HomeMy WebLinkAboutPK12-193 - Original - Russ Lloyd Cleaning & Demolition - Martinjussi Property Demolition, Removal & Asbestos Abatement - 06/14/2012 Records M gemen e
KENT - Document
WASHINGTGH
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: Russ Lloyd Clearing and Demolition
Vendor Number:
JD Edwards Numbe(r
-Ien
Contract Number: or t'Oq — I -5
This is assigned by City Clerk's Office
Project Name: Demolition and Asbestos Abatement Agreemetnfor Matinlussi Property
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 6/6/2012 Termination Date: 7/1/2012
Contract Renewal Notice (Days): 0
Number of days required notice for termination or renewal or amendment
Contract Manager: Brian Levenhagen (tp) Department: Parks Planning & Dev
Detail: (i.e. address, location, parcel number, tax id, etc.):
C Q -11.,
S•Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
�-/ KENT
PUBLIC WORKS AGREEMENT
between City of Kent and
Russ Lloyd Clearing & Demolition
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
" and Russ Lloyd Clearing & Demolition organized under the
corporation hereinafter the "City"), Y 9 9
p ( Y )
laws of the State of Washington, located and doing business at P.O. Box 4203, Federal Way, WA
98063, Russ Lloyd, 253-661-6967 (hereinafter the "Contractor").
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:
Removal and disposal of all associated buildings, foundations, walkways, out-
buildings and asbestos abatement at the Matinjussi Property located at 11220 SE
204t' Kent, WA 98032 as described in the contractor's proposal dated April 12, 2012
attached and incorporated as Exhibit A.
Contractor further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices within the Puget Sound
region in effect at the time such services are performed.
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, the Contractor shall complete the work described in Section I within 30
days.
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed
Thirty Two Thousand Dollars and no/100 ($32,000.00), including any applicable Washington
State Sales Tax, for the work and services 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 Payment and Performance Bond. Because this contract, including
applicable sales tax, is less than $35,000, and pursuant to Chapter 39.08
RCW, the Contractor, in lieu of providing the City a payment and
PUBLIC WORKS AGREEMENT - 1
(Over$1OK, under$35K, and No Performance Bond)
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, the State Department of Labor &
Industries, and the State Employment Security Department, 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 CONTRACTOR AS UNSETTLED AT THE
TIME FINAL PAYMENT IS MADE AND ACCEPTED.
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 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.
B. The Contractor maintains and pays for its own place of business from which
Contractor's services under this Agreement will be performed.
C. The Contractor has an established and independent business that is eligible
for a business deduction for federal income tax purposes that existed before
the City retained Contractor's services and is a service other than that
furnished by the City, or the Contractor is engaged in an independently
established trade, occupation, profession, or business of the same nature as
that involved under this Agreement.
D. The Contractor 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 Contractor has registered its business and established an account with
the state Department of Revenue and other state agencies as may be
PUBLIC WORKS AGREEMENT - 2
(Over$10K, under$35K, and No Performance Bond)
required by Contractor's business, and has obtained a Unified Business
Identifier (UBI) number from the State of Washington.
F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW
or an electrical contractor license pursuant to Ch. 19.28 RCW.
G. The Contractor maintains a set of books dedicated to the expenses and
earnings of its business.
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.
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
PUBLIC WORKS AGREEMENT - 3
(Over$10K, under$35K, and No Performance Bond)
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.
VIII. 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 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.
At a minimum, a Contractor'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.
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.
PUBLIC WORKS AGREEMENT - 4
(Over$1OK, under$35K, and No Performance Bond)
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 IS COMPLETE OR CONTRACTOR'S ABILITY TO
FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY
APPLICABLE STATUTORY 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 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 reasonable 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.
XI. 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.
PUBLIC WORKS AGREEMENT - 5
(Over$1OK, under$35K, and No Performance Bond)
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.
In the event Contractor 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
Contractor's part, then Contractor 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 Contractor's part.
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.
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 Dilutes 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
PUBLIC WORKS AGREEMENT - 6
(Over$1OK, under$35K, and No Performance Bond)
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 XII 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 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.
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.
PUBLIC WORKS AGREEMENT - 7
(Over$10K, under$35K, and No Performance Bond)
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.
CONTRACTOR: CITY OF KENT:
By: r By:
(si nature (signature)
Print Name:�zlsrr �1Y�' int Nam uzeotte Cooke
Its s Ma
(title)
DATE: OV14 er —/O DATE: b �-
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
Russ Lloyd Brian Levenhagen
Russ Lloyd Clearing & Demolition City of Kent
P.O. Box 4203 220 Fourth Avenue South
Federal Way, WA 98063 Kent, WA 98032
253-661-6967 (telephone) (253) 856-5116 (telephone)
253-661-1574 (facsimile) (253) 856-6050 (facsimile)
APPR VED AS TO FO M:
' ,A^Q
vVY
Kent Law Departmen
PUBLIC WORKS AGREEMENT - 8
(Over$1OK, under$35K, and No Performance Bond)
LX 1-
r
Russ Lloyd Clearing & Demolition
Russ Lloyd
President
DBA: R.L. Clearing&Excavating;Inc.
P.O. Box 4203 Telephone: 253 661-6967
Federal Way, WA 98063 Fax: 253 661-1574
April 12, 2012
City of Kent Park Planning &Development
Ph 253 856-5116
Re: 11220 SE 204'h Kent,WA 98032
Attn: Brian Levenbagen
R.L. Clearing&Excavating,Inc.proposes to provide the labor and the equipment for the
demolition and removal of the buildings as per specifications. Includes haul off and
disposal of demolition debris and concrete. Includes abatement as per specifications.
Includes demolition permit required by PSCAA.
Lump slam $28,416.00 plats sales tax
Not included in bid: Decommissioning well.
Thank you.
Russ Lloyd-President
Exclusions:
Security Fencing Utility Disconnect Sewer Caps Rodent/Pest Control
Underground Tanks Underground Utilities Traffic Control Permits
Asbestos Survey Imported Materials Erosion Control Shoring
Asbestos Contaminated Materials Brush&Stumps Street Cleaning
Saw Cutting Tree Protection Utility Caps Asphalt
Freon Recovery Right of Way Septic Tanks Air Monitoring
Contractors License 9 RLCLEEI097N2
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSTRUCTION PROJECTS
Insurance
The Contractor shall procure and maintain for the duration of the
Agreement, insurance against claims for injuries to persons or damage
to property which may arise from or in connection with the
performance of the work hereunder by the Contractor, their agents,
representatives, employees or subcontractors.
A. Minimum Scope of
Insurance
Contractor shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be
written on Insurance Services Office (ISO) form CA 00 01
or a substitute form providing equivalent liability coverage.
If necessary, the policy shall be endorsed to provide
contractual liability coverage.
2. Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01 and shall cover liability
arising from premises, operations, independent contractors
and personal injury and advertising injury. The City shall
be named as an insured under the Contactor's Commercial
General Liability insurance policy with respect to the work
performed for the City.
3. Excess Liability insurance covering both the Commercial
General Liability and Automobile policies.
4. Pollution Legal Liability insurance covering losses caused
by pollution conditions that arise from the operations of
the Contractor. The Pollution Legal Liability insurance shall
be written in an amount of at least $1,000,000 per loss,
with an annual aggregate of at least $1,000,000.
Coverage may be written on a claims-made basis.
5. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
EXHIBIT B (Continued)
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.
3. Excess Liability insurance shall be written with limits no
less than $1,000,000 per occurrence in excess of both
the CGL and Auto Liability policies cited above.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the
following provisions for Automobile Liability and Commercial General
Liability:
1. The Contractor's insurance coverage shall be primary
insurance as respect the City. Any insurance, self-insurance,
or insurance pool coverage maintained by the City shall be
excess of the Contractor's insurance and shall not contribute
with it.
2. The Contractor's insurance shall be endorsed to state that
coverage shall not be cancelled by either party, except after
thirty (30) days prior written notice by certified mail, return
receipt requested, has 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.
EXHIBIT B (Continued)
D. Contractor's Insurance For Other Losses
The Contractor shall assume full responsibility for all loss or damage
from any cause whatsoever to any tools, Contractor's employee owned
tools, machinery, equipment, or motor vehicles owned or rented by
the Contractor, or the Contractor's agents, suppliers or contractors as
well as to any temporary structures, scaffolding and protective fences.
E. Waiver of Subrogation
n the City waive all rights against each other an of
The Contractor and y g g Y
their Subcontractors, Sub-subcontractors, agents and employees, each
of the other, for damages caused by fire or other perils to the extend
covered by Builders Risk insurance or other property insurance
obtained pursuant to the Insurance Requirements Section of this
Contract or other property insurance applicable to the work. The
policies shall provide such waivers by endorsement or otherwise.
F. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating
of not less than ANII.
G. 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 Automobile Liability and Commercial
General Liability insurance of the Contractor before commencement of
the work.
H. 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.
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federaj 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 day of , 20_.
By: 4� W
100,
For:
Title: 0w/I
Date: 6 -160`)q
EEO COMPLIANCE DOCUMENTS - 1
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 (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 120
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
Client#:17856 RLCLEARI
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE IDD/YrrY)
121/2012
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)
PRODUCER CONTACT Amanda Rush
NAME
Propel Insurance PHONE 800.499.0933 WIC,No 866 577.1326
E Ect
Tacoma Commercial Insurance ADDRIESS atr@propelinsurance.com
1201 Pacific Ave,.Suite 1000 INSURER(S)AFFORDING COVERAGE NAIL#
Tacoma,WA 98402 INSURERA Transportation Insurance Compan
INSURED INSURER B American Casualty Co of Reading
R.L.Clearing&Excavating Inc
INSURER C
PO Box 4203
INSURER D
Federal Way,WA 98063
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 CONTRACTOR 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
LTR R INSR WVD
TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY
DNYVY MMILDDNYYY LIMBS
IN
A GENERAL LIABILITY X X 1029711069 04/1512012 0411512013 EACH OCCURRENCE $1,000 OOO
X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED
c r nce $100,000
CLAIMS-MADEF^'OCCUR MED EXP(Any one person) $5 O00
X PD Ded:2,000 PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEML AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $1,000,000
POLICY X JERCO7 LOC $
B AUTOMOBILE LIABILITY 1029711072 4115/2012 0415/201 EOaaBINEDt SINGLE LIMITfccu 1,000,000
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $ -
X HIRED AUTOS X AUTOS Peraxident
A X UMBRELLA LIAB X OCCUR 11029711086 04/15/2012 04115/2013 EACH OCCURRENCE $1,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000
DED X RETENTION$10000 $
WORKERS COMPENSATION
AND EMPLOYERS LIABILITYYIN WA Stop Gap only WC STATU- X OTH-
A ANY PROPRIETORPARTNER'EXECUTIVE 1029711069 0411512012 04/15/201 E L EACH ACCIDENT $1,000,000
OFFICER(MEMBER EXCLUDED? N NIA
(Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000,000
If cer
Dyes descnbeRIPTION OF O E L DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION in OPERATIONS below
A Leased&Rented 1029711069 4/15/2012 04/1612013 $150,000
Equipment $1,000 Deductible
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
Re. Matinjussi-11220 SE 204th Kent,WA 98032
CERTIFICATE HOLDER CANCELLATION
ANYELLED
City of Kent Admininstration THEULD EXPIRATTIIONH DATE V THEREOFDESCRE NOTTICEI ES WIBLL CBE CDELIVERED NE
Parks, Recreation &Community Serve ACCORDANCE WITH THE POLICY PROVISIONS
Attn.Teri Petrole
220 Fourth Ave So AUTHORIZED REPRESENTATIVE
Kent,WA 98032
@ 1988-2010 ACORD CORPORATION All rights reserved
ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S919132/M8973113 ATR00
R L Cleanng&Excavating Inc 1029711069 v
G-140331-C
CNA (Ed 10110)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
- WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE(OPTIONAL)
Name of Additional Insured Persons Or Organizations
(As required by"written contract" per Paragraph A. below.)
Locations of Covered Operations
(As per the"written contract,"provided the location is within the"coverage territory'of this Coverage Part.)
A. Section II - Who Is An Insured is amended to 2. We will not provide the additional insured any
include as an additional insured. broader coverage or any higher limit of
1. Any person or organization whom you are / insurance than the least that is:
required by "written contract" to add as an J a. Required by the"written contract'
additional insured on this Coverage Part; and b. Described in B.I.above; or
2. The particular person or organization, if any, c. Afforded to you under this policy.
scheduled above.
B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance
limited as follows: available to the additional insured whether on a
primary, excess, contingent or any other basis.
1. The person or organization is an additional But if required by the "written contract," this
insured only with respect to liability for "bodily insurance will be primary and non-contributory
injury," "property damage," or "personal and relative to insurance on which the additional
advertising injury"caused in whole or in part by insured is a Named Insured.
a. Your acts or omissions;or 4. The insurance provided to the additional insured
does not apply to "bodily injury," "property
b. The acts or omissions of those acting on damage," or "personal and advertising injury
your behalf arising out of
In the performance of your ongoing operations a. The rendering of, or the failure to render,
specified in the 'written contract', or any professional architectural, engineering,
c. "Your work" that is specified in the "written or surveying services, including:
contract" but only for "bodily injury" or property damage included in the (1) The preparing, approving, or failing to
"products-completed operations hazard," prepare or approve maps, shop
and only if drawings, opinions, reports, surveys,
y field orders, change orders or drawings
(1) The "written contract" requires you to and specifications;and
provide the additional insured such (2) Supervisory, inspection, architectural or
coverage, and engineering activities, or
(2) This Coverage Part provides such
coverage
G-140331-C Includes copyrighted matenal or Insurance Services Office,Inc.,with its permission Page 1 of 2
(Ed. 10110)
R L clearing S Excavating Inc 1029711069 G-140331-C
CNA (Ed 10110)
b. Any premises or work for which the We have no duty to defend or indemnify an
additional insured is specifically listed as an additional insured under this endorsement until
additional insured on another endorsement we receive from the additional insured written
attached to this Coverage Part notice of a claim or"suit"
C. SECTION IV — COMMERCIAL GENERAL 2. With respect only to the insurance provided by
LIABILITY CONDITIONS is amended as follows. this endorsement, the first sentence of
1. The Duties In The Event of Occurrence, Paragraph 4.a. of the Other Insurance Condition
Offense, Claim or Suit condition Is amended to is deleted and replaced with the following:
add the following additional conditions 4. Other Insurance
applicable to the additional insured. a, primary Insurance
An additional insured under this endorsement This insurance is primary and non-
will as soon as practicable- contributory except when rendered
(1) Give us written notice of an "occurrence" or excess by endorsement G-140331-C,
an offense which may result in a claim or or when Paragraph b. below applies.
"sult" under this insurance, and of any claim D. Only for the purpose of the insurance provided by
or suit thakdoesresult; this endorsement, SECTION V — DEFINITIONS is
(2) Except as provided in Paragraph B.3 of this amended to add the following definition:
endorsement, agree to make available any "Written contract" means a written contract or
other Insurance the additional Insured has written agreement that requires you to make a
for a loss we cover under this Coverage person or organization an additional insured on this
Part; Coverage Part, provided the contract or agreement:
(3) Send us copies of all legal papers received, 1. Is currently in effect or becomes effective during
and otherwise cooperate with us in the the term of this policy, and
investigation, defense, or settlement of the
claim or"suit", and 2. Was executed prior to:
(4) Tender the defense and indemnity of any a. The"bodily injury"or"property damage",or
claim or "suit" to any other insurer or self b The offense that caused the "personal and
insurer whose policy or program applies to a
loss we cover under this Coverage Part. advertising injury"
But if the "written contract" requires this for which the additional insured seeks coverage
insurance to be primary and non- under this Coverage Part
contributory, this provision (4) does not
apply to insurance on which the additional
Insured is a Named Insured.
G-140331-C Includes copyrighted material of Insurance Services Office,Inc.,with Its permission Page 2 of 2
(Ed. 10110)
Certificate of Insurance
Effective immediately, Propel Insurance will no longer issue certificates of insurance
not handled in accordance with statutory laws We will only issue the most current
edition of the ACORDO certificates of insurance In addition, the only information
allowed to be entered in the Description of Operations area of the ACORDO certificates
of insurance are the description of operations, the locations and/or vehicles covered by
the in-force policy
The issuance or modification of a certificate of insurance that in any way misrepresents
any material term, condition, coverage or other provision as set forth in the policy, or
deliberately or falsely amends or alters the insurance policy or assists in such issuance
or modification violates the state law and subjects the violator to civil and criminal
penalties
Please note a certificate of insurance is simply a summary of the designated insurance
policy and does not /cannot modify or amend the referenced insurance policy or confer
any right upon the certificate holder In addition, the certificate holder is owed no duty to
be notified in the event the insurance policy is cancelled
For purposes of this notice, "certificate" or"certificate of insurance" means any
ACORDO certificate of insurance, which is prepared or issued by an insurer or
insurance agent as evidence of property or casualty insurance coverage but does not
include an actual copy of the insurance policy or insurance binder
Please contact your state department of insurance for further explanation or inquiries.
R L Clearing&Excavating Inc
1029711069 G-18652-1
CNA (Ed. 07/09)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Coverage afforded under this extension of coverage endorsement does not apply to any person or organization
covered as an additional insured an any other endorsement now or hereafter attached to this Coverage Part
SCHEDULE
Coverages are summarized below. For particulars and limitations affecting each coverage, please refer to the
corresponding policy provisions in the body of this endorsement.
1. Miscellaneous Additional Insureds 13. Liberalization Clause
7 additional insured extensions 14. Unintentional Failure To Disclose Hazards
2. Employees As Insureds—Health Care Services 15. Notice of Occurrence
3. Joint Ventures/PartnershiplLimited Liability 16. Broad Knowledge of Occurrence
Companies
Coverage for your Interest in such terminated or 17. Aggregate Limits Per Project
ended organizations 18, Bodily Injury—Extension of Coverage
4. Expanded Personal And Advertising Injury 19. Expected Or Intended Injury
5. Medical Payments Reasonable force—bodily injury or property
Limits increased to$15.000. damage.
Reporting increased to three years from the 20. Wrap-Up Extension
date of accident
6. Legal Liability And Borrowed Equipment 21. Contractual Liability—Railroads
Extended perils. Expanded definition of"insured contract"
Limit increased to$200,000 for Damage to 22. Blanket Waiver of Subrogation
Premises Rented To You Waiver of subrogation where required by written
7. Non-owned Watercraft contract or written agreement.
Increased to 55 feet. 23. In Rem Actions
B. Non-owned Aircraft Coverage
9. Contractual Liability For Personal And
Advertising Injury
10. Supplementary Payments
Cost of bail bonds increased to$2,500,
Daily loss of earnings increased to$1,000.
11. Liquor Liability Coverage Extension
12. Newly Formed Or Acquired Organizations
Coverage extended to the end of the policy period.
G-16652-1 includes copyrighted material of Insurance Services Office,Inc,with Its permission. Page 1 of 8
(Ed. 07/09)
R L Clearing&Excavating Inc
1029711069 G-18652-1
CNA (Ed 07/09)
1. MISCELLANEOUS ADDITIONAL INSUREDS b. Controlling Interest
Section II Who Is An Insured is amended to Any persons or organizations with a
include as an insured any person or organization controlling interest in you but only with
(called additional insured) described in Paragraphs respect to their liability arising out of:
2.a. through 2.g. below whom you are required to (1) Their financial control of you, or
add as an additional insured on this policy under a
written contract or written agreement. However, the (2) Premises they own, maintain or
written contract or written agreement must be- control while you lease or occupy
these premises
1. Currently in effect or becoming effective
during the term of this policy, and This insurance does not apply to
structural alterations, new construction
2. Executed prior to the "bodily injury," and demolition operations performed by
"property damage" or "personal injury and or for such additional Insured.
advertising injury, but
c. Managers or Lessors of Premises
Only the following persons or organizations are
additional insureds under this endorsement and A manager or lessor of premises but
coverage provided to such additional insureds Is only with respect to liability arising out of
limited as provided herein, the ownership, maintenance or use of
that specific part of the premises leased
a. State or Governmental Agency or to you and subject to the following
Subdivision or Political Subdivisions additional exclusions:
A state or governmental agency or This insurance does not apply to:
subdivision or political subdivision
subject to the following provisions: (1) Any"occurrence"which takes place
after you cease to be a tenant in
(1) This insurance applies only with that premises; or
respect to the following hazards for
which the state or governmental (2) Structural alterations, new
agency or subdivision or political construction or demolition
subdivision has issued a permit or operations performed by or on
authorization in connection with behalf of such additional insured.
premises you own, rent, or control d, Mortgagee,Assignee or Receiver
and to which this insurance applies:
a The existence, maintenance, A mortgagee, assignee their
receiver but
( ) only with respect to their liability as
repair, construction, erection, or mortgagee, assignee, or receiver and
removal of advertising signs, arising out of the ownership,
awnings, canopies, cellar maintenance, or use of a premises by
entrances, coal holes, you.
driveways, manholes,
marquees, hoistaway openings, This insurance does not apply to
sidewalk vaults, street banners, structural alterations, new construction
or decorations and similar or demolition operations performed by
exposures; or or for such additional insured.
(b) The construction, erection, or e. Owners/Other Interests — Land is
removal of elevators; or Leased
(2) This insurance applies only with An owner or other interest from whom
respect to operations performed by land has been leased by you but only
you or on your behalf for which the with respect to liability arising out of the
state or governmental agency or ownership, maintenance or use of that
subdivision or political subdivision specific part of the land leased to you
has issued a permit or and subject to the following additional
authorization. exclusions:
This insurance does not apply to "bodily This insurance does not apply to-
injury," "property damage" or "personal (1) Any "occurrence"which takes place
and advertising injury" arising out of after you cease to lease that land;
operations performed for the federal or
govemment, state or municipality.
G-18552-1 Includes copyrighted material of Insurance Services Office,Inc,with Its permission Page 2 of 8
(Ed 07109)
R L Clearing&Excavating Inc
1029711069 G-18652-1
CNA (Ed 07/09)
(2) Structural alterations, new this insurance be either primary or
construction or demolition primary and noncontributing. Where
operations performed by or on required by written contract or
behalf of such additional insured. written agreement, we will consider
any other insurance maintained by
f. Co-owner of Insured Premises the additional insured for injury or
A co-owner of a premises cc-awned by damage covered by this
you and covered under this insurance endorsement to be excess and
but only with respect to the co-owners noncontributing with this insurance
liability as co-owner of such premises 2. EMPLOYEES AS INSUREDS — HEALTH CARE
g. Lessor of Equipment SERVICES
Any person or organization from whom Paragraph 2.a.(1)(d) of Section 11 — Who Is An
you lease equipment. Such person or Insured is deleted
organization are Insureds only with 3. JOINT VENTURES I PARTNERSHIP / LIMITED
respect to their liability arising out of the LIABILITY COMPANY COVERAGE
maintenance, operation or use by you
of equipment leased to you by such A. The following is added to Section 11 —Who Is
person or organization. A person's or An Insured:
organization's status as an insured 4. You are an insured when you had an
under this endorsement ends when interest in a joint venture, partnership or
their written contract or written limited [lability company which terminated or
agreement with you for such leased ended prior to or during this policy period
equipment ends. but only to the extent of your interest in such
With respect to the insurance afforded joint venture, partnership or limited liability
these additional insureds, the following company.This coverage does not apply'
additional exclusions apply: a. Prior to the termination date of any joint
This insurance does not apply: venture, partnership or limited liability
(1) To any "occurrence" which takes company, or
place after the equipment lease b. If there is other valid and collectible
expires; or insurance purchased specifically to
(2) To "bodily injury," "property insure the partnership, joint venture or
damage," or "personal and limited liability company.
advertising injury" arising out of the c. To a joint venture, partnership or limited
sole negligence of such additional liability company which is or was
insured. Insured under a"consolidated (wrap-up)
Any insurance provided to an additional insured insurance program."
designated under Paragraphs a. through g. "Consolidated (wrap-up) Insurance
above does not apply to "bodily injury" or program" means a construction, erection or
"property damage" included within the demolition project for which the prime
"products-completed operations hazard" contractor/project manager or owner of the
construction project has secured general
As respects the coverage provided under this
liability insurance covering some or all of the
provision, Paragraph 4.b.(1) of Section 1V —
contractors or subcontractors involved in
Commercial General Liability Conditions is
deleted and replaced with the following: the protect, otherwise referred to as an
Owner Controlled Insurance Program
4. Otherinsurance (O.C.I P.) or Contractor Controlled
b. Excess Insurance Insurance Program (C.C.I.P.).
1 This insurance is excess over. S. The last paragraph of Section 11 —Who Is An
( ) Insured is deleted and replaced by the
Any other insurance naming the following:
additional insured as an Insured Except as provided in Paragraph 4. above, no
whether primary, excess, person or organization is an insured with
contingent or on any other basis respect to the conduct of any current or past
unless a written contract or written partnership, joint venture or limited liability
agreement specifically requires that
G-18652-1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 3 of 8
(Ed.07/09)
R L Cleanng&Excavating Inc
1029711069 G-18652-1
CNA (Ed 07109)
company that is not shown as a Named Insured — I — Coverage C for all medical expenses
in the Declarations, because of "bodily injury" sustained by any
4. EXPANDED PERSONAL AND ADVERTISING one person. The Medical Expense Limit is
INJURY the greater of:
A. The following is added to Section V — (1) $15,000, or
Definitions, the definition of "Personal and (2) The amount shown in the
advertising injury": Declarations for Medical Expense
h. Discrimination or humiliation that results in Limit.
injury to the feelings or reputation of a B. This provision 5. (Medical Payments) does not
natural person, but only if such apply if Section I — Coverage C Medical
discrimination or humiliation is: Payments is excluded either by the provisions
(1) Not done intentionally by or at the of the Coverage Part or by endorsement.
direction of: C. Paragraph 1.a.(3)(b) of Section I—Coverage C
a The insured; or — Medical Payments, is replaced by the
O following
(b) Any "executive officer," director, (b) The expenses are incurred and reported to
stockholder, partner, member or us within three years of the date of the
manager(if you are a limited liability accident, and
company)of the insured,and
(2) Not directly or indirectly related to the 6. LEGAL LIABILITY AND BORROWED
employment, prospective employment, EQUIPMENT
past employment or termination of A. Under Section I—Coverage A—Bodily Injury
employment of any person or persons and Property Damage 2. Exclusions,
by any insured. Exclusion j.is replaced by the following.
B. Exclusions of Section I — Coverage B — "Property damage"to:
Personal and Advertising Injury Liability is (1) Property you own, rent,or occupy;
amended to include the following
Discrimination Relating To Room, (2) Premises you sell, give away or
Dwelling or Premises abandon, if the property damage
arises out of any part of those
Caused by discrimination directly or premises;
indirectly related to the sale, rental, lease or (3) Property loaned to you,
sub-lease or prospective sale, rental, lease
or sub-lease of any room, dwelling or (4) Personal property in the care,
premises by or at the direction of any custody or control of the insured,
insured. (5) That particular part of real property
Fines Or Penalties on which you or any contractors or
Fines or penalties levied or imposed by a subcontractors working directly or
governmental entity because of indirectly on your behalf are
discrimination. performing operations, if the
property damage arises out of
D. This provision 4. (EXPANDED PERSONAL those operations; or
AND ADVERTISING INJURY COVERAGE) (6) That particular part of any property
does not apply if Section I — Coverage B — that must be restored, repaired or
Personal And Advertising Injury Liability is replaced because "your work" was
excluded either by the provisions of the incorrectly performed on it.
Coverage Part or by endorsemenL
5. MEDICAL PAYMENTS Paragraph (2) of this exclusion does not
apply if the premises are "your work"
A. Paragraph 7. Medical Expense Limit, of and were never occupied, rented or
Section III — Limits of Insurance is deleted held for rental by you.
and replaced by the following: Paragraphs (1), (3) and (4) of this
7. Subject to Paragraph 5. above (the Each exclusion do not apply to:
Occurrence Limit), the Medical Expense (i) "property damage" to tools
Limit is the most we will pay under Section or equipment loaned to you
G-1 B652-1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 8
(Ed 07/09)
R L Clearing&Excavating Inc
1029711069 G-18652-1
CNA (Ed. 07109)
if the tools or equipment b. The Damage To Premises Rented To
are not being used to You Limit shown in the Declarations.
perform operations at the D. Paragraph 4.b.(1)(a)(ii) of Section IV —
time of lass; or Commercial General Liability Conditions is
(fi) "property damage" (other deleted and replaced by the following
than damage by fire) to (ii) That is property insurance
premises rented to you or for premises rented to you
temporarily occupied by or temporarily occupied by
you with the permission of you with the permission of
the owner, or to the the owner; or
contents of premises
rented to you for a period of E. This provision 6. (LEGAL LIABILITY AND
7 or fewer consecutive BORROWED EQUIPMENT) does not apply if
days. A separate limit of Damage To Premises Rented To You Liability
Insurance applies to under Section I — Coverage A is excluded
Damage To Premises either by the provisions of the Coverage Part or
Rented To You as by endorsement
described in Section III —Limits Of Insurance. 7 NON-OWNED WATERCRAFT
Paragraphs (3), (4), (5) and (6) of this Under Section I — Coverage A, Exclusion 2.g.,
exclusion do not apply to liability subparagraph (2) is deleted and replaced by the
assumed under a sidetrack agreement following
Paragraph (6) of this exclusion does not (2) A watercraft you do not own that is:
apply to "property damage" included in (a) Less than 55 feet long, and
the "products-completed operations
hazard." (b) Not being used to carry persons
or property for a charge.
B. Under Section I—Coverage A—Bodily Injury
and Property Damage the last paragraph of 2. 8. NON-OWNED AIRCRAFT
Exclusions is deleted and replaced by the Exclusion 2.9. of Section I—Coverage A—Bodily
fallowing. Injury and Property Damage, does not apply to an
Exclusions c, through in. do not apply to aircraft you do not own, provided that:
damage by fire to premises while rented to you 1. The pilot in command holds a currently
or temporarily occupied by you with permission effective certificate issued by the duly
of the owner or to the contents of premises constituted authority of the United States of
rented to you for a period of 7 or fewer America or Canada, designating that person
consecutive days. as a commercial or airline transport pilot;
A separate limit of insurance applies to this 2. It is rented with a trained, paid crew; and
coverage as described in Section III — Limits
Of Insurance. 3. It does not transport persons or cargo for a
C. Paragraph 6. Damage To Premises Rented To charge.
You Limit of Section III—Limits Of Insurance 9• CONTRACTUAL LIABILITY FOR PERSONAL
is replaced by the following: AND ADVERTISING INJURY
6. Subject to Paragraph S. above, (the Each Exclusion e. Contractual Liability of Section I —
Occurrence Limit), the Damage To Coverage B Is deleted.
Premises Rented To You Limit is the most 10. SUPPLEMENTARY PAYMENTS
we will pay under Section—I—Coverage A
for damages because of"property damage" A. Under Section I—Supplementary Payments—
to any one premises while rented to you or Coverages A and B, Paragraph 1.b., the limit of
temporarily occupied by you with the • $250 shown for the cost of bail bonds is
permission of the owner, including contents replaced by$2,500.
of such premises rented to you for a period B. In Paragraph 1.d., the limit of $250 shown for
of 7 or fewer consecutive days. The daily loss of earnings is replaced by$1,000.
Damage To Premises Rented To You Limit
is the greater of: 11. LIQUOR LIABILITY
a. $200,000; or Exclusion c.of Section I—Coverage A is deleted.
G-18652-1 Includes copyrighted material of Insurance Services Office, Inc,with Its permission. Page 5 of 8
(Ed. 07/09)
R L Clearing&Excavating Inc
1029711069 G-18552-1
CNA (Ed 07109)
12. NEWLY FORMED OR ACQUIRED (4) A manager, if you are a limited
ORGANIZATIONS liability company.
Paragraph 3.a. of Section II —Who Is An Insured 17. AGGREGATE LIMITS PER PROJECT
is deleted and replaced by the fallowing: A. For all sums which the insured becomes legally
Coverage under this provision Is afforded only until obligated to pay as damages caused by
the end of the policy period or the next anniversary "occurrences" under Section I — Coverage A,
of this policy's effective date after you acquire or and for all medical expenses caused by
form the organization,whichever is earlier. accidents under Section I—Coverage C,which
13. LIBERALIZATION CLAUSE can be attributed only to ongoing operations at a
single construction project away from premises
If we adopt a change in our forms or rules which owned by or rented to the insured:
would broaden coverage for contractors under this 1, A separate Single Construction Project
endorsement without an additional premium charge, General Aggregate Limit applies to each
your policy will automatically provide the additional construction project away from premises
coverages as of the date the revision is effective in owned by or rented to the insured, and that
your state. limit is equal to the amount of the General
14. UNINTENTIONAL FAILURE TO DISCLOSE Aggregate Limit shown in the Declarations.
HAZARDS 2. The Single Construction Project General
Based on our reliance on your representations as to Aggregate Limit is the most we will pay for
existing hazards, if unintentionally you should fail to the sum of all damages under Coverage A,
disclose all such hazards at the 'inception date of except damages because of "bodily injury'
your policy, we will not deny coverage under this or "property damage" included in the
Coverage Part because of such failure. "products-completed operations hazard,"
15. NOTICE OF OCCURRENCE and for medical expenses under Coverage
C regardless of the number of:
The following is added to Paragraph 2. of Section a. Insureds,
IV — Commercial General Liability Conditions —
Duties In The Event of Occurrence, Offense, It. Claims made or"suits"brought; or
Claim or Suit: c. Persons or organizations making claims
Your rights under this Coverage Part will not be or bringing "suits."
prejudiced if you fail to give us notice of an 3. Any payments made under Coverage A for
"occurrence," offense, claim or"suit" and that failure damages or under Coverage C for medical
is solely due to your reasonable belief that the expenses shall reduce the Single
bodily injury' or property damage is not covered Construction Project General Aggregate
under this Coverage Part However, you shall give
written notice of this "occurrence," offense, claim or Limit for that construction project away from
"suit" to us as soon as you are aware that this premises owned by or rented to the insured.
Such payments shall not reduce the
insurance may apply to such "occurrence," offense
claim or"suit." General Aggregate Limit shown in the
Declarations nor shall they reduce any other
16. BROAD KNOWLEDGE OF OCCURRENCE Single Construction Project General
The followingis added to Paragraph 2, of Section Aggregate Limit for any other separate
g p construction project away from premises
IV — Commercial General Liability Conditions — owned by or rented to the insured.
Duties in The Event of Occurrence, Offense,
Claim or Suit: 4. The limits shown in the Declarations for
You must give us or our authorized representative Each Occurrence, Damage To Premises
"occurrence," offense, claim, or "suit' Rented To You and Medical Expetoad se
notice of an "o
„ continue to apply. However, Instead of
only when the occurrence, offense, claim or"suit' being subject to the General Aggregate
is known to Limit shown in the Declarations, such limits
(1) You, if you are an individual; will be subject to the applicable Single
Construction Project General Aggregate
(2) A partner, if you are a partnership; Limit.
(3) An executive officer or the B. For all sums which the insured becomes legally
employee designated by you to give obligated to pay as damages caused by
such notice, if you are a "occurrences" under Section I — Coverage A,
corporation, or
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and for all medical expenses caused by 20. OWNER CONTROLLED INSURANCE PROGRAM,
accidents under Section 1—Coverage C,which CONTRACTOR CONTROLLED INSURANCE
cannot be attributed only to ongoing operations PROGRAM OR CONSOLIDATED (WRAP-UP)
at a single construction project away from INSURANCE PROGRAMS
premises owned by or rented to the insured. The endorsement EXCLUSION—CONSTRUCTION
1. Any payments made under Coverage A for WRAP-UP PROGRAM which is attached to this
damages or under Coverage C for medical policy is amended as follows.
expenses shall reduce the amount available A. If the endorsement EXCLUSION —
under the General Aggregate Limit or the CONSTRUCTION WRAP-UP or another
Products-Completed Operations Aggregate exclusionary endorsement pertaining to Owner
Limit,whichever is applicable; and Controlled Insurance Programs (O.C.I P.) or
2. Such payments shall not reduce any Single Contractor Controlled Insurance Programs
Construction Project General Aggregate (C.C.I.P.) is attached to this policy, then it Is
Limit. amended to add the following-
C. When coverage for liability arising out of the With respect to a "consolidated (wrap-up)
"products-completed operations hazard" is insurance program" project in which you are or
provided, any payments for damages because were involved, this exclusion does not apply to:
of"bodily injury" or"property damage" included
in the "products-completed operations hazard" 1. Your liability for "bodily injury," "property
will reduce the Products-Completed Operations damage," or"persona( or advertising injury"
Aggregate Limit, and not reduce the General that occurs during your ongoing operations
Aggregate Limit nor the Single Construction at the project, or during such operations of
Project General Aggregate Limit anyone acting on your behalf,
D. If a single construction project away from 2. Your liability for "bodily injury" or "property
premises owned by or rented to the insured has damage included within the "products-
been abandoned and then restarted, or if the completed operations hazard that arises
authorized contracting parties deviate from
out of those portions of the project that are plans, blueprints, designs, specifications or not"residential structures."
timetables, the project will still be deemed to be B. The following is added to Paragraph 4.b.(1) of
the same construction project Section IV-Commercial General Liability
E. The provisions of Section III — Limits Of Conditions
Insurance not otherwise modified by this This insurance is excess over
endorsement shall continue to apply as
stipulated. (c) Any of the other insurance whether
primary, excess, contingent or any other
18. EXPANDED BODILY INJURY basis that Is insurance available to you
Section V — Definitions, the definition of "bodily as a result of your being a participant in
injury" is changed to read: a "consolidated (wrap-up) insurance
program," but only as respects your
"Bodily injury" means bodily injury, sickness or involvement in that"consolidated (wrap-
disease sustained by a person, including death, up)insurance program."
humiliation, shock, mental anguish or mental injury C. The fallowing is added to Section V —
by that person at any time which results as a Definitions:
consequence of the bodily injury, sickness or
disease. "Consolidated (wrap-up) insurance program"
19. EXPECTED OR INTENDED INJURY means a construction, erection or demolition
project for which the prime contractor/project
Exclusion a. of Section I — Coverage A — Bodily manager or owner of the construction project
Injury and Property Damage Liability is replaced has secured general liability insurance covering
by the following, some or all of the contractors or subcontractors
a. "Bodily injury" or "property damage" involved in the project, otherwise referred to as
expected or intended from the an Owner Controlled Insurance Program
standpoint of the insured. This (O.C.I.P ) or Contractor Controlled Insurance
exclusion does not apply to "bodily Program (C.0 i P.).
injury" or "property damage" resulting "Residential structure" means any structure
from the use of reasonable force to where 30% or more of the square foot area is
protect persons or property. used or is intended to be used for human
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residency including but not limited to single or (1) That indemnifies an architect,
multifamily housing, apartments, condominiums, engineer or surveyor for injury or
townhouses, co-operatives or planned unit damage arising out of:
developments and also includes their common (a) Preparing, approving or failing
areas and/or appurtenant structures (including to pools, hot tubs, detached garages, guest prepare of approve maps,
s
houses or any similar structures).When there is shop drawings, opinions,
no individual ownership of units, residential reports, surveys, field orders,
structure does not include military housing, change orders or drawings and
college/university housing or dormitories, long specifications; or
term care facilities, hotels, or motels. (b) Giving directions or instructions,
Residential structure also does not include or failing to give them, if that is
hospitals or prisons. the primary cause of the injury
21. CONTRACTUAL LIABILITY—RAILROADS or damage;
With respect to operations performed within 50 feet (2) Under which the insured, if an
of railroad property, the definition of "insured architect, engineer or surveyor,
contract" in Section V— Definitions is replaced by assumes liability for an injury or
the following damage arising out of the insured's
rendering or failure to render
"Insured Contract" means: professional services, including
a. A contract for a lease of premises. those listed in (1) above and
However, that portion of the contract for supervisory, inspection,architectural or engineering
a lease of premises that indemnifies
any person or organization for damage activities.
by fire to premises while rented to you 22. BLANKET WAIVER OF SUBGROGATION
or temporarily occupied by you with The Transfer Of Rights Of Recovery Against
permission of the owner is not an Others To Us Condition (Section IV—Commercial
"insured contract"; General Liability Conditions) is amended by the
b. A sidetrack agreement, addition of the following:
c. Any easement or license agreement; We waive any right of recovery we may have
d. An obligation, as required by ordinance, against any person or organization because of
to indemnify a municipality, except in payments we make for injury or damage arising out
of
connection with work for a municipality,
e. An elevator maintenance agreement; 1. Your ongoing operations; or
f. That part of any other contract or 2. "Your work" included in the "products-
agreement pertaining to your business completed operations hazard."
(including an Indemnification of a However, this waiver applies only when you have
municipality in connection with work agreed in writing to waive such rights of recovery in
performed for a municipality) under a contract or agreement, and only if the contract or
which you assume the tort liability of agreement:
another party to pay for"bodily injury" or"property damage" to a third person or 1. Is in effect or becomes effective during the
organization. Tort haUlity means a term of this policy; and
liability that would be imposed by law in 2. Was executed prior to loss.
the absence of any contract or
agreement 23. IN REM ACTIONS
Paragraph f. does not include that part Any action in rem against any vessel owned,
of any contract or agreement operated by or for, or chartered by or for you will be
treated in the same manner as though the action
were in personam against you.
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(Ed. 07/09)
POLICYNUMBER 1029711072 COMMERCIAL AUTO
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This endorsement modifies insurance provided under the following
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by
this endorsement
This endorsement identifies person(s) or organization(s)who are "insureds" under the Who Is An Insured Provision of the
Coverage Form This endorsement does not alter coverage provided in the Coverage Form
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below
Endorsement Effective Countersigned By
Named Insured R.L. Clearing & Excavatin
Inc Authorized Representative)
SCHEDULE
Name of Person(s)or Organization(s)
City of Kent Administration Parks, Recreation & Community Services
Attn: Teri Petrole 220 Fourth Avenue South
Kent, WA 98032
Re : Matin 'ussi - 11220 SE 204th Kent WA 98032
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to the endorsement.)
0
Each person or organization shown in the Schedule is an"insured"for Liability Coverage, but only to the extent that person
or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage
0 Form
N
r
N
CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
REQUEST FOR MAYOR'S SIGNATURE
KENT Please Fill in All Applicable Boxes
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Reviewed by Director
Originator: Brian Levenha en Phone (Originator): x5115
Date Sent: June , 2012 Date Required:
Return Signed Document to: Brian/Teri CONTRACT TERMINATION DATE:
VENDOR NAME: Russ Lloyd Clearing/Demo DATE OF COUNCIL APPROVAL: June 5, 2012
ATTACH MOTION SHEET FOR THE MAYOR
Brief Explanation of Document:
This contract is to demolish the house and out buildings and complete asbestos abatement at
the Matinjussi property located in the Panther Lake Annexation area. The work needs to be
completed by the end of June to qualify for the reimbursement through the RCO grant that the
city received to acquire the Matinjussi property.
All Contracts Must Be Routed Through The Law Department
(This area to be completed by the Law Department)
Received:
L
Approval of Law Dept.:
Law Dept. Comments: jUN 0 8 2012
F
Date Forwarded to Mayor: _
Shaded Areas To Be Completed By Administration Staff r
Received:
Recommendations and Comments:
Disposition:
�r7r✓C�el-� v47
Date Returned: