HomeMy WebLinkAboutPK10-261 - Original - Construction Management Services of Washington - Van Dyke and Lake House Asbestos Inspections - 12/17/10 405 �. Records MaFiage'Fe' n -L$
KENT Document
WASHINOTON
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 Clerk's Office.
Vendor Name: J 1 CdvtS ��c �`` V� ,�l4- �k-Ll, e, o�
(Nas\. ti-�,4a� lt, c
Vendor Number: 22 ' 6 R e
JD Edwards Number
Contract Number: PK to-
This is assigned by City Clerk's Office L 1
Project Name: Vo A �`1 t-``K-¢ �� 'res -F Lid 1�S+eec7�?�
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment�Contract
❑ Other:
Contract Effective Date: 2 +� Termination Date:
Contract Renewal Notice (Days): _
Number of days required notice for termination or renewal or amendment
Contract Manager:�v���{�� Department: p6LY �-5-
Detail: (i.e. address, location, parcel number, tax id, etc.):
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S,Publlc\RecordsMa nagement\Forms\ContractCover\adcc7832 11/08
KENT
W A HI N 0 T 0 N
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Construction Management Services of Washington, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Construction Management Services of Washington, Inc. (CMSI)
organized under the laws of the State of Washington, located and doing business at 4227 S
Meridian, STE C #625 Puyallup, WA 98373 P: 253-683-1144 (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the
following described plans and/or specifications:
Inspect houses for asbestos and lead and create a report of the findings for the Van
Dyke property (11244 SE 204) and the Lake house (12651 SE 240) in Kent,
Washington as described in the vendor's proposals dated December 6, 2010
attached and incorporated as Exhibit A.
Consultant further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices within the Puget Sound
region in effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks
described in Section I above immediately upon the effective date of this Agreement. Upon the
effective date of this Agreement, Consultant shall complete the work described in Section I
within 30 days.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to
exceed Two Thousand Three Hundred Thirty Dollars ($2,330.00) 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 amendment to this 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
CONSULTANT SERVICES AGREEMENT - 1
(Under$10,000)
I \
an invoice. If the City objects to all or any portion of an invoice, it shall notify the
Consultant and reserves the option to only pay that 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. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. 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.
B. The Consultant maintains and pays for its own place of business from which
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible
for a business deduction for federal income tax purposes that existed before
the City retained Consultant's services, or the Consultant is engaged in an
independently established trade, occupation, profession, or business of the
same nature as that involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with
the state Department of Revenue and other state agencies as may be
required by Consultant's business, and has obtained a Unified Business
Identifier (UBI) number from the State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and
earnings of its business.
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.
CONSULTANT SERVICES AGREEMENT - 2
(Under$10,000)
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.
In the event Consultant refuses tender of defense in any suit or any claim, if that tender
was made pursuant to this indemnification clause, and if that refusal is subsequently determined
by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the
Consultant's part, then Consultant shall pay all the City's costs for defense, including all
reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and
fees incurred because there was a wrongful refusal on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this
Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and
incorporated by this reference.
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.
CONSULTANT SERVICES AGREEMENT - 3
(Under$10,000)
r
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, including all appeals, 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.
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
CONSULTANT SERVICES AGREEMENT - 4
(Under$10,000)
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.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONSULTANT: CITY OF KENT:
r
By: i By: \Q(k (-11
(sign turd (signature)
Print Name: >lo ��P,Vh 'e , ,.,a Print e: Jeff Watling
Its: i7� 45'Pec-eI&..mot Its: Parks Director
(title)
DATE: 12,h0 d DATE: Ito
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Robert Simmons Brian Levenhagen
CMSI City of Kent
4227 S Meridian, STE C #625 220 Fourth Avenue South
Puyallup, WA 98373 Kent, WA 98032
253-683-1144 (telephone) (253) 856-5116 (telephone)
(253) 856-6050 (facsimile)
Lake and Van Dyke Asbestos&Lead Palnt Inspection
CONSULTANT SERVICES AGREEMENT - 5
(Under$10,000)
s
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this _ _ day of ,���C palm , 2010.
1
By: r i
For: �iw/$y�ii7J/ ��lPLicr��jeC
1
Title: SC'GLP/dw/
Date: k id
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date) between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this day of , 2011.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
q : MSI
i Environmental Specialties
" Construction Management Services of Washington,Inc.
4227 S Meridian,STE C,4625 •Puyallup,WA 98373•(253)683-1144
December 6,2010
Brian Levenhagen
Kent Parks
City of Kent
220 4th Ave S
Kent,WA 98032
Subl ect. Asbestos&Lead Paint Inspection
11244 SE 204th,Kent WA
Dear Mr Levenhagen:
Thank you for requesting a proposal from CMSI. We can provide you with an asbestos inspection and
Lead Paint at the above listed address As a pre-demolition inspection we will need to do destructive
sampling which usually includes opening small holes in several walls to verify the type of building
materials used The EPA has new regulations on lead paint since last April which add to the already in
place regulations regarding disclosure of lead materials present. Lead paint samples that characterize the
quantity of lead in the paint are highly recommended Waste handlers may require a Lead Toxic
Characteristic Leachate Procedure(TCLP)test of the demolition waste stream We can also provide that
if lead paint as defined by EPA is verified and it is required by the waste hauler
The inspector will not know how many samples are needed until the inspection is underway. Due to the
sampling protocol each building is treated differently The number of samples proposed is based on
previous inspections of similar structures You will only be charged for the samples collected Should
additional samples or additional services be needed the inspector will contact you as soon as is possible
Below is an estimate of costs for your inspection project.
Inspection&report,asbestos&lead $340
1
30 bulk asbestos samples @$20 each 600
5 lead paint samples @$20 each 100
I TCLP waste stream sample 125
Total $1165
Our hourly rate for inspection is$85. If additional services are needed we can operate on the hourly rate,
the proposed unit costs and cost plus 15% It usually takes a week to ten days to turn around a report. Let
me know when you want to start.
Sincerely,
�4G�tx f. 5:"f.
Robert F Simons
Project Manager
I
I n MSI
Environmental Specialties
Construction Management Services of Washington,Inc
4227 S Meridian, STE C,#625 •Puyallup,WA 98373•(253)683-1144
December 6,2010
Brian Levenhagen
Kent Parks
City of Kent
220 4th Ave S
Kent,WA 98032
Subject: Asbestos&Lead Paint Inspection
12651 SE 240th,Kent WA 98031
Dear Mr Levenhagen
Thank you for requesting a proposal from CMSL We can provide you with an asbestos inspection and
Lead Paint at the above listed address As a pre-demolition inspection we will need to do destructive
sampling which usually includes opening small holes in several walls to verify the type of building
materials used The EPA has new regulations on lead paint since last April which add to the already in
place regulations regarding disclosure of lead materials present Lead paint samples that characterize the
quantity of lead in the paint are highly recommended Waste handlers may require a Lead Toxic
Characteristic Leachate Procedure(TCLP)test of the demolition waste stream We can also provide that
if lead paint as defined by EPA is verified and it is required by the waste hauler
The inspector will not know how many samples are needed until the inspection is underway Due to the
sampling protocol each building is treated differently The number of samples proposed is based on
previous inspections of similar structures You will only be charged for the samples collected Should
additional samples or additional services be needed the inspector will contact you as soon as is possible
Below is an estimate of costs for your inspection project
Inspection&report,asbestos&lead $340
30 bulk asbestos samples @$20 each 600
5 lead paint samples @$20 each 100
1 TCLP waste stream sample 125
Total $1165
Our hourly rate for inspection is$85. If additional services are needed we can operate on the hourly rate,
the proposed unit costs and cost plus 15% It usually takes a week to ten days to turn around a report Let
me know when you want to start
Sincerely,
1
Raw F.
Robert F Simons
Project Manager
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 City shall be named as an
insured under the Contractor's Commercial General Liability
insurance policy with respect to the work performed for the
City using ISO additional insured endorsement CG 20 10 11
85 or a substitute endorsement providing equivalent
coverage.
2. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
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 A:VII.
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.
CERTIFICATE OF LIABILITY INSURANCE OP ID PM DATE(MMIDDNYYY)
08/19/10
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT If the certificate holders an ADDITIONAL INSURED,the policy(les)must be endorsed 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 endorsements)
PRODUCER NAME
Obenchain Insurance, Inc. VHI
264 Main Ave South PC,No,Ext) (Arc,No)
P. O. Box 269 ADDRESS
DUCEN
Twin Falls ID 83303 CUSTOMERID*: CMSOF-1
Phone:208-733-1076 INSURERS)AFFORDING COVERAGE NAIC#
INSURED INSURER Schinnerer & Company, Inc.
CMS of Washington, Inc. ; INSURER
PCM Inc
11165 N Culdesac INSURER
Boise ID 83714 INSURER1)
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED EELCW HAVE EEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING MY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WH CH 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LTR TYPE OF INSURANCE INSR WVC POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYI'Y) LIMBS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
LU
A X COMMERCIAL GENERAL LIABILITY 2099440319 01/11/10 01/11/11 PREMISES(Ea occurrence) $
X CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $
A X MCH288280941 01/12/10 01/12/11 PERSONAL&ADVINJURY $ 1,000,000
X Professional GENERAL AGGREGATE s2,000,000
GEN'L AGGREG 4TE_F,11T A'PLI ES PER PRODUCTS-COMPIOP ASS $2,000,000
POLICY P"O_ECT LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000
(Ea accidant)
A ANY AUTO 2099451773 01/11/10 01/11/11 BODILY INJURY(Per person) $
ALL OWNED AUTOS BODILY INJURY(Per accident) $
SCHEDULED AUTOS X PROPERTY DAMAGE
HIRED AUTOS
(Par accident) $
NON-OWNED AUTOS $
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION 5 $
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER
ANY PROPRIETOR/PAR—NERIEXECUTIVE I A E L EACH ACCIDENT $
CFFICER/MEMBER EXCLUDED?
(Tdandatcry in NH) EL DISEASE-EA EMPLOYEE $
If yes describe under
DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1$
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,AdAtlonat Remarks Sehaduls,If more space Is required)
The certificate holder is listed as additional insured on all policies
(except professional liability)as respects work performed by or on behalf of
the contractor. 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.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MISCE-1 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED N
ACCORDANCE WITH THE POLICY PROVISIONS XXXXXXXXXXXX
City of Kent
Kent Parks & Open Space AUTHORIZED REPRESENTATIVE
Tony Donati
220 4th Ave So Robert L. Blake,CIC
ant WA 98032-5895
m 1988-2009 ACORD CORPORATION All rights reserved.
ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD
• AUG/26/2010/THU 04:35 PM Obenchain Insurance FAX No, 208-733-1093 P, 002
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 2099440319
Name of Additional Insured Person(s)
or Organization s : Locations of covered Operations
Ctty of Kent, Kent Parks & Open Space
220 4th Ave So
Kent, WA 98032-5895
Information required to complete this Schedule if not shown above, will be shown in the Declaratlons.
A. Section II-Who Is an Insured is amended to This Insurance does not apply to "bodily in-
Include as an additional insured the parson(s) jury"or"property damage" occurring after
or organization(s) shown In the Schedule, but ,All work includin materials, parts or
only with respect to liability for "bodily injury"' 1, equipment work,
furnished m connection with
"property damage or personal and advertis- SUCK work, the project (other than
ing injury caused, in whole or In part, by:
service, maintenance or repairs) to be
1. Your acts or omissions; or performed by or on behalf of the addi-
2. The acts or omissions of those acting on tional insured(s) at the location of the
Covered operations has been completed;
your behalf; or
In the performance of your ongoing opera- 2, That portion of "your work" out of which
dons for the additional insured(s) at the loca- the injury or damage arises has been put
tion(s)designated above, to its intended use by any person or or-
B. With respect to the insurance afforded to ganization other than another contractor
these additional insureds, the following addi- or subcontractor engaged in performing
tional exclusions apply: operations for a principal as a part of the
same project
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