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HomeMy WebLinkAboutPW12-017 - Change Order - #1 - G C Systems, Inc. - 2012 Inspection and Valve Rebuild - Additional Part Replacement - 04/10/2012 Records Ma-pa`"g4*emen T Document VJ I.SXINpTON 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: GC Systems, Inc. Vendor Number: JD Edwards Number Contract Number: This Is assigned by City Clerk's Office Project Name: Inspection and Rebuild of Valves Description: ❑ Interlocal Agreement ® Change Order ❑ Amendment ❑ Contract ❑ Other: Contract Effective Date: Date of the Mayor's Signature Termination Date: 4/30/12 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Kevin Swlnford Department: PW Operations Detail: (i.e. address, location, parcel number, tax id, etc.): The-Contractor shall replace brass and stainless steel components due to excessive wear. S.Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 -.000'0"�. KEN T WA5MINGTON CHANGE ORDER NO. 1 NAME OF CONTRACTOR: GC Systems, Inc. ("Contractor") CONTRACT NAME & PROJECT NUMBER: Inspection and Rebuild of Valves ORIGINAL CONTRACT DATE: February 21, 2012 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, Contractor shall provide all labor, materials, and equipment necessary to: Replace brass and stainless steel components due to excessive wear. For a list of the components, see the attached which is attached as Exhibit A and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $229056.59 (including applicable alternates and WSST) Net Change by Previous Change Orders $0 (incl. appbcable WSST) Current Contract Amount $22,056.59 (incl. Previous Change Orders) Current Change Order $1,460.00 Applicable WSST Tax on this Change $138.70 Order Revised Contract Sum $23,655.29 CHANGE ORDER - 1 OF 3 Original Time for Completion 4/30/12 (insert date) Revised Time for Completion under n/a prior Change Orders (Insert date) Days Required (f) for this Change n/a calendar days Order Revised Time for Completion 4/30/12 (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, the Contractor accepts all requirements of this Change Order by signing below. Also, pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written below. CONTRACTOR: CITY OF KENT: By: By: (signature) (signature) Print Name: 14l?Ry /3�77�.�z�c, rant Suzette Cooke Its Its Mayor (title) (t� ) DATE: DATE: /v .JL CHANGE ORDER - 2 OF 3 APPROVED AS TO FORM: (applicable If Mayor's signature required) Kent Law Department GC Systems-2012 Valve Rebuild COI/Swmford 0 CHANGE ORDER - 3 OF 3 EXH BIT A W . Date: 3/29/2012 Service nvoice 000003620 t i Service For: CITY OF KENT PW OPERATIO S ACCOUNTS PAYABLE 220 4TH AVENUE SOUTH i KENT, WA 98032-5895 �. r y„ sJktiCuStO er R t mM� 2 a ae;kk:� ,Ia i} 7, . +x, l.li !>,z;S ,; Invoice Date: Service Date: a , Salesman: .? •i-.t,C;_ _ i r ^.:y F r;, r,E ,k'f 3/29/2012 3/14/2012 BEAU aService Desert lion: "i � ��� �Zia;t,�ws�;'���� _�'=� ;�•�� ^E� is}-=� � �uF` >( i�,Net Price: p '�s:-T•_T�.kl' k i' Str thi`,�'%: 4v'i.��, � 1:.' :et rat,,:dt"1,1="Y7.e.i.,S-S n`i7_`'��`t REBUILD CLA-VAL CONTROL VALVES PER PRO OSAL $20,143.00 INSTALLED ADDITIONAL METAL PARTS: $0,00 1 -2" 10041 D{SC GUI DE ST.ST, w 00 2 - 2" 100-01 DISC RETAINERS @ $80 00 EA. $160 00 1 -2" 100.01 BRASS DISC GUIDE $57.ao $76 00 1 -4" 100-02 DISC GUIDE $232.00 1 -4" 100-01 DISC RETAINER $153 00 2-6" 100 01-DISC @ $287AQ EA, $574.00 1 -CRL STEM $50,00 1 -3/8"X 3/8"X4BA STRAINER $56 00 1 - BELLEVILLE WASHER _ ! $5.00 �SnbTOtal: i, $21,60300 $1,460.00 tSalesTax: ' $2,05229 $138.70 Sales Tax $23,655.29 $1,598.70 Change Order Total i ppct (j*« ±T �v�vt+.•�. 1', I it a i �a� . 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CERTIFICATE OF LIABILITY INSURANCE °11062o z"' iIS 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 BYTHE 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,subject10 9 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 NAME Sandy Kutseth ` Propel Insurance PRONE 360 252 2368 Nc 360 754 7537 AIC No Ext Olympia Commercial Insurance ADDRESS' Sik@propelinsurance.com P O.Box 2007 cusroM x GCSYSTEM2 Olympia,WA 98507 INSURER(S)AFFORDING COVERAGE NAIC0 INSURED INSURER West American Insurance Company 44393 G C Systems Inc INSURER B Ohio Casualty Insurance Company Inter Ave Business Park INSURER C• P.O.Box 848 INSURER — Sumner,WA 98390-0160 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 INSR RUOUSLISRI POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE NSR WO POLICYNUMBER MMIDOM'YY MM/DDNYYY A GENERALLIABILITY x BKW52962081 0610112011 0610112012 EACHOCCURRENCE $1000000 IJAMAQt TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $100 000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $10 000 X PD Ded:500 PERSONAL&AOV INJURY $1,000 000 GENERAL AGGREGATE $2,000,000 ' GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG j?,000,000 _ 17 POLICY r X PRO- LOC S B AUTOMOBILEUABIU Y BAO529620811 6/01/2011 06101/2012 COMBINED SINGLE LIMIT $ (Ea accident) 1.000.000 X ANYAUTO BODILY INJURY(Par person) S ALL OW NED AUTOS BODILY INJURY(Par accident) S SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Peraccidant) S X NON-OW SNED AUTOS _ -- B I�rc UMBRELLA LIAB OCCUR US052962081 6101/2011 06101/201 EACH OCCURRENCE $1 000 000 %CESS LIAB CLAIMS-MADE AGGREGATE $1 000 000 EDUCTIBLE $ ETENnoN & 10000 $ WORKERS COMPENSATION BKW52962081 6/01/2011 06101/247 WC STATU- OTH- AND EMPLOYERS'LIABILITY 000 000 A ANY PROPRIETORIPARTNERIEXECUTIVEYyN WA STOP GAP EL EACH ACCIDENT $1, _ OFFICERWEMBER EXCLUDED? ® NIA (Mandatory In NH) EL DISEASE-EA EMPLOYEEI$1,000,000 Ifymclescnbsunder EL DISEASE-POLICY LIMIT $1,000000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,W more space Is required) Re:On going work performed by Insured 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:Kevin Swlnford ACCORDANCE WITH THE POLICY PROVISIONS. 220 So 4th Street Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION.All rights reserved ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #SS389361M686994 JB00 G C Systems Inc BKW52962081 COMMERCIAL GENERAL LIABILITY CG 88 10 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY-ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES A AND B 3 ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY-ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR"LIMITS OF INSURANCE" 5 WHO IS AN INSURED-INCIDENTIAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES B NEWLY FORMED OR ADDITIONALLY AQUIRED ENTITIES B FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 7 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US- 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU 02070 Liberty Mutual Insurance Company.All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance services Office,Inc,with its permission. Page I of 7 BKW52962081 5 With respect to coverage afforded by this endorsement,the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury And Property Damage Liability, exclusion g.Aircraft,Auto Or Watercraft does not apply to an aircraft provided: v 1. It is not owned by any Insured; 2. It is hired,chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate,issued by the duly constituted authority of the United States of America or Canada,designating her or him a commercial or airline pilot; and 4. it is not being used to carry persons or property fora charge. However,the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible Insurance,whether primary,excess(other than insurance written to apply specifically In excess of this policy),contingent or on any other basis,that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Pa ragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion U.Aircraft,Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; end (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY-ELEVATORS { 1. Under Paragraph 2.Exclusions of Section I-Coverage A- Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6)of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts.Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary,excess,contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) If Damage To Premises Rented To You Is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j.Damage To Property is replaced by the follow- ing: Paragraphs(1),(3)and (4)of this exclusion do not apply to"property damage"(other than damage by fire, lightning,explosion,smoke,or leakage from an automatic fire protection system)to: (i) Premises rented to you for a period of 7 or fewer consecutive days;or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of Insurance applies to this coverage as described In Section III - Limits oft• ' Insurance. 0201fl Liberty Mutual insurance Company.All rights reserved. CG as 10 10 09 Includes copyrighted material of Insurance Services Office,[no,with rs permission. Page 2 of 7 BKW52962081 b. The last paragraph of subsection 2.Exclusions is replaced by the following: Exclusions c.through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises 1 Rented To You as described in Section ill-Limits Of Insurance. 2. Paragraph 6.under Section IiI-Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 6. above,the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage"to: a. Anyonepremise: (1) While rented to you;or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection Sys- tems;or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage)-Paragraph P.a.of Definitions is replaced with the following: 8.a.A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement,is not an"insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1.Insuring Agreement of Section I-Coverage C-Medical Payments, Subparagraph (b)of Paragraph a.Is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident;and F. EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES A AND B 1. Under Supplementary Payments-Coverages A and B,Paragraph 1.b.is replaced by the following: b. Up to$3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies We do not have to furnish these bonds. 2. Paragraph 1.d.is replaced by the following: d. All reasonable expenses Incurred by the insured at our request to assist us In the Investigatlon or defense of the claim or "suit", including actual loss of earnings up to$500 a day because of time off from work. G. ADDMONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 1. Paragraph 2. under Section it -Who is An Insured is amended to include as an Insured any person or organization whom you have agreed to add as an additional insured in a written contrast, written agreement or permit Such person or organization is an additional insured but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions,or the acts or omissions of those acting on your behalf,in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising Injury" is committed,subsequent to the signing of such written contract or written agreement;or d2D10 Liberty Mutual Insurance Company.All rights reserved. CG 8810 10 09 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 7 BKW52902061 b. Premises or facilities rented by you or used by you;or c. The maintenance,operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has Issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury"arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily Injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own,rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures;or (b) The construction,erection,or removal of elevators;or (c) The ownership,maintenance,or use of any elevators covered by this insurance. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work,including materials, parts or equipment furnished In connection with such work,on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional Insured(s)at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor r engaged in performing operations fora principal as a part of the same project. ` With respect to Paragraph 1.b, above, a person's or organization's status as an additional Insured under this endorsement ends when their written contract or written agreement with you for such premises orfacilities ends. With respects to Paragraph 1.c.above,this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor; The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the"bodily injury" or"property damage", We have no duty to defend an additional Insured under this endorsement until we receive written notice of a "sult" by the additional Insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV- Commercial General liability Condi- tions. 2. With respect to the insurance provided by this endorsement,the following are added to Paragraph 2. Exclusions under Section I-Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily Injury" or"property damage"arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily Injury" or"property damage"occurs. c. "Bodily injury","property damage" or"personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, Including: 02010 Liberty Mutual Insurance Company.All rights reserved. CG BB 10 10 09 Includes copyrighted material of insurance Services Office,inc.,whh its permission. Page 4 of 7 BKVV52962081 f1) The preparing, approving, or failing to prepare or approve, maps'�shop drawings, opinions, i reports,surveys,field orders,change orders or drawings and specifications;or (2) Supervisory,inspection,architectural or engineering activities. d. "Bodily injury"or"property damage"occurring after: (i) All work, including materials, parts or equipment furnished in connection with such work,on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or (2) That portion of "your work" out of which the injury or damage arises has been put to Its Intended use by any person or organization other than another contractor or subcontractor engaged In performing operationsfor a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations- by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. H. PRiMARYAND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qua lifies as an additional Insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION iV-COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is addedto Paragraph a.Primary insurance: If an additional insured's policy has an Other insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis,this policy shall be primary and we will not seek contributlon from the additional insured's policy for damages we cover. r b. The following Is added to Paragraph b.Excess Insurance: When a written contract or written agreement,other than a premises tease,facilities rental contract or agreement, an equipment rental or lease contract or agreement,or permit issued by a state or political subdivision between you and an additional Insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional Insured is designated as a Named insured. Regardless of the written agreement between you and an additional Insured,this insurance Is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR"LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2.Duties in The Event Of Occurrence,Offense,Claim or Suit: An additional insured under this endorsement will as soon as practicable: e. Give written notice of an"occurrence" or an offense that may result in a claim or"suit" under this insurance to us; b Tender the defense and indemnity of any claim or "salt" to all insurers whom also have Insurance available to the additional insured;and c. Agree to make available any other insurance which the additional insured has for a loss we i cover under this Coverage Part. 02010 Liberty Mutual Insurance Company.All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance services office,inc.,with its permission. Page 5 of 7 BKW52962081 d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit"by the additional insured. 2. The limits of Insurance applicable to the additional insured are those specified In a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less, These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO iS AN INSURED-INCIDENTIAL MEDICAL ERRORS!MALPRACTICE WHO IS AN INSURED.FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section Il-Who Is An Insured is replaced with the following: (1) "Bodily injury"or"personal and advertising injury": (a) To you,to your partners or members(if you area partnership or joint venture),to your members fIf you are a limited liability company),to a co-"employee" white in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs(1)(a)or(b)above; or (d) Arising out of his or her providing or failing to provide professional health care services.However, if you are not In the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement,this provision(Paragraph (d)) does not apply. Paragraphs(a) and(b)above do not applyto "bodily injury"or"personal and advertising Injury"caused by an "employee"who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, Includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out oftheirwillful conduct,which is defined as the purposeful orwilfful intent to cause "bodily Injury" or "personal and advertising injury", or caused In whole or in part by their Intoxica- tion by liquor or controlled substances, The coverage provided by provision J.is excess over any other valid and collectable Insurance available to your"employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3.of Section it-Who is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there Is no other similar insurance available to that organization.However: a. Coverage under this provision is afforded only until the expiration of the policy period In which the entity was acquired or formed by you, b. Coverage A does not apply to "bodily injury" or"property damage"that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal end advertising Injury" arising out of an offense committed before you acquired orformed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured In the Declarations or qualifies as an insured under this provision. 02010 liberty Mutual insurance company.All rights reserved CG 88.1610 09 Includes copyrighted material of Insurance Services Office,Inc,with Its permission. Page 6 of 7 BKW52962081 L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES • Under Section IV-Commercial General Liability Conditions,the following is added to Condition B.Repre- sentations: Yourfallure to disclose all hazards or prior"occurrences"existing as of the Inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior"occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT Under Section IV-Commercial General Liability Conditions,the following Is added to Condition 2.Duties In The Event of Occurrence,Offense,Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any Insured shall not in itself constitute knowledge of the Insured unless an insured listed under Paragraph 1. of Section it-Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses,claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge,your policy will automatically provide the coverage as of the day the revision is effective In your state. O. BODILY INJURY REDEFINED Under Section V-Definitions,Definition 3.is replaced by the following: 3. 'Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock,fright or death that results from such physical injury, sick- ness or disease. P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following; a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the Insured. This exclusion does not apply to "bodily Injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 0. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV-Commercial General Liability Conditions,the following is added to Condition S.Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage erlsing 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" provided: 1. You and that person or organization have agreed In writing In a contract or agreement that you waive such rights against that person or organization;and 2. The injury or damage occurs subsequent to the execution of the written contractor written agree- ment. 02010 Liberty Mutual Insurance Company.All rights reserved. CG 881D 10 09 includes copyrighted material of Insurance Services offine,Ina.,with its permission. Page 7 of 7 REQUEST FOR MAYOR'S SIGNATURE • Please FIII in All Applicable Boxes KENO WASHINGTON This form must he printed can cherry paper Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Originator Kevin Swinford Phone (Originator) 5613 Date Sent- �U9//a Date Required- 4lle- l,, Return Signed Document to Nancy Yoshitake CONTRACT TERMINATION DATE: 4/30112 VENDOR NAME: GC Systems, Inc DATE OF COUNCIL APPROVAL: Brief Explanation of Document. The attached Change Order No 1 to the Valves contract is for the contractor to replace brass and stainless steel components due to excessive wear For an explanation, see the attached prepared by Kevin Swinford All Contracts Must Be Routed Through the Law Department (This Area to be Completed By the Law Department) Received. RECEIVED -�w 1 ' K A- Approval of Law Dept � r' APR Q 9 2012 Law Dept Comments: KENT LAW DEPT Date Forwarded to Mayor: Shaded Areas to Be Completed by Administration Staff Received- Recommendations & Comments: Disposition: Date Returned: age5870_templatebase 2/07