HomeMy WebLinkAboutCAG2003-0496 - Original - Nexxpost, LLC - Lease Postage Equipment - 08/01/2003 Records M e me
KENT Document
W/ASHIHOTOH ��;
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Cle ks Office. All
portions are to be completed, If you have questions, please contact Mary Simn ions, City
Clerks Office.
Vendor Name: 41.fJ'/ U
AJ
Contract Number.
This Is assigned by Mary Simmons
Vendor Number:
Project Name:
Contract Effective Date:
Contract Termination Date: ^ C;Z0 U
Contract Renewal Notice (Days): CJ
Number of days required notice for termination renewal or amendment
Contract Manager: Z4
/D- VZ / ,.SCE
Department: CzeS /yIejec
Abstract:
ADCL7832 07/02
KENT
WMSNINOTON
GOODS & SERVICES AGREEMENT
between the City of Kent and
Nexxpost / Hasler
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Nexxpost / Hasler, a Washington limited liability company, located and doing
business at 6111 - 12th Avenue South, Seattle,WA 98108-2704 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK
Vendor shall provide the following goods and materials and/or perform the following services for the
City:
See, Scope of Work, attached as Exhibit"A" and incorporated by reference.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and
services through other sources.
II. TIME OF COMPLETION. Vendor shall supply the postage equipment within thirty (30)
calendar days from the effective date of this Agreement, and shall provide all other goods, materials, and
services for the term of this Agreement.
III. COMPENSATION. The City shall pay the Vendor the following amounts according to the
following schedule:
The first year annual payment shall be $5,007.00, plus tax in the amount of $440.62, for a
total first year payment of$5,447.62, or$453.97 per month,.
The annual payment for years two through five shall be $5,907.00, plus tax in the amount
of$519.82, for a total payment of$6,426.82 per year, or$535.57 per month.
GOODS&SERVICES AGREEMENT—Page 1
(Between City of Kent and Nexxpost/Hasler)
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to
only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort
to settle the disputed portion.
A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor
for any defective or unauthorized goods, materials or services. If Vendor is unable, for any
reason, to complete any part of this Agreement, the City may obtain the goods, materials or
services from other sources, and Vendor shall be liable to the City for any additional costs
incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs
and attorney fees, incurred by the City beyond the maximum Agreement price specified above.
The City further reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the Vendor.
B. Final Payment: Waiver of Claims. THE MAKING OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY
MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR
FINAL PAYMENT IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement and that the Vendor has the ability to control and
direct the performance and details of its work, the City being interested only in the results obtained under this
Agreement.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of this
Agreement.
VI. CHANGES. The City may issue a written change order for any change in the goods, materials or
services to be provided during the performance of this Agreement. If the Vendor determines, for any reason,
that a change order is necessary, Vendor must submit a written change order request to the person listed in the
notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date
Vendor knew or should have known of the facts and events giving rise to the requested change. If the City
determines that the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all
equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable
adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either
a written change order from the City or an oral order from the City before actually receiving the written change
order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make
any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor
disagrees with the equitable adjustment, the Vendor must complete the change order work; however, the
Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims,
below
The Vendor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Vendor as
provided in this section shall constitute full payment and final settlement of all claims for contract time and for
GOODS&SERVICES AGREEMENT—Page 2
(Between Cary of Kent and Nexxpost/Hasler) (June 13, 2003)
direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected
by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by a change order, another written
order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the
City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City
of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or
within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events
giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or
extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been
waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions
of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1
through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING
THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate was
determined; and
5. An analysis of the progress schedule showing the schedule change or disruption if
the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of
the asserted events giving rise to the claim. The City shall have access to any of the Vendor's
records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also
waives any additional entitlement and accepts from the City any written or oral order (including
directions, instructions, interpretations, and determination).
GOODS&SERVICES AGREEMENT—Page 3
(Between City of Kent and Nexxpost/Hasler) (June 13, 2003)
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the City
any written or oral order(including directions, instructions, interpretations, and determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD.
IX. WARRANTY. This Agreement is subject to all warranty provisions established under the
Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are
merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance
with their specifications and Vendor's representations to City. The Vendor shall correct all defects in
workmanship and materials within one (1) year from the date of the City's acceptance of the Contract work. In
the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts
will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for
one (1) year from the date such correction is completed and accepted by the City. The Vendor shall begin to
correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the
Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may
complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the
correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or
sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the
presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and
available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend,indemnify and hold the City,its officers,officials,
employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including
all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this
Agreement, except for that portion of the injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
GOODS&SERVICES AGREEMENT—Page 4
(Between City of Kent and Neuxpost/Hasler) (June 13, 2003)
The provisions of this section shall survive the expiration or termination of this Agreement.
MI. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit "B" attached and incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions
and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the
contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's
own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or
held for use in connection with the work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.90 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price preference
may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement
in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements
or options, and the same shall be and remain in full force and effect.
C. Resolution of DiiMutes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute,
difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving
that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction
of the King County Superior Court, King County, Washington, unless the parties agree in writing to an
alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties'
performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending
or bringing such claim or lawsuit, in addition to any other recovery or award provided by law; provided,
however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section
VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the
addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice
hereunder shall become effective three(3)business days after the date of mailing by registered or certified mail,
and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such
other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent of
the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms
of this Agreement shall continue in full force and effect and no further assignment shall be made without
additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor.
GOODS&SERVICES AGREEMENT—Page 5
(Between City of Kent and Nexxpost/Hasler) (June 13, 2003)
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the
City, and such statements shall not be effective or be construed as entering into or forming a part of or altering
in any manner this Agreement. All of the above documents are hereby made a part of this Agreement.
However, should any language in any of the Exhibits to this Agreement conflict with any language contained in
this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendofs business,
equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance
of those operations.
IN WITNESS,the parties below execute this Agreement,which shall become effective on the last
date entered below.
i
VENDOR: CITY:
NEXXPOST/HASLER CITY OF KENT:
Bar` By:
(signature) (sign re)
Pnnt Name: �(�� _ 0 vyw Print e: Jim White
Its WMAJA16 W�C Its Mayor
l Title)
DATE: Za�o03 DATE:
APPROVED AS TO FORM:
2!��= a, - z
fi-
Kent City Attorney
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Attu: ;,r pk f f „`.— Brenda Jacober, City Clerk
Nexxpost/Hasler City of Kent
6111 - 12'h Avenue South 220 Fourth Avenue South
Seattle, WA 98108 Kent, WA 98032
�� Vy �'a °0(telephone) (253) 856-5728 (telephone)
2,0 - 76 9006 (facsimile) 1 (253) 856-6700 (facsimile)
P\Cml\FILES\OpenFile\0024-2D03\NexxpostP=ageAgme t-REVISED doc
GOODS&SERVICES AGREEMENT-Page 6
(Between City of Kent and Nexxpost/Hasler) (June 13, 2003)
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity
within their organization and, if holding Agreements with the City amounting to $10,000 or more within any
given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal
opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and
equal opportunity requirements shall be considered in breach of contract and subject to suspension or
termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works
Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are
familiar with the regulations and the City's equal employment opportunity policy.
2. Monitoring to assure adherence to federal, state and local laws,policies and guidelines.
EEO COMPLIANCE DOCUMENTS- 1
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all
contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with
the regulations of the City's equal employment opportunity policies.
The following questions specifically identify the requirements the City deems necessary for any contractor,
subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of
the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier
willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of
contract and it will be at the City's sole determination regarding suspension or termination for all or part of the
Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color,
national origin, age, or the presence of all sensory,mental or physical disability.
3. During the time of this Agreement the prime contractor will provide a written statement to all new
employees and subcontractors indicating commitment as an equal opportunity employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of
women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime
Contractor, that the Prime Contractor complied with the requirements as set forth above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of , 200_.
By.
For: AI�5«Y/ -Tt
Title:
Date: ��ZO��?3
EEO COMPLIANCE DOCUMENTS- I
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement
known as that was entered into on the (date) ,
between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent
Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part
of the before-mentioned Agreement.
Dated this day of 200 .
BY /4(b4W
For: ��
Title: Gf%_a C)
Date: U &J�Q 3
EEO COMPLIANCE DOCUMENTS-2
COMMIT-.A
NEXXPOSTIHASLER GOODS & SERVICES AGREEMENT
SCOPE OF WORK
EQUIPMENT TO BE PROVIDED:
❖ Power Post Digital Mail Machine—Model DM800
❖ Power Post IBIP meter
❖ Dynamic Scale with Static 10 lb capacity
❖ MP100 100 lb Platform Scale
❖ Power Post Conveyor
❖ Global Light Software
SERVICES TO BE PROVIDED:
❖ Equipment Maintenance(Parts, Labor, Technical Support)
❖ Software Maintenance(Updates and Upgrades)
❖ Rate Upgrades from Post Office.
ITEMS NOT INCLUDED IN AGREEMENT AND TO BE PURCHASED BY THE
CITY ON AN AS NEEDED BASIS ARE AS FOLLOWS:
❖ Postage Meter Roll Tape
Unit Price $32.00 per 2000 tapes—Each roll 4 inch(4") tape
❖ Ink Cartridge
Unit Price $120.00 per unit—40,000 impressions per unit
EXHIBIT B
INSURANCE REQUIREMENTS
Insurance
The Vendor shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may arise from or in
connection with products and materials supplied to the City.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the type described below:
Commercial General Liability insurance shall be written on Insurance Services Office
(ISO) occurrence form CG 00 01 and shall cover products liability. The City shall be
named as an insured under the Vendor's Commercial General Liability insurance policy
using ISO Additional Insured-Vendors Endorsement CG 20 15 or a substitute
endorsement providing equivalent coverage.
B. Minimum Amounts of Insurance
Vendor shall maintain the following insurance limits:
Commercial General Liability insurance shall be written with limits no less than
$1,000,000 each occurrence, $1,000,000 general aggregate and a$2,000,000 products
liability aggregate limit.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions
for Commercial General Liability insurance:
1. The Vendor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Vendor's insurance and
shall not contribute with it.
2. The Vendor's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty(30) days
prior written notice by certified mail,return receipt requested, has been
given to the City.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not less than
AN II.
EXHIBIT B (Continued)
E. Verification of Coverage
Vendor shall furnish the City with original certificates and a copy of the amendatory
endorsements, including but not necessarily limited to the additional insured
endorsement, evidencing the insurance requirements of the Vendor before goods,
materials or supplies will be accepted by the City.
ACORD. CERTIFICATE OF LIABILITY INSURANCE °A """"'
0712V037/21103
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Cahill-Lee Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8046 161st Ave NE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Redmond,WA 98052 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA Allstate Insurance Company
NexxpostLLC INSURERB
6111 12th Ave S
Seattle,WA 98108 INSURER C
INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR D POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TYPE OF INSURANCEGENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
7T COMMERCIAL GENERAL LIABILITY 050787202 10/19/2002 10/19/2003 DAMAGETORENTED
PREMISES Ea o reir $ 50,000
A CLAIMS MADE 1XI OCCUR WED EXP(Any one poison) $ 5,000
PERSONAL-6 AOV INJURY $ 100,000
GENERAL AGGREGATE $ 100,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 1000000
POLICY PRO- LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMB
ANY AUTO (Ea a dent) $
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per awdent)
PROPERTY DAMAGE $
(Per aaadent)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $
WORKERS COMPENSATION AND WCSTATU-LIMITSI OTH-
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
EL EACH ACCIDENT $
OFFICEPoMEMBER EXCLUDED? E L DISEASE-EA EMPLOYE $
If yas,de be under
SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
City Of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION
220 4th Ave S DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 5 0 DAYS WRITTEN
Kent, WA 98032 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES
AUTHORISED REPRESENTATIVE
ACORD 25(2001108) 0 ACORD CORPORATION 1988
ALLSTATE INSURANCE COMPANY
DECLARATIONS AMtr.UEJ OECLAKATWN ULT u4t eojuj
SVtLIAL IwURt CUSTUMILER Pf3LILY wu• Ll SU ?o7L'i e LU/IA
,
1 The insured
Mailing Address »12UW j1vyE5T�tt'�+TS LLL
L;t1A rwk%Xi'iST
bill 12TH AVE S
stATTLt w.4 4616Un
LOCATION OF INSURED PREMISES j
bill 1, TH Hit i StATTLC inA '1611 8
MmjJ;'iRY nHJL%SALt- BuILUIN6 1
,
2.Poky Period From � TO i
JLr b L 5. Uct3 UCT 11, c17U4 ,
c tv IPvt�I r1v ,.i4U tIWUI,s a Id JI AoNe v ST A,vUARU T IMt_ AT T HI; AUL. KL " Ut- T"t-
1NSURtu STATEU "'uUVt
3.The Insured is A C 0kP iJK A 111JN
t
i
4.Additional Interests
This policy also covers the interests of any of the following when indicated by an"X"and named below t
r
t
The Mortgagee,under The Loss Payee,under Other i
s -Ware"A—Part One. Iiil Cover ,A—Part Two i
-r
The Additional Insured for Leased Premises,under The Vendor under
Coverage B—Part One Coverage B—Part One
Name k
PLLAZ)L aEFtH TU Irnt ATIACHta NUI1Lt
Address
¢,Palley Coverage provided
-This pohcy applies to each of the Coverages and Parts shown below Under Coverage A,Coverage is provided only for property at the Insured
Premises ffor which a specific limit of liability is shown
Part Buildings Limits of Liability
One RtPLHCEMtNT LUST
The Property Insurance $ 2 S e I JLJ.J
Adjustment Condition I S applicable to this policy
y Business $
Two Contents RLYLALtMr_NT LOsT SUtudd
I
DEDUCTIBLE $ 41 i J Applicable to each adjusted loss. r
r r 1
--Part =mqt� Limits of Ualillityt
f One Comprehensive Liability $ 1 v ii UU v U UU Each Accidental
Event
Fire and Specified Peril Legal Liability $ S Each Accidental
Li v LIU U Event
Advertising Injury Liability $ 100,000
Two Medical Payments $ $5,000 Each Person
25,000 Each Accident
6.Optional Coverages
The following optional coverages,if any,are provided underthis policy
Loc.No. Coverage Part Title
il316 IJL1 1, 0 ADCITIUNAL IfiSURED
k
2 Annual Premium for the Policy and Optional Coverages $ Cs ?41•L!t!
8. Endorsements The following endorsements amend this policy.
I � �i1s'�SuAserttSS ?Sri-1• L,uS7�4etsU5?SIB- 1e4�1.iS7br,edUSdUt,rljlry6Ub-`iez.'ieSb`I6sti1f56`i`te
&u57CIO
Countersigned By L AH I L L—L t L INS Authorized Agent nt, ,—uti a 64
Supplemental Declarations—This schedule supplements Items 6 and 8 of the Declarations.
6.Optional Coverages
The following optional coverages,it any,are provided under this policy
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8.The following forms and endorsements amend this policy.
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Coverage B—Business Liability
050 787202 Additional insureds
Lessor of Leased Equipment
The'Persons Insured' provisions of Coverage B—Business Liability, Part One, Comprehensive Liability, is
amended to include the person(s) or organization(s) shown below, but only with respect to their liability
arising out of the maintenance, operation or use by you of equipment leased to you by such person(s)
or organization(s) subject to the following additional exclusions:
We do not cover.
1. Any accidental event which takes place after the equipment lease expires;
2. Accidental events arising out of the sole negCgence of the person or organization shown below.
Name of Person or Organization
CITY OF KENT '
220 4TH AVE S
KENT, WA 98032
BUS728
(Ed. 1-90)
t SePPLEM04,T .MCLAOn
This Supplemental Declarations suppleients Items 4,s and$of the D41iiations U SO 7467�L d
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4. AddhionalInterests
This policy also covers the interests of any of the following when named below.The Mortgagee,under Coverage A—Part One,
the Loss Payee under Coverage A—Part TWo,the Additional Insured under Coverage B—Part One and the Vendor,under
Coverage B—Part One.
LOC. Additional Interest Name and Address
No.
001 -001 )4UkT(AtA-t LARRY Ja Let ANd ELIZAdLTH Me LEi:
3667 44TH AVENUL NE SEA TT LE WA 981Ub
LU AN Nei.. NA
001—OU1 LPL CITY OF Kt NT
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c2d0 4114 AVE S KENT wA 9bLid
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S. Under Coverage A,insurance is provided only for property at the Insured Premises for which a specific limit of hability is shown.
Part 10in—Buildings
LOC. Insured Premises RC or ACV* Limits of Liability
No.
Put TWO—Busiuess Contents
LOCNO. Insured Premises RC or ACV* Limits of Liability
No.
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L OC. Coverage Put Title
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