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HomeMy WebLinkAboutPK07-297 - Original - Sunset Septic Tank Co., Inc. - Three Friends Fishing Hole Pumping - 06/01/2007 Records Manag" ernerit KENT Document 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: ��h SC T JC QT` I �� r C d - Contract Number: Pk TWC le �ecinnoA by AAr r%, Cimmnne y..�.. ..7 ., Y ,,....... ., I Vendor Number: ✓ G —7 O -7 Project Name: a ree f tx m Pt"'wj I 2-ov—I Contract Effective Date: Contract Termination Date: Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Department: Abstract: ADCL7832 07102 KENT Wwsri"�roN GOODS & SERVICES AGREEMENT between the City of Kent and Sunset Septic Tank Co., Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Sunset Septic Tank Co , Inc. organized under the laws of the State of Washington, located and doing business at 918 Central Avenue South, Kent, Washington 98032(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: Vendor to provide labor, materials and equipment to pump the 2,000 gallon holding tank in the restroom at the Three Friends Fishing Hole Park, located adjacent to the Green River at South 196`h Street and 58" Place (formerly Russell Road). The Vendor to pump the vault once a month, beginning June 1, 2007 as described in the proposal dated July 20, 2007 attached and incorporated as Exhibit A. 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. IL TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services monthly beginning June 1, 2007 and concluding December 31, 2007. III. COMPENSATION. The.City shall pay the Vendor an amount not to exceed Six Thousand Two Hundred and Seventy Dollars and NO/100ths ($6,270 00), plus 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. Upon completion of each month's pumping, the Vendor shall invoice the City for $570.00 plus applicable Washington State Sales Tax. 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. I GOODS& SERVICES AGREEMENT- 1 (Under$10,000 00, including WSST) 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 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 GOODS& SERVICES AGREEMENT-2 (Under SIO,000 00, including WSST) 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 I 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. 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). VHI. 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. GOODS&SERVICES AGREEMENT-3 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. XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this Agreement. XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. 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. GOODS&SERVICES AGREEMENT-4 (Under$10,000 00, including WSST) XIV. MISCELLANEOUS PROVISIONS. A. Recvclable 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 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. Assign ent 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 Vendoi. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. GOODS&SERVICES AGREEMENT-5 (Under$10,000 00, including WSST) IN WITNESS,the parties below execute this Agreement,which shall become effective on the last date entered below. VENDOR: CITY OF KENT: By: -fJBy: ,,5551 (signature) (signature) Print Name: Gary Harwood Print Jeff Watling Its Owner PfAF5 Its• Director (Title) (Title) DATE: S— -7 -a�7 DATE: e(3 f l0'7 L— NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Gary Harwood Lori Flemm,Project Manager Sunset Septic Tank Co., Inc. Kent Parks, Recreation & Community Services 918 Central Avenue South 220 Fourth Avenue South Kent, WA 98032 Kent, WA 98032-5895 (253) 852-3210 (telephone) (253) 856-5128 (telephone) (253) 854-3810 (facsimile) (253) 856-6120 (facsimile) Three Friends Fishing Hole Pumping,2007 GOODS&SERVICES AGREEMENT-6 (Under S10,000 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 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 1, 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 2007. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS- 1 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 fl 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 Sunset Septic Tank Co., Inc. Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as Three Friends Fishing Hole Pumping,2007 that was entered into on the (dateZ, 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 12007. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS-3 of 3 SUNSET SSEPTIC TANK CO.,INC. 918 Central Avenue South Kent,Wasbington 98032 Phone 253-852-3210 Fax 253-854-3810 July 200 2007 To: City of Kent Parks, Recreation & Community Services 220-4"' AV S Kent, WA 98032-5895 Fax 253-1156-6050 Attn: Lori Hastings Brian Tony Subject: Three Friends Fishing Hole Park Scope of Work/Proposal: Sunset Septic Tank Company, Inc. will provide the labor, materials and equipment to pump the 2000 gallon holding tank in the restroom at the Three Friends Fishing Hole Park located adjacent to the Green River at South 196th Street and 58th Place (formerly Russell Road). Sunset Septic Tank Company, Inc. will pump the vault once per month, or as requested, beginning In June of 2007. The cost of the afarementloned pumping will be $570.00 plus Washington State sales tax, currently 8.9%. Should the King County Dump fees Increase, Sunset Septic Tank Company, Inc. may notify City of Kent Parks, Recreation and Community Services of a slight rate increase. For any further questions, please call. Sincerely yours, Gal 413arwood President. EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS 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. 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 11 85 The Citv 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. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit 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 A.M. Best rating of not less than AN IL 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 AC'ORDM CERTIFICATE OF LIABILITY INSURANCE G ''y` ' 071241z 0 PRODUCER (425)226-8221 FAX (425)255-9342 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Humble & Davenport Ins Brokers Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO Box 1150 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Renton, WA 98057 INSURERS AFFORDING COVERAGE NAIC# INSURED Sunset Septic Tank Co Inc INSURERA Oregon Auto 23922 918 Central Ave S INSURER Kent, WA 98032 INSURER INSURER D 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 INSR rADDL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY C17115396 09/09/2006 09/09/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,00 CLAIMS MADE Ifl OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,00 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,0001 POLICY PRO LOC ECT AUTOMOBILE LIABILITY C17115396 09/09/2006 09/09/2007 COMBINED SINGLE LIMIT ANY AUTO (Ea amdeM) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULEDAUTOS (Perperson) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per amdenl) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE S DEDUCTIBLE $ RETENTION $ $ XAMMMMINIMMUMM" C17115396 09/09/2006 09/09/2007 WC STATU- CTH- EMPLOYERS'LIABILITY WA STOP GAP E L EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E L DISEASE-EA EMPLOYEE $ 1,000,00C It yes,dascnbe under - SPECIALPROVISIONSbelow EL DISEASE-POLICY LIMIT I$ 1,000,00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is additional insured with respects to the operations of the named insured per the attached form CG 2013 1185. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Kent Parks Department 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Tony BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 220 4th Ave S OF ANY KIND UPON THE INSURERffi AGENTX'Q REPRESENTATIVES Kent, WA 98032 AUTHORIZED REP S TATN ACORD 25(2001108) FAX: (253)856-6050 ©A ORD CORPORATION 1988 JLJ1 ev Ur UelUap CERTIFICATE OF INSURANCE This certifies that STATE FARM FIRE AND C.ASIJAL1Y COMPANY, Bloormngtoo,lllil [] sTATE FARM GENERAL INSURANCE COMPANY. $Ioorrivigton, Ifinnis t SPATE FARIA FIRE AND CASUALTY COMPANY, Aurora Ontarru [j STATE FARM FLORIDA INSURANC$COMPANY, Winter Haw,vi. r-londa �} STATE FARM LLOYDS, Dallas, exas insures the following poticy'to,cer forthe coverages indicated below. polleyholder miry ;vernon A.d�''255 Gt p61acy1►oldar Y.U. ln;r. 114 t1 t.A' -.-'�'--,•••�•.•.._v- __.-...._.-��. �jCat'le WA Location of ope'ratinns c.>y of x nr --- ^ Uescripi+on of operations Nur.al Thos pol,ces listed Mow ivivt bmi issuo3 I.3 the ffA the policy oeriods shown The artsurar"L-ae,entled an these ?o(acn:s a '�utalact to all rt,e term,, eyclu5,runS,and condatlons of those polaucs 1 he tunrta of la,aoiflty snawri may gave been reducod by a'1v paid claims — -----•-.- —_ POLICY PERIOD �LIMITS OF LIACMLITY POLICY t lUldElER { TYPE OF INSUIF3AWCE EftectLve Date_ EXParai OWW (at Ih;gpraningl of policy peraud) nI,-t•,' 7?'r r,—{) C6fa•IptAli6nyn+4 i[;-1:�'U(7J �J-: 1 ;'J•J•: l��NAJ-2Y AND F uamness Laabaldy f7ROPERl Y DAMAGE —mess - ...... --------- - lhrs Insuram'e includes Products-Completed Operations G Contractual tiaab+:aty EachOcaurrence $ 1,out.,U:;7 �]PLMsonal Jn)uay [�Advertr;nr4 Injury GenAraI Aggregate S P,OQU,00o Products-Corripleteo S,2, U,UUu l � 4peratruny A reante POLICY PERIOD �13oUllY INJURY,�^!C) F2GrC tTv C'AIkAC� EXGCSS UAB:1-iTY Eypoci),Je Date : Expiration DA.- (Comhinec;Single U rrt) 0 Umbrella Each(Occur+gnoe S `Z Other Aggregatc POLICY PERIOD I Wart I -VvQrkarr,Ctlmpc:mdtaon - Slwutn^y Effective Date: ER_pir�an Workers Compen5ataoa+ part N -Employers 4aabaftty { aria Emplayoss La 6aaty r D Accx ent 5 Dist- — — Oasease-Each Employee 5 -_ Orseaar- Policy:"lmd POLICY PrRI00 LIMITS OF LIABILITY POLICY NUMBERTYPE OF INStJRAIVGIE Effettavo Date Expimton Babe (at beginning of polrcy wriod) THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT Of INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMCr>OS.EXTENDS OR ALTERS THE: COVERAGE APPROVED BY ANY POLICY DFSCRISED HEREIN, Narne and Address sf Certificato Holder If any of thg eescrabed policies are crincelod be fore Add L i 7 n zu:, their expiration date, Slate Farm will try to mat!a ,NrtttEtn noLcetq the cr,Ykfic:ate hcrider 45 days L�efore Ci.y of liwrat canceNutir.n It hC-wy,•er,we fail to rr,a,l such notice, Xtr,t� +rAvcrtiUr3:: an(xlaatr+iKyv�n;tbermyylStateFarm ov ikpIftnits o relIlentativ�X A Awljie of Authorzgd Feprt�a atrae F Title Jute Agern Name - -- --- --- Telephen?NtampGt 2CG-542-Ph00 Agem'tcageStamp .�...--- Awt r:a& 201 i AFOCtde f`485 5�1i-�n,.6 PaM'tadm U.^>A Ruv OS49.2006 POLICY NUMBER. C17ii5396 COMMERCIAL-GENERAL LIABILITY THIS ENDORSI-MENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS RELATING TO PREMISES This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDUI-E State or Political Subdivision; City of Kent Parks Department 22C 4th Ave S Kent, WA 98032 (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 1. The existence, maintenance, repair, construction, include as an Insuied any state or political subdivision erection, or removal of advertising signs, awnings, shown In the Schedule, subject to the following addi- canopies, cellar entrances, coal holes, driveways, tional provision manholes, marquees, hoist away openings, side- This insurance applies only with respect to the follow- 'walk vaults, street banners, or decorations and ing hazards for yvhich the state or political subdivision similar exposures; or has issued a permit in connection with premises you 2. The construction, erection, or removal of eleva- own, rent, or control and to which this insurance ap- Mors,or plies 3. !The ownership, maintenance, or use of any eleva- tors covered by this insurance. CG 201311 85 Copyright, Insurance Services,Office, Inc, 1984 Page 1 of I E3