A September 26, 2018 LA18.635 Xxxxxxx Xxxxx, E.I. Associate Engineer City of Fernley Public Works Department 000 Xxxxxx Xxxx Xxxx. Xxxxxxx, XX 00000 RE: Proposal for Engineering Services to Design a Waterline to Service the City of Fernley Wastewater Treatment Plant Dear Xx. Xxxxx: Lumos & Associates Inc. (Lumos) in pleased to provide this proposal for engineering services to design a potable waterline to serve the City of Fernley (City) Wastewater Treatment Plant (WWTP).
CONTRACT ACCEPTANCE AND EXECUTION. The Board of Supervisors for Carson City, Nevada at their publicly noticed meeting of December 15, 2016 approved the acceptance of the attached Contract hereinbefore identified as CONTRACT No. 1617-084. Further, the Board of Supervisors authorizes the Mayor of Carson City, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. CARSON CITY, NEVADA XXXXXX X. XXXXXXX, MAYOR DATED this 15th day of December, 2016. ATTEST: XXXXX XXXXXXXXXXX, CLERK-RECORDER DATED this 15th day of December, 2016. SAMPLE INVOICE Invoice Number: Invoice Date: Invoice Period: Vendor Number: Invoice shall be submitted to: Xxxxxx City Public Works Attn: Xxxxx Xxxxx 0000 Xxxxx Xxx Xxxxxx Xxxx XX 00000 Line Item # Description Unit Cost Units Completed Total $$ Total for this invoice Original Contract Sum $ Less amount previously billed $ = contract sum prior to this invoice $ Less this invoice $ =Dollars remaining on Contract $ ENCLOSE COPIES OF RECEIPTS & INVOICES FOR EXPENSES & OUTSIDE SERVICES November 22, 2016 Xxxxx Xxxxxxxx Utility Manager 0000 Xxxxx Xxx Xxxxxx Xxxx, XX 00000 Dear Xx. Xxxxxxxx, Eurofins Xxxxx Analytical, Inc. (EEA) is pleased to submit fees and qualifications for your 2017 through 2019 water quality testing contract. The following summarizes key aspects of our service to the City of Xxxxxx City making us uniquely qualified to continue under the new contract. • EEA provides in-house capabilities for all Safe Drinking Water Act testing with full Nevada certification therefore no subcontracting for any listed parameters resulting in tightly controlled quality assurance and reduced cost to the City. • EEA is Nevada’s most experienced and largest drinking water Laboratory, our clients include; Xxxxxx City, Truckee Meadow Water Authority (including Washoe County), Southern Nevada Water Authority and the State of Nevada Health Lab (providing statewide small system testing). We provide the City with comprehensive knowledge of the State’s compliance requirements and Lab-to- State reporting capabilities. • EEA is holding our fees for the next three years (unchanged for 6 years) providing the City with predictable low cost service to help the City manage budgets. This is achieved through our centralized laboratory business model, $1,000,000 plus annual technology investments and centralized purchasing power to keep costs down. • EEA has been working with the City continuously since 2002. We are f...
CONTRACT ACCEPTANCE AND EXECUTION. The Board of Supervisors for Carson City, Nevada at their publicly noticed meeting of February 6, 2020 approved the acceptance of the attached Contract hereinbefore identified as CONTRACT No. 1819-240. Further, the Board of Supervisors authorizes the Mayor of Carson City, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. CARSON CITY, NEVADA ATTEST: XXXXXX X. XXXXXXX, MAYOR DATED this 6th day of February 2020. XXXXXX XXXXXXX, CLERK-RECORDER DATED this 6th day of February 2020. SAMPLE INVOICE Invoice Number: Invoice Date: Invoice Period: Vendor Number: Invoice shall be submitted to: Xxxxxx City Public Works Attn: Xxxxxx Xxxxxxx 0000 Xxxxx Xxx Carson City NV 89701 Line Item # Description Unit Cost Units Completed Total $$ Total for this invoice Original Contract Sum $ Less amount previously billed $ = contract sum prior to this invoice $ Less this invoice $ =Dollars remaining on Contract $ ENCLOSE COPIES OF RECEIPTS & INVOICES FOR EXPENSES & OUTSIDE SERVICES Exhibit A
CONTRACT ACCEPTANCE AND EXECUTION. The City Council of Fernley, Nevada, at their publicly noticed meeting of , 20 , approved the acceptance of this Contract. Further, the City Council authorizes the Mayor of Fernley, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. FERNLEY: XXX XXXXXXXXX XX, MAYOR DATED this day of , 20 . ATTEST: XXX XXXXXXX, CITY CLERK DATED this day of , 20 . Xxx Xxxxxx, being first duly sworn, deposes and says: That Intermountain Slurry Seal Inc. is the Contractor; that Xxx Xxxxxx has read the foregoing Contract; and that Xxx Xxxxxx understands the terms, conditions, and requirements thereof. CONTRACTOR BY: Xxx Xxxxxx TITLE: Manager/Estimator FIRM: Intermountain Slurry Seal Inc. BUSINESS LICENSE #: Address: 0000 Xxxxxxxx Xxx City: Reno State: Nv Zip Code: 89502 Telephone: 000-000-0000 / Fax #: 000-000-0000 E-mail Address: (Signature of Contractor) DATED this day of , 20 . STATE OF ) ) ss County of ) On this day of , in the year 20 , before me, / Notary Public, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowledged that he executed it. WITNESS my hand and official seal. Notary's Signature
CONTRACT ACCEPTANCE AND EXECUTION. The City Council of Fernley, Nevada, at their publicly noticed meeting of , 20 , approved the acceptance of this Contract. Further, the City Council authorizes the Mayor of Fernley, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. FERNLEY: XXX XXXXXXXXX, MAYOR DATED this day of , 20 . ATTEST: XXX XXXXXXX, CITY CLERK DATED this day of , 20 . Xxxxx Xxxx, being first duly sworn, deposes and says: That Western Environmental Testing Laboratory (WETLAB) is the Contractor; that Xxxxx Xxxx has read the foregoing Contract; and that Xxxxx Xxxx understands the terms, conditions, and requirements thereof. CONTRACTOR BY: TITLE: FIRM: BUSINESS LICENSE #: Address: City: State: Zip Code: Telephone: / Fax #: E-mail Address: (Signature of Contractor) DATED this day of , 20 . STATE OF ) ) ss County of ) On this day of , in the year 20 , before me, / Notary Public, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowledged that he executed it. WITNESS my hand and official seal. Notary's Signature
CONTRACT ACCEPTANCE AND EXECUTION. The Board of Supervisors for Carson City, Nevada at their publicly noticed meeting of May 21, 2020, approved the acceptance of the attached Contract hereinbefore identified as CONTRACT No. 19300135 and titled Xxxx Street Fiber Optic Project. Further, the Board of Supervisors authorizes the Mayor of Carson City, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. CARSON CITY, NEVADA XXXXXX X. XXXXXXX, MAYOR DATED this 21st day of May, 2020. ATTEST: XXXXXX XXXXXXX, CLERK-RECORDER DATED this 21st day of May, 2020. Bond #: Doc. No. 2151 (Rev. 11-17-99) KNOW ALL MEN BY THESE PRESENTS, that I/we as Principal, hereinafter called CONTRACTOR, and a corporation duly organized under the laws of _, as Surety, hereinafter called the Surety, are held and firmly bound unto Carson City, Nevada a consolidated municipality of the State of Nevada, hereinafter called CITY, for the sum of $ (state sum in Words) for the payment whereof CONTRACTOR and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
CONTRACT ACCEPTANCE AND EXECUTION. The Board of Supervisors for Carson City, Nevada at their publicly noticed meeting of June 20 2019 approved the acceptance of the attached Contract hereinbefore identified as CONTRACT No. 1920-001. Further, the Board of Supervisors authorizes the Mayor of Carson City, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. CARSON CITY, NEVADA ATTEST: XXXXXX X. XXXXXXX, MAYOR DATED this 20th day of June, 2019. XXXXXX XXXXXXX, CLERK-RECORDER DATED this 20th day of June, 2019. FEE AND PAYMENT SCHEDULE Service Agreement Term: 7/1/19 – 6/30/22 Services: Fees: Claims Administration of: Workers’ Compensation, General Liability, Auto Liability, Law Enforcement Liability, E&O and EPL Claims CCMSI will manage all workers’ compensation claims for the Life of Agreement for an annual fee as follows: Workers’ Compensation: No Claim Cap July 1, 2019 – June 30, 2020 $28,750 July 1, 2020 – June 30, 2021 $30,187 July 1, 2021 – June 30, 2022 $31,696 Takeover Claims with Date of Injury Between $45.00 per month while 7/1/92-6/30/03 claim remains open Workers’ Compensation Claim Definitions Indemnity Claims – Claims involving lost-time, questionable compensability, legal involvement, subrogation, second injury fund, probable permanent impairment/disability, jurisdictional issues, coverage issues or claims involving complex issues that are assigned or transferred to the indemnity adjuster for claims handling. Medical Only Claims – Claims which have no issues of lost time, no evidence of other indemnity benefit exposure, no obvious question of compensability, no evidence of potential subrogation or second injury fund recovery, no evidence of problematic medical issues and no requirement or need for any formal statements. Report Only/Incident Only Claims – Reported claims which require only input into RMIS system and requires no claims management activity. CCMSI will manage all General Liability, Auto Liability, Law Enforcement Liability, E&O, and EPL claims for the Life of Agreement on a per-claim fee as follows: G/L – Bodily Injury $995.00 per claim A/L – Bodily Injury $995.00 per claim G/L – PD $550.00 per claim A/L – PD $550.00 per claim Law Enforcement Liability $1,025.00 per claim EPL/E&O Annual Administration • Designated client service team • Development of specific client service requirements • Monthly loss reporting • Quarterly claim reviews at client’s request • Issuance of 1099’s • ...
CONTRACT ACCEPTANCE AND EXECUTION. The City Council of Fernley, Nevada, at their publicly noticed meeting of _ , 20 , approved the acceptance of this Contract. Further, the City Council authorizes the Mayor of Fernley, Nevada to set his hand to this document and record his signature for the execution of this Contract in accordance with the action taken. FERNLEY: XXX XXXXXXXXX, MAYOR DATED this day of , 20 . ATTEST: XXX XXXXXXX, CITY CLERK DATED this day of , 20 . Western Nevada Supply, being first duly sworn, deposes and says: That Western Nevada Supply is the Contractor; that has read the foregoing Contract; and that he understands the terms, conditions, and requirements thereof. CONTRACTOR BY: TITLE:
