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HomeMy WebLinkAboutPW11-046 - Original - Jones & Stokes Associates, Inc. - S 228th St Hot Spot Analysis - 02/08/2011 Records M -a-nagerne KENT � W..SHINGTON 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 City Clerk's Office. Vendor Name: Jones & Stokes Associates, Inc. Vendor Number: ID Edwards Number Contract Number: p011 - oy(0 This Is assigned by City Clerk's Office Project Name: S. 228th St. Hot Spot Analysis Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 2/8/11 ' Termination Date: 4/30/11 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Mark Madfai Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Conduct a carbon monoxideCOZhot_spot analysis of the Intersection at S. 228th St. and West Valley Highway. S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT WASHINGTON CONSULTANT SERVICES AGREEMENT between the City of Kent and )ones & Stokes Associates, Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Jones & Stokes Associates, Inc. organized under the laws of the State of Delaware, located and doing business at 1108 11th Street, Suite 301, Bellingham, WA 98225 Phone: 360 255-2920/Fax: (360) 255-2924, Contact: Chris Soncarty (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: The Consultant shall conduct a carbon monoxide (CO) hot spot analysis of the intersection at S. 228th Street and West Valley Highway. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorported by this reference. 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 by April 30, 2011. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed One Thousand, Five Hundred Dollars ($1,500.00) 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 CONSULTANT SERVICES AGREEMENT - 1 (Under$10,000) Agreement. The City shall provide payment within thirty (30) days of receipt of 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. 5108 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) 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: By: � / By: (slgnatur ) (signature) Print Name: CIle w'lr Print Name: Mark Howlett Its: �c�. r�S/ �h O Its: Design Engineering Manager � �(t a�) DATE: L2-2 / O DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Chris Soncarty Timothy J. LaPorte, P.E. Jones & Stokes Associates, Inc. City of Kent 1108 111h Street, Suite 301 220 Fourth Avenue South Bellingham, WA 98225 Kent, WA 98032 (360) 255-2920 (telephone) (253) 856-5500 (telephone) 360 255-2924 facsimile (253) 856-6500 (facsimile) Jones&Stokes-22e Hop Spot/MaClal CONSULTANT SERVICES AGREEMENT - 5 (Under$10,000) 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, //II agree to fulfill the five requirements referenced above. Dated this �T�7 day of ���� 20 For: Title: Date: �Za0// 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 Jones & Stokes Associates, Inc. Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as S. 228t" St Nat Slot Analysis that was entered into on the February 8. 2011, 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 s day of wnr y 2011_ By' For: Title Date' EEO COMPLIANCE DOCUMENTS - 1 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD,YYYY) 02103/2011 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 holder is an ADDITIONAL INSURED,the policy(ies)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 4rz certificate holder in lieu of such endorsement(s) c PRODUCER CONTACT L Ann Risk Services Northeast, Inc NAME New York NY Office (A/C No EXt) (212) 941-1000 AIC No (212) 441-1953 4) 199 water street E41MIL o New York NY 10038-3551 USA PRODUCER 570000024256 CUSTOMER IDM INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A. Great Northern insurance Co 20303 .)ones & Stokes Associates, Inc. INSURERS ICE International, Inc 9300 Lee Highway INSURER Fairfax VA 22031-1207 USA INSURER INSURER E INSURER F COVERAGES CERTIFICATE NUMBER 570041538726 REVISION NUMBER THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Limits shown are as requested INSR Lim OF INSURANCE INSR WVD POLICY NUMBER MM'DDIYY MMIDDM/YV LIMITS GENERAL LIABILITYj5612409 EACH OCCURRENCE $1,000,000 % COMMERCIAL GENERAL LIABILITY Package - Domestic $1,000,000 PREMISES(Ea eccurrenee CLAIMS MADE El OCCUR MED EXP(Anyone person) $10,000 Prod-Comp Op Intl In Gen I Agg PERSONAL&ACV INJURY S1,000,000 X n GENERAL AGGREGATE $2,000.1 N GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG X POLICY PRO LOC I r A AUTOMOBILE LIABILITY 7 COMBINED SINGLE LIMIT Automobile - All States Ilia ricadentl $1,000,000 X ANY AUTO BODILY INJURY(Per person) Z ALL OWNED AUTOS BODILY INJURY(Per accident) d SCHEDULED AUTOS PROPERTY DAMAGE V P G X HIRED AUTOS (Per accident ,: X NON OWNED AUTOS U UMBRELLA LU\B HOCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION WORKERS COMPENSATION AND WC STATU- OTH- EMPLOVERTLIABILITY YIN TORY LIMITS ER ANY PROPRIETOR(PARTNER/EXECUTIVE O EL EACHACCIDENT OFFICERIMEMBER EXCLUDED' N(A (Mandatory In NHi EL DISEASE-EA EMPLOYEE I yes describe under DESCRIPTION OF OPERATIONS below IEL DISEASE POLICY LIMIT FTh IO IPTION OF OPERATIONS/LOCATNS/VEHICLES(Attach ACORD 101.Additionala lunal Remarks Schedule, map space is required) - south 228th street e city of Kent is included as an Additional insured as its interest may appear 1 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE - POLICY PROVISIONS City Of Kent AUTHORIZED REPRESENTATIVE Public works Department 220 Fourth Avenue south Kent, wA 98032 USA r.,d /�f vClJ e,,, 1 FiI a. a 019988-e2009 ACORD cCORPORATION All rights reserved ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID. 570000024256 LOC# ,41�2a® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED Aon Risk services Northeast, Inc Jones & stokes Associates, Inc. POLICY NUMBER see certificate Number 570041538726 CARRIER NAIC CODE see certificate Number, 570041538726 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER ACORD 25 FORM TITLE Certificate of Liability Insurance Additional Description of 0perabons I Locations,Vehicles 2 - subject to the standard terms and conditions of the individual policies, the indicated coverage is primary but only as respect work being done by Jones & stokes Associates, Inc for the city of Kent. 3 - Except with respect to the limits of Insurance, and any rights or duties specifically assigned to the First Named Insured, insurance applies separately to each insured against whom claim is made or "suit" is brought ACORD 101 (2008101) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD DATE A��R�® CERTIFICATE OF LIABILITY INSURANCE 01/27/2011YY) O1/27/2011 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 holder is 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 endorsement(s) PRODUCER 1-804-000-0000 CONTACT Carolyn O Varnier NAME Arthur J. Gallagher Riek Management Services, Inc. PHONE 804-916-6846 aC No 804-916-6897 4860 Cox Road, Suite 200 E-MAIL ADDRESS PRODUCER Glen Allen, VA 23059 T Carolyn O. Varnier INSURERS AFFORDING COVERAGE NAK:N INSURED INSURER LM INS CORP 33600 JONES & STOKES ASSOCIATES, INC. INSURER 9300 LEE HIGHWAY INSURER INSURER D FAIRFAX, VA 22031 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER 19516059 REVISION NUMBER. THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE MD-DI.SUBR POLICY NUMBER MM OWYYYY MMIDDIYYYY LIMITS LTR INSR MD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Kl,NIoccurrence) $ CLAIMS-MADE r7 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY F7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJJRY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Peracc,dent) NON-OWNED AUTOS $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC5-Z31-508381-010 06/25/1 06/25/11 X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN IDEJ-UMES ER ANY PROPRIETORIPARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED9 NIA (Mandatory In NH) EL DISEASE-EA EMPLOYE $ 1,000,000 If yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OPERATIONS I LOCATIONS I VEHICLES (Attach IiCORD 101,Additional Remarks SChedUle,If more space Is ragWred) SOUTH 228TH STREET HOT SPOT ANALYSIS PROJECT CERTIFICATE HOLDER CANCELLATION CITY OF RENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUBLIC WORKS DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS 220 FOURTH AVENUE SOUTH AUTHORIZED REPRESENTATIVE KENT, WA 98032 ]] r USA yT � yti carolynvar m 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 19516059