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HomeMy WebLinkAboutPW11-347 - Original - System Interface, Inc. - Guiberson Corrison Control Facility Upgrade Programming & Commissioning Services - 11/21/2011 x� —a 4eTMs g+ �3 Sw Records M i�eme�r � 1 KENT Document WASHINGTON -e�5_ � 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: Systems Interface Inc. Vendor Number: ID Edwards Number Contract Number: EGA t L ,3(-( 7 This is assigned by City Clerk's Office Project Name: Guiberson Corrison Control Facility Upgrade Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: 11-21- 11 Contract Effective Date: Date of the Mayor's Signature Termination Date: 12/31/12 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Dave Brock Department: PW Operations Detail: (i.e. address, location, parcel number, tax id, etc.): Provide-programmmci and commissioning services for the project. _ _v _ CKL IIIrS� II S'Publlc\Records Management\Forms\ContractCover\adcc7832 1 11/08 • KEN T CONSULTANT SERVICES AGREEMENT between the City of Kent and Systems Interface Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Systems Interface Inc. organized under the laws of the State of Washington, located and doing business at 22125 17`h Ave. SE, Suite 111, Bothell, WA 98021- 7406, Phone: (425) 481-1225/Fax: (425) 481-2115, Contact: Robert Schommer (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide programming and commissioning services for the Guiberson Corrosion Control Facility Upgrade project. For a description, see the Consultant's July 15, 2011 Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Upon the effective date of this Agreement, Consultant shall complete the work described in Section I by December 31 2012. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Sixteen Thousand, Three Hundred Fifty Dollars ($16,350.00), plus applicable Washington State sales tax, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. CONSULTANT SERVICES AGREEMENT - 1 (Over$10,000) B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant 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. 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 Consultant 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 Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant 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 Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant 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. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor 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. Consultant shall execute the attached City of Kent Equal Employment CONSULTANT SERVICES AGREEMENT - 2 (Over$10,000) Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant 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 Consultant'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 Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'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 Consultant 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 Consultant's part, then Consultant 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 Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant 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. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The City's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work CONSULTANT SERVICES AGREEMENT - 3 (Over$10,000) authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant 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 Consultant's own risk, and Consultant 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. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by 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 VII 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 Consultant. 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 CONSULTANT SERVICES AGREEMENT - 4 (Over$10,000) 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 Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. 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. CONSULTANT: CITY OF KENT: By: 1`- v-x By: < 4� L (signature) (signature) Print Name: $,P-,C KM 01— Pri(tNa)4ua zette Cooke Its V t cE PR�c Its or (rya ) DATE: 10� 7.4 lLp{t DATE: !/ o2r !/ NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Robert Schommer Timothy J. LaPorte, P.E. Systems Interface Inc. City of Kent 22125 17"' Ave. SE, Suite 111 220 Fourth Avenue South Bothell, WA 98021-7406 Kent, WA 98032 (425) 481-1225 (telephone) (253) 856-5500 (telephone) (425) 481-2115 (facsimile) (253) 856-6500 (facsimile) APPROVED AS TO FORM: K t Law Department Systems Interface-Gwbeson/Brock CONSULTANT SERVICES AGREEMENT - 5 (Over$10,000) 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 2 TA- day of ©CTO(° IEYL , 20�. By: �aQi ScHdr�ME12 For: (M'T 5 I �J 1M(W le I n1C. Title: Vt(le Date: 10 1 2y LZo�1 EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 I SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this pro?ect by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Systems Interface Inc. Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as Guiberson Corrosion Control Facility Warade that was entered into on the November 21, 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. Sr Dated this day of C7 gEiE 201 2 . By: S�t4aw4>ctt For. S`�SSp lN� -�FCE 1t.�L Title: Date, EEO COMPLIANCE DOCUMENTS - 1 Systems Interface Inc. 22125 17thAvenue SE•Surte 111 •Bothell,Washington 98021-7406•USA•Tel 425 481 1225•Fax 425 481 2115•www systems-interface corn EXHIBIT A David Brock, P E July 15i", 2011 City of Kent S111315 5821 South 240" Street Kent, Washington 98032 Re City of Kent, Guiberson Corrosion Control Facility Upgrade Project- Professional Services Dear Mr Brock, Thank you for the opportunity to provide Professional Engineering services for the City of Kent Systems Interface proposes to provide programming and commissioning services for the City of Kent, Guiberson Corrosion Control Facility Upgrade project Our scope of supply for this project includes • Engineering services to program and test the new Siemens S7-315-2DP PLC system that will be utilized at the Guiberson Corrosion Control Facility The City of Kent standard programming library and methodologies will be utilized Engineering services to program the Operator Interface Touchscreen Unit Standardized City of Kent User Interface screens and functionality will be utilized • Preparation of a Detailed Software Design Submittal with annotated PLC Program Listings, Operator Interface Screen Pictures, and Database Configuration for City Review and Approval • Attendance at a Software Design Meeting with the City to review the functionality of the station and the Software Design Submittal • Configure, commission, and test radio telemetry communications from this site to the headquarters • Provide program interface documentation to the City to allow for the proper integration of this new site with the headquarters radio telemetry, SCADA, and Siemens S7-400 systems • Provide on-site technical services for inspections, system commissioning, witnessed acceptance testing, and as-built documentation We can break the above scope items into 3 phases Phase 1 Programming of the PLC and Operator Interface Unit Phase 2 Configure, test, and document the radio telemetry systems to properly communicate to the Headquarters Phase 3 On-site startup, testing, training, and as-built documentation Below is the price break-out for each of the phases and total proposed Not-To-Exceed budgets PHASE 1: Program PLC and OIU Description Rate/hr Est.Hrs Total Project Manager & Professional Engineer $105 3 $315 Project Engineer(incl programming) $98 72 $7,056 Admin Support(documentation) $55 2 $110 Project expenses (mail, binders,supplies, mileage, etc ) $100 Contingency (control strategy revisions, reviews, revising $98 6 $588 designs) TOTAL: $8,169 Fax 253-856-6600 Systems Interface Inc. 22125 17thAvenue SE a Suite 111 • Bothell,Washington 98021-7406• USA•Tel 425 481 1225• Fax 425 481 2115 •www systems-interface com PHASE 2: Telemetry and Radio Interface Description Ratelhr Est.Hrs Total Project Manager& Professional Engineer $105 1 $105 Project Engineer(Radio Config, HQ telemetry Interface) $98 16 $1,568 Project expenses (mad, docs, supplies, mileage, etc) $50 Contingency (control strategy revisions, reviews, revising $98 4 $392 designs) TOTAL: $2,115 PHASE 3: On-site Testing, Commissioning &Training Description Ratelhr Est.Hrs Total Project Manager & Professional Engineer $105 2 $210 Project Engineer(Testing, Tuning, etc) $98 44 $4,312 Admin Support (copying &transmit As-Built docs) $55 2 $110 Drafting (as-Built Documentation) $65 6 $390 Project expenses (copies, supplies, mileage, etc ) $260 Contingency(revising designs, added scope of work, etc) $98 8 $784 TOTAL: $6,066 We propose that we bill the City of Kent on a Time and Material basis with a Not-To-Exceed Professional Services contract value of$16,350 Systems Interface will invoice only for actual time spent on the project and not exceed the maximum contract value, while guaranteeing to provide all agreed upon scope of work items We would invoice the City on a monthly basis with timecard and expense information attached Delivery of the Detailed Software Design Submittal documents would be approximately five to six weeks from receipt of a Notice to Proceed, all other phases of the project (such as on-site testing and startup) will be coordinated with the City and Contractors involved in the manufacturing and installing the new control and telemetry systems Thank you again for the opportunity to work again with the City of Kent Please call with any questions Sincerely, Systems Interface Inc. Robert H Schommer, P E Vice President email rhs@systems-interface com Fax 253-856-6600 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant 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 Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01. The City shall be named as an Additional Insured under the Consultant'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 Consultant 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. 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: EXHIBIT B (Continued) 1. The Consultant'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 Consultant's insurance and shall not contribute with it. 2. The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant 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 Consultant'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 ANII. E. Verification of Coverage Consultant 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 Consultant before commencement of the work. F. Subcontractors Consultant 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 Consultant. Client#:27700 SYSTINT ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE 1014/2024/20`11YY) 11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREII 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 CONTACT NAME Bell-Anderson Ins-Renton C/L PHONE 425 291-5200 AX 4252915100 A/C No Est A/C,No 600 SW 39th Street,Suite 200 E-MAIL ADDRESS Renton,WA 98057 INSURER(S)AFFORDING COVERAGE NAIL if 425 291-5200 INSURER A The Travelers Property&Cas Co INSURED INSURER B Travelers Property Casualty Co Systems Interface,Inc. INSURER C Travelers Property Cas Co of Am 22125 17th Ave SE#111 INSURER D Travelers Indemnity Co. Bothell,WA 98021-7406 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS II NTRR TYPE OF INSURANCE NSR WVD POLICY NUMBER ADDLSUBR MM/DDY MMIDDfYEYVY LIMITS A GENERAL LIABILITY x 6309357NO7A 10/0112011 10/0112012 EACH OCCURRENCE _ $1000000 X COMMERCIAL GENERAL LIABILITY PREMISESOE.RENTED nee $300,000 CLAIMS-MADE F7x OCCUR MED EXP(Any one person) $10 000 PERSONAL B A_DV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2,000,000 POLICY 7 PE LOC $ D AUTOMOBILE LIABILITY BA9361 N07A 10/01/2011 1010112012 COMBINED SINGLE LIMIT 1,000,000 Ea accident) ___ 1_ X ANY AUTO BODILY INJURY(Per person) $ .ALL OWN ED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON OWNED PROPERTY DAMAGE $ AUTOS Per acmdani B UMBRELLA LIAR X OCCUR CUP9357N07A 0/01/2011 10/01/201 EACH OCCURRENCE $1 O00 000 �( EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DEC) X RETENTION$10000 $ WORKERS COMPENSATION 6309357NO7A 0/0112011 10101/2012 WC 6TO MI OTH- AND EMPLOYERS'LIABILITY YIN A ANY PROPRIETORIPARTNERJEXECUTIVE (WA Stop Gap) EL EACH ACCIDENT $1,000,000 D'+ N N I A CIrRCERIMEMBER EXCLUDE (Mandatory in NH) EL DISEASE-EA EMPLOYEE $1,000,000 + If yes describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000 C Professional TE08401647 10/01/2011 10/01/2012 $1,000,000 Each Agg Liability $1,000,000 Each Claim $10,000 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE Prolect#S71G15 City of Kent is additional insured for general liability, but only if required by written contract or written agreement per the attached endorsement CGD417 0708 CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Nancy Yoshitake ACCORDANCE WITH THE POLICY PROVISIONS 400 West Gowe Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2D10 ACORD CORPORATION.All rights reserved ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S353688/M351503 PLJ COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TECHNOLOGY XTEND ENDORSEMENT This endorsement modifies insurance provided under the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement The following listing is a general cover- age description only Limitations and exclusions may apply to these coverages Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered A. Reasonable Force Property Damage — Exception J. Blanket Additional Insured — Lessors Of Leased To Expected Or Intended Injury Exclusion Equipment B. Non-Owned Watercraft Less Than 75 Feet K. Blanket Additional Insured — Persons Or Organi- C. Aircraft Chartered With Pilot zations For Your Ongoing Operations As Re- quired By Written Contract Or Agreement D. Damage To Premises Rented To You L. Blanket Additional Insured—Broad Form Vendors E. Increased Supplementary Payments M. Who Is An Insured—Unnamed Subsidiaries F. Who Is An Insured — Employees And Volunteer Workers—First Aid N. Who Is An Insured — Liability For Conduct Of Un- named Partnerships Or Joint Ventures G. Who Is An Insured — Employees — Supervisory O. Contractual Liability—Railroads Positions H. Who Is An Insured — Newly Acquired Or Formed P. Knowledge And Notice Of Occurrence Or Offense Organizations Q Unintentional Omission I. Blanket Additional Insured — Owners, Managers R. Blanket Waiver Of Subrogation Or Lessors Of Premises PROVISIONS of SECTION I — COVERAGES — COVERAGE A A. REASONABLE FORCE PROPERTY DAMAGE— BODILY INJURY AND PROPERTY DAMAGE EXCEPTION TO EXPECTED OR INTENDED IN- LIABILITY JURY EXCLUSION (2) A watercraft you do not own that is: The following replaces Exclusion a , Expected Or (a) Less than 75 feet long, and Intended Injury, in Paragraph 2., of SECTION I— (b) Not being used to carry any person or COVERAGES — COVERAGE A BODILY IN- property for a charge JURY AND PROPERTY DAMAGE LIABILITY C. AIRCRAFT CHARTERED WITH PILOT a. Expected Or Intended Injury Or Damage The following is added to Exclusion g , Aircraft, "Bodily Injury" or"property damage" expected Auto Or Watercraft, in Paragraph 2 of SECTION or Intended from the standpoint of the in- I — COVERAGES — COVERAGE A BODILY IN- sured This exclusion does not apply to "bod- JURY AND PROPERTY DAMAGE LIABILITY ily Injury" or "property damage" resulting from the use of reasonable force to protect any This exclusion does not apply to an aircraft that person or property is B. NON-OWNED WATERCRAFT LESS THAN 75 (a) Chartered with a pilot to any insured; FEET (b) Not owned by any insured, and The following replaces Paragraph (2) of Exclusion (c) Not being used to carry any person or prop- g , Aircraft, Auto Or Watercraft, in Paragraph 2. erty for a charge CG D4 17 07 08 ©2008 The Travelers Companies, Inc Page 1 of 6 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY D. DAMAGE TO PREMISES RENTED TO YOU 5. The following is added to the DEFINITIONS 1. The first paragraph of the exceptions in Ex- Section clusion t , Damage To Property, in Para- "Premises damage" means "property dam- graph 2. of SECTION I — COVERAGES — age" to COVERAGE A BODILY INJURY AND a. Any premises while rented to you or tem- PROPERTY DAMAGE LIABILITY is deleted porarily occupied by you with permission 2. The following replaces the last paragraph of of the owner, or Paragraph 2 , Exclusions, of SECTION I — b. The contents of any premises while such COVERAGES - COVERAGE A BODILY IN- premises is rented to you, if you rent such JURY AND PROPERTY DAMAGE LIABIL- premises for a period of seven or fewer ITY consecutive days Exclusions c., g. and h., and Paragraphs (1), 6. The following replaces Paragraph 4.b.(1)(b) (3) and (4) of Exclusion f., do not apply to of SECTION IV — COMMERCIAL GENERAL "premises damage" Exclusion f.(1)(a) does LIABILITY CONDITIONS not apply to "premises damage" caused by fire unless Exclusion f. of Section I — Cover- (b) That is insurance for "premises damage", age A — Bodily Injury And Property Damage or Liability is replaced by another endorsement 7. Paragraph 4.b.(1)(c) of SECTION IV — to this Coverage Part that has Exclusion —All COMMERCIAL GENERAL LIABILITY CON- Pollution Injury Or Damage or Total Pollution DITIONS is deleted Exclusion in its title A separate limit of insur- E. INCREASED SUPPLEMENTARY PAYMENTS ance applies to "premises damage" as de- scribed in Paragraph 6 of Section III — Limits 1. The following replaces Paragraph 1 b of Of Insurance SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- ' 3. The following replaces Paragraph 6. of SEC- AGES TION III— LIMITS OF INSURANCE b. Up to $2,500 for cost of ball bonds re- 6. Subject to 5. above, the Damage To quired because of accidents or traffic law Premises Rented To You Limit is the violations arising out of the use of any most we will pay under Coverage A for vehicle to which the Bodily Injury Liability damages because of "premises damage" Coverage applies We do not have to fur- to any one premises nish these bonds The Damage To Premises Rented To 2, The following replaces Paragraph 1.d. of You Limit will be SUPPLEMENTARY PAYMENTS — COVER- a. The amount shown for the Damage AGES A AND B of SECTION I — COVER- To Premises Rented To You Limit on AGES the Declarations of this Coverage d. All reasonable expenses incurred by the Part, or insured at our request to assist us in the b. $100,000 if no amount is shown for investigation or defense of the claim or the Damage To Premises Rented To "suit", including actual loss of earnings up You Limit on the Declarations of this to $500 a day because of time off from Coverage Part work 4. The following replaces Paragraph a. of the F. WHO IS AN INSURED — EMPLOYEES AND definition of "insured contract" in the DEFINI- VOLUNTEER WORKERS—FIRST AID TIONS Section 1. The following is added to the definition of"oc- a. A contract for a lease of premises How- currence" in the DEFINITIONS Section ever, that portion of the contract for a Unless you are in the business or occupation lease of premises that indemnifies any of providing professional health care services, person or organization for "premises "occurrence" also means an act or omission damage" is not an "insured contract", committed by any of your "employees" or "volunteer workers", other than an employed Page 2 of 6 ©2008 The Travelers Companies, Inc CG D417 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY or volunteer doctor, in providing or falling to or in which you maintain the majority provide first aid or"Good Samaritan services" ownership Interest, will qualify as a to a person Named Insured if there is no other msur- 2. The following is added to Paragraph 2.a.(1) of ance which provides similar coverage to SECTION II—WHO IS AN INSURED that organization However Unless you are in the business or occupation a. Coverage under this provision is af- of providing professional health care services, forded only Paragraphs (1 )(a), (b), (c) and (d) above do (1) Until the 180th day after you ac- not apply to "bodily injury" arising out of pro- quire or form the organization or viding or failing to provide first aid or "Good the end of the policy period, Samaritan services" by any of your "employ- whichever is earlier, if you do not ees" or "volunteer workers", other than an report such organization in writing employed or volunteer doctor Any of your to us within 180 days after you "employees" or "volunteer workers" providing acquire orform it, or or failing to provide first aid or"Good Samari- (2) Until the end of the policy period, tan services" during their work hours for you when that date is later than 180 will be deemed to be acting within the scope days after you acquire or form of their employment by you or performing du- such organization, if you report ties related to the conduct of your business such organization in writing to us 3. The following is added to Paragraph 5. of within 180 days after you acquire SECTION III —LIMITS OF INSURANCE or form it, and we agree in writing For the purposes of determining the applica- that it will continue to be a ble Each Occurrence Limit, all related acts or Named Insured until the end of omissions committed by any of your "employ- the policy period, ees" or "volunteer workers" in providing or b. Coverage A does not apply to "bodily failing to provide first aid or "Good Samaritan injury" or "property damage" that oc- services" to any one person will be deemed to curred before you acquired or formed be one "occurrence" the organization, and 4. The following is added to the DEFINITIONS c. Coverage B does not apply to "per- Section sonal injury" or "advertising injury" "Good Samaritan services" means any emer- arising out of an offense committed gency medical services for which no compen- before you acquired or formed the sation is demanded or received organization G. WHO IS AN INSURED — EMPLOYEES — SU- I. BLANKET ADDITIONAL INSURED —OWNERS, PERVISORY POSITIONS MANAGERS OR LESSORS OF PREMISES The following is added to Paragraph 2.a.(1) of The following is added to SECTION II —WHO IS SECTION II—WHO IS AN INSURED AN INSURED Paragraphs (1)(a), (b) and (c) above do not apply Any person or organization that is a premises to "bodily injury" or "personal injury" to a co- owner, manager or lessor is an insured, but only "employee" in the course of the co-"employee's" with respect to liability arising out of the owner- employment by you arising out of work by any of ship, maintenance or use of that part of any prem- your "employees" who hold a supervisory posi- ises leased to you tion The insurance provided to such premises owner, H. WHO IS AN INSURED — NEWLY ACQUIRED manager or lessor does not apply to OR FORMED ORGANIZATIONS a. Any "bodily injury" or "property damage" The following replaces Paragraph 4. of SECTION caused by an "occurrence" that takes place, II—WHO IS AN INSURED or "personal injury" or "advertising injury" 4. An organization caused by an offense that is committed, after y g you newly acquire or you cease to be a tenant in that premises, or form, other than a partnership or joint venture, of which you are the sole owner CG D4 17 07 08 ®2008 The Travelers Companies, Inc Page 3 of 6 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY b. Structural alterations, new construction or Any person or organization that is a vendor and demolition operations performed by or on be- that you have agreed in a written contract or half of such premises owner, manager or les- agreement to Include as an additional insured on sor this Coverage Part is an Insured, but only with re- J. BLANKET ADDITIONAL INSURED — LESSORS spect to liability for "bodily injury" or "property OF LEASED EQUIPMENT damage"that The following is added to SECTION II —WHO IS a. Is caused by an "occurrence"that takes place AN INSURED after you have signed and executed that con- tract or agreement, and Any person or organization that is an equipment lessor is an Insured, but only with respect to liabil- b. Arises out of "your products" which are dis- ity for "bodily injury", "property damage", "per- tributed or sold in the regular course of such sonal injury" or "advertising injury" caused, in vendor's business whole or in part, by your acts or omissions in the The insurance provided to such vendor is subject maintenance, operation or use by you of equip- to the following provisions ment leased to you by such equipment lessor a. The limits of Insurance provided to such ven- The insurance provided to such equipment lessor dor will be the limits which you agreed to pro- does not apply to any "bodily injury" or "property vide in the written contract or agreement, or damage" caused by an "occurrence" that takes the limits shown in the Declarations, which- place, or "personal injury" or "advertising injury" ever are less caused by an offense that is committed, after the b. The insurance provided to such vendor does equipment lease expires not apply to K. BLANKET ADDITIONAL INSURED— PERSONS (1) Any express warranty not authorized by OR ORGANIZATIONS FOR YOUR ONGOING you, OPERATIONS AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT (2) Any change in "your products" made by such vendor, The following is added to SECTION II —WHO IS AN INSURED (3) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, Any person or organization that is not otherwise testing, or the substitution of parts under an Insured under this Coverage Part and that you instructions from the manufacturer, and have agreed in a written contract or agreement to then repackaged in the original container, include as an additional insured on this Coverage Part is an insured, but only with respect to liability (4) Any failure to make such inspections, ad- for"bodily injury"or"property damage"that justments, tests or servicing as vendors a. Is caused b an "occurrence"that takes lace agree to perform or normally undertake to Y P perform in the regular course of business, after you have signed and executed that con- in connection with the distribution or sale tract or agreement, and of"your products", b. Is caused, in whole or in part, by your acts or (5) Demonstration, installation, servicing or omissions in the performance of your ongoing repair operations, except such operations operations to which that contract or agree- performed at such vendor's premises in ment applies or the acts or omissions of any connection with the sale of "your prod- person or organization performing such op- ucts", or erations on your behalf (8) "Your products" which, after distribution The limits of insurance provided to such insured or sale by you, have been labeled or re- will be the limits which you agreed to provide in labeled or used as a container, part or in- the written contract or agreement, or the limits gredient of any other thing or substance shown in the Declarations, whichever are less by or on behalf of such vendor L. BLANKET ADDITIONAL INSURED — BROAD Coverage under this provision does not apply to FORM VENDORS a. Any person or organization from whom you The following Is added to SECTION II — WHO IS AN INSURED have acquired "your products", or any ingre- Page 4 of 6 ©2008 The Travelers Companies,Inc CG D4 17 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY dient, part or container entering Into, accom- P. KNOWLEDGE AND NOTICE OF OCCUR- panying or containing such products, or RENCE OR OFFENSE b. Any vendor for which coverage as an addi- The following is added to Paragraph 2., Duties In tional Insured specifically is scheduled by en- The Event of Occurrence, Offense, Claim or dorsement Suit, of SECTION IV — COMMERCIAL GEN- M. WHO IS AN INSURED — UNNAMED SUBSIDI- ERAL LIABILITY CONDITIONS. ARIES e. The following provisions apply to Paragraph The following is added to SECTION II — WHO IS a. above, but only for the purposes of the in- AN INSURED surance provided under this Coverage Part to you any Insured fisted In Paragraph 1 or 2. of Se Any of your subsidiaries, other than a partnership c ction II—Who Is An Insured or joint venture, that is not shown as a Named In- sured in the Declarations is a Named Insured if (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- a. You maintain an ownership Interest of more than 50% in such subsidiary on the first day is only after the "occurrence" or offense of the policy period, and s known to you (if you are an individual), any of your partners or members who is b. Such subsidiary is not an insured under simi- an individual (if you are a partnership or lar other Insurance joint venture), any of your managers who No such subsidiary is an insured for"bodily injury" is an individual (If you are a limited liability or "property damage" that occurred, or "personal company), any of your trustees who is an injury" or "advertising injury" caused by an of- individual (if you are a trust), any of your fense committed "executive officers" or directors (if you are an organization other than a partnership, a. Before you maintained an ownership interest joint venture, limited liability company or of more than 50% in such subsidiary, or trust) or any "employee" authorized by b. After the date, If any, during the policy period you to give notice of an "occurrence" or that you no longer maintain an ownership in- offense terest of more than 50% in such subsidiary 2( ) If you are a partnership,Point venture, Ilm- N. WHO IS AN INSURED — LIABILITY FOR CON- ited liability company or trust, and none of DUCT OF UNNAMED PARTNERSHIPS OR your partners, joint venture members, JOINT VENTURES managers or trustees are Individuals, no- The following replaces the last paragraph of tice to us of such "occurrence" or offense SECTION II—WHO IS AN INSURED must be given as soon as practicable only No person or organization is an Insured with re- after the "occurrence"or offense is knownby spect to the conduct of any current or past part- nership or joint venture that is not shown as a (a) Any individual who is: Named Insured In the Declarations This para- (I) A partner or member of any part- graph does not apply to any such partnership or nership or joint venture, joint venture that otherwise qualifies as an in- (ii) A manager of any limited liability sured under Section II—Who Is An Insured company, O. CONTRACTUAL LIABILITY—RAILROADS (III) A trustee of any trust, or 1. The following replaces Paragraph c. of the (iv)An executive officer or director of definition of "insured contract" in the DEFINI- any other organization, TONS Section that is your partner, joint venture c. Any easement or license agreement, member, manager or trustee, or 2. Paragraph f.(1) of the definition of "insured (b) Any "employee" authorized by such contract" in the DEFINITIONS Section is de leted partnership, joint venture, limited II- ability company, trust or other organi- zation to give notice of an "occur- rence"or offense CG D4 17 07 08 m 2008 The Travelers Companies, Inc Page 5 of 6 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY (3) Notice to us of such "occurrence" or of- The unintentional omission of, or unintentional fense will be deemed to be given as soon error in, any Information provided by you which as practicable if it is given in good faith as we relied upon in Issuing this policy will not preju- soon as practicable to your workers' dice your rights under this Insurance However, compensation insurer This applies only if this provision does not affect our right to collect you subsequently give notice to us of the additional premium or to exercise our rights of "occurrence" or offense as soon as prac- cancellation or nonrenewal in accordance with ticable after any of the persons described applicable insurance laws or regulations in Paragraphs a (1) or (2) above discov- R. BLANKET WAIVER OF SUBROGATION ers that the "occurrence" or offense may result in sums to which the Insurance The following is added to Paragraph 8., Transfer provided under this Coverage Part may Of Rights Of Recovery Against Others To Us, apply of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS However, if this policy includes an endorse- ment that provides limited coverage for "bod- If the insured has agreed in a contract or agree- ily Injury" or "property damage" or pollution ment to waive that insured's right of recovery costs arising out of a discharge, release or against any person or organization, we waive our escape of "pollutants" which contains a re- right of recovery against such person or organiza- quirement that the discharge, release or es- tion, but only for payments we make because of cape of "pollutants" must be reported to us a. "Bodily injury" or "property damage" caused within a specific number of days after its by an "occurrence"that takes place, or abrupt commencement, this Paragraph e. b. "Personal injury" or "advertising injury" does not affect that requirement caused by an offense that Is committed, Q. UNINTENTIONAL OMISSION subsequent to the execution of the contract or The following is added to Paragraph 6., Repre- agreement sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS Page 6 of 6 ©2008 The Travelers Companies, Inc CG D4 17 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TECHNOLOGY XTEND ENDORSEMENT This endorsement modifies insurance provided under the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage Is excluded or limited by such an endorsement The following listing is a general cover- age description only Limitations and exclusions may apply to these coverages Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered A. Reasonable Force Property Damage — Exception J. Blanket Additional Insured — Lessors Of Leased To Expected Or Intended Injury Exclusion Equipment B. Non-Owned Watercraft Less Than 75 Feet K. Blanket Additional Insured — Persons Or Organi- C. Aircraft Chartered With Pilot zations For Your Ongoing Operations As Re- quired By Written Contract Or Agreement D. Damage To Premises Rented To You L. Blanket Additional Insured— Broad Form Vendors E. Increased Supplementary Payments M. Who Is An Insured—Unnamed Subsidiaries F. Who Is An Insured — Employees And Volunteer N. Who Is An Insured — Liability For Conduct Of Un- Workers—First Aid named Partnerships Or Joint Ventures G. Who Is An Insured — Employees — Supervisory O, Contractual Liability—Railroads Positions H. Who Is An Insured — Newly Acquired Or Formed P. Knowledge And Notice Of Occurrence Or Offense Organizations Q. Unintentional Omission L Blanket Additional Insured — Owners, Managers R. Blanket Waiver Of Subrogation Or Lessors Of Premises PROVISIONS of SECTION I — COVERAGES — COVERAGE A A. REASONABLE FORCE PROPERTY DAMAGE— BODILY INJURY AND PROPERTY DAMAGE EXCEPTION TO EXPECTED OR INTENDED IN- LIABILITY JURY EXCLUSION (2) A watercraft you do not own that is The following replaces Exclusion a., Expected Or (a) Less than 75 feet long, and Intended Injury, in Paragraph 2 , of SECTION I — (b) Not being used to carry any person or COVERAGES — COVERAGE A BODILY IN- property for a charge JURY AND PROPERTY DAMAGE LIABILITY a. Expected Or Intended Injury Or Damage C. AIRCRAFT CHARTERED WITH PILOT The following Is added to Exclusion g., Aircraft, "Bodily injury" or"property damage" expected Auto Or Watercraft, in Paragraph 2. of SECTION or intended from the standpoint of the in- I — COVERAGES — COVERAGE A BODILY IN- sured This exclusion does not apply to "bod- JURY AND PROPERTY DAMAGE LIABILITY ily injury" or "property damage" resulting from This exclusion does not apply to an aircraft that the use of reasonable force to protect any person or property is B. NON-OWNED WATERCRAFT LESS THAN 75 (a) Chartered with a pilot to any insured, FEET (b) Not owned by any insured, and The following replaces Paragraph (2) of Exclusion (c) Not being used to carry any person or prop- g., Aircraft, Auto Or Watercraft, in Paragraph 2. erty for a charge CG D4 17 07 08 ©2008 The Travelers Companies, Inc Page 1 of 6 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY D. DAMAGE TO PREMISES RENTED TO YOU 5. The following is added to the DEFINITIONS 1. The first paragraph of the exceptions in Ex- Section clusion j., Damage To Property, in Para- "Premises damage" means "property dam- graph 2. of SECTION I — COVERAGES — age"to COVERAGE A BODILY INJURY AND a. Any premises while rented to you or tem- PROPERTY DAMAGE LIABILITY is deleted porarily occupied by you with permission 2. The following replaces the last paragraph of of the owner, or Paragraph 2., Exclusions, of SECTION I — b. The contents of any premises while such COVERAGES - COVERAGE A BODILY IN- premises is rented to you, if you rent such JURY AND PROPERTY DAMAGE LIABIL- premises for a period of seven or fewer ITY consecutive days Exclusions c., g. and h., and Paragraphs (1), 6. The following replaces Paragraph 4.b.(1)(b) (3) and (4) of Exclusion j., do not apply to of SECTION IV — COMMERCIAL GENERAL "premises damage" Exclusion C(1)(a) does LIABILITY CONDITIONS not apply to "premises damage" caused by fire unless Exclusion f. of Section I — Cover- (b) That is Insurance for "premises damage"; age A — Bodily Injury And Property Damage or Liability is replaced by another endorsement 7. Paragraph 4.b.(1)(c) of SECTION IV — to this Coverage Part that has Exclusion —All COMMERCIAL GENERAL LIABILITY CON- Pollution Injury Or Damage or Total Pollution DITIONS is deleted Exclusion in its title A separate limit of insur- E. INCREASED SUPPLEMENTARY PAYMENTS ance applies to "premises damage" as de- scribed in Paragraph 6 of Section III — Limits 1. The following replaces Paragraph 1.b. of Of Insurance SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- T 3. The following replaces Paragraph 6. of SEC- AGES TION III—LIMITS OF INSURANCE b. Up to $2,500 for cost of bail bonds re- 6. Subject to 5. above, the Damage To quired because of accidents or traffic law Premises Rented To You Limit is the violations arising out of the use of any most we will pay under Coverage A for vehicle to which the Bodily Injury Liability damages because of "premises damage" Coverage applies We do not have to fur- to any one premises nish these bonds The Damage To Premises Rented To 2, The following replaces Paragraph 1.d. of You Limit will be SUPPLEMENTARY PAYMENTS — COVER- a. The amount shown for the Damage AGES A AND B of SECTION I — COVER- To Premises Rented To You Limit on AGES the Declarations of this Coverage d. All reasonable expenses incurred by the Part, or insured at our request to assist us in the b. $100,000 if no amount is shown for investigation or defense of the claim or the Damage To Premises Rented To "suit", including actual loss of earnings up You Limit on the Declarations of this to $500 a day because of time off from Coverage Part work 4. The following replaces Paragraph a. of the F. WHO IS AN INSURED — EMPLOYEES AND definition of "insured contract" in the DEFINI- VOLUNTEER WORKERS—FIRST AID TIONS Section 1. The following is added to the definition of"oc- a A contract for a lease of premises How- currence" in the DEFINITIONS Section ever, that portion of the contract for a Unless you are in the business or occupation lease of premises that indemnifies any of providing professional health care services, person or organization for "premises "occurrence" also means an act or omission damage" is not an "insured contract", committed by any of your "employees" or "volunteer workers", other than an employed Page 2 of 6 ®2008 The Travelers Companies, Inc CG D4 17 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY or volunteer doctor, in providing or falling to or in which you maintain the majority provide first aid or"Good Samaritan services" ownership interest, will qualify as a to a person Named Insured if there is no other insur- 2. The following is added to Paragraph 2.a.(1)of ance which provides similar coverage to SECTION II—WHO IS AN INSURED that organization However Unless you are in the business or occupation a. Coverage under this provision is af- of providing professional health care services, forded only Paragraphs (1 )(a), (b), (c) and (d) above do (1) Until the 180th day after you ac- not apply to "bodily injury" arising out of pro- quire or form the organization or viding or failing to provide first aid or "Good the end of the policy period, Samaritan services" by any of your "employ- whichever is earlier, if you do not ees" or "volunteer workers", other than an report such organization in writing employed or volunteer doctor Any of your to us within 180 days after you "employees" or "volunteer workers" providing acquire or form it, or or failing to provide first aid or "Good Samari- (2) Until the end of the policy period, tan services" during their work hours for you when that date is later than 180 will be deemed to be acting within the scope days after you acquire or form of their employment by you or performing du- such organization, If you report ties related to the conduct of your business such organization in writing to us 3. The following is added to Paragraph 5. of within 180 days after you acquire SECTION III—LIMITS OF INSURANCE or form it, and we agree in writing For the purposes of determining the applica- that it will continue to be a ble Each Occurrence Limit, all related acts or Named Insured until the end of poli cy omissions committed by any of your "employ- the p y period, ees" or "volunteer workers" in providing or b. Coverage A does not apply to "bodily failing to provide first aid or "Good Samaritan Injury" or "property damage" that oc- services" to any one person will be deemed to curred before you acquired or formed be one "occurrence" the organization, and 4. The following is added to the DEFINITIONS c. Coverage B does not apply to "per- Section sonal injury" or "advertising Injury" "Good Samaritan services" means any emer- arising out of an offense committed gency medical services for which no compen- before you acquired or formed the sation is demanded or received organization I. BLANKET ADDITIONAL INSURED —OWNERS, G. WHO IS AN INSURED — EMPLOYEES — SU-PERVISORY POSITIONS MANAGERS OR LESSORS OF PREMISES The following is added to Paragraph 2.a.(1) of The following is added to SECTION II —WHO IS SECTION II—WHO IS AN INSURED AN INSURED Paragraphs (1)(a), (b) and (c) above do not apply Any person or organization that is a premises to "bodily injury" or "personal injury" to a co- owner, manager or lessor is an insured, but only "employee" in the course of the co-"employee's" with respect to liability arising out of the owner- employment by you arising out of work by any of ship, maintenance or use of that part of any prem- your "employees" who hold a supervisory posi- ises leased to you tion The insurance provided to such premises owner, H. WHO IS AN INSURED — NEWLY ACQUIRED manager or lessor does not apply to OR FORMED ORGANIZATIONS a. Any "bodily injury" or "property damage" The following replaces Paragraph 4. of SECTION caused by an "occurrence" that takes place, 11 —WHO IS AN INSURED or "personal injury" or "advertising injury" other than n a partnership or joint you newly acquire or caused by an offense that is committed, after form, other than 4. Any o you cease to be a tenant in that premises, or venture, of which you are the sole owner CG D4 17 07 08 ®2008 The Travelers Companies, Inc Page 3 of 6 I Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY b. Structural alterations, new construction or Any person or organization that is a vendor and demolition operations performed by or on be- that you have agreed in a written contract or half of such premises owner, manager or les- agreement to include as an additional insured on sor this Coverage Part is an Insured, but only with re- J. BLANKET ADDITIONAL INSURED — LESSORS spect to liability for "bodily injury" or "property OF LEASED EQUIPMENT damage"that The following is added to SECTION II — WHO IS a. Is caused by an "occurrence"that takes place AN INSURED after you have signed and executed that con- Any person or organization that is an equipmenttract or agreement, and lessor Is an Insured, but only with respect to liabil- b. Arises out of "your products" which are dis- hy for "bodily injury", "property damage", "per- tributed or sold in the regular course of such sonal injury" or "advertising injury" caused, in vendor's business whole or in part, by your acts or omissions in the The Insurance provided to such vendor is subject maintenance, operation or use by you of equip- to the following provisions ment leased to you by such equipment lessor a. The limits of Insurance provided to such ven- The Insurance provided to such equipment lessor dor will be the limits which you agreed to pro- does not apply to any "bodily injury" or "property vide in the written contract or agreement, or damage" caused by an "occurrence" that takes the limits shown in the Declarations, which- place, or "personal Injury" or "advertising Injury" ever are less caused by an offense that is committed, after the b. The insurance provided to such vendor does equipment lease expires not apply to K. BLANKET ADDITIONAL INSURED— PERSONS (1) Any express warranty not authorized by OR ORGANIZATIONS FOR YOUR ONGOING you OPERATIONS AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT (2) Any change in "your products" made by The following Is added to SECTION II —WHO IS such vendor, AN INSURED. (3) Repackaging, unless unpacked solely for the purpose of Inspection, demonstration, Any person or organization that is not otherwise testing, or the substitution of parts under an insured under this Coverage Part and that you Instructions from the manufacturer, and have agreed in a written contract or agreement to then repackaged In the original container, include as an additional insured on this Coverage Part is an insured, but only with respect to liability (4) Any failure to make such inspections, ad- for"bodily injury"or"property damage"that justments, tests or servicing as vendors agree to perform or normally undertake to a. Is caused by an "occurrence"that takes place perform in the regular course of business, after you have signed and executed that con- in connection with the distribution or sale tract or agreement, and of"your products", b. Is caused, In whole or in part, by your acts or (5) Demonstration, installation, servicing or omissions in the performance of your ongoing repair operations, except such operations operations to which that contract or agree- performed at such vendor's premises in ment applies or the acts or omissions of any connection with the sale of "your prod- person or organization performing such op- ucts", or erations on your behalf (8) "Your products" which, after distribution The limits of insurance provided to such insured or sale by you, have been labeled or re- will be the limits which you agreed to provide in labeled or used as a container, part or in- the written contract or agreement, or the limits gredient of any other thing or substance shown in the Declarations, whichever are less by or on behalf of such vendor L. BLANKET ADDITIONAL INSURED — BROAD Coverage under this provision does not apply to FORM VENDORS The following is added to SECTION II — WHO IS a. Any person or organization from whom you AN INSURED have acquired "your products", or any ingre- Page 4 of 6 ®2008 The Travelers Companies, Inc CG D4 17 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY dient, part or container entering into, accom- P. KNOWLEDGE AND NOTICE OF OCCUR- panying or containing such products, or RENCE OR OFFENSE b. Any vendor for which coverage as an adds- The following is added to Paragraph 2., Duties In tional insured specifically is scheduled by en- The Event of Occurrence, Offense, Claim or dorsement Suit, of SECTION IV — COMMERCIAL GEN- M. WHO IS AN INSURED — UNNAMED SUBSIDI- ERAL LIABILITY CONDITIONS ARIES e. The following provisions apply to Paragraph The following is added to SECTION II —WHO IS a. above, but only for the purposes of the in- AN INSURED surance provided under this Coverage Part to you or any Insured listed in Paragraph 1. or 2. Any of your subsidiaries, other than a partnership of Section II—Who Is An Insured or joint venture, that is not shown as a Named In- sured in the Declarations is a Named Insured if (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- a. You maintain an ownership interest of more ble only after the "occurrence" or offense than 50% in such subsidiary on the first day is known to you (if you are an individual), of the policy period, and any of your partners or members who is b. Such subsidiary is not an insured under simi- an individual (if you are a partnership or lar other insurance joint venture), any of your managers who No such subsidiary is an insured for"bodily injury" is an individual (if you are a limited liability or "property damage" that occurred, or "personal company), any of your trustees who is an injury" or "advertising injury" caused by an of- individual (if you are a trust), any of your "executive officers" or directors (if you are fence committed ` an organization other than a partnership, a. Before you maintained an ownership interest joint venture, limited liability company or of more than 50% in such subsidiary, or trust) or any "employee" authorized by b. After the date, if any, during the policy period you to give notice of an "occurrence" or that you no longer maintain an ownership in- offense terest of more than 50% in such subsidiary 2( ) If you are a partnership, joint venture, lim- N. WHO IS AN INSURED — LIABILITY FOR CON- ited liability company or trust, and none of DUCT OF UNNAMED PARTNERSHIPS OR your partners, joint venture members, JOINT VENTURES managers or trustees are individuals, no- The following replaces the last paragraph of tice to us of such "occurrence" or offense SECTION II—WHO IS AN INSURED must be given as soon as practicable only after the "occurrence" or offense is known No person or organization is an insured with re- by spect to the conduct of any current or past part- nership or joint venture that is not shown as a (a) Any individual who is. Named Insured in the Declarations This para- (i) A partner or member of any part- graph does not apply to any such partnership or nership or joint venture, joint venture that otherwise qualifies as an in- (iI) A manager of any limited liability sured under Section II—Who Is An Insured company, O. CONTRACTUAL LIABILITY—RAILROADS (III)A trustee of any trust, or 1. The following replaces Paragraph c. of the (iv)An executive officer or director of definition of "insured contract" in the DEFINI- any other organization, TIONS Section that is your partner, joint venture c. Any easement or license agreement, member, manager or trustee, or 2. Paragraph f.(1) of the definition of "insured (b) Any "employee" authorized by such contract" in the DEFINITIONS Section is de- leted partnership, joint venture, limited li- ability company, trust or other organi- zation to give notice of an "occur- rence" or offense CG D4 17 07 08 ®2008 The Travelers Companies, Inc Page 5 of 6 Includes the copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL GENERAL LIABILITY (3) Notice to us of such "occurrence" or of- The unintentional omission of, or unintentional fense will be deemed to be given as soon error In, any information provided by you which as practicable If It Is given In good faith as we relied upon in Issuing this policy will not prelu- soon as practicable to your workers' dice your rights under this Insurance However, compensation Insurer This applies only if this provision does not affect our right to collect you subsequently give notice to us of the additional premium or to exercise our rights of "occurrence" or offense as soon as prac- cancellation or nonrenewal in accordance with ticable after any of the persons described applicable insurance laws or regulations In Paragraphs e. (1) or (2) above discov- R BLANKET WAIVER OF SUBROGATION ers that the "occurrence" or offense may result in sums to which the Insurance The following Is added to Paragraph 8., Transfer provided under this Coverage Part may Of Rights Of Recovery Against Others To Us, apply of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS However, if this policy includes an endorse- ment that provides limited coverage for "bod- If the insured has agreed In a contract or agree- ily injury" or "property damage" or pollution ment to waive that insured's right of recovery costs arising out of a discharge, release or against any person or organization, we waive our escape of "pollutants" which contains a re- right of recovery against such person or organlza- gwrement that the discharge, release or es- tlon, but only for payments we make because of cape of "pollutants" must be reported to us a. "Bodily Injury" or "property damage" caused within a specific number of days after Its by an "occurrence"that takes place, or abrupt commencement, this Paragraph e. b. "Personal injury" or "advertising injury" does not affect that requirement caused by an offense that Is committed, Q. UNINTENTIONAL OMISSION subsequent to the execution of the contract or The following Is added to Paragraph 6 , Repre- agreement sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS Page 6 of 6 ©2008 The Travelers Companies, Inc CG D4 17 07 08 Includes the copyrighted material of Insurance Services Office, Inc with its permission REQUEST FOR MAYOR'S SIGNATURE • Please Fill in All Applicable Boxes KENO Wp SHINGTON This form must be printed on cherry paper Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Originator Dave Brock Phone (Originator) 5658 Date Sent- 11/16/11 Date Required. 11/23/11 Return Signed Document to Nancy Yoshitake CONTRACT TERMINATION DATE: 12/31/12 VENDOR NAME: Systems Interface Inc DATE OF COUNCIL APPROVAL: 11/15/11 Brief Explanation of Document: The attached agreement is for Systems Interface to provide programming and commissioning services for the Guiberson Corrosion Control Facility Upgrade protect For a summary,see the attached from Dave Brock R �t All Contracts Must Be Routed Through the Law Department (This Area to be Completed By the Law Department) Received: _ i;lB Ci l f Approval of Law Dept..- '= Law Dept. Comments INOV 16 2011 Date Forwarded to Mayor 'I 1`) ( (( I Shaded Areas to Be Completed by Administration Staff Received: ' I Recommendations & Comments: I j:, ' Disposition: 9 xvz! elly� Date Returned: Iage5870_templatebase • 2/07