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HomeMy WebLinkAboutPK12-161 - Original - Fountain Works - Town Square Plaza Fountain Review & Instruction - 06/22/2012 - Records NV,nagern6ri t KENT WASNINGTON Document 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: Fountain Works Vendor Number: ID Edwards Number 19 Contract Number: I k 1 2-' This is assigned by City Clerk's Office Project Name: Town Square Plaza Fountain Review and Instruction Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 6/30/12 Termination Date: 7/30/12 Contract Renewal Notice (Days): 0 Number of days required notice for termination or renewal or amendment Contract Manager: Garin Lee tp Department: Park Operations Detail: (i.e. address, location, parcel number, tax id, etc.): S:Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 - = .r: ,- KENT WA9"INC TON PUBLIC WORKS AGREEMENT between City of Kent and Fountain Works THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Fountain Works 107 Willow Grove Dr. San Antonio TX 78245 Ph —210-858-8903 organized under the laws of the State of Washington, located and doing business at(hereinafter the "Vendor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications Work to be performed at Town Square Plaza Park located at 211 2"d Ave in Kent, WA: Contractor will be on- site in Kent Washington to trouble shoot VFd and Pl-c for issues and correct them. Evaluate other fountain equipment for any additional repairs that may be needed. Create backup files for the programming of the fountain controls Provide training and troubleshooting advice to Parks Maintenance staff Contractor further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices in effect at the time such services are performed. 4 t II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon execution of this Agreement. Upon the effective date of this Agreement, Contractor shall complete the work described in Section I within 30 days of the contract being executed III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed Four Thousand Two Hundred and Seventy Five Dollars and 00 Cents. (4275.00) Washington state sales Tax included. Applicable Washington State Retail Sales Tax on this contract shall be governed by WAC 458-20-171 and its related rules for the work contemplated in this Agreement The City shall pay the Contractor fifty percent (50%) of the Contract amount upon completion and acceptance of the work by the City, and the remainder upon fulfillment of the conditions listed below and throughout this Agreement. A. No Performance Bond. Because this contract, including applicable sales tax, is less than $25,000, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a performance bond, has elected to have the owner retain the final fifty percent (50%) of the Contract amount for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue and the State Department of PUBLIC WORKS AGREEMENT- 1 (Roadway/Pedestrian Path- Under$10K and No Performance Bond) Labor & Industries and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement: and extra work and materials furnished without the City*s written approval. If Contractor is unable, for any reason. to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor 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 Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. C. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRAC FOR AS UNSETTLED AT THE TIME FINAL PAYMENT 1S MADE AND ACCEPTL:D IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement and that the Contractor 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. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events- A. The Contractor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work B. The Contractor's failure to complete the work within the time specified in this Agreement. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor's breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor's possession pertaining to this project which may be used by the City without restriction. PUBLIC WORKS AGREEMENT-2 (Roadway/Pedestrian Path- Under$10K and No Performance Bond) VI. PREVAILING WAGES. Contractor shall file a"Statement of Intent to Pay Prevailing Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract work. Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. if the Contractor determines, for any reason, that a change order is necessary, Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date Contractor 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 Contractor'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 Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor 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 VIIL CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall give written notice to the Y p 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 Contractor 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 Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement PUBLIC WORKS AGREEMENT-3 (Roadway/Pedestrian Path- Under$IOK and No Performance Bond) At a minimum, a Contractor's written claim shall include the information set forth in subsections A, items I 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. A. Notice of Claim. Provide a signed written notice of claim that provides the following information. 1. The date of the Contractor'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 Contractor is asserting a schedule change or disruption. B. Records. The Contractor 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 Contractor'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. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor 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 Contractor 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 Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK 1S COMPLETE OR CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLL S"1 ATUTORY LIMITATIONS PERIOD X. WARRANTY. Upon acceptance of the contract work, Contractor must provide the City a one- year warranty bond in a form and amount acceptable to the City. The Contractor 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 parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts PUBLIC WORKS AGREEMENT-4 (Roadway/Pedestrian Path- bnder$IOK and No Performance Bond) 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 Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a seasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction XL DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor 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. Contractor 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 XII. INDEMNIFICATION. Contractor 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 Contractor'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 Contractor'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 Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'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. The provisions of this section shall survive the expiration or termination of this Agreement. XIII. INSURANCE. The Contractor 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. XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor 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 Contractor's own risk, and Contractor 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 XV. MISCELLANEOUS PROVISIONS. PUBLIC WORKS AGREEMENT-5 (RoadwayiPedestrtan Path- Under$IOK and No Performance Bond) 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, sunless 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, 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 X1I 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. Assi ng ment 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 Contractor 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 PUBLIC WORKS AGREEMENT-6 (RoadwaJI/Pedestrian Path- Under$10K and No Performance Bond) H. Compliance with Laws. The Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. C NTRACT CITY OF ENT: y By: r n me l (signature) Print-lame 1 Ch�� Print ame: Garin Lee Its. Its: Park Superintendent � nn (l itle) ____JJ 1 tile) DATE: l5C DATE:� ��� NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Sandra M. Erpelding Ben Levenhagen Fountain Works City of Kent 107 Willow Grove Dr. 220 Fourth Avenue South San Antonio, TX. 78245 Kent, WA 98032 PH-210-701-6616 (253) 856-5133 (telephone) (253) 856-6120 (facsimile) PUBLIC WORKS AGREEMENT-'7 (Roadway/Pedestrian Path- Under$10K and No Performance Bond) 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 l u `LR— 1(�JC42A-e7l 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-0 da of _07ZL Z 17_ 200`- te. g. - Ir Za l Z— EEO COMPLIANCE DOCUMENTS-3 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. 1 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 Ins�day of � ►l yi . For: Title: Date: EEO COMPLIANCE DOCUMENTS- I 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 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 Z 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 l tf l Q , 200 BO 'RAI y. For. —)3 Title- )�Iovv Date: LZ EEO COMPLIANCE DOCUMENTS-3 a EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. Minimum Scope of Insurance Contractor 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. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85 The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 2. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. EXHIBIT B NTIN E(CO U D Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. EEO COMPLIANCE DOCUMENTS-4 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. W EEO COMPLIANCE DOCUMENTS-5 A� CERTIFICATE OF LIABILITY INSURANCE 12129/201/ ""' 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(1es)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 andorsement(s). PRODUCER CONTACT NAME James Englishbee PHONE Enghshbee Insurance Agency _N 210-615 6731 t�GN�10-615 6745 7400 Louis Pasteur Ste 211 ADDRESS)englishbee@allstate corn San Antonio,TX 78229 PVSOOCER OMPxIDx INSURERS AFFORDING COVERAGE NAICa INSURED INSURER A —Lloyd's of London Fountain Works INSURER 0 107 Willow Grove Dr INSURER San Antonio,TX 78245 INSURER 0' 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 ADVIL SUB MTSRR 1 TYPE OF INSURANCE Ina POLICY NUMBER MM(U /Yri MrU E1CP LIMITS GENERAL LIABILITY GSFAG-U 09120/2011 09/20/2012 EACH OCCURRENCE $1,tJU4,000 t--, DAMAGE TO R NT K COMMERCIAL GENERAL LIABILITY PIA fEa occurrence) $1 C�CLAIMS-MADE OCCUR MED EXP Any one person) S 5,000 A PERSCNAL&ADVINJURY s1,()Q(),000 GENERAL AGGREGATE $2,000,000 GENT.AGGREGATE Umrr APPLIES PER PRODUCTS-COMPIOPAGG I$1,000,000 Q POLICY I JECT PRO n LOD $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea amdent) ANY AUTO BODILY INJURY(Par person) $ ALL OWNED AUTOS BODILY INJURY(Peraccident) $ S SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Par acmdent) $ NON-O)ANED AUTOS I $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS{JAB CtA1M;.MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY DO NY PROPRIETORIPARTNEWEXECUTNE EL EACH ACCIDENTFFICERIMEMBER EXCLUDED? NIA Mandatory in NH) E L DISEASE-EA EMPLOYE yes describe under ESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD tei,Addrdonai Remarks Schedule,R more space is required) Camfica'e Holder m named as an AA&"4ed a Waiver of Subrogation with respects ro GL and AL Per attached endorsements GL insurance N Primary and Non-Corkillft oty to any abler Insurance oW lehle to certficale holder CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Kent Washington THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS A RRED REPRESENTATIVE J , ©1988-2009 ACORD CORPORATION All rights reserved ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person or Organization CITY OF KENT,WASHINGTON 220 FOURTH AVENUE SOUTH KENT,WA 98032 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) A. Section it-Who Is An Insured is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury"caused in whole or in part, by 1 Your acts or omissions,or 2 The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s)at the location(s)designated above B. With respect to the insurance afforded to these additional insureds,the following additional exclusion(s)apply This insurance does not apply to"bodily injury"or"property damage"occurring after (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 engaged in performing operations for a principal as a part of the same project CG 20 10 07 04 Copyright, ISO Properties, Inc,2004 Page 1 of 1 Agent ENDORSEMENT INVOICE Name of Assured Producer Mike Perry dba 3800001 Fountain Works Northeast Brokerage Agencies, Inc 107 Willow Grove Drive 6467 Main Street-Suite 104 San Antonio, TX 78245 Williamsville, NY 14221 POLICY NUMBER. AMTE012048 ENDORSEMENT NUMBER: 002 COMPANY. Lloyd's of London POLICY EFF.DATE: 09/20/2011 POLICY EXP DATE: 0912012012 ENDORSEMENT EFF DATE: 0 6/1 412 0 1 2 INVOICE DUE DATE: 07/04/2012 Flat Additional Annual Base Premium $100 00 Policy Fee Difference $0 00 Flat Additional State Fees $0 06 Flat Additional Tax $4 85 Flat Additional Annual Gross Premium $104 91 THIS INVOICE DOES NOT REFLECT ANY PRIOR DEBITS OR CREDITS WHICH MAY BE PENDING. TAPCO accepts Visa,MasterCard,and electronic(ACH)checks. This Invoice is issued by GSFAG-U TAPCO Underwriters, Inc Post Office 286 80013340 557 27216 Burlington, NO 9 x I I'�III)IiI�II III IIIII IIIII iI)l�ll Authorized Representative Page 1 of 1 1002 tar )co JNDFR\h PIT�-RS, Ins ' POLICY ENDORSEMENT Name of Assured Producer Mike Perry dba 3800001 Fountain Works Northeast Brokerage Agencies, Inc 107 Willow Grove Drive 6467 Main Street-Suite 104 San Antonio, TX 78245 Williamsville, NY 14221 POLICY NUMBER: AMTE012048 ENDORSEMENT NUMBER: 002 COMPANY: Lloyd's of London POLICY EFF.DATE: 09/20/2011 POLICY EXP. DATE: 0912012012 ENDORSEMENT EFF.DATE: 0 6/1 412 0 1 2 Endorsement 002 Form CG2010 (07-04) is added to list the following as additional insured City of Kent,Washington Premium is 100% eamed See attached form Premium, Tax and Fee Changes Prior Annual Base Premium $1,221 00 New Annual Base Premium $1,321 00 Flat Additional Annual Base Premium $100 00 Flat Additional Tax $4 85 Flat Additional State Fees $0 06 Flat Additional Annual Gross Premium $104 91 This Endorsement is issued by GSFAl TAPCO Underwriters, Inc Post Office 8001334-5579 x 726 6 IIIIIII IIIIII IIII IIII IIIII III III Authorized Representative Page 1 of 2 1002