HomeMy WebLinkAboutPW12-203 - Original - The Watershed Company - Meridian Valley Creek Enhancements - 08/13/2013 Records Mana— erne-n�
KENT Document
W n 5 H I NOTON
t
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: The Watershed Company
Vendor Number:
JD Edwards Number
Contract Number: &g , ;to3
This is assigned by City Clerk's Office
Project Name: Meridian Valley Creek Enhancements
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 8/13/12 Termination Date: 6/30/13
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Matt Knox Department: Engineering
Detail: (i.e. address, location, parcel number, tax id, etc.):
Assist with technical questions during construction of the project.
S•Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
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KENT
WASHINGTON
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
The Watershed Company
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and The Watershed Company organized under the laws of the State of
Washington, located and doing business at 750 Sixth St. S., Kirkland, WA 98033, Phone: (425)
822-5242/Fax: (425) 827-8136, Contact: Hugh Mortensen (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the
following described plans and/or specifications:
The Consultant shall assist with technical questions during the construction of the
Meridian Valley Creek Enhancements Project. For a description, see the
Consultant's July 12, 2012 Scope of Work which is attached as Exhibit A and
incorporated by this reference.
Consultant further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices within the Puget Sound
region in effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks
described in Section I above immediately upon the effective date of this Agreement. Upon the
effective date of this Agreement, Consultant shall complete the work described in Section I by
June 30, 2013.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to
exceed Seven Thousand, Eight Hundred Dollars ($7,800.00), plus applicable
Washington State sales tax for the services described in this Agreement. This is
9 9
the maximum amount to be paid under this Agreement for the work described in
Section I above, and shall not be exceeded without the prior written authorization
of the City in the form of a negotiated and executed amendment to this agreement.
The Consultant agrees that the hourly or flat rate charged by it for its services
contracted for herein shall remain locked at the negotiated rate(s) for a period of
one (1) year from the effective date of this Agreement. The Consultant's billing
rates shall be as delineated in Exhibit A.
B. The Consultant shall submit monthly payment invoices to the City for work
performed, and a final bill upon completion of all services described in this
CONSULTANT SERVICES AGREEMENT - 1
(Under$10,000)
Agreement. The City shall provide payment within forty-five (45) days of receipt of
an invoice. If the City objects to all or any portion of an invoice, it shall notify the
Consultant and reserves the option to only pay that portion of the invoice not in
dispute. In that event, the parties will immediately make every effort to settle the
disputed portion.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. The Consultant has the ability to control and direct the performance and
details of its work, the City being interested only in the results obtained
under this Agreement.
B. The Consultant maintains and pays for its own place of business from which
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible
for a business deduction for federal income tax purposes that existed before
the City retained Consultant's services, or the Consultant is engaged in an
independently established trade, occupation, profession, or business of the
same nature as that involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with
the state Department of Revenue and other state agencies as may be
required by Consultant's business, and has obtained a Unified Business
Identifier (UBI) number from the State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and
earnings of its business.
V. TERMINATION. Either party may terminate this Agreement, with or without
cause, upon providing the other party thirty (30) days written notice at its address set forth on
the signature block of this Agreement. After termination, the City may take possession of all
records and data within the Consultant's possession pertaining to this project, which may be
used by the City without restriction. If the City's use of Consultant's records or data is not
related to this project, it shall be without liability or legal exposure to the Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on
behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
employment relates. Consultant shall execute the attached City of Kent Equal Employment
Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion
of the contract work, file the attached Compliance Statement.
CONSULTANT SERVICES AGREEMENT - 2
(Under$10,000)
VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Consultant's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any.of Consultant's work when completed shall not
be grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or
damages to property caused by or resulting from the concurrent negligence of the Consultant
and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability
hereunder shall be only to the extent of the Consultant's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
In the event Consultant refuses tender of defense in any suit or any claim, if that tender
was made pursuant to this indemnification clause, and if that refusal is subsequently determined
by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the
Consultant's part, then Consultant shall pay all the City's costs for defense, including all
reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and
fees incurred because there was a wrongful refusal on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this
Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and
incorporated by this reference.
IX. EXCHANGE OF INFORMATION.. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of
completion of the work under this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents,
drawings, designs, reports, or any other records developed or created under this Agreement
shall belong to and become the property of the City. All records submitted by the City to the
Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents,
and files available to the City upon the City's request. The City's use or reuse of any of the
documents, data and files created by Consultant for this project by anyone other than
Consultant on any other project shall be without liability or legal exposure to Consultant.
XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent
contractor with the authority to control and direct the performance and details of the work
authorized under this Agreement, the work must meet the approval of the City and shall be
subject to the City's general right of inspection to secure satisfactory completion.
CONSULTANT SERVICES AGREEMENT - 3
(Under$10,000)
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all
necessary precautions and shall be responsible for the safety of its employees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection necessary
for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be
responsible for any loss of or damage to materials, tools, or other articles used or held for use in
connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. If the parties are unable
to settle any dispute, difference or claim arising from the parties' performance of this
Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by
filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court,
King County, Washington, unless the parties agree in writing to an alternative dispute resolution
process. In any claim or lawsuit for damages arising from the parties' performance of this
Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award
provided by law; provided, however, nothing in this paragraph shall be construed to limit the
City's right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
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
CONSULTANT SERVICES AGREEMENT - 4
(Under$10,000)
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Consultant's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONSULTAN CITY OF KENT:
By, Atal� By:
(Sig ature)
Print Name: /7 Print Name: Timothy J. LaPorte, P.E.
Its: Its: Pujblic Works Director
(title)
DATE: DATE: 2D��-
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Hugh Mortensen Timothy J. LaPorte, P.E.
The Watershed Company City of Kent
750 Sixth St. S. 220 Fourth Avenue South
Kirkland, WA 98033 Kent, WA 98032
(425) 822-5242 (telephone) (253) 856-5500 (telephone)
425 827-8136 facsimile (253) 856-6500 (facsimile)
Watershed Co Meridian Valley CA 2/Knox
CONSULTANT SERVICES AGREEMENT - 5
(Under $10,000)
1
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, II agree to fulfill the five requirements referenced above.
Dated this 2r0 4�day of �L1/ , 2012- .
B
Y•
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 1
y
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
E
t
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
t
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 The Watershed Company Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the
Agreement known as Meridian Valley Creek Enhancements Project that was entered into on
the August 13, 2012, 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.
4f
Dated this day ofy , 201 4?
By:
For: /L I C W�"z Y ';� 4cril V
Title: f ��t�
Date: t
a
8
i
I
EEO COMPLIANCE DOCUMENTS - 1
EXHIBIT A
SCIENCE & l) ES IG N
WATERSHED
( `r 71�✓t I'rA i� 1
July 12, 2012
Matt Knox
City of Kent Environmental Engineering I Public Works Department
220 Fourth Avenue South
I
Kent, WA 98032
Re: Meridian Creek Restoration—Consulting services during construction
Dear Matt:
This letter outlines a scope of work and associated fees for providing additional services
on an on-call basis, The proposed scope of work is as follows:
I
1) Provide review and response to City requests for information(RFI's)as submitted
by the construction contractor. These responses will be in the form of a technical
memorandum to provide additional detail regarding the design plans or to approve
proposed alternative construction techniques or materials. Estimated cost- $900
per memo (assumes no site visit needed). Assuming no more than three
responses,the Not-To-Exceed (NTE) cost for this item is $2,700.
2) Construction monitoring inspections will be provided and will include one-half
day site visit followed by an inspection report detailing site conditions and
recommendations to conform to plans, specifications or project intent, Estimated
cost: $1,800 per inspection and report, Assuming no more than two inspections,
the NTE cost for this item is $3,600
3) Review and comment on punch-list items as provided by City staff, summarized
in a technical memorandum. Estimated cost: $1,500. Assuming one punch list
response,the NTE cost for this item is $1,500.
The overall not-to-exceed cost for this proposal is$7,800.
Please call if you have any questions or if I can provide you with any additional
information.
Sincerely,
Hugh Mortensen,PWS
Principal
750 Sixth Street South Kirkland,WA 98033
p 425 822 5242 1 425 827 8136 watershedco tom i
t .
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned,
hired and leased vehicles. Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage. If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01. The City shall be named as an
Additional Insured under the Consultant's Commercial General
Liability insurance policy with respect to the work performed for the
City using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Consultant shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined single
limit for bodily injury and property damage of $1,000,000 per
accident.
2. Commercial General Liability insurance shall be written with limits
no less than $1,000,000 each occurrence, $2,000,000 general
aggregate.
i
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified mail, return receipt requested, has
been given to the City.
3. The City of Kent shall be named as an additional insured on all
policies (except Professional Liability) as respects work performed
by or on behalf of the Consultant and a copy of the endorsement
naming the City as additional insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required insurance policies. The Consultant's
Commercial General Liability insurance shall also contain a clause
stating that coverage shall apply separately to each insured against
whom claim is made or suit is brought, except with respects to the
limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Consultant before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
AC RO o• CERTIFICATE OF LIABILITY INSURANCE DATE (M12012
Qnzn2o12
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 H 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 endorsements)
PRODUCER Phone (360)598-3700 Fax (360)598.3703 CONTACT MICHAEL J.HALL&COMPANY
AME
MICHAEL J HALL&COMPANY PHONE FAX 598.3703
HALL&COMPANY Arc Ne E6 (360)598-3700 ac No (360)
E-MAIL
19660 10TH AVENUE N.E. ADDRESS
INSURERS)AFFORDING COVERAGE NAIC ItPOULSBO WA 98370
INSURER Underwriters at Lloyd's,London
INSURED INSURERS Hartford Casualty Insurance Co. 29424
The Watershed Company
750 6Th St S INSURER Sentinel Insurance Company 11000
Kirkland,WA 98033-6715 INSURER
INSURER
INSURER F
COVERAGES CERTIFICATE NUMBER: 164793 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE ADD'L SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR MD MMIO MMIO
B GENERAL LIABILITY X X 52SBALG6505 09130111 09/30112 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED 3OD,000
X COMMERCIAL GENERAL LIABILITY PREMISES(Eaoccurence) $
CLAIMS-MADE OCCUR LIED EXP(Anyone person) $ 10,000
X OCP,XCU,BFPD PERSONAL&ADV INJURY $ 2,000,000
X Separation of Insureds GENERAL AGGREGATE $ 4,000,000
GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 4,000,000
PRO-
, POLICY X JECT LOC $
INEDC AUTOMOBILE LIABILITY X X 52UECJR5898 09/30111 09/30112 COMBident) NGLELIMIT 1,000,000
(Ea accident) $
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNEDN
SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $
X HIRED AUTOSNON-OWNED PROPERTYDAMAGE $
AUTOS (per accidaM)
X UMBRELLA LIAB OCCUR X 52SBALG6505 11111111 09130/12 EACHOCCURRENCE $ 1,000,000
Excess LIAe CLAIMS-MADE AGGREGATE $ 1,000,000
DIED I X RETENTION$ 10,000 $
WORMERS COMPENSATION 52SBALG6505 09/30/11 09130/12 wcSTATu X " WA Stop Ga
B AND EMPLOYERS LIABILITY X TORY LIMITS ER $ 0 P
YIN EL EACH ACCIDENT $ 1,000,DOO
ANY PROPRIETORIPARTNEPJEXECUTNE
OFFICERIMEMBER EXCLUDED? ❑ MIA EL DISEASE-EA EMPLOYEE $ 1,000,000
(Marl Cory in NH)
If yes,descnbe under
DESCRIPTION OF OPERATIONS bebw EL DISEASE-POLICY LIMIT $ 1,000,000
A Professional Liability Claims Made Finn 11238719421011 09130/11 09/30/12 $1,000,000 Per Claim Retro Date:
$1,000,000 Aggregate Sep 30,1993
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
Project Meridian Valley Creek
City of Kent is an Additional Insured on the Commercial General Liability and Auto Liability when required by written contract or
agreement regarding activities by or on behalf of the Named Insured.This insurance is pnmary insurance and any other insurance
maintained by the Additional Insured shall be excess only and non-contributing with this insurance A waiver of subrogation applies to the
Commercial General Liability,Auto Liability,Umbrella/Excess Liability and WA Stop Gap/Employers Liability in favor of the Additional
Insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS
220 Fourth Avenue South AUTHORIZED REPRESENTATIVE
Kent,WA 98032
Attention
Ashley L Hurd
ACORD 25(2010105) c 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to--
control is being exercised for any (1) "Bodily injury" or "property damage"
purpose by you, any of your
"employees", "volunteer workers", that occurred; or
any partner or member (d you are (2) "Personal and advertising injury"
a partnership or joint venture), or arising out of an offense committed
any member (if you are a limited before you acquired or formed the
liability company). organization.
b. Real Estate Manager 4. Operator Of Mobile Equipment
Any person (other than your"employee"or With respect to "mobile equipment"registered in
"volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while driving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property permission. Any other person or organization
Any person or organization having proper responsible for the conduct of such person is
also an insured, but only with respect to liability
temporary custody of your property if you arising out of the operation of the equipment,and
die, but only. only if no other insurance of any kind is available
(1) With respect to(!ability arising out of the to that person or organization for this liability.
maintenance or use of that property,and However,no person or organization is an insured
(2) Until your legal representative has with respect to:
been appointed. a. "Bodily injury" to a co-"employee" of the
d. Legal Representative If You Die person driving the equipment, or
Your legal representative if you die, but b. "Property damage" to property owned by,
only with respect to duties as such. That rented to, in the charge of or occupied by
representative will have all your rights and you or the employer of any person who is
duties under this insurance an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which is a legally incorporated entity is less than 51 feet long and is not being used
of which you own a financial interest of to carry persons for a charge, any person is an
more than 50% of the voting stock on the insured while operating such watercraft with
effective date of this Coverage Part. your permission. Any other person or
The insurance afforded herein for any organization responsible for the conduct of
subsidiary not shown in the Declarations such person is also an insured, but only with
as a named insured does not apply to respect to liability arising out of the operation
injury or damage with respect to which an of the watercraft, and only if no other
be insurance of any kind is available to that
insured under another policy or would be
insured under this insurance �s also person or organization for this liability.
an insured under such policy but for its However, no person or organization is an
termination or upon the exhaustion of its insured with respect to:
limits of insurance a. "Bodily injury" to a co-"employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft;or
Any organization you newly acquire or form, b. 'Property damage" to property owned by,
other than a partnership, joint venture or rented to, in the charge of or occupied by
limited liability company, and over which you you or the employer of any person who is
maintain financial interest of more than 50% of an insured under this provision.
the voting stock, will qualify as a Named 6. Additional Insureds When Required By
Insured rf there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However. Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified in
only until the 180th day after you acquire Paragraphs a. through f. below are additional
or form the organization or the end of the insureds when you have agreed, in a written
policy period,whichever is earlier;and
Form SS 00 08 04 05 Page 11 of 24
The Hartford
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (e) Any failure to make such
permit issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional insured on your agreed to make or normally
policy, provided the injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement,or the issuance of the permit. with the distribution or sale of the
A person or organization is an additional products;
insured under this provision only for that (f) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit. except such operations performed
at the vendor's premises i
However,no such person or organization is an
additional insured under this provision if such connection with the sale of the
person or organization is included as an product;
additional insured by an endorsement issued (g) Products which, after distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
Including all persons or organizations added or relabeled or used as a
as additional insureds under the specific container, part or ingredient of any
additional insured coverage grants in Section other thing or substance by or for
F.—Optional Additional Insured Coverages. the vendor;or
a. Vendors (h) "Bodily injury" or "property
Any person(s)or organization(s) (referred to damage" arising out of the sots
below as vendor), but only with respect to negligence of the vendor for its
own acts or omissions or those of
"bodily injury" or "property damage" arising
its employees or anyone else
out of "your products" which are distributed
or sold in the regular course of the vendor's acting on its behalf. However,this
business and only if this Coverage Part exclusion does not apply to
provides coverage for "bodily injury" or (1) The exceptions contained in
"property damage" included within the Subparagraphs(d)or(f);or
"products-completed operations hazard". (it) Such inspections, adjustments,
(1) The insurance afforded to the vendor tests or servicing as the vendor
is subject to the following additional has agreed to make or normally
exclusions. undertakes to make in the usual
This insurance does not apply to: course of business, in
connection with the distribution
(a) "Bodily injury" or "property or sale of the products.
damage" for which the vendor is (2) This insurance does rot apply to any
obligated to pay damages by insured person or organization from
reason of the assumption of whom you have acquired such products,
liability in a contractor agreement or any ingredient, part or container,
This exclusion does not apply to entering into, accompanying or
liability for damages that the containing such products.
vendor would have in the absence
of the contract or agreement; b. Lessors Of Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
(c) Any physical or chemical change
with respect to their liability for"bodily
injury', property damage" or
in the product made intentionally "personal and advertising injury"
by the vendor; caused, in whole or in part, by your
(d) Repackaging, except when maintenance, operation or use of
unpacked solely for the purpose of equipment leased to you by such
inspection, demonstrabon, testing, person or organization
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container,
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded e. Permits Issued By State Or Political
to these additional insureds, this Subdivisions
insurance does not apply to any (1) Any state or political subdivision, but
"occurrence" which takes place after only with respect to operations
you cease to lease that equipment. performed by you or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has issued a permit.
whom you tease land or premises, but (2) With respect to the insurance afforded
only with respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to
of that part of the land or premises (a) "Bodily injury", "property damage"
leased to you or "personal and advertising
(2) With respect to the insurance afforded injury" arising out of operations
to these additional insureds, this performed for the state or
insurance does not apply to municipality;or
(a) Any "occurrence" which takes (b) "Bodily injury" or"property damage"
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises;or f. Any Other Party
(b) Structural alterations, new
construction or demolition (1) Any other person or organization who
s not an insured under Paragraphs a.
operations performed by or on through e above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. "property damage" or "personal and
d. Architects, Engineers Or Surveyors advertising injury"caused, in whole or
(1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those acting
injury", "property damage" or "personal on your behalf,
and advertising injury"caused, in whole (a) In the performance of your
or in part, by your acts or omissions or ongoing operations;
the acts or orrussiens of those acting on (b) In connection with your premises
your behalf: owned by or rented to you;or
(a) In connection with your premises; (c) In connection with"your work"and
or included within the "products-
(b) In the performance of your completed operations hazard", but
ongoing operations performed by only if
you or on your behalf. (I) The written contract or written
(2) With respect to the insurance afforded agreement requires you to
to these additional insureds, the provide such coverage to
following additional exclusion applies; such additional insured; and
This insurance does not apply to (III) This Coverage Part provides
"bodily injury", "property damage" or coverage for "bodily injury" or
"personal and advertising injury" "property damage" included
arising out of the rendering of or the within the "products-
faWre to render any professional completed operations hazard".
services by or for you,including- (2) With respect to the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure to prepare or approve, insurance does not apply to
maps, shop drawings, opinions, "Bodily injury", "property damage" or
reports, surveys, field orders, "personal and advertising injury"
change orders, designs or arising out of the rendering of, or the
drawings and specifications, or failure to render, any professional
(b) Supervisory, inspection, architectural, engineering or surveying
architectural or engineering services, including-
activities.
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "property damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arising out of fire, lightning or
drawings and specifications, or explosion.
(b) Supervisory, inspection, 3. Each Occurrence Limit
architectural or engineering Subject to 2.a. or 2.b above, whichever
activities. applies,the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
insureds are described in Section D. — Limits "property damage" and medical expenses
Of Insurance. arising out of any one 'occurrence" is the
How this insurance applies when other Liability and Medical Expenses Limit shown in
insurance is available to an additional insured the Declarations,
is described in the Other Insurance Condition The most we will pay for all medical expenses
in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any
General Conditions. one person is the Medical Expenses Limit
No person or organization is an insured with shown in the Declarations
respect to the conduct of any current or past 4. Personal And Advertising Injury Limit
partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for
company that is not shown as a Named Insured in the sum of all damages because of all
the Declarations. "personal and advertising injury" sustained by
D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
Declarations
1. The Most We Will Pay
S. Damage To Premises Rented To You Limit
The Limits of Insurance shown in the
Declarations and the rules below fix the most The Damage most
e will
Rented us You
we will pay regardless of the number of. Limit is the most we r dl pay under Business
Liability Coverage for damages because of
a. Insureds, "property damage"to any one premises, while
b. Claims made or"suits"brought; or rented to you, or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing"suits" temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for: In the case of damage by fire, lightning or
explosion,the Damage to Premises Rented To
a. Damages because of "bodily injury" and You Limit applies to all damage proximately
"property damage" included in the caused by the same event, whether such
"products-completed operations hazard" is damage results from fire,lightning or explosion
the Products-Completed Operations or any combination of these
Aggregate Limit shown in the 6. How Limits Apply To Additional Insureds
Declarations.
b. Damages because of all other "bodily The most we will pay on behalf of a person or
injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of:
expenses, is the General Aggregate Limit a. The limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies permit issued by a state or political
separately to each of your "locations" subdivision, or
owned by or rented to you. b• The Limits of Insurance shown in the
"Location" means premises involving the Declarations.
same or connecting lots, or premises Such amount shall be a part of and not in
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this (1) Immediately send us copies of any
policy and any endorsements attached thereto demands, notices, summonses or
applies to any claim or"suit", the most we will pay legal papers received in connection
under this policy and the endorsements is the with the claim or"suit";
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit". However, this other information,
paragraph does not apply to the Medical Expenses
limit set forth in Paragraph 3.above (3) Cooperate with us in the investigation,
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply against the"suit"; and
separately to each consecutive annual period and to (4) Assist us, upon our request, in the
any remaining penod of less than 12 months,starting
with the beginning of the policy period shown in the enforcement of any right against any
be
Declarations, unless the policy period is extended liaperson or insured
nation that may ry
after issuance for an addrtional period of less than 12 or d m the insured because of rniury
months In that case, the additional period will be or damage ly which this insurance
deemed part of the last preceding period for purposes may also apply.
of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost
No insured will, except at that insured's own
E. LIABILITY AND MEDICAL EXPENSES cost, voluntarily make a payment, assume
GENERAL CONDITIONS any obligation, or incur any expense, other
1. Bankruptcy than for first aid,without our consent
Bankruptcy or insolvency of the insured or of e. Additional Insured's Other insurance
the insured's estate will not relieve us of our If we cover a claim or "suit" under this
obligations under this Coverage Part Coverage Part that may also be covered
2. Duties In The Event Of Occurrence, by other insurance available to an
Offense,Claim Or Suit additional insured, such additional insured
a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the
You or any additional insured must see to other insurer for defense and indemnity.
- it- that we are notified as soon as However, this provision does not apply to
practicable of an "occurrence" or an the extent that you have agreed in a
offense which may result in a claim. To written contract, written agreement or
the extent possible, notice should include, permit that this insurance is primary and
non-contributory with the additional
(1) How,when and where the"occurrence" insured's own insurance.
or offense took place; f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses;and
Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury any additional insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" is
"occurrence"or offense. known to
b. Notice Of Claim (1) You or any additional insured that is
If a claim is made or "suit" is brought an individual;
against any insured, you or any addibonat (2) Any partner, rf you or an additional
insured must: insured is a partnership;
(1) Immediately record the specifics of the (3) Any manager, if you or an additional
claim or "suit" and the date received; insured is a limited liability company;
and
(4) Any "executive officer" or insurance
(2) Notify us as soon as practicable. manager, if you or an additional
You or any additional insured must see to insured is a corporation;
it that we receive a written notice of the (5) Any trustee, if you or an additional
claim or"suit"as soon as practicable, insured is a trust,or
c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you
Insured or an additional insured is a political
You and any other involved insured must: subdivision or public entity
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to (3) We have issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of Hazards
financial responsibility for the future under If unintentionally you should fail to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the inception date of this
provided by the policy for "bodily injury" Coverage Part, we shall not deny any
liability and "property damage" liability will coverage under this Coverage Part
comply with the provisions of the law to because of such failure
the extent of the coverage and limits of 7. Other insurance
insurance required by that law.
If other valid and collectible insurance is
b. With respect to "mobile equipment" to available for a loss we cover under this
which this insurance applies, we will Coverage Part, our obligations are limited as
provide any liability, uninsured motorists, follows
underinsured motorists, no-fault or other
coverage required by any motor vehicle a. Primary Insurance
law. We will provide the required limits for This insurance is primary except when b.
those coverages. below applies If other insurance is also
4. Legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described in c.
this Coverage Form, below
a. To torn us as a party or otherwise bring us b. Excess insurance
into a "suit" asking for damages from an This insurance is excess over any of the
insured,or other insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis
all of its terms have been fully compiled (1) Your Work
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or
on an agreed settlement or an a final judgment similar coverage for"your work";
against an insured, but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of
this insurance or that are in excess of the That fire, lightning explosion
applicable limit of insurance An agreed insurance for premises rented to you
settlement means a settlement and release of or temporarily occupied by you with
liability signed by us, the insured and the permission of the owner,
claimant or the claimant's legal representative. (3) Tenant Liability
5. Separation Of Insureds That is insurance purchased by you to
cover your liability as a tenant for
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned "property damage" to premises rented
in this policy to the first Named Insured, this w you or temporarily the owner,
occupied by you
with permission of th
insurance applies:
w
a. As if each Named Insured were the only (4) Aircraft,Auto Or Watercraft
Named Insured;and If the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft,"autos"or watercraft to
a claim is made or"suit"is brought the extent not subject to Exclusion g.of
6, Representations Section A.—Coverages.
(6) Property Damage To Borrowed
a. When You Accept This Policy Equipment Or Use Of Elevators
By accepting this policy,you agree: If the loss arises out of "property
(1) The statements in the Declarations damage" to borrowed equipment or
are accurate and complete, the use of elevators to the extent not
(2) Those statements are based upon subject to Exclusion k. of Section A.—
representations you made to us;and Coverages
Page 16 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this insurance is excess over other
Additional Insured To Other insurance, we will pay only our share of
Insurance the amount of the loss, if any, that
That is other Insurance available to exceeds the sum of:
you covering liability for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss in the
operations,or products and completed absence of this insurance,and
operations, for which you have been (2) The total of all deductible and self-
added as an additional insured by that insured amounts under all that other
insurance;or insurance.
(7) When You Add Others As An We will share the remaining loss,if any,with
Additional Insured To This any other insurance that is not described in
Insurance this Excess Insurance provision and was not
That is other insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown in the
However, the following provisions Declarations of this Coverage Part.
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the other insurance permits
additional insured under this Coverage contribution by equal shares,we will follow
Part: this method also Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid its applicable limit of
This insurance is primary it you insurance or none of the loss remains,
have agreed in a written contract, whichever comes first_
written agreement or permit that If any of the other insurance does not pemut
this insurance be primary. If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method, each
share with all that other insurance insurer's share is based on the ratio of its
by the method described in c. applicable limit of insurance to the total
below. applicable limits of insurance of all insurers.
(b) Primary And Non-Contributory S. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written If the insured has rights to recover all or
contract, written agreement or part of any payment, including
permit that this insurance is Supplementary Payments, we have made
primary and non-contributory with under this Coverage Part, those rights are
the additional insured's own transferred to us The insured must do
insurance, this insurance is nothing after loss to impair them, At our
primary and we will not seek request, the insured will bring "suit" or
contribution from that other transfer those rights to us and help us
insurance. enforce them. This condition does not
Paragraphs(a)and(b) do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional 'V'"b, Waiver Of Rights Of Recovery (Waiver
insured has been added as an Of Subrogation)
additional insured. If the insured has waived any rights of
When this insurance is excess, we will recoverya
have no duty under this Coverage Part to against any person or
organization for all or part of any payment,
defend the insured against any"suit" if any including Supplementary Payments, we
other insurer has a duty to defend the have made under this Coverage Part, we
insured against that "suit", If no other also waive that right, provided the insured
Insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other insurers agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
1
COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM
ENDORSEMENT
This endorsement modifies insurance provided under the following
0
No BUSINESS AUTO COVERAGE FORM
o
To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other
'i o provisions of the Coverage Form,the provisions of this endorsement apply
Ln
�
1. BROAD FORM INSURED B, Employees as Insureds
w A. Subsidiaries and Newly Acquired or Paragraph A 1 -WHO IS AN INSURED - of
N Formed Organizations SECTION II - LIABILITY COVERAGE is
N The Named Insured shown in the amended to add
o Declarations is amended to include. d_ Any "employee" of yours while using a
Ln
o (1) Any legally incorporated subsidiary in covered "auto" you don't awn, hire or
* which you own more than 50% of the borrow in your business or your
voting stock on the effective date of the persona{affairs.
Coverage Form However, the Named C. Lessors as Insureds
Insured does not include any subsidiary Paragraph A.1 • WHO IS AN INSURED - of
that is an "insured" under any other Section II - Liability Coverage is amended to
_ automobile policy or would be an add:
"insured" under such a policy but for its
termination or the exhaustion of its Limit e The lessor of a covered "auto" while the
"auto' is leased to you under a written
of Insurance
agreement if:
(2) Any organization that is acquired or
formed by you and over which you (1) The agreement requires you to
maintain majority ownership However, provide direct primary insurance for
the Named Insured does not include any the lessor and
newly formed or acquired organization (2) The "auto" is leased without a driver.
(a) That is a partnership, joint venture Such a leased "auto" will be considered a
or limited liability company covered "auto" you own and not a covered
(b) That is an"insured" under any other "auto"you hire
policy, 2. AUTOS RENTED BY EMPLOYEES
(c) That has exhausted its Limit of Any "auto" hired or rented by your "employee"
Insurance under any other policy, or on your behalf and at your direction will be
_ (d) 180 days or more after its considered an "auto"you hire
acquisition or formation by you, The OTHER INSURANCE Condition is amended
unless you have given us notice of by adding the following.
the acquisition or formation If an "employee's" personal insurance also
Coverage does not apply to "bodily applies on an excess basis to a covered "auto"
injury" or "property damage" that results hired or rented by your "employee" on your
from an "accident" that occurred before behalf and at your direction, this insurance will
you formed or acquired the organization be primary to the "employee's" personal
insurance
Form HA 9916 07 06 Page 1 of 3
02006, The Hartford (Includes copyrighted material
of ISO Properties, Inc with its permission)
3. AMENDED FELLOW EMPLOYEE EXCLUSION 6. LEASE GAP COVERAGE
EXCLUSION 5 - FELLOW EMPLOYEE - of Under SECTION III - PHYSICAL DAMAGE
SECTION 11 - LIABILITY COVERAGE does not COVERAGE, if a long-term leased "auto" is a
apply if you have workers' compensation covered "auto" and the lessor is named in the
insurance in-force covering all of your policy as a Loss Payee, we will pay in the event
"employees", of a total "loss" your additional legal obligation to
Coverage is excess over any other collectible the lessor for any difference between the actual
insurance cash value of the "auto" at the time of the "loss"
4. HIRED AUTO PHYSICAL DAMAGE and the"outstanding balance"of the lease
COVERAGE "Outstanding balance" means the amount you
owe on the lease at the time of "loss" less any
If hired "autos" are covered "autos" for Liability amounts representing taxes- overdue payments,
Coverage and if Comprehensive, Specified penalties, interest or charges resulting from
Causes of Loss, or Collision coverages are overdue payments, additional mileage charges;
provided under this Coverage Form for any excess wear and tear charges, lease termination
"auto" you own, then the Physical Damage fees.
Coverages provided are extended to "autos" you AIRBAG COVERAGE
hire or borrow, subject to the following limit 7.
The most vie will pay for "loss" to any hired Under Paragraph B EXCLUSIONS - of SECTION
"auto" is III - PHYSICAL DAMAGE. COVERAGE, the
(1) $50,000. following is added
{2} The actual cash value of the damaged or The exclusion relating to mechanical breakdown
does not apply to the accidental discharge of an
stolen property at the time of the"loss" or airbag
(3) The cost of repairing or replacing the g, ELECTRONIC EQUIPMENT-BROADENED
damaged or stolen property, COVERAGE
whichever is smallest, minus a deductible The The exceptions to Paragraphs BA -
deductible will be equal to the largest deductible EXCLUSIONS - of SECTION III - PHYSICAL
applicable to any owned "auto" for that DAMAGE COVERAGE are replaced b the
coverage. No deductible applies to "loss" p y
following
caused by fire or lightning Hired Auto Physical
Damage coverage is excess over any other Exclusions 4 c.and 4 d do not apply to
collectible insurance. Subject to the above limit, a Equipment designed solely for the
deductible and excess provisions, we will reproduction of sound and accessories used
provide coverage equal to the broadest with such equipment, provided such
coverage applicable to any covered "auto" you equipment is permanently installed in the
own covered "auto" at the time of the "loss" or
We will also cover lass of use of the hired "auto" such equipment is removable from a
if it results from an "accident", you are legally housing unit which is permanently installed
liable and the lessor incurs an actual financial in the covered "auto" at the time of the
loss subject to a maximum of $1000 per "loss", and such equipment is designed to
"accident" be solely operated by use of the power from
This extension of coverage does not apply to the "autos" electrical system, in or upon the
or
covered'auto'
any "auto" you hire or borrow from any of your
"employees", partners (if you are a partnership), b. Electronic equipment that is necessary for
members (if you are a limited liability company), the normal operation of the covered "auto"
or members of their households. or the monitoring of the covered "auto's"
5 PHYSICAL DAMAGE -ADDITIONAL operating system, or
TEMPORARY TRANSPORTATION EXPENSE c. Electronic equipment that is an integral part
COVERAGE of the same Unit housing any sound
reproducing equipment described in
Paragraph A 4.a. of SECTION III - PHYSICAL
Paragraph a, above and permanently
DAMAGE COVERAGE is amended to provided
a limit of $50 per day and a maximum limit of installed i the opening of the dash or
t
console of the covered "auto" normally used
S1 000 by the manufacturer for installation of a
radio
Form HA 9916 07 06 Page 2 of 3
d; Any other electronic equipment that receives (2) A partner, if you are a partnership;
or transmits audio, visual or data signals if (3) A member, if you are a limited liability
such equipment company, or
(1) is permanently installed in a covered (4) An executive officer or insurance manager if
"auto" at the time of the "loss": and you are a corporation
(2) is designed to be solely operated by use 13, UNINTENTIONAL FAILURE TO DISCLOSE
of the power from the "auto's" electrical HAZARDS
system, in or upon the covered "auto"; If you unintentionally fail to disclose any hazards
and existing at the inception date of your policy, we
(3) was initially installed or is a replacement will not deny coverage under this Coverage
of equipment that was initially installed Form because of such failure.
by the auto manufacturer or dealer 14. HIRED AUTO -COVERAGE TERRITORY
before the covered "auto" was delivered Paragraph e. of GENERAL CONDITIONS 7. -
o to the original purchaser, and POLICY PERIOQ, COVERAGE TERRITORY of
(4) the value of the equipment was included SECTION IV- BUSINESS AUTO CONDITIONS is
CD in the retail cost the original purchaser replaced by the following,
� paid for the covered "auto"
C3 9. EXTRA EXPENSE-BROADENED e For short-term hired "autos", the coverage
COVERAGE territory with respect to Liability Coverage is
in anywhere in the world provided that if the
154 Under Paragraph A. - COVERAGE - of SECTION "insured's" responsibility to pay damages for
N III - PHYSICAL DAMAGE COVERAGE, we will "bodily injury" or "property damage" is
N pay for the expense of returning a stolen covered determined in a"suit,"the "suit" is brought in
o "auto"to you. the United States of America, the territories
0 10. GLASS REPAIR -WAIVER OF DEDUCTIBLE and possessions of the United States of
Under Paragraph D.-DEDUCTIBLE-of SECTION America, Puerto Rico or Canada or in a
III - PHYSICAL DAMAGE COVERAGE, the settlement we agree to
following is added, 15. WAIVER OF SUBROGATION
No deductible applies to glass damage if the TRANSFER OF RIGHTS OF RECOVERY
glass is repaired rather than replaced AGAINST OTHERS TO US - of SECTION IV -
11. TWO OR MORE DEDUCTIBLES BUSINESS AUTO CONDITIONS is amended by
Under Paragraph D -DEDUCTIBLE-of SECTION adding the following:
III - PHYSICAL DAMAGE COVERAGE, the We waive any right of recovery we may have
following is added against any person or organization with whom
If another Hartford Financial Services Group, you have a written contract that requires such
Inc. company policy or coverage form that is not waiver because of payments we make for
an automobile policy or coverage form applies to damages under this Coverage Form
the same"accident",the folowing applies 16. RESULTANT MENTAL ANGUISH COVERAGE
(1) If the deductible under this Business Auto The definition of "bodily injury" in SECTION V-
Coverage Form is the smaller (or smallest) DEFINITIONS is replaced by the following
deductible, it will be waived, "Bodily injury" means bodily injury, sickness or
(2) If the deductible under this Business Auto disease sustained by any person, including
Coverage Form is not the smaller (or mental anguish or death resulting from any of
smallest) deductible, it will be reduced by these
the amount of the smaller (or smallest) 17. EXTENDED CANCELLATION CONDITION
deductible Paragraph 2 of the COMMON POLICY
12. AMENDED DUTIES IN THE EVENT OF CONDITIONS - CANCELLATION - applies except
ACCIDENT, CLAIM,SUITOR LOSS as follows
The requirement in LOSS CONDITIONS 2.a - If we cancel for any reason other than
DUTIES IN THE EVENT OF ACCIDENT, nonpayment of premium, we will mail or deliver
CLAIM, SUIT OR LOSS - of SECTION IV - to the first Named Insured written notice of
BUSINESS AUTO CONDITIONS that you must cancellation at least 60 days before the effective
notify us of an "accident" applies only when the date of cancellation
"accident"is known to
(1) You, if you are an individual,
Form HA 99 16 07 06 Page 3 of 3