HomeMy WebLinkAboutPK06-295 - Original - Refugee Women's Alliance - Somali Community Engagement Project - 12/21/2006 w,
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KENO -W/�9 HINGTON Document
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: Refugee Women's Alliance (ReWA) Vendor Number: 34755
✓J JD Edwards Number
Contract Number:
This is assigned by Deputy City Clerk
Description: Somali Community Engagement Protect
Detail: Funds used to hire a consultant to identify the human services needs and barriers to
services for Somali residents living within the City of Kent
Project Name Somali Community Engagement Prolect
Contract Effective Date: 12/21/06 Termination Date: 3/31/07
Contract Renewal Notice (Days): 30
Number of days required notice for termination or renewal or amendment
Contract Manager: Dinah Wilson Department: Parks/Human Services
Abstract: This is a contract that is funded through CDBG Planning & Admin. City Council
approval received on 11/1/05 for our 2006 P & A budget line item.
S Public\Recordsmonagement\Forms\ContractCover\ADCL7832 07/02
�-� KENT
WASHINGTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
REFUGEE WOMEN'S ALLIANCE (ReWA)
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Refugee Women's Alliance organized under the laws of the State of Washington,
located and doing business at 4008 Martin Luther King Jr. Way South, Seattle, WA 98108, 206-721-0243
(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-
Consultant shall provide consultant services to identify the human services needs and barriers to
services for Somali residents living within the City of Kent. Scope of Work is outlined in
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 within five days from the effective date of this Agreement. Upon the effective date of this
Agreement, Consultant shall complete the work described in Section I by March 31, 2007.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
$5,000.00 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 agrc-.s 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 shalt be as
delineated in Exhibit A. Billing shall be submitted
B. The Consultant shall submit a properly executed Billing Voucher form, which is attached as
Exhibit B, to the City for work perfonned on a monthly basis, and a final bill upon completion
CONSULTANT SERVICES AGREEMENT- 1
(Under$10,000)
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 immediately make every effort to settle the disputed
portion
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationslup 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, ansmg 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'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, S%XrLY 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 terminatiop 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
(Under$10,000)
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.
XIL 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.
i
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 effec".
C. Resolution of Disputes and Govemins 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 ansing 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 attomey'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 Ci%y'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 maihng 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
(Under$10,000)
E. Assiemnent 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:
By By: c"_Pp
(signature) (signature)
Print Name: Someireh Amirfaiz Print . Jeff Watling
Its: Executive Director Its: Director Parks,Recreation &
(Title) Community Services
DATE: 12 ��/o DATE: 1 L 't l / 06
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Someireh Amirfaiz, Executive Director Dinah Wilson,C'DBG Coordinator
Refugee Women's Alliance City of Kent
4008 Martin Luther King Jr.Way. S. 220 Fourth Avenue South
Seattle, WA 98108 Kent, WA 98032
206.721.0243 (telephone)
206 721.0282 (facsimile) 253.856.5076 (telephone)
253.856.6070 (facsimile)
CONSULTANT SERVICES AGREEMENT-4
(Under$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 I, the prime contractor, will actively consider hiring and promotion of
women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime
Contractor, that the Prime Contractor complied with the requirements as set forth above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this 1 FS day of L7 eta, ��on ,200�.
By:
For: Refugee Women's Alliance
Title: Executive Director
Date: \ 2 ( ( !W .19
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 Refugee Women's Alliance, hereby acknowledge and declare
that the before-mentioned company was the prime contractor for the Agreement known as Consultant Services
Agreement 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. Someireh Amirfaiz
For: Refugee Women's Alliance
Title: Executive Director
Date:
EEO COMPLIANCE DOCUMENTS-3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity
within their organization and, if holding Agreements with the City amounting to $10,000 or more within any
given year,must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal
opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and
equal opportunity requirements shall be considered in breach of contract and subject to suspension or
termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works
Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are
familiar with the regulations and the City's equal employment opportunity policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS-2
EXHIBIT A
SCOPE AND SCHEDULE OF WORK
2006—2007 CONSULTANT SERVICES AGREEMENT
Refugee Women's Alliance(ReWA)
Somali Community Engagement Project Consultant
SCOPE OF WORK
The purpose of this agreement is to procure consultant services to identify the human services needs and barriers to
services for Somali residents living within the City of Kent In addition,a goal of this project is to determine the
strengths/resources that are available within the Somali community to address the human service needs of the population
and how the various constituencies can unite to address common goals. This project is funded by the United States
Department of Housing and Urban Development through the City of Kent's Community Development Block Grant During
the term of this agreement,the Consultant shall:
A Meet with or conduct a focus group with Somalis who live in the Sp6ngwood Public Housing Apartments,Cascade
Apartments, and Valli Kee Apartments to identify humans services needs and resources that exist in the Somali
community The Consultant shall publicize the meetinglfocus group within the housing complexes and among on-
site apartment managers. Notices shall be written in English and Somali.
B. Meet with or conduct a focus group with front-line staff who work regularly with Somalis and can provide
recommendations on the needs and barriers to services for the target population. The Consultant shall connect
with potential meeting/focus group participants by phone and send out invitations.
C. Meet with or conduct a focus group with religious and other leaders from the Somali community who can provide
insight into the needs and barriers to services for the target population The Consultant shall connect with potential
meeting/focus group participants by phone and send out invitations.
D. Conduct meetings in the Somali language,when appropriate.
E. The Consultant shall document attendance and information received at the meetings/focus groups.
F Based on information received at meetings and from focus groups, provide a written report to the City regarding the
needs and gaps in services for the target population
G Based on information received at meetings and from focus groups, provide a written report to the City on the
resources that are available within the Somali community to address the needs and gaps in services for the target
population The report shall also include suggestions on how the various constituencies can unite to address
common goals.
H. At least two face-to-face meetings with Human Service Department staff prior to completion of the project.
I. Provide a written report to the City by project completion date.
J. Maintain ongoing communication with Human Services Department staff;i e.,telephone and electronic, regarding
project status and dates/times for meetings/focus groups. Human Services Department staff shall be provided as
much notice as possible regarding scheduled meetings/focus nioup,and in no event shall staff be provided less
than ten working days notice.
Outcome(s)
• Identification of the human services needs and barriers to sgvices for Somali residents living within the City
• Identification of the strengths/resources that are available vAin the Somali community to address the human service
needs of the population and how the various constituencies can unite to address common goals
• Written report to the City.
Budget:
Consultant Activities(Billed @$40/hr.) $4,000
Miscellaneous/Mileage' $ 1000
Total $5,000
Biilina Timeline&Schedule of Work
The Consultant shall be reimbursed on a monthly basis,upon submittal of appropriate documentation Such documentation
will include the following (as applicable). Billing Voucher (Exhibit B) itemizing the work that was done, number of hours
worked, the hourly rate charged, etc Billing must be submitted on forms provided by the City by the 10'" of the following
month for the previous month of service. The billing timeline and Schedule of Work are as follows:
Billing Timeline:
Billing Voucher(Exhibit B) 10T"day following the reporting month
Final Billing Voucher 15th day of the month following the month of the
last activity
Schedule of Work:
Establish contacts with staff at apartment complexes Within five(5)days from execution of Agreement2
Begin discussions with community leaders Within ten days from execution of Agreement
Schedule first meeting or focus group Within fifteen days from execution of Agreement
Conduct first meeting or focus group Within twenty-one days from date of execution of
Agreement
Conduct second meeting or focus group Within fifteen days from date of first focus
group/meeting
Conduct third meeting or focus group Within fifteen days from date of second focus
group/meeting
Conduct fourth meeting or focus group(if needed)3 Within fifteen days from date of third focus
group/meeting
Meet with City staff Dates will be decided in consultation with City staff
Final Report Due by March 31, 2007
Contract Administration and Management
The Consultant shall notify the City, in writing,within(10)days of any changes in project personnel. No changes in
personnel shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant.
The above services shall begin within five days from execution of the Consultant Services Agreement. The Final Report(s)
shall be provided no later than March 31, 2007. Failure to provide services by the dates listed in the Schedule of Work could
lead to the termination of this Agreement and forfeit payment to the Consultant.
Total Project Reimbursement: $5,000
Please sign to indicate acceptance of the Scope and Schedule of Work listed above.
' 9 parking, copying stationery, p 4
E g , mileage, arkin co m costs, statione reimbursement for food, etc Receipts required,when
applicable
2 Execution date shall be the last date entered on the Consultant Services Agreement. ReWA shall be notified
of this date.
3 Need for fourth focus group/meeting will be decided inconsultation with City staff.
2
Someireh iz, Executive Director Date
Re o s A ce
12 . 21• o &
Kather' John n, 'y e t HumaitServices Manager Date
3
EXHIBIT B - ReWA
Billing Voucher
SOMALI COMMUNITY ENGAGEMENT PROJECT CONSULTANT
Agency/Person: Someireh Amirfaiz
Mailing Address: Refugee Women's Alliance
To: 4008 Martin Luther King Jr.Way. S.
Dinah Wilson Seattle, WA 98108
Housing & Human Services
Parks Recreation &Community Services
220 4tI Ave. South, Kent,WA 98032
drwdson(fti kent wa us
Phone: 253.856.5076 Telephone: 206.721.0243
E-mail: someireh@rewa.org
Reporting Period Program Amount Requested
Month/Quarter
CONSULTATION $
BUDGET SUMMARY
Total Contract Amount $5,000
Current Request $ 'Balali : $ ?.V
ITEMIZED BILLING*
I. CONSULTANT ACTIVITIES:
DATE WORK PERFORMED AMOUNT
Hrs./Rate_/ Total:
Hrs./Rate_/ Total:
Hrs./Rate I Total:
Hrs./Rate ! Total:
Hrs./Rate / Total:
Hrs./Rate+/ Total:
Hrs./Rate ! Total:
Hrs./Rate / Total:
Hrs./Rate ! Total:
Hrs./Rate_+/ Total•
Hrs./Rate_! Total:
Hrs./Rate / Total:
Hrs./Rate+l Total:
Hrs./Rate ! Total:
Hrs./Rate / Total:
Hrs./Rate_/ Total:
Hrs./Rate 1 Total:
TOTAL:
II. TRAVEL
DATE & Purpose MILES AMOUNT (billed @ 44.5¢per
mile '
TOTAL:
III. MISCELLANEOUS EXPENSES
DATE DESCRIPTION AMOUNT
TOTAL:
GRAND TOTAL:
Authorized Signature Date
FOR DEPARTMENT USE ONLY
AUTHORIZED FOR PAYMENT
BY: DATE:
*Receipts must be attached for expenses.
' Mileage rate subject to change for 2007 travel. Consultant will be informed if rate changes.
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 apse 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 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 1185. 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 1185 or a substitute endorsement
providing equivalent coverage.
2. 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.
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 lipilt.
2. Automobile Liability insurance with a minimum combined single limit for bodily
injury and property damage of$1,000,000 per accident.
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 shallbe 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.
EXHIBIT C (continued )
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
ANII.
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 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
,, 1217106
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TYRISCO,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
6912 220th St S W,Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Mountlake Terrace WA 98043
Phone 425-712.5007 Fax 425-712-SM INSURERS AFFORDING COVERAGE NAIC#
INSURED Refugee Women's Alliance&ReWA Center INSURER A Philadelphia Insurance Co
4008 MLK Jr Way South INSURER B
Seattle WA 98198 INSURER C
INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR DO• POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1000 000
A X_ COMMERCIAL GENERAL LIABILITYDAMAGE TO RENTED
PHPK200807 11121106 11/21101 $100 000
1 CLAIMS MADE t X OCCUR MED EXP Any me i2erwnI $ 5,000
X Abuse&Molestation _ PERSONAL&ADV INJURY $ 1,000,000
X_ Errors&omissions _ GENERAL AGGREGATE $2 000 000
GEN'1 AGGREGATE I IMIT APPLIES PER PRODUCTS--COMPIOP AGG $2,000,000
X I POLICY PROJFCT — LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
B ANY AUTO PHPK200807 11121106 11121107 (Eaaccldent, s 1,000,000
Al I OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Pemon) $
X HIRED AUTOS BODILY INJURY
4X NON-OWNED AUTOS (Per ecadent) $
-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE
OGG IR _J CLAIMS MADE AGGREGATE $
DEDUCTIBLE
-- S
REFENTON $ $
WORKERS COMPENSATION AND WC STATU- X OTH- WA StopGap
EMPLOYERS'LIABILITY
DRYI
A ANY pROPRIETORIPARTNER/EXECU7NIE PHPK200807 11121106 11121/07 EL EACH ACCIDENT $ 1000000
OFFICFR/MFMBFR FXCLUDFO� EL DISEASE-EA EMPLOYEE 1,000,000
If yes describe under
P IA PROVISIONS
R VI N E L DISEASE-POLICY LIMIT I$ 1.000.000
OTHER Limit $100,000
rB Employee Dishonesty PHPK200807 11121107 ill/21107 Deductible $1,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The certificate holder is named as additional insured per the attached
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Kent DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN
Human Services Divislon NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
220 4th Ave S IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Kent,WA 98032 REPRESENTATIVES
` AUTHORIZED REPRESENTATIVE �
n: 1d,�,
ACORD 25(2001108) %)AL;UKD CORP TION 1988
INSURED: Refugee Women's Alliance
POLICY NUMBER: PHPK200807 COMMERCIAL GENERAL LIABILITY
COMPANY: Philadelphia Insurance Co. CG 20 26 07 04
Effective: 11/2112006 - 1112112007
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - DESIGANTED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s) or Organization(s)
City of Kent
(Information required to complete this Schedule, if not shown above, will be shown in the Declarations )
Section 11 — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by, your acts or
omissions, or the acts or omissions of those
acting on your behalf
A. In the performance of your ongoing
operations or
B. In connection with your premises owned
by or rented to you
i
n
CG 20 26 07 04 Copyright, ISO Properties, Inc 2004 p