HomeMy WebLinkAboutPK11-201 - Original - Belarde Company, Inc. - Town Square Plaza Lithocrete - 07/20/2011 Records Mana-ge ent-4
KENT Document
WASHINGTON
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
completed.
to City Clerks Office. All portions are to be com p
If you have questions, please contact City Clerk's Office.
Vendor Name: Q l(ti✓� 41
Vendor Number: 1 3
JD Edwards Number
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Contract Number: hol ��O�QI
This is assigned by City Clerk's Office
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Project Name: i A S( (/1 Gt✓ a e— I ` l 0 C vt-k
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment 5�ontract
❑ Other: �1
Contract Effective Date: r 7iC) ' Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Tlt/Vi Q-C4-61 C Department: PC>- / � 5
Detail: (i.e. address, location, parcel number, tax id, etc.):
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S,Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
KENT
WA3MIHGTOH
PUBLIC WORKS AGREEMENT
between City of Kent and
Belarde Company
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and Belarde Company organized under the laws of the State
of Washington, located and doing business at P. O. Box 684, Woodinville, WA 98072, Rob Vass,
Telephone: 425-376-2500, Fax: 425-376-0332 (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:
At Town Square Plaza in Kent, Washington, strip and buff wash all the Lithocrete@
areas with 100% glass and repair of damaged areas to be patched to match
surrounding glass fields. All work to then be resealed and restored, as described in
the contractor's proposal dated July 14, 2011, attached and incorporated as Exhibit —
A.
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 15
days of the Notice to Proceed.
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed
Six Thousand, Eight Hundred and Ninety Dollars and no/100, plus Washington State Sales Tax
($6,890.00, plus WSST), including any applicable Washington State Sales Tax, for the work and
services contemplated m this Agreement. The City shall a the Contractor fifty percent 50%
P 9 Y pay YP ( )
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.
PUBLIC WORKS AGREEMENT - 1
(Under$10K and No Performance Bond)
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.
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.
PUBLIC WORKS AGREEMENT - 2
(Under$1OK and No Performance Bond)
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
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
PUBLIC WORKS AGREEMENT - 3
(Under$1OK and No Performance Bond)
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 b the City, the Contractor may file a claim as provided in this
P � Y Y, Y
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
P
incurred as a result of the asserted events giving rise to the claim. The City shall
have access to an of the Contractor's records needed for evaluating the protest.
Y 9
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
PUBLIC WORKS AGREEMENT - 4
(Under$1OK and No Performance Bond)
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
connection with the Contractor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
PUBLIC WORKS AGREEMENT - 5
(Under$10K and No Performance Bond)
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.
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
PUBLIC WORKS AGREEMENT - 6
(Under$IOK and No Performance Bond)
_ r
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$10K and No Performance Bond)
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONTRACTOR: CITY OF KENT:
By: O�"`� By: V4
(signatur ) (signature)
Print Name: V/-S.S PrA N e: Jeff Watling
Its �Y+( Its: Director of Parks, creation and
(rive) Community Services
DATE: -7�/��20/�
DATE: ? Zo I I
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
Rob Vass Hope Gibson, Manager Parks Planning &
Belarde Company Development
P.O. Box 684 City of Kent
Woodinville, WA 98072 220 Fourth Avenue South
Kent, WA 98032
425-376-2500 (telephone)
425-376-0332 (facsimile) (253) 856-5112 (telephone)
(253) 856-6050 (facsimile)
[In this field,you may enter the electronic file0ath where the mntraa has been saved]
PUBLIC WORKS AGREEMENT - 8
(Under$IOK and No Performance Bond)
s
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of 20
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
�.�MIMN ,
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k
Architectural Concrete Solutions
LICENSE BELARCO2?QK
Date: 7/14/11
To: Hope Gibson
City of Kent- Parks, Recreation & Community Services
5821 S. 240t' St
Kent WA 98032
253.856.5112
h i? bson(a,ci.kent.wa.us
Re: Kent Town Square Repair & Restoration
Belarde Company, Inc. is pleased to submit our proposal for the above referenced project. Our quote is
based on job walk on 7/11/11.
Pricing is subject to the scope of work and qualifications that follows•
Belarde Company to strip and buff wash all the Lithocrete®areas with 100%glass and repair of damaged
areas to be patched to match surrounding glass fields.All work to then be resealed and restored.
Lump Sum $6,890.00
General Inclusions
• Labor,equipment and material to wash,repair and seal Lithocrete®
• Clean up of our work
Exclusions • All costs associated with drug screening
• This bid excludes any,and all cost • All surveying,engineering,design,testing
escalations past the 2011 construction year. and layout
• All plumbing work • Night work/weekend operations
• Demolition,saw cutting,dewatermg • Permits,fees,licenses&variances,all
• Electrical or mechanical block-outs,piping builders risk insurance
or utility adjustments • All work not specifically included above
• Conduits, sleeves,trench drains,embedded • Segmented and piecemealed work areas and
items quantities are specifically excluded
• Traffic and pedestrian control • Sales Tax and Bond
• Protection of finished concrete including all
weather protection
Items to be provided by Owner:
• Work areas to be provided in sufficient quantities and size to allow for continuous and uninterrupted work
in order to achieve maximum efficiencies and production levels
• Access for equipment and personnel
• Water and Electricity
• Traffic and pedestrian control
eer
Belarde Company 0 P.0 Box 684 • Woodinville WA 98072.0684 • Phone 425 376 2500 • Fax (425 376 0332
OP ID:MA
CERTIFICATE OF LIABILITY INSURANCE DA oif+s "
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 pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements.
PRODUCER 425489.4500 REACT
Hub Intemstlonal Northwest 425-489.4501 PHONE ac Ne:
P.O.Box 3018 E-MAIL
ADDRESS
Bothell,WA 980413018 PRODUCER gELAR-1
Chad Epple CUSTOMER ID M
INSURER 9 AFFORDING COVERAGE NAIC 0
INSURED Belarde Company,Inc. INSURERA Travelers Prop Cas Co.of Amer
PO BOX 684 INSURERS Travelers IndemnityCo.
Woodinville,WA 98072 INSURERC.
INSURER D
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 MAY HAVE BEEN REDUCED BY PAID CLAIMS
ILA POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE POLICY NUMBER MMIDD MMMU
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0
A X COMMERCIAL GENERAL LIABILITY X 4TC0526D9186TIL11 02116111 02116112 PREMISES Eao=rrenoe $ 300,000.
CLAIMS-MADE F—XI OCCUR MED EXP(Any one Person) $ 6,00
PERSONAL BADV INJURY $ 1,000,00
X STOPGAP LIABILIT GENERAL AGGREGATE $ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,00
POLICY X PRO LOC Emp Ben. $ 1,000,00
AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT S 1,000,00
(EaB X ANY AUTO BA52GD918611CNS 02116111 02116112 BODILY
ar dent)
BODILY INJURY(Per person) S
ALL OWNED AUTOS BODILY INJURY(Par amdenl) $
SCHEDULED AUTOS PROPERTY DAMAGE
HIREDAUTOS (Per emdent) $
NON-OWNED AUTOS $
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS W18 CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION S $
WORKERS COMPENSATION WC STATU- X OTH-
AND EMPLOYERS'LIABILITY
EL
A ANY PROPRIETORIPARTNERIEXECUTIVEY� NIA 4TC0526D9186TIL11 02116111 02/16/12 EL EACH ACCIDENT $ 1,000,00
OFFICERIMEMBER EXCLUDED?
(Mandatory In NHl EL DISEASE-EA EMPLOYEO$ 1,000,00
Iyes describe under
DESIRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1,000,00
DESCRIPTION OF OPERATIONS I LO)OCATIONS I VEHICLES(Attach ACORD 101.AddMonal Remarks Scheduta,N mores ace Is rewired)
ICY
TERDMOSIONAL CONDITIONSDLIMITATIONS AND ATUIRED BY TACHED ENDORSEMENT TTEN ((GL fL AUTO SUBJECT TO space
OF KEW. COVERAGk AFFORDED IS PRIMARY AND DN-CONTRIBUT'ORY.
CERTIFICATE HOLDER CANCELLATION
CIKENT7
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF KENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
220 4TH AVENUE SOUTH ACCORDANCE WITH THE POLICY PROVISIONS.
KENT,WAS8032 AUTHORIZED REPRESENTAA77VE
®1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO COVERAGE PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorse- (d) Costs for extended warranties,Credit LUS
ment, the provisions of the Coverage Form apply Insurance, Health, Accident or Dlsabigty
unless modified by the endorsement. Insurance purchased with the loan or
A. PERSONAL EFFECTS COVERAGE lease'and
SECTION in — PHYSICAL DAMAGE COVER- (a) Carry-over balances from previous loans
AGE,A. Coverage, 4. Coverage Extensions is or leases.
amended by adding the following: C. COVERAGE EXTENSION — AUDIO, VISUAL
Personal Effects Coverage AND DATA ELECTRONIC EQUIPMENT NOT
DESIGNED SOLELY FOR THE PRODUCTION
We will pay up to $400 for'loss"to wearing ap• OF SOUND
pares and other personal effects which are: SECTION IN — PHYSICAL DAMAGE COVER-
(1) owned by an"Insured";and AGE, B. Excluslons, exception paragraph a. to
(2) in or on your covered"auto°; exclusions 4.c&4.d is deleted and replaced with
In the event of a total theft"lose of your covered the following:
"euto". a. Equipment and accessories used with such
No deductibles apply to Personal Effects Cover- equipment, except tapes, records or discs,
age provided such equipment Is permanently in-
stalled in the covered'auto"at the time of the
B. AUTO LOAN LEASE GAP COVERAGE yb• or Is removable from a housing unit
SECTION III — PHYSICAL DAMAGE COVER- which is permanently installed in the covered
AGE, A. Coverage, 4. Coverage Extensions Is •auto- at the time of the "loss", and such
amended by adding the following: equipment is designed to be solely operated
Auto Loan Lease Gap Coverage for Private by use of the power from the 'auto's" electrl-
Passenger Type Vehicles cal system,in or upon the covered"auto";or
In the event of a total"lose to a covered"auto'of D. WAIVER OF DEDUCTIBLE—GLASS
the private passenger type shorn in the Schedule SECTION III — PHYSICAL DAMAGE COVER-
or Declarations for which Physical Damage Cov- AGE, D. Deductible Is amended by adding the
erage is provided,we wig pay any unpaid amount following:
due on the lease or loan for such covered"auto• No deductible for a covered "auto" will apply to
less the following: glass damage if the glass is repaired rather than
(1) The amount paid under the Physical Damage replaced.
Coverage Section of the policy for that"auto"; E. HIRED AUTO PHYSICAL DAMAGE COVER-
and AGE
(2) Any: SECTION in — PHYSICAL DAMAGE COVER-
(a) Overdue leasslloen payments at the time AGE,A. Coverage, 4. Coverage Extensions is
of the"loss"; amended by adding the following:
(b) Financial penalties Imposed under a Hired Auto Physical Damage Coverage Exten-
lease for excessive use, abnormal wear Won
tear or high mileage;
and tear 9 . if hired autos are covered autos for Liability
(c) Security deposits not retumed by the les- Coverage and this policy also provides Physical
sor, Damage Coverage for an owned"auto",then the
CA T4 20 07 06 Includes ire copyrighted material or Insurance Services Office,Inc.with is perrrdsskm Page 1 of 2
Includes the copyrighted material of The St.Paul Travelers Companies,Inc.
COMMERCIAL AUTO
Physical Damage Coverage Is extended to tent required of you by a written contract exe-
"autos'that you hire,rent or borrow subject to the euted prior to any 'acddent" or 'loss', pro-
following; vided that the"acddere or"loss"arises out of
(1) The most we will pay for"kosa"In any one the operations contemplated by such con-
'accidenr to a hired, rented or borrowed treat The waiver applies only to the person or
'auto"is the lesser of: organization designated in such contract.
(a) $50,000; G. BLANKET ADDITIONAL INSURED
(b) The actual cash value of the dam- SECTION 11—LIABILITY COVERAGE,part A.1.
aged or stolen property as of the time Who te An Insured,paragraph c.is amended by
of the loss";or adding the following:
(c) The cost of repairing or replacing the Any person or organization that you are required
damaged or stolen property with to Include as an additional insured on this Cover-
other property of like ldnd and quality. age Form in a written contract or agreement that
Is signed and executed by you before the"bodily
(2) An adjustment for depredation and Injury'or"property damage"occurs and that Is in
physical condition will be made in deter- effect during the policy period Is an Insured"for
mining actual cash value in the event of a Liability Coverage, but only for damages to which
total lose. this Insurance applies and only to the extent that
(3) If a repair or replacement results in better person or organization qualities as an Insured"
than like Idnd or quality, we will not pay under the Who Is An Insured provision contained
for the amount of betterment. In Section 11.
(4) A deductible equal to the highest Physical H. EMPLOYEE HIRED AUTOS
Damage deductible applicable to any SECTION p — LIABILITY COVERAGE, A. Cov-
owned covered"auto'. arage,1.Who Is An Insured is amended by add-
(5) This Coverage Extension does not apply Ing the following:
to: An "employee" of yours Is an Insured"while op-
(a) Any'auto'that is hired,rented or bor- orating an 'auto"hired or rented under a contract
rowed with a driver,or or agreement In that "employee's" name, with
(b) Any"auto"that is hired,rented or bor- your permission, while performing duties related
rowed from your"employee". to the conduct of your business.
F. BLANKET WAIVER OF SUBROGATION 1. COVERAGE EXTENSION—TRAILERS
SECTION IV—BUSINESS AUTO CONDITIONS, SECTION I — COVERED AUTOS, C. Certain
A. Loss Conditions, 5. Transfer Of Rights Of Trailers, Mobile Equipment and Temporary
Recovery Against Others To Us is deleted and Substitute Autos, paragraph 1. Is deleted and
replaced by the following: replaced by the following:
5. Transfer Of Rights Of Recovery Against 1. "Trailers" with a load capacity of 3,000
Others To Us pounds or leas designed primarily for travel
We waive any right of recovery we may have on public roads.
against any person or organization to the ex-
Page 2 of 2 Includes the copyrighted material or Insurance Services office,Inc.with Ira pemdsslon. CA T4 20 07 06
Includes the copyrighted material of The St.Paul Travelers Companies,Inc.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies insurance provided under the following,
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. WHO IS AN INSURED—(Section II) is amended c) The insurance provided to the additional in-
to include any person or organization that you sured does not apply to "bodily injury" or
agree in a "written contract requiring insurance" "property damage" caused by "your work"
to include as an additional insured on this Cover- and included in the "products-completed op-
age Part, but, erations hazard" unless the "written contract
a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you
"property damage"or"personal injury", and to provide such coverage for that additional
Insured, and then the insurance provided to
b) if, and only to the extent that, the injury or the additional insured applies only to such
damage is caused by acts or omissions of "bodily injury" or "property damage" that oo-
you or your subcontractor in the performance curs before the end of the penod of time for
of "your work" to which the "written contract which the "written contract requiring insur-
reguinng insurance" applies. The person or ance" requires you to provide such coverage
organization does not qualify as an additional or the end of the policy penod, whichever is
insured with respect to the independent acts earlier.
or omissions of such person or organization. 3. The insurance provided to the additional insured
2. The insurance provided to the additional insured by this endorsement is excess over any valid and
by this endorsement is limited as follows, collectible "other insurance", whether primary,
a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is
this Coverage Part shown in the Declarations available to the additional insured for a loss we
exceed the limits of liability required by the cover under this endorsement However, if the
"wntten contract reguinng insurance", the in- "written contract requiring insurance" specifically
surance provided to the additional insured requires that this insurance apply on a primary
shall be limited to the limits of liability re- basis or a primary and non-contributory basis,
quired by that "written contract requiring m- this inert a is primary to adddmarl insured which insurance"
surance . This endorsement shall not in available-
crease the limits of insurance described in that person or organization as a named insured
Section III—Limits Of Insurance for such loss, and we wit not share with that
"other insurance" But the insurance provided to
b) The insurance provided to the additional m- the additional insured by this endorsement still is
sured does not apply to"bodily injury", "prop- excess over any valid and collectible "other in-
erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or
of the rendering of, or failure to render, any on any other basis, that is available to the addi-
professional architectural, engineering or sur- tional insured when that person or organization is
veying services,including: an additional insured under such "other insur-
i. The preparing, approving, or failing to ance".
prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the
ings, opinions, reports, surveys, field or- additional insured by this endorsement,
ders or change orders, or the preparing,
approving, or failing to prepare or ap- a) The additional insured must give us written
prove,drawings and specifications,and notice as soon as practicable of an "occur-
rence" or an offense which may result in a
if. Supervisory, inspection, architectural or claim. To the extent possible, such notice
engineering activities should include
CG D2 46 08 05 0 21305 The St. Paul Travelers Companies, Inc. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
1. How, when and where the "occurrence" any provider of"other insurance"which would
-_ or offense took place; cover the additional insured for a loss we
it, The names and addresses of any injured cover under this endorsement However, this
persons and witnesses, and condition does not affect whether the insur-
ance provided to the additional insured by
Ill. The nature and location of any injury or this endorsement is primary to "other insur-
damage ansing out of the"occurrence"or ante" available to the additional insured
offense which covers that person or organization as a
b) if a claim is made or"suit"is brought against named insured as described In paragraph 3.
the additional insured, the additional insured above.
must S. The following definition is added to SECTION V.
1. Immediately record the specifics of the —DEFINITIONS.
claim or"suit"and the date received; and "Written contract requiring insurance" means
li. Notify us as soon as practicable. that part of any written contract or agreement
under which you are required to include a
The additional insured must see to It that we
person or organization as an additional in-
receive written notice of the claim or"suit"as sured on this Coverage Part, provided that
soon as practicable, the "bodily injury" and "property damage"oc-
c) The additional insured must immediately curs and the"personal injury"is caused by an
send us copies of all legal papers received in offense committed
connection with the claim or"suit", cooperate a. After the signing and execution of the
with us in the investigation or settlement of contract or agreement by you;
the claim or defense against the "suit", and
otherwise comply with all policy conditions b. While that part of the contract or
d) The additional insured must tender the de- agreement is in effect, and
fense and indemnity of any claim or"suit"to c. Before the end of the policy period.
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Page 2 of 2 ®2005 The St.Paul Travelers Companies,Inc. CG D2 46 06 05
002002