HomeMy WebLinkAboutPW10-190 - Amendment - #1 - Shearer Desing LLC - S 224th Street Bridge/SR 167 Overcrossing Desing & Bid Documents - 06/23/2011 Records Mana"' -g--' ern0n-v,,,
KEN O T
WASHINGTON - 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: Shearer Design LLC
Vendor Number:
JD Edwards Number
Contract Number: `t'Lt) it) - L 1D
This is assigned by City Clerk's Office
Project Name: S. 224t" St. Bridge/SR 167 Overcrossing
Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract
❑ Other:
(o , )_3- It
Contract Effective Date: Date of Mayor's signature Termination Date: 6/30/12
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Garrett Inouye Department: Engineering
Detail: (i.e. address, location, parcel number, tax id, etc.):
Extend the time for completion to June_30, 2012 so the consultant can continue to assist
with design and preparation of bid documents.
S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
KENT
WASHINGTON
AMENDMENT NO. 1
NAME OF CONSULTANT OR VENDOR: Shearer Design LLC
CONTRACT NAME & PROJECT NUMBER: S. 2241h Street Bridge/SR 167 Overcrossing
ORIGINAL AGREEMENT DATE: 7/19/10
This Amendment is made between the City and the above-referenced Consultant or
Vendor and amends the original Agreement and all prior Amendments. All other provisions of
the original Agreement or prior Amendments not inconsistent with this Amendment shall remain
in full force and effect. For valuable consideration and by mutual consent of the parties,
Consultant or Vendor's work is modified as follows:
1. Section I of the Agreement, entitled "Description of Work," is hereby modified to
add additional work or revise existing work as follows:
In addition to work required under the original Agreement and any
prior Amendments, the Consultant or Vendor shall:
No change is necessary to the scope of work, however an
amendment is needed to extend the time of completion to June
30, 2012 so the Consultant can continue to assist with the
design and preparation of bid documents.
2. The contract amount and time for performance provisions of Section II "Time of
Completion," and Section III, "Compensation," are modified as follows:
Original Contract Sum, $262,540.00
Including applicable WSST
Net Change by Previous Amendments $0
including applicable WSST
Current Contract Amount $262,540.00
including all previous amendments
Current Amendment Sum $0
Applicable WSST Tax on this $0
Amendment
Revised Contract Sum $262,540.00
AMENDMENT - 1 OF 2
e +
Original Time for Completion 6/30/11
(Insert date)
Revised Time for Completion under 0
prior Amendments
(Insert date)
Add'I Days Required (f) for this 366 calendar days
Amendment
Revised Time for Completion 6/30/12
(Insert date)
The Consultant or Vendor accepts all requirements of this Amendment by signing below,
by its signature waives any protest or claim it may have regarding this Amendment, and
acknowledges and accepts that this Amendment constitutes full payment and final settlement of
all claims of any kind or nature arising from or connected with any work either covered or
affected by this Amendment, including, without limitation, claims related to contract time,
contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless
otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the
guarantee and warranty provisions of the original Agreement.
All acts consistent with the authority of the Agreement, previous Amendments (if any),
and this Amendment, prior to the effective date of this Amendment, are hereby ratified and
affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment
shall be deemed to have applied.
The parties whose names appear below swear under penalty of perjury that they are
authorized to enter into this Amendment, which is binding on the parties of this contract.
IN WITNESS, the parties below have executed this Amendment, which will
become effective on the last date written below.
CONSULT VENDOR: CITY OF KENT:
By: r By: ,, P:�n�(signature) (signature)
Print Name)C)4.4 vu Print ()ae: Suzette Cooke
Its ()V3 lnaL Its Mayor
(title) tr((le)
DATE: ��Zn�/I DATE: lg�d��j J
APPROVED AS TO FORM:
(applicable If Mayor's srgnatur ur d)
11
Kent Law DeparGent
Shearer-22e Bridge Ad 1/Inouye
AMENDMENT - 2 OF 2
AC" ovzo/2n011Dll CERTIFICATE OF LIABILITY INSURANCE DATE (MYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
rPRTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
OW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
r,=PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policylles) must be endorsed If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements)
PRODUCER Phone (360)598-3700 Fax (360)598-3703 ACT AJ Fugltt
MICHAEL J HALL&COMPANY "E (360)598-3700 a No (360)598-3703
JC No Ex
HALL&COMPANY E-MAa
19660 10TH AVENUE N E. ADOREss certificates@hal land company com
.lAN 2 6 2011 PRODUCER 12609
POULSBO WA 98370 CUSTOMER ID
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED RERA Travelers Casualty and Surety Co of Am
Shearer Design CITY OF KE N
3613 Phinney Ave N#A ENGINEERING DE RMERB Hartford Insurance Co 38288
Seattle,WA 98103-8522 INSURER C
INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 129174 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 F :.q III ITqqHQW1' ` "HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE IADD'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMIDDIYYYY MM/DDlYYYY
B GENERAL LIABILITY 52SBAIJ6571 02/09/11 02/09/12 EACH OCCURRENCE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDEMISES $ 300,000
PR Ea occurence _
CLAIMS-MADE XIOCCUR MED EXP(Any one person) $ 10,000
X XCU/BFPD/OCP PERSONAL&ADV INJURY $ 2,000,000
X Separation of Insureds GENERAL AGGREGATE $ 4,000,000
GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMI AGG $ 4,000,000
t PRO-
POLICY LOD $
B AUTOMOBILE LIABILITY 52SBAIJ6571 02/09/11 02/09/12 COMBINED SINGLE LIMIT $ 2,000,000
(Ea accident)
ANY AUTO
BODILY INJURY(Per person) $
ALL OWNED AUTOS BODILY INJURY(Per accident) $
SCHEDULED AUTOS PROPERTY DAMAGE
X HIRED AUTOS $
(Per accident)
X NON-OWNEDAUTOS $
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ 1 1 L $
B WORKERS COMPENSATION 52SBAIJ6571 02/09/11 02/09/12 1WeR sTATu- X OTH $ WA STOP GAP
AND EMPLOYERS' LIABILITY YIN TO ,LIMITSFIR
ANY PROPRIETORIPARTNERIEXECUTIVE F EL EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED? NIA
(Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
If yes describe under
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 1,000,000
A Professional Liability Claims Made Form 105388690 01/11/11 01/11/12 $2,000,000 Per Claim
$2,000,000 Aggregate
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
Project S 224th Street/SR167/ Bridge The City of Kent is an Additional Insured on the Commercial General Liability and Auto Liability
when required by written contract or agreement regarding activities by or on behalf of the Named Insured This insurance is primary
insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
400 W Gowe St
Kent,WA 98032-6019 AUTHORIZED REPRESENTATIVE
Attention: Chad Bierensee
c
n J Fu t
ACORD 25(2009109) 0 09 ACORD CORPORATION All rights reserved.
The ACORD name and logo are registered marks of ACORD
,4 •
u ,
BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control is being exercised for any (1) Sodlly injury" or `property damage
purpose by you, any of your that occurred;or
"employees", "volunteer workers",
any partner or member (if you are (2) "Personal and advertising injury"
a partnership or joint venture), or arising out of an offense committed
any member (if you are a limited before you acquired or formed the
fiabgity company). organization.
b. Real Estate Manager • 4. Operator Of Mobile Equipment
Any person(other than your"employee"or, With respect to"mobile equipment'registered in
`volunteer worker', or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while driving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property pennission. Any other person or organization
responsible for the conduct of such person is
Any person or organization having proper also an Insured, but only with respell to liabii'rty
temporary custody of your property if you arising out of the operation of the equipment,and
die,but only: only tf no other insurance of any kind is available
Cl) With respect to liability arising out of the to that person or organization for this liability.
maintenance or use of that property,and However,no person or organization is an insured
(2) Until your legal representative has with respectto:
been appointed, a. "Bodily injury" to a co-"employes" of the
d. Legal Representative If You Die person driving the equipment;or
Your legal representative if you die, but h. "Property damage" to property owned by,
only with respect to duties as such. That rented to, in the charge of or occupied by
representative will have all your rights and you or the employer of any person who is
dirties under this insurance. an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respell to watercraft you do not own that
yours which is a legally incorporated enfrty is less than 51 feet long and is not being used
of which you own a financial interest of to carry persons for a charge,any person is an
more than 50% of the voting stook on the insured while operating such watercraft with
effective date of this Coverage Part your permission. Any other person or
The insurance afforded herein for any organization responsible for the:conduct of
subsidiary not shown in the Declarations such person is also an insured, but only with
as a named insured does not apply to respect to liability arising out of the operation
Injury or damage with respect to which an of the watercraft, and only if no other
insured under this insurance is also an insurance of any kind is available to that
insured under another policy or would be person or organization for this frabttity.
an insured under such policy but for its However, no person or organization is an
termination or upon the exhaustion of its insured with respect to:
limits of insurance. a. Bodity injury" to a r o-"employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft;or
Any organization you newsy acquire or form, b. 'Property damage" to property owned by,
other than a partnership, joint venture or rented to, in the charge of or occupied by
limited liability company, and over which you you or the employer of any person who is
maintain financial interest of more than 50%of an insured under this provisim
the voting stock, will qualify as a Named - S. Additional Insureds When Required By
insured if there is no other similar insurance Written Contract, WriHan Agreement Or
available to that organization. However. Permit
a. Coverage under this provision is afforded The person(s) or organizations) identified in
only until the 18Dth day after you acquire Paragraphs a.through f, below are additional
or form the organization or the end of the insureds when you have agreed, in a written
policy period,whichever is earlier,and
Form SS 00 DB D4 05 i Page 11 of 24
The Hartford ' - --. - •- -
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (eJ Any failure to make such
permit issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional insured on your agreed to make or nonnaily
policy, provided the injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement,or the issuance of the permit with the distnution or sale of the
A person or organization is an additional products;
insured under this provision only for that (t) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit, except such operations performed
However,no such person or organization is an at the vendor's premises in
connection with the sate of the
additional insured under this provision if such product
person or organization is included as an
additional insured by an endorsement issued (g) Products which, after disirhbution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including art persons or organizations added or relabeled or used as a
as additional Insureds under the specific container, part or ingredient of any
additional insured coverage grants in Section other thing or substance by or for
F.—Optional Additional Insured Coverages. the vendor,or
a. Vendors (h) 'Bod'ly injury" or "property
Any person(s)or organization damage" arising out of the sofas) {referred to negligence of the vendor for its
below as vendor), but only with respect to
"bodily injury" or "property damage" arising own acts or omissions or those of
out of"your products"which are distributed its employees or anyone else
or sold in the regular course of the vendor`s acting on its behalf. However,this
business and only if this Coverage Part
exclusion does not apply to:
provides coverage for "bodily injury" or (1) The exceptions contained in
"property damage" inducted within the , Subparagraphs(d)or(t);or
"products-completed operations hazard". (I It Such inspections, adjustments,
(1) The insurance afforded to the vendor tests or servicing as the vendor
is subject to the following additional has agreed to make or normally
exclusions: undertakes to make in the usual
This insurance does not apply to: course of business, In
oormecion with the distribu8on
(a) "BocWy mNrr or 'property or sale of the products.
damage" for which the vendor is
obligated to pay damages by (2) This insurance does not apply to any
reason of the assumption of insured Person or organization from
liability in a contract or agreement whom you have acquired such products,
This exclusion does not apply to or arty ingredient, part or container,
liability for damages that the entering into, accompanying or
vendor would have in the absence containing such products.
of the contract or agreement; b. Lessors Of Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
(d) Any physical or chemical change with respect to their liabiirty for"bodily
in the product made intentionally injury", "property damage" or
"personal and advertising injury"
by the vendor, caused, in whole or in part, by your
(d) Repackaging, except when maintenance, operation or use of
unpacked solely for the purpose of equipment leased to you by such
Inspection, demonstration, basing, person or organization.
or the substiiiAon of parts under
Instructions from the manufacturer,
and then repackaged in the
original container,
Page 12 of 24 Form SS 00 08 04 05
F '
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded e. Permits Issued By State Or Political
to these additional insureds, this Subdivisions
insurance does not apply to any (1) Any state or political subdivision, but
"occurrence" which takes place after only with respect to operations
you cease to lease that equipment performed by you or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has issued a permit
whom you lease land or premises, but (2) With respect to the insurance afforded
only With respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to:
of that part of the land or premises (a) 'Bodily injury", "property damage
leased to you. or "personal and advertising
(2) With respect to the insurance afforded injury" arising out of operations
to these additional insureds, this performed for the state or
insurance does not apply to: municipality;or
(a) Any "occurrence" which takes- (b) "Bodily injury"or•properly damage•
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises;or E Any Other Party
(b) Structural alterations, new (1) Any other person or organtiation who
construction or demolition is not an insured under Paragraphs a.
operations performed by or on through e. above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. "property damage" or "personal and
d. Architects, Engineers Or Surveyors advertising injury"caused, in whole or
(1) Any architect, engineer, or surveyor,but in part, by your acts or omssions or
only with respect to liability for "bodily the acts or omissions of those acting
injury', "property damage" or "personal on your behaf-..
and advertising injury" caused,'Iin whole (a) In the performance of your
or in part, by your ads or omissions or ongoing operations;
the acts or omissions of those acting on
your 6ahalf. (b) in connection with your premises
owned by or rented to you;or
(a) in connection with your premises; (c) in connection with"your work"and
or included within the "products-
(b) In the performance of your completed operations hazard", but
ongoing operations performed by only if
you or on your behalf.
With respect to the insurance afforded (� The written contract or written
{2) P- agreement requires you to
to these additional insureds, the provide such coverage to
following additional exclusion applies: such additional insured;and
This insurance does not apply to (fi) This Coverage Part provides
"bodily injury", "property damage" or coverage for "bodily injury' or
"personal and advertising injury" "property damage included
arising out of the rendering of or the within the 'products-
failure to render any professional completed operations hazard".
services by or for you,including:
(2) With respect to the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, "Bodily injury", "property damage" or
reports, surveys, field orders, "personal and advertising injury'
change orders, designs or arising out of the rendering of, or the
drawings and specifications;or failure to render, any professional
(b) Supervisory, inspection, architectural,engineering or surveying
architectural or engineering services,including:
activities.
Form SS 00 08 04 05 Page 13 of 24
• 1
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "property damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arising out of fire, lightning or
drawings and specifications; or explosion.
(b) Supervisory, inspection, 3. Each Occurrence Limit
archilacturai or , "engineering Subject to 2.a. or 2.b above, whichever
activities. apples,the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
insureds are described in Section D. — Limits - "property damage" and medical expenses
Of insurance, arising out of any one *occurrence is the
How this insurance apples when other Liability and Medical Expenses Limit shown in
insurance is available to an additional insured the Declarations.
is described in the Other Insurance Condition The most we will pay for all medical expenses
in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any
General Conditions. - one person is the Medical Expenses Limit
No person or organization is an insured with shown in the Declarations.
respect to the conduct of any current or past 4. Personal And Advertising Injury Limlt
partnership, joint venture or limited liability Subject to 2.b,above,the most we will pay for
company that is not shown as a Named Insured in the sum of all damages because of all
the Declarations. "personal and advertising injury"sustained by
D. LIABILITY AND MEDICAL. EXPENSES any one person or organization is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
1. The Most We Will Pay Declarations.
The Limits of insurance shown in the 5. Damage To Premises Rented To You Limit
Declarations and the rules below fix the most The Damage To Premises Rented To You
we will pay regardless of the number-. Limit is the most we wig pay under Business
a. Insureds; Liability Coverage for damages because of
property damage to any one premises,while
b. Claims made or"suits"brought;or rented to you,or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing"suits temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for. In the case of damage by fire, lightning or
a. Damages because of "bodil and explosion,the Damage to Premises Rented To
g y injury" You Limit applies to all damage proximately
"property damage" included in the caused by the same event, whether such
"products-completed operations hazard"is damage results from fire, lightning or explosion
the Products-Completed Operations or any combination of these.
Aggregate Limit shown in the g, Now Limits Apply To Additional Insureds
Declarations.
b. Damages because of all other "bodily The most we wig pay on behalf of a person or
injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of:
expenses,is the General Aggregate Limit a. The iimits of insurance specified in a
shown in the Declarations, written contract, written agreement or
This General Aggregate Limit apples parrdt issued by a state or political
separately to each of your "locations' subdivision;or
owned by or rented to you. b. The Limits of Insurance shown in the
"Location" means premises involving the Declarations.
same or connecting lots, or premises Such amount shag be a part of and not in
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 DB 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this (1) immediately send us copies of any
policy and any endorsements attached thereto demands, notices, suinmonses or
applies to any claim or"suit',the most we will pay legal papers received in camection
under this policy and the endorsements is the with the claim or"suit";
single highest limit of liability of all coverages
applicable to such claim or"suit". However, this (2) Authorize us to obtain records and
paragraph does not apply to the Medical Expenses often infonnafion;
limit set forth in Paragraph 3.above. (3) Cooperate with us in the irrvestigation,
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply against the"suet";and
separately to each consecutive annual period and to
the
any remaining period of less than 12 months,starting (4) Assist us, upon our r to
with the beginning of the pofucy period shown in the enforcement of any righutt against any
Declarations, unless the policy period is extended person or organization fuse may be
after issuance for an additional period of less than 12 Gable to the insured because of injury
months. In that case, the additional period will be or damage which this insurance
deemed part of the fast preceding period for purposes may also apply
.
of determining the Urnks of insurance, d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own
cost, voluntarily make a payment, assume
GENERAL CONDITIONS any obligation, or incur any expense, ofrter
1. Bankruptcy than for first aid,without our conserrt
Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance
the insured's estate wil( not relieve us of our If we cover a claim or "suit" under this
obrigations under this Coverage Part Coverage Part that may also be covered
2. Duties in The Event Of Occurrence, by other insurance available to an
Offense,Claim Or Suit additional insured, such additional insured
a. Notice Of Occurrence Or Offense must submit such da`um or "suit" to the
other insurer for defense and indemnity.
You or any additionalrninsured must see s However, this provision does not a
it-that we are notified as soon as P PPIY to
practicable of an "occurrence" or an the extent that you have agreed in a
offense which may result in a claim. To written contract, written agreement or
the extent passible,notice should include: permit that this insurance is primary and
non-contributory with - the additional
(1) How,when and where the"occurrence" insured's own insurance.
or offense took place;
4, f. Knowledge Of An Occurrence,Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses;and
(3) The nature and location of an injury Paragraphs and apply to you or to
y any additional insurree d only when such
or damage arising out of the "occurrence", offense, claim or "suit' is
occurrence or offense. known to:
b. Notice Of Claim
(1) You or any additional insured that is
If a claim is made or "suit" is brought an indnriduaf;
against any insured, you or any additional
insured must (2) Any Partner, if you or an additional
insured is a partnership;
(1) Immediately record the specifics of the
claim or "suit" and the date received; (3) Any manager, if you or an additional
insured is a limited liability company
and
(2} Notify us as soon as practicable. manager,
Any "executive officer" or insurance
manager, if you or an additional
You or any additional insured must sea to insured is a corporation;
if that we receive a written notice of the
claim or"suit"as soon as practicable. (5) Any trustee, 'rf you or an additional
insured is a trust;or
c. Assistance And Cooperation Of The
{assured (B) Any elected or appointed official,if you
or an additional insured is a political
You and any other involved insured muss: subdivision or public entity.
Farm SS 00 OB 04 OS rage 15 of 24
n Z
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to (3) We have issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of Hazards
financial responsibility for the future under If unintentionally you should fail to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the inception date of this
provided by the policy for "bodily injury" Coverage Part, we shall not deny any
liability and"property damage" fiabitiiy will coverage under this Coverage Part
comply with the provisions of the law to because of such failure.
the extent of the coverage and limits of 7, Other insurance
insurance required by that law.
b. With respect to "mobtle equipment to If other valid and collectible insurance is
which this insurance applies, we will available for a loss we cover under this
provide any liability, uninsured motorists, Coverage Part, our obligations are Broiled as
underinsured motorists, no-fault or other fotlows:
coverage required by any motor vehicle a. Primary insurance
law. We will provide the required limits for This insurance is primary except when b.
hose coverages. below applies, if other insurance is also
4" Legal Action Against Us primary, we will share with al that other
No person or organization has a right under insurance by the method described in c.
this Coverage Form: below.
a. To join us as a party or otherwise bring us b• Excess tnsurance
into a "suit" asidng for damages from an This insurance is excess over any of the
insured;or other insurance, whether primary;excess,
b. To sue us on this Coverage Form unless contingent or on any other basis:
all of its terms have been fully complied (1) Your Work
with.- That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or"
on an agreed settlement or on a final judgment similar coverage for"your worm;
against an insured; but we wiB not be liable for
damages that are not payable under the terms of (2) Premises Rented To You
this insurance or that are in excess of the That is fire, lightning or explosion
applicable fimit of insurance. An agreed insurance for prersases rented to you
settlement means a settlement and release of or temporarily occupied by you with
lability signed by us, the insured and the permission of the owner,
claimant or the claimant's legal representative. (3) Tenant LiablKy
5. Separation Of Insureds I That is insurance purchased by you to
Except with respect to the Limits of Insurance cover your liability as a tenant for
and any rights or duties specifically assigned "property damage"to premises rented
in this policy to the first Named Insured, this to you or temporarily occupied by you
insurance applies: wide permission of the owner,
a. As if each Named insured were the only (4) Aircraft,Auto Or Watercraft
Named insured;and If the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft,"autos"or watercraft to
a claim is made or"suit"is brought. the extent not subject to Exclusion g.of
B. Representations Section A.—Coverages.
a. When You Accept This Policy (5) Property Damage To Borrowed
Equipment Or Use Of Elevators
By accepting this policy, you agree: If the loss arises out of "properly
(1) The statements in the Deciarafions damage" to borrowed equipment or
are accurate and complete; the use of elevators to the extent not
(2) Those statements are based upon subject to Exclusion k,of Section A.—
representations you made to us;and Coverages.
Page 16 of 24 Form SS 00 00 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this insurance is excess over other
Additional Insured To Other insurance, we will pay only our share of
Insurance the amount of the loss, if any, that
That is other insurance available to exceeds the sum of:
you covering liability for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss in the
operations, or products and completed absence of this insurance; and
operations, for which you have been (2) The total of all deductible and self-
added as an additional insured by that insured amounts under all that other
insurance;or insurance.
(7) When You Add Others As An We will share the remaining loss,If any, with
Additional Insured To This any other insurance that is not described in
Insurance this Excess Insurance provision and was not
That is other insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown in the
However, the following provisions Declarations of this Coverage Part
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the, other_ insurance permits
additional insured under this Coverage contribution by equal shares,we will follow
Part: this method also. Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid its applicable limit of
This insurance is primary if you insurance or none of the loss remains,
have agreed in a written contract, whichever comes first.
written agreement or permit that If any of the other insurance does not permit
this insurance be primary If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method,each
share with all that other insurance insurer's share is based on the ratio of its
by the method described in c. applicable limit of insurance to the total
below. applicable limits of insurance of all insurers.
" (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written If the insured has rights to recover all or
contract, written agreement or part of any payment, including
permit that this insurance is Supplementary Payments, we have made
primary and non-contributory with under this Coverage Part, those rights are
the additional insured's own transferred to us The insured must do
insurance, this insurance is nothing after loss to impair them. At our,
_primary and we will not seek request, the insured will oring "suit" or
contribution from that other transfer those rights to us and help us
insurance. enforce them. This condition does not
Paragraphs (a)and (b) do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver
insured has been added as an Of Subrogation)
additional insured.
If the insured has waived any rights of
When this insurance is excess, we will recovery against any person or
have no duty under this Coverage Part to organization for all or part of any payment,
defend the insured against any"suit" if any including Supplementary Payments, we
other insurer has a duty to defend the have made under this Coverage Part, we
insured against that "suit" If no other also waive that right, provided the insured
insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other insurers. agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
REQUEST FOR MAYOR'S SIGNATURE
40
• Please Fill in All Applicable Boxes
KENT rr
WaS�INGTDN This form must be printed on cherry paper
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Originator Garrett Inouye Phone (Ongmator) 55411
Date Sent 6/22/11 Date Required 6129/11
Return Signed Document to Nancy Yoshitake CONTRACT TERMINATION DATE: 6/30/12
VENDOR NAME: Shearer Design, LLC DATE OF COUNCIL APPROVAL: 6/15/10
Brief Explanation of Document
The attached Amendment No 1 to the S 224th St Bridge/SR 167 Overcrossing agreement is necessary to extend the
time for completion to June 30, 2012 Additional time is neeced so the consultant can continue to assist with the
design and preparation of bid documents for the project For further explanation, see the attached from Garrett Inouye
All Contracts Must Be Routed Through the Law Department
(This Area to be Completed By the Law Department) RECEIVED
Received
Approval of Law Dept } _
Law Dept Comments i�� ` � � Ityof K611T
BENT LAW DEPT office of the r,AaYOr
Date Forwarded to Mayor a 3
i-
n ��
Shaded Areas to Be Completed by Administration Staff
Received: I
L1 V1'JN 2
Recommendations & Comments. 01�,0_
FFC JT
•�-t
Disposition
Date Returned:
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