HomeMy WebLinkAboutPW06-194 - Original - UPM - Labor & Equipment to Ultra Sonic Inspect Pump - 01/13/2006 Records Management
KENT
Document
WASHINGTON
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 City Clerks Office.
Vendor Name: en!�T "" y dor Number: lST
/' � .c����'1 V
JD Edwards Number
Contract Number: locj 6) 7 q
This Is assigned by Deputy City Clerk
Description: OtGc � JC�Y�2
Detail: It C
Project Name:
Contract Effective Date: /—/3 O46 Termination Date: z2
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: �� epartment:
Abstract:
5 Public\RecordsManagement\Forms\ContractCover\ADCL7832 07/02
.5
K E N T
WASHINGTON January13, 2006
PUBLIC WORKS
Larry R. Blanchard
Public Works Director
PUBLIC WORKS Mr. Stuart Gribble
OPERATIONS UPM
14500 260th SE
Mailing Address Issaquah, WA 98027
220 Fourth Ave S.
Kent,WA 98032-5895 Dear.Mr. Gribble:
Location Address.
5821 South 240th Thank you for returning the two signed originals of the contract between UP
Kent,Washington
and the City of Kent for the supply of labor and equipment to ultrasonically
Phone: 253-856-5600 inspect pump bearings for noise and use an infrared device to test wiring and
Fax:253-856-6500� connection points for excessive heat at eight locations in Kent. We have also
received the Commercial Certificate of Insurance from Fanners, however they
still need to fax to us the necessary additional insured endorsement (CG20-10).
he
have
een
by our Public
TheOperations manager,tand we are t ready to have you Works
two originals of Proceed with the work.
Enclosed is one fully signed original for your records. In the meantime,if you
have any questions, feel free to call me at 253-856-5600.
�Sincerely,
� /
Tom Iverson
Utilities Field Supervisor
TUmap
Enclosure: Signed Public Works Goods and Services Agreement
for Ordinary Maintenance between the City of Kent and UPM.
P operations\PWOpsContract\Coverretter3igned 1-06AgeementUPMUltrasonicpumpBeannglnspecuon
40000
KENT
GOODS & SERVICES AGREEMENT
FOR
ORDINARY MAINTENANCE
between the City of Kent and
UPM
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and UPM organized under the laws of the State of Washington, located and doing
business at 14500 26oth SE,Issaquah, Washington 98027; phone: 425-392-2975 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following services for the
City:
Contractor will inspect pump bearings for noise twice during 2006--the first visit will
consist of infrared and ultrasound testing; the second visit will be ultrasound testing only.
Testing of the pump bearings will take place at the following lift stations:
1) Lindental
2) Horseshoe Sanitary
3) Victoria Ridge
4) Linda Heights
5) Skyline
6) Kentview
7) 3`d Avenue Storm
8) Washington Avenue Storm
Contractor will also use an infrared device to test wiring and connection points for
excessive heat.
This inspection is done semi-annually and this contract covers both inspections in 2006.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and
services through other sources.
11. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services by December 31, 2006.\
GOODS &SERVICES AGREEMENT FOR ORDINARY MAINTENANCE- 1
(Under$10,000 00, including WSST)
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Six Hundred
Dollars ($600.00), including applicable Washington State Sales Tax, for the goods, materials, and services
contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the
following schedule:
Contractor will be paid for the services described herein within thirty (30) days of receipt
of an invoice.
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to
only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort
to settle the disputed portion.
A. Defective or Unauthorized Work The City reserves its right io withhold payment from Vendor
for any defective or unauthorized goods, materials or services. If Vendor is unable, for any
reason, to complete any part of ttus Agreement, the City may obtain the goods, materials or
services from other sources, and Vendor shall be liable to the City for any additional costs
incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs
and attorney fees, incurred by the City beyond the maximum Agreement price specified above.
The City further reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the Vendor.
B. Final Payment: Waiver of Claims. THE MAKING OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY
MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR
FINAL PAYMENT IS MADE.
IV. PREVAILING WAGES. Vendor shall file a Statement of Intent to Pay Prevailing Wages,"
with the State of Washington Department of Labor & Industries prior to commencing the Contract work.
Vendor shall pay prevailing wages in effect on the date the bid is accepted or executed by Vendor, and comply
with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate
provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is
attached.
V. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement and that the Vendor has the ability to control and
direct the performance and details of its work, the City being interested only in the results obtained under this
Agreement.
VI. 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.
GOODS&SERVICES AGREEMENT FOR ORDINARY MAINTENANCE-2
(Under$10,000 00, including WSST)
VII. CHANGES. The City may issue a written change order for any change in the goods, materials
or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason,
that a change order is necessary, Vendor must submit a written change order request to the person listed in the
notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date
knew or should have known of the facts and events giving rise to the requested change. If the City
Vendor kn g g q g y
determines that the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all
equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable
adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either
a written change order from the City or an oral order from the City before actually receiving the written change
order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make
any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor
disagrees with the equitable adjustment, the Vendor must complete the change order work; however, the
Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims,
below.
The Vendor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate
acceptance, or(3) not protesting in the way this section provides. A change order that is accepted by Vendor as
provided in this section shall constitute full payment and final settlement of all claims for contract time and for
direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected
by the change.
VHL CLAIMS. If the Vendor disagrees with anything required by a change order, another written
order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the
City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City
of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or
within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events
giving rise to the claim whichever occurs first . An claim for damages, additional payment for an reason or
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extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been
waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions
of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1
through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING
THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions rn this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate was
determined; and
5. An analysis of the progress schedule showing the schedule change or disruption if
the Vendor is asserting a schedule change or disruption.
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE-3
(Under$10,000 00, including WSST)
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of
the asserted events giving rise to the claim. The City shall have access to any of the Vendor's
records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also
waives any additional entitlement and accepts from the City any written or oral order (including
directions, instructions, interpretations, and determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the City
any written or oral order(including directions, instructions, interpretations, and determination).
IX. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD.
X. WARRANTY. This Agreement is subject to all warranty provisions established under the
Uniform Commercial Code, Title 62A, Revised Code of Washington Vendor warrants goods are
merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance
with their specifications and Vendor's representations to City. The Vendor shall correct all defects in
workmanship and materials within one (1) year from the date of the City's acceptance of the Contract work In
the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts
will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for
one (1) year from the date such correction is completed and accepted by the City. The Vendor shall begin to
correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect If the
Vendor does not accomplish the corrections within a reasonable time as detennmed by the City, the City may
complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the
correction.
XI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or
sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the
presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and
available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XII. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials,
employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including
GOODS &SERVICES AGREEMENT FOR ORDINARY MAINTENANCE-4
(Under$10,000 00, including WSST)
all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this
Agreement, except for that portion of the injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this Agreement.
XIII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit A attached and incorporated by this reference.
XIV. WORK PERFORMED AT VENDOR'S RISK Vendor shall take all necessary precautions
and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the
contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's
own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or
held for use in connection with the work.
XV. 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
XII 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.
GOODS&SERVICES AGREEMENT FOR ORDINARY MAINTENANCE-5
(Under$10,000 00, including WSST)
E. Assignment. Any assignment of this Agreement by either party without the written consent of
the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms
of this Agreement shall continue in full force and effect and no further assignment shall be made without
additional written consent
F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the
City, and such statements shall not be effective or be construed as entering into or forming a part of or altering
in any manner this Agreement. All of the above documents are hereby made a part of this Agreement.
However, should any language in any of the Exhibits to this Agreement conflict with any language contained in
this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendor'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.
VENDOR: CITY OF KENT:
By: o Z� By:
(signature) (signature)
Print Name: �S7Zls/�9` of E' Print Name: Donald C. Millett
Its: Its. Acting Public Works Operations
(nue) �, Manager
DATE: �— /d — (Title)
DATE: _ 13 , b
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Stuart Gribble Tom Iverson Utilities Supervisor
G�/�.I� City of Kent
14500 260'h SE 220 Fourth Avenue South
Issaquah, WA 98027 Kent, WA 98032
(425) 392-2975 (telephone) (253) 856-5600 (telephone)
[Insert Fax Number] (facsimile) (253) 856-6600 (facsimile)
P Operations\PWOpsContracts\UhUries\UPMConhaet2OO6lnspechonPumpBeanngsEightLiftStations
GOODS &SERVICES AGREEMENT FOR ORDINARY MAINTENANCE-6
(Under$10,000 00, including WSST)
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity
within their organization and, if holding Agreements with the City amounting to $10,000 or more wrthm any
given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal
opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and
equal opportunity requirements shall be considered in breach of contract and subject to suspension or
termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works
Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are
familiar with the regulations and the City's equal employment opportunity policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS- 1
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 -/0-0 ate
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 �.(JG� , 200_i�.
By:
For: '0W Ix (�
Title: C./GCJ,lae!5�
Date:
EEO COMPLIANCE DOCUMENTS-2
EXHIBIT A
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
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. Automobile Liability insurance covering all owned, non-owned, hired
and leased vehicles. Coverage shall be written on Insurance Services
Office (ISO) form CA 00 01 or a substitute form providing equivalent
liability coverage. If necessary, the policy shall be endorsed to
provide contractual liability coverage.
Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability ansmg 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. 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.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined single limit
for bodily injury and property damage of $1,000,000 per accident.
2. 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.
P Operahons\PWOpsContrauslUtiliheslUPM\ExhibitAlnsReg2006lnspechons8Locahons
EXHIBIT A (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 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 II.
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.
P Operations\PWOpsContracts\Utilities\UPM\ExhiMtAlnsReg2006lnspechons8locahons
JAN 11,2006 17:53 Farmers Insurance 2066334036 Page 1
Commercial Certificate of Insurances FARM E R S
Agrrt(Y
Nnm° Issue Date (MM/UI)/YY) I lime h, 2005 -- —
Address I'his rrltilii all is issui-d a,<t mdt(er of uifornation only and rnnfers,no rlp,*
upon the terurrcate holder This reniniraw does tint ametid,exrend.H alter the
St rovelage iPoi(l,(IIry rlie p,dl;In shown beluw
74 r),st, 03 Agent 114
Companies Providing Covtragc:
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N^TI'e dha tltirasome Predictable Mt LetC�Hohans B fanners Insurance Fxchangr
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x. I4S011 260rh til r mupany C Mid Century Insurance Company
Address Isisayualt,WA 99027 LOW
G•nglany Q
Irll[r
Coverages --_.... . _—• _--
Tlus n to tertdy Ilia(die policies of insurance lured below have been usued to the insured named above for the polity period usdlrared NntwMisundmg
any reyuuemem,term or condition of any contract or other docunirnr with rrsprrt to which this rezrifirdr may N mtird of may pviwin, the unutansr
afforded by the pohues drat nhed herrui rs%blei i to all the terns exclusions and condo«ins of nrrh pollru•s I irmlc show-n may bast•kern redu(rd by
paid claims ,- ---
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Type of Incur itue Pulley Number Date wwuumm Date mtM!L L)/Y)j Policy Limits
li General Liability 61)iWS li 27 01/0912005 01/0,Y2006 (•rnrral ANN+roan' S 300,000
PrUdnLb CumplOPS
covirnwrldl General Aggtrgme S 1p11,U110
1 Willay I
Personal&
X OLLW rent,Version Advrrusutg Injury A 1110,f!00
Contractual Incidental IrahfLilnu'nte S 100,(I(lU
l atly rim Damage
(Any onr Ise) S 90,0o0
Owners b Contractors Prot Medical Expemue
(Any uul psnur) S 5,000
Aulomubde Lidblldy Combined Single
All Owned Commercial Limit S
Autos Buddy Innuy
S heduled Autos (pi z plrvHi $
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(Pei II(+tlenl) S
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C.aragr 1rah+hty Garage Aggregate S
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Certificate Holder Cancellation
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Nano, , V20 Atli Ave S lhereuf the visiting company will endeavor to sail 3U days written nuuse to the
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