HomeMy WebLinkAboutIT07-238 - Original - IQM2, LLC - Video on Demand Minute Traq Subscription & Hosting Fee - 09/25/2007 Records Management l
KENT �f Document'
WASHINGTON
- x er r
I
CONTRACT COVER SHEET
he Contract Manager to submission to City This is to be completed by t er prior g p Y Clerks Office. All
portions are to be completed, if you have questions, please contact Mary Simmons, City
Clerks Office.
Vendor Name: SCE M-Z i;_LC Vendor Number: l tot _10n
I JD Edwards Number
Contract Number: _" a 3y
This is assigned by Mary Simmons
Description: i a o n" on - 2�0-can a-CL CA
Detail: m41t%u-'Q Tri n � .�DC�(�Z'iD��►�R "y-, .,
Project Name: . dew - n cI _ (I„C?S!n n CA
Contract Effective Date: CI Termination Date:
Contract Renewal Notice (Days): 3 D S � N.-He-0 c;�7 ` _Osat'4�1�� d R
I
Number of days required notice for termination or re al or amendment
Contract Manager: Department: nr,
Te�hnol
Abstract: U
ADCL7832 07/02
r
KVNT
WA$HINGTCN
GOODS & SERVICES AGREEMENT
between the City of Kent and
IQm2, LLC
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and IQm2, LLC organized under the laws of the State of New York, located and doing
business at 90-D Raynor Avenue,* Ronkonkoma, NY 11779 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following services for
the City:
Scope of Service and Typical Timeline
IQM2 has developed an implementation methodology that we use for all of our projects. To begin the
process, we have outlined a timeline to ensure that your solution is implemented in an efficient and
organized manner:
Task Date IQM2 receives signed contract and full purchase order
from customer. Then the sales rep has a turnover Pre-Kickoff
meeting introducing the implementation project manager
and schedules the Kickoff Meeting.
Kickoff Meeting - Project plan is customized by M2
and customer to work with schedules and resourc Kickoff
Project start date is identified.
Setup - Our staff will work with your technical staff to
install hardware, software, databases and our application. Week 1
Any website or other integrations are performed
Configuration - System is customized and configured by Week 1
our staff by working with your core team.
Training - The core team completes several 2 hour
online or on-site training sessions with our training staff. Week 2
After the core team is done, other departments are
trained on using their part of application.
Parallel - All users begin using the software for the next Week 2
meeting cycle.
Go Live / User Acceptance: Client releases remaining Week 3 / 4
funds in accordance to the contract terms
GOODS & SERVICES AGREEMENT- I
(Over$10,000 00, includingWSST)
One Time — Purchases
MinuteTraq Training & Implementation
MediaTraq Hardware, Configuration &Training
One Time Purchases
Monthly Subscription
MinuteTraq Software, Hosting, Support & Maintenance
MediaTraq Software, Support, Storage &Streaming Services
Monthly Subscription
It is understood that the monthly subscription cost includes 15 G of storage or 100 hours. Additional
hours of programming may be listed then directed to a server local to the City of Kent or additional
hours may be purchased.
Miscellaneous
1. IQm2 will develop a site for the City of Kent.
2. IQm2 will be protected by source code escrow in case of financial or other vendor problems.
3. A reference manual and client software will be shipped.
4. IQm2 will create a City of Kent database.
5. A kickoff meeting will be held and implementation customized
6. IQm2 will install and customize the City of Kent site on their servers
7. A remote orientation overview demo of the entire Mediatraq will be performed.
8. Follow-up will result in a checklist to configure the system and data and to tailor the system.
9. 2 onsite training sessions will be held
10 4-6 remote training sessions will be held as needed.
11. A council meeting will be put to Mediatraq after the fact as part of training
12 Troubleshooting will be done
13. A parallel meeting will be conducted with new and old process both.
14. Troubleshooting will be done
15. 3rd council meeting will be live Mediatraq only
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. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services October 31, 2007.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed $11,550 for
training and implementation, $1,165 per month for subscription, including applicable Washington State Sales
Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the
following amounts according to the following schedule:
GOODS & SERVICES AGREEMENT-2
(Over$10,000 00, including WSST)
40% of the $11,550 will be due and payable with the order.
30% payable upon completion of onsite training
20% payable when the website is up and running satisfactorily for the City of Kent.
10% payable 30 days after website is up and running satisfactorily.
Monthly subscription fees are payable quarterly or annually in advance.
If the City objects to all or any portion of an invoice, it shall 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. 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.
VI. CHANGES. The City may issue a written change order for any change in the goods, materials or
services to be provided during the performance of this Agreement. If the Vendor determines, for any reason,
that a change order is necessary, Vendor must submit a written change order request to the person listed in the
notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date
Vendor knew or should have known of the facts and events giving rise to the requested change. If the City
determines that the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all
equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable
adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either
a written change order from the City or an oral order from the City before actually receiving the written change
order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make
any claim or submit subsequent change order requests for that portion of the contract work If the Vendor
disagrees with the equitable adjustment, the Vendor must complete the change order work; however, the
GOODS& SERVICES AGREEMENT-3
(Over$10,000 00, including WSST)
Vendor`may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims,
below.
The Vendor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Vendor as
provided in this section shall constitute full payment and final settlement of all claims for contract time and for
direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected
by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by a change order, another written
order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the
City, the Vendor may file a claim as provided in this section The Vendor shall give written notice to the City
of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or
within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events
giving rise to the claim, whichever occurs first Any claim for damages, additional payment for any reason, or
extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been
waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions
of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1
through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING
THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate was
determined; and
5. An analysis of the progress schedule showing the schedule change or disruption if
the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of
the asserted events giving rise to the claim. The City shall have access to any of the Vendor's
records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this Agreement.
GOODS & SERVICES AGREEMENT-4
(Over$10,000 00, including WSST)
6
.g
5
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also
waives any additional entitlement and accepts from the City any written or oral order (including
directions, instructions, interpretations, and determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the City
any written or oral order (including directions, instructions, interpretations, and determination)
VIII. 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.
IX. 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 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.
X. 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.
XL 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.
GOODS& SERVICES AGREEMENT-5
(Over$10,000 00, including WSST)
The provisions of this section shall survive the expiration or termination of this Agreement.
XIL INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit [Insert Exhibit #] attached and incorporated by
this reference.
XIIL 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.
XIV. 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 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 Crty's right to indemnification under Section
XI 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
GOODS &SERVICES AGREEMENT-6
(Over$10,000 00, including WSST)
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.
IN WITNESS, the parties below execute this Agreement,which shall become effective on the last
date entered below.
VENDOR: CITY OF KENT:
By: Z P By: 0, 7&L
rgnature) (signature)
Print Name. r Pri Name: (Sukette Cooke
Its �S/n�s3 ,�t���f its, Mayor
DATE:
(Title)
DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Rick McElroy Dea Drake
IQm2, LLC City of Kent
90-D Raynor Avenue 220 Fourth Avenue South
Ronkonkoma, NY 11779 Kent, WA 98032
(631) 563-5005 (telephone)
(631) 207-8387 (facsimile) (253) 856-4646 (telephone)
(253) 856-4700 (facsimile)
APPROVED AS TO FORM:
_ t
Kent Law Depar m
[In this field,you may enter the electronic filepath where the contract has been saved]
GOODS & SERVICES AGREEMENT-7
(Over$10,000 00, including WSST)
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:
I. 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_7.
By:
For: ( � /
Title: I Aeu�5/�ll9S AvC'/l,7/C
Date:
EEO COMPLIANCE DOCUMENTS- l of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity
within their organization and, if holding Agreements with the City amounting to $10,000 or more within any
given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal
opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and
equal opportunity requirements shall be considered in breach of contract and subject to suspension or
termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works
Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are
familiar with the regulations and the City's equal employment opportunity policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS-2 of 3
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 of 3
Y
E
INSURANCE REQUIREMENTS
ADDENDUM TO THE CITY OF KENT/IQm2 AGREEMENT
Licensor has obtained and shall maintain for the duration of this Agreement and all
warranty periods the insurance coverage described in the Certificate of Insurance hereto
attached.
IN WITNESS WHEREOF, the parties have executed this Addendum to the
License Agreement in several counterparts at the date this 4-5 day of tZX4 —
2007.
CITY OF KENT IQm2
c
By: By:
Its- r 4( cetwor"
ident
('`L' cnsee")
Address: Address:
220 4,h Avenue S. 90—D Raynor Ave
Kent, WA 98032 Ronkonkoma, NY 11779
- F ,
YN
ACORD,R CERTIFICATE OF LIABILITY INSURANCE p DC 09-11-2007
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
C M S, LLC/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
127496 P• (866) 467-8730 F: (800) 308-5459 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
4401 MIDDLE SETTLEMENT RD
NEW HARTFORD NY 13413 INSURERS AFFORDING COVERAGE
INSURED INSURER A Hartf ord Fire Ins Co
INSURERB Twin City Fire Ins Co
IQM2 LLC INSURER
90 D RAYNOR INSURER D
RONKONKOMA NY 11779 INSURER
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 DUCUMENT 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 MA', HAVE BEEN REDUCED BY PAID CLAIMS
ASR TYPE OF NYSUAAACE POLICYNZ4118M POLICY£FFECTNE POLLCYOW 1A7ION
DATE L#WFS
CL)LERAL L14BALITY EAUH VUWRRENUE 61 OOO, 000
A COMMERCIAL GENERAL LIABILITY 12 SBA I E 19 4 8 0 8/0 2/C 7 0 8/0 2/0 8 FIRE DAMAGE(Arty one Bre) 63 0 0,0 0 0
CLAIMS MADE I OCCUR MED EXP 1Any one persm) $10 0 0 0
X General Liab PERSONAL&ADV INJURY $1 000 000
bENERAL AbbREUATE s2, O00 000
GEN1 AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG 62, 000, 000
POLICYPRECO- X LOC
T
AUTOWGUME MAB2ITY COMBINED SINbLE LIMIT
ANY AUTO IEa xnaart) $ ,
ALL OWNED AUTOS BODILY IN..URY
SCHEDULED AUTOS (Per perwn) $
HIRED AUTOS
BODILY INJURY 6
NUN-OWNED AUTOS IPer acatleml
PRUPERTYDAMAGE S
IPer 6c dmtl
GARAGE LIAB"FY AUTO ONLY-EA ACCIDENT 6
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY AQ0 $
EXCESSLLABSITY EACH UCWRRENCE $
OLCUR CLAIMS MADE AbbRE�ATE 8
6
DEDUCTIBLE e
RETEN-IUN $
WORftRS COMPENSATpN AhO X WC STATU- OTH-
B EMPLOYERSL)AB2ITY 12 WEC PQ3208 08/02/07 08/02/08 ELEAUTACUIDENT 6100 000
E L DISEASE-EA EMPLOYEE 8100 000
E L DISEASE POLICY LIMIT $5 0 0, 0 0 0
O TNER
DESCA.PnON OF OPEIN TIONS2OCA TIONS/YERICLES&XCLUS1W ADDED BY EAODASEMEWA!IPECBIL PRO WNIMES
Those usual to the Insured' s Operatijns. Certificate holder is an Additional
Insured per the Business Liability Coverage form SS0008, attached to this
policy.
CERTIFICATE HOLDER 2L I AMIRV u WSUm D INSURER LETTER A 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(10 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE
City of Kent HOLDER NAMED TO THE LEFT BU-FAILURE TO DO SO SHALL IMPOSE NO
OBUUA ION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
220 4th Ave. S. REPRESENTATIVES
Kent WA 98032
AVFAOR EO RERWSEWAAVE
ACORU 25—S(7197) ACORD CORPORATION 1988
3
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGE
This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated
below
rn
Policy Number: 12 SBA IE1948 DW COPY
r
ti
0
Named Insured and Mailing Address; IQM2, LLC.
co
a
0
90—D RAYNOR AVENUE
v
RONKONKOMA NY 11779
rn
HPolicy Change Effective Date: 08/02/07 Effective hour is the same as stated in the
Declarations Page of the Policy.
0
o Policy Change Number: 001
Agent Name: C M. S, LLC/PHS
Code: 127496
POLICY CHANGES:
HARTFORD FIRE INSURANCE COMPANY
ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING
STATEMENT.
THIS IS NOT A BILL.
NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE
BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED
ADDITIONAL INSURED(S) ARE ADDED
THE FOLLOWING ARE ADDITIONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN
_ THIS POLICY.
LOCATION 001 BUILDING 001
PERSON/ORGANIZATION: SEE FORM IH 12 00
le
FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE:
PRO RATA FACTOR: 1.000
THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN.
Form SS 1211 04 05 T Page 0o1 (CONTINUED ON NEXT PAGE)
Process Date: 09/21/07 Policy Effective Date: 08/02/07
Policy Expiration Date: 08/02/08
UW COPY
POLICY CHANGE (Continued)
Policy Number. 12 SSA Ir.1948
Policy Change Number: 001
IH12001185 ADDITIONAL INSURED - PERSON-ORGANIZATION
Form SS 1211 04 05 T Page 002
Process Date: 09/21/07 Policy Effective Date: 08/02/07
Policy Expiration Date: 08/02/08
POLICYNUMBER: 12 SBA IE1949 AL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - PERSON-ORGANIZATION
d CITY OF KENT
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220 4TH AVE S
o KENT, WA 98032
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Form IH 1200 11 85 T SEQ. NO. 001 Printed in U.S.A. Page 001
Process Date: 0 9/2 1/0 7 Expiration Date. 0 8/02/0 8
UW COPY