HomeMy WebLinkAboutPW09-340 - Amendment - #3 - Gray & Osborne, Inc. - 640 Zone Water Reservoir - 11/28/2011 me=
Records Maagesa
KENT Document
Wes HiHcro.
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: Gray & Osborne, Inc.
Vendor Number:
JD Edwards Number
Contract Number: Jpoc)
This is assigned by City Clerk's Office
Project Name: 640 Zone Reservoir
Description: p Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract
❑ Other: "
Contract Effective Date: Date of the Mayor's Signature Termination Date: 3/31/12
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Ken Langholz Department: Engineering
Detail: (i.e. address, location, parcel number, tax id, etc.):
Extend the time of completion to March 31, 2012 so the consultant can continue to_
provide construction support and complete as-built drawings.
S:Pub lic\RecordsManagement\Forms\ContractCover\adcc7832 11/08
4
• 3
KENT
Was Hincror
AMENDMENT NO. 3
NAME OF CONSULTANT OR VENDOR: Gray & Osborne, Inc.
CONTRACT NAME & PROJECT NUMBER: 640 Zone Reservoir
ORIGINAL AGREEMENT DATE: December 11, 2009
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:
An extension to the time of completion is necessary so the
Consultant can continue to provide construction support and
complete as-built drawings for the project.
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, $131,970.00
Including applicable WSST
Net Change by Previous Amendments $107,700.00
Including applicable WSST
Current Contract Amount $239,670.00
including all previous amendments
Current Amendment Sum $0
Applicable WSST Tax on this $0
Amendment
Revised Contract Sum $239,670.00
AMENDMENT - 1 OF 2
Original Time for Completion 12/31/10
(Insert date)
Revised Time for Completion under 12/31/11
prior Amendments
(Insert date)
Add'I Days Required (t) for this 91 calendar days
Amendment
Revised Time for Completion 3/31/12
(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, °I
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.
CONSULTANT/VENDOR: CITY OF KENT:
By: By:
(signature) (signature)
Print Name:Tkol"a c M. Z&-Ay /LPL_ Pr' t Na e uzette Cooke
Its /es �d¢.,T It Ma or
(t/t!e itle)
DATE: /i �/ // DATE: // Al
APPROVED AS TO FORM:
(applicable if Mayor's signature required)
/mkk N
KeA Law Department
Gray&Osborne-640 Zone Amd 3/Langnolz
AMENDMENT - 2 OF 2
1 DATE (MMIDDIYYYY)
ACOROa CERTIFICATE OF LIABILITY INSURANCE
09106/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
F _tW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
K <ESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER,
IMPORTANTIf 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 endorsement(s)
PRODUCER Phone (360)598-3700 Fax (360)598-3703 CONTACT MICHAEL J HALL&COMPANY
NAME
MICHAEL J.HALL&COMPANY PHONE (360)598-3700 FA Nri (360)598-3703
HALL&COMPANY E-MAIL
ADDRESS
19660 10TH AVENUE N.E. PRODUCER
POULSBO WA 98370 CUSTOMER ID 4
INSURER(S) AFFORDING COVERAGE NAIC#
INSURED INSURER Travelers Casualty and Surety Co of America 31194
GRAY&OSBORNE INC
701 DEXTER AVENUE N#200 INSURER B Hartford Casualty Insurance Co. 29424
SEATTLE WA 98109 INSURER
INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER 144739 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 ALLTHE TERMS,
EXCLUSIONS ANF)CONDITIONS OF SI l(r,H P I[r.IFq I IMITS SHOWN MAY HAVE BEEN RFF)IJCFD BY PAI D QI AIMS
INSR TYPE OF INSURANCE ADD'L SUER I POLICYNUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMfD MMIDDIYYYY
B GENERAL LIABILITY 52SBADU7303 09/10/11 09/10/12 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED. $ 300,000
PREMISES Ea000u
CLAIMS-MADE I X1 OCCUR MED EXP(Any one person) $ 10,000
X OCP,XCU,BFPO PERSONAL&ADV INJURY $ 1,000,000
X Separation of hsureds GENERAL AGGREGATE $ 2,000,000
N'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,000
PRO-
POLICY X LOG $
B AUTOMOBILE LIABILITY 52UECJS3276 09/10/11 09/10/12 COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED AUTOS
BODILY INJURY(Per accident) $
SCHEDULED AUTOS PROPERTYDAMAGE
X HIRED AUTOS (Per accident) $
X NON-OWNEDAUTOS $
$
B UMBRELLA LIAB X OCCUR 52SBADU7303 09/10/11 09/10/12 EACH OCCURRENCE $ 1,000,000
Excess uaB CLAIMS-MADE AGGREGATE $ 1,000,000
DEDUCTIBLE $
X RETENTION $ 10,000 $
B WORKERS COMPENSATION 52SBADU7303 09/10/11 09/10/12 lgsTL%M, X OTH $ WA Stop Gap
AND EMPLOYERS' LIABILITY YIN FR
ANY PROPRIETORIPARTNERIEXECUTIVE I� EL EACH ACCIDENT $ 1,000,000
OFFICER)MEMBER EXCLUDED? NIA
fMandatory 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 105339819 09/10/11 09/10/12 $1,000,000 Per Claim
't $1,000,000 Aggregate
DESCRIPTION OF OPERATIONS y LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
SEE SUPPLEMENTAL CERTIFICATE INFORMATION
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ty of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
JO West Gowe
Kent,WA 98032 AUTHORIZED REPRESENTATIVE
Attention: nyoshitake@ci kentwa us
AshleyLHurd�
ACORD 25(2009109) 9)1988-2009 ACORD CORPORATION All rights reserved
The ACORD name and logo are registered marks of ACORD
DATE
SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #144739 sEP62011
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS
640 Water Reservoir
City of Kent is an additional insured per written contract or agreement between insured and Insured's client on the General
Liability and Automobile Liability regarding liability arising out of 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
Awaiver of subrogation applies to the General Liability,Auto Liability,&Employers Liability and Umbrella 1 Excess Liability in favor
of the Additional Insured.
Certificate# 144739
Gray&Osborne,Inc Policy#52SBADU7303
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) 'Bodily injury" or "property damage"
purpose by you, any of your that occurred;or
"employees", "volunteer workers", (2) "Personal and advertising injury"
any partner or member (if you are
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
liability 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 j
c. Temporary Custodians Of Your equipment along a public highway with your
Property pemtission. Any other person or organization
responsible for the conduct of such person is
Any person or organization having proper w
temporary custody organization
your property you also an insured, but only with respect to liability
arising out of the operation of the equipment,and
die,but only: only if no other insurance of any kind is available
(1) 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 respect to:
been appointed. a. "Bodily injury" to a co-"employee" of the
d. Legal Representative If You Die person driving the equipment;or
Your legal representative if you die, but b. "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
duties under this insurance. an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which is a legally incorporated entity 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 stock 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
such person is also an insured, but only with
subsidiary not shown in the Declarations respect to liability arising out of the operation
as a named insured does not apply to of the watercraft, and only if no other
injury or damage with respect to which an 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 liability.
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. "Bodily injury" to a co=employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft;or
Any organization you newly 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 provision.
the voting stock, will qualify as a Named 6. Additional Insureds When Required By )
Insured if there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However. Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified In
only unfit the 180th 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 08 04 05 1.9 Page 11 of 24
i
The Hartford
Gray&Osbome,Inc Policy#52SBADU7303
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (ey 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 normally
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 distribution or sale of the
A person or organization is an additional products;
insured under this provision only for that (f) 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 sale 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 distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including all 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) 'Bodily injury" or "property
Any person(s)or organization(s)(referred to damage" arising out of the solenegligence of the vendor for its
below as vendor), but only with respect to
"bodily injury" or "property damage" arising own acts or emissions or those out of"your products" which are distributed acting
employees or anyone else
or sold in the regular course of the vendor's acting on ittss behalf. However,this
exclusion does not apply to:
business and only if this Coverage Part
provides coverage for "bodily injury" or (I) The exceptions contained in
"property damage" included within the Subparagraphs(d)or(f);or
"products-completed operations hazard". (ii) 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 normafly
exclusions: undertakes to make in the usual
This insurance does not apply to: course of business, in
connection with the distribution
(a) "Bodily injury" or "property or sale of the products.
damage" for which the vendor is (2) This insurance does not apply to any
obligated to pay damages by insured person or organization from
reason of the assumption of whom you have acquired such products,
liability in a contract or agreement or any ingredient. part or container,
This exclusion does not apply to entering into, accompanying or
liability for damages that the containing such products.
vendor would have in the absence
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
(c) Any physical or chemical change with respect to their liability for "bodily
"jury property damage' or
in the product made intentionally ,
"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, testing, person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container,
Page 12 of 24 Form SS 00 Oa 04 05
Gray&Osborne,Inc Policy#52SBADU7303
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 j
"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"property damage" a
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises;or f. Any Other Party
(b) Structural alterations, new (1) Any other person or organization 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 omissions or
only with respect to liability for "bodily the acts or omissions of those acting
injury", "property damage" or "personal on your behalf:
and advertising injury"caused, in whole _ (a) In the performance of your
or in part, by your acts or omissions or ongoing operations;
the acts or omissions of those acting on (b) In connection with your premises
your behalf 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. (1) The written contract or written
(2) With respect to the insurance afforded 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 (!I) 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 engineenng services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
j
Gray&Osborne,Inc Policy#52SBADU7303
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
architectural or '"'engineering Subject to 2.a. or 2.1b above, whichever
activities. applies,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
Now this insurance applies 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 Limit
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
Declarations.
1. The Most We Will Pay
S. Damage To Premises Rented To You Limit
The Limits of Insurance shown in the
Declarations and the rules below fix the most The Damage To Premises Rented To You
we will pay regardless of the number of, Limit is the most we will pay under Business
Liability Coverage for damages because of
a. Insureds; "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
explosion, the Damage to Premises Rented To
a. Damages because of "bodily injury" and 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 S. How Limits Apply To Additional Insureds
Declarations.
b. Damages because of all other "bodily The most we will 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 limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies permit 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 shall 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 08 04 05
Gray&Osborne,Inc Policy 0 528BADU7303
BUSINESS LiABILFTY COVERAGE FORM
If more than one limit of insurance under this (1) Immediately send us copies of any d
policy and any endorsements attached thereto demands, notices, summonses or
applies to any claim or"suit",the most we will pay legal papers received in connection
under this policy and the endorsements is the with the claim or"suit";
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit'. However, this other information;
paragraph does not apply to the Medical Expenses
limit set forth in Paragraph 3.above. (3) Coopers with us in the investigation,
settlement
of the claim or defense
The Limits of Insurance of this Coverage Part apply against the"suit';and
separately to each consecutive annual period and to (4) Assist us, upon our request, in the
any remaining period of less than 12 months,starting
with the beginning of the policy period shown in the enforcement any right against any
Declarations, unless the policy period is extended Person or organization that may be
after issuance for an additional period of less than 12 liable the insured because of injury
months. In that case, the additional period will be or damage which this insurance
deemed part of the last preceding period for purposes may also apply
.
of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own
GENERAL CONDITIONS cost, voluntarily make a payment, assume
any obligation, or incur any expense, other
1. Bankruptcy than for first aid,without our consent. d
Bankruptcy or insolvency of the insured or of s. Additional Insured's Other insurance
the insured's estate will not relieve us of our If we cover a claim or "suit" under this
obligations 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 claim or "suit" to the
other insurer for defense and indemnity.
You or any additional insured must see to t l t d this
s provision does no apply o
i#= that we are notified as soon as H 7
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 possible, notice should include: permit that this insurance is primary and
(1) Haw,when and where the"occurrence" non-contributory with - the additional
insured's own insurance.
or offense took place; f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses;and Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury any additional insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" is
-- . - x.-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 individual;
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 (3) Any manager, if you or an additional
claim or "suit" and the date received; insured is a limited liability company;
and
(2} Notify us as soon as practicable. (4) Any "executive officer" or insurance
manager, if you or an additional
You or any additional insured must see to insured is a corporation;
it that we receive a written notice of the
claim or"suit"as soon as practicable (5) Any trustee, if you or an additional
insured is a trust;or
c. Assistance And Cooperation Of The
Insured (6) Any elected or appointed official, if you
or an additional insured is a political
You and any other involved insured must: subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
Gray&Osborne,Inc Policy#52SBADU7303
BUSINESS LIABILITY COVERAGE FORME
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" liability 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 "mobile equipment" to a other valid and collectible insurance is
which this insurance applies, we will available for a loss we cover under this
Coverage Part, our obligations are limited as
provide any liability, uninsured motorists,
follows:
undennsured motorists, no-fault or other
coverage required by any motor vehicle a. Primary Insurance
law. We will provide the required limits for This insurance is primary except when b.
those coverages. below applies. If other insurance is also
4. Legal Action Against'Us primary, we will share with all 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 Insurance
into a suit asking 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
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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 work";
against an insured; but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of
this insurance or that are in excess of the That is ce forr fire, lightning or explosion
insurance
applicable Knot of insurance. An agreed premises rented to you
settlement means a settlement and release of or temporarily occupied by you with
liability signed by us, the insured and the permission of the owner;
claimant or the claimants legal representative. (3) Tenant Liability
5. Separation Of Insureds That is insurance purchased by you to
cover your -liability as a tenant for
Except with respect to the Limits of Insurance, "property damage"to premises rented
and any rights or duties specifically assigned to you or temporarily occupied by you
in this policy to the first Named Insured, this
insurance applies: with 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
Section A.—Coverages.
6. Representations (5) Property Damage To Borrowed
a. When You Accept This Policy Equipment Or Use Of Elevators
By accepting this policy, you agree: If the loss arises out of "property
(1) The statements in the Declarations 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 08 04 05
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Gray&Osborne,Inc Policy#52SBADU7303 1'
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
a
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
y insurance, this insurance is h nothing after loss to impair them. At o4S,,
primary and we will not seek request, the insured will bring "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
insured has been added as an b. Waiver Of Rights Of Recovery (Waiver
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 ail or part of any payment,
defend the insured against any"suit"if any
other insurer has a duty to defend the including Supplementary Payments, we
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
Gray&Osborne,Inc Policy#52SBADU7303
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT - AGGREGATE LIMITS (PER PROJECT)
This endorsement modifies insurance provided under the following:
BUSINESS LIABILITY COVERAGE FORM
A. Section D. LIABILITY AND MEDICAL EXPENSES 4. If the applicable "project" has been abandoned,
LIMITS OF INSURANCE is amended as follows delayed, or abandoned and then restarted, or if
1. The General Aggregate Limit under Section D. the authorized contracting parties deviate from
LIABILITY AND MEDICAL EXPENSES LIMIT plans, blueprints, designs, specifications or
OF INSURANCE applies separately to each of timetables, the "project' will still be deemed to
your"projects" be the same"project'
2. The limits shown in the Declarations for Liability 5. The provisions of Section D. LIABILITY AND
and Medical Expenses, Damage To Premises MEDICAL EXPENSES LIMIT OF INSURANCE
Rented To You and Medical Expenses continue not otherwise modified by this endorsement
to apply shall continue to apply as stipulated
3. When coverage for liability ansing out of the B. Additional Definitions
"products-completed operations hazard" is The following definition is added to Section G.
provided, any payments for damages because LIABILITY AND MEDICAL EXPENSES
of "bodily injury" or "property damage" included DEFINITIONS
in the "products-completed operations hazard" 1. "Project' means "your work" at location(s) away
will reduce the Products-Completed Operations from premises owned or rented to you
Aggregate Limit, and not reduce the General
Aggregate Limit
Form SS 04 33 04 05 Page 1 of 1
0 2005,The Hartford
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Gray&Osborne,Inc Policy#52UECJS3276
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED AND
RIGHTS OF RECOVERY AGAINST OTHERS
This endorsement modifies insurance provided under the following
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BUSINESS AUTO COVERAGE FORM
A. Any person or organization whom you are required by contract to name as additional insured is an
"insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an
"insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE
B. For any person or organization for whom you are required by contract to provide a waiver of subrogation,
the Loss Condition -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable I
Iff
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Form HA 99 13 0187 Printed in U S.A 1
REQUEST FOR MAYOR'S SIGNATURE
Z�• Please Fill in All Applicable Boxes
IKNO WASNINGTON This Form must be printed on cherry paper
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Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Originator: Ken Langholz Phone (Originator): 5516
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Date Sent Date Required 1 1/a0/1 t
Return Signed Document to Nancy Yoshitake CONTRACT TERMINATION DATE: 3/31/12 ka
VENDOR NAME: Gray&Osborne, Inc DATE OF COUNCIL APPROVAL: 12/8109
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Brief Explanation of Document
The attached Amendment No 3 to the 640 Zone Reservoir agreement Is necessary to extend the time of completion to j
March 31, 2012 so Gray& Osborne can continue to provide construction support and complete as-built drawings For
further explanation, see the attached
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All Contracts Must Be Routed Through the Law Department
(This Area to be Completed By the Law Department)
Received
Approval of Law Dept.:
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Law Dept Comments: NOV :) 2 2011
Date Forwarded to Mayor I 2_� f t
Shaded Areas to Be Completed by Administration Staff
Received: 1
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Recommendations & Comments:
Disposition: /���P i' �' z`�✓t� fyt.p /�--
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Date Returned:
Iage5870_templatebase • 2/07
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