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HomeMy WebLinkAboutPW11-331 - Original - Northstar Chemical, Inc. - Water Treatment Chemical Supply - 12/20/2011 Records Ma ,_ 5 gemer; t KENT Document WASHINGTON d 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: Northstar Chemical, Inc. Vendor Number: JD Edwards Number Contract Number: eb) l 1 - 3,3 1 This is assigned by City Clerk's Office Project Name: Water Treatment Chemical Supply Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 12/20/11 Termination Date: 12/31/12 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Sean Bauer Department: PW Operations Detail: (i.e. address, location, parcel number, tax id, etc.): Supply the Water Department with water treatment chemicals for 2012. _ S:Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT WA5HINGTON GOODS & SERVICES AGREEMENT between the City of Kent and Northstar Chemical, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Northstar Chemical, Inc. organized under the laws of the State of Oregon, located and doing business at 14200 SW Tualatin-Sherwood Rd., Sherwood, OR 97140, Phone: (503) 625-3770/Fax: (503) 625-1478, Contact: David Warren (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City: The Vendor shall supply the City of Kent Water Department with water treatment chemicals (bid items 7 and 8) according to the bid proposal submitted November 211 2011, which is attached as Exhibit A and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by December 31, 2012. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Five Thousand, Six Hundred Eighty Eight Dollars ($5,688.00), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: GOODS & SERVICES AGREEMENT - 1 (Under$10,000.00, including WSST) I Compensation of up to $5,688.00 is based on an estimated annual need. Actual need may vary from zero to 2,400 gals. for bid item 7 and zero to 1,200 gals. for bid item 8. Therefore, actual compensation will be between $0 and $5,688.00 and be based on the exact quantity of chemicals ordered by the City. Vendor shall be paid after submittal of invoice. If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor 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 Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. 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 Vendor 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 Vendor maintains and pays for its own place of business from which Vendor's services under this Agreement will be performed. C. The Vendor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required GOODS & SERVICES AGREEMENT - 2 (Under$10,000.00, including WSST) by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor 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 Vendor'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 Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by Vendor 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. VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor 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 Vendor 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 Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor'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. GOODS & SERVICES AGREEMENT - 3 (Under$10,000,00, including WSST) A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Vendor'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 Vendor is asserting a schedule change or disruption. B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor 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 Vendor 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 Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR 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 VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. This Agreement is subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor 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 part of the goods are repaired, 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 Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. GOODS & SERVICES AGREEMENT - 4 (Under$10,000.00, including WSST) X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor 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. Vendor 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. XI. INDEMNIFICATION. Vendor 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 Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'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 Vendor 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 Vendor's part, then Vendor 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 Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor 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 Vendor's own risk, and Vendor 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. XIV. 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. GOODS & SERVICES AGREEMENT - 5 (Under$10,000.00, including WSST) 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 t 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 XI 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 Vendor. 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 Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this i Agreement or accruing out of the performance of those operations. GOODS & SERVICES AGREEMENT - 6 (Under$10,000.00, including WSST) 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. V CITY OF KENT: By: gy: ( gnat e) (signature) Print Name Print Name: Timothy J. LaPorte, P.E. Its: Its: Public Works Director ) 1(title) DATE: / 1,Z [Ill DATE: /T/26// NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: �/� CITY OF KENT: IV�o4 J� TimothyJ. LaPorte, P.E. Northstar Chemical, Inc. City of Kent 14200 SW Tualatin-Sherwood Rd. 220 Fourth Avenue South Sherwood, OR 97140 Kent, WA 98032 (503) 625-3770 (telephone) (253) 856-5500 (telephone) (503) 625-1478 (facsimile) (253) 856-6500 (facsimile) Northstar-2012 Water Chemicals/Bauer GOODS & SERVICES AGREEMENT - 7 (Under$10,000.00, Including WSST) 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 oZ day of� �P^� , 201 Z- By: For: ` ofl: AcS Title: Date: �oZ til EEO COMPLIANCE DOCUMENTS - 1 of 3 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. t EEO COMPLIANCE DOCUMENTS - 2 of 3 i CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT I I This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the 1 Agreement. i I, the undersigned, a duly represented agent of Nothstar Chemical, Inc. Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as 2012 Water Treatment Chemicals that was entered into on the December 20, 2011, between the firm I represent and the City of Kent, I declare that I complied fully with all of the requirements and obligations as outlined In the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. Dated this a1 day of y kd'r� , 201.7 By: For: Title: e'v — Date: yJ 2 D!� EEO COMPLIANCE DOCUMENTS - 1 EXHIBIT A WATER TREATMENT CHEMICAL SUPPLY FOR 2012 PROPOSALFORM The undersigned hereby proposes to provide all equipment, labor, materials and supplies to perform the service as specified in this contract (see Special Provisions 1.3 & 1.6) for the following fees: Bidder' Name: /V�' TZ'T rat.✓ G�y'yi "`'� C�(r �. jh`, Item Estimated Description Bid Unit Total Annual Unit Prices Usage 7 2,400 12 1/2% Sodium Hypochlorite in $ �� �O $ 3� -7 92. M GALS* 500-1,000 Gal. Deliveries BULK GAL. FOB 212th St. Treatment Plant Total $ 3, :7 7, *Estimated annual need is 2,400 Gals. Actual need may vary. Company Submitting Proposal Authorized Signature Note: Contractor must submit a firm proposal for the contract term(s). WATER TREATMENT CHEMICAL SUPPLY FOR 2012 PROPOSALFORM The undersigned hereby proposes to provide all equipment, labor, materials and supplies to perform the service as specified in this contract (see Special Provisions 1.3 & 1.6) for the following fees: Bidder' Name: Item Estimated Description Bid Unit Total Annual Unit Prices Usage 8 1,200 12 1/2% Sodium Hypochlornte in $ $ GALS* 100 to 400 Gal. Deliveries BULK GAL. FOB Garrison Well Total *Estimated annual need is 1,200 Gals. Actual need may vary. Company Submitting Proposal Authorized Signature Note: Contractor must submit a firm proposal for the contract term(s). P EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, Fired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. EXHIBIT B (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has j been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. / . ® DATE(MM/DONYYY) 12112/2011 AS A OF THIS IS ISSUCERTIFIECATERMOATION (ABILITY NLY AND sNS NO RURANCE UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) PRODUCER OD08408 1-415-541-7900 CONTACT NAME Wells Fargo Insurance Services USA, Inc. PHONE FAX E No Exl A/C Ni 45 Fremont Street E-MAIL ADDRESS Suite 800 San Francisco, CA 94105 INSURE S AFFORDING COVERAGE _ NAIC# INSURER Chards Specialty Insurance Company INSURED INSURERS Commerce fi Industry Insurance Co. Northstar Chemical Company, Inc. INSURER C 14200 SW Tualatin-Sherwood Road INSURER INSURER E Sherwood, OR 97140 INSURER F COVERAGES CERTIFICATE NUMBER: 24407219 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 INSRLTR TYPE OF INSURANCE INSR SUBR POLICY NUMBER MMlDOlYEFF Mm DI EXP LIMITS A GENERAL LIABILITY X X EG2010724 09/01/1 09/01/12 EACH OCCURRENCE $ 1,000,000 X DAWGETO RENTED 300,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS-MADE ul OCCUR MED EXP(Any one person) $ 25,000 X BI/PD $10,000 Ded. PERSONAL B ADV INJURY $1,000,000 X Pollution Included GENERAL AGGREGATE $2.000,000 GEN'L AGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY F PRO- LOD $ JECTB AUTOMOBILE LIABILITY X CA717952 COMBINED SINGLE LIMIT Ea accd 11000,000 en_g_ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS X NCS 90 X $10,000 $ A X UMBRELLA LIAB X OCCUR EGU2010748 09/01/1 09/01/12' EACH OCCURRENCE $ 5.000,000 i EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10,000 $ WORKERS COMPENSATION WC STATU- OR AND EMPLOYERS'LIABILITY IM T TH- ANY PROPRIETOR/PARTNEFIJEXECUTIVE YIN E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E L DISEASE-EA EMPLOYE $ If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ B Auto Physical Damage CA7179527 09 O1/1 09/01/12 Comp/Coll Ded. 2,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Included as Additional Insured and/or Loss Payee per the language provided in the attached policy endorsements, but Dial as respects to General Liability and Auto Liability arising from the Named Insured's operations: City of Rant 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 220 Fourth Ave 8 AUTHORIZED REPRESENTATIVE Kent, WA 98032 USA ©1988-2010 ACORD CORPORATION All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD mmmilleza 24407219 Northatal- Chemical, Inc. Policy #IRG201O724, pp 16 of 46, 24-25 of. 46 COVERAGE F 7- PROOUCTFi POLL UTION AND EXPOSURE LIABILITY 1.'v "'di Ii[fy I"fl P ',IW1', 14-01 ill,- rlStirkjj .,2'0',1.t4 1:10sly(+Ellis}Br.0 01 p,Y zi$ 112M.5 b(IG5ONe OI hudtly iillhr} prapc"y damage w rinv)rnnnienhll damugc inwiha) low" Pupation conditiuua Mnst't' t; your peuea.+ct )• nn.a+tle.l it, Or(, ptodui-)-, completed t+ilorati(Mi t hazard Sib '41 r,lyp (.lily '111Aev ;IoJM5, in,ii thu awwod in u"wz, Ionaliy hi)IWJ:Rd io on, as Io%9 hPrav,,,, Of i)odlly ullurq or property ,l irwipe rfndgla,fl hall 'swbol 1 ( allle;mlon of ,' 't Vroh )I W .,fll ,'I o, I'crlikk-', '+-'Its#„ t,l-lrrat: u. c11,ter tl(p ahu(I irQ'P your produe:I dtl,l Inr;,ph,(' 'ti del ptotluris cofllptstad )perkiliO m hdtard I COVtBAUF E 3 t.ONT€CAt;TUI1: POLLUTION LIABILITY +sir tAll pd', ' lrwn 'ha.' Lim Inqur,C) born-nau li•eldlly obligal'd Io ow, tao InraS t,1Cs,1IriP Of hochly ln)ury, ptopigly Ilaninge, M, onvlronmunial damage rf" ;itllpt Iroir put1tabn cumhhon9 n anal b, yea)," wnlc COVIFRAGE EA THANSPORIED CARGO 1L'r vn€t p,ip moat' "tans I1dl the ,nSUN3.11 I womeS WgoHV anhgatud to pray as lost, Swum- of buddy inluiy, ptup+:rty don-age w emkonmt:ntal Sl amaye fo<tdlu,cl ?I"nt ptaliulion t"oudthuns i(laud be' .in vcf ur'ent,e ON .'I win USASPnil 6D11 .at Caigo (;'OVFRA(ic F I'MRS61INCY RESPONSE COSTS Loa vwli pity emergency response costs rosulhng iron pollution i;t)r1CH60114, utatlSled by' la} 1104F, :.'77iohil or lu+lw, Iful'1 a houble HIO 110vided MWrIMIJ E I ',� pUlr•hde„ 1, it) your prodl.tri laovtdoo l',,''Jb'•+,IC' I, l a punnii,ed 4., yo"T v✓tort. mov.de:d Eaivt„age L1 is p{1it=h1b o. at 00 -ol trucur,enre tdonivi Me b on5portmhan li Ingo PiobrWo UoCeiiipe F -I iS pin(Jlebred Enn tUitiM y tespowne cons nitl5l zw Wat wMU%fq R 17'r Rt4wi 'anal 'Up"elf'd lu U6 Jtl'du) ilm 003, ;,mmd 'IP rG,3 na &G,o i prat ;to, evwJvnvy t(JSPonSc (13110 to 10, '1 rr'bro1 hf(l n, d't'<1ldMMV Alth Meow iV:. ,-,I dv, I t4 o mid +,! polluotl,) teand,mad'. inu:.i h' win%puoino wo wnton;i+::. hoot d.+' ';I uh,,P. M 9s, Instaav ",io cal 'hr ',lev,v') p I itPapl"<15 zilpial able li)Covi hatlo5 E i lhromil I",'I. , a ;a;G 'a11 rinmY, Elit1ntl .I ply rf di'Inle tht' irffitaFdl to 111e Px of ;,ppl(ablp ullrl7;r rflx)I7 Inve'+Fane of l rpi'fl+gl F I Ihfnloll, E I, 3116,MSt -,iltr 5l)R vtekrgl dwomy; in badly !Mug, urappily (iuteagrl t' ,9 U'luaa»ta?IItAI damage 'u,t1=,cr1. %v vw: We nU CIW7 !o UnNarw Me anwa.l upwo, ,n. out sl Kup One ..dl .4wh I,, ..1`'" ll.r g1�tf,'QW NOIS U& ,IPAY W :01y at t)Ld oil 0-1310u, 1hWSI1gA ' fill; CICLVJI"i C ah ON air, claim a still Ili..;nt.:•, ID"'dj, {3„a€ 1) ihf w t,un_ iv, mil pay K damagest is linumd ds duserd o In SECTION III LIMITS Of INSURtlNCi AND DI_DUCTIB I r,a,xl i2, Coo nTh, bnrl am to dirk-od ead Wiwn %".*) IItive used tap Inc, ,ioplicable hnit o1 t,lsw,air i to pv Ielv,1wiu 9d je,4IIII"ot5 I ;,r.L"':mP,IaS !,nde'r Czivemzjo 0 A or H, uludic al I.xuwlsvy ulliiE"r S,.Jta'raC)C G, 0" l0sH li t& I ( •4.*.,we& 13 DI I 10, ovwr ttb)1pown al hattl^u. to t',fy So T15 (I perion?a Sao" 0� IS txv,.ied iiflldSS e),phriiy' mt,vtdo l V), ootwfSUPFLttvIENIARY PAYMENTS COVERAGES A, PS .and It ih,t vinamme ai)pin<, it, bodily mliny,Property damage, Or fanvu0nmental dalul(ta 11'.Ir 11 (1) 111et hurhly in;tiry properly damage, or env+romulentdl damage IS cat+svd by d„ uamlrtonee Ina; w1up, plzitre In Iri„ COVef Oge 101`61eiy' dn(f W Iho bodily 111jury, properly danlatla a envirnnntanfal damage utr,nra dunked the IxI14ry wriod dud 01133 1 it,*1 Pale lip cl Q, (2) Property damage or environmental damage to property: (a) Owated, occupied of used by, Ib) Ranted to, in the care, custody or control of, or over v,Auch physical control is being exercised for any Purpose by you, any of your employees, volunteer workers, any partner or member (if you are a partnership or joint venture), or any marnber (if you are a lentwd liability company), b. Any person (other than your empioyee or volunteer worker) or any organization while acting as your real astatr. manager. c. Arty person or organization having proper temporary custody of your property it you die, but only. 11) With respect to linbility arising out of the maintenance or use of that property; aril 12) Until your legal representative has been appointed, d. Your legal representative if you die, but only viith respect to duties as such. That representative Wil have all Your rights and duties under this Policy. e. Any subsidiary, associated, affiliated or allied company or corporation, including subsidiauos thereot, of which you have more than 50% ownership interest as of the Inception date of this Policy 3. Any organization you newly acquire or form, other than a partnership, feint venture, or limited liability company, and over wtuch you maintain ownership or majority interest, wilt quality as a Named insuted if there is no outer sinutar insurance available to that organization However a. Coverage under this provision is afforded only(a) until the 180th day after you acquire or foii�i the organization or the and of the policy period, vvluchever is earlier, (b) provided that you give us mitten notification vo thin 180 day:, of the date of such acquisition or formation or tx:fore the end of the policy period, tirdrichever is earlier, and (c) an additional premtum to be charged at our discrotion, determined by the rates utilized at policy mcoption, is paid when due, b. Coverages A and r cto not apply to bodily injury, property damage, environmental damage or emergency response costs that occurred before you acquired or formed the organization, and c. Coverage 8 does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization 4. Any person or organization, other than a third party carrier, oath Main you agreed to au Jude as an insured, because of a mitten contract, written agreement or permit, but only vmth respect to bodily injury, property damage, environmental damage, emergency response costs or personal and advertising injury caused, in whole or in part, by your acts of omissions or the arts or omissions of those acting am your behalf, arising out of your oporations, your work, egwpment or premises leased, rented or owned by you, or your products which are distributed or sold in the regular course of a vendor's business, however: As respects vendoia, this insurance. (.lees not apply to- a. Bodily Injury, property damage, environmental damage or emergency response costs for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. I"his exclusion does not apply to liability for damages that the vendor would have in the absonce of the contract or agloentent, b Any express warranty unauthorized by you, 103124(10/0% Page 24 of 46 C14329 c. Any physical or chemical change in Ole product made intentionally by the vendor, d. Repackarting, except when unpacked solely for the purpose of inspoctiun, domonbtraton, testing, Or the SUhStitlilen of parts under instructions from the manufacturer, and then repackaged In tile, ouglnal comailler, e Any tailors to make: Such Inspections, adjustments, tests or servicing as tl'ie vendor hers agreed to make or normally undertakes to make in the usual course of b sinass, in connection with the distribution or sale of Ole products, f Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection vwth the sale of the product; g. Products Witch, after distribution or sale by you, have been labeled or relabeled Or used as a contarnor, part or ingredient of any other thing or substance by or for the vendor, or 1). Bodily injury, property damage, environmental damage or emergency response costs arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf, However, this exclusion does not apply to (1) The exceptions contained in Sub-paragraphs d. or f. above;or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to mako or normally undertakes to make it the usual course of business, in wrinuchon with the distribution or sale of the products As respacts a manager or lessor of premises, a lessor of leased equipment, or a mortgagee, assignee, or receiver, this insurance does not apply to ia) Any occurrence which takes place after the equipment lease expires or you cease to be a tenant. ib) Structural aHerabons, new construction or demolition operations performed by or oil behalf of the manager or lessor of premises, or rnartgagee, assignee, or ieceiver. S. Any person or organization that has at least a 50410 controlling interest in you but only with respect to bodily injury, property damage, environmental damage, emergency response costs or personal and advertising injury caused, in whole or in part, by your acts or omissions or the acts or orni mops of those acting on your bohaif, arlsing out of O)eir financial control of you. No person or organization is an insured tmth respect to the conduct of any current or past partnership, joint venture, or limited liability company unless a current or past partnership, faint venture, or limited liability company is an Insured pursuant to paragraphs 1. through 5. above. Applicable to Coverage D Each of die following * an insured under Coverage D. The Named Insured designated in the declarations and any past or present director, officer, partner, rnernbor or eniployee thereof, while acting within file Scapa of his or her duties as such and any customer with idiom you have agreed in miting to includo, prior to a claim being made or loss being incurred with respect to such customer, as an insured for foss ansing from your storage, handling, treatment, piocessing or disposal of their product or twiste on any insured property SECTION III - LIMITS OF INSURANCE AND DEDUCTIBLE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most M will pay regardless of the nuniher of: a. InSOOICI5; 103124 1 1 0/09) Page 26 of 46 C14329 i 4. Other Insurance Applicable to Coverages A, B and E If other valid and collectible insurance is available to the insured for damages or loss we, cuver under Coverages A, B or E of this Policy, our Obligations are limited as follows, a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we wit share wwth all that other insurance by the method descnhed in c. below Hovwver, regardless of Wiethei b, below applies, in Hie event that a written contract oi agrcennent or permit requires this insurance to be primary for any person or organization wth idiom you agreed to insure and such f person or ciganizatmon is an insured under this policy, vw writ not seek contributions from any sm.lt otnor tnsumance issued to such person or organization. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance,whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Binder's Risk, Installation Risk or stinilar coverage for your work: lb) That is Fire insurance for premises rantod to you or temporarily occupied by You with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you of temporarily uccupied by you will permission of the ovmmer, or (d) it the damages or loss arises out of Alto maintenance or use of aircraft, autos or watercraft to the: extent not subject to Exclusion g, of Coverage A (2) Any other insurance available to you covering liability for damages arising out of Hie premises or Operations for viohich you have boon added as an additional Insured by attachment of an endorsement. When His insurance is excess, we wi,l have no duty under Coverage A, 8 or E to defend the insured against any suit if any other Insurer has a duty to defend the insured against that suit If no other insurer defends, wa will undertake to do so, but we vall be entitled to the insured's rights against all those other insurers. When this insuranco is excess over other insurance, m wit pay only out share of the amount of the damages or toss, it any, that exceeds the sum of. (1) The total amount Hnat all such other insuranre would pay for Hie damages or loss in the absence of this insurance: and (2) The total of all deductible and self-insured amounts under all that other insurance. WP will share the remaining damages or loss, if any, with any oHiar insurance dial is not described to fits Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shows in the D", :arntions of tuns Policy. c. Method of Sharing If all of the other insurance penmas contribution by equal shares, we will follow this method also, Undor this 103124 11009f Page 30 of 46 Ct4329 ENDORSEMENT NO. 6 This endorsement,effective 1241 AM, SEPTEMBER1,2011 Forms apart of Policy No: EG 2010724 Issued to: NORTHSTAR CHEMICAL, INC By: CHARTIS SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US ENDORSEMENT This endorsement modlfles Insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM It is hereby agreed as lotioww SECTION IV- CONDITIONS, Paragraph 7.Transfer of Rights of Recovery Against Others to Us - Applicable to Coverages A. B, C and E is amended by the addition of the following at the end of such subparagraph: We waive any right of recovery we may have agairist tie person or organization shown in the Schedule belc-N because of payments we make under Coverage A, 8, C and E for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shovon in the Schedule below. SCHEDULE Name of Person or Organization: BLANKET BASIS WHERE REQUIRED BY WRITTEN CONTRACT. All other terms, condbons, and exclusions Shalt remain the same. AUTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 94283(3R7) PAGE 1 OF 1 C13021 OMB No, 2126-0008 Pubic Burden Statement Expiration Date 03/31/11 A Federal Agency may not conduot or sponsor,and a person is not required to respond to,nor shell a person be"set to a penafty for failure to comply wnh a collection of information subject to the requo.iinls of the Paperwork Reducton Act unless that collection of information displays a current vapd OMB Control Number The OMB central Number for this information collection is 2126-000e Public reporting for this collect on of information is estimated to be approximately 2 minutes per response,including the bras for mvmw,rg nstructione,gather ng the data needed and completing and renewing the collation of information AN responses to this collection of information are mandatory Send Lummeme regarding this burden estimate or arty other aspect of this caNecton of mformari mcludmg suggestions for reducing this burden to Informalmr Collection Clearance Officer Fai Motor Cartier Safely Administrat on,MC RRA,Wasrengton,D C 20590 C� U.S Department of Transportation ENDORSEMENT FOR Federal Motor Carrier MOTOR CARRIER POLICIES OF INSURANCE FOR PUBLIC LIABILITY Safety Administration UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Issued to NORTHSTAR CHEM I CAL I NC of E Dated at ES CA 90017 this I S 1 day of Amending Policy No CA 717-9S-27 Effective Date 09/01/2011 Name of Insurance Company COMMERCE INDUSTRY RANCE COMPANY Countersigned by Aulhoraed Company Representebve The policy to which this endorsement is attached provides primary or excess Insurance,as indicated by " XN",for the limits shown LJ V This insurance is primary and the company shall not be liable for amounts in excess of S 1 ,000 000 for each accident. Old F] This insurance is excess and the company shall not be liable for amounts in excess of$ for each accident in excess of the underlying limit of$ for each accident Whenever required by the Federal Motor Carrier Safety Administration (FMCSA),the company agrees to furnish the FMCSA a duplicate of sand policy and all its endorsements The company also agrees, upon telephone request by an authorized representative of the FMCSA,to verify that the policy is in force as of a particular date The telephone number to call is 05 83b_3394 Cancellation of this endorsement may be effected by the company or the Insured by giving (11 thirty-five (35) days notice In writing to the other party (said 35 days notice to commenue from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2)if the Insured is subject to the FMCSA's registration requirements under 49 U S C 13901, by providing thirty (30)days notice to the FMCSA(said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington, D C 1 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions Environmental Restoration means restitution for the loss, damage, which results in bodily Injury, property damage, or environmental or destruction of natural resources arising out of the accidental damage which the Insured neither expected nor intended discharge, dispersal, release or escape into or upon the land, Motor Vehicle means a land vehicle, machine, truck, tractor, atmosphere, watercourse, or body of water, of any commodity trailer, or semitrailer propelled or drawn by mechanical power and transported by a motor carrier This shall include the cost of used on a highway for transporting property, or any combination removal and the cost of necessary measures taken to minimize or thereof mitigate damage to human health, the natural environment, fish, Bodily Injury means injury to the body, sickness, or disease to any shellfish, and wildlife person,including death resulting from any of these Public Lmlib iy means liability for bodily injury, property damage, Property Damage means damage to or loss of e of tangible and environmental restoration Is property The insurance policy to which this endorsement is attached of, shall relieve the company from liability or from the payment of provides automobile liability insurance and is amended to assure any final judgment, within the limns of liability herein described, compliance by the insured, within the limns stated herein, as a irrespective of the financial condition, insolvency or bankruptcy of motor carrier of property, with Sections 29 and 30 Of the Motor the insured However, all terms, conditions, and limitations in the Carrier Act of 1980 and the rules and regulations of the Federal policy to which the endorsement is attached shall remain in full Motor Carrier Safety Administration(FMCSA) force and effect as binding between the insured and the company In consideration of the premium stated in the policy to which this The insured agrees to reimburse the company for any payment endorsement is attached, the insurer (the company) agrees to pay, made by the company on account of any accident, claim, or sun within the limits of liability described herein, any final judgment involving a breach of the terms of the policy, and for any payment recovered against the insured for public liability resulting from that the company would not have been obligated to make under negligence in the operation, maintenance or use of motor vehicles the provisions of the policy except for the agreement contained in subject to the financial responsibility requirements of Sections 29 this endorsement Sr and 30 of the Motor Carrier Act of 1980 regardless of whether or It is further understood and agreed that, upon failure of the not each motor vehicle is specifically described in the policy and company to pay any final judgment recovered again the insured as fs whether or not such negligence occurs on any route or in any provided herein, the judgment creditor may maintain an action in ,s territory authorized to be served by the insured or elsewhere Such any court of competent jurisdiction against the company to compel insurance as is afforded, for public liability,does not apply to injury such payment to or death of the insured's employees while engaged in the course The limits of the company's lability for the amounts prescribed in of their employment, or property transported by the insured, this endorsement apply separately to each accident and any designated as cargo It is understood and agreed that no condition, payment under the policy because of any one accident shall not provision, stipulation, or limitation contained in the policy, this operate to reduce the liability of the company for the payment of endorsement,or any other endorsement thereon,or violation there- final judgments resulting from any other accident THE SCHEDULE OF LIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE The limits shown in the schedule are for information purposes only ) Form MCS-90 (page 1 of 2) SCHEDULE OF LIMITS--PUBLIC LIABILITY Type of carnage Commodity transported Jan 1, 1985 (1) For-hire (In interstate or foreign commerce, with a Property(nonhazardous) S 750,000 gross vehicle weight rating of 10,000 or more po- unds) 12) For-hire and Private (In interstate, foreign or intr- Hazardous substances, as defined in 49 CFR 171 S. astate commerce, with gross vehicle weight ra- transported in cargo tanks, portable tanks, or hopper- S 5,000,000 Ling of 10,000 or more pounds) type vehicles with capacities in excess of 3,500 water gallons, or in bulk Division 1 1 , 1 2, and 1 3 materials Division 2 3, Hazard Zone A, or Division 6 1, Packing Group I, Hazard Zone A material, in bulk Division 2 1 or 2 2, or highway route controlled quantities of a Class 7 material,as defined in 49 CFR 173 403 (3) For-hire and Private (In interstate or foreign com- Od listed in 49 CFR 172 101, hazardous waste, haz- 1 merce, in any quantity, or in intrastate commerce, ardous materials, and hazardous substances defined in S 1,000,000 in bulk only, with a gross vehicle weight rating of 49 CFR 171 8 and listed in 49 CFR 172 101, but not 10,000 or more pounds), mentioned in(2)above or(4)below 14) For-hire and Private (1n interstate or foreign Any quantity of Division 1.1, 1.2, or 1 3 material, any commerce, with a gross vehicle welght rating of quantity of a Division 2 3, Hazard Zone A, or Division $ 5,000,000 less than 10,000 pounds) 6 1, Packing Group 1, Hazard Zone A material or high- way route controlled quantities of a Class 7 material as defined in 49 CFR 173 403 Form MCS-90 (page 2 of 2) POLICY NUMBER: CA 717-95-27 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following. BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below Endorsement Effective- 09/01/2011 Countersigned By: Named Insured: NORTHSTAR CHEMICAL, INC (Authorized Representative) SCHEDULE Name of Person(s)or Organization(s): Any person or organization for whom you are contractually bound to provide Additional Insured status but only to the extent of such person or organizations liability arising out of the use of covered auto. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to the endorsement.) Each person or organization shown in the Schedule 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 contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: CA 717-95-27 COMMERCIAL AUTO CA 20 01 03 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below Named insured: NORTHSTAR CHEMICAL, INC Endorsement Effective Date: 09/01/2011 Countersignature Of Authorized Representative Name: Title: Signature- Date: SCHEDULE Insurance Company: COMMERCE AND INDUSTRY INSURANCE COMPANY Policy Number: CA 717-95-27 Effective Date: 09101/2011 Expiration Date: 09/01 /2012 Named Insured: NORTHSTAR CHEMICAL, INC Address- 14200 SW TUALATIN SHERWOOD RD SHERWOOD, OR 97140-9706 CA 20 01 03 06 0 ISO Properties, Inc 2005 Page 1 of 3 ❑ Additional Insured BLANKET WHERE REQUIRED BY A WRITTEN CONTRACT (Lessor): OR AGREEMENT Address: Designation or Description of "Leased Autos": ALL COVERED VEHICLES LEASED BY THE NAMED INSURED Coverages Limit Of Insurance Liability $1 ,000,000 Each "Accident" Comprehensive Actual Cash Value Or Cost Of Repair Whichever is Less, Minus $1 ,000 Deductible For Each Covered "Leased Auto" Collision Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus $1 ,000 Deductible For Each Covered "Leased Auto" Specified Causes of Loss Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Deductible For Each Covered "Leased Auto" (If no entry appears above, information required to complete this endorsement will be shown in the Dec- larations as applicable to this endorsement ) Additional Insured (Lessor): BLANKET WHERE REQUIRED BY WRITTEN CONTRACT Address: Designation or Description of "Leased Autos": ALL COVERED AUTOS LEASED TO THE NAMED INSURED Coverages Limit Of Insurance Liability $1 000,000 Each "Accident" Comprehensive Actual Cash Value Or Cost Of Repair Whichever is Less, Minus $ 2.000 Deductible For Each Covered "Leased Auto" Collision Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus $ 2,000 Deductible For Each Covered "Leased Auto" Specified Causes of Loss Actual Cash Value Or Cast Of Repair Whichever Is Less, Minus $25 Deductible For Each Covered "Leased Auto" (If no entry appears above, information required to complete this endorsement will be shown in the Dec- larations as applicable to this endorsement.) CA 20 01 03 06 0 ISO Properties, Inc ,2005 Page 2 of 3 A. Coverage and the lessor named in this endorsement 1. Any "leased auto" designated or described for "loss" to a "leased auto" in the Schedule will be considered a covered 2. The insurance covers the interest of the "auto" you own and not a covered "auto" lessor unless the "loss" results from fraud- you hire or borrow. ulent acts or omissions on your part. 2. For a "leased auto" designated or described 3 If we make any payment to the lessor, we in the Schedule, Who Is An Insured is will obtain his or her rights against any other changed to include as an "insured" the party lessor named in the Schedule However, the C. Cancellation lessor is an 'insured" only for "bodily injury" or "property damage" resulting from the acts 1. If we cancel the policy, we will mail notice or omissions by. to the lessor to accordance with the Can- a. You; collation Common Policy Condition b. Any of your "employees" or agents; or 2. If you cancel the policy, we will mad notice to the lessor c. Any person, except the lessor or any 3. Cancellation ends this agreement "employee" or agent of the lessor, op- erating a "leased auto" with the per- D. The lessor is not liable for payment of your mission of any of the above premiums. 3. The coverages provided under this endorse- E. Additional,Definition ment apply to any "leased auto" described in As used in this endorsement: the Schedule until the expiration date shown "Leased auto" means an "auto" leased or in the Schedule, or when the lessor or his or rented to you, including any substitute, re- her agent takes possession of the "leased placement or extra "auto" needed to meet auto", whichever occurs first, seasonal or other needs, under a leasing or B. Loss Payable Clause rental agreement that requires you to provide 1. We will pay, as interest may appear, you direct primary insurance for the lessor CA 20 01 03 06 0 ISO Properties, Inc.,2005 Page 3 of 3 ❑