OPCMR EXERCISE OF RENEWAL OPTION GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF PROPERTY & PROCUREMENT CONTRACT NO. P016DPWT24 DATED: November 28, 2023 EXERCISE OF RENEWAL OPTION Contractor Description of Scope of Work/Services Piotr Gajewski 9715 Estate Thomas, PMB 54 St. Thomas, VI 00802 Design Program Manager to provide Program Management Assistance in the administration of the Federal-Aid Highway Program Pursuant to the renewal option provision of Contract No. P016DPWT24, and subject to the appropriation and allotment of necessary funds, notice is hereby given that the Government of the U.S. Virgin Islands, Department of Public Works, exercises its option to renew and does hereby renew the aforementioned contract for the period November 4, 2024, to November 3, 2025, at the stipulated cost therein. All the terms, covenants, and conditions of the contract affected shall continue in full force and effect. A facsimile, electronic or digital signature on this Contract shall be deemed an original and binding upon the Parties hereto. Please acknowledge receipt and acceptance hereby signing and returning to: The Department of Property and Procurement Bldg. #1, Subbase, Third 3rd Floor St. Thomas, VI 00802 ____________________________________________________________________________________ ACKNOWLEDGMENT & ACCEPTANCE: GOVERNMENT OF THE VIRGIN ISLANDS __________________________________ __________________________________ Piotr Gajewski Derek Gabriel, Commissioner Department of Public Works DATE: __________ DATE: __________ ____________________________________ DATE: __________ Lisa M. Alejandro, Commissioner Department of Property & Procurement 10/10/2024 12/17/2024 Renewal Option to Contract P016DPWT24 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES ST. THOMAS, VIRGIN ISLANDS PURCHASE ORDER DATE: ____________ PAGE:_____OF_____ PURCHASE ORDER NUMBER: _________________ REQUISITION NUMBER: ______________________ Item# Description/Part No. UNIT PRICE AMOUNT P&P-ROIV-22-73 (FORM F.D.-2-36/50 (REV.) COMM. OF PROP. & PROC. APPROVED 2006 UNIT QUANTITY Department or Agency Certifying Officer Order Total SHIP TO: BILL TO: VENDOR: VENDOR REMIT DELIVERY TERMS: _____________________________________________ Department of Property & Procurement Purchasing or Contracting Officer Purchase Order Authorization THIS PURCHASE ORDER IS ONLY VALID FOR NINETY (90) DAYS FROM DATE SPECIFIED ABOVE THE PRICE ON THIS PURCHASE ORDER IS FIXED AND SHOULD NOT CHANGE WITHOUT ADVANCE WRITTEN CONSENT VENDOR  CONTACT 00000081 217 DEPT OF PUBLIC WORKS STX DEPT OF PUBLIC WORKS STX 11/14/2024 147,810.40 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 PIOTR GAJEWSKI 9715 ESTATE THOMAS PMB 54 ST THOMAS, VI 00802 49607 PAYMENT DUE 0 DAYS FROM INVOICE 1 1 The Above Purchase Order Number Must Appear On All Correspondence - Packing Sheets And Bills Of Lading 1 TO ENCUMBER FUNDS FOR RENEWAL CONTRACT - PG ENGINEER SERVICES EACH $147,810.40 1 $147,810.40 20496104 - 564120 - S8925 147,810.40 Mailing Address PIOTR GAJEWSKI Physical Address PMB #54 ST THOMAS ST. THOMAS VI 00802 ST THOMAS 15803 License No: 1-15803-1L Licensee: PIOTR GAJEWSKI 2J6 ESTATE LURKENLUND 9715 ESTATE THOMAS ST. THOMAS VI 00802 Trade Name: Business No: THE GOVERNMENT OF THE VIRGIN ISLANDS DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS BUSINESS LICENSE That, in accordance with the applicable provisions of Title 3 Chapter 16 and Title 27 V.I.C. relating to the licensing of businesses and occupations, and compliance having been made with the provisions of 10 V.I.C. Sec. 41 relating to the Civil Rights Act of the Virgin Islands, the following license is hereby granted. KNOW ALL BY THIS PRESENT As provided by law, the authorized licensing authority shall have the power to revoke or suspend any License issued hereunder, upon finding, after notice and adequate hearing, that such revocation or suspension is in the public interest; provided, that any persons aggrieved by any such decision of this office shall be entitled to a review of the same by the Territorial Court upon appeal made within (30) days from the date of the decision; provided, further, that all decisions of this office hereunder shall be final except upon specific findings by the Court that the same was arrived at by fraud or illegal means. Project Coordinator/Consultant Types of License(s) 2024 If a renewal is desired, the holder is responsible for making application for same without any notice from this office. It is the responsibility of the Licensee to notify the Department in writing within (30) days, when a license is to be cancelled or placed in inactive status. Failure to do so will result in the assessment of penalties as authorized by law. Valid from 07/10/2024 Printed on St. Thomas,V.I. Issued at 97.50 Fee Commissioner, Department of Licensing and Consumer Affairs THIS LICENSE MUST BE PROMINENTLY DISPLAYED AT PLACE OF BUSINESS 05/01/2024 until 05/31/2025 H. Nathalie Hodge OPCMR 1 Contract No. _P016DPWT24 Contractor’s Initials: ________ CONTRACT FOR PROFESSIONAL SERVICES THIS AGREEMENT is made this _______ day of ____________, 20___, in the Territory of the Virgin Islands, by and between the Government of the Virgin Islands, Department of Property and Procurement, on behalf of the Department of Public Works (hereinafter referred to as "Government") and Piotr Gajewski (hereinafter referred to as "Contractor"). WITNESSETH: WHEREAS, the Government is in need of the services of a Contractor to provide Program Management Assistance in the administration of the Federal-Aid Highway Program, which duties and responsibilities are more particularly described in Addendum I (Scope of Services) attached hereto; and WHEREAS, the Contractor was selected in accordance with 31 V.I.C. §239(a)(8); and WHEREAS, the Contractor is currently the territorial Design Program Manager, for the Government’s Federal-Aid Highway Program; and is performing the services under Contract No. P008DPWT20, renewed on November 2, 2022; and WHEREAS, the Government has a continued need for a Design Program Manager to provide Program Management Assistance in the administration of the Federal-Aid Highway Program; and WHEREAS, the Contractor represents that it is willing and capable of providing such services; and NOW, THEREFORE, in consideration of the mutual covenants herein contained, and intending to be legally bound by this written instrument, the parties hereto do covenant and agree as follows: 1. SERVICES The Contractor shall provide the services described in Addendum I (Scope of Services) attached hereto and made a part of this contract. 2. TERM AND EFFECTIVE DATE The Term of this Contract shall be from November 4, 2023, through November 3, 2024. Upon execution of this Contract by the Commissioner of the Department of Property and Procurement, this Contract shall be effective for the Term set out herein. The Government, in its sole discretion, shall have the option to renew this Contract for a period of one (1) additional year subject to the same terms noted herein, by providing the Contractor with sixty (60) days written notice of the Government's election to renew. November 28th 23 OPCMR 2 Contract No. . _P016DPWT24 Contractor’s Initials: ________ 3. COMPENSATION The Government, in consideration of the satisfactory performance of the services described in Addendum I (Scope of Services), agrees to pay Contractor a sum not to exceed One Hundred Forty-Seven Thousand, Eight Hundred Ten Dollars and Forty Cents ($147,810.40) in accordance with the provisions set forth in Addendum II (Compensation) attached hereto and made a part of this contract. 4. TRAVEL EXPENSES Inclusive of the compensation for services as specified in Paragraph 3 (Compensation) above, the Government agrees to pay documented transportation, subsistence, lodging and other travel expenses, while in travel status, for trips which have been authorized in writing, in advance, by the Government. These costs shall be advanced or reimbursed on the same basis as is applicable to non-contract employees of the Government, or as agreed to by an addendum to this Contract, however, said costs and expenses shall not exceed Ten Thousand Dollars and Zero Cents ($10,000.00). 5. RECORDS The Contractor when applicable, will present documented precise records of time and/or money expended under this Contract. 6. PROFESSIONAL STANDARDS The Contractor agrees to maintain the professional standards applicable to its profession and to consultants doing business in the United States Virgin Islands. 7. DOCUMENTS, PRINTOUTS, ETC. All documents, books, records, instructional materials, programs, printouts, and memoranda of every description derived therefrom and pertaining to this Contract shall become the property of the Government and shall be turned over to it at the termination of this Contract. The above- described materials shall not be used by Contractor or by any other person or entity except upon the written permission of the Government. 8. LIABILITY OF OTHERS Nothing in this Contract shall be construed to impose any liability upon the Government to persons, firms, associations, or corporations engaged by Contractor as servants, agents, or independent contractors, or in any other capacity whatsoever, or make Government liable to any such persons, firms, associations, or corporations for the acts, omissions, liabilities, obligations and taxes of Contractor of whatsoever nature, including but not limited to unemployment insurance, gross receipt, excise, and social security taxes for Contractor, its servants, agents or independent contractors. OPCMR 3 Contract No. . _P016DPWT24 Contractor’s Initials: ________ 9. ASSIGNMENT The Contractor shall not subcontract or assign any part of the services under this Contract without the prior written consent of the Government. 10. INDEMNIFICATION Contractor agrees to indemnify, defend, and hold harmless Government from and against any and all loss, damage, liability, claims, demands, detriments, costs, charges and expenses (including attorney’s fees) and causes of action of whatsoever character which Government may incur, sustain or be subjected to, arising out of or in any way connected to the services to be performed by Contractor under this Contract and arising from any cause, except the sole negligence of Government. 11. INDEPENDENT CONTRACTOR The Contractor shall perform this Contract as an independent contractor, and nothing herein contained shall be construed to be inconsistent with this relationship or status. 12. GOVERNING LAW This Contract shall be governed by the laws of the United States Virgin Islands and jurisdiction shall remain in the United States Virgin Islands. 13. WAIVERS AND AMENDMENTS No waiver, modification or amendment of any term, condition, or provision of this Contract shall be valid or of any force or effect unless made in writing, signed by the parties hereto or their duly authorized representatives, and specifying with particularity the nature and extent of such waiver, modification, or amendment. Any such waiver, modification or amendment in any instance or instances shall in no event be construed to be a general waiver, modification, or amendment of any of the terms, conditions, or provisions of this Contract, but the same shall be strictly limited and restricted to the extent and occasion specified in such signed writing or writings. 14. ENTIRE AGREEMENT This agreement constitutes the entire agreement of the parties relating to the subject matter addressed in this Agreement. This agreement supersedes all prior communications, contracts, or agreements between the parties with respect to the subject matter addressed in this agreement, whether written or oral. 15. RIGHT TO WITHHOLD If work under this Contract is not performed in accordance with the terms hereof, Government will have the right to withhold out of any payment due to Contractor, such sums as Government may OPCMR 4 Contract No. . _P016DPWT24 Contractor’s Initials: ________ deem ample to protect it against loss or to assure payment of claims arising therefrom, and, at its option, Government may apply such sums in such manner as Government may deem proper to secure itself or to satisfy such claims. Government will immediately notify the Contractor in writing in the event that it elects to exercise its right to withhold. No such withholding or application shall be made by Government if and while Contractor gives satisfactory assurance to Government that such claims will be paid by Contractor or its insurance carrier, if applicable in the event that such contest is not successful. 16. CONDITION PRECEDENT This Contract shall be subject to the availability and appropriation of funds and to the approval of the Commissioner of the Department of Property and Procurement. 17. TERMINATION The Government shall have the right to terminate this Contract if the Contractor’s work is deemed unsatisfactory by providing sixty (60) days written notice to the Contactor specifying the date of termination. 18. PARTIAL TERMINATION The performance of work under this Contract may be terminated by the Government, in part, whenever the Government shall deem such termination advisable by providing sixty (60) days written notice to the Contractor. This partial termination shall be effected by delivering to the Contractor a Notice of Partial Termination specifying the extent to which the term and/or duties under this Contract are terminated and the date upon which such termination becomes effective. The Contractor shall be entitled to receive payment for services provided to the date of termination, including payment for the period of the sixty (60) day notice. 19. NON-DISCRIMINATION No person shall be excluded from participating in, be denied the proceeds of or be subject to discrimination in the performance of this Contract on account of race, creed, color, sex, religion, disability or national origin. 20. CONFLICT OF INTEREST (a) Contractor covenants that it has no interest and will not acquire any interest direct or indirect, which would conflict in any manner or degree with the performance of services required to be performed under this Contract. (b) Contractor further covenants that it is: (1) not a territorial officer or employee (i.e., the Governor, Lieutenant Governor, member of the Legislature, or any other elected territorial official; or an officer or employee of the legislative, executive or judicial branch of the Government OPCMR 5 Contract No. . _P016DPWT24 Contractor’s Initials: ________ or any agency, board, commission or independent instrumentality of the Government, whether compensated on a salary, fee or contractual basis); or (2) a territorial officer or employee and, as such, has: (i) familiarized itself with the provisions of Title 3, Chapter 37 of the Virgin Islands Code, pertaining to conflicts of interest, including the penalties provision set forth in section 1108 thereof; (ii) not made, negotiated or influenced this Contract, in its official capacity; and (iii) no financial interest in the Contract as that term is defined in section 1101(1) of said Code chapter. 21. NOTICE Any notice required to be given by the Terms of this Contract shall be deemed to have been given when the same is sent by certified mail, postage prepaid or personally delivered, addressed to the parties as follows: GOVERNMENT Lisa M. Alejandro Commissioner Department of Property and Procurement 8201 Sub Base, Suite 4 St. Thomas, Virgin Islands 00802 Derek Gabriel Commissioner Department of Public Works 8244 Sub Base St. Thomas, VI 00802 CONTRACTOR Piotr Gajewski 9715 Estate Thomas, PMB 54 St. Thomas, VI 00802 22. LICENSURE The Contractor covenants that it has: (a) obtained all of the applicable licenses or permits, permanent, temporary or otherwise as required by Title 27 of the Virgin Islands Code; and (b) familiarized itself with the applicable provisions of Title 27 of the Virgin Islands Code pertaining to professions and occupations. OPCMR 6 Contract No. . _P016DPWT24 Contractor’s Initials: ________ 23. OTHER PROVISIONS Addenda I, and II attached hereto are a part of this Contract and are incorporated herein by reference. 24. DEBARMENT CERTIFICATION By execution of this contract, the contractor certifies that it is eligible to receive contract awards using federally appropriated funds and that it has not been suspended or debarred from entering into contracts with any federal agency. The Contractor shall include this provision in each of its subcontracts hereunder and shall furnish its subcontractors with the current “LIST OF PARTIES EXCLUDED FROM FEDERAL PROCUREMENT OR NON-PROCUREMENT”. In the event the Contractor or any subcontractor misrepresents its eligibility to receive contract awards using federal funds, the Contractor or subcontractor agrees that it shall not be entitled to payment for any work performed under this contract or any subcontract and that the Contractor or subcontractor shall promptly reimburse the Government of the Virgin Islands for any progress payments heretofore made. 25. FALSE CLAIMS Contractor warrants that it shall not, with respect to this Contract, make or present any claim upon or against the Government of the Virgin Islands, or any officer department, board, commission, or other agency thereof, knowing such claims to be false, fictitious, or fraudulent. The Contractor acknowledges that making such a false, fictitious, or fraudulent claim is an offence under Virgin Islands law. 26. NOTICE OF FEDERAL FUNDING Contractor acknowledges that this Contract is funded, in whole or in part, by federal funds. Contractor warrants that it shall not, with respect to this Contract, make or present any claim knowing such claim to be false, fictitious, or fraudulent. The Contractor acknowledges that making such a false, fictitious, or fraudulent claim is a federal offence. 27. FACSIMILE, ELECTRONIC & DIGITAL SIGNATURES A facsimile, electronic or digital signature on this Contract shall be deemed an original and binding upon the Parties hereto. OPCMR 7 Contract No. . _P016DPWT24 Contractor’s Initials: ________ IN WITNESS WHEREOF, the parties have hereunto set their hands on the day and year first above written. GOVERNMENT OF THE VIRGIN ISLANDS ______________________________ ________ Derek Gabriel, Commissioner Date Department of Public Works ______________________________ ________ Lisa M. Alejandro, Commissioner Date Department of Property and Procurement CONTRACTOR ______________________________ ________ Piotr Gajewski Date (Corporate seal if Contractor is a corporation) APPROVED AS TO LEGAL SUFFICIENCY DEPARTMENT OF JUSTICE BY: _____________________________ Date _________ PURCHASE ORDER NO.______________________________ 11/7/23 /s/ Jessica McKenney, esq. 11/28/2023 11/28/2023 Addendum I OPCMR 8 Contract No. . _P016DPWT24 Contractor’s Initials: ________ ADDENDUM I SCOPE OF SERVICES Design Program Manager – St. Thomas, St. John, St. Croix PRINCIPAL DUTIES AND RESPONSIBILITIES The Contractor shall serve in the capacity of Design Program Manager for the Territory of the U.S. Virgin Islands and will be responsible for accomplishing the work with the assistance of one or more Engineers and Technicians. The Contractor will oversee and lead others on complex highway design or other transportation related design project(s) of such scope and character that considerable judgment must be exercised in administering the contract to meet field conditions encountered. The Contractor will be managing typical projects that involve design of various types of grading, drainage, pavements and structures where conventional designs are used. The Contractor shall utilize professional knowledge and application of the Department of Public Works (DPW) and Federal Highway Administration (FHWA) highway engineering principles, practices, policies and standards, along with design contract administration surveillance and inspection procedures, practices, precedents and policies in accomplishing the work. Within this framework, the Contractor shall perform the following: HIGHWAY DESIGN 1. Supervise and manage preliminary engineering data collection either by consultant contract or with in house personnel. Assist and coordinate with the Office of Highway Planning and Research (HPR), Division of Transportation for the identification of highway needs and in the formulation of projects. 2. Review, comment, and approve plans, specifications and environmental documents prepared by design consultants. 3. Assist the Director of Highway Engineering/Federal-Aid Highway Program Manager in reviewing design consultant contracts and review and approve invoices submitted for work completed. 4. Facilitate the presentation of projects to the public at public hearings and to government officials. In addition, the Contractor will be expected to: A. Maintain a technical library oriented towards the construction industry; including catalogs, manuals and software available on the market. B. Qualify and classify local subcontractors and use this information to develop a data bank. C. Perform consultations and prepares technical reports. D. Perform other duties and responsibilities as assigned. OPCMR 9 Contract No. . _P016DPWT24 Contractor’s Initials: ________ ADDITIONAL DUTIES The Contractor shall be responsible for developing and maintaining a weighted average bid item data sheet for the island of St. Thomas. 1. Based on this data and any available historic data develop a construction cost inflation data sheet for Federal-Aid projects on St. Thomas. 2. The data sheets shall be initially due within the first 90 days after execution of this Contract and subsequently updated quarterly and distributed to DPW and FHWA personnel involved with the Federal-Aid Program. The Contractor shall also be responsible for scheduling and chairing Quarterly Utility Coordination Meetings and generally acting as coordinator for the Office of Highway Engineering on all utility matters. The Contractor is also required to learn and apply FHWA policy and regulations regarding the implementation of Federal-Aid highway projects, such as 23 CFR 172 and 23 CFR 620 and 637. SUPERVISORY RELATIONSHIP The Contractor shall report to the Director of Highway Engineering/Federal-Aid Highway Program Manager who provides program and policy guidance for the Department of Public Works Highway Programs. The Director/Highway Program Manager is given broad authority and responsibility for developing programs and procedures to accomplish the Department’s objectives. The reports prepared and advice given by the Director/Highway Program Manager are assumed to be technically correct and in conformance with good engineering practices and established Federal Highway Administration policies, procedures, and regulations. The Contractor shall provide leadership and incentive to other team members and/or Contractors engaged by the Department of Public Works to maximize technical assistance to the Federal-Aid Highway Program. Addendum II OPCMR 10 Contract No.. _P016DPWT24 Contractor’s Initials: ________ ADDENDUM II COMPENSATION For Year One..................................................................................................................$137,810.40 Travel...............................................................................................................................$10,000.00 Maximum Amount Payable...........................................................................................$147,810.40 SCHEDULE OF PAYMENTS Partial Payments Fees to be disbursed in even payments as follows: Beginning on the effective date of the contract, periodical payments in the amount of $5,300.40 for the full term of the contract shall be made bi-weekly. Travel expenses for the full term of the contract shall be $10,000.00. The Contractor will be allowed a total of twenty (20) payable non-worksite days per year to attend courses required as per Federal Highway Regulations or for continuous education, to attend conferences and seminars and any non-worksite related activities. The day or days will be mutually agreed upon between the Contractor and the Commissioner of the Department of Public Works. Compensation for the payable days is included in the compensation set forth above. The Government shall use its best efforts to, within thirty (30) days of receipt of an invoice, pay the invoice in full or give a written explanation for non-payment of any contested portions of the invoice. Failure of the Government, despite its best efforts to respond to an invoice within thirty (30) days of receipt of the invoice shall not be interpreted as an indication that the Government no longer desires the Contractor’s services. Funding Source GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES ST. THOMAS, VIRGIN ISLANDS PURCHASE ORDER DATE: ____________ PAGE:_____OF_____ PURCHASE ORDER NUMBER: _________________ REQUISITION NUMBER: ______________________ Item# Description/Part No. UNIT PRICE AMOUNT P&P-ROIV-22-73 (FORM F.D.-2-36/50 (REV.) COMM. OF PROP. & PROC. APPROVED 2006 UNIT QUANTITY Department or Agency Certifying Officer Order Total SHIP TO: BILL TO: VENDOR: VENDOR REMIT DELIVERY TERMS: _____________________________________________ Department of Property & Procurement Purchasing or Contracting Officer Purchase Order Authorization THIS PURCHASE ORDER IS ONLY VALID FOR NINETY (90) DAYS FROM DATE SPECIFIED ABOVE THE PRICE ON THIS PURCHASE ORDER IS FIXED AND SHOULD NOT CHANGE WITHOUT ADVANCE WRITTEN CONSENT VENDOR CONTACT 00018139 25176 DEPT OF PUBLIC WORKS STX DEPT OF PUBLIC WORKS STX 08/14/2023 147,810.40 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 PIOTR GAJEWSKI 9715 ESTATE THOMAS PMB 54 ST THOMAS, VI 00802 49607 PAYMENT DUE 0 DAYS FROM INVOICE 1 1 The Above Purchase Order Number Must Appear On All Correspondence - Packing Sheets And Bills Of Lading 1 TO ENCUMBER FUNDS FOR PG CONTRACT ENGINEER SERVICES EACH $147,810.40 1 $147,810.40 20496104 - 564120 - S8925 147,810.40 Gov't of the U.S. Virgin Islands PURCHASE ORDER INQUIRY PROFILE REPORT Report generated: 11/15/2023 09:15 User: 6036cprevost Program ID: poinqury Page 1 Purchase Order Type Normal Fiscal Yr 2023 11 PO# 00018139 Batch CLR PO Date 08/14/2023 Requisition 00025176 Department Code 6102 DEPT OF PUBLIC WORKS STX Allocation Code 00000000 Review Code Buyer ID 6036devparris Deviqua Parris Needed By Date General Commodity 925 ENGINEERING SERVICES, PROFESSI Vendor 049607 PIOTR GAJEWSKI Work Order 000000000 Activity 0 9715 ESTATE THOMAS PMB 54 ST THOMAS, VI 00802 Ship To Address 6102 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 Ship To Reference Shipping Method Bill To Address 6102 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 PO Description ENGINEERING SERVICES, PROFESSIONAL Special Handling None Status Printed Distribution 1 Total PO Amount $147,810.40 Liquidated $ 0.00 Canceled $ 0.00 Open Encumbrance $147,810.40 Line Item Details ------------------------------------------------------------------------------ Line 001 Commodity 92533 Req 25176 Qty 1.00 UOM EACH Unit Price 147810.40000 % Disc 0.00 Credit 0.00 Freight 0.00 ------------------------------------------------------------------------- Line Item Total $147,810.40 Qty Received 0.00 Liquidated $ 0.00 Qty Canceled 0.00 Canceled $ 0.00 Line Item Open Encumbrance $147,810.40 ------------------------------------------------------------------------- Description TO ENCUMBER FUNDS FOR PG CONTRACT ENGINEER SERVICES ------------------------------------------------------------------------- Department 6102 1099 Box Capital AssetN Needed By Quote Bid Ship To Address 6102 DEPARTMENT OF PUBLIC WORKS 6002 ESTATE ANNA'S HOPE C'STED ST. CROIX, VI 00820-4428 Gov't of the U.S. Virgin Islands PURCHASE ORDER INQUIRY PROFILE REPORT Report generated: 11/15/2023 09:15 User: 6036cprevost Program ID: poinqury Page 2 Ship To Reference ----------------------------------------------------------------------- Allocation Details Org Obj Proj Description Encumbered Amt Bud ------------------------------------------------------------------- 20496104 564120 S8925 CONTRACT $147,810.40 U Liquidated $ 0.00 Canceled $ 0.00 Allocated Open Encumbrance $147,810.40 --------------------------------------------------------------------------- ** END OF REPORT - Generated by Claudia Prevost ** BUSINESS DOCUMENTS [x] Business License Expires: 5/31/2024 [x] Insurance Waiver Request Mailing Address PIOTR GAJEWSKI Physical Address PMB #54 ST THOMAS ST. THOMAS VI 00802 ST THOMAS 15803 License No: 1-15803-1L Licensee: PIOTR GAJEWSKI 2J6 ESTATE LURKENLUND 9715 ESTATE THOMAS ST. THOMAS VI 00802 Trade Name: Business No: THE GOVERNMENT OF THE VIRGIN ISLANDS DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS BUSINESS LICENSE That, in accordance with the applicable provisions of Title 3 Chapter 16 and Title 27 V.I.C. relating to the licensing of businesses and occupations, and compliance having been made with the provisions of 10 V.I.C. Sec. 41 relating to the Civil Rights Act of the Virgin Islands, the following license is hereby granted. KNOW ALL BY THIS PRESENT As provided by law, the authorized licensing authority shall have the power to revoke or suspend any License issued hereunder, upon finding, after notice and adequate hearing, that such revocation or suspension is in the public interest; provided, that any persons aggrieved by any such decision of this office shall be entitled to a review of the same by the Territorial Court upon appeal made within (30) days from the date of the decision; provided, further, that all decisions of this office hereunder shall be final except upon specific findings by the Court that the same was arrived at by fraud or illegal means. Project Coordinator/Consultant Types of License(s) 2023 If a renewal is desired, the holder is responsible for making application for same without any notice from this office. It is the responsibility of the Licensee to notify the Department in writing within (30) days, when a license is to be cancelled or placed in inactive status. Failure to do so will result in the assessment of penalties as authorized by law. Valid from 06/07/2023 Printed on St. Thomas,V.I. Issued at 97.50 Fee Commissioner, Department of Licensing and Consumer Affairs THIS LICENSE MUST BE PROMINENTLY DISPLAYED AT PLACE OF BUSINESS 05/01/2023 until 05/31/2024 August 8, 2023 Mrs. Lisa M. Alejandro Commissioner Designee Department of Property & Procurement 8201 Subbase Third Floor St. Thomas, VI 00802 RE: REQUEST FOR INSURANCE WAIVER Commercial General Liability, Professional Insurance, and Worker’s Compensation for Federal Aid Contract Employees Dear Commissioner Designee Alejandro: The Department of Public Works hereby submits this formal request for waiver of the requirement of General Liability and Professional Liability Insurance for DPW Federal-Aid contract employees. I have attached for your reference the previously approved waiver granted on September 6, 2022. The FHWA contract employees are working under the umbrella of the Department of Public Works and therefore are not required to sign off or place their professional stamp or seal on construction documents on behalf of the Department of Public Works. Also, the contract employees have no employees and therefore are not required to provide proof of Worker's Compensation. If you have any questions or concerns, kindly contact Kizma L. Petersen, Chief Procurement Officer at 340.773.1290, extension 2257, or via email at kizma.petersen@dpw.vi.gov. Sincerely, Derek Gabriel Commissioner DG/klp APPROVED/DISAPPROVED ______________________________ ____________ Lisa M. Alejandro Date Commissioner Designee 8/11/2023