HomeMy WebLinkAboutPW08-206 - Original - TMG Services - Chloration System Annual Service Maintenance - 03/25/2008 Records Management
KENT Document
W A S M I N 6 T 0 N
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 City Clerks Office.
Vendor Name: T/na , Vendor Number: 2�3�3
JD Edwards Number
Contract Number: AL)C) 9�
This is assigned by Deputy City Clerk
•
Description•
Detail:
ING
Project Name:
Contract Effective Date: ��0�5 v�4/, Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: 4,W4 I--\ Ddpartment:
Abstract:
S:Public\RecordsManagement\Forms\ContractCover\ADCL7832 07/02
•
KENT
WASHINGTON
GOODS & SERVICES AGREEMENT
FOR
ORDINARY MAINTENANCE
between the City of Kent and
T M G Services, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and T M G Services, Inc. organized under the laws of the
State of Washington, located and doing business at 3216 East Portland Avenuue, Tacoma, WA
98404 phone: 253-779-4160, fax: 253-779-4165, contact: Mary Gazdik (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 shall perform annual service maintenance for the chlorination system at the
City's following well sites: Kent Springs, Clark Springs, East Hill, and Armstrong
Springs. For a detailed description of the scope of work, see the 2-page annual
service quote which is attached as Exhibit A and incorporated by reference into this
contract.
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 within sixty (60) days of both
parties signing this agreement.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed six
thousand three hundred thirty-five dollars and 46/100 ($6,335.46), including applicable
Washington State Sales Tax, for the goods, materials, and services contemplated in this
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 1
(Under$10,000.00, including WSST)
Agreement. The City shall pay the Vendor the following amounts according to the following
schedule:
Upon completion of the services provided herein and acceptance by the City,
Vendor will issue an invoice and City will pay for these services within thirty (30)
days of receipt of the invoice.
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. PREVAILING WAGES. Vendor shall file a "Statement of Intent to Pay Prevailing
Wages," with the State of Washington Department of Labor & Industries prior to commencing
the Contract work. Vendor shall pay prevailing wages in effect on the date the bid is accepted or
executed by Vendor, and comply with Chapter 39.12 of the Revised Code of Washington, as well
as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision
issued by the Department of Labor and Industries is attached.
V. 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.
VI. 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.
VII. 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
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 2
(Under$10,000.00, including WSST)
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.
VIII. 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.
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 3
(Under$10,000.00, including WSST)
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).
IX. 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.
X. 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.
XI. 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.
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 4
(Under$10,000.00, including WSST)
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.
XII. 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.
XIII. 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.
XIV. 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.
XV. 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
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 5
(Under$10,000.00, including WSST)
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 XII 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 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: a., �►. By: nAwAdIP to A410W
(signatu (signs re)
Print Nam ar 4 z�� Print Name: Donald C. Millett
Its: Its: Public Works Operations Manager
(Title) (Titl )
DATE: 05 Jad /d DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: _rM CT S;et- Vic-eS, `mac • CITY OF KENT:
Mary Gazdik Sean Bauer, Water Quality Field Supervisor
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 6
(Under$10,000.00, including WSST)
f
T M G Services, Inc. City of Kent
3216 East Portland Avenue City of Kent
Tacoma, WA 98404 220 Fourth Avenue South
Kent, WA 98032
(253) 779-4160 (telephone)
(253) 779-4165 (facsimile) (253) 856-5516 (telephone)
(253) 856-6600 (facsimile)
P.Operations\PW OpsContracts\Water\TMGServicesAn nua Nal ntCh lon nation Services4locations2-08
GOODS & SERVICES AGREEMENT FOR ORDINARY MAINTENANCE - 7
(Under$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:
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.
w[
Dated this ?0 _ day of M4�J-- , 200�.
By: 0, U
- (;�,"
4ry az A I
For: �/N1 G SeF-v r ces, -
Title: prems' Glen-/
Date: d3 /ao /OF
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 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
• S
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
• 1
Exhibit A
ALAN* T M G Services, Inc. 3216 E.Portland Avenue
UMMIEC.) Tacoma,WA 98404
253-779-4160
Fax 253-779-4165
We've Got The Answers--Leave It In Our Hands tmginc®tmgsemices.net
January 29,2008
Sean Bauer
Kent, City of-Water
220 Fourth Avenue.S.
Kent,WA 98032-5895
Reference: Annual Service Quote
Dear Sean:
Thank you for your continued support of TMG Services,Inc. Please seethe estimates below for annual service
maintenance at Kent Springs,Clark Springs,Armstrong,Seven Oaks and East Hill Well Sites.Separate quote
attached for replacing equipment at Seven Oaks Well site.
Please note this is an estimate for recommended annual routine preventative maintenance and does not include
any major components that may be damaged or broken.
Kent Springs
Service Labor 16 Hours $102 $1,305.60
Service Travel 2 Hours $102 $163.20
Service Miles 65 Miles $.50 $32.50
Misc. Part(Please see Below) 1 Each $1,452 $1,452
Tax $259.95
TOTAL: $3,213.25
Kits,Gaskets,O-Rings.Tubing,Etc.
Labor: Clean, Inspect&Re-Gasket
(2)VR201C Vacuum Regulators with Ton Containers
(2)Low Pressure O-Ring Style Ejectors
(2)4100 Series Automatic Chlorinators,Including:
(2)Remote Ratemeter Assemblies
(2)Gas Check Valves
(2)Primary D/P Reguiators
(2)Automatic Valves
(2)Gas Check Valves
(2)Primary D/P Regulators
(1) 1610B Chlorine Gas Leak Detectors
Clark Springs
Service Labor 4 Hours $102 $326.40
Service Travel 1 Hours $102 $81.60
Service Miles 60 Miles $.50 $30
Misc. Part(Please see Below) •1 Each $394 $394
Tax: $71.38
TOTAL: $903.38
Kits,Gaskets,O-Rings,Tubing,Etc.
Labor: Clean, Inspect&Re-Gasket
(1) V10K Panel Mounted Chlorinator S/N BM11337
(1) Set 210S Automatic Switchover Module w/ton container
SIN's BM15878&BM15879
i
�Sbven Oaks
Service Labor 4.5 Hours $102 $3 7: —
Service Travel 1 Hour $102 81.60
Service Miles 60 Miles $.50 $30
Misc. Part(Please see Below) 1 Each $896
Tax: $119.69
TOTAL: 1,494.49
Kits,Gaskets,O-Rings,Tub' C.
Labor: Clean, Inspec e-Gasket
(1) V500 Vac hlorinator with Integral Pressure Relief
(1) Set Vacuum Regulators ,
0 Pressure O-Ring Style Ejector
1610E Chlorine Leak Detector
East Hill
Service Labor 4 Hours $102 $326.40
Service Travel 1 Hours $102 $81.60
Service Miles 60 Miles $.50 $30
Misc. Part(Please see Below) 1 Each $338 $338
Tax: $66.39
TOTAL: $842.39
Kits,Gaskets,O-Rings,Tubing,Etc.
Labor: Clean, Inspect&Re-Gasket
(2) V10K Panel Mounted Chlorinator S/N BM11337
(2) Set 210S Automatic Switchover Module
Armstrona Springs
Service Labor 5.5 Hours $102 $448.80
Service Travel 1 Hour $102 $81.60
Service Miles 60 Miles $.50 $30
Misc. Part(Please see Below) 1 Each $814 $706
Tax: $110.04
TOTAL: 1,376.44
Kits,Gaskets, O-Rings,Tubing, Etc.
Labor: Clean, Inspect&Re-Gasket
(2) V500 Vacuum Chlorinator
(2) Set 200C Vacuum Regulators
r,>i ;= iinnr, Irine-fnr
(1) 1610B Chlorine Leak Detector
It is always a pleasure to work with you. If you have any questions please do not hesitate to call me at
(253)779-4160.
Sincerely,
Teresa Corrington
TMG Services, Inc.
h
R Client#:41012 TMGSERVI
ACORD- CERTIFICATE OF LIABILITY INSURANCE 0DATE(MM/D
3/18/08DNYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bratrud Middleton Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Brokers, Inc.-Tac General HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1201 Pacific Ave,Suite 1000
Tacoma,WA 98402 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A OREGON AUTOMOBILE INSURANCE
TMG Services Inc.
INSURER B
3216 E Portland Ave
INSURER C
Tacoma,WA 98404
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
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR NSR DATE MM/DD/YY DATE M/DD/YY
A GENERAL LIABILITY C14129242 06/05/07 06/05/08 EACH OCCURRENCE $1 000 000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED a $100 000
CLAIMS MADE 51 OCCUR MED EXP(Any one person) $5 000
X PC Ded:500 !t ONAL&ADV INJURY $1 000 000
GENERAL AGGREGATE s2,000,000
[GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2 000 000
POLICY X PRO LOC
JECT
A AUTOMOBILE LIABILITY C14129242 06/05/07 06/05/08 COMBINED SINGLE LIMIT OOO$1
X ANY AUTO (Ea accident) a ,000
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
A EXCESSIUMBRELLA LIABILITY C14129242 06/05/07 06/05/08 EACH OCCURRENCE s2,000,000
X OCCUR CLAIMS MADE AGGREGATE s2,000,000
DEDUCTIBLE $
RETENTION $ $
TATLij WORKERS COMPENSATION AND WC SLIMIT CER
EMPLOYERS'LIABILITY
A C14129242 06/05/07 06/05/08 E.L.EACH ACCIDENT $1 OOO OOO__
ANY PROPRIETOR/PARTNE FXFCUTNE -_ _-- _ - — _- - - - - - - - _-_----
OFFICEIFMEMBER EXCL ED, E L.DISEASE-EA EMPLOYEE $1,000,000
IT yes,describe under
SPECIAL PROVISIONS below E L.DISEASE-POLICY LIMIT $1 000 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Annual Service Maintenance of Chlorination System
Certificate holder is additional insured per the attached.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Kent DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL AS DAYS WRITTEN
220 4th Ave.S. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Kent,WA 98032-5838 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
ASOE�R RTIVE
ACORD 25(2001/08)1 of 2 #S212143/M183698 PVC \` KMKOO 0 ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S(2001/08) 2 of 2 #S212143/M183698
BLANKET ADDITIONAL INSUREDS — CONTRACTORS
This endorsement modified insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. A. Section 11—Who Is An Insured is amended to include as an insured the following:
1. Any person or organization for whom you are performing operations when you and such person or
organization have agreed in writing in a contract or agreement that such person or organization be
added as an additional insured on your policy. Such person or organization is an additional
insured only with respect to liability arising out of your ongoing operations performed for that
insured. A person's or organization's status as an insured under this endorsement ends when
your operations for that insured are completed.
2. Any person or organization from whom you lease a premises when you and such person or
organization have agreed in writing in a contract or agreement that such person or organization be
added as an additional insured on your policy. Such person or organization is an insured only
with respect to liability arising out of the ownership, maintenance,or use of that part of the
premises leased to you. A person's or organization's status as an insured under this
endorsement ends when their contract or agreement with you for such leased premises ends.
3. The architects,engineers or surveyors while not engaged by you,that are contractually required
to be added as an additional insured to your policy, but only with respect to liability arising out of
your ongoing operations performed by you or on your behalf.
B. With respect to the insurance afforded these additional insureds,the following additional exclusions
apply.
1. The insurance afforded under Paragraph I.A.I.and 1.A.3 of this endorsement does not apply to:
"Bodily injury","property damage"or"personal and advertising injury"arising out of the rendering
of,or the failure to render, any professional architectural,engineering or surveying services,
including:
A. The preparing,approving,or failing to prepare or approve, maps,shop drawings,
opinions, reports,surveys,field orders,change orders,drawsings,designs or
specifications;and
B. Supervisory, inspection,architectural or engineering activities.
2. The insurance afforded under Paragraph 1.A.2.of this endorsement does not apply.
A. To any"occurrence"which takes place after you cease to be a tenant in that premises;
B. To structural alterations, new construction or demolition operations performed by or on
behalf of the person or organization from whom you lease the premises.
LNGL 40 32 10 01 Contains ISO copyrighted material,with Its permission
Copyright,Insurance Services Office,Inc.,2001