HomeMy WebLinkAboutPD05-353 - Original - Valley Cities Counseling & Consultation - Substance Abuse Treatment - 11/08/2005 -,000,0"�.
KEN T
WAS"I"GTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Valley Cities Counseling & Consultation
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Valley Cities Counseling & Consultation organized under the laws of the State of
Washington, located and doing business at 2704 "I" Street NE, Auburn, Washington 98002 (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 substance abuse relapse prevention pre-treatment group instruction for offenders at the
City of Kent Corrections Facility (CKCF). Aftercare will be offered to offenders on home
detention, assigned to alternative programs such as work release and after they are released from
jail to provide ongoing counseling and support. The scope of work is outlined in Exhibit A,
which is attached and incorporated by this reference.
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 by December 31, 2006 An option for a
second one-year term commencing on January 1, 2007, and ending December 31, 2007, is contingent upon the
availability of funds and the parties' agreement to the required performance The renewal shall be completed
upon execution of a Change Order prior to termination of this Agreement and its current term.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $24,750
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 B.
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
CONSULTANT SERVICES AGREEMENT- I
(Over$10,000)
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 immediately make every
effort to settle the disputed portion.
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 performance of
this Agreement, except for that portion of the injuries and damages caused by the City's negligence.
The City shall defend, indemnify and hold Consultant, 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 performance of this Agreement, except for
that portion of the injuries and damages caused by the Consultant'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.
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 C attached and incorporated by this reference.
CONSULTANT SERVICES AGREEMENT-2
(Over$10,000)
11
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.
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 OF INSPECTION. Even 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 work must meet the approval of the City and shall be subject to the City's general right of
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.
CONSULTANT SERVICES AGREEMENT-3
(Over$10,000)
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 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.
CONSULTANT: CITY OF KENT:
1
By: y
(stgir ture) (segna re)
Print Name: Print Name: 1 r cn•r r yea-
Its e G?ffl GPI Its Mayor
'rrre) / ,,r �rrtre
DATE: t / / 6 S DATE: 0 c5 r CJ
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Marilyn LaCelle Debra LeRoy
Valley Cities Counseling & Consultation City of Kent
2704 "I" Street NE 220 Fourth Avenue South
Auburn, WA 98002 Kent, WA 98032
253-833-7444 (telephone) (253) 856-5856 (telephone)
253-833-0480 (facsimile) (253) 856-6802 (facsimile)
AP ROVED AS TO FORM:
Ken Law e rtment
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 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 1, 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 3/st day of �� , 200_5
By:
For:
Title:
Date: / C
EEO COMPLIANCE DOCUMENTS- 1
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
o
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment pp opportu
nity
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-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 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:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS -3
EXHIBIT A
SCOPE OF WORK
A. The Consultant's responsibilities include:
1. Program Administration
a. Corrections Programs staff will provide consultant with names of inmates
on a relapse prevention pre-treatment group instruction waiting list If less
than ten male or five female inmates are listed, the consultant will hold an
inmate orientation session to fill the class. The consultant will provide a
final class roster to the CKCF Programs staff prior to beginning group
instruction (In the event that ten eligible inmates are not identified for a
group, instruction may proceed with no less than three inmates )
Each group meets for four weeks or a minimum of 24 hours Pre-
treatment groups will alternate between female and male groups.
However, if less than three inmates are enrolled for any one gender's
group the Contractor will provide group treatment for the opposite gender
if more than three inmates are enrolled A one week break will be
scheduled between groups.
b. Coordinate twice weekly two and one-half hour group meeting dates and
times with Corrections Programs staff. (Group class scheduling is limited
at the CKCF due to space and staff limitations.)
C. Conduct a monthly total of up to three hours group instruction at the CKCF
once or twice each month providing there are a minimum of two clients for
each group. These are co-ed groups. These sessions will include lectures on
various topics to include, but not limited to Grief/Loss/Self Esteem/Self
Actualization.
d. Perform inmate patient assessments using American Society for Addiction
Medicine (ASAM) diagnostic criteria for volunteer inmate clients.
Perform up to 50 assessments for CKCF inmates to meet court, probation,
Department of Corrections and Child Protective Services requirements.
Prepare and mail letters to appropriate correctional supervision agencies
documenting assessment of inmate clients. In addition, perform
assessments/evaluations upon Programs supervisor and coordinators
requests
EXHIBIT A
SCOPE OF WORK
PAGE 1 OF 3
20052006 Va 11eyCrtjes.Exh ibitA.doc
e. Provide original reference materials and forms for program.
f. Obtain written evaluation surveys of program to use as feedback from
those inmates completing program. Provide copies of the surveys to
Debra LeRoy at the Kent Police Department within one month following
completion of each pre-treatment group.
2. Records
a. Consultant staff will maintain all pre-treatment instruction and assessment
records
b. Consultant staff will transport records to and from the treatment site,
maintaining inmate client confidentiality as per Title 70 RCW and WAC
440-22-330.
C. Consultant shall create and provide inmate pre-treatment registration form
including release of information language for the program's evaluation
purposes. Kent Police Department (KPD) staff or a research intern hired
by KPD shall have access to all inmate client records at the Consultant's
business address for program research and evaluation purposes only.
3. Policy and Procedure Manual
Consultant will maintain a policy and procedure manual for activities and services
provided by Consultant staff This manual will promote inmate client and
Consultant staff safety as per WAC 440-22-025(2)(b).
4. Monthly Reports
The Consultant will provide monthly statistical reports on the pre-treatment
program in the CKCF to include, but not limited to:
a. Number of inmates registered to begin pre-treatment instruction.
b. Number of inmates completing group pre-treatment instruction.
C. Number and names of inmates who dropped out of group pre-treatment
instruction and reason for dropping out.
d. Number of registrants with prior addiction treatment.
e. Number of registrants referred to continuum treatment.
f. Length of abstinence for each registrant
EXHIBIT A
SCOPE OF WORK
PAGE 2 OF 3
20052006ValleyCities ExhlbltA.doe
g. Number and names of registrants recommended as needing assessments.
h. Number and names of inmate clients that received assessments.
i. Number and names of CKCF offenders entering treatment at Valley Cities.
5. Consultant employees
a. Consultant will run background checks on all employees with access to
inmates or their records in order to protect their confidentiality.
b. Consultant's treatment counselor is required to complete CKCF background
application and receive jail orientation from Programs staff prior to providing
treatment services or entering the jail for treatment planning.
B. The City's responsibilities include:
1. Provide a classroom with furnishings and security for group treatment.
2. The CKCF Administrator, or designee, will meet at least quarterly with the
Consultant staff to review the recovery program.
3. Coordinate group treatment class schedules with Consultant.
4. Photocopy class materials and forms for inmate registrants.
EXHIBIT A
SCOPE OF WORK
PAGE 3 OF 3
20052006ValleyCrties ExhibitA.doc
Exhibit B
Consultant Services Agreement
between the City i of Kent and
Valley Cities Counseling & Consultation
Fee Schedule
Total Contract
Fee Units Total
Group Instruction $75.00/hr 200 $15,000.00
Assessments $120.00/each 40 4,800.00
Aftercare $75.00/hr 36 2,700.00
Linkage
Inmate referral Assistance
.25 hour per each inmate requesting assistance $75.00/hr 30 2,250.00
Contract Total $24,750.00
EXHIBIT C
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 from 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 Liabilitv 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.
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.
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.
EXHIBIT B Continued
3. The City of Kent shall be named as an additional insured on all policies (except
Professional Liability) as respects work performed b or on behalf of the contractor
P P Y
and a co of the endorsement naming the City as additional insured shall be attached
PY g Y
to the Certificate of Insurance. The City reserves the right to receive a certified copy
of all required insurance policies. The Contractor's Commercial 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
AN IL
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.
ACORD. CERTIF[CATE OF LIABILITY INSURANCE DATEIMMDOIYY)
7120/05
PRODUCER 206-701-5000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Acordfa ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License # 0531007 HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 91143 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Seattle, WA 98 1 1 1-9774 INSURERS AFFORDING COVERAGE
INSURED Valley Cities Counseling INSURER A MENTAL HEALTH RISK RETENTION j
and Consultation INSURER SUBSCRIBING UNDERWRITERS
2704 1 St, NE INSURER
Auburn WA 98002-0000 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 1
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 POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER M DDYV LIMITS
A GENERAL LIABILITY CCL00014157 7115/05 71151116 EACH OCCURRENCE 4 1000000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Arty one fire) 4 3 D0000
X1 CLAIMS MADE [—]OCCUR MED EXP(Any one peranN 4 5000
PERSONAL ADV INJURY 4 1000000 j
X STOP GAP EMPLOYERS LIAB GENERAL AGGREGATE 4 1000000
GEN L AGGREGATE LIMIT APPLIES PER $1,000,000 LIMIT PRODUCTS-COMPIOP AGG ! 1000000
POLICY PAC LOC
B AUTOMOBILE LIABILITY SEE ATTACHED
COMBINED SINGLE LIMIT ! I
ANY AUTO IEa accident)
ALL OWNED AUTOS
BODILY INJURY 4 I
SCHEDULED AUTOS IPer Person)
HIRED AUTOS J
BODILY INJURY 4 1
NON OWNED AUTOS (Per accljwt) i
PROPERTY DAMAGE 4
IPer aoadent)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 8
ANY AUTO OTHER THAN EA ACC 8
AUTO ONLY-
AGO ! I
B EXCESS LIABILITY XLS0011989 7/1 5/05 7115/06 EACH OCCURRENCE 4 2000000 i
OCCUR O CLAIMS MADE EXCESS OVER AGGREGATE 4 2000000
i
GENERAL LIABILITY 4
DEDUCTIBLE &PROF LIABILITY o
RETENTION 4 4
WORKERS COMPENSATION AND WC STATU OTH- i
EMPLOYERS LIABILITY DRY
ER
E L EACH ACCIDENT 4
EL DISEASE-EA EMPLOYEE !
EL DISEASE-POLICY LIMIT 4
A OTHER CCL0001467 7115105 7/15106
PROFESSIONAL $1,000,000 EACH CLAIM
LIABILITY $1,000,000 AGGREGATE
DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENOORSEMEMT/SPECUIL PROVISIONS
THE CITY OF KENT, ITS ELECTED&APPOINTED OFFICIALS, ITS EMPLOYEES AND
AGENTS ARE NAMED AS ADDITIONAL INSUREDS AS RESPECTS OPERATIONS
PERFORMED BY VALLEY CITIES COUNSELING &CONSULTATION REPLACES ALL PREVIOUSLY
SEE ATTACHED CG2025&CCL-59S JHWL ISSUED CERTIFICATES
CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 6E CANCELLED BEFORE THE EXPIRATION
CITY OF KENT DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
220 4th Avenue South NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
Kent, WA 98032-5895 IMPOSE NO OBLIGATION 09 LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
RE TATIVES
AUTHORI RESE(NTA E
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ACORD 25-S 17197) 11-38 aACORD CORPORATION 1988
11, 07/2CO5 J9: -0 2537354111 1
d Cox i 'z Covexage Policy #
Columbia Insurance Ccmpany Pe_iod: 7/15/05 - 7/15/05
51 , 000, 000 limit fox ow-led Policy #71AP 369531
Ve:..Lcle only - ' 43 Chev , Van
Xen:al health Risk Retentio: Group Pexlod: 7/15/03 - 7/15/.5
$1 , C00 , 000 limit for Non-c.�ried Pclicy # CCL0001967
& Hired vehicles . :1y
Admiral inBurarce Company °exxcd: 7/15/05 - 7/15/05
$2 , 000, COO limit excess of Policy ;;EX000002393-01
o' n ed; Vo owner] & Fixed vehicles
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MOVERCIAL GENERA-UABILTY
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POLICY NUMBER CCL0001467
TH 3 E%DCRS5YEN'CHANGES THE ODLICY PLEASE READ r;CAREFULLY
ADDITIONAL INSURED-DESIGNATED PERSON
OR ORGAN14ATION
I? is endotsemcr t mcd Pies insuTan_c pio:^ded under '!tc foLtowmg.
COKNIERCIAL GFNERAL LIABILITY COVnRAGH'.%RT
SCHEDULE
Name of?erson or, Oi ga_'tizahe7.
IIw C7IY OF KEN I, II'S£LECI I D R APPON 7ED OT-FICIA15,
ITS E.Mi'LOYEES AND AGENTS
p"1 220 4"Avenue South
k Xont,V'VA 98032-5895
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if-io entry apFews above,xfoirnat:or cegLiued to complete th:s endousement',S-L be shown inthe Declatatcns as
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as an ^suzed L-.,t onh•i• tLh>espect to aabilfty a_uirg out of you: cpeiat;ons of prcroses owred by you ien'ed to you
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