HomeMy WebLinkAboutPW12-286 - Original - Anita L. Lehmann - Contract - 11/15/2012 Z 41 ,4�6 Records Management-
KENT Document
W nSHINGTON
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. Anita H. Lehmann
Vendor Number:
JD Edwards Number
Contract Number: Poi a- ggil�
This is assigned by City Clerk's Office
Project Name: Lower/Lowest Russell Road Levee
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 11/15/12 Termination Date: 1/31/13
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Mark Madfai Department: Engineering
Detail: (i.e. address, location, parcel number, tax id, etc.):
Provide illustrations for a i informational brocure.
S:Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
K E N T
Wr.s11.or 11
GOODS & SERVICES AGREEMENT '
between the City of Kent and
• Anita H. Lehmann
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and Anita H. Lehmann organized under the laws of the State
of Washington, located and doing business at 1625 11th Ave. W., Seattle, WA 98119, Phone:
(206) 286-8996 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following
services for the City:
The Vendor shall provide illustrations for an informational brochure for the
Lower/Lowest Russell Road Levee Project. For a description, see the Vendor's
October 26, 2012 Scope of Work which is attached as Exhibit A and incorporated by
this reference.
Vendor acknowledges and understands that it is not the City's exclusive provider of these
goods, materials, or services and that the City maintains its unqualified right to obtain these
goods, materials, and services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall
complete the work and provide all goods, materials, and services by January 31, 2013.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Three
Thousand, Two Hundred Fifty Dollars ($3,250.00), including applicable Washington State Sales
Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay
the Vendor the following amounts according to the following schedule:
GOODS & SERVICES AGREEMENT - 1
(Under$10,000.00, including WSST)
The Vendor shall be paid after execution of agreement and submittal of
illustrations.
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves
the option to only pay that portion of the invoice not in dispute. In that event, the parties will
immediately make every effort to settle the disputed portion.
A. Defective or Unauthorized Work. The City reserves its right to withhold payment
from Vendor for any defective or unauthorized goods, materials or services. If
Vendor is unable, for any reason, to complete any part of this Agreement, the City
may obtain the goods, materials or services from other sources, and Vendor shall
be liable to the City for any additional costs incurred by the City. "Additional costs"
shall mean all reasonable costs, including legal costs and attorney fees, incurred by
the City beyond the maximum Agreement price specified above. The City further
reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the
Vendor.
B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT
SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND
PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME
REQUEST FOR FINAL PAYMENT IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. The Vendor has the ability to control and direct the performance and details
of its work, the City being interested only in the results obtained under this
Agreement.
B. The Vendor maintains and pays for its own place of business from which
Vendor's services under this Agreement will be performed.
C. The Vendor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the
City retained Vendor's services, or the Vendor is engaged in an
independently established trade, occupation, profession, or business of the
same nature as that involved under this Agreement.
D. The Vendor is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Vendor has registered its business and established an account with the
state Department of Revenue and other state agencies as may be required
GOODS & SERVICES AGREEMENT - 2
(Under$10,000.00, Including WSST)
by Vendor's business, and has obtained a Unified Business Identifier (UBI)
number from the State of Washington.
F. The Vendor maintains a set of books dedicated to the expenses and earnings
of its business.
V. TERMINATION. Either party may terminate this Agreement, with or without
cause, upon providing the other party thirty (30) days written notice at its address set forth on
the signature block of this Agreement.
VI. CHANGES. The City may issue a written amendment for any change in the goods,
materials or services to be provided during the performance of this Agreement. If the Vendor
determines, for any reason, that an amendment is necessary, Vendor must submit a written
amendment request to the person listed in the notice provision section of this Agreement,
section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have
known of the facts and events giving rise to the requested change. If the City determines that
the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the
Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will
determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the
amended work upon receiving either a written amendment from the City or an oral order from
the City before actually receiving the written amendment. If the Vendor fails to require an
amendment within the time allowed, the Vendor waives its right to make any claim or submit
subsequent amendment requests for that portion of the contract work. If the Vendor disagrees
with the equitable adjustment, the Vendor must complete the amended work; however, the
Vendor may elect to protest the adjustment as provided in subsections A through E of Section
Y P ]
VII, Claims, below.
The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a
separate acceptance, or (3) not protesting in the way this section provides. An amendment that
is accepted by Vendor as provided in this section shall constitute full payment and final
settlement of all claims for contract time and for direct, indirect and consequential costs,
including costs of delays related to any work, either covered or affected by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by an amendment,
another written order, or an oral order from the City, including any direction, instruction,
interpretation, or determination by the City, the Vendor may file a claim as provided in this
section. The Vendor shall give written notice to the City of all claims within fourteen (14)
calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14)
calendar days of the date the Vendor knew or should have known of the facts or events giving
rise to the claim, whichever occurs first . Any claim for damages, additional payment for any
reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively
deemed to have been waived by the Vendor unless a timely written claim is made in strict
accordance with the applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in
subsections A, items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS
SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY.
GOODS & SERVICES AGREEMENT - 3
(Under$10,000.00, including WSST)
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that
estimate was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred
as a result of the asserted events giving rise to the claim. The City shall have
access to any of the Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are
followed. If the City determines that a claim is valid, the City will adjust payment
for work or time by an equitable adjustment. No adjustment will be made for an
invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall
proceed promptly to provide the goods, materials and services required by the City
under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides,
the Vendor also waives any additional entitlement and accepts from the City any
written or oral order (including directions, instructions, interpretations, and
determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures
of this section, the Vendor completely waives any claims for protested work and
accepts from the City any written or oral order (including directions, instructions,
interpretations, and determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD.
IX. WARRANTY. This Agreement is subject to all warranty provisions established
under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants
goods are merchantable, are fit for the particular purpose for which they were obtained, and will
perform in accordance with their specifications and Vendor's representations to City. The Vendor
shall correct all defects in workmanship and materials within one (1) year from the date of the
City's acceptance of the Contract work. In the event any part of the goods are repaired, only
original replacement parts shall be used—rebuilt or used parts will not be acceptable. When
defects are corrected, the warranty for that portion of the work shall extend for one (1) year
from the date such correction is completed and accepted by the City. The Vendor shall begin to
correct any defects within seven (7) calendar days of its receipt of notice from the City of the
defect. If the Vendor does not accomplish the corrections within a reasonable time as
determined by the City, the City may complete the corrections and the Vendor shall pay all costs
incurred by the City in order to accomplish the correction.
GOODS & SERVICES AGREEMENT - 4
(Under $10,000.00, including WSST)
X. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on
behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy
completion of the contract comon
Declaration, Comply with City Administrative Policy 1.2, and upon p
work, file the attached Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Vendor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
In the event Vendor refuses tender of defense in any suit or any claim, if that tender was
made pursuant to this indemnification clause, and if that refusal is subsequently determined by a
court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the
Vendor's part, then Vendor shall pay all the City's costs for defense, including all reasonable
expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred
because there was a wrongful refusal on the Vendor's part.
The provisions of this section shall survive the expiration or termination of this
Agreement.
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and
incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors
in the performance of the contract work and shall utilize all protection necessary for that
purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any
loss of or damage to materials, tools, or other articles used or held for use in connection with the
work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
GOODS & SERVICES AGREEMENT - 5
(Under$10,000 00, including WSST)
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. If the parties are unable
to settle any dispute, difference or claim arising from the parties' performance of this
Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by
filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court,
King County, Washington, unless the parties agree in writing to an alternative dispute resolution
process. In any claim or lawsuit for damages arising from the parties' performance of this
Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award
provided by law; provided, however, nothing in this paragraph shall be construed to limit the
City's right to indemnification under Section XI of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Vendor.
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
other representative of the City, and such statements shall not be effective or be construed as
entering into or forming a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any language in any of
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Vendor's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
GOODS & SERVICES AGREEMENT - 6
(Under$10,000 00, mcludIng WSST)
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
VENDOR: CITY OF KENT:
By; By: A
�sIgna re) (signature)
Print Name: - r Print Name: Mark Howlett
Its: Its: Design Engineering Manager
(title)
DATE — f DATE: II-IS^11
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Timothy J. LaPorte, P.E.
Anita H. Lehmann City of Kent
1625 11t' Ave. S. 220 Fourth Avenue South
Seattle, WA 98119 Kent, WA 98032
(206) 286-8996 (telephone) (253) 856-5500 (telephone)
(253) 856-6500 (facsimile)
Lehmann-Lower/Lowest Russell Rd/Madtal
GOODS & SERVICES AGREEMENT - 7
(Under$10,000.00, including WSST)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
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 day of
i
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 1 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 of 3
MAR 0 b 2013
CITY OF KENT z „�
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STA-11`0 i = T�
-6AiUN G T I I-PT
I
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 Anita H. Lehmann Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the
Agreement known as Lower/Lowest Russell Road Levee that was entered into on the
November 15. 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.
Dated this 1�7 day of �� f 3 , 201_.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 1
EXHIBIT A i
Anita H Lehmann
Aidwect
October 26,2012
Mark Madfai,Design Engineering Supervisor
Alex M.Murillo,PE,Environmental Engineering Supervisor
City of Kent Public Works
220 4'Ave So.
Kent,WA 98032-5895
Re Boeing Levee Protect
Flood Wall Illustrations Lower/Lower Russell Road
Dear Mr Madfai.
I will be happy to assist the City of Kent with design/illustrations to be used
for your informational brochure with County officials,public,and consultants
Please find the outline of tasks deliverables listed below.
Task A Perspective view base information provided by City of Kent Public Works
Create one rough layout,for review and approval.
Create one final view of illustration
1 @ 11"x 17"/18"x 24",color illustrations- Lower/Lower Russell Road
$2,000
Task B Illustrated Sections existing/new:base information provided by City of Kent Public Works
Create one rough layout,for review and approval
Create one final view of illustration
1 @ 11"x 17"/18"x 24",color illustrations- Lower/Lower Russell Road
$750.00
Task C,
Meetings critical to creation of illustration-hourly @$150 00/hr
2 hours,$300
Task D
Provide high resolution scans to City of Kent hourly @$150 00/hr
1 hour.$150
Reimbursable for scan @$50.00
Completion
Finals to be determined
Work not to exceed$3,250.00
Thank you again for considering me to assist the City with this protect If you have any questions or would
like additional information,please feel free to call.
Warmly,
Anita H.Lehmann,Architect
1625 11 th Ave West www alildraws com
Seattle,WA 98119 r,�✓.
(206;286-8996 ph www 2beepennlworks com
www 2beepenciiworks blogspot.mm -
amta@ahtdraws coin www cityalphabets com
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,
Fired 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.
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 A:VII.
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.
KtNtWAL RECEIVED
Personal Umbrella
JUN 2 a 2012
Policy Declarations CITY OF KENT
Summary
NGWEERI G DEFT
NAMEDINMURED(S) YOUR ALLSTATE AGENT IS: CONTACT YOURA09NTAT:
Rex Lyon&Anita Lehmann Olson Agency (206)783-2005
162511th Ave W 1738 NW Market St
Seattle WA 9811 9-29 03 Seattle WA 98107
POLICY NUMBER POLICY PERIOD PREMIUMPERIOD
9 20 925084 07108 Begins on July 8,2012 July 8,2012 to July 8,2013
at 12:01 AM.standard time, at 12.01 AM standard time
with no fixed date of expiration
Total Premium for the Premium Period (Yourb(ll wltl ba rnalledseoarately)
TOTAL $376.92
°
Your policypremium has been developed using the following information:
3Vehicla(s),,3 Operator(s)in the household, Supporting Allstate H ome and/or Auto
Poitoy(ies)
PROP
MCO21-s IIIIIIII'�IjIIIUi�lll3i'Ill�lll�idlli�iilllllHlllill !IIIIIIIIIIIIIIII!I IIIII IIIIIIIIIII� WyN2012 YJJPave M98RBD1
ALZ
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REQUIRED UNDERLYING INSURANCE
w ,
Failure to maintain the following coverages and required underlying limits affestthe rights of an insured person
underthis policy.
COVERAGE REQUIRED UNDERLYING LIMIT
Personal Llability-Bodily Injury and Property Damage Liablllty Combined Single Limit
1 Homeowners,Condominium,Renters,Mobilehome, $300,000
-Manufactured Home or other Personal Liability Policy per occurrence
2.Farmowner or Farm Comprehensive Personal Liability $300,000
per occurrence
One,Two,Three or Four Family Residential Rental Property-- $300,000
Bodily Injury and Property Damage Liability peroccurrence
Automcbdes and Motor Homes Bodily Injury $250,000 each person
$600,000 each accident
Property Damage $100,000 each accident
or
Combined Single Limit
$500,000 per accident
Motorcycles,Motor Scooters,Mopeds and Recreational Vehicles Bodily Injury $100,000 each person
$300,000 each occurrence
Property Damage $100,000 each occurrence
or
Combined Single Limit
$300,000 per occurrence
Personal Watercraft such as Jet skis and wet bikes Bodily Injury $100,000 each person
$300,000 each occurrence
Property Damage $100,000 each occurrence
or
Combined Single Limit
$300,000 per occurrence
Watercraft Llability--craft Bodily Injury $100,000 each person
under 26 feet and up to 5D horsepower _ $300,000 each occurrence
(U.S.horsepower) Property Damage $100,000 each occurrence
OF
Combined Single Limit
$300,000 per occurrence
Watercraft L(abillty--craft Bodily Injury $250,000 each person
26 feet and over or greater than 50 horsepower $500,000 each occurrence
(U.S horsepower) Property Damage $100,000 each occurrence
or
Combined Single Limit
$500,000 per occurrence
Employers'Llabtlity-if Workers'Compensation orsim(lar $300,000 each accident
coverage for Domestic Workers is required or purchased $300,000 each employee
voluntarily $500,000 policy aggregate
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May 24 W2 MOW
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POLICY COVERAGES AND LIMITS OF LIABILITY
rr' '
COVERAGES LIMITS OF LIABILITY
Excess Liability $1,000,000 each occurrence
your Polley Docrfinenfs
Your Personal Umbrella policy consists of this Policy Declarations and the documents listed below.Please keep these
together.
-Personal Umbrella Policy form A514 -Amendment of Policy Provisions form AS371
-WA Personal Umbrella Amendatory End,form AS25-2
Important Payment and Coverage Information
It is time to renewyour policy.If no changes are made to your coverage before July 8,2012 the minimum amount
due on or before July 8,2012 will be one-twelfth(1112)of your$376.92 renewal premium plus any outstanding
balance from your current policy and any applicable mstallmentfee(s).You can make your payment at your agent's office or
you can wait until you receive your next bill and mail your paymentat that time You should receive that bill approximately two
weeks before your July 8,2012 due date
IN WITNESS WHEREOF,Allstate has caused this policy to be signed by two of its officers at Northbrook,
Illinois,and if required by state law,this policy shall not be binding unless countersigned on the Policy
Oecllratioris by an authatized agent of Allstate.
Steven P Sorenson Mary J.McGinn
President Secretary
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