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PK12-271 - Original - Entreprises Climbing Walls - Arbor Heights 360 Park Climbing Wall Repair - 11/16/2012
Records Man-agerneti- KENT Document WASH$NGTOH w 4a 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: Entreprise8 Climbing Walls Vendor Number: ]D Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: Arbor Heights 360 Park Climbing Wall Repair Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 10/15/12 Termination Date: 12/31/2012 Contract Renewal Notice (Days): 0 Number of days required notice for termination or renewal or amendment Contract Manager: Andy Sheridan(tp) Department: Park Operations Detail: (i.e. address, location, parcel number, tax id, etc.): S Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT WAS"INOTON PUBLIC WORKS AGREEMENT between City of Kent and Entreprises Climbing Walls THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Entreprises Climbing Walls organized under the laws of the State of Oregon, located and doing business at 63085 181h Street, Suite 101, Bend, Oregon, 98133, (541)388-5463, and Sander Culliton (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: At Arbor Heights 360 Park: -Clean and paint entire internal frame with rust inhibiting paint on both climbing structures. -Strip hand holds and pressure was exterior of both climbing structures. -Paint entire exterior of both climbing structures for U.V. protection and longevity. -Paint to match existing color patterns. -Re-install all climbing hand holds with proper routes. -Seal rope rubs at the top of big climbing structure. -Seal hole in smaller climbing wall. -Seal all cracks in both climbing structures. -Replace webbing at rap anchor with a longer one that includes a rap ring and reaches just over the top of the wall to minimize rope rub. -Replace top rope quick links with stainless "V" anchors (8 in all). This work will occur at Arbor Heights 360 Skate Park in Kent, Washington as described in the contractor's proposal dated August 15, 2012 attached and incorporated herein 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 by August PUBLIC WORKS AGREEMENT - 1 (Over$1OK, under $35K, and No Performance Bond) 1, 2013. Work is weather dependent and shall commence upon written notification by the City. Any adjustment to the work schedule shall be made upon mutual, prior written agreement between the two parties. III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed Eighteen Thousand Dollars and no/100 ($18,000.00), 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 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. PUBLIC WORKS AGREEMENT - 2 (Over$10K, under$35K, and No Performance Bond) 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 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 PUBLIC WORKS AGREEMENT - 3 (Over$1OK, under$35K, and No Performance Bond) of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. 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; PUBLIC WORKS AGREEMENT - 4 (Over$10K, under$35K, and No Performance Bond) 4. The estimated dollar cost, If any, of the claimed work and how that estimate was determined; and S. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruption. B. Records. The Contractor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Contractor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK 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, PUBLIC WORKS AGREEMENT - 5 (Over$1OK, under$35K, and No Performance Bond) discriminate against any person who is qualified and available to perform the work to which the employment relates. Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XII. INDEMNIFICATION. Contractor shall defend, Indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Contractor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement Is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. 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. PUBLIC WORKS AGREEMENT - 6 (Over$1OK, under$35K, and No Performance Bond) A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, 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 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$1OK, 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: (sign (signature) Print Name: :�aSt",\ tc��IC Pri t e Suzette Cooke Its Its Mayor (title) DATE: DATE: 6 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Sander Culliton Andrew Sheridan Entreprises Climbing Walls City of Kent 63085 18th Street, Suite 101 220 Fourth Avenue South Bend, Or 97701 Kent, WA 98032 (541) 408-6970 (telephone) (253) 856-5122 (telephone) (541) 388-3248 (facsimile) (253) 856-6120 (facsimile) APPROVED AS TO RM: Kent Law Departmen [In this field,you trey MW the electmnk flMOath whom the aantmat has Nun saved] PUBLIC WORKS AGREEMENT - 8 (Over$1OK, under $35K, and No Performance Bond) 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. S. 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 �('5t day of 0C46 , 20 (Z. By:t: -/ For: e5 Title: �Mbwq&l� �iltC-�dr Date: ��- 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 , 20 By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 ENTRE PRISES PF Chni Walls CLIMBING WALL REPAIR PROPOSAL Date 8 15 12 Attn City of Kent Contact Brian Saw Arbor 360 climbing wall Email bsawna a kent wa us 220 Fourth Ave South Phone 253 856 5126 Kent,WA 98032 Job number 1846 Freeform surface Imprint Surface Total surface of the wall 200 m' 2152 sf INSPECTION Paint Surface 4 ea $700 00 $2 800 00 Paint Frames 2 ea $700 00 $1,400 00 Strip/Clean 1 ea $700 00 $700 00 Surface RepairslAnchors 1 ea $700 00 $700 00 Roulesetting 1 ea $700 00 $700 00 Expenses 1 ea $3,856 25 $3,856 25 Hardware/Materials 1 ea $2,333 00 $2,333 00 Equipment Rental 1 ea $1,03125 $1,03125 'TOTAL BY EP. $13,520.60 not including taxes Customer hereby authorizes EP USAto perform an inspection/service of the above-identified climbingwall in accordance with the above-detailed Maintenance Quotation and the attached Terms and Conditions of Service, and agrees to pay EP USA the inspection/service fee specified above at the time of mspection/service EP USA has the right not to release its Inspection Report or Certificate without payment in full Customer's signature below acknowledges that he/she has read,understands,and agrees to be bound by the Terms and Conditions below Any acceptance or use of the Inspection Report shall constitute acceptance of all of the Terms and Conditions below Accepted by Title Date NOTES Entre paws USA,6308518th Street,Suite 101, Bend OR 97701 Phone(541)388-5463 Fax (641)388-3248 w epusa com EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. 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. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 2. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. EXHIBIT B (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 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. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. BEECHEER�A�RLS©N "aw_LC Passion. Innovation.Accountability. Why We Are Using the Latest ACORD 25 Certificate of Insurance In September 2009, ACORD revised the ACORD 25 Certificate of Insurance form One of the major changes was the removal of the cancellation notice provision For the following reasons, we are unable to issue an older edition of this form, modify the current form, or complete a proprietary form you provide • ACORD certificate forms must be fled and approved for use in our state When a new form is approved, prior versions can no longer be used Therefore, it is illegal for us to issue anything other than the currently approved ACORD form • Notice of cancellation is a policy right, not an unregulated service No insurer shown on this certificate is able to provide the cancellation notice you desire by endorsement For example, the insured can cancel Immediately, so it would be Impossible for the Insurer to give you the notice you request State law also grants the Insurer the right to cancel for reasons such as nonpayment with less notice than you require • For the reason just cited, if our agency was to issue a certificate that provides the cancellation notice you request, we would do so with the full knowledge that it would be impossible to actually give that amount of notice under certain circumstances As such, the certificate could be alleged to constitute a misrepresentation or fraud which could subject our agency and staff to serious civil and criminal penalties • If a certificate purports to provide a policy right different from that provided by the policy Itself, then the certificate effectively purports to be a policy form Policy forms must be filed and approved by our state department of insurance Use of nonfiled policy forms is illegal and could result in legal sanctions distinct from the assertion that the certificate is fraudulent • Under the ACORD Corporation's licensing agreement, the prior editions of superseded forms can be used for one year from the time the new forms are introduced Beginning in September 2010, this is another reason we cannot use an older edition of the ACORD 25 Doing so would violate ACORD's licensing agreement and, as a copyrighted document, federal copyright law • Likewise, we are unable to modify the new certificate to add a notice of cancellation ACORD forms are designed to be completed, not altered ACORD's Forms Instruction Guide says that a certificate should not be used "To waive rights To quote wording from a contract To quote any warding which amends a policy unless the policy itself has been amended "Also, since our state requires ACORD forms to be filed, any alteration to a filed form would require its refiling In addition, our insurance company contracts only allow us to issue unaltered ACORD forms • We are often asked to issue proprietary certificates provided by the certificate requester Again, our insurance company contracts only allow us to issue unaltered ACORD forms In addition, our state requires the filing of all certificates of insurance and has very specific regulatory guidelines on certificate language Many proprietary certificates include broad, vague or ambiguous language that may or may not be incompliance with state laws, regulations, and insurance department directives Therefore, we cannot issue any proprietary certificates that have not been reviewed by our state insurance department Several states have voiced strong concern over certificates as evidenced in below links: • Oregon Insurance Dept http//www cbs state or us/external/ins/producer/topics/certificate-insurance article pdf • Atlanta, Georgia See detailed study they conducted in 2008 http//tinyurl com/26guax8 • Click following link for current update by state http/Av wv iiaba net/eprise/mainNU/NonMemberMilsonCertLawSRegs htm#Alabama We appreciate your understanding of the legal restrictions on our ability to fully comply with your request 220 l2nd Ave Ste 800 Portland,OR 97209-1831 (503)222-1831 Main (503)274-0323 Fax CA License#OF09618 OR License#816307 WA License#252204 i A� CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDYYVV) 10/24/2012 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 Beecher Carlson Insurance Agency, LLC CONTACT NAME (BENDI Juh 296 SW Columbia St, Suite D PHONE A/C,No Extl 541-749-4 FAX A/C No541-749-4959 Bend, OR 97702 E MAIL ADDRESS )ulle hammon=beechercarlson.com INSURERS AFFORDING COVERAGE NAIC0 INSURER Great American E&S Insurance INSURED INSURERS OregonAutomobile Entre Prises USA Inc 63085 18th Street INSURER SAIF Corporation Suite 101 INSURER Evanston insurance Company Bend OR 97701 INSURER Zurich American INSURER F COVERAGES CERTIFICATE NUMBER. 14508474 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 CLAIMSADDL _ —POLICY EX INSR TYPE OF INSURANCE INSR wynSUBI POLICY NUMBER MM/DDY LTR IYYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY V ✓ PL527954108 5/15/2012 5/15/2013 EACH OCCURRENCE $ 1,000,000 ✓ COMMERCIAL GENERAL LIABILITY PREMISES(EaEocccuvDence) $ 300,000 J CLAIMS-MADE C OCCUR MED EXP(Any one person) $ 5,000 ✓ Washington Stop Gap PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY ✓ ' PRO- LOC $ B AUTOMOBILE LIABILITY ✓ ✓ CD2173$9$ 5/15/2012 5/15/2013 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ✓ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Peraccident) S AUTOS AUTOS NI PROPERTY DAMAGE ✓ HIREDAUTOS ✓ AUTOS Peracadent $ $ A ✓ UMBRELLA LIAB ✓ occuR UM557420109 5/15/2012 5/15/2013 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED ✓ RETENTION$10,000 $ C WORKERS COMPENSATIONIE 959833(Oregon) 7/1/2012 7l1/2013 W SSTATu- orI- AND EMPLOYERS'LIABILITY ✓ TORY LIMITS E E ANY PROPRIETOR/PARTNERXECUTIVEY/N WC9663307(Multi-State) 7/1/2012 7/1/2013 OFFICERIMEMBER EXCWDED> ❑N NIA EL EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1$ 1,000,000 D Professional Liability-Claims Made SP856844 5/15/2012 5/15/2013 1,000,000 per Claiml$2,000,000 Aggregate B Installation Floater CO2173898 5/15/2012 5/15/2013 300,000 Inland M nn -Leased/R n I CO2173 9 /1 /2 1 /15/2013 100 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE Any and all operations of the insured Forms CG1010 10/01,CA2048 02/99,CG2503 05/09,CG2037 07104,AES3206 05/10,CA8514 07/04,430a attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent, its officers, officials, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN employees, agents and volunteers ACCORDANCE WITH THE POLICY PROVISIONS Andrew Sheridan 220 Fourth Ave S AUTHORIZED REPRESENTATIVE Kent WA 98032 (PORT)Charles W Flober ©1988-2010 ACORD CORPORATION All rights reserved ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO 14BC8474 [BEND] Julie Hammond 10/24/2012 11 20 16 AM Fa e 1 of 15 This certificate cartels and supersedes ALL previously issued certificates f 10/24/2012 POLICY NUMBER PL527954108 COMMERCIAL GENERAL LIABILITY Entre Prises USA Inc CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY INSURANCE SCHEDULE Name of Person or Organization: City of Kent, its officers, officials, employees, agents and volunteers Andrew Sheridan 220 Fourth Ave S Kent WA 98032 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured B. With respect to the insurance afforded to these additional insureds, the following exclusion is added 2. Exclusions This insurance does not apply to "bodily injury"or"property damage" occurring after (1) All work, including materials, parts or equipment furnished in connection with such work, on the protect (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed, or (2) That portion of `your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the dame protect The insurance is primary and any other insurance maintained by such Additional Insureds is non-contributing with this insurance as respects claims or liability arising out of or resulting from the acts or omissions of the named insured, or of others for work performed by or on behalf of the Named Insured CG 20 10 10 01 Copyright, Insurance Services Office, Inc , 1992 Page 1 of 1 C£RT NO 14508474 (BEND) Julie Hammcnd 10/24/2012 11 20 16 AM Page 2 of 15 This certificate cancels and supersedes ALL nrevi cusly issued certificates POLICY NUMBER CO2173898 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 Provi- sion 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 indi- cated below Endorsement Effective 5/15/2012 Countersigned By Named Insured Entire Prises USA Inc Authorized Re resentative SCHEDULE Name of Person(s) or Organization(s): City of Kent,its officers,officials employees,agents and volunteers Andrew Sheridan (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form CA 20 48 02 99 Copyright, Insurance Services Office, Inc , 1998 Page 1 of 1 ❑ CEAT NO 14508474 (EENDi Sulne Hammond 10/24/2012 11 20 it A �aqqe 3 of is This certificate cancels and supersedes ALL previously issued certificates POLICY NUMBER PL527954108 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by 'occur- damages or under Coverage C for medical rences" under Section I—Coverage A, and for all expenses shall reduce the Designated Con- medical expenses caused by accidents under struction Project General Aggregate Limit for Section I — Coverage C, which can be attributed that designated construction project Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above shall they reduce any other Designated Con- t. A separate Designated Construction Project struction Protect General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- "property damage" included in the "products- cable Designated Construction Protect Gen- completed operations hazard", and for medi- eral Aggregate Limit cal expenses under Coverage C regardless of the number of a. Insureds, b. Claims made or"suits" brought, or c. Persons or organizations making claims or bringing "suits" CG 25 03 05 09 C Insurance Services Office, Inc, 2008 Page 1 of 2 ❑ CERT M 14508474 (PEND) Julie Hammond 10/24/2012 11 20 16 AM Page 4 of 15 This certificate cance-s and supersedes ALL previously issued certificates B. For all sums which the insured becomes legally C. When coverage for liability ansing out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is pro- rences" under Section I —Coverage A, and for all vided, any payments for damages because of medical expenses caused by accidents under "bodily injury" or 'property damage" included in Section I — Coverage C, which cannot be attrib- the 'products-completed operations hazard" will uted only to ongoing operations at a single des- reduce the Products-completed Operations Ag- ignated construction protect shown in the Sched- gregate Limit, and not reduce the General Ag- ule above gregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit damages or under Coverage C for medical D. If the applicable designated construction protect expenses shall reduce the amount available has been abandoned, delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized contract- Products-completed Operations Aggregate ing parties deviate from plans, blueprints, de- Limit,whichever is applicable, and signs, specifications or timetables, the project will 2. Such payments shall not reduce any Desig- still be deemed to be the same construction pro- nated Construction Project General Aggre- ject gate Limit E. The provisions of Section III — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated Page 2 of 2 0 Insurance Services Office, Inc , 2008 CG 25 03 05 09 ❑ CERT NO 1450841, (BEM) JUll� H...end 1u;24/2012 11 20 16 AM PaK 5 of 15 This certificate cereals and supersedes ALL previously issued certificates CG 20 37 IEd, 07 04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Orson Ization{s), Location and Description of Completed Operations, Blanket as required by written Contract with prior approval by GA Custom underw( ter . Information required to complete this Schedule, if not shotimi above, will be shown in the Declarations. SECTION II - WHO IS AN INSURED is amended to include as an Additional Insured the personls) or organizationts) shown in the Schedule, but only with respect to liability for 'bodily injury" or "property damage' caused, in whole or in part, by"your work" at the location designated and described in the schedule of this endorsement performed for that Additional Insured and included in the "products-completed operations hazard" Copyright, ISO Properties, Inc, 2004 CG 20 37 (Ed. 07104) PRO {Page 1 of 11 C2RT NO 14508474 (BEND) Julie Hammond 10/24/2012 11 20 16 AM Page 6 of 15 This certificate cancels and supersedes ALL previously issued certificates AES 3206 (Ed 05 10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIALTY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement For complete details on specific coverages, consult the Policy contract wording Subjects of Insurance Non-Owned Watercraft up to 51 feet Non-Owned Aircraft Chartered with Crew Medical Expenses - $5,000 Limit Medical Expenses - Completed Operations - Dental Services Who Is an Insured - Fellow Employee Coverage - Broadened Named Insured Additional Insured - Ongoing Operations (Subject to Exclusions) Additional Insured - Vendors (Subject to Exclusions) Fire Legal Liability - $300,000 Limit Broad Notice of Occurrence Unintentional Errors or Omissions Waiver of Subrogation Non-Employee Discrimination Incidental Malpractice Liability Contractual Liability for Railroad Exposures The following amends the Commercial General Liability Coverage Part NON-OWNED WATERCRAFT SECTION I - COVERAGES, Coverage A Bodily Injury and Property Damage Liability, 2. Exclusions, 9.. Aircraft, Auto yor Watercraft, (2), is deleted and replaced with the following SAES 32067IEd�efi6/ 0�1R&cud 10/24/2012 11 20 16 AM Page 7(f? e 1 of 7) This certificate cancels and superse ss ALL previously issued certaf icates� (2) until your legal representative has been appointed I d. Your legal representative if you die, but only with respect to duties as such That representative will have all your rights and duties under this Coverage Part 3. Any organization that you own at the inception of this Policy, or any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if a. there is no other similar insurance available to that organization, and b. the first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization, and c. that organization is incorporated or organized under the laws of the United States of America However. (1) coverage under this provision 3 is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier, and (2) coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization, and (3) coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization ADDITIONAL INSURED - ONGOING OPERATIONS The following is added to SECTION II — WHO IS AN INSURED — SECTION 2.- e. Any person or organization (called additional insured) that you are required to add as an additional insured on this Policy under (1) a written contract or agreement or, (2) an oral contract or agreement where a certificate of insurance showing that person or organization as an additional insured has been issued, however the written or oral contract must be (a) currently in effect or becoming effective during the term of this Policy, and {b) executed prior to the "bodily injury," "property damage," "personal injury," or "advertising injury" which first manifests on or after the date of the inception of this policy period, as shown in the Declarations Page of the Policy but prior to the earlier of the date of expiration or cancellation of this Policy With respect to the insurance afforded such additional insured, the following additional provisions apply (1) that person or organization is only an additional insured with respect to liability arising out of (a) premises or equipment you own, rent, lease, or occupy, or c6E& 3?G&,(EdjBfir6/$ Rond 10/24/2012 11 20 16 AM Page 8 Page 4 of 7) T rs certi icatc cancels and superyase es ALL previously issued certn P icates� i Ib) your ongoing operations performed for that additional insured by or for you The insurance provided to such additional insured does not apply to "bodily injury" or "property damage" included within the "products-completed operations hazard" (2) The Limits of Insurance applicable to any such additional insured are those specified in the written contract or agreement or in the Declarations for this Policy, whichever are less and are subject to the terms and conditions of this Coverage Form These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance shown in the Declarations (3) A person's or organization's status as an additional insured under this endorsement ends 30 days after your operations or agreement for that additional insured are completed or cease, or the expiration of this Policy, whichever is earlier The insurance provided to any additional insured does not apply to "bodily injury," "property damage," "personal injury," or "advertising injury" arising out of an architect's, engineer's, or surveyors' rendering of or failure to render any professional services including (1) the preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications, and (2) supervisory, inspection, or engineering services It is further agreed that this insurance shall be primary and noncontributory, but only in the event of the Named Insured's sole negligence ADDITIONAL INSURED - VENDORS The following is added to SECTION II - WHO IS AN INSURED - 2 f. Any person or organization (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions (1) The insurance afforded the vendor does not apply to. (a) "bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement, (b) any express warranty unauthorized by you, (c) any physical or chemical change in the product made intentionally by the vendor; (d) repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, (e) any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products (f) demonstration, installation, servicing or repair operations, except such operations performed by the vendor in full compliance with the manufacturer's written instructions at �] ((���� C the vendor's premises in connection with the sale of the product, c ff V?Q &7i[Ed(B®5/�Q� Wed 10/24/2012 11 20 16 AM Page 9�aQe 5 Of 7) Thh s ceru cate cancels and saperse es ALL previously issued certrf icates `� WAIVER OF SUBROGATION SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS - 8., is deleted and replaced with the following S. Transfer or Rights of Recovery Against Others to Us a. If the Insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us The Insured must do nothing after loss to impair those rights At our request, the Insured will bring "suit' or transfer those rights to us and help us enforce those rights b. If required by a written "insured contract" executed prior to the occurrence or offense, we waive any right of recovery we have against any person or organization named in such "insured contract," because of payments we make for injury or damage arising out of your ongoing operations or "your work" for that person or organization NON EMPLOYMENT DISCRIMINATION LIABILITY Unless Coverage B Personal and Advertising Injury Liability is excluded from this Policy, the following applies The following is added to SECTION V - DEFINITIONS, 14. "Personal and advertising injury" h. discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury" and not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured INCIDENTAL MALPRACTICE LIABILITY The following is added to SECTION V - DEFINITIONS 23. "Incidental Medical Malpractice" means injury arising out of the negligent rendering or failure to render medical or paramedical services to persons by any physician, dentist, nurse, emergency medical technician or paramedic who is employed by you to provide such services provided you are not engaged in the business or occupation of providing any services referred to in this definition CONTRACTUAL LIABILITY FOR RAILROAD EXPOSURES SECTION V - DEFINITIONS - S. "Insured Contract' f.(1), is deleted in its entirety. This endorsement does not change any other provision of the Policy. cdAE& 9,gG&,(Ed(B65/4U% Y#R--d 10/24/2012 11 20 16 M Page ARage 7 of 7) Th. certrf rcate cartels and supersedes ALL previously issued certif routes THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MASTER PAK@ FOR COMMERCIAL AUTOMOBILE This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below Endorsement effective Policy No Named Insured Countersigned by (Authorized Representative) (If no entry appears above,the information required to complete this endorsement will be shown in the declarations as applicable to this endorsement) This summarizes the various coverages provided by this endorsement, no coverage is given by this summary Actual coverage descriptions are within the form SUBJECT LIMITS OF INSURANCE OR CHANGE IN ITEM# CONDITION ACCIDENTAL AIR BAG DEPLOYMENT 13 ADDITIONAL TRANSPORTATION EXPENSE $50 Per Day,$1000 Maximum 6 WAIVER OF TRANSFER OF RIGHTS OF 12 RECOVERY AGAINST OTHERS TO US CANCELLATION 1 CELL PHONE COVERAGE Included If Permanently Installed 17 DUTIES IN THE EVENT OF AN ACCIDENT 8 EMPLOYEE HIRED AUTO COVERAGE 18 -LIABILITY&PHYSICAL DAMAGE FELLOW EMPLOYEE EXCLUSION 4 GLASS BREAKAGE 7 HIRED CAR COVERAGE TERRITORY World Wide 10 HIRED CAR PHYSICAL DAMAGE- Excess Coverage, $35,000 Maximum 5 Excess Coverage MENTAL ANGUISH 11 PARKED AUTO COLLISION COVERAGE Private Passenger Types&Light Trucks 15 (WAIVER OF DEDUCTIBLE) RENTAL REIMBURSEMENT Private Passenger Types&Light Trucks 16 $50 Per Day, $1000 Maximum SUPPLEMENTARY PAYMENTS 3 -Bail Bonds$3000 -Loss Of Earnings Up To$500 Per Day TOWING&LABOR COVERAGE Private Passenger Types&Light Trucks 14 Up To$50 Per Occurrence UNINTENTIONAL FAILURE TO DISCLOSE 9 WHO IS AN INSURED 2 Includes copyrighted material of Insurance Services Office,Inc,with its permission CA 85 14 07 04 Copyright, Insurance Services Office,Inc,2003 Page 1 Of 4 CERT NO 14506414 (SEMI Julie Ha Qnd 10/24/2012 11 20 if M Pa e 11 of 15 This certificate cancels and supersedes ALL previously issued certificates The provisions contained in this endorsement replace those found elsewhere in the policy 1. Cancellation Provision Paragraph 2 B of the Common Policy Provisions-Cancellation reads as follows 60 days before the effective date of cancellation if we cancel for any other reason 2. Who Is An Insured Paragraph A 1 -Who Is An Insured -of Section II, Liability Coverage, is amended to add D. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the coverage form However, "Insured"does not include any subsidiary that is an "Insured" under any other automobile liability policy or would be an"Insured" under such policy but for Its termination or the exhaustion of its limits E. Any organization that is acquired or formed by you and over which you maintain majority ownership However, "Insured" does not Include any newly formed or acquired organization (1) that is a joint venture or partnership, (2) that is an "Insured" under any other policy, (3) that has exhausted Its limit of insurance under any other policy, or (4) 180 days or more after its acquisition of formation by you, unless you have given us notice Coverage does not apply to"bodily injury" or"property damage"that results from an accident that occurred before you formed or acquired the organization F. Any employee of yours while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs 3. Coverage Extensions- Supplementary Payments Paragraph A Supplementary Payments Sub-Paragraphs A 2 and A 4 are amended as follows- (2) Up to$3000 for the cost of ball bonds (Including bonds for related traffic law violations) required because of an "accident"we cover We do not have to furnish these bonds (4) All reasonable expenses incurred by the"Insured"at our request, Including actual loss of earnings up to$500 a day because of time off from work 4. Fellow Employee Exclusion In those states where Workers Compensation laws have not been legally determined to be the sole remedy for employee injuries, the following provision is added Section II - Liability Coverage, Exclusion B.S., Fellow Employee is amended by adding the following But this exclusion does not apply if the"bodily injury" results from the use of a covered"auto"you own or hire Coverage is excess over any other collectible insurance In those states where Workers' Compensation Insurance has been determined to be the sole remedy for employee injuries, this coverage enhancement does not apply S. Hired Car Physical Damage—Excess Coverage If hired "autos"are covered autos for Liability Coverage and if Comprehensive, Specified Causes of Loss or Collision Coverages are provided under this coverage form for any 'auto"you own, then the Physical Damage Coverages provided are extended to"autos" you hire subject to the following (a) The most we will pay for any one accident or loss is$35,000, actual cash value or cost of repair whichever is the least, minus a deductible (b) No deductible applies to loss caused by fire or lightning (c) The deductible will be equal to the largest deductible applicable to any owned auto for that coverage (d) Hired car physical damage coverage is excess over any other collectible insurance available to the insured or the employee renting the vehicle, either from another auto policy or from the collision damage waiver provisions of a credit card (e) Subject to the above limit, deductible and excess provisions,we will provide coverage equal to the broadest coverage applicable to any covered"auto"you own shown in the declarations We will also cover loss of use of the hired borrowed auto if it results from an accident for which you are legally liable and the lessor incurs an actual financial loss, subject to a maximum limit of$500 per accident Includes copyrighted material of Insurance Services Office, Inc,with its permission CA 85 14 07 04 Copyright,Insurance Services Office,Inc,2003 Page 2 of 4 CERT M 14508474 (BEND) Julie Hammond 10/24/2012 11 20 16 AM Page 12 of 15 This certi Eicate carcels and supersedes ALL previously issued certificates 6. Physical Damage-Additional Transportation Expense Coverage Paragraph A 4 of Section III Physical Damage Coverage is amended to provide a limit of$50 per day and a maximum limit of$1000 7. Physical Damage- Glass Breakage The following paragraph is added to A 3 , Glass Breakage, of Section III, Physical Damage Coverage Any deductible shown in the Declarations for Comprehensive Coverage will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced 8. Duties In The Event Of Accident, Claim, Suit Or Loss A. The requirement in Condition 2 A that you must notify us of an"accident"applies only when the "accident" is known to (1) you, if you are an individual, (2) a partner, if you are a partnership, or (3) an executive officer or insurance manager, if you are a corporation (4) your partners, employees, members of limited liability companies, directors or shareholders but only while acting within the scope of their duties B. The requirement in Condition 2 B that you must notify us of a claim or"suit"will not be considered breached unless the breach occurs after such claim or"suit"is known to (1) you, if you are an individual, (2) a partner, if you are a partnership, or (3) an executive officer or insurance manager, if you are a corporation (4) your partners, employees, members of limited liability companies, directors or shareholders but only while acting within the scope of their duties 9. Unintentional Failure To Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception or renewal date of the policy,we will not deny coverage under this coverage part because of such failure This provision does not apply to any auto owned, leased, acquired or held for sale by you prior to the effective date of the policy or the current renewal 10. Hired Car-Coverage Territory Paragraph E is added to the definition of coverage territory in General Condition 7- Policy Period, Coverage Territory E. For autos hired 30 days or less,the coverage territory is anywhere in the world, provided that if the insured's responsibility to pay for damages is determined in a"suit", that suit is brought in the territory described in Paragraph B 7 - Policy Period, Coverage Territory- under Section IV Business Auto Conditions 11. Mental Anguish The definition of"bodily injury" in the definitions section is replaced by the following "bodily injury"means bodily injury, sickness or disease sustained by any person, including mental anguish, or death resulting from any of these 12. Waiver Of Transfer Of Rights Of Recovery Against Others To Us Paragraph 5, TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US in Section IV, Business Auto Conditions, is amended by the addition of the following If the person or organization has waived those rights before a loss, our rights are waived also 13. Accidental Air Bag Deployment Coverage We will pay for the cost of reinstalling factory installed air bag(s) in"your covered auto"for any reason other than deployment due to a collision loss Any insurance we provide shall be excess over any other collectible insurance, or reimbursement by manufacturer's warranty However, we agree to pay any deductible applicable to the other coverage or warranty This coverage is applicable only if"other than collision"coverage is on your policy Includes copyrighted matenal of Insurance Services Office,Inc,with its permission CA 85 14 07 04 Copyright, Insurance Services Office, Inc,2003 Page 3 of 4 CERT NO 14508474 (SEND) Julie Hammond 10/24/2012 11 20 16 AN Page 13 of 15 This certificate cancels and supersedes ALL previously issued certificates 14. Towing and Labor Costs Coverage We will pay up to$50 for towing and labor costs incurred each time a covered"auto"of the private passenger type or light weight truck with a gross vehicle weight of 10,000 Ibs or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry is disabled However, the labor must be performed at the place of disablement 15. Parked Auto Collision Coverage(Waiver of Deductible Under Collision Coverage) The deductible does not apply to"loss"caused by collision to such covered "auto"of the private passenger type or light weight truck with a gross vehicle weight of 10,000 Ibs or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry while it is 1. In the charge of an"Insured", 2. Legally parked, and 3. Unoccupied 4. Must be reported to police authorities within 24 hours of known damage The total amount of the damage to the covered"auto"must exceed the deductible shown in the Declarations This provision does not apply to any"loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business 16. Rental Reimbursement Coverage When there is a"loss"to a covered "auto"of the private passenger type or light weight truck with a gross vehicle weight of 10,000 Ibs or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry we will pay for rental reimbursement expenses incurred by you for the rental of an"auto"of similar type Payment applies in addition of the otherwise applicable amount of each coverage you have on a covered "auto" No deductibles apply to this coverage This coverage applies only 1. For those expenses incurred during the policy period beginning 24 hours after the loss, 2. To necessary and actual expenses Incurred, 3. To a "loss"for which we also pay a"loss" under PHYSICAL DAMAGE COVERAGE for Comprehensive Coverage, Specified Causes of Loss Coverage or Collision Coverage, and 4. If there are no spare or reserve"autos"available to you for your operations Our payment will be limited to that period of time reasonably required to repair or replace the covered "auto" We will pay up to$50 per day to a maximum of$1000 17. Permanently Installed Cellular Telephones Exclusion B 4 c of Section III-Physical Damage Coverage does not apply to any permanently installed, non-removable telephone designed to be operated by use of the power from the auto's electrical system 18. Employee Hired Auto Coverage- Liability and Physical Damage If this policy provides Liability and/or Physical Damage Coverage for Hired Autos, these coverages will be extended to any employee renting a vehicle in their own named, but only while used in the business of the named insured For Employee Hired Auto Coverage, the following conditions apply 1. The hired auto must be rented under a written rental agreement, 2. Coverage will only apply while the employee is conducting business on behalf of the insured, 3. Employee Hired Auto Coverage is excess over any personal auto policy applicable to the employee, and 4. Employee Hired Auto Coverage does not apply to any Loss of Use or administrative charges imposed by the rental car agency All the above additional coverages are subject to all other provisions of this policy Includes copyrighted material of Insurance Services Office,Inc,with its permission CA 85 14 07 04 Copyright, Insurance Services Office,Inc,2003 Page 4 of 4 CERT NO 14508474 (BEND) Julie Hammond 1C/24/2C12 ii 20 le AN Page 14 of 15 This certificate cancels and supersedes ALL previously issued certificates i www.salf.com saifcorporation Carrier No: 20001 Endorsement No: WC000313i Policy No: 959833(Oregon) Agency: Entre Prises USA Inc 63085 18th Street BEECHER CARLSON INS AGENCY LLC Suite 101 220 NW 2ND AVE#800 Bend OR 97701 PORTLAND, OR 97209 Waiver of Our Right to Recover From Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a wntten contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule Schedule Description, ALL OPERATIONS Contract* ALL WRITTEN CONTRACT Contractor Name- PERSONS AND/OR ORGANIZATIONS WITH WHOM THE INSURED-EMPLOYER IS REQUIRED BY WRITTEN CONTRACT TO WAIVE SUBROGATION RIGHTS This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one(1)percent of your manual premium. Effective Date: 7/1/2012 This endorsement is part of your policy This endorsement amends and controls anything to the contrary It is otherwise subject to all other terms of your policy Countersigned at Salem, Oregon �r�PPRJIIn, 430a Brenda President and Chief Executive Officer 400 High St SE l Salem.OR 973121 P•800 285 8525 CERT NO 14508474 (BEn) Suhe Nand 10/24/2012 11 20 16 AM Pa g9e 15 of 15 This certificate cancels and supersedes ALL previously issued certn fuatea 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: Andy Sheridan x 5130 Dept: Park Operations Date Sent: 10/9/2012 Date Required: 10/12/2012 Return Signed Document to: Andy S. CONTRACT TERMINATION DATE: 12/31/2012 VENDOR NAME: Entreprises Services, Inc DATE OF COUNCIL APPROVAL: n/a <$25k ATTACH MOTION SHEET FOR THE MAYOR Brief Explanation of Document. Climbing wall repair at Arbor Heights 360 Park. _ �t-QCfctr�- l1.�C, I�+t.4..ntc.va.V^cG r h J 1 All Contracts Must Be Routed Through The Law Department (This area ca,be completed by the Law Department) Received: NOV j Approval of Law Dept � (k �> _ rr` i i Law Dept. Comments: Faterwarded to Mayor: �� r Shaded Areas To Be Completed By Administration Staff Received: i Recommendations and Comments• �� � -OIL__ C ,l Disposition: / /,6�Z/ 62 l�ahc�� 71V Date Returned: