HomeMy WebLinkAboutPK06-301 - Original - SB & Associates, Inc. - Wilson Playfields Backstop Renovations - 11/08/2006 T Records M,Aqarn. eend
VI
KEN _ABHIN6TON Document
A i
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact Mary Simmons, City
Clerks Office.
Vendor Name: s 9y �`� �'L `5 �✓1C:
Contract Number:
This is assigned by Mary Simmons
Vendor Number:
Project Name:
Contract Effective Date:
Contract Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager:
Department:
Abstract:
ADCL7832 07/02
KENT
W.3HINGTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
SB & Associates, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and SB & Associates, Inc. organized under the laws of the State of Washington, located
and doing business at 1148 NW Leary Way, Seattle, Washington 98107 (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following described
plans and/or specifications.
Provide design and construction documents for the work adjacent to the three existing backstops
at Wilson Playfields in Kent, Washington as described in the Consultant's Scope and Fee
Proposal dated October 27, 2006 attached and incorporated as Exhibit A.
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices in effect at the time those services are performed
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement Upon the effective date of this
Agreement, Consultant shall complete the work described in Section I by January 31, 2007
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
Nineteen Thousand, Three Hundred Sixty-Two and NO/100ths ($19,362.00) 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 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 Exlubit A.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and a
final bill upon completion of all services described in this Agreement. The City shall provide
payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any
portion of an invoice, it shall notify the Consultant and reserves the option to only pay that
portion of the invoice not in dispute. In that event, the parties will immediately make every
effort to settle the disputed portion
CONSULTANT SERVICES AGREEMENT- 1
(Over$10,000)
f
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's inspection or acceptance of any of Consultant's work when completed shall not be grounds to
avoid any of these covenants of indemnification
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4 24.115,
then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused
by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees,
agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's
negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE
MUTUALLY NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit$ attached and incorporated by this reference.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work
under this Agreement
CONSULTANT SERVICES AGREEMENT-2
(Over$10,000)
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents,
drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the
Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request.
The city's use or reuse of any of the documents, data and files created by Consultant for this project by anyone
other than Consultant on any other project shall be without liability or legal exposure to Consultant.
XI. CITY'S RIGHT O F INSPECTION. E ven though Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, t he w ork in ust in eet t he approval o f t he C ity and s hall b e subj ect t o t he C rty's general r ight o f
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be
done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools,
or other articles used or held for use in connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price preference
may be available for any designated recycled product
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement
in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements
or options, and the same shall be and remain in full force and effect.
C Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute,
difference or claim ansmg 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 ansmg 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 sufficientlyeven if sent to the addressee at the address stated m this Agreement or such
g �
other address as may be hereafter specified in writing.
E. Assi merit. 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 terns
of this Agreement shall continue in full force and effect and no further assignment shall be made without
additional written consent.
CONSULTANT SERVICES AGREEMENT-3
(Over$10,000)
F. Modification No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the
City, and such statements shall not be effective or be construed as entering into or forming a part of or altering
in any manner this Agreement. All of the above documents are hereby made a part of this Agreement.
However, should any language in any of the Exhibits to this Agreement conflict with any language contained in
this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws The Consultant agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business,
equipment, and personnel engaged in operations covered by tlus 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.
CONSUL N CITY OF KE T:
By By:
(signature) (signature)
Print Name: Michael R Lamb Pri t N e Suzette Cooke
Its Principal Its Mavor
(Title) (T le)
DATE: 4G-7 -gi 200� DATE: 0
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Michael Lamb Perry Brooks, Project Manager
SB & Associates, Inc. Kent Parks, Recreation & Community Services
1148 NW Leary Way 220 Fourth Avenue South
Seattle, WA 98107 Kent, WA 98032
(206) 789-2133 (telephone) (253) 856-5114 (telephone)
(206) 789-2186 (facsimile) (253) 856-6050 (facsimile)
APPROVED AS TP FORM:
en Law Dep nt
Wilson Playfields Backstop Renovations
a
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 Prune Contractor complied with the requirements as set forth above
By signing below, I agree to fulfill the five requirements referenced above.
Dated this�3 1 day of_ p , 2006.
By:
For:
Title: a�
Date:
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
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
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 SB &Associates, Inc. Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement
known as Wilson Playfields Backstop Renovations 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 , 2006.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS-3
EXHIBIT A
S � �
ARCHITECTS
S➢ & ASIOLIATES, INC
I146 LW LLARY WAY
S1,ATTLE WA 96107
ld0l>)T9 Zl l l t e QPb)i N9 2 B6
Oct 27, 2006
Perry Brooks, Project Manager,Parks and Open Space Planner
City of Kent Parks, Recreation and Community Services
220—4"'Avenue South
Kent, Washington 98032-5895
Re: Wilson Field Backstops Renovations
Landscape Architectural Services
Scope and Fee Proposal
Dear Perry,
Thank you for selecting SB and Associates (SB&A)to work with you on the Wilson Field Backstops
Renovation Project Based on our meeting at the fields on October 23, 2006, I have prepared the
attached project description/parameters, scope of services, and proposal for professional services and fee
proposal for the construction document preparation for the improvements to the three existing backstops
It is anticipated that MLA Structural Engineers will be providing design and construction documents for
the backstops and fencing SB &Associates will provide design and construction documents for the
work adjacent to the backstop including the artificial turf, concrete flat work, demolition, layout and site
restoration plans
Scope of Work:
1. Project Administration—Provide project coordination and communication with City Staff and
Structural Engineer Provide monthly invoicing and progress reports
2 Develop 60% Plans and Specifications-Construction document will be developed including a
cover sheet, demolition, layout, site restoration plans and details Preliminary specification and
will also be developed
Plans to include
Cover Sheet
Demolition and Site Preparation
Layout
Site Restoration
Construction Details (3 sheets)
• Attend initial project kick-off meeting On-Site with City/MLA and SB&A.
• Conduct data gathering site visit
• Attend one meeting with the City/Engineer to review 60% Plans and Specifications
Page 2 of 2
• Attend one Constructability Meeting with City/Engineer and Reviewing Contractor
3. Develop 100% bid ready plans and specifications Final bid ready documents will be
produced including plans and specifications Modifications will be made based on City
comments prior to bid advertisement Incorporate City review comments from 60% design and
Constructability review
Plans to include-
Cover Sheet
Demolition and Site Preparation
Layout
Site Restoration
Construction Details (3 sheets)
• Attend one meeting with the City/Engineer to review 100%Plans and Specifications
• Incorporate minor revisions to the Plans and Specification documents based on City
review comments
• Provide City with one reproducible set of Plans and Specification documents Printing
of Bid Sets will be the responsibility of the City and is not a part of this contract
• Preparation of a SEPA Checklist and meetings with the public and/or public hearings are
not a part of this scope If these services are required,they will be considered as
additional services and will be provided on a time and expenses basis
4 Bidding: Provide up to 8 hours to assist City during the bidding phase to answer contractor
questions, addendums, and bid evaluations.
5. Construction Services: Construction Services are not a part of this scope and fee At the
request of the City, SB&A will provide a written request for additional services to be determined
at a later date.
The following represents our fee proposal for the project.
Summary of Fees
Work Phase Base Fee
Project Administration $1,847
Construction Documents 60% $10,049
Construction Documents 100% $6,187
Bid Assistance $879
Expenses $400
Total $19,362
All work would be invoiced monthly based upon the percentage of work completed during the billing
period.
SBA is prepared to begin work immediately, and proceed through the design phases.
I am available at your convenience to meet and review the specific items included, and on behalf of
SB&A team, I look forward to a successful completion of this project
Sincerely,
Michael R. Lamb,Principal
SB and Associates, Inc
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may 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. 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
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide the Aggregate Per Project
Endorsement ISO form CG 25 03 11 85 There shall be no
endorsement or modification of the Commercial General Liability
insurance for liability arising from explosion, collapse or underground
property damage The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy with
respect to the work performed for the City using ISO additional
insured endorsement CG 20 10 11 85 or a substitute endorsement
providing equivalent coverage.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington
4. Professional Liability insurance appropriate to the Consultant's
profession
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
EXHIBIT B (Continued )
3. Professional Liability insurance shall be written with limits no less
than $1,000,000 per claim and $1,000,000 policy 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
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 AM Best rating of not less than
A•VII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the amendatory
endorsements, including but not necessarily limited to the additional insured
endorsement, evidencing the insurance requirements of the Contractor before
commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall furnish
separate certificates and endorsements for each subcontractor. All coverages for
subcontractors shall be subject to all of the same insurance requirements as stated herein
for the Contractor.
• DATE
ACORD,. CERTIFICATE OF LIABILITY INSURANCE sBCSR (MMDD/YYYY)
11 01/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Sprague Israel Giles HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
1501 Fourth Avenue, Suite 2000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Seattle WA 98101-1637
Phone 206-623-7035 Fax:206-682-4993 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA National sire imurance Co
INSURER B
SIB & Associates INSURER
1148 NW Leary Way INSURER
Seattle WA 9BI07
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 TH,S 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
DO L POLICY EFFECTIVE P LICV EXPIRATION
LTR NSR TYPE OF INSURANCE POLICYNUMBER DATE MM/DDIYY DATE MM/DDIVY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X X COMMERCIAL GENERAL LIABILITY 2084731811 04/12/06 04/12/07 PREMISES(Eaoccurence) $200,000
CLAIMS MADE [X] OCCUR MED EXP;Any one person) $ 10,0 00
X STOP GAP PERSONAL B ADV INJURY $ 1, 000,000
GENERAL AGGREGATE s2, 000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2,000,000
POLICY PEA LOG
i
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $ $1,000,000
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
A X NON-OWNED AUTOS 2084731811 04/12/06 04/12/07 (Per accident) $
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
I ANYAUTO OTHER THAN EA ACC $
AUTO ONLY AGO $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
GSTATU
WORKERS COMPENSATION AND TORV LIMITS ER
EMPLOYERS LIABILITY EL EACH ACCIDENT $
ANY PROPRI ETOR/PARTNER)EXECUTIVE
OFFICEPoMEMSER EXCLUDED
EL DISEASE-EA EMPLOYEE $
If yes describe under
SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Kent is added as Additional insured with respects Wilson Playfields
Backstops PO #47774
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Kent Parks, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Recreation & Community Services IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
220 4th Avenue South REPRESENTATIVES
Kent WA 98032-5895 AUTHO EPRES TATIV
ACORD 25(2001/08) 0 ACORD CORPORATION 1988
POLICY NUMBER. 2084731811 COMMERCIAL GENERAL LIABILITY
CG20100397
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization-
City of Kent, Parks Recreation & Community Services
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement )
Who Is An Insured (Section II) is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured.
CG 20 10 03 97 Copyright, Insurance Services Office, Inc , 1996 Page 1 of 1
I