HomeMy WebLinkAboutPW07-071 - Original - HWA Geosciences, Inc. - Analyze Pavement Repair Overlay Program at Kent Kangley Road - 02/21/2007 Records Manageme�n tr
KENT Document
W ASHINGTON
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: HWA Geosciences Inc.
Contract Number: (.y 07
This is assigned by Mary Simmons
Vendor Number:
Project Name: Kent Kangley Road
Contract Effective Date: February 21, 2007
Contract Termination Date: 30 days
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Bill Thomas
Department: PW Operations
Abstract:
Provide engineering services to analyze the current pavement repair/overlay program at
Kent Kangley Road, and provide new concrete and asphalt pavement designs.
ADCL7832 07/02
� r
KENT
WASHINGTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
HWA Geosciences, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and HWA Geosciences, hic organized under the laws of the State of Washington,
located and doing business at 19730 64th Ave W , Lynnwood, WA 98036, Phone- (425) 774-0106/Fax. (425)
774-2714, Contact. Bryan Hawkins (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 provide engineering services to analyze the current pavement repair/overlay
program at Kent Kangley Road, and provide new concrete and asphalt pavement designs. 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 furmshed under this Agreement will be performed in
accordance with generally accepted professional practices in effect at the time those services are performed
IL 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 within 30 days.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Four
Thousand, Eight Hundred Eighty Six Dollars ($4,886.00) 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 penod of one (1) year from the effective date of this
Agreement The Consultant's billing rates shall be as delineated in Exhibit 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
CONSULTANT SERVICES AGREEMENT- 1
(Under$10,000)
1 l
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 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 Exhibit B attached and incorporated by this reference.
CONSULTANT SERVICES AGREEMENT-2
(Undej S10,000)
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. 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, the w ork in ust in eet the approval o f the C ity and s hall b e subject to the C ity's general right o f
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessar
y
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.
XIIL 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 Govermng 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 tlus Agreement or such
other address as may be hereafter specified in writing
CONSULTANT SERVICES AGREEMENT-3
(Under$10,000)
E Assi ng 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 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 tlus 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:
G
By. By: 0 it
(st nature) (stgnature)
Print Name: �f _ /,lam Print Name Don illett
Its• Its• Public Works Operations Manager
(Tt
DATE: Ova /2/�sZ DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Bryan Hawkins Larry R Blanchard
HWA Geosciences, Inc. City of Kent
19730 64th Ave S 220 Fourth Avenue South
Lynnwood, WA 98036 Kent, WA 98032
(425) 774-0106 (telephone) (253) 856-5500 (telephone)
(425) 774-2714 (facsimile) (253) 856-6500 (facsimile)
HWA-KK Pavemenffhomas
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 day of / 200_.
By �-
For- d Jn
Title: ��� �
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 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 , 200_
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS -3
EXHIBIT A
Project Cost Estimate IIWA Ref: P5746 _
Kent Kangley Road Analysis � 't I HWAGf-OSCIENCES INC Date, 02-reb•07
Pavement Anglyses&Design Revised Date
Kent,Washington Prepared By, ItKIi
3, �a ' .43)- �,js Rug ' txs Qxxu,.jv�,CI ✓tx ik aa4, s.; .'t.• i il;ti•y
^£'+, ,�+`"
rras• ;i� ra'j":"�i- '��,N�rw�v�e�a�`I+."i-'+�tdiaa4,fed'ar'�Rrlarnt;:��r..•��,a.•,a•��:nr:.,.,t",,:.` -
This scope ofwork uroludes analyzing the anticipated design life ofthe current pavement repanloverlay program to beunderlokon by the
City o.Kent HWA will also perform new concrete and asphalt pavement designs for a 20-year design life utilizing traffic data plovided by
the City of'Kent IIWA will prepared report presenting the reusks of our analysis at the planted Improvements along with the new pavement
designs H_WA will submit 4 copies of the pavement engineering repor^staripcd by a professional engineer
1'<1 '� [lei "2!. 1 ,xx + ' •'t'4
.'- `1'3K� _ ybI ,°:3x1 't :, ti(s .ss :. .n '�vi2."t',ti:'s..t,'. fa'•rx`x', y {iY'r' se" qtry�Fg,
::3'✓i425s`ze„ ,<ir„?5::€r;w(t%;.ir1,n..St�,ri>.r�"..._i .`i`G�$Y__._x_83' "n
ES'IYMATED HWA"LABOR•r"
PERSONNEL&2007 DIRECT SALARY RATES
WORKTASK Principal Engr IV Engr III Geul III Geol I_ CAD Adnu❑ TOTAL -TOTAL
DESCRIPTION $200 00 $118 00 $114 00 $95 00 47400 $65 00 $62 00 HOURS AMOUNT
Project Se(_up/Coordmatean 2 _ - _ 2__ $228
Pavemenr Analyses — 4 4 _ — _ 8 $928
Pavement Design -------8 - _— 12 20 52,312
Report Prep_arotm_n 1 4 4 _ 1 _ 10
Project Management 2 2 $228
TOTAL DIRECT SALARY LABOR: 1 16 24 0 0 0 1 42 $4,886
LABORATORY' ST 8 4ARY: LSl[nA1L D DIRECT EXPENSESr
Est.No Unit Taal Mileage®0 485hm $0
Test Tests Cost Cost laboratory Testing(See details to icro $o
Natural Moisture Content _ _ _0_ $13 _$0_ Mucella,teous extxnses $o
Gram Size Distribution 0 $75 $o FWD Rcnial ar 5175/hour $0
Alterberg Limits(plasticity index) 0 $110 SO Pavenwnt Cores at$20 per core So
Consolidation 0 $425 $0 TOTAL DIRECT EXPENSM $0
Modified Proctor(moisture density) 0 $150 SO
LARORATORYTOTAI% $0 SUBCONTRACTOR&
Dnliing Subcoraract(See worksliee0 $o
I rarGc Control(see worksheel) $0
Excxvalmn Subcontract(sec worksheoQ $0
TOTAL SUBCONTRACTOR COSTS: $O
PRO.ILCT I OrALS AND SUMMARY
Duect Sal'ry $4,886
Subcontractor Costs $0
Odier Diaet Expenses $0
GRAND TOTAL: $4,886
Assumed Conditions:
1 All hours and Items are estimated,and may be increased or decreased within the limits of the
budget at the discretion of HWA's project manager
P5746
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 arise from or in
connection with the performance of the work hereunder by the Contractor, their agents,
representatives, employees or subcontractors
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. 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
2. Workers' Compensation coverage as required by the Industrial Insurance laws
of the State of Washington
3. Professional Liability insurance appropriate to the Consultant's profession.
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 limit
2. Professional Liability insurance shall be written with limits no less than
$1,000,000 per claim and$1,000,000 policy aggregate limit.
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions
for Automobile Liability and Commercial General Liability insurance.
1. The Contractor's insurance coverage shall be primary insurance as respect the
City Any Insurance, self-insurance, or insurance pool coverage maintained
by the City shall be excess of the Contractor's insurance and shall not
contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall not
be cancelled by either party, except after thirty (30) days prior written notice
by certified mail, return receipt requested, has been given to the City
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf of
the contractor and a copy of the endorsement naming the City as additional
insured shall be attached to the Certificate of Insurance The City reserves
the right to receive a certified copy of all required insurance policies The
Contractor's Commercial General Liability insurance shall also contain a
clause stating that coverage shall apply separately to each insured against
whom claim is made or suit is brought, except with respects to the limits of
the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current AM 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
r
ACORD DATE(&WDDlYYYV)
TM CERTIFICATE OF LIABILITY INSURANCE 02/20/2007
PRODUCER Phone (360)598-3700 Fax (360)598-3703 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MICHAEL J HALL&COMPANY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
19578 10TH AVENUE N E. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POULSBO WA 98370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE NAIC#
i
Agency Lick 91-1461089
INSURED INSURERA
HWA GEOSCIENCES,INC INSURER B HARTFORD CASUALTY INS CO.
19730 64TH AVENUE WEST,SUITE 200 1 LYNNWOOD WA 98036 NSURER C HARTFORD FIRE INS CO.
—
INSURER 0
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 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR Aar TYPE OF INSURANCE POLICY NUMBER POLICY EFFECT POLICY EXPIRATION LIMITS
LTR IN
GATE MMID DATEIMM)DUPA
GENERAL LIABILITY 52SBAGM1960 12/01/06 12O1107 EACH OCCURRENCE _ $ 1,000,00
X COMMERCIAL GENERAL LIABILITY DALIAGET
PREMISESC(Eaacc RENTED ce) g 300,000
_ _
CLAIMS MADEE OCCUR MED EXP(Any we Penn) $ 10,000
B PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY — PRO-
JECT LOG
AUTOMOBILE LIABILITY 52UECGJ3815 12/O1/O6 12/01/07COMBINED
X ANY AUTO (Ea amcent)INGLELIMIT
$ 1,000,000
ALL OWNED AUTOS BODILY INJURY
SCHEDVLEDAUTOS (Per person) $
C I X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per acudent)
PROPERTY DAMAGE g
(Per amideM)
I GARAGE LIABILITY
AUTO_ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY pGG $
EXCESS!UMBRELLA LIABILITY 52SBAGM1960 72l01/O6 12/01/07 EACH OCCURRENCE $ 2,000,OOD
X OCCUR J CLAIMS MADE AGGREGATE S 2,000,000
B ff
DEDUCTIBLE $
I
RETENTION$ $
WORKERS COMPENSATION AND WC SrATa OTHER
EMPLOYERS'LIABIUTY 5256AGM1960 12/01/06 12/01/07 TORYLIMITS X STOPGAP
B ANY PROPRIET01WART11EIYEXE1U'rM EL EACH ACCIDENT _ $ 1,000,000
OFFICERIMEMBER EXCLUDED?
EL DISEASE-EA EMPLOYEE IS 1,000,000
N Ye•aucdbe unear r___ _
SPECIAL PROVISIONSW. �E L DISEASE-POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re-Kent Kangley Road
City of Kent is an additional insured per written contract or agreement between insured and insured's client on the Commercial General
Liability and Automobile Liability Policies as respects liability arising out of activities by or on behalf of the named Insured
CERTIFICATE HOLDER CANCELLATION
City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Public Works Design Engineers EXPIWRIITENION DATE NOT NOTICE TO THEOF. THE ISSUING INSURER CERT CERTIFICATE OLDER NAMEDLTO ENDEAVOR
THE LEFT OBUTIL 30 VS
FAILURE
400 West Gowe TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,
Kent WA 98032 ITS AGENTS OR REPRESENTATIVES
AUTHORIZED REPRESENTATIVE � 7
Attention NancyYoshitake hley L Hurd
I
ACORD 25(2001/08) Certificate# 50913 m ACORD CORPORATION 1988 i
I
POLICY NUMBER COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY NUMBER: 52SBAGM1960
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - (FORM B)
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of Kent
(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 work"for that insured by or for you
CG 20 10 11 85 Copyright, Insurance Services Office, Inc, 1984 Page 1 of 1 0