HomeMy WebLinkAboutPK07-285 - Original - SB & Associates, Inc., P.S. - Town Square Plaza Construction Administration - 10/01/2007 Records Management
KENT
WASHINGION Document
- I .
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact Mary Simmons, City
Clerks Office.
Vendor Name:
Contract Number:—A 6 7- 020
This is assir mn A by AAnry Cimm^ne
Vendor Number:
Project Name: 5B `t - I C7L'kj� ✓e F/M Q
4Q0 2 CGIvS-1N2,ut7f, o fTOM t .
Contract Effective Date:
Contract Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: ! `
Department: F IL
Abstract:
ADCL7832 07/02
40000
KENT
W/ I.G,.N
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
SB & Associates, Inc., P.S.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and SB & Associates, Inc., P.S. organized under the laws of the State of Washington,
located and doing business at 1148 NW Leary Way Seattle, Washington 98107. Telephone- (206)789-2133.
Fax. (206) 789-2186 (hereinafter the "Consultant"). Supplying
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following described
plans and/or specifications: __�
Construction Administration Services for Town Square Plaza as described in the consultant's June 8, 2007 Scope
of Work, attached and incorporated as Exhibit A.
Consultant further represents that the services furnished under this Agreement will be performed in
4 accordance with generally accepted professional practices in effect at the time those services are performed.
H. 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 December 31, 2007.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed sixty
one thousand, three hundred forty and no/100 ($61,340 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 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
SB&Associates Agreement for Town Square Plaza Page 1
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.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement and that the Consultant has the ability to control and
direct the performance and details of its work, the City being interested only in the results obtained under this
Agreement.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of this
Agreement After termination, the City may take possession of all records and data within the Consultant's
possession pertaining to this project; which may be used by the City without restriction. If the City's use of
Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the
Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national
origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is
qualified and available to perform the work to which the employment relates. Consultant shall execute the
attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative
Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement.
VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits,
including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of
this Agreement, except for that portion of the injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,
then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused
by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees,
agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's
negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE
MUTUALLY NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit A attached and incorporated by this reference.
SB&Associates Agreement for Town Square Plaza Page 2
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. Even 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 work must meet the approval of the City and shall be subject to the City's general right of
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be
done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools,
or other articles used or held for use in connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price preference
may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement
in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements
or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute,
difference or claim 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.
SB&A Agreement for Town Square Plaza Page 3
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 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.
CONSULTANT: CITY OF KENT:
By: 1 -1 By:
(signature) (signature)
Print Name: MtLg&*g t� C.H wt3 Pri Suzette Cooke
Its P�ml rAGOAz Its Mayor
(Tole (Tale)
DATE: S%3/ pro? DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Perry Brooks
SB&A & Associates, Inc. City of Kent
1148 NW Leary Way 220 Fourth Avenue South
Seattle, Washington 98107 Kent, WA 98032
206-789-2133 (telephone)
206-789-2186 (facsimile) (253) 856-5110 (telephone)
(253) 856-6050 (facsimile)
APTOVED AS TO FORM:
Amdl�_�
en Law ep ent
SB&A Agreement for Town Square Plaza Page 4
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 Z 7 day of 12007.
By:_ �
For: A 9_A!551-14-k ArTEG
Title:
Date: 61/Z7 oZZ
EEO COMPLIANCE DOCUMENTS - I
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 2007.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS-3
1+
Elm
LANDSCAPE
ARCHITECTS
S13 & ASSOCIATES, INC
1148 NW LEARY WAY
SEATTLE, WA 98107
(206)789 2133 F,x(206)789 2186
June 8, 2007
Kent Parks, Recreation& Community Services
220 Fourth Ave S.
Kent, WA 98032
Attn
Perry Brooks, Project Manager
Re: Construction Administration Services for Kent Town Square Plaza
Perry,
Thank you for selecting the SB and Associates(SB&A)team to work with you on the Kent Town Square
Plaza Project Based on our conversations and review of the bid documents,I have prepared the following
project scope of services and fee proposal for construction services I have also had conversations with Chris
Kovac,PE at DOWL Engineers It is anticipated that DOWL Engineers will be providing construction services
for areas such as storm and utility work,fountain mechanics,and roadway improvements Services performed
by DOWL will be under a separate contract with the City of Kent SB &Associates and DOWL Engineers will
coordinate throughout the construction period Additional services by other firms such as electrical,
geotechnical,mechanical,and structural are also not apart of this contract.
Assumptions are as follows:
1. The City will provide staff members to observe construction and serve as the City
representative during the entire construction period
2. SB&A will assist the above staff members during the construction period and will review
written field directives and changes issued by the staff members.
3 The City of Kent will provide City Inspections for all work within the Right of Way.
4. If additional services by other firms is required the City will contract directly with those firms.
5. Weekly construction meetings will be conducted by City Staff and will be attended by
members of the SB&A team as needed All meeting minutes will be developed by the City and
distributed to the appropriate parties.
6 The anticipated construction period is 35 weeks starting April 23, 2007 through December 18,
2007. If construction exceeds 35 weeks, the contract will be adjusted to address the additional
services.
7. Supplemental Design input is not included in this scope of work.
SCOPE OF SERVICES
1. Task 1: Construction Services
1.1. Kick Off Meeting/Pre-Construction Coordination
Kent Town Square Plaza
6/26/2007
Page 2 of 2
1.1.1. Attend one Kick Off meeting with City Staff, Contractor and SB&A.
1.1.2. Attend one Pre-Construction Meeting at City of Kent for ROW improvements.
1.2. Weekly Construction Meetings/Site Observation
1.2.1 Attend weekly construction meetings and conduct site observations. SB&A will
conduct up to 35 site visits.
1.2.2 Provide Site Observation Notes from site visits.
1.2.3 Provide one preliminary punch list compiled during one of the weekly construction
meetings listed above.
1.2.4 Provide one final punch list complied from the last weekly construction meeting listed
above.
1.2.5 Conduct up to 2 additional site visits following distribution of the final punch list to
observe completed task on the punch list.
1.3. Coordination/Correspondence
1.3.1 Assist City during the construction phase addressing contractor questions. Provide
coordination and correspondence with City Project Manager, City Representative, City
Inspector, and Contractor. SB&A will provide up to 140 hours coordination/
correspondence.
1.4. Change Order Proposal/Change Order
1.4.1. Assist City during the construction phase addressing change order proposals and change
orders. SB&A will provide up to 36 hours.
1.5. Submittal Review
1.5.1. Assist City during the construction phase reviewing Contractor submittals. SB&A will
provide up to 28 hours.
1.6. Project Closeout and Record Drawing Review
1.6.1. Provide project closeout services and review contractor provided record drawings.
SB&A will provide up to 16 hours.
1.7. Invoicing and Review
1.7.1. Provide monthly invoice and work description.
FEE
The fee for the above services are calculated as follows:
Approximately 13 hours(1 '/z days) per week for 35 weeks.
SB&A Fee $61,340
If you have any questions please give me a call.
Sincerely,
Michael R. Lamb,Principal
SB and Associates, Inc
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EXHIBIT B
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 arise 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.
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 1185 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.
2. 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, $2,000,000 general aggregate
and a $1,000,000 products-completed operations aggregate limit.
C. Other Insurance Provisions
EXHIBIT B (Continued)
The insurance policies are to contain, or be endorsed to contain, the following provisions
for Automobile Liability and Commercial General Liability insurance.
l. 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 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 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.
CERTIFICATE OF LIABILITY INSURANCE CSR SP DATE(MM DD YYYY)
ACORD SB&AS-1 09/04/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Sprague Israel Giles HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
1501 Fourth Avenue, Suite 2000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Seattle WA 98101-1637
Phone: 206-623-7035 Fax:206-682-4993 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A gational Fiza Ineuzance Co
INSURER B
SB & Associates INSURER
1148 NW Learyy Way INSURER D
Seattle WA 9E107
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 ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
AUw ICY EXPIRATION
LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POL DATE MMIDO/YY DATE MM/DD/YY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A X X COMMERCIAL GENERAL LIABILITY 2084731811 04/12/07 04/12/08 PREMISES(Eaoccurence) $300, OOO
CLAIMS MADE a OCCUR MED EXP(Any one person) $ 10,000
X STOP GAP PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE s2,000,000
GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG s2,000,000
POLICY PRO LOC
JECT
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $sl,OOO,0OO
ANY AUTO (Ea accident)
ALL OW NED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS BODILY INJURY
A X NON-OWNEDAUTOS 2084731811 04/12/07 04/12/08 (Per accident) $
PROPERTY DAMAGE $
(Per acmdenQ
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHERTHAN EA ACC E
AUTO ONLY qGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
E
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY TORY LIMITS I I ER
ANY PROPRTTORIPARTNERIEXECU`IVE E L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
E L DISEASE-EA EMPLOYEE $
If yes,describe under I
SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT I$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Certificate holder is additional insured with respects liability arising out
of operations by or on behalf of the named insured.
Re: Kent Town Square Plaza
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Kent NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Parks, Recreation & Community IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Services
220 4th Avenue South REPRESENTATIVES
Kent WA 98032-5895 AUTHO EPRES ATIV
ACORD 25(2001108) 0 ACORD CORPORATION 1988
POLICY NUMBER: 2084731811 COMMERCIAL GENERAL LIABILITY
CG 20 10 03 97
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of Kent, Parks Recreation& Community Services
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement )
Who Is An Insured (Section II) is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured,
CG 20 10 03 97 Copyright, Insurance Services Office, Inc , 1996 Page 1 of 1 ❑