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PW11-110 - Original - Columbia Basin Water Works - Test of Large Distribution Water Meters - 02/08/2011
Records Management WA H1 Document WA9 NGTON 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: Vendor Number: ID Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: / d� ���dZ� m Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment Wcontract ❑ Other: c Contract Effective Date: C.4�!1 —1 f Termination Date: Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: epartment: Detail: (i.e. address, location, parcel number, tax id, etc.): 5•Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT Wn5 HIry GTGN PUBLIC WORKS AGREEMENT between City of Kent and Columbia Basin Water Works THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Columbia Basin Water Works organized under the laws of the State of Oregon, located and doing business at 405 Church Street, Gaston, Oregon 97119; phone 503-985-1231 (hereinafter the "Contractor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications: Test large distribution water meters (3 inch and larger). Testing shall be conducted in accordance with AWWA standards )plus or minus 3% accuracy) by a certified tester. In the event the meter does not meet AWWA standards, it will be calibrated or repaired by a certified independent tester. The City reserves the right to replace the meter in lieu of calibration or repair. Meters to be tested are listed in Exhibit A (attached and incorporated by reference). The testing is scheduled to take place February 14 through May 31, 2011. Contractor 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 such services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon execution of this Agreement. Upon the effective date of this Agreement, Contractor shall complete the work described in Section I within 120 days from the effective date of this Agreement . III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed ten thousand dollars ($10,000) including the cost of parts and based on an hourly rate of sixty dollars ($60) per hour and, including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor fifty percent PUBLIC WORKS AGREEMENT - 1 (Under $10K and No Performance Bond) (50%) of the Contract amount upon completion and acceptance of the work by the City, and the remainder upon fulfillment of the conditions listed below and throughout this Agreement. A. No Payment and Performance Bond. Because this contract, including applicable sales tax, is less than $25,000, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a payment and performance bond, has elected to have the owner retain the final fifty percent (50%) of the Contract amount for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City's written approval. If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor 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 Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. C. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. 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 Contractor 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 Contractor maintains and pays for its own place of business from which Contractor's services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Contractor's services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. PUBLIC WORKS AGREEMENT - 2 (Under$1OK and No Performance Bond) D. The Contractor 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 Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor's failure to complete the work within the time specified in this Agreement. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor's breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor's possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. Contractor 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. Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by Contractor, 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. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change PUBLIC WORKS AGREEMENT - 3 (Under$1OK and No Performance Bond) increases or decreases the Contractor'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 Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor 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 Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. The Contractor 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 Contractor 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 Contractor 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 Contractor may file a claim as provided in this section. The Contractor 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 Contractor 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 Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor'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 Contractor'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 Contractor is asserting a schedule change or disruption. B. Records. The Contractor 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 Contractor's records needed for evaluating the protest. PUBLIC WORKS AGREEMENT - 4 (Under$10K and No Performance Bond) 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. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor 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 Contractor 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 Contractor 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. CONTRACTOR 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 CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. X. WARRANTY. Upon acceptance of the contract work, Contractor must provide the City a one-year warranty bond in a form and amount acceptable to the City. The Contractor 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 parts are repaired or replaced, 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 Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor 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 Contractor, its sub-contractors, or any person acting on behalf of the Contractor 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. Contractor 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. Contractor 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 PUBLIC WORKS AGREEMENT - 5 (Under$1OK and No Performance Bond) connection with the Contractor'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 Contractor'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 Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'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 Contractor 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 Contractor's part, then Contractor 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 Contractor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XIII. INSURANCE. The Contractor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit Exhibit B attached and incorporated by this reference. XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor 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 Contractor's own risk, and Contractor 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. PUBLIC WORKS AGREEMENT - 6 (Under$1OK and No Performance Bond) 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 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 Contractor. 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 Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. } PUBLIC WORKS AGREEMENT - 7 (Under$1OK and No Performance Bond) 5 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. CONTRACTOR: CITY OF KENT: By:--- �- `z. r�- By:�, V& (signature (signature) Print Name:.�ODKPI` C . I vSnl Print Name: Donald C. Millett Its VN-c,r / 190tsAA ✓i'- Its: Public Works Operations Manager (title) DATE: DATE: a z NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Joseph Tyson Elbert English, Water Distribution Lead Columbia Basin Water Works City of Kent 405 Church Street 220 Fourth Avenue South Gaston, Oregon 97119 Kent, WA 98032 (503) 985-1231 (telephone) (253) 856-5600 (telephone) (503) 985-1249 (facsimile) (253) 856-6600 (facsimile) P Operations\PWOPsContracts\Water\ColumbiaBasmWaterWorks\2011TesbngLargeMetersM PUBLIC WORKS AGREEMENT - 8 (Under$10K and No Performance Bond) 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 J c,\ �� , 2011 By: Aa�a ,nti- 4 . �— For: Title: (�W�-c ✓ s��-� Date: 1- aB - o'2C�11 EEO COMPLIANCE DOCUMENTS - 1 h 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 M ww Zrc Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as Lc.(� l�`rti� cr I r'SAwoc 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 2 2 day of Jan�A* M , 201 L By: ±k4wk- E, T►is��. For: CC3wW 1►.� . Title: P-t--to, 01'Jrk Date: EEO COMPLIANCE DOCUMENTS - 3 Large Water Meter Inventory Exhibit A Scope of Work ENTRANCE Tvpe Size Installed PZone Comments COM 8" 01/01/1966 240 VAULT CONTAINS A 8"x 4"x I" MFM x MCT-MHD METER SETUP. THE BYPASS INDICATED IS A DUAL FEED FROM THE 10" x 6" x 1.5' LOCATED AT S 203TH S-i AND EAST VALLEY HIGHWAY. FRONT VALVE IS IN THE LEFT TURN LANE SW OF VAULT ((SEE ATTACHED SCANNED COMMLN-i5)) Service Tvpe Test Plug Size Test Ready Screen Single Cheek valve Remote Read Notification R UNKNW 200 Y N Y Y N Has Bypass Bvpass Size Bvpass Tvpe Bvpass Yoke/Stem Installed N 0.00 N Vault Tvpe Vault Length Vault Width Vault Dept i Entry Tvpe Entry Length Entry Width CONC 9.00 7.00 950 HATCH 6.00 4.50 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Grou Status 02/22/2010 ANNUAL OK 2 ^.,�•„ -r"�JA`�p,'�uTY'"e;'or ��1 `s 3if�u ja;4. 4� Tvpe Size Installed PZone Comments COM 6" 12/10/2009 240 ((SEE ATTACHED SCANNED COMMENTS)) Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri CI 2.00 Y N N Y N Has Bypass Bvpass Size Bvpass Type Bvpass Yoke/Stem installed Y 4.00 CI N Vault Tvpe Vault Length Vault Width Vault Dept i Entry Tvpe Entry Length Entry Width CONC 2050 9 50 650 MANHOLE 2.00 2.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 01/05/2011 ANNUAL OK 't' a WW44---- .� a Aw n T, F Air '27 1 '-�-16403 68 AV S BOEING • • Type Size Installed PZone Comments COM 8" 01/01/1968 240 ((SEE ATTACHED SCANNED COMMENTS))4"CHECK VALVE TENDS TO STICK IN THE OPEN POSITION. POSSIBLE ((((HAZARD WHILE FLUSHING.)))) 4" Cast Bypass Pipe has been removed due to corrosion 05/09 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2.00 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed N 0.00 N Vault Tvpe Vault Length Vauit Width Vault Dept[ Entry Type Entry Length Entry Width CONC 20 50 10.00 6.50 MANHOLE 2.00 200 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status 02/22/2010 ANNUAL OK ft 1 1 • : • Type Size Installed PZone Comments COM 10" 01/01/1966 240 DUAL FEED WITH BOEING/GOODYEAR METER AT 7818 SOUTH 212TH STREET.((SEE ATTACHED SCANNED COMMENTS)) Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R UNKNW 200 Y N Y Y N Has Svpass Bypass Size Svpass Tvpe Glipass Yoke/Stem inG'0@Fed N 0.00 N Vault Type Vault Length Vault Width Vault Dept[ Entry Type Entry Length Entry Width CONC 13.00 7.00 10.50 HATCH 450 4.50 Vault Floor Type Has Sump Pump Rep Ladder Rec Air Monitor Reg N Y Y Y I-aft TteW Group status 2/22/2010 -ANNUAL OK IF Xtx 1148384 19819 84 S HEXCELL/AKA HEATH TEMA Type Size Installed PZone Comments COM 6" 01/01/1968 240 Service TVpe Test Plug Size Test Ready Screen, Single Check Valve Remote Read Notification Ri UNKNW 2.00 Y N N Y N Has Svpass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3.00 GALVZ N Vault Tvpe Vault Length Vault Width Vault Deptt Entry Tvpe Entry Length Entry Width CONC 4 50 3 50 4.00 STEEL 4.00 3.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg GRAV N Y Y Y Last Tested Group Status 02/25/2010 ANNUAL OK >J qw 5312056 25246 106 SE KENT HML TOWNHOMES Me Size Installed PZona Comments COM 8" 01/01/1973 590 Bypass located in old meter vault 201 west. Service Type Test Fluq Size Test Ready Screen Single Check Valve Remote Read NotigicnfionRi 200 Y N N N N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 C1 N Vault Time Vault Lpnath Vault Width Vault Depti Entry Type Entry Length En"Width CONC 8 so 7 00 7 50 HATCH 5.50 300 Vault Floor Tv pe Has Sump Pump Rag Ladder Rac Air Monitor Reg CONC Y y Y Y Last Tested Group Status 03/03/2010 ANNUAL OK 1/10/2011 3 iyµ`xxc . Type Size Installed PZone Comments COM 6" 01/01/1976 590 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R DI 2 00 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 6.00 DI y Vault Type Vault Length Vault Width Vault Deptt Entry Type Entry Length Entry Width CONC 1100 6.00 500 HATCH 300 5.50 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg GRAV N Y Y Y = Last Tested Group Status 02/24/2010 ANNUAL OK ' Air s' i • , TWO Size Installed PZone Comments COM 6" 02/09/2002 240 RPBA installed on backside of meter in Hot Box Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read c9c fication Ri UNKNW 2.00 Y Y N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem InsUled Y 400 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 1100 10 50 7 50 HATCH 350 3.00 Vault Floor Type Has Sump Pump Reg Ladder Re c Air Monitor Reg CONC N Y N Y Last Tested Group Status 02/25/2010 ANNUAL OK { c i 1506257 • 1 3AMES ST REGIONAL TyL SrL,, Installed Pzone Comments COi"t 8" 01/01/1995 240 8" Hersey A 3" Sensus t urbo Service Type Test Plug Size Test Ready Screen Single Check Valve Remote ad Nol fh:ation R DI 2 00 Y N y y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 8 00 DI y Vault Type Vault Length Vault Width vow ONO Entry Tyw Entry Length Entry Width CONC 12 50 7 50 860 HATCH 5.00 3.50 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC y y N y Last Tested Group Status 02/22/2010 ANNUAL OK -177 r r 3• ` 9506996 401REGIONAL Tvpe Size Installed Pzone Comments COM 8" 01/01/1995 240 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notificationl DI 2 00 y N y N N Has Bvpass Bvpass Size Bypass Tripe Bypass YokelSiem Installed y 8.00 DI y Vault Tvpe Vault Length Vault Width Vault Dept F Entry Tvpe Eniry Length Entry Width CONC 12.50 7.50 8.00 HATCH 5.00 3.50 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC y y N y Last Tested Group Status 02/22/2010 ANNUAL OK ° �4a 6047295 19443 77 AV S SOUTH • AUCTION Type Size Installed Pone Comments CCM 8" 01/01/1980 240 8x4x1 Meter Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri Jf`JKNW 2.00 y N N y N -las Bypass 13wass Size Bypass Tvpe Bypass YokelSt m Installed y 4.00 DI N Vault Tvpe Vault Length Vault Width Vault ®eptl Enh-y Type Enliy Length Eniry C,'u'idih CONC 9.00 6.00 8.00 HATCH 0.00 0.00 Vault FI_�ipe Has Sump Pump Req Ladder Rec Air Monitor Reg 5 CONC y Y Y Y ;4* Last Tested Group Status OK Testing Setup � OK 11 100 0% Totai 11 100 0% t Testing Group ■ ANNUAL 11 1000% Total 11 100 M/° k 1/10/2011 6 ' Large Water Meter Inventory Exhibit A Scope of Work Type Size Installed PZone Comments COM 3" 09/30/2009 240 This meter was down sized 9/30/09 from SRH 6" to Omni 3" Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Lenqth Vault Width Vault Dept F Entry Type Entry Length Entry Width CONC 1100 550 7 00 HATCH 5.50 3 00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 02/24/2010 ODD OK ' iY�T W�4•��P"1Fvy.. a-° 1 1 Type Size Installed PZone Comments COM 4" 10/28/2004 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI Y Vault Type Vault Length Vault Width Vault Dept P Entry Type Entry Length Entry Width CONC 900 500 700 HATCH 5 50 3.00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y Y Y Last Tested Group Status 01/23/2009 ODD OK SOUTH Tvpe Size Installed PZone Comments COM 3" 01/01/1992 240 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed 1/10/2011 1 y 3 00 DI y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Lenqth Entry Width` CONC 8 50 7 00 800 HATCH 5 50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y N N Y Last Tested Group Status 02/23/2009 ODD OK Type Size Installed PZone Comments COM 3" 01/01/1986 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri UNKNW 2.00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 7 00 500 500 HATCH 6 00 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y Y y Last Tested Group Status 03/08/2010 ODD OK Ar r` y ' Type Size Installed PZone Comments COM 3" 08/17/2002 240 Located on East side of building near entrance to Alki Bakery Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI y Vault Type Vault Length Vault Width Vault Deptt Entry Type Entry Length Entry Width CONIC 8 50 450 650 HATCH 3 50 3.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONIC N y Y y Last Tested Group Status 03/08/2010 ODD OK 1/10/2011 2 V p 1 t "d F2 4-1- 4 11541448 1POINT/CASCADE Type Size Installed PZone Comments COM 3" 05/11/2002 240 REPLACED 3" HERSEY WITH 3" SRH Located on south east side of building near loading dock area. Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI N Vault Type Vault Length Vault Width Vault Dept F Entry Type Entry Length Entry Width CONC 900 5.00 7.00 HATCH 3 50 3.00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y Y Y Last Tested Group Status 03/08/2010 ODD OK 4 � 1641441 Y 20829 72 " S CENTER POINT/CASCADE WEST Type Size Installed PZone Comments COM 3" 05/11/2002 240 Meter located on south west side of building Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 300 DI Y Vault Tvpe Vault Length Vault Width Vault Dept i Entry Tvpe Entry Length Entry Width CONC 850 450 7 00 HATCH 3.50 300 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y Y Y Last Tested Group Status 03/08/2010 ODD OK Or 1/10/2011 3 1641442 6811 S 204 ST CENTER PCIINT/THE Type Size Installed PZone Comments COM 3" 08/17/2002 240 Meter located on the south side of 204th St. Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, UNKNW 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 300 DI y Vault Type Vault Length Vault Width Vault Dept i Entry Type Entry Length Entry Width CONC 900 500 7 00 HATCH 5.50 3 00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N y y y Last Tested Group Status 03/08/2010 ODD OK w� L 1 Y 66600609 Type Size Installed PZone Comments COM 4" 09/25/2008 240 Up-graded vault and meter assembly 9/25/08 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, CI 2.00 y y y y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 400 DI y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 5.00 600 HATCH 5.50 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N y Last Tested Grou Status O1/29/2009 ODD OK i o aZ _ is UN Alm 1N 1343129 1 4 AV S CITY HALL Type Size Installed PZone Comments COM 4" 10/18/2002 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R UNKNW 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 400 DI y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 750 5 00 850 HATCH 600 3.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Re 1/10/2011 4 C$NC Y Y N Y Last Tested Group Status 02/23/2009 ODD OK w P 1543939 I RUSSELL RD CITY OF Tvpe Size Installed PZone Comments COM 4" O1/01/1998 240 Outside Vault 100-0146 Meter Assembly 100-0144 , 100-0145 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Tvpe Bypass Yoke/Stem Installed Y 400 DI Y Vault Tvpe Vault Length Vault Width Vault Dept t Entry Tvpe Entry Length Entry Width CONC 1100 5 50 5 50 HATCH 5 50 3.00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status O1/29/2009 ODD OK g g� j X t r • ' 61792405 22520 Tvpe Size Installed PZone Comments COM 3" 12/15/2004 240 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI Y Vault Tvpe Vault Length Vault Width Vault Depth Entry Type Entry Length Entry Width CONC 9.00 5 00 7 00 HATCH 5 50 3.00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status 10/29/2010 ODD OK 1/10/2011 5 00, . 516 KENOSIA • COURT TWO Size Installed Hone Comments COM 3" 01/01/1971 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri GALV 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 1 00 COPPER N Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONCET 7.00 400 400 STEEL 200 1 50 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg GRAV N N N Y Last Tested Group Status 02/23/2009 ODD OK IOU 1 E3 ,,55 S Tvpe Size Installed Hone Comments COM 4" 01/O1/1999 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 700 4 50 HATCH 5 50 400 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 01/23/2009 ODD OK a 1/10/2011 6 f139850 1401 W MEEKER ST GREEN RIVER COURT Type Size Installed PZone Comments COM 3" 01/01/1996 240 Outside Vault 100-0148 Meter Assembly 100-0147 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2 00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3.00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 800 600 500 HATCH 5 50 3.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 02/23/2009 ODD OK '4 yam. ✓»� .. ..w ... _ HAMPTON INN & SUITES Type Size Installed PZone Comments COM 3" 240 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 N Y Y N N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 4.00 DI Y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 9 00 5 00 5 00 HATCH 5 50 3 00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status ODD Meter has never been tested 69927831 z a ,i 26020 104 SE HOMEDEPOT Type Size Installed PZone Comments COM 3" 03/18/2009 590 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y N Y N N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 5 00 600 HATCH 600 3 00 1/10/2011 7 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status 01/22/2009 ODD OK �i ,x COMMONS Type Size Installed Hone Comments COM 4" 01/01/1993 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri UNKNW 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 GALV N Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 450 4 50 400 HATCH 3 00 3 00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg GRAV N N Y Y Last Tested Grou Status O1/29/2009 ODD OK rtu 60421115 • CORRECTIONS Type Size Installed Hone Comments COM 3" 02/15/2003 240 Service Tvpe Test Plug Size Test Readv Screen Single Check Valve Remote Read Notification Ri UNKNW 2.00 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 7.00 450 5 00 HATCH 3 50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status O1/28/2009 ODD OK 1/10/2011 $ c ' 4 Type Size Installed PZone Comments COM 3" 01/01/1999 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2.00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 450 7 00 8.00 HATCH 5.50 300 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 02/23/2009 ODD OK Tvpe Size Installed PZone Comments COM 3" 06/04/2004 590 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri UNKNW 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3.00 DI N Vault Tvpe Vault Length Vault Width Vault Dept F Entry Tvpe Entry Length Entry Width CONC 900 5 00 7 00 HATCH 6 00 300 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y Y Y Last Tested Group Status 01/22/2009 ODD OK � t y 1/10/2011 9 POLICE Type Size Installed PZone Comments COM 3" 01/01/1992 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Rt UNKNW 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI N Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 700 450 450 HATCH 5 00 3 50 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y y N Y Last Tested Group Status 03/02/2010 ODD OK _ - --- -- COUNTY • • • Type Size Installed PZone Comments COM 4" 01/01/1985 590 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri UNKNW 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 1.00 COPPER N Vault Tvpe Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONCET 6 00 4.00 4.00 STEEL 600 4.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Rep GRAV N N N Y Last Tested Group Status 01/28/2009 ODD OK se � 4:201 z , 3 • . • Tvpe Size Installed PZone Comments COM 4" 11/02/2004 590 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y Y N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI Y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC Soo 600 6 50 HATCH 600 3.00 Vault Floor Type Has Sumg Pump Reg Ladder Rec Air Monitor Reg 1/10/2011 10 CONC N y N y Last Tested Group Status 01/29/2009 ODD OK ow n ntis�Al q F f , h .f Type Size Installed PZone Comments Com 4" 12/31/2008 240 Service Type Test Plum Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 200 y y y y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 400 DI y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 11.00 5 50 700 HATCH 5 50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC y y N y Last Tested Group Status 01/23/2009 ODD OK Type Size Installed PZone Comments Com 4" 09/29/2004 240 Service Type Test Plum Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2.00 y y y y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed y 4.00 DI y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 9.00 500 650 HATCH 5.50 3 00 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC y y y y Last Tested Group Status 02/23/2009 ODD OK 1/10/2011 li I i u is e� 2 63862622 27825 118 SE PINE TREE ELEMENTARY Tvpe Size Installed PZone Comments COM 3" 01/30/2005 590 Outside Vault 100-0152 Meter Assembly 100-0151 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y Y Y Y N Has Bypass Bypass Size Bypass Tvpe Bypass Yoke/Stem Installed Y 3.00 DI Y Vault Type Vault Length Vault Width Vault Dept F Entry Tvpe Entry Length Entry Width CONC 9 00 500 5.00 HATCH 5 50 300 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N N Last Tested Group Status 02/23/2009 ODD OK V 5 A e Tvpe Size Installed PZone Comments COM 3" 08/17/2005 590 Meter Assembly 100-0125 Outside Vault 100-0126 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2.00 y y Y Y N Has Bypass Bypass Size Bypass Tvpe Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Tvpe Vault Length Vault Width Vault Dept F Entry Tvpe Entry Length Entry Width CONC 900 500 5 00 HATCH 5 50 300 Vault Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y N N Y Last Tested Group Status O1/28/2009 ODD OK 1/10/2011 12 _ 7 65857604 1104 AV SE SCENIC VISTA APTS Type Size Installed Hone Comments COM 3" 08/15/2006 590 Outside Vault 100-0129 Meter Assembly 100-0128 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2 00 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 Soo 7.00 HATCH 5 50 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status O1/22/2009 ODD OK 1593118 r v x• _ ,+'q" 1 S 228 ST SEARS DISTRIBUTION CENTER/METER REMOVED1 Tvpe Size Installed PZone Comments COM 3" 01/01/2002 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2 00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI N Vault Type Vault Length Vault Width Vault Dept F Entry Tvpe Entry Length Entry Width CONC 12 50 650 750 HATCH 6.00 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y N N Y Last Tested Group Status 02/23/2009 ODD OK 7 y4 .x. 1/10/2011 13 64801655 24420 RUSSELL RD SHAFRAN • - Type Size Installed PZone Comments COM 3" 05/25/2006 240 Outside Vault 100-0140 Meter Assembly 100-0141 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 200 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 9.00 5 00 5 00 HATCH 5 50 3.00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 01/29/2009 ODD OK y s7 P y i s i 1 SHOWARE CENTER Tvpe Size Installed PZone Comments COM 4" 08/31/2009 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI Y Vault Tvpe Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 1100 6.00 6 50 HATCH 5 50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status 03/05/2010 ODD OK # 'v at Type Size Installed PZone Comments COM 4" 02/23/2002 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri DI 2.00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 4.00 DI Y Vault Tvpe Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 900 5.00 6 00 HATCH 5 50 300 1/10/2011 14 rlh�ult Floor Tvpe Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y Y y Last Tested Group Status 01/22/2009 ODD OK g DIARY Type Size Installed PZone Comments COM 4" 01/01/1987 240 Service Tvpe Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 2 00 Y N V Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 4.00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 5 00 600 HATCH 5.50 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y Y Y Last Tested Group Status 01/22/2009 ODD OK ti 7 t , 1292219 Type Size Installed PZone Comments COM 3" 01/01/1989 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri UNKNW 2 00 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI y Vault Type Vault Length Vault Width Vault Dept F Entry Type Entry Length Entry Width CONC 7 00 450 8 00 HATCH 3.00 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y N Y Last Tested Group Status 01/29/2009 ODD OK TOTEM Type Size Installed PZone Comments COM 4" O1/01/1981 565 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Rt UNKNW 2 00 Y N Y Y N 1/10/2011 15 Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 400 DI N Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 9 50 6 00 5 00 HATCH 5.50 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N N Last Tested Group Status 03/08/2010 ODD OK arv. r Aw j i7000710 26401 Type Size Installed PZone Comments COM 3" 06/03/2008 240 Currently has 3" metron 4/06/09 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass YokelStem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept i Entry Type Entry Length Entry Width CONC 8 50 450 4 50 HATCH 5.50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 03/08/2010 ODD OK a r i 123420 Type Size Installed Hone Comments COM Y 01/01/1998 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R( DI 200 Y N Y N Y Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3.00 DI N Vault Type Vault Length Vault Width Vault Dept i Entry Type Entry Length Entry Width CONC 900 5 00 7 00 HATCH 5.50 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 02/24/2009 ODD OK 1/10/2011 16 t r 4� PARK/AKA REITH ROAD PARK Type Size Installed PZone Comments COM 3" O1/12/2005 529 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, UNKNW 200 Y N Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 3 00 DI Y Vault Type Vault Length Vault Width Vault Dept t Entry Type Entry Length Entry Width CONC 900 5 00 600 HATCH 600 300 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC N Y Y Y Last Tested Group Status 02/24/2009 ODD OK DES MOINES RI 1 -'ESTATES APTS Tvpe Size Installed PZone Comments COM 3" 01/01/1982 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification R, DI 200 Y Y Y Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 300 DI Y Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 9.00 500 5 50 HATCH 5.50 3 00 Vault Floor Type Has Sump Pump Reg Ladder Rec Air Monitor Reg CONC Y Y N Y Last Tested Group Status 02/24/2009 ODD OK ti;ar a 1/10/2011 17 1511069 26620 68 AV S WS DEPT.OF TRANSPORTATION Type Size Installed PZone Comments ' COM 4" O1/01/1973 240 Service Type Test Plug Size Test Ready Screen Single Check Valve Remote Read Notification Ri GALVZ 200 Y N N Y N Has Bypass Bypass Size Bypass Type Bypass Yoke/Stem Installed Y 100 COPPER N Vault Type Vault Length Vault Width Vault Dept l Entry Type Entry Length Entry Width CONC 5.50 400 3 00 HATCH 400 3.00 Vault Floor TVpe Has Sump Pump Rep Ladder Rec Air Monitor Reg GRAV N N N N Last Tested Group Status 01/22/2009 ODD OK Testing Setup ■ Meter has never been tested 1 2 4% R OK 40 97 6% Total 41 100 0% 40 Testing Group #' ■ ODD 41 100 0% Total 41 100 0/. 1/10/2011 18 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSTRUCTION AND 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. 2. 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. 3. 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 hmlt 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. P:Operations\PWOpsContracts\Water\Columbia Basin\ExhibitBInsurancePeg2011 resting LargeMeters EXHIBIT B Cont. 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. P:Operation s\PWOpsContracts\Water\Columbia Basin\ExhibitBInsuranceReg2011 restingLargeMeters 1: 2/1/2011 2:53 PM FROM: Tri-County Inurance Trico Insurance TO: 1-253-856-6600 PAGE: 001 OF 003 1� 1 ■ Trico Insurance c o In f i d e n t i a l To: Steve Reynolds Fax Number.• 1-253-856-6600 From: Lynne Robbins Fax Number. 503646-3962 Business Phone: Home Phone: Pages: 3 Date,Mme: 2/1/2011 2 53 35 PM Subject: Certificate of Insurance 2/1/2011 2:53 PM FROM: Tri-County Inurance Trico In3ucance TO: 1-253-956-6600 PAGE. 002 OF 003 ace CERnFlCATE o� u,a�uTY INSURANCE F02tQ1120airAsn 1 TM+ 2/01f2011 PKOCUErt Phare.(500)6413131 TWS CER(1FICATE IS ISSUED AS A fVAT'rER OF IWOiVtI MON LY AND COWERS NO MGHTS UPONTHE CERTINCATE Tticolnsurance, t1.0 HDHDUO T"S CER7nRCATE DOES NOT AIVEND,D(MNDOR P.O. BOX 1640 ALTER THE E COVERAGE AFFCPZe3 9Y THE PCUgES BELOW. 1 Beaverton, OR 97076 i I INSURERS A>=FOR_D(N_G COVERAGE _ _ NAtC#f _ INSLF90 ---------- --- - ---- rr�RB-RA AL�lINM—YruALINSURANQEGflt4_ AANY C=MENABASINWATBRWXWS,INC. IKQ-T'I=Ra _-- —___--- PO BOX476 1131RERC --- i -- -— OASTON,OR 97119 Iua a J31❑ _--------_ I ER E CCVEIRAGES ---_ TI-E,KYJCAE=SCPIN LIRMNICEUSTIH:)BELCVJI-AVE BEEN[SSUEOTOTt-E]W-RF-Dt`VWMABOI/EFMInIEPCLJCYPEf7ICOINGiC%TED NOTV - A5 ,VNG PV�l(REQURSVE IT,TERMC')RCC�\D'nCrNOFPNYCONT�C OROH3RDDCLdJ3,TTWTHF C.TTOWgadTHSg74iIFICATENAYPEI--k=- OR NN�Y Pl3�TPlN TI�INStK�,PNC.'EryP��O�R��C1FL7i3`fTI-EPq.ICIP_5[�.�',�9EET)F-�{�Nla'�.1.H1Et✓LTOP1171-E TEF+1l�6 Ec�I�CNSPl�CC%J(7-O C+�f,F SlK9i PCXJCI[�AL�REC-?.TE U M1fi7Y,3 WV R/'/LL`.h^HY F{AVE E1�T1 Rt.-�K,d'�b'Y PA1D g1x1Nb ILTR III —_.r_—_ PCAJLY IalA4 R PC FATEUR. n-M R0.10Y nKgy(Q ryY) L1k718 A Y cgNmALLLLAaurY 6P1706029 0112012MI 01120(2012 $ 1000000 E X mnBtpALGB—mALL!AEaun PEZP-Ns�ff svcml_ s --'Ip1�a0f9 C1ANSNWcE ®omR _UMFXP�,Aryoar )- - - - ' $ 1'0w'000 2 9 000 GENLALXXCCATEUMT I a vpla'A s 2(qp - I I , l ♦ X POLICYL 1 Lx AUTM%ML9UA[R5UTY ax,�an�gtx�cutaT i _�_ FNYPII�O (Ea a�03t) $ A L CA11,0DAUTOS I j-- l3mLY1^lJlX3Y $ SCFEDLLEUPLTrjS HFGDAJRDS BxLYINUUaY $ I � N�r7✓�i4=pPutC+s lr'tr a_ac+crt)--— ----- `------ Iir�r-.ramaxq r,ARACF-I.IPP.1117Y Alff0CMY-EAA0CIEZW LS AWAUTO I Oi7-ER THIN 6'NP.C-I S A TOOKY A G S i CCCIR CIAPA3 WArE — I f ISLE I FETU.CN $ $ wcsrATu o t+, EF43'LOY15RS LW0141Y Atw pKYY�F�ETGfJPfUTi7�72'E7(FQJ714E DEL F�(' fPC.7CII'JT __ �.___--� EL L7SFA"��"--tALflrf''t. - 5 SPFOA. I EL ClSEA-PCLICYUMT $ OiFi�R 6PTItMIi�CPERA77�{3lLGClITtfAV31 VENClES/EX(%d1S10fdSADL�D 8Y6�Z5E]VE1YP/�QFd.P12Clv1:d� *-E CITY OF PQE VU SFKLL BEAN AMAGNIAL INSMEDAS RESPECT$COVES OPEIZATIONS OF 11 INSURED I CJiMCATE HOLLER TION :a+aOlnArrr cF Tr�.amarr c�sclvem P'q.IC16�cAM1Kxiim sfr�r�,t-�ExPlydanav 04gE 9T-�f7ClYr hl£1SStgAX�IPd":lC�`�.'1hILLEt�E4L4S2 TOM18L 10__ cxvswa-rrw THE CITY OF M1(F...Ni' �mceTOTrlEccrrn�ca� �ffz w n eD u r� �r cu ra L�n oo� ruu 2204THAVE @lFOSENOOSUCAnONORLIAOUTYCIC ANY FCWUPC`V. Tl-SIMSLPZTI ITS AC-13MOR KFXT,WA 98032 P(PA11UFa _ Prtrted by 1, R u-I F�,,brte y 01,2011 at 02 41 KI 2/1/2011 2:53 PM FROM: Tri-County Iaurance Trico Insurance TO: 1-253-856-6600 PAGE: 003 OF 003 INPOR1A 1 If trs certificate hdder is an AMIICNAl_ll� ,,the pd,cy(es)rrut be endosed Astaterre t on tiros cedificAe cice s rut confer ruts tc tl-oerbfic�tv Wder in lieu of s r_h er arert(s) If TIC N IS VvoJ VED,&Jb ect to the to n's aid m ons of the pdi cy,oatdn pdiaes mw rec"re m erxIorsm=rt A staten-ait on ti-is certfiicte does mA confer rights to tl,aahficate hdda in Leta of such enda sei r (s) ENSCLAIMER T h--Cet ttficeie of Imumori x3 en the re✓er--,--sde of the form does rut ax stitrte a ocrdrart beto to a-i the iss urxt inaxer(s), aiti-ni zedrepresentative cr prod-car,aril its?oftinc3te hdder, ncr cis it aflrrrr tivdy or rr-.,attvdy (Tu-)d, ewta-d or E ter ti-e, afc re l by Tie pd iaes listed ttrxison. I ACORD 25(2001108) Aimed by LAP,an FdxLuy 01 2011 at UL41 PM 'r 3010 Pacific Ave,Suite A Forest Grove,OR ' Adam 503-357.3500 (Phone) Farm 3+ 503-992-2373 (Fax) I:bx To. Steve Reynolds From: Jessica Clark Fam., 253-85"600 Pages• 3 pages Phone, Date- 2/1/11 Re: Proof of insurance for Joe Tyson 0 Urgent ❑For Review ❑Please Comment ❑Please Reply ❑Please Recycle ®Comment5: Please let me know if you need anything addffional. Thanks. CONFlDEN774L7TY NOT7CE This FOmmile is intended only for the above addressee+, ft contains infomrat on drat is privileged conbdenLo!Or otherwise pmfected from use and disdawm ff you are not dro intended reopien&you are hereby nofflied that any review,disd*wm copying or dissemination of this Faasimde;or the taidng of arty action in reliance on ffs contenfs or other use isshkOypvohWed ffyou received fhisFars;MAWnenor plem bwtedvWydeWe ftand naft the sender. Thank you. A�R& CERTIFICATE OF LIABILITY INSURANCE °oz0m1m oilm THIS CERTIFICATE 18 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 RETWEEN 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 andorsed. If$UBROGATION IS WANED,subject to the terms and conditlons of the policy, certain poBclos may require an endorsement A statement on this cartiflcate does not confer rights to the certificate holder In lieu of such andomemant(s). CONTACT PRODUCER Adam Hunt NAME: Jessica ClarkPRONE State Farm p F,cq 5Q3 357 3500 V Me):5w_M2 7 a 3010 Pacific Ave Ste A PMCAIL s lesslca.clark qaqhQatatefarm,cum Forest Grove, OR 97119 INSURER(SI AFFORDING COVERAGE_ __ HAIG0 _INSURER A:State Farm Mutual Automobile Insurance Company 2617e INSURED Rebecca&Joseph Tyson INSURERe: _ PO BOX 476 INSURER L Gaston, OR 97119 INSURERD: — INSURER E: INSURER F' COVERAGES CERTIFICATE NUMBER: 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 1$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE;BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE POLICY NUMBER MMID�EFF �Y EXP LIMITS GENERAL IIABILrrY ❑❑ EACH OCCURRENCE S CCMMERCIAL GENERAL LIABILITY FPEM15z5_ l $ CLAIMS-MADE OCCUR MED EXP(Any one IV 0) F PERSCNAL&ADVINJURY A _ GENERALAGOREGATF 11 GE_N'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COM_PIOPAGG $ POLICY JECT 7 PRO- LOC S AUTOMOBILE LIABILITY ❑❑ 11 AmId5n SINGLE LIMIT — ANYAUTO BODRY(NJ URY(P0r p9mun)ALL Q S 1,000,000 AUTOPED X AUT08ULED BODILY INJURY(Paramddent) $ 1,000,000 NON-OMECI 008 eel 5-807_3'7N 02707/2011 �ID712D11 - rTffAMA0E HIRED AUTO^e AUTOS (Por uccldmrA) S Sao ona S UMBRELLA LIAR OCCURLJL EACH OCCURRENCE 5 EXCESS LIAR LJ CLAIMS•MADE AGGREGATE 5 DcD RETENTIONS I5 WORKERS COMPENSATION W_STATU- OTH- AND EM Rs'u YIN PLOYEABIL17Y _ _ TORY ER_ ANY PROPRIETCR/PARTNHRIEXECUTNE EL EACH ACCIDENT $ OPPICPVMPf4 ICR eXCLUOEO+ NIA❑ -------- - (MMdaluylnNH) 171. DISEASE-FA EMPLOYE Si [ISMS.(1eeMhe under E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,AddlOonal R=arlo,Schedule,If mom apace Is required) 2006 Dodge 2500 Van VAN#WD0PD744565958501 CERTIFICATE HOLDER CANCELLATION City of Kent Washington SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Ave South ACCORDANCE TI4EPOUCYPROVISIONS. Kent,WA 98032 AUTHORIZED ENTATIVE /� ®198e-201 CO .CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are r t Bred marks of A RO 1001486 1328496 11-15-2010 ACO,Ra DATE(Ixhtmam'h �- CERTIFICATE OF LIABILITY INSURANCE 02/0 1120 1 1 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 WANED,subject to tho terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to lho certificate holder In lieu of such endorsement(&). PRODUCER Adam Hunt _NAME: Jessica Clark State Farm PHONE 503A92.2373 3010 Pacific Ave Ste A aoOARes-f�esslca.dark.aogh(�statefarm-com Forest Grove, OR 97119 INSURER(JAFPORDINGCOVERAGE _ ___ NATO# INSURER.A•State Fann Muhiel Automobile Insurance Coma 26976 INSURED Rebecca 8r Joseph Tyson INSURER B: _ __— PO Box476 INSURER Gaston,OR 97119 _INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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',NAY HAVE BEEN REDUCED BYIPAID CLAIMS. INS" TYPE OF INSURANCE POLICY NUMBER �MBN E UMITS GENERAL DAMLITY _EACH OCCURRENCE S C_OMMERC'ALGENERALLIABIDTY PRE EajFzn oCcurratce $ lCLAIMS•MAOE r I OCCUR MEDEXP(,An onep9mn) $ PERSONAL&A17V INJURY $ _ GENERPL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS-COMPICP AGG S _ POLICY 71 PRO- E LOG $ AUTOMOBILE UABILITY IEsa�dem' S ANY AUTO BODILY INJURY(per Peron) g 1,000,000 -- ALL OWNED SCHEDULED AUTOS X AUTOS HDDILY INJURY(F�r ecclderm $ 1,00D,CE❑ NON-OWN€0 0088fi15,807�7N OB107l2010 02107lZ071 �7 --- HIRED AUTOS AUTO, _(Per aCcldpM) 3 500,000 5 UMBRELLA LIAB (_ OCCUR EACH OCCURPENCE S EXGE99 UAD l_ CLAIMS-MADE AGGREGATE S 1 DE9 RETENTION$ 9 WORKERS COMPENSATION I %C STATU. I OTH• AND EMPLOYERS'UABILITY --- ANYPROPRIETORJPARTNERIEXECUTIVE YIN E,L,E T ACH ACCII,?S $ OFFICEIMMBER EXCLUDED? Li NIA —'-- IMandHory In NN) E L DISEASE•EA EMPLOYE $ If Ye0.deegSLe Untle E.L.DISEASE-POLICY I,IMIT $ DESGFnPTION OF OPERATIONS I LOCATIONS I VENICLES (Attach ACORD101,AddWone)Remarks Schedule,N MM'pace IA required) 2006 Dodge 2500 Van VIN 9 WD0PD7445$$9585D1 CERTIFICATE HOLDER CANCELLATION City of Kent Washington SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Ave South ACCORDANCE wITH THE POLICY PROVISIONS. Kentr WA 98032 AUTHORI711ryX--1PrR�EA8EIffAW%A ©198 2 0 A ORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo ar Istered marks WACORD 1001406 132849.E 11-15-2010 PUBLIC WORKS OPERATIONS Donald C Millett Operations Manager 2204th Avenue South Kent, WA 98032 KEN T Fax, 253-856-6600 W.SHINGTON PHONE: 253-856-5600 February 9, 2011 Mr. Joseph E. Tyson Columbia Basin Water Works, Inc. 405 Church Street Gaston, Oregon 97119 Dear Mr. Tyson: We have received the signed originals of the contract between Columbia Basin Water Works, Inc. and the City of Kent for the testing of large distribution water meters. We have also received your required proof of insurance. The contract has been signed by our Public Works Operations manager, and we are ready to have you proceed with the work. Enclosed is one fully signed contract for your records. In the meantime, if you have any questions, feel free to call me at 253-856-5600. Sincerely, Steve Reynolds Water Distribution Field Supervisor SR:rcb Enclosure: One fully signed original of the 2011 Public Works Agreement between the City of Kent and Columbia Basin Water Works, Inc. V1 ru 3 Y C N Y U • MAYOR SUZETTE �� S On rac Over c G Ge a er5 p "ter igne on rac o um i asm a er ors e`s�ina City of Kent Public Works Department Timothy ] LaPorte, P E , Public Works Director