HomeMy WebLinkAboutPK05-224 - Original - David A. Clark Architects, PLLC - West Fenwick Park Restroom Building Design - 07/07/2005 iba==
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WASHINGTON Document
1
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact Mary Simmons, City
Clerks Office.
Vendor Name: aa U Id /A-Y"1�11 i Gis 19
Contract Number: jkOS'- 2ZA
This is assigned by Mary Simmons
Vendor Number:
Project Name: ].A-)PSt aPI w 614' PG-Wr (LL Y/1 W
Contract Effective Date: 7"O
Contract Termination Date: 2 1 31 '
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: r
Department:
Abstract:
ADCUB32 07/02
KENT
WASMINOTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
David A. Clark Architects, PLLC
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and David A Clark Architects, PLLC organized under the laws of the State of
Washington, located and doing business at 11737 SE 256t Place, Kent, Washington 98031-7897 (hereinafter
the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following described
plans and/or specifications:
Provide design and construction drawings for the restroom/picmc shelter building at West
Fenwick Park as described in the Consultant's Proposal dated March 2, 2005 and revised May
31, 2005 attached and incorporated as Exhibit A.
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices in effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. Upon the effective date of this
Agreement, Consultant shall complete the work described in Section I within ninety(90) days.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Thirty
Thousand, Three Hundred Eighty-eight Dollars and 45/100ths ($30,388.45) for the services
described in this Agreement. This is the maximum amount to be paid under this Agreement for
the work described in Section I above, and shall not be exceeded without the prior written
authorization of the City in the form of a negotiated and executed supplemental agreement. The
Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein
shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of
this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and a
final bill upon completion of all services described in this Agreement. The City shall provide
payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any
portion of an invoice, it shall notify the Consultant and reserves the option to only pay that
portion of the invoice not in dispute. In that event, the parties will i mmediately m ake every
effort to settle the disputed portion.
CONSULTANT SERVICES AGREEMENT- 1
(Over$10,000)
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement and that the Consultant 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. After termination, the City may take possession of all records and data within the Consultant's
possession pertaining to this project, which may be used by the City without restriction. If the City's use of
Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the
Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor 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. Consultant 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.
VII. INDEMNIFICATION. Consultant 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 Consultant's negligent
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 Consultant's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,
then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused
by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees,
agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's
negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'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.
The provisions of this section shall survive the expiration or termination of this Agreement
VIII. INSURANCE. The Consultant 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.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work
under this Agreement.
CONSULTANT SERVICES AGREEMENT-2
(Over S10,000)
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents,
drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the
Consultant Consultant shall make such data, documents, and files available to the City upon the City's request.
The city's use or reuse of any of the documents, data and files created by Consultant for this project by anyone
other than Consultant on any other project shall be without liability or legal exposure to Consultant.
XI. CITY'S RIGHT O F INSPECTION. E ven though Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, the w ork in ust in eet the approval o f t he C ity and s hall b e subject t o t he C ity's general r ight o f
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant 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 Consultant's own risk, and Consultant 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.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3 80 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 Disputes 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.
CONSULTANT SERVICES AGREEMENT-3
(Over$10,000)
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 Consultant.
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 Consultant agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Consultant's 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.
C U TAN ���'^� CITY KENT:
By: By:
(signature) (signature)
Print Name: in A . C—c-c44LV� Print ame: Jim White
Its Its Mayor
(Title) r (Title) _
DATE: t7 9 a) DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Dave Clark Perry Brooks, Project Manager
David A. Clark Architects, PLLC Kent Parks, Recreation & Community Services
11737 SE 256th Place 220 Fourth Avenue South
Kent, WA 9803a789-7 Kent, WA 98032-5895
(253) 813-8877 (telephone) (253) 856-5114 (telephone)
(253) 854-7898 (facsimile) (253) 856-6050 (facsmnle)
APP r% AS TO FORM:
nt aw Depa ent
West Fenwick Park Restroom Design
CONSULTANT SERVICES AGREEMENT-4
(Over$10,000)
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 12.
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.
41L Dated this_G day of JV NLI , 2005.
By: %-4U-4t--,L
For- -b) N 1'0 A. C L AR V--
Title: ®e 0%,y1'l N�, h
Date:
EEO COMPLIANCE DOCUMENTS- I
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 arnountmg 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-2
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 David A. Clark Architects, PLLC Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement
known as West Fenwick Park Restroom Design 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 , 2005.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS-3
EXHIBIT A
e •
Kent Parks,Recreation and Community Services
West Fenwiek Park Prepared 2-Mar-05
*,y, test oo►iiSh her ti ding '_es lI8cTl v�t�gs{o ty)'r1Re�tsed 31-May-05
'total
Drafting Principal Hours Fee
Preliminary Design $ 3,51293
Site Visit,documentation 0 6989 2 12752 2 $ 25504
Compile exist data 1 6999 0 12752 1 $ 6989
Preliminary Design 0 6989 6 12752 6 $ 765 12
PD drawings 0 6989 5 12752 5 $ 63760
Client Meetings(entire project) 0 6999 12 12752 12 $ 1,53024
Consultant meetings(entire project) 0 6989 2 12752 2 $ 25504
Work Completed on previous rebuild project $ 1,15135
PD,Const drawings,meetings 11 6989 3 12752 14 $ 1,151 35
PP,r,nst dFawnigs,meeting —4 6999 6 „—�52 4-0 S 1,044 68 No charge
Construction Draeings $ 5,76901
G-001 General Sheet 5 6989 1 12752 6 $ 47697
A-100 Site Plan 10 6989 3 12752 13 $ 1,08146
A-101 Plans 15 6989 5 12752 20 $ 1,68595
A-201 Elevations 12 6989 2 12752 14 $ 1,093 72
A-501 Details 15 6989 3 12752 18 $ 1,43091
S-001 Structural Notes Staaleson Engineering,P C (Sub Consult) $ 4,50000
S-101 Foundation Plan,Details
S-102 Roof Framing Plan
S-103 Details
P-001 General Notes TEC Engineering (Sub Consult) $ 2,90000
P-101 Plumbing Plan
P-601 Fixture Schedule
E-001 General Notes 3 Omega Engineering,Inc (Sub Consult) $ 3,56500
E-101 Electrical Floor Plan,Panel Schedules
E-601 One Line,Fixture Schedules
Specifications $ 7,26864
00020 Scope of Work By others
00030 Call for Bids By others
00100 Instructions for Bidders By others
00200 Checklist of Required Bid Forms By others
00220 Contractor's Qualifications Statement By others
00300 Bid Proposal By others
00400 Non Coll form By others
00410 EOE Form By others
00430 Compliance Form By others
00480 Sub List By others
00481 3%Sub List By others
00490 Bid Bond By others
00500 Contract By others
00700 General Conditions By others
00800 FOE Policy By others
00810 EOE Comp Statement By others
00900 Perf/Payment Bonds By others
00950 PieNailing Wage Rates By others
David A Clark Architects,PLLC West Fenwick Park Restroom Proposal design only 053105 5/31/2005,3 38 PM
1000 Special Conditions By others
1200 Project Meetings By others
1330 Submittals By others
1770 Project Closeout By others
1780 Project Record Drawings By others
1830 Operation and Maintenance By others
2200 Excavation,Grading and Compaction 0 4846 3 12752 3 $ 38256
2500 Asphalt Paving 0 4846 2 12752 2 $ 25504
2700 Site Utilities 0 4846 3 12752 3 $ 38256
2810 Irrigation By others
2900 Landscaping By others
3240 Fiberous Reinforcing 0 6989 3 12752 3 $ 38256
3300 Concrete 0 6989 3 12752 3 $ 38256
3400 Hollow Core Planks 0 6989 6 12752 6 $ 765 12
4220 CMU 0 6989 3 12752 3 $ 38256
5500 Metal Fabrications 0 6989 3 12752 3 $ 38256
6200 Finish Carpentry 0 6989 4 12752 4 $ 51008
7200 Insulation 0 6989 3 12752 3 $ 38256
7400 Single Ply Membrane Roofing 0 6989 4 12752 4 $ 51008
7620 Metal Flashing and Trim 0 6989 4 12752 4 $ 51008
7900 Caulking and Sealants 0 6989 2 12752 2 $ 25504
8100 HM Doors&Frames 0 6999 2 12752 2 $ 25504
8710 Finish Hardware 0 6989 2 12752 2 $ 25504
9900 Painting 0 6989 2 12752 2 S 25504
10165 Toilet partitions 0 6989 2 12752 2 $ 25504
10440 Signage 0 6989 2 12752 2 $ 25504
10800 Toilet Accessories 0 6989 4 12752 4 $ 51008
15000 Mechanical Specifications Included above
16000 Electrical Specifications Included above
Cost Estimating $ 765 12
Final Cost Estimate 0 6989 6 12752 6 $ 765 12
Bidding $ 95640
Prebid meeting 0 6989 15 12752 15 $ 191 28
Bidding 0 6989 6 12752 6 $ 765 12
594
Exclusions
Construction Admin-will be done on an hourly basis
Reunbursables
Any work beyond 5'outside of the building
SEPA Work
All Boiler Plate,Bid documents
Assumptions
4 month construction period
DACA handles Permit submittal and revisions
David A Clark Architects,PLLC West Fenwick Park Restroom Proposal design only 053105 5/31/2005,3 38 PM
ATTACHMENT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may arise fiom or in
connection with the performance of the work hereunder by the Contractor, their agents,
representatives, employees or subcontractors
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below.
1. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract The Commercial General Liability
insurance shall be endorsed to provide the Aggregate Per Project
Endorsement ISO form CG 25 03 11 85 There shall be no
endorsement or modification of the Commercial General Liability
insurance for liability arising from explosion, collapse or underground
property damage The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy with
respect to the work performed for the City using ISO additional
insured endorsement CG 20 10 11 85 or a substitute endorsement
providing equivalent coverage.
2. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington
3. Professional Liability insurance appropriate to the Consultant's
profession
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits
1 Commercial General Liability insurance shall be written with limits no
less than $1,000,000 each occurrence, $1,000,000 general aggregate
and a$1,000,000 products-completed operations aggregate limit
2. Professional Liability insurance shall be written with limits no less
than$1 000,000 per claim and$1,000,000 policy aggregate limit
EXHIBIT B (Continued )
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions
for Automobile Liability and Commercial General Liability insurance.
1. The Contractor'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 Contractor's insurance and shall not contribute with it
2. The Contractor'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
3. The City of Kent shall be named as an additional insured on all policies (except
Professional Liability) as respects work performed by or on behalf of the contractor
and a copy of the endorsement naming the City as additional insured shall be attached
to the Certificate of Insurance The City reserves the right to receive a certified copy
of all required insurance policies The Contractor's Commei cial General Liability
insurance shall also contain a clause stating that coverage shall apply separately to
each insured against whom claim is made or suit is brought, except with respects to
the limits of the insurer's liability
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A M Best rating of not less than
A VII
E. Verification of Coverage
Contractor 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 Contractor before
commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall furnish
separate certificates and endorsements for each subcontractor All coverages for
subcontractors shall be subject to all of the same insurance requirements as stated herein
for the Contractor
r
ACORD,N CERTIFICATE OF LIABILITY INSURANCE UODC 05-16-2005
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MARSH ADVAN AMER/PHS /SEATTLE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
819941 P: (877) 616-7474 F: (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
P. O. BOX 33015 SAN ANTONIO T_X_78265 INSURERS AFFORDING COVERAGE
_
INSURED — IN SURERA_Hartfor_d Casualty Ins Co
DAVID A. CLARK ARCHITECTS PLLC DAVID INSURERB
CLARK INSURER C
11737 SE 256TH PLACE INSURER
KENT WA 98031 INSURER
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 rypE OF INSURANCE POLICY NUMBER POLICYEFF£CTAVE POLICY EXPIRATION LIMITS
LTR _ _ DATE(MMMDIYY OAT�MMDD/YY
GENERAL LIABILITY EACH OCCURRENCE s2, 000, 000
A COMMERCIAL GENERAL LIABILITY 52 SBA KT7316 10/27/04 10/27/05 FIRE DAMAGE IAny one fire) $300, 000
j CLAIMS MADE O OCCUR MED EXP(Any one person) $1 0 000
X Business Liab PERSONAL&ADV INJURY $2 000, 000
GENERAL AGGREGATE $4, 000, 000
GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $4, 0 0 O 000
POLICY �PROCT X LOC
JE
AUTOMOBILE LIABILITY
A ANY AUTO 52 SBA KT7316 10/27/04 10/27/05 COMBINED SINGLE LIMIT g2 EaOOO OOO
Ea accident) � �
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGELIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION S $
WC STATU- OTH
WORKERS COMPENSATION AND ORY_410J , _
EMPLOYERS LIABILITY
A 52 SBA KT7316 10/27/04 10/27/05 EL EACH ACCIDENT $1, 000, 000
E L DISEASE-EA EMPLOYEE $1, 000, 000
EL DISEASE-POLICY LIMIT I$1, O00 OOO
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPEC/AL PROVISIONS
Those usual to the Insured' s Operations City of Kent is an Additional Insured
per the Business Liability Coverage Form SS0008, attached to this policy. Ref
Project : West Fenwick Restroom Building.
CERTIFICATE HOLDER X I ADOITIONAL INSURED,INSURER LETTER A CANCELLATION
City Of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
y EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Parks Planning and Development 30 DAYS WRITTEN NOTICE(10 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE
Attn: Joan Broom 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
220 4th Ave South REPRESENTATIVES
Kent, WA 98032-5895
AUTHORIZED REPRESEENTAA.M
ACORD 25-S(7197) o ACORD CORPORATION 1988
(d) Any structure, basin, excavation, c. A limited liability company, you are an
premises or place prepared or used insured Your members are also insureds,
for the storage or disposal of"waste", but only with respect to the conduct of
and includes the site on which any of the your business Your managers are
foregoing is located, all operations insureds, but only with respect to their
conducted on such site and all premises duties as your manager
used for such operations, d. An organization other than a partnership
"Nuclear material" means "source or joint venture or limited liability company,
material", "special nuclear material" or you are an insured Your "executive
"byproduct material", officers" and directors are insureds, but
only with respect to their duties as your
"Nuclear reactor" means any apparatus officers or directors Your stockholders
designed or used to sustain nuclear are also insureds, but only with respect to
fission in a self-supporting chain reaction their liability as stockholders
or to contain a critical mass of fissionable
material, 2. Each of the following is also an insured:
"Property damage" includes all forms of a. Your "employees", other than either your
radioactive contamination of property, "executive officers" (if you are an
organization other than a partnership, joint
"Source material" has the meaning given it
venture or limited ha
in the Atomic Energy Act of 1954 or in any
your managers (if you are
company) or
a limited liability
law amendatory thereof, company), but only for acts within the
"Special nuclear material" has the scope of their employment by you or while
meaning given it in the Atomic Energy Act performing duties related to the conduct of
of 1954 or in any law amendatory thereof, your business However, none of these
"Spent fuel" means any fuel element or "employees" is an insured for
fuel component, solid or liquid, which has (1) "Bodily injury" or "personal and
been used or exposed to radiation in a advertising injury"
"nuclear reactor", (a) To you, to your partners or
"Waste" means any waste material- members (if you are a partnership
(a) Containing "byproduct material" other or joint venture), to your members
than the tailings or wastes produced (if you are a limited liability
by the extraction or concentration of company), or to a co-"employee"
uranium or thorium from any ore while that co-"employee" is either
processed primarily for its "source in the course of his or her
material"content; and employment or performing duties
(b) Resulting from the operation by any
related to the conduct of your
person or organization of any "nuclear business;
facility" included under paragraphs (a) (b) To the spouse, child, parent,
and (d) of the definition of "nuclear brother or sister of that co-
facility" "employee" as a consequence of
Paragraph (1)(a) above,
C. WHO IS AN INSURED (c) For which there is any obligation
1. If you are designated in the Declarations as- to share damages with or repay
a. An individual, you and your spouse are someone else who must pay
insureds, but only with respect to the damages because of the injury
conduct of a business of which you are described in Paragraphs (1)(a) or
the sole owner (b) above, or
b. A partnership or joint venture, you are (d) Arising out of his or her providing
an insured Your members, your partners or failing to provide professional
and their spouses are also insureds, but health care services
only with respect to the conduct of your (2) "Property damage"to property.
business. (a) Owned, occupied or used by, or
Form SS 00 08 03 00 1
(b) Rented to, in the care, custody or Coverage under this provision includes
control of, or over which physical the following:
control is being exercised for any (1) When an engineer, architect or
purpose by you, any of your surveyor becomes an insured under
,.employees", any partner or provision 2f, the following additional
member (if you are a partnership exclusion applies
or joint venture), or any member
(if you are a limited liability "Bodily injury", "property damage" or
company) "personal and advertising injury"
b. Any person (other than your "employee"), arising out of the rendering of or the
or any organization while acting as your failure to render any professional
real estate manager services by or for you including
c. Any person or organization having proper (a) The preparing, approving, or
temporary custody of your property if you failure to prepare or approve
die, but only maps, drawings,opinions, reports,
surveys, change orders, designs
(1) With respect to liability arising out of or specifications, and
the maintenance or use of that
property, and (b) Supervisory, inspection or
engineering services
(2) Until your legal representative has
been appointed (2) When a lessor of leased equipment
becomes an insured under provision
d. Your legal representative if you die, but 2.f., the following additional exclusions
only with respect to duties as such That apply
representative will have all your rights and (a) To any "occurrence" which takes
duties under this policy place after the equipment lease
e. Any"employee" of the insured while acting expires, or
in the scope of his/her duties as a retail (b) To "bodily injury" or "property
pharmacist, or optician or optometrist damage" arising out of the sole
f. Additional Insureds by Contract, negligence of the lessor
Agreement or Permit (3) When owners or other interests
Any person or organization with whom you from whom land has been leased
agreed, because of a written contract or become an insured under provision
agreement or permit, to provide insurance 2.f., the following additional exclusions
such as is afforded under this Business apply,
Liability Coverage Form, but only with
respect to your operations, "your work" or (a) Any "occurrence" which takes
facilities owned or used by you. place after you cease to lease that
However, coverage under this provision
land, or
does not apply (b) Structural alterations, new
(1) Unless the written contract or construction or demolition
agreement has been executed or a operations performed by or on
permit has been issued prior to the behalf of the owners or other
interests from whom land has
bodily injury', property damage' or
"personal and advertising injury" been leased
under
(4) When managers or lessors of
(2) To any person or organization premises become an insured under
included as an insured under provision g. (Broad Form Vendors) provision 2.f., the following exclusions(3) To any other person or organization apply
shown in the Declarations as an (a) Any "occurrence" which takes
Additional Insured place after you cease to be a
tenant in that premises- or
Form SS 00 08 03 00
(b) Structural alterations, new (g) Products which, after distribution
construction or demolition or sale by you, have been labeled
operations performed by or on or relabeled or used as a
behalf of the manager or lessors container, part or ingredient of any
of the premises. other thing or substance by or for
g. Additional Insured - Broad Form the vendor
Vendors (2) This insurance does not apply to any
Any person or organization with whom you insured person or organization, from
agreed, because of a written contract or whom you have acquired such
agreement to provide insurance, but only products, or any ingredient, part or
with respect to "bodily injury" or "property container, entering into,
damage" arising out of "your products" accompanying or containing such
which are distributed or sold in the regular products
course of the vendor's business, subject to (3) This provision g. does not apply to
the following additional exclusions any vendor included as an insured by
(1) The insurance afforded the vendor an endorsement issued by us and
does not apply to made a part of this Coverage Part
(a) "Bodily injury" or "property (4) This provision g. does not apply if
damage" for which the vendor is "bodily injury" or "property damage"
obligated to pay damages by included within the "products-
reason of the assumption of completed operation hazard" is
liability in a contract or agreement. excluded either by the provisions of
This exclusion does not apply to the Coverage Part or by endorsement
liability for damages that the In. Broad Form Named Insured
vendor would have in the absence Any organization you newly acquire or
of the contract or agreement, form, other than a partnership or joint
(b) Any express warranty venture, and over which you maintain
unauthorized by you, ownership or majority interest, will qualify
(c) Any physical or chemical change as a Named Insured if there is no other
in product made intentionally by similar insurance available to that
the vendor, organization However
(d) Repackaging, unless unpacked (1) Coverage under this provision is
solely for the purpose of afforded only until the 180th day after
inspection, demonstration, testing, you acquire or form the organization
or substitution of parts under or the end of the policy period,
instructions from the whichever is earlier, and
manufacturer, and then (2) Coverage under this provision does
repackaged in the original not apply to
container; (a) "Bodily injury" or "property
(e) Any failure to make such damage"that occurred, or
inspections, adjustments, tests or (b) "Personal and advertising injury"
servicing as the vendor has arising out of an offense
agreed to make or normally committed before you acquired or
undertakes to make in the usual y q
course of business, in connection formed the organization
with the distribution or sale of the 1. Newly Formed or Acquired
products, Organizations
(f) Demonstration, installation, Any subsidiary and subsidiary thereof, of
servicing or repair operations yours which is a legally incorporated entity
except such operations performed of which you own a financial interest of
at the vendor's premises in more than 50% of the voting stock on the
connection with the sale of the effective date of this policy
product,
Form SS 00 08 03 00
The insurance afforded herein for any 2.a. To any insured, except volunteer
subsidiary not shown in the Declarations workers
as a named insured does not apply to (3) When used in this provision
injury or damage with respect to which an volunteer worker(s) means a person
insured under this policy is also an insured who is not paid a fee, salary or other
under another policy or would be an compensation
insured under such policy but for its
termination or upon the exhaustion of its 3. Additional Insured -Mobile Equipment
limits of insurance With respect to "mobile equipment" registered
j. Additional Insured -Volunteers in your name under any motor vehicle
registration law, any person is an insured
Any person(s)who are volunteer worker(s) while driving such equipment along a public
for you, but only while acting at the highway with your permission. Any other
direction of, and within the scope of their person or organization responsible for the
duties for you conduct of such person is also an insured, but
(1) However, no volunteer worker(s) are only with respect to liability arising out of the
insureds for. operation of the equipment, and only if no
(a) "Bodily injury", "property damage" other insurance of any kind is available to that
or "personal and advertising person or organization for this liability
injury" arising out of rendering or However, no person or organization is an
the failure to render professional insured with respect to
services a. 'Bodily injury" to a co-"employee" of the
(b) "Bodily injury" or "personal and person driving the equipment, or
advertising injury" b. "Property damage" to property owned by,
(i) To you, to your partners or rented to, in the charge of or occupied by
members (if you are a you or the employer of any person who is
partnership or joint venture), an insured under this provision
to your members (if you are a No person or organization is an insured with
limited liability company), your respect to the conduct of any current or past
other volunteer worker(s) or to partnership, joint venture or limited liability
your "employees" arising out company that is not shown as a Named Insured in
of and in the course of their the Declarations
duties for you; D. LIABILITY AND MEDICAL EXPENSES
(ii) To the spouse, child, parent, LIMITS OF INSURANCE
brother or sister of your
volunteer worker(s) or your 1. The Limits of Insurance shown in the
"employees" as a Declarations and the rules below fix the most
consequence of paragraph (1) we will pay regardless of number of
(a) above, or a. Insureds,
(c) "Property damage"to property: b. Claims made or"suits" brought, or
(i) Owned, occupied or used by, c. Persons or organizations making claims or
n Rented to, in the care, bringing"suits"
custody or control of, or over 2• Aggregate Limits
which physical control is being The most we will pay for
exercised for any purpose by
a. Injury or damages under the "products-
you, any of your other volunteer completed operations hazard" arising from
workers, your "employees", any all "occurrences" during the policy period
partner or member (if you are a is the Products-Completed Operations
partnership or joint venture) or any Aggregate Limit shown in the
member (if you are a limited Declarations
liability company)
b. All other injury or damages, including
(2) Exclusion B.2.a. Applicable to Medical medical expenses, arising from all
Expenses Coverage is replaced by "occurrences" during the policy period is
the following the General Aggregate Limit shown in the
Declarations
Form SS 00 08 03 00
This General Aggregate Limit applies be deemed part of the last preceding period for
separately to each of your "locations" purposes of determining the Limits of Insurance
owned by or rented to you E. LIABILITY AND MEDICAL EXPENSES
"Location" means premises involving the GENERAL CONDITIONS
same or connecting lots, or premises
whose connection is interrupted only by a 1. Bankruptcy
street, roadway or right-of-way of a Bankruptcy or insolvency of the insured or of
railroad. the msured's estate will not relieve us of our
This aggregate limit does not apply to obligations under the policy
"property damage" to premises rented to 2. Duties in The Event of Occurrence, Claim
you arising out of fire, lightning or or Suit
explosion a. You must see to it that we are notified
3. Subject to item 2. above, the most we will pay promptly of an "occurrence" or an offense
for the sum of all damages because of all which may result in a claim To the extent
"bodily injury", "property damage" and medical possible, notice should include
expenses arising out of any one "occurrence" (1) How, when and where the "occurrence"
is the Liability and Medical Expenses Limit or offense took place,and
shown in the Declarations
(2) The names and addresses of any
The most we will pay for all medical expenses injured persons and witnesses, and
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit (3) The nature and location of any injury
shown in the Declarations, or damage arising out of the
4. Subject to item 2. above, the most we will pay occurrence or offense
for the sum of all damages because of all This condition applies only when the
"personal and advertising injury" sustained by "occurrence" or offense is known to
any one person or organization is the Personal (1) You, if you are an individual,
and Advertising Injury Limit shown in the (2) A partner, if you are a partnership, or
Declarations
(3) A manager if you are a limited liability
5. The most we will pay under Business Liability company,
Coverage for damages because of "property (4) An "executive officer" or insurance
damage" to premises rented to you, or in the manager, if you are a corporation, or
case of fire, while rented to you or temporarily
occupied by you with permission of the owner, (5) Any elected or appointed official, if
is the Damage To Premises Rented To You you are a political subdivision or public
Limit shown in the Declarations, entity
The Damage to Premises Rented To You b. If a claim is made or "suit" is brought
Limit applies to all damage proximately against any insured, you must
caused by the same event, whether such (1) Immediately record the specifics of the
damage results from fire, lightning or claim or "suit" and the date received;
explosion or any combination of the three and
If more than one limit of insurance under this (2) Notify us as soon as practicable.
policy and any endorsements attached thereto You must see to it that we receive a
applies to any claim or "suit", the most we will pay written notice the claim "suit" as soon
under this policy and the endorsements is the
single highest limit of liability of all coverages as practicable
applicable to such claim or "suit" However, this But this condition will not be considered
paragraph does not apply to the Medical breached unless the breach occurs after
Expenses limit set forth in paragraph 3. above such claim or"suit" is known to
The limits of this policy apply separately to each (1) You, if you are an individual,
consecutive annual period and to any remaining (2) A partner, if you are a partnership,or
period of less than 12 months, starting with the (3) A manager if you are a limited liability
beginning of the policy period shown in the company,
Declarations, unless the policy period is extended (4) An "executive officer" or insurance
after issuance for an additional period of less than manager, if you are a corporation, or
12 months In that case, the additional period will
Form SS 00 08 03 00
c. You and any other involved insured must* 5. Separation of Insureds
(1) Immediately send us copies of any Except with respect to the Limits of Insurance,
demands, notices, summonses or and any rights or duties specifically assigned
legal papers received in connection in this policy to the first Named Insured, this
with the claim or "suit", insurance applies:
(2) Authorize us to obtain records and a. As if each Named Insured were the only
other information, Named Insured, and
(3) Cooperate with us in the investigation, b. Separately to each insured against whom
settlement of the claim or defense a claim is made or"suit" is brought.
against the"suit"; and 6. Unintentional Failure to Disclose Hazards
(4) Assist us, upon our request, in the
enforcement of any right against any It is agreed that based on our reliance on your
may be representations as to existing hazards, if
person or organization that
liable to the insured because be unintentionally you should fail to disclose all
or damage to which this insurance such hazards at the inception date of your
may also apply. policy, we shall not deny any coverage under
d. No insureds will, except at their own cost, this Coverage Form because of such failure
voluntarily make a payment, assume any 7. Other Insurance - Primary Additional
obligation, or incur any expense, other Insured
than for first aid, without our consent. If the written contract or agreement or permit
3. Financial Responsibility Laws requires this insurance to be primary for any
a. When this policy is certified as proof of person or organization with whom you agree
financial responsibility for the future under to include in WHO IS AN INSURED, this Other
the provisions of any motor vehicle
Insurance Provision is applicable
financial responsibility law, the insurance If other valid and collectible insurance is
provided by the policy for "bodily injury" available for a loss we cover under this
liability and "property damage" liability will Business Liability Coverage Form, our
comply with the provisions of the law to obligations are limited as follows
the extent of the coverage and limits of a. Primary Insurance
insurance required by that law. This insurance is primary We will not
b. With respect to "mobile equipment" to seek contributions from other insurance
which this insurance applies, we will available to the person or organization
provide any liability, uninsured motorists, with whom you agree to include in WHO
underinsured motorists, no-fault or other IS AN INSURED, except when b. applies.
coverage required by any motor vehicle b. Excess Insurance
law We will provide the required limits for
those coverages This insurance is excess over.
4. Legal Action Against Us (1) Any other insurance, whether primary,
No person or organization has a right under excess, contingent or on any other
this coverage form basis
a. To loin us as a party or otherwise bring us (a) That is Fire, Extended Coverage,
into a "suit" asking for damages from an Builder's Risk, Installation Risk or
insured, or similar coverage for"your work",
b. To sue us on this coverage form unless all (b) That is Fire insurance for
of its terms have been fully complied with premises rented to you or
A person or organization may sue us to temporarily occupied by you with
permission of the owner,
recover on an agreed settlement or on a final
judgment against an insured obtained after an (c) That is insurance purchased by
actual trial, but we will not be liable for you to cover your liability as a
damages that are not payable under the terms tenant for "property damage" to
of this policy or that are in excess of the premises rented to you or
applicable limit of insurance An agreed temporarily occupied by you with
settlement means a settlement and release of permission of the owner, or
liability signed by us, the insured and the
claimant or the claimant's legal representative
(d) If the loss arises out of the not subject to Exclusion g. of
maintenance or use of aircraft, Section A.—Coverages.
"autos" or watercraft to the extent
Form SS 00 08 03 00
(2) Any other primary insurance available 1. Additional Insured - Designated Person or
to you covering liability for damages Organization
arising out of the premises or WHO IS AN INSURED under Section C. is
operations for which you have been amended to include as an insured the person
added as an additional insured by or organization shown in the Declarations, but
attachment of an endorsement only with respect to liability arising out of your
When this insurance is excess over other operations or premises owned by or rented to
insurance, we will pay only our share of you
the amount of the loss, if any, that 2. Additional Insured - Managers or Lessors
exceeds the sum of- of Premises
(1) The total amount that all such other a. WHO IS AN INSURED under Section C. is
insurance would pay for the loss in the amended to include as an insured the
absence of this insurance, and person(s) or organization(s) shown in the
(2) The total of all deductible and self- Declarations, but only with respect to
insured amounts under all that other liability arising out of the ownership,
insurance maintenance or use of that part of the
We will share the remaining loss, if any, premises leased to you and shown in the
with any other insurance that is not Declarations and subject to the following
described in this excess of the Limits of additional exclusions
Insurance shown in the Declarations of b. Additional Exclusions
this Coverage Part This insurance does not apply to:
c. Method of Sharing (1) Any "occurrence" which takes place
If all the other insurance permits after you cease to be a tenant in that
contribution by equal shares, we will follow premises, or
this method also Under this approach, (2) Structural alterations, new
each insurer contributes equal amounts construction or demolition operations
until it has paid its applicable limit of performed by or for that person or
insurance or none of the loss remains, organization.
whichever comes first
3. Additional Insured -Grantor of Franchise
If any of the other insurance does not WHO IS AN INSURED under Section C. is
permit contribution by equal shares, we amended include as an insured the
will contribute by limits Under this
method, each insurer's share is based on person(s) or organization(s) shown in the
the ratio of its applicable limit of insurance Declarations, but only with respect to their
to the total applicable limits of insurance of liability as grantor of franchise to you.
all insurers 4. Additional Insured - Lessor of Leased
This provision provides such insurance as Equipment
is afforded under this policy, but only with a. WHO IS AN INSURED under Section C. is
respect to your operations, "your work" or amended to include as an insured the
facilities owned or used by you person(s) or organization(s) shown in the
F. OPTIONAL COVERAGES Declarations, but only with respect to their
liability arising out of the maintenance,
If listed or shown as applicable in the Declarations, operation or use by you of equipment
one or more of the following Optional Coverages leased to you b such
also apply. These coverages are subject to the organization(s)
y Person(s) or
terms and conditions applicable to Business b. Additional Exclusions
Liability Coverage in this policy, except as
provided below This insurance does not apply:
(1) To any "occurrence" which takes
place after the equipment lease
expires, or
(2) To "bodily injury" or "property
damage" arising out of the sole
negligence of the lessor
Form SS 00 08 03 00
5. Additional Insured - Owners or Other This exclusion does not apply to
Interests From Whom Land Has Been liability for damages that the
Leased vendor would have in the absence
WHO IS AN INSURED under Section C. is of the contract or agreement,
amended to include as an insured the person (b) Any express warranty
or organization shown in the Declarations, but unauthorized by you,
only with respect to liability arising out of the (c) Any physical or chemical change
ownership, maintenance or use of that part of in the product made intentionally
the land leased to you and shown in the by the vendor,
Declarations and subject to the following
additional exclusion (d) Repackaging, unless unpacked
solely for the purpose of
This insurance does not apply to inspection, demonstration, testing,
a. Any "occurrence" that takes place after or the substitution of parts under
you cease to lease that land, or instructions from the
b. Structural alterations, new construction or manufacturer, and then
demolition operations performed by or for repackaged in the original
the person or organization shown in the container,
Declarations (e) Any failure to make such
6. Additional Insured - State or Political inspections, adjustments, tests or
Subdivision -Permits servicing as the vendor has
a WHO IS AN INSURED under Section C. is agreed to make or normally
undertakes to make in the usual
amended to include as an insured the
course of business, in connection
state or political subdivision shown in the
with the distribution or sale of the
Declarations, but only with respect to products,
operations performed by you or on your behalf for which the state or political (f) Demonstration, installation,
subdivision has issued a permit servicing or repair operations,
b. Additional Exclusions except such operations performed
at the vendor's premises in
This insurance does not apply to: connection with the sale of the
(1) "Bodily injury", "property damage" or product,
"personal and advertising injury" (g) Products which, after distribution
arising out of operations performed for or sale by you, have been labeled
the state or political subdivision, or or relabeled or used as a
(2) "Bodily injury" or "property damage" container, part or ingredient of any
included in the "product-completed other thing or substance by or for
operations" hazard the vendor
7. Additional Insured -Vendors (2) This insurance does not apply to any
a. WHO IS AN INSURED under Section C. is insured person or organization, from
amended to include as an insured the whom you have acquired such
products, or any ingredient, part or
person(s) or organization(s) (referred to container, entering into,
below as vendor) shown in the accompanying or containing such
Declarations, but only with respect to
"bodily injury" or "property damage" products
arising out of "your products" which are (2) This Provision 7. does not apply to
distributed or sold in the regular course of any vendor included as an insured by
the vendor's business an endorsement issued by us and
b. Additional Exclusions made a part of this Coverage Form
(3) This Provision 7. does not apply if
(1) The insurance afforded the vendor does not apply to: "bodily injury" or "property damage"
included within the "products-
(a) "Bodily injury" or "property completed operations hazard" is
damage" for which the vendor is excluded either by the provisions of
obligated to pay damages by this Coverage Form or by
reason of the assumption of endorsement
liability in a contract or agreement
Form SS 00 08 03 00
1
8. Additional Insured — Controlling b. Any other publication that is
Interest given widespread public
WHO IS AN INSURED under distribution
Section C. is amended to include as However, "advertisement" does not
an insured the person(s) or include the design, printed material,
organization(s) shown in the information or images contained in,
Declarations but only with respect to on or upon the packaging or labeling
their liability arising out of of any goods or products.
a. Their financial control of you; or 2. "Advertising idea" means any idea
b. Premises they own, maintain or for an "advertisement"
control while you lease or 3. "Auto" means a land motor vehicle,
occupy these premises trailer or semi-trailer designed for
This insurance does not apply to travel on public roads, including any
structural alterations, new attached machinery or equipment
construction and demolition But "auto" does not include "mobile
operations performed by or for that equipment'
person or organization
9. Additional Insured — Owners, 4. "Bodily injury' means bodily injury,
Lessees or Contractors — sickness or disease sustained by a
Scheduled Person or person, including mental anguish or
Organization. death resulting from any of these at
WHO IS AN INSURED under any time.
Section C. is amended to include as 5. "Coverage territory"means
insured the person or organization a. The United States of America
shown in the Declarations, but only (including its territories and
with respect to liability arising out of possessions), Puerto Rico and
your ongoing operations performed Canada,
for that insured b. International waters or airspace,
10. Additional Insured — Co-Owner of provided the injury or damage
Insured Premises does not occur in the course of
WHO IS AN INSURED under travel or transportation to or
Section C. is amended to include as from any place not included in a.
an insured the person(s) or above, or
Organization(s) shown in the c. All parts of the world if:
Declarations, but only with respect (1) The injury or damage arises
to their liability as co-owner of the out of
premises shown in the Declarations
G. LIABILITY AND MEDICAL (a) Goods or products
made or sold by you in
EXPENSES DEFINITIONS the territory described in
1. "Advertisement" means a a. above, or
dissemination of information or (b) The activities of a
images that has the purpose of person whose home is
inducing the sale of goods, products in the territory described
or services through in a, above, but is away
a. (1) Radio; for a short time on your
(2) Television; business, and
(3) Billboard, (2) The insured's responsibility
to pay damages is
(4) Magazine; determined in a "suit"on the
(5) Newspaper; or merits in the territory
described in a. asettlement
to which we agree
Form SS 00 08 03 00
6. "Employee" includes a "leased
worker" "Employee" does not
include a "temporary worker"
7. "Executive officer" means a person
holding any of the officer positions
created by your charter, constitution,
by-laws or any other similar
governing document
8. "Hostile fire" means one which
becomes uncontrollable or breaks
out from where it was intended to
be
9. "Impaired property" means tangible
property, other than "your product"
or "your work", that cannot be used
or is less useful because:
a. It incorporates "your product" or
"your work" that is known or
thought to be defective,
deficient, inadequate or
dangerous; or
b. You have failed to fulfill the
terms of a contract or
agreement
if such property can be restored to
use by
a. The repair, replacement,
adjustment or removal of "your
product" or"your work", or
Your fulfilling the terms of the contract or
agreement
Form SS 00 08 03 00
• ISSUE DATE(MM/DD/YY)
04AN05
R
PRODUCER THIS CERI IFICATE IS ISSUED AS A MATTER OF INFORNIATION ONLY AND CONFERS NO RIGHTS
UPON rHEIR CERT IFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICIES BELOW
Marsh Affinity Group Services
1215 Fouith Avenue
Suite 600 COMPANIES AFFORDING COVERAGE
Seattle,WA 98161
COMPANY A Continental Casualty Company(CNA)
LETTER
INSURED COMPANY B
LETTER
David A.Clark Architects,PLLC COMPANY C
11737 SE 256`h Place LETTER
Kent, WA 98031-7897 COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT 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
co TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE POLICYEXPIRATION
LTR DATE(MMD DATE(MWDD/YY)
GENERAL LIABILITY GENERALAGGREGATE
COMMERCIAL GENERAL LIABILITY PRODUCTS COMPiOPS AGGREGATE
CLAIMSMADE FJ OCCURRENCE PERSONAL&ADVERTISING NTRY
OWNERS&CONTRACTORS PROTECTIVE EACH GCCORENCE
FIRE DAMAGE(ANY ONE FIRE)
MEDICAL EXPENSE(ANY ONE PERSON)
AUTOMOBILE LIABILITY CSL
ANY AUTO
ALL OWNED AUTOS BODILY
INJURY
SCHEDULED AUTOS (PER PERSON) $
HIRED AUTOS BODILY
INJURY
NON-OWNED AUTOS (PER $
ACCIDENT)
GARAGE LIABILITY PROPERTY
DAMAGE
$
EXCESS LIABILITY EACH AGGRE
OCCURRENCE GATE
$ $
OTHER THAN UMBRELLA FORM
STATUTORY
WORKERS'COMPENSATION S (EACH ACCIDENT)
AND $ (DISEASE POLICY LIMIT)
EMPLOYERS'LIABILITY $ (DISEASE-EACH EMPLOYEE)
A OTHER SFA 11-407-09-44 06/15/02 06/15/05 LIMITS $ 2,000,000 each claim
Professmnal LTablhty 2,000,000 aggregate
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
Evidence of insurance
Project West FenwlckRestroontBuilding
r
ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE
ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Cl Of Kent WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BL1
TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILITY OP ANY
Parks Planning and Development N THE COMPANY,ITS AGENTS OR REPRESENTATIVES
Attn Joan Broom RIZED REPRESENTATIVE
220 4`hAve S �Kent, WA 98032-5895 ^