HomeMy WebLinkAboutPW07-053 - Original - GeoEngineers, Inc. - 116th Avenue SE Improvements - 03/06/2007 i
Records Ma-nd-g' '-eme" nt T ---
WASHY„GTON - Document
�ONE:
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: GeoEngineers, Inc.
Contract Number: P(A)0-7 ` C,)S3
This is assigned by Mary Simmons
Vendor Number:
Project Name: 116th Avenue SE Improvements
Contract Effective Date: March 6 2007
Contract Termination Date: March 31, 2007
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Mark Madfai
Department: Engineering
Abstract:
The Consultant shall conduct groundwater sampling.
ADCL7832 07/02
KENT
W A 5 H I N G T O N
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
GeoEngineers, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and GeoEngineers, Inc. organized under the laws of the State of Washington, located
and doing business at 1101 Fawcett Avenue, Suite 200, Tacoma, WA 98402, Phone- (253) 383-4940/Fax-
(253) 383-4923, Contact- Gary Henderson (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:
The Consultant shall conduct groundwater sampling for the 116 Avenue SE Improvements
project For a description, see the Scope of Work which is attached as Exhibit A and
incorporated by this reference.
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices in effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement Upon the effective date of this
Agreement, Consultant shall complete the work described in Section I by March 31, 2007
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Five
Thousand, One Hundred Sixty Dollars (S5,160 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 Exhibit B.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and a
final bill upon completion of all services described in this Agreement The City shall provide
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
(Under$10,000)
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 i s 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 Exlubit C 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
(Under S10,000)
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 OF 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 subject t o the C ity's general r ight o f
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
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
maybe available for any designated recycled product
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement
in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements
or options, and the same shall be and remain in full force and effect
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington If the parties are unable to settle any dispute,
difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving
that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction
of the King County Superior Court, King County, Washington, unless the parties agree in writing to an
alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties'
performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending
or bringing such claim or lawsuit, in addition to any other recovery or award provided by law, provided,
however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section
VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the
addresses listed on the signature page of the Agreement, unless notified to the contrary Any written notice
hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail,
and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such
other address as may be hereafter specified in writing
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.
CONSULTANT SERVICES AGREEMENT-3
(Under$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 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.
CONSULTA CITY OF KENT:
—4
G�. 64,l
By: By:
(eIgnatu e) (signature)
Print Name. A0- UJ- 9(�1)6tS,?n/ Print Name: Larry R Blanchard
Its PKi tvC t P,4 L Its: Public Works Director
(Title) (Title)
DATE: -o 'I DATE: p3 -Ob—O'�
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Gary Henderson Larry R Blanchard
GeoEngmeers, Inc. City of Kent
1101 Fawcett Avenue, Suite 200 220 Fourth Avenue South
Tacoma, WA 98402 Kent, WA 98032
(253) 383-4940 (telephone) (253) 856-5500(telephone)
(253) 383-4923 (facsimile) (253) 856-6500 (facsimile)
GeoEngmeers-116th/Madfai
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 o?C. day of f ✓U&r u , 2oo 7
By:
For & p
Title: Sp�rcr� 'L
Date: o? JG- 6 -7
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 Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement
known as that was entered into on the (date) ,
between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent
Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part
of the before-mentioned Agreement.
Dated this day of 1200 ._
By:
For:
Title:
Date.
EEO COMPLIANCE DOCUMENTS-3
EXHIBIT A
SCOPE OF SERVICES
CITY OF KENT
116TH AVENUE SE FROM
KENT KANGLEY ROAD TO SE 256TH STREET
FILE NO. 0410-154-00
This task will involve the following work:
1. Drill one boring to 25- to 30-feet in depth; to be drilled at the site of the stormwater pond The
boring will have a piezometer installed
2. Review existing utility locations and contact the"One-Call'utility locating service.
3. Evaluate the need for dewatering to construct the stormwater pond.
4. Provide recommendations for design and construction of one stormwater pond,as appropriate.
5. Provide a report including a description of site conditions and recommendations.
GWH gb
TACO\0\04101541OOTinals1041015400Scope.doe
Attachment: Exhibit B—Fee Estimate
File No 0410-154-00
January 23,2007 GEOENGINEENS-jo
EXHIBIT B
FEE ESTIMATE
CITY OF KENT
116TH AVENUE SE FROM
KENT KANGLEY ROAD TO SE 256TH STREET
FILE NO 0410-154-00
Classification Hours x Rate = Cost
Principal-Project Manager(Gary Henderson) 4 x $185 = $740
Engineer 1 (Morgan McArthur) 16 x $95 = $1,520
Senior Technician 4 x $80 $320
Support 1 4 x $70 = $280
Subtotal Personnel Cost(direct costs) $2,860
Other Expenses
Drilling $2,100
Expendables(sampling, photographs,equipment charges etc) $200
Subtotal $2,300
Total Estimated Costs $5,160
f TACO 101041 01 54 0 01Finals1041 01 540 0FeeEst As
File No 0410-154-W
January23,2007 GEOENGINEERS05
EXHIBIT C
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may anse from or in
connection with the performance of the work hereunder by the Consultant, their agents,
representatives, employees or subcontractors.
A. Minimum Scope of Insurance
Consultant 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
Consultant'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.
B. Minimum Amounts of Insurance
Consultant 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 C (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 Consultant'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 Consultant's insurance and shall not
contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage shall not
be cancelled by either party, except after tlurty(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 Consultant 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
Consultant'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
Consultant 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 Consultant before
commencement of the work
F. Subcontractors
Consultant 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 Consultant
ACOR ,, CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 02/27/2007
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willis Nortb America, Inc. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 305191
Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC#
INSURED GeoEngineers, Inc. INSURERA Travelers Property Casualty Company of Am 25674-003
1101 S. Fawcett
Suite 200 INSUAERB Travelers Indemnity Company 25658-001
Tacoma, WA 98402 MAR Q 6 INSURERC
LL, INSURER
CITY (�d} I :
INSURER E
COVERAGES { I
THE POLICIES OF INSURANCE LISTED BEL AVE 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 ADD POUCYEFFECTIVE POLICY EXPIRATION
LTR INSR TYPE OFINSURANCE POLICY NUMBER D T M V AT LIMITS
A X GENERAL LIABILITY 630532DS375TIL06 11/l/2006 11/l/2007 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE To $ 100,000
CLAIMS MADE a OCCUR MED EXP(Anyone person) $ 5,000
X WA Stop Gap PERSONAL&ADV INJURY $ 1,000,000
GENERALAGGREGATE S 2 000 000
GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000.000
POLICY M
PRO-ECT LOG
B AUTOMOBILE LIABILITY 810532D8375TIL06 ll/l/2006 11/1/2007
COMBINED SINGLE LIMIT $ 1,000,000
X ANY AUTO (Ea acodent)
ALLOWNEDAUTOS BODILY INJURY $
SCHEDULEDAUTOS
(Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per amdent)
GARAGELIABRJTY AUTO ONLY-EAACCI DENT $
ANY AUTO OTHERTHAN EAACC $
AUTOONLY AGG $
EXCESSLIABILITY EACHOCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS'LIABILITY
YLM17ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $
If yes,describe under
SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT I$
OTHER
DESCRIPTION OF OPERA'IONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENOORSEMEN(SPECIAL PROVISIONS
RE: City of Kent, 116th Avenue SE Improvement Project, Kent, Washington. GeoEngineers File #
0410-154-00.
It is agreed that City of Kent and its affiliates or subsidiaries are included as Additional
Insured as respects to General Liability, but solely in regards to work being performed by or on
behalf of the named insured in connection with the project described herein.
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
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
City of Kent, Public Works Engineering Attn: Nancy Yoshitake REPRESENTATIVES
400 West (,Owe AUTHOR TIVE
Kent, WA 98032
ACORD 25(2001108) Coll:1904620 Tpl:564197 Cert:8612215 OACORD CORPORATION 1988
Page 2 of 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s)
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon
ACORD25(2001108) C011:1904620 Tp1:564197 Cert:8612215
v .
COMMERCIAL GENERAL LIABILITY
Named Insured: GeoEngineers, Inc.
Policy Number 630532D8375TIL06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY - CONTRACTORS COVERAGE PART
1. WHO IS AN INSURED - (Section II) is amended to include any person or
organization you are required to include as an additional insured on this policy by
a written contract or written agreement in effect during this policy period and
signed and executed by you prior to the loss for which coverage is sought. The
person or organization does not qualify as an additional insured with respect to
the independent acts or omissions of such person or organization The person or
organization is only an additional insured with respect to liability caused by "your
work" for that additional insured.
2. The insurance provided to the additional insured is limited as follows:
a) In the event that the limits of liability stated in the policy exceed the limits
of liability required by a written contract or written agreement in effect
during this policy period and signed and executed by you prior to the loss
for which coverage is sought, the insurance provided by this endorsement
shall be limited to the limits of liability required by such contract or
agreement. This endorsement shall not increase the limits stated in Section
Ill - LIMITS OF INSURANCE
b) The insurance provided to the additional insured does not apply to "bodily
injury", "property damage", "personal injury" or "advertising injury"
arising out of an architect's, engineer's or surveyor's rendering of or failure
to render any professional services including
I. The preparing, approving or failing to prepare or approve maps,
shop drawings, opinions, reports, surveys, field orders, change
orders, or drawings and specifications, and
II. Supervisory or inspection activities performed as part of any
related architectural or engineering activities.
C) This insurance does not apply to "bodily injury" or "property damage"
caused by "your work" included in the "products-completed operations
hazard" unless you are required to provide such coverage for the
additional insured by a written contract or written agreement in effect
during this policy period and signed and executed by you prior to the loss
for which coverage is sought and then only for the period of time required
by such contract or agreement and in no event beyond the expiration date
of the policy.
CG D2 46 10 02 Copyright,The Travelers Indemnity Company,2002 Page 1 of 2
a .
COMMERCIAL GENERAL LIABILITY
3. Subpart (1)(a) of the Pollution exclusion under Paragraph 2.,Exclusions of Bodily
Injury and Property Damage Liability Coverage (Section I - Coverages) does not
apply to you if the "bodily injury" or "property damage" arises out of"your work"
performed on premises which are owned or rented by the additional insured at the
time "your work" is performed.
4. Any coverage provided by this endorsement to an additional insured shall be
excess over any other valid and collectible insurance available to the additional
insured whether primary, excess, contingent or on any other basis unless a written
contract or written agreement in effect during this policy period and signed and
executed by you prior to the loss for which coverage is sought specifically
requires that this insurance apply on a primary or non-contributory basis. When
this insurance is primary and there is other insurance available to the additional
insured from any source, we will share with that other insurance by the method
described in the policy.
5. As a condition of coverage, each additional insured must:
a.) Give us prompt written notice of any"occurrence" or offense which may
result in a claim and prompt written notice of "suit'.
b.) Immediately forward all legal papers to us, cooperate in the investigation
or settlement of the claim or defense against the "suit,"and otherwise
comply with policy conditions.
c.) Tender the defense and indemnity of any claim or "suit'to any other
insurer which also insures against a loss we cover under this endorsement.
This includes, but is not limited to, any insurer which has issued a policy
of insurance in which the additional insured qualifies as an insured. For
purposes of this requirement, the term "insures against' refers to any self-
insurance and to any insurer which issued a policy of insurance that may
provide coverage for the loss, regardless of whether the additional insured
has actually requested that the insurer provide the additional insured with
a defense and/or indemnity under that policy of insurance.
d.) Agree to make available any other insurance that the additional insured
has for a loss we cover under this endorsement.
CG D2 46 10 02 Copyright,The Travelers Indemnity Company,2002 Page 2 of 2
Verify Workers' Comp Premium Status - Employer Liability Certificate Page 1 of 1
Washington State Department of Ctr Employer Liability
Labor and Industries �k Certificate
Department of Labor and Industries
Employer Liability Certificate
Date: 02/26/2007
UBI #: 600 375 010
Legal Business Name:
Account#: 429,351-00
'Doing Business As' Name: GEOENGINEERS INC
Estimated Workers Reported: Quarter 4 of Year 2006 "Greater than 100 Workers"
(See Description Below)
Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and
paid their premiums
Licensed Contractor? Yes
License- GEOENI*1107E
Expire Date: 4/5/2007
Account Representative: T6/ SAM RIENBOLT(360)902-4659 - Email:
RIEN235@lni.wa gov
What does "Estimated Workers Reported" mean?
Estimated workers reported represents the number of full time position requiring at least 480
hours of work per calendar quarter. A single 480 hour position may be filled by one person, or
several part time workers.
Industrial Insurance Information
Employers report and pay premiums each quarter based on hours of employee work already
performed, and are liable for premiums found later to be due Industrial insurance accounts have
no policy periods, cancellation dates or limitations of coverage. (See RCW 51.12 050 and
51.16.190.)
Did you know...
...that under Washington State law*,you may be liable for the unpaid workers' compensation
(industrial Insurance) premiums of any business you hire or contract with9 (*See RCW
51.12.070). In the construction industry,you can avoid liability for your subcontractor's
unpaid premiums by performing all 6 steps listed on the previous menu page,which
includes printing a copy of this liability certificate for your records.
https•//fortress.wa.gov/lni/crpsi/AcctInfoPrint.aspx?Accountld=42935100&AccountManag... 2/26/2007