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HomeMy WebLinkAboutFD07-004 - Original - Airgas Nor Pac, Inc. - Medical O2-Provide, Pickup & Refill Cylinders - 01/19/2007 ENT Document WASHIw GTO« =3 x , ., 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: / Gl//�Q 4 ��/� Vendor Number: 61 — T JD Edwards Number Contract Number: FV Q 7- O O ,5� This is assigned by Deputy City Clerk Description: ya Detail: Project Name: / V/ Contract Effective Date: l lZI-2 Termination Date: Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager. i ��'��� Department: /l,P Abstract: 5 Public\RecordsManagement\Forms\ContractCover\ADCL7832 07/02 KENT wAs Hi"c ra" 1. GOODS & SERVICES AGREEMENT between the City of Kent and Airgas - Nor Pac, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation ("City"), and Airgas - Nor Pac, Inc., a corporation organized under the laws of the State of Washington, located and doing business at 11900 N.E. 95" St. #400, Vancouver, WA 98682 ("Vendor"). 11. AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials or perform the following services for the City: Vendor will provide weekly pick-up of empty City-owned cylinders and delivery of City-owned cylinders filled with medical oxygen, in accordance with Vendor's specifications, a copy of which is attached and incorporated herein as Exhibit A. All City-owned cylinders will be clearly marked with the City logo, remain the property of City and be used only for City purposes in accordance with this Agreement. Vendor will protect City-owned cylinder--med Pa+t�'-9V;Red GY11Rd@F6 feF QLY-9 f q from damage and unauthorized use by Vendor or third parties. Weekly pick-ups and deliveries will alternate between Kent Fire Stations 71 and 74. City will provide Vendor with an accessible, secure location for the pick-ups and deliveries at the back parking lot of each station during normal business hours of 8.00 a.m. to 5:00 p m., Monday through Friday Vendor will provide required hydrostatic testing to the cylinders as needed. 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. II. TERM. Upon the effective date of this Agreement, Vendor will begin the work and provide all goods, materials, and services for an initial one (1)-year term, unless terminated sooner in accordance with this Agreement. The City, at its sole option, may extend this Agreement for additional one (1)-year terms upon 60 days written notice prior to the expiration of the then current term. III. COMPENSATION AND MANNER OF PAYMENT. The City shall pay the Vendor for each delivery of filled cylinders or testing of cylinders in accordance with the following fee schedule, plus any applicable taxes. The prices will be firm during the one (1)-year term. If the City exercises its option to extend the agreement for additional one (I)-year terms, the parties may mutually agree to increase the prices in the fee schedule up to 6% of the prior year's prices, which will be reflected in a written amendment to this Agreement and remain firm for that one (1)-year term. Vendor will invoice City on a monthly basis in a form acceptable to the City with reasonable supporting documentation of the charges. GOODS&SERVICES AGREEMENT- 1 �, Item Descriation Price OX USPDC Medical Oxygen Steel "D" Cylinder (customer-owned) $5.40 OX USPDAC Medical Oxygen Alum. "D" Cylinder (customer-owned) $5.40 OX USPM22C Medical Oxygen Alum. M22 Cylinder (jumbo "D") $5.40 (customer-owned) OX USP125 Medical Oxygen 125 cf Cylinder $8.64 CYM HYDRO Cylinder Hydrotesting per Cylinder $12.00 CYM VALVE Cylinder Valve Maintenance/Replacement $10.00 Haz mat charge per delivery $2.25 Delivery charge per delivery $7.00 Cylinder Rental per Medical Large Cylinder per Month $4.00 If the City objects to all or any portion of an invoice, it will 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 to 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 this 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. 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. V. TERMINATION. The City may terminate this Agreement, with or without cause, upon providing Vendor ninety (90) days advance written notice. VI. 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. VII. 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 GOODS&SERVICES AGREEMENT• 2 time as determined 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. VIII. 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, copies of which are attached and incorporated as Exhibit C. IX. 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 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. X. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XI. 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. City, as llqwidated -1--nder per , XIII. MISCELLANEOUS PROVISIONS. A - Pprgrlahlp Materials Gaty -Gvde, t1tr-GAr(U"1 P"), ? 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. GOODS&SERVICES AGREEMENT- 3 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 IX of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. 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. GOODS&SERVICES AGREEMENT•4 IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. VENDOR: CITY OF KENT: By: By: �g ur (signature) Print Name: Print am : Suzette Cooke Its Its Mayor � ���� (Tale) DATE: 6/�/�/�6 DATE: v NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Kerry Davidson Beth Gallup Airgas Inc. City of Kent 3021 Martin Way 24611 116th Ave. SE Olympia, WA. 98503 Kent, WA 98030 360-754-7624 (telephone) (253) 856-4300 (telephone) 360-252-8613 (facsimile) (253) 856-6375 (facsimile) APPROVED AS TO FORM: A/ AW01 t I- W D artment P•\Civil\Files\OpenFiles\0040-2006\Alrgas oxygen services doc GOODS&SERVICES AGREEMENT-5 EXHIBIT B 1.2. INSURANCE REQUIREMENTS FOR 13. GOODS AND SERVICES CONTRACTS Insurance The Vendor 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 Vendor, their agents, representatives, employees or subcontractors. 2. Minimum Scope of Insurance Vendor 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 it 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. 3. Minimum Amounts of Insurance Vendor 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, $2,000,000 general aggregate and a $2,000,000 products- completed operations aggregate limit. I 3.1.1. EXHIBIT B (Continued ) 4. 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 Vendor'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 Vendor's insurance and shall not contribute with it. 2. The Vendor'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 A:VII. E. Verification of Coverage Vendor 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 Vendor before commencement of the work. F. Subcontractors Vendor 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 Vendor. EXHIBIT C DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to compliance with Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement will comply with the regulations of the City's equal employment opportunity policies The City requires any contractor, subcontractor or supplier working on this Agreement to certify that the following statements are true If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the statements below, it will be considered a breach of contract, subject to suspension or termination of the Agreement, in whole or in part, in the City's sole discretion. The statements are as follows: 1. The Vendor has read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement, the Vendor 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 Vendor 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, the Vendor will actively consider hiring and promoting women and minorities. By signing below, the Vendor certifies that it is in compliance with the City's equal opportunity policies regarding contractors, subcontractors and suppliers. Dated this 2$ day of —/KzJ , 200,E . By: For: Title: U� Date: EXHIBIT C (Continued) 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. EXHIBIT C (Continued) CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled �� out UPON COMPLETION of the work by the Vendor under this Agreement. �/G`C I declare that 7 - , the Vendor under and Agreement with the City of Kent, for , that was entered into on 7W9ri Zd' , 2006 and completed 2006., 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 the Agreement. Dated this day of , 200,15r—o . By: For: Title: Date: �1� �� rmu l vent r are wept. 5ta I-HK NU. 25.5bt>bb,515 Jan. 18 2007 08:03RM P1 DATu(pf'ljW.NYI_ AC4RQ. CERTIFICATE OF LIABILITY INSURANCE 1 211 712 00 7 _i_ Ol/17'b007^ oaoouccR THISCERTIFICATEISISSUEDASAMATTEROFINFORWATIOk I LOCKTON COMPANIES,LLC-1 KANSASCITY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4441N.47lhSvM,S0ff9OO HOLDER TSIS CERTIFICATE OCES NOT AMEND, EX7EtiDOR KDDsesCll Mo64112.19 6 �, YFRAGE a ROED BY Tki��04101ES BF.1�?YY, (816)960-90DD INSURERS AFFORDING COVERAGE INWRSD INsueea AjyZFAfC4NiTQ1�jF 4SSi� iN('F,('0 1066143 AIRGAS NOR FAC,INC. 11900NE95THSTREEi InsuREP SL 1�CF. Co.OF 1Tm STATL• op PA* ------4 SUITE 0400 'NsuREP C T IINUIS?NT-A'U ONA _INS,CO' VANCOUVER WA98682 MATi..r,. wp\V YORK I��LR-PD It REV 7 THIC C- CAT OF NL DcN;z C AG 9 cc SG I G COVERAGE$ RTN01 Y.F INSURERf51 AUTHORtEC RfiRRESENTATIVE OR PRODUCER AND THE CERTIFIC TE r DER "nE POLICIES OF INSURANCE LISTE06FLOW HAVE BEENISSUEO-OTV,E 1NSUREDNAME0A6OV5 °ORCKE POLICY PERIOD INCI C,ATE D NCTN'ITHSTANCINl I ANC REOUIPEMENT. TERM ORCONOITIONOF ANY CONTRACT OR OTHER DOCUMENT MATH RESPECT TO VvHICH "wS CERTIFICATE MAY BE ISSUEO CR MAY OERTAIN, THEINSURANCE AFFOROEDRY TNEPOUCIES DE>C RISEO HE REIN IS SUBJECT TO Al»TMETERNS,EX'%USiONS AND CONCI-IONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN etAY HAVE BEEN REDUCED BY PAIO CLAIMS _ INSR I POUCT F FECT VE POUCY EXPIP0. ION' TR TYPE O?INSURANCE , POLICY NIIMEER MTF'MMRJQI�� DAT^VryyOgt i 41UtS GENERAL LIMLITY i 'LJtC�COC',1zReNCE �n(C 1 A X .cmNERCIA'.OENERALtmwv7Y GL6007653 12)17/2006 i 12717/2J07 1.0+)O1i0(Q__; , ,I CLMVBMAOEOCCUR I NEC cYP,An:. } PERSON-L a ACV INJURY 2,000 UtO _J_ 1 _^E4 EP.4 uC•REGNTE.. 1 3 d 000 w6 41 tS E;J'_AEG`.E=>'a l'M IpT AFPLIE:FER ' ,?GOCUCTS Oa'PYJP:.GC s 4.000 Cl(`)_� PO.tCY I i>Rc4 AUTOMOBILE LIABILITY 1 CCNI9INEC SINCrE.INIT A Xiur,-J7c CA20d50?F(AOS) 1:1172006 l?;17Pn67 I(Ee,•_x 4 Ai —1 11 171?0i I !=lllt?;07 jOsi RY A CA:)4506 VA) I' 17i2006 12I17Q0)1 m i` XXY.KXxX I wREOAVTOE ) I I v I—__ �J ' I CCrLY INJURY YKx�,.= NCyV.OWNEO ALI'C9 } ) t - I I ?RCPr72TT DS11=G: s )OO(X= I (P.r clUrl t GARAGE LIABILITY , 1 'AI„TC 01LY-EAACCIDEST I S_XiXXXX ANY AUTO I NOT APPLICABLE I I I OT�_R 71AN EA ACC �: XXXXX,ap{JCXV�l I iLTC ONLY P(.0 �.xx EXCE68 UADILtTY I EP.^,*I Cf GUFFEENCS I s 3.00D,O('0�1 A 7 COWR J C-VosN'.DC 445791 I 12,170006 i21172W7 (��RSCF-. _ :000 Om x wwnRalA I 1. XXX?'.XX*< 09%'CTI;t ❑FOPA i I I �._ xxxxxxx RETENTION ; ' ! 'j XXXK"m I I 5'"n'• I TN E woRltCRscOMPENSA-ICNANC I WC58)91 se(CA) 120/200F 1'_,1"r.CJ)7 X h •; -� .___ �� EMPWYFRS'UA91UTY A WCSS93lS7(PZ,ID,MD,OR,YA) I 121b:005 i 12 17.100 =t Ee:.ACCcfn• _1J000,0CC_ _ A I WC5S99189(AOS) I 13/1'7rOJ(> 1 1-17'?DOT E� D'��J�E E4R+PLOYeES 1.0004N)_� C WC530PIu0(ILjvnMN.XY.UTI 12i172006 12,17/20,37 1915E'Po,c .Noll LUDOJC0 OTHER I-ter I I I I DESCRIPTION OF OPIRA11ON5R.00ATIONSNEHICLES/EXCLWI043 ADDED BY EN0C4t5EMENTp PEGALPROVUONA CITY OF(CENT IS INCLUDED AS AN ADDITIONAL INSURED V--0UMQU[FEC 3Y%T:rTENO)NT?vL?.BUT O�Cl N AvXVWAFCZ ! f WITH FOLIC-'TERT,4.5,CONDITIONS AND EXCLUSIONS i T IIR� ED'.INB 1RF: TrPRINH IRF: TrPR . WWD 2783780 SHOLLD AN"OP THE ABOVE DP30AIBED POLICIES Bc CANcEUAD EEFORS TN_EXPIRATION j CITY OF KENT ATTN.BETH GALLUP CATE TH'cREOP.THE IS3MG ISSURERWI'1ENDEAVOR TOMAIL 30 DAYS`AW7TEN 2�46�1�1 118TH AVE SE NOTIC;TO TH6 CERTIPICA7E L,ULOER NAMED TO THE LEFT,BUT FAILJRE TO DO SO SHALL j KEN T WA 96050 INPORR NO OBLISATION 00 L146ILITY OF ANYXIND UP)NTHE INBuiER ITS AGENT"- OR I REPRESENTATIV". i AUTHORIZED REPRESEV7ATIVE ! ��I ACORD25-S(7N7) PolglPspeDnyPrtNpllbbnlhnl.,e.nhe'UrwmE.IY.Mrnlh'. aK. rwnaee and.PcNnrec�.bc.:eerAuoll �CDRK%dk 0NIM FROM : Kent Fire Dept. Sta 75 FAX ND. 2538566375 Jan. 1B 2007 88:04AM P2 Y i vv• .v� 1/ 1 1 1 a.u V , V l i a , v V . ,• • •••� POLICY NUMBER.See Attachod CartI leate COMMERCIAL GENERAL LIABILITY CG 20 10 11 85 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REoD IT CAREFULLY. ADDITIONAL INSURED -• OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modfies insurance provid¢d under the following: CCMMERCIAL GENERAL LIABILI,Y COVERAGE DART SCHEDULE Name of Person or Oeganlzation: Any person or organization, only as per ccntractWth the namadinsured. (If no entryappears above, informaton required to ccrnplate this endorsement wtll be shovm jr th. Ded'aiations as applicable to this endorsement) WHO IS AN INSURED (SEcem II)is amended to include as an inwred the person or organization shown In the Schedule, but only tNth respect to 1!0b tyarising out of"your work" fo- :ha.insured by or for you. CG 20 10 1185 Copyright, Insurance rServicas Office, Inc, 1°24 Cerfficate ID•2763760 &Iise Attachment -.M50030