SCHEDULE C
FORM OF QUOTATION
Road Restoration Services No. 1220-040-2014-028
PAGE 35 OF 51
SCHEDULE C
FORM OF QUOTATION
RFQ Title: ROAD RESTORATION SERVICES
RFQ No:
1220-040-2014-028
CONTRACTOR
Legal Name: ___________________________________________________________________
Address:
___________________________________________________________________
Phone:
___________________________________________________________________
Fax:
___________________________________________________________________
Email:
___________________________________________________________________
TO:
City Representative: Richard D. Oppelt
Purchasing Manager
Address:
Courier/Hand Deliver:
Surrey City Hall
Finance & Technology Department – Purchasing Section
Reception Counter 5th Floor West
13450 – 104th Avenue, Surrey, BC, V3T 1V8
Telephone:
Email:
604-590-7274
purchasing@surrey.ca
1. The Contractor offers to supply to the City of Surrey the Work for the prices excluding applicable
taxes as follows:
F.O.B.
Payment Terms:
Ship Via:
Destination
A cash discount of ____% will be allowed if invoices are paid within ___ days, or
Freight Prepaid
the ___ day of the month following, or net 30 days, on a best effort basis.
Table: 1
REFERENCE
DESCRIPTION
MMCD
CITY
02223
SS 2.4
1.1
UNIT
UNIT PRICE
Pavement Patching (Interim / Temporary) 2 Lifts of Asphalt with No Milling
R.28
Major and Through Collector & Arterial Roads - Lower Course #1
R.28
(35mm & 65mm for surface & base respectively)
a)
< 50 sq.m
sq.m
$ ____________
b)
50 sq.m to 100 sq.m
sq.m
$ ____________
c)
100 sq.m to 200 sq.m
sq.m
$ ____________
Road Restoration Services No. 1220-040-2014-028
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d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1001 sq.m
sq.m
$ ____________
R.28
02223
SS 2.4
1.2
a)
< 50 sq.m
sq.m
$ ____________
b)
50 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
Pavement Patching (Interim / Temporary) 1 Lift of Asphalt with No Milling
R.28
SS 2.4
1.3
Major and Through Collector and Arterial Roads - Lower Course #1
(65mm)
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 1,000 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
R.28
02223
Local and Limited Collector Roads - Lower Course #2
(35mm & 50mm for surface & base respectively)
Local and Limited Collector Roads - Lower Course #2
(50mm)
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
Hot-Mix Pavement Patch (Permanent) 1 Lift of Asphalt with Milling
R.28
Major and Through Collector and Arterial Roads - Upper Course #1
(65 mm)
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,000 sq.m
sq.m
$ ____________
R.28
a)
Local and Limited Collector Roads - Upper Course #2
(50mm)
< 50 sq.m
Road Restoration Services No. 1220-040-2014-028
sq.m
$ ____________
PAGE 37 OF 51
02223
SS 2.4
1.4
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
Hot-Mix Pavement Patch (Permanent) Final Lift of Asphalt with No Milling
R.28
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
a)
Local and Limited Collector Roads - Upper Course #2
(35mm)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
R.28
02223
SS 2.4
1.5
Major and Through Collector and Arterial Roads - Upper Course #1
(35mm)
Hot-Mix Pavement Patch (Permanent) 1st & Final Lifts with Milling
R.28
Major and Through Collector and Arterial Roads – Lower & Upper Course #1
(35mm & 65mm for surface & base respectively)
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
a)
< 50 sq.m
sq.m
$ ____________
b)
51 sq.m to 100 sq.m
sq.m
$ ____________
c)
101 sq.m to 200 sq.m
sq.m
$ ____________
d)
201 sq.m to 500 sq.m
sq.m
$ ____________
R.28
$ ____________
Local and Limited Collector Roads – Lower & Upper Course #2
(35mm & 50mm for surface & base respectively)
Road Restoration Services No. 1220-040-2014-028
PAGE 38 OF 51
e)
501 sq.m to 1,000 sq.m
sq.m
$ ____________
f)
> 1,001 sq.m
sq.m
$ ____________
Table: 2
REFERENCE
MMC
D
2223
DESCRIPTION
CITY
SS 2.4
2234
2234
2233
2546
2547
2512
2.1
2.2
2512
2226
UNIT
SS 2.26
SS 2.5
SS 2.8
SS 2.8
SS 2.11
SS 2.11
SS 2.9
2.3
2.4
2.5
2.6
2.7
2.8
2.9
UNIT PRICE
(A)
QUANTITY
(B)
SUBTOTAL
RANGE/VISIT
(A) x (B)
Common Excavation
cu.m
$ ________
≤ 25
cu.m
$ ________
> 25
Hand Spread Asphalt (Items in Table 1 will be used for quantities ≥
2)
tonne
$ ________
<2
tonne
$ ________
≤50
tonne
$ ________
>50
sq.m
$ ________
≤750
sq.m
$ ________
>750
tonne
$ ________
≤50
tonne
$ ________
>50
tonne
$ ________
≤50
tonne
$ ________
>50
litre
$ ________
≤100
litre
$ ________
>100
litre
$ ________
≤100
litre
$ ________
>100
Sub Grade Fill (Granular)
Sub-grade Preparation
Sub-base (Granular)
Base (Granular)
Prime Coat
Tack Coat
Asphalt Pavement
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a
b
c
d
2.10
2226
2725
SS 2.17
Lower Course #2: Local
Upper Course #1: Arterial
& Collector
Upper Course #2: Local
tonne
$ ________
≤75
tonne
$ ________
>75
tonne
$ ________
≤75
tonne
$ ________
>75
tonne
$ ________
≤75
tonne
$ ________
>75
tonne
$ ________
≤75
tonne
$ ________
>75
tonne
$ ________
≤25
tonne
$ ________
>25
each
$ ________
≤3
each
$ ________
>3
each
$ ________
≤3
each
$ ________
>3
each
$ ________
≤3
each
$ ________
>3
each
$ ________
≤3
each
$ ________
>3
sq.m
$ ________
≤100
sq.m
$ ________
>100
m-cm
$ ________
≤150
m-cm
$ ________
151-500
m-cm
$ ________
>501
m-cm
$ ________
≤150
m-cm
$ ________
Gravel Shoulder Capping
2.11
Replace & Adjust Manhole Cover
a
Manhole Frame & Cover
Replacements
b
c
d
2210
Lower Course #1:
Arterial & Collector
2.12
2.13
Manhole Frame & Cover
Replacements
Manhole Cover
Replacements
Manhole Adjustment
Major
Shoulder Grading (only grading)
Saw Cut Pavement
Asphalt
Concrete
Road Restoration Services No. 1220-040-2014-028
151 - 300
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m-cm
2574
SS 2.7
2.14
Milling Existing Asphalt Pavement
a
Full Depth Milling (85mm 100mm)
b
2523
SS 2.12
2.15
a
b
c
d
2523
SS 2.12
2.16
a
b
c
2512
SS 2.11
2.17
2.18
Surface Milling (35mm –
50mm)
$ ________
>301
sq.m
$ ________
≤200
sq.m
$ ________
>200
sq.m
$ ________
≤200
sq.m
$ ________
>200
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤25
sq.m
$ ________
>25
sq.m
$ ________
≤25
sq.m
$ ________
>25
lin.m
$ ________
≤25
lin.m
$ ________
>25
lin.m
$ ________
≤25
lin.m
$ ________
>25
lin.m
$ ________
≤25
lin.m
$ ________
>25
tonne
$ ________
≤10
tonne
$ ________
>10
Concrete Sidewalk
120 mm thick
100 mm thick
Drive crossings – 120 mm
thick
Driveway crossings – 160
mm thick
Concrete Curb
Type B
Type R
Type M
Asphalt Sidewalks
Extruded Curb
Road Restoration Services No. 1220-040-2014-028
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a
b
2950
SS 2.20
2.19
a
b
c
d
e
2523
Asphalt Style Ex.
Concrete Style Ex.
Grass
Asphalt
Exposed Aggregate
Concrete
Limestone Chip
Course Broom Concrete
Driveway Restoration
a
Asphalt Driveways
(65mm)
c
$ ________
Base Rate
lin.m
$ ________
L.Sum
$ ________
Base Rate
lin.m
$ ________
>20
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤25
sq.m
$ ________
>25
sq.m
$ ________
≤25
sq.m
$ ________
>25
sq.m
$ ________
≤25
sq.m
$ ________
>25
sq.m
$ ________
≤75
sq.m
$ ________
>75
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
Boulevard Strip
2.20
b
L.Sum
Concrete Driveways
(Residential 120mm)
Concrete Driveways
(Industrial 200mm)
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Exposed Aggregate
Concrete Driveways
(Residential 120mm)
d
Exposed Aggregate
Concrete Driveways
(Commercial 200mm)
e
Broom Finish Concrete
Driveways (Residential
120mm)
f
Broom Finish Concrete
Driveways (Commercial
200mm)
g
h
Stamped Concrete
Driveways
2.21
2580
2.22
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
sq.m
$ ________
≤50
sq.m
$ ________
>50
lin.m
$ ________
≤50
lin.m
$ ________
>50
Interlocking Pavers (80mm)
Temporary Road Marking
SUBTOTAL
Table 2 only
CURRENCY: Canadian Dollars
$
GST (5%)
$
PST (7%)
$
TOTAL
Quotation Price
Table 2 including
taxes
Note:
$
All unit price estimates shall be based on the range of units accomplished per visit.
Road Restoration Services No. 1220-040-2014-028
PAGE 43 OF 51
FORCE ACCOUNT RATES
(LABOUR):
TRADE/CRAFT (CLASSIFICATION)
REGULAR HOURLY RATE ($)
OVERTIME HOURLY RATE ($)
EQUIPMENT RATES:
EQUIPMENT TYPE
[INCLUDING OPERATOR]
REGULAR HOURLY RATE ($)
OVERTIME HOURLY RATE ($)
REGULAR HOURLY RATE ($)
OVERTIME HOURLY RATE ($)
TRAFFIC CONTROL RATES:
EQUIPMENT TYPE / PERSONAL
If the prices shown above are only open to a particular date, please indicate the date: ______________
2.
If this Quotation is accepted by the Owner, a Contract will be created as described in:
(a)
(b)
(c)
the Agreement;
the RFQ; and
other terms, if any, that is agreed to by the parties in writing.
Road Restoration Services No. 1220-040-2014-028
PAGE 44 OF 51
3.
Capitalized terms used and not defined in this Quotation will have the meanings given to them in
the Agreement and RFQ. Except as specifically modified by this Quotation, all terms, conditions,
representations, warranties and covenants as set out in the Agreement and RFQ will remain in
full force and effect.
4.
In addition to the warranties provided in the Agreement, this Quotation includes the following
warranties:
5.
Contractor's relevant experience and qualifications in delivering Work similar to those required by
the Agreement (use the spaces provided and/or attach additional pages, if necessary):
6.
Contractor's references (name and telephone number) (use the spaces provided and/or attach
additional pages, if necessary). The Owner 's preference is to have a minimum of three
references:
7.
Contractor should provide information on the background and experience of all key personnel
proposed to provide the Work (use the spaces provided and/or attach additional pages, if
necessary):
Key Personnel
Name:
Experience:
Dates:
Project Name:
Responsibility:
8.
Contractor should provide the following information on the background and experience of all
sub-contractors proposed to undertake a portion of the Work (use the spaces provided and/or
attach additional pages, if necessary):
DESCRIPTION OF WORK
Road Restoration Services No. 1220-040-2014-028
SUBCONTRACTORS
NAME
YEARS OF
WORKING WITH
CONTRACTOR
TELEPHONE
NUMBER AND
EMAIL
PAGE 45 OF 51
9.
I/We have reviewed the Agreement. If requested by the Owner, I/we would be prepared to enter
into the Agreement, amended by the following departures (list, if any):
Section
10.
Requested Departure(s) / Alternative(s)
The Owner requires that the successful Contractor have the following in place before providing
the Work:
(a)
(b)
(c)
(d)
(e)
(f)
Workers’ Compensation Board coverage in good standing and further, if an “Owner
Operator” is involved, personal operator protection (P.O.P.) will be provided,
Workers' Compensation Registration Number __________________________________;
Prime Contractor qualified coordinator is Name: __________________ and Contact
Number: ______________;
Insurance coverage for the amounts required in the Agreement as a minimum, naming
the Owner as additional insured and generally in compliance with the Owner’s sample
insurance certificate form;
City of Surrey business license;
If the Contractor's Work are subject to GST, the Contractor's GST Number is
____________________________________; and
If the Contractor is a company, the company name indicated above is registered with the
Registrar of Companies in the Province of British Columbia, Canada, and Incorporation
Number ____________________________________.
As of the date of this Quotation, we advise that we have the ability to meet all of the above
requirements except as follows (list, if any):
Section
Requested Departure(s) / Alternative(s)
EXPERIENCE, REPUTATION AND RESOURCES:
11.
Contractor's relevant experience and qualifications in delivering Work similar to those
required by the RFQ (use the spaces provided and/or attach additional pages, if necessary):
12.
Contractor should provide:
a) a brief history of the firm; and
b) size of permanent staff and categories
13.
Contractor should provide a list of previous projects undertaken and completed involving similar
scope of work. The Owner’s preference is to have a minimum of three references (use the
spaces provided and/or attach additional pages, if necessary):
Road Restoration Services No. 1220-040-2014-028
PAGE 46 OF 51
YEAR
14.
DESCRIPTION
OF
CONTRACT
FOR WHOM
WORK
PERFORMED
PHONE &
CONTACT
SCOPE
OF
WORK
BUDGET
ORIGINAL
WORK SCHEDULE
ACTUAL
PROPOSED
ACTUAL
Contractor should provide information on the background and experience of all key personnel proposed to
provide the Work (use the spaces provided and/or attach additional pages, if necessary):
15.
Name:
Name:
Years of Experience: ______________________
Years of Experience:
Responsibility: ___________________________
Responsibility:
Name:
Name:
Years of Experience: ______________________
Years of Experience:
Responsibility: ___________________________
Responsibility:
Contractor should provide the following information on the background and experience of all subcontractors proposed to undertake a portion of the Services (use the spaces provided and/or attach
additional pages, if necessary):
DESCRIPTION OF PARTS OF
WORK TO BE SUBLET
16.
SUB-CONTRACTORS
NAME
YEARS OF
WORKING WITH
CONTRACTOR
PHONE NUMBER, FAX
NUMBER, AND EMAIL
ADDRESS
Contractor should provide the following information on the plant and equipment that will be utilized in the
performance of the Services (use the spaces provided and/or attach additional pages, if necessary):
Plant and/or Equipment Under Contractors Control:
1.
2.
3.
4.
5.
6.
7.
8.
Road Restoration Services No. 1220-040-2014-028
PAGE 47 OF 51
Plant and/or Equipment to be Rented:
1.
2.
3.
4.
5.
6.
7.
8.
Plant and/or Equipment to be Purchased:
1.
2.
3.
4.
5.
6.
7.
8.
17.
I/We the undersigned duly authorized representatives of the Contractor, having received and carefully
reviewed the RFQ including without limitation the General Terms and Conditions, submit this Quotation in
response to the RFQ.
This Quotation is executed by the Contractor this _______ day of _______________, 2014
CONTRACTOR
I/We have the authority to bind the Contractor.
________________________________________
(Legal Name of Contractor)
_________________________________________
(Signature of Authorized Signatory)
________________________________________
(Signature of Authorized Signatory)
_________________________________________
(Print Name and Position of Authorized Signatory)
________________________________________
(Print Name and Position of Authorized Signatory)
Road Restoration Services No. 1220-040-2014-028
PAGE 48 OF 51
ATTACHMENTS
1.
2.
Prime Contractor Designation Letter of Understanding
Risk, Health & Safety
Road Restoration Services No. 1220-040-2014-028
PAGE 49 OF 51
ATTACHMENT #1
PRIME CONTRACTOR DESIGNATION
LETTER OF UNDERSTANDING
As per the requirements of the Workers’ Compensation Act Part 3, Division 3, Section 118 (1-3),
which states:
Coordination of multiple-employer workplaces
118
(1)
In this section:
“multiple-employer workplace” means a workplace where workers of 2 or more employers are
working at the same time:
“prime Contractor” means in relation to a multiple-employer workplace,
(a) the directing Contractor, employer or other person who enters into a written
proposal with the Owner of that workplace to be the prime Contractor for
the purposes of this Part, or
(b) if there is no proposal referred to in paragraph (a), the Owner of the
workplace.
(2)
The prime Contractor of a multiple-employer workplace must
(a) ensure that the activities of employers, workers and other persons at the
workplace relating to occupational health and safety are coordinated, and
(b) do everything that is reasonably practicable to establish and maintain a
system or process that will ensure compliance with this Part and the
regulation in respect to the workplace.
(3)
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.
By signing this Contract, the Contractor accepts all responsibilities of a Prime Contractor as
outlined in the Workers’ Compensation Act, and WCB OH&S Regulation.
As a Contractor signing this Contract with the Owner, you are agreeing that your Company,
Management staff, Supervisory staff and workers will comply with the Workers’ Compensation
Board (WCB) Occupational Health and Safety Regulation and the Workers’ Compensation (WC)
Act.
Any WCB 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 Owner.
Any penalties, sanctions or additional costs levied against the Owner, as a result of the actions
of the Prime Contractor are the responsibility of the Prime Contractor.
The Contractor acknowledges having read and understood the information above.
By signing this Contract, the Contractor agrees to accept all responsibilities of the Prime
Contractor for this project.
The Contractor fully understands and accepts the responsibilities of the prime Contractor
designation in accordance with the Workers’ Compensation Act while contracted by Owner for
project and will abide by all Workers’ Compensation Board Regulation requirements.
Contract No.:
_______________________________________________
Contract Title:
_______________________________________________
Company Name:
_______________________________________________
WORKSAFEBC #:
_______________________________________________
Road Restoration Services No. 1220-040-2014-028
PAGE 50 OF 51
ATTACHMENT #2
RISK, HEALTH & SAFETY
Responsibility of Contractor(s)
The Owner strives to maintain a safe work environment for employees and contractors and insists upon
the enforcement of safe practices and procedures in all premises and in all work activities. It is essential
that all contractors and their employees and sub-contractor(s) perform in the same manner.
As a contractor to the Owner, you are expected to conform to the requirements of the Workers’
Compensation Act, the WCB Occupational Health and Safety Regulation and to all federal, provincial and
local laws and regulations. Any Owner employee has the authority to order an unsafe act to cease or to
have an unsafe piece of equipment removed from the premises or, in extreme situations, to shut down a
job entirely.
The following information is provided as typical Owner requirements, but does not relieve the contractor
from complying with all applicable local, provincial and federal laws, regulations and bylaws.
PERSONNEL
You are expected to inform your employees of any potential hazard in the workplace and advise of
appropriate action to be taken should a hazard be found or a fire or accident occur.
Contractors shall restrict persons invited on the premises to employees only. No families or friends are
permitted.
The contractor shall advise the Owner of any on-site accidents involving the contractor’s employees, or
injuries to others caused by the contractor’s business.
GENERAL SAFETY RULES
Horseplay, gambling and the use of alcohol or narcotics will not be tolerated.
Orderliness and good housekeeping are basic requirements and must be maintained at all times.
Any equipment, which could create a hazard, must be maintained in good condition.
Restricted and controlled products shall be labeled, used and stored in accordance with the associated
regulations, e.g. WHMIS.
Contractors shall use a regular system of inspections to detect and correct hazardous conditions, safety
violations and unsafe working practices on the job site.
Contractors shall ensure their employees utilize proper safety equipment and clothing as required for job
site activities.
Contractors must follow and have on site proper written safe work procedures for hazardous work, e.g.
confined space entry, lockout, excavations and shoring, etc.
All ladders must be of an approved type and length. Unacceptable ladders must be removed immediately
from the premises.
All vehicles and equipment on City property must be kept in safe mechanical condition at all times, and be
operated only by persons with a valid driver’s license and/or proper training and qualifications.
Contractors shall not operate any equipment, valves, switches, etc., which are part of the Owner’s
operation, unless specific permission is received from the Owner representative.
Accumulation of oily rags, combustible refuse or similar fire hazards will not be tolerated.
Your safety record and attitude are important criteria used to judge your qualification for future bidding on
solicitations with the Owner.
You can help ensure employee safety and your eligibility for future business with the Owner if you exhibit
and practice a “Safe Work - Safe City” attitude.
Road Restoration Services No. 1220-040-2014-028
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