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HomeMy WebLinkAboutPK12-078 - Original - United Site Services of Nevada, Inc. - Portable Restroom Services - 02/23/2012 Records Man geme r + . KENT Document WASHINGTON Aftia-L- 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: United Site Services of Nevada, Inc. Vendor Number: JD Edwards Number Contract Number: yli� U- 0 r This is assigned by City Clerk's Office Project Name: Portable Restroom Service Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 2/23/2012 Termination Date: 12/31/2013 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Teri Petrole Department: Parks Administration Detail: (i.e. address, location, parcel number, tax id, etc.): Portable Restroom service at No. Meridian, Service Club, East Hill Shops 5 Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT W P s M I N G T O N GOODS & SERVICES AGREEMENT between the City of Kent and United Site Services of Nevada, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and United Site Services of Nevada, Inc. organized under the laws of the State of Washington, located and doing business at 5202 South Proctor Street Tacoma, WA 98409 P: 253-475-6392 (hereinafter the "Vendor"). y AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City: Continue servicing portable restroom, currently on site at North Meridian Park with hand sanitizer and seat covers, once per week while including charges for 6 tip over services as well as adding new services at Service Club Ballfields (October - March) and at the East Hill Shops (year round) as described in the vendor's quotation dated December 16, 2011 attached and incorporated as Exhibit A. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by December 31, 2013. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Six Thousand Five Hundred Twenty Eight Dollars and Fifty Cents ($6,528.50), plus applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: GOODS & SERVICES AGREEMENT - 1 (Under$10,000.00, including WSST) The vendor shall invoice the city monthly. , If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Vendor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Vendor maintains and pays for its own place of business from which Vendor's services under this Agreement will be performed. C. The Vendor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required GOODS & SERVICES AGREEMENT - 2 (Under$10,000.00, mcludIng WSST) by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor P 9 P 9 r n reason that an amendment is necessary, Vendor must submit a written determines, for any y, amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. GOODS & SERVICES AGREEMENT - 3 (Under$10,000.00, including WSST) A. Notice of Claim. Provide a signed written notice of claim that provides the followirag information: 1. The date of the Vendor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. This Agreement is subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall correct all defects in workmanship and materials within one (1) year from the date of the City's acceptance of the Contract work. In the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for one (1) year from the date such correction is completed and accepted by the City. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. GOODS & SERVICES AGREEMENT - 4 (Under$10,000.00, including WSST) a X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. GOODS & SERVICES AGREEMENT - 5 (Under$10,000.00, including WSST) B. `Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XI of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. GOODS & SERVICES AGREEMENT - 6 (Under$10,000.00, including WSST) I. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. VENDOR: Ltv)'Ited -`j _ ,5erj(jcW jkkVo,&4 CITY OF KENT: By: ;int : g ature) (signature) Print Name: N me: Jeff Watling Its:CI r A oynscI �►-- Ser yL- Parks Director (ti le) DATE: ' i z _ _ DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Jeri Houart Brian Saw United Site Services City of Kent 5202 S Proctor St 220 Fourth Avenue South Tacoma, WA 98409 Kent, WA 98032 253-475-6392 x4503 (telephone) (253) 856-5126 (telephone) 253-474-3105 (facsimile) (253) 856-6120 (facsimile) North Meridian,Service Club and East Hill Shops Sanican Service GOODS & SERVICES AGREEMENT - 7 (Under$10,000.00, including WSST) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this /sue- day of t ed a.ey , 201p, B .� Y� For: GLA %Dnc- Title: Gla,47ir� Date:_ SA y- EEO COMPLIANCE DOCUMENTS - 1 of 3 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 of 3 Y CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. Dated this day of , 20 By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 xhtV,- pi- United Site Services of Nevada. Inc. Salesperson Contact 5202 South Proctor Street JENNIFER M HOUART Tacoma, WA 98409 7Mobile - Office. Office.25 5 6392 03 Faxax 253-474-31-3105 SITE SERVICES- jennifer.houart@umtedsiteservices com Site Service Quotation Quote No.: 41 4-1 6061 Quote Date: 12/16/11 Quote Expires: 02/16/12 Sell To: CITY OF KENT Ship To: CITY OF KENT BARBARA HANEY VARIOUS LOCATIONS 220 4TH AVE S KENT,WA 98032 KENT,WA 98032 Cust.#: PNW-20390 Attn: BRIAN SAW Phone: 253-856-5111 Phone: 253-856-5126 Terms: Due Upon Receipt Comments&Special Instructions OPTION A-2012-2013 CONTRACT RENEWAL(STANDARD RESTROOMS W/1 XWK SVC) ALL PREVIOUS CONTRACTURAL AGREEMENTS SIGNED ON 1/1/11 TO BE RENEWED FOR 1/1/12- 12/31/13 THIS RENEWAL TO INCLUDE THE FOLLOWING AMENDMENTS TO ORIGINAL AGREEMENT: OPTION A PROPOSAL TO INCLUDE CHARGES FOR 6 TIPOVER SERVICES WORKED INTO RENTAL COST THROUGHOUT THE YEAR (FOR NORTH MERIDIAN PARK ONLY) RENTAL PRICES BASED ON 1XWK SERVICE WITH HAND SANITIZER& SEAT COVERS INCLUDED AT NO EXTRA CHARGE NO DELIVERY FEE WOULD BE ASSESSED ON THE RENEWAL OF STANDARD UNIT THAT IS ALREADY ONSITE ANY ADDITIONAL DELIVERIES WOULD INCUR A$40 00 DELIVERY FEE ADDITIONAL PROVISIONS, PRICING ADDED FOR 1 STD RESTROOM AT SERVICE CLUB BALLFIELD FOR OCT-MAR ONLY PRICING ADDED FOR 1 STD RESTROOM AT EAST HILL SHOPS YEAR ROUND THESE RESTROOMS DO NOT INCLUDE THE ADDITIONAL TIP OVER PROVISION ONE TIME DELIVERY FEE APPLIES TO INITIAL DELIVERY OF THESE RESTROOMS ONE TIME STAKE DOWN/CHAIN DOWN CHARGE APPLIES IF POSSIBLE Item Unit Quantity From Thru Unit Price Total Price STD-NORTH MERIDIAN PARK(YR ROUND) EA 1 01/01/12 Indef 10.00 10.00 per billing cycle Weekly Service EA 1 01/01/12 Indef 11470 11470 per billing cycle Hand Sanitizer-NO CHARGE EA 1 01/01/12 Indef 000 000 per billing cycle Toilet Seat Cover- NO CHARGE EA 1 01/01/12 Indef 000 000 per billing cycle Per Billing Cycle Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124.70 Delivery-NO CHARGE EA 1 01/01/12 01/01/12 000 000 one time STD-NORTH MERIDIAN PARK(YR ROUND)Subtotal: . . . . . . . . . . . . . . . . . . . . . . . . . . 124.70 STD-SVC CLUB BALLFIELDS(OCT-MAR) EA 1 10/01/12 Indef 10.00 10.00 per billing cycle Weekly Service EA 1 10/01/12 Indef 7700 7700 per billing cycle Hand San tizer-NO CHARGE EA 1 10/01/12 Indef 000 000 per billing cycle Toilet Seat Cover- NO CHARGE EA 1 10/01/12 Indef 000 000 per billing cycle Per Billing Cycle Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87.00 Stake Down EA 1 10/01/12 10/01/12 2500 2500 one time Delivery, Setup, Removal EA 1 10/01/12 10/01/12 4000 4000 one time Continued.. a United Site Services of Nevada. Inc. Salesperson Contact 5202 South Proctor Street JENNIFER M HOUART Tacoma,WA 98409 Mobile United Office 25 5-6392 03 Faxax 253-474-31-3105 SITE SERVICES- Jennifer houart@unitedsiteservices com Site Service Quotation Quote No.: 414-16061 Quote Date: 12/16/11 Quote Expires: 02/15/12 Sell To: CITY OF KENT Ship To: CITY OF KENT BARBARA HANEY VARIOUS LOCATIONS 220 4TH AVE S KENT,WA 98032 KENT,WA 98032 Cust.#: PNW-20390 Attn: BRIAN SAW Phone: 253-856-5111 Phone: 253-856-5126 Terms: Due Upon Receipt Item Unit Quantity From Thru Unit Price Total Price One Time Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65.00 STD-SVC CLUB BALLFIELDS(OCT-MAR)Subtotal: . . . . . . . . . . . . . . . . . . . . . . . . . . . 152.00 STD-EAST HILL SHOPS(YR ROUND) EA 1 01/01/12 Indef 10.00 10.00 per billing cycle Weekly Service EA 1 01/01/12 Indef 7700 7700 per billing cycle Hand Sanitizer- NO CHARGE EA 1 01/01/12 Indef 000 000 per billing cycle Toilet Seat Cover-NO CHARGE EA 1 01/01/12 Indef 000 000 per billing cycle Per Billing Cycle Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87.00 Delivery, Setup, Removal EA 1 01/01/12 01/01/12 40.00 4000 onetime STD-EAST HILL SHOPS(YR ROUND)Subtotal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127.00 Total: 403.70 Accepted Date Remit To United Site Services,PO Box 53267,Phoenix,AZ 85072-3267 NOTE Total prices have been calculated for 1 billing period only Damage Waiver is optional Please read the terms and conditions on the last page of this document for more information • . 1 ® DATE(MM/OD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 11/02/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 1-212-295-8000 CONTACT Joseph Roberta PRODUCER NAME P Integro USA Inc. PHONE (212) 295-5360 aC No (212) 295-5361 dba Integro Insurance Brokers C No Ea 1 State Street Plaza AADDRESS 7oseph.roberta@lntegrogroup.com 9th Floor INSURER(Sl AFFORDING COVERAGE NAIC# New York, NY 10004 INSURER Liberty Nut Fire Ins Co. 23035 INSURED INSURER Liberty Ins Corp. 42404 United Site Services of Nevada, Inc. INSURER C 5202 South Proctor Street INSURER INSURER E Tacoma, WA 98409 INSURER F COVERAGES CERTIFICATE NUMBER- 23964334 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 AODL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR POLICY NUMBER MMIDD/YYYY MM/DDNYYY A GENERAL LIABILITY X X TB2-641-435338-021 11/03/1 11/03/12 EACHOCCURRENCE $ 1,000,000 DAMAGETORENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 111 OCCUR MED EXP(Any one person) $ 10,000 PERSONALS ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 , GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,000 __x1 POLICYF_J PE O LOC $ A AUTOMOBILELIABILfTY X X JLSZ-641-435338-031 11 12 EOMaBINdM SINGLE LIMIT 2,000,000 Ix ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTPX NONCOWNED PeOra RTY DAMAGE $ HIRED AUTOSAUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ ) DED RETENTION$ $ E WORKS SCOMPENSATION X WA7-64D-435338-011 ADS 11/03/1 11/03/12 X WC57A7U- BR AND EMPLOYERS'UABILITV B ANY PROPRIETOR/PARTNERIEXECUTIVE YIN NIA WC7-641-435338-071 OR 11/03/1 11/03/12 EL EACH ACCIDENT $ 1,000,000 OFFICERIOEMBER EXCLUDED? N❑ (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under EL DISEASE-POLICY LIMIT $ 1,000,000 DESCRI PTIO�N OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101.Additional Remarks Schedule,If mom space Is required) Re: North Meridian Park - For all on going and completed Operations. City of Kent is included as additional insured on the General Liability and Automobile policies. Coverage is primary an non-contributing per coverage form. Waiver of subrogations appplies to the certificate holder on the General Liability, A Automoble and workers compensation as per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Rent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS i 220 4th Avenue South, AUTHORIZED REPRESENTATIVE Kent, WA 98032-5895 ,/ USA ©1988-2010 ACORD CORPORATION All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Ocaro 23964334 r THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modiiHes insurance provided under the following Business Auto Coverage Form Garage Coverage Form Truckers Coverage Form Motor Carrier Coverage Form SCHEDULE Premium: nmL Name of Person or Organization: Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us,but only if the contract is executed prior to the injury or damage occurring. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US condition is amended by the addition of the following: We waive any right of recovery we may have agahst the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your operations of covered auto done under contract with that person or organization, This waiver applies only to the person or orgaribmtion shown to the Schedule above. Policy No:AS2-641435338-031 Issued By: Liberty Mutual Fire insurance Co. Effective Date. t l/03111 Expiration Date- 11/03/I2 Sales Office 0324 I AX 1210 02 05 8 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED r This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provlslons of the Coverage Form apply unless modi- fied by this endorsement This endorsement identifies person(s)or organizations)who are 'insureds"under the Who Is An Insured Provi- sion of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Refer to De i nate Insured Schedul Name of Person(s)or Organizatlon(s): United Site Services Parent Holding Corp., and USS Intermediate Holding Corp., and any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. (If no entry appears above,Information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement) Each person or organization shown in the Schedule is an insured"for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. P Policy No-AS2-641-435338-031 Issued By. Liberty Mutual Fire Insurance Co. Effective Date, 11/03/11 Expiration Date. 11/03/12 Sales Office 0324 CA 20 48 02 99 Copyright,Insurance Services Office,Inc., 1998 Page 1 of 1 l .WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We MR not enforce our right against the person or orgahizatlon named in the Schedule. {this agreement applies only to the extent thatyou perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or Indirectly to benefit anyone not named in the Schedule. Schedule Where required by contract or written agreement Thts endorsemerd is exaaded by the Liberty Insur8we Cpzppration 21814 Premium$ Effective Date 1110311I Expiration Date 11/03/12 For attachment Policy No. WA7-64DA3 53 3 8-01 1 coumtoWgmad dy rwthor¢estklepresemratne . WC no 0313 Ed.4/111984 Copyright i9m masonai council on Ccrnpensatbrt Insurance. I WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO-US This endorsement modifies insuranod provided und0r the foilowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or organization:Any person or organization with whom you have agreed in writing to waive any right of recovery prior to a loss. Information re uired to complete this Schedule,if not shown above,will be shown in the Declarations. The following is added to Paragraph 8, Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown In the Schedule above because of payments we make for injury or damage' arising out of your ongoing operations or "your work"done under a contract with that person or organization and included in the 'products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. This mdorarmatt w asnevied by tha LIBERTY WMAL PMR rNSURANCs COMPANY Premium$ Effective Date 11/03/11 Expiration Date 11/03/12 For attachment Policy No. TB2-641-435338-021 Audit Basis rscued To • SfiCRLRARY •1 PRl'SCOB7T I • issual 'Sala OZiia and No CG 24 04 05 09 0 Insurance Services Office,Inc.,2008 Page 1 of 1 f r TEM ENDORSEMENT CFIANGES THE POLMY. PLEASE READ IT CAREFUI"LY. BLANKET KETADDITIONALINSURED This cudomemearmodilies insurance provided under the folloviiag. COADdERCIt1LGENELALLIABII. i'CONTERAGEFORhi SECTION 11-WHO IS AN INSURED is amended to mdndc as an insured any person or orgauiation for whom you have agreed m writing to provde liabiny insurance. But: The insurance provided by this amendment'. 1. Applies only to"bodily mpuy"or"property damage"aming out of(a)"your work"or(b)pretmises or other property owned by or reined to you; 2 Applies only to coverage and min limits ofinsu;ance required by the written agreement,bat in no event Cxcetds either the scope of coverage or the limits of insurance provided by this policy;and S Does not apply to any person or organization for whom you have procured separate liab17riyinsurance while such inst•zrce is in effect,regardless of when=the scope of coverage or limits of rnsrs211cc Of Ibis policy exceed those of such orhermsi ance or whether such other insurance is valid and collectible. The following provisions also apply. 1. Where the applicable written agm=ent requires the insured to provide liability iasurance on a purany,excess,contingent,Or any other basis,this pohey will apply solely on the basis required by such written ogteement and ltem 4.Other Imunace of SECTION IV of this policy will not epplV. 2. Where the applicable written agreement does not specify on what basis the ltabrluy insurance will apply,the proviswris of Item 4.0thec Insurance of SECTION IV of this policy will govem. 3 This endozsameat shall not apply to any person or organization fur any"bodily injury"or"property damage"if arty other additional insured endorsement on this policy applies to(bat pets on err organization with regard to the"bodily mjug"or "properly d'a'agen• 4. If any other additional insured endorscmeat applies to any person or organization and you are obligated mtder a Vdam agreement to provide liability insurance on a primary,excess,contingent,or any other bass for that additional instued,this policy will apply solely on the basis required by such written agreement and Item 4.Other Insurance of S=ON IV of this policy will not apply,xegudkss ofwhether the person or organization has avallable other valid and collectible tasuranee.IF thv applicable vernier agreement does oot specify on what basis the liability Insurance wX apply,the provisions of Item 4. Other Insurance of SECTION IV of this policy will.govem. Mir andotsanent ss««uted W the LIBERTY MUTUAL I'=INSURANCE COMPANY Premium$ Effective Date 11/03/11 Expiration Date l 1/03/12 For attachment Policy No. T132-641-435338-021 Audit Basis Im.ed To SECRETARY Is coward Sala Office and No. LN 29 0106 05 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by thrs policy. We will not enforce our right against the person or organization named in the Schedule. {This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirecffy to benefit anyone not named in the Schedule. Schedule Wbere required by contract or written agreement TNe endorsements executed by M9 Liberty Znaurance Corporation 21814 Premium$ Effective Date 11/03/11 Expiration Date I I/03/12 i For attachment Policy No WC7-641-435338-071 4 - Coumemignedby_ �� �R— AWwnzed RePFeWdattve WC000S13 Ed,4/1/1984 Copyright IBM NafimW Counal en Compensation rruurmep-