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HomeMy WebLinkAboutPW13-004 - Original - A & M Consulting - Utility Coordination Downey Farmstead Project - 01/08/2013 + v e Records Manage' 'm" ent " KENT I Document W asHiNcroH 5' 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: A & M Consulting Vendor Number: JD Edwards Number Contract Number: `ik,) 13 -no T This is assigned by City Project Name: Downey Farmstead Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 1/8/13 Termination Date: 12/31/13 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Beth Tan Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Provide public and_prlvate utility coordination for the project. S:Publlc\RecordsManagement\forms\ContractCover\adcc7832 1 11/08 Y KENT A'ASHIHcT o. CONSULTANT SERVICES AGREEMENT between the City of Kent and A & M Consulting THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and A & M Consulting organized under the laws of the State of Washington, located and doing business at 18119 NE 30th Street, Redmond, WA 98052, Phone: (206) 276-3635/Fax: (253) 209-4886 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide public and private utility coordination for the Downey Farmstead Project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be p 9 performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Upon the effective date of this Agreement, Consultant shall complete the work described in Section I by December 31, 2013. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Nine Thousand, Two Hundred Forty Dollars ($9,240.00), plus applicable Washington State sales tax, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit B. B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this CONSULTANT SERVICES AGREEMENT - 1 (Under $10,000) r ' Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. CONSULTANT SERVICES AGREEMENT - 2 (Under$I0,000) VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit C attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The City's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. CONSULTANT SERVICES AGREEMENT - 3 (Under$10,000) XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; .provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of CONSULTANT SERVICES AGREEMENT - 4 (Under$10,000) the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONSULTANT: CITY OF KENT: By: By: .�((signatur (sig ture) Print Name: /`t I ?qe- Print Name: Timothy J. LaPorte, P.E. Its: An Its: Public Works Director (trt ) DATE: 4-4 2 Z DATE: / f3 z��3 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Arnie Tomac Timothy J. LaPorte, P.E. A & M Consulting City of Kent 18119 NE 30" St. 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (206) 276-3635 (telephone) (253) 856-5500 (telephone) 253 209-4886 facsimile (253) 856-6500 (facsimile) A&M Consulting-Downey/Tan CONSULTANT SERVICES AGREEMENT - 5 (Under$10,000) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this 349 day of Op C- , 2017,. 11 By: ^ L For: � � /� �G✓t / �7 t &E Title: Prt S c War, f Date: EEO COMPLIANCE DOCUMENTS - 1 I , CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (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 EXHIBIT A A & M Consulting Downey Farmstead Scope of Work The Consultant shall provide consultation services to the City for public and private utility coordination for the Downey Farmstead project. These services shall include the following: • Evaluate impacts of City's project on private utilities' equipment. • Coordinate with Puget Sound Energy to execute an agreement for relocation of the overhead power lines. • Coordinate with private property owners to facilitate any service interruptions that may be needed. • Coordinate with other utilities such as CenturyLink and Comcast as needed for relocation of their facilities. • Provide construction coordination and provide advice on resolution of conflicts related to private utilities during construction of City's public works project. EXHIBIT B A & M Consulting Downey Farmstead Budget Project Hours Billing Total Rate Downey 140 66.00 $9,240 Farmstead EXHIBIT C INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01. The City shall be named as an Additional Insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. EXHIBIT C (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. F. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. ACOR1 DATE(MM/DDNYYYI III CERTIFICATE OF LIABILITY INSURANCE 10-18-2012 THIS CERTIFICATEIS 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 ADDITIONALINSURED,the policylies)must be endorsed. If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) CONTACT PRODUCER NAME AJ GALLAGHER RSK MGMT SVCS INC/PHS PHONE 812490 P: (866) 467-8730 F• (877) 905-0457 pICNoExt) (866)467-8730 IA/O,No) (877) 905-045 ADDRESS PO BOX 33 015 INSURER(S)AFFORDING COVERAGE NAIC k SAN ANTONIO TX 78265 INSURER Hartford Casualty Ins Co INSURED INSURER B INSURER C ARNOLD TOMAC DBA A & M CONSULTING INSURER D 18119 NE 3 0TH ST INSURER E REDMOND WA 98052 INSURER F COVERAGES CERTIFICATE NUMBER. REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CER-11FICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS OLIO LIC LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM(DDlYYYYI (MM;DD/YVYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 1, 000, 000 GE r�REI s 3 0 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) 0, 000 A CLAIMS MADE u OCCUR � MED EXP(Any one person) $ 10, 000 X General Liab L`J' U 52 SBM UK5025 11/01/2012 11/01/2013 PERSONAL&ADV INJURY S 1, 000, 000 GENERAL AGGREGATE S 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2, 000, 000 POLICY PR JEST X I LOC 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident) $ if 000, 000 BODILY INJURY(Per person) $ ANY AUTO '_I _I � A ALL OWNED SCHEDULED u IJ 52 SBM UK5025 11/01/2012 11/01/2013 BODILY INJURY(Per accid $ent)11 AUTOS u AUTOS PROPERTY DAMAGE X HIRED AUTOS X NON OWNED (Per acciden0 $ AUTOS $ UMBRELLA LIAR U OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE u u AGGREGATE S DEDI I RETENTION $ 5 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETORTARTNER/EXECUTIVEYlN I I EL EACH ACCIDENT $ 1 000, 000 A OFFICER/MEMBER EXCLUDED? u N/A LJ 52 SBM UK5025 11/01/2012 11/01/2013 (Mandatory in NH) EL DISEASE -EA EMPLOYE $ 1, 000, 000 If yes,describe under E L DISEASE-°OLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS below uu DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remerke Schedule,if more spice is required) Those usual to the Insured' s Operations . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City of Kent BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Public Works Engineering DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS 222 Fourth Ave. S . AUTHORIZE R RESENTATIVE / Kent WA 98032 �Z— 11 1988-2010 ACORD CORPORATION All rights reserved ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD kJ GALLAGHER RSK MGMT SVCS INC/PHS 'O BOX 33015 3AN ANTONIO TX, 78265 12137 The City of Kent Public Works Engineering 222 Fourth Ave . S . Kent WA 98032 m N ry N N m M N N N O O O N 4 ACORD 25 (2010/05) IMPORTANT NOTICE TO POLICYHOLDERS To help your insurance keep pace with increasing costs, we have increased your amount of insurance . . . giving you r better protection in case of either a partial,or total loss to your property. Ln If you feel the new amount is not the proper one, please contact your agent or broker. rn CD O LO N O Ln N LP N O O M is c��� An 7VA A Auiwl...d I—11 0 A 25 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any 50 other Forms and Endorsements issued to be a part of the Policy This insurance is provided by the stock UK insurance company of The Hartford Insurance Group shown below. SBM INSURER: HARTFORD CASUALTY INSURANCE COMPANY ONE HARTFORD PLAZA, HARTFORD, CT 06155 COMPANY CODE- 3 Policy Number: 52 SBM UK5025 DX THE !d HARTFORD SPECTRUM POLICY DECLARATIONS ORIGINAL m Named Insured and Mailing Address: ARNOLD TOMAC DBA A & M LO (No , Street, Town, State, Zip Code) CONSULTING C> 18119 N.E. 30TH STREET REDMOND WA 98052 M ,A Policy Period: From 11/01/12 To 11/01/13 1 YEAR Ln 12 01 a m , Standard time at your mailing address shown above Exception: 12 noon in New Hampshire. N Ln Name of Agent/Broker: AJ GALLAGHER RSK MGMT SVCS INC/PHS Na Code: 812490 cal v Previous Policy Number: 52 SBM UK5025 0 0 Named Insured is: INDIVIDUAL Audit Period: NON-AUDITABLE Type of Property Coverage: NONE Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy TOTAL ANNUAL PREMIUM IS: $425 MP IN RECOGNITION OF THE MULTIPLE COVERAGES INSURED WITH THE HARTFORD, YOUR POLICY PREMIUM INCLUDES AN ACCOUNT CREDIT. Countersigned by 09/17/12 Authorized Representative Date Form SS 00 02 12 06 Page 001 (CONTINUED ON NEXT PAGE) Process Date: 09/17/12 Policy Expiration Date: 11/01/13 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below Location: 001 Building: 001 18119 N.E. 30TH STREET REDMOND WA 98052 Description of Business: REAL ESTATE APPRAISER Deductible: NO COVERAGE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING NO COVERAGE BUSINESS PERSONAL PROPERTY REPLACEMENT COST NO COVERAGE PERSONAL PROPERTY OF OTHERS REPLACEMENT COST NO COVERAGE MONEY AND SECURITIES INSIDE THE PREMISES NO COVERAGE OUTSIDE THE PREMISES NO COVERAGE Form SS 00 02 12 06 Page 002 (CONTINUED ON NEXT PAGE) Process Date: 09/17/12 Policy Expiration Date: 11/01/13 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $1,000,000 MEDICAL EXPENSES -ANY ONE PERSON $ 10,000 PERSONAL AND ADVERTISING INJURY $1,000,000 DAMAGES TO PREMISES RENTED TO YOU $ 300,000 ANY ONE PREMISES LO o AGGREGATE LIMITS PRODUCTS-COMPLETED OPERATIONS $2,000,000 ram+ GENERAL AGGREGATE $2,000,000 0 un o EMPLOYMENT PRACTICES LIABILITY Ln COVERAGE: FORM SS 09 01 (V N EACH CLAIM LIMIT $ 5,000 0 0 ,M DEDUCTIBLE -EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 5,000 RETROACTIVE DATE: 11012005 This Employment Practices Liability Coverage contains claims made coverage. Except as may be otherwise _ provided herein, specified coverages of this insurance are limited generally to liability for injuries for which claims are first made against the insured while the insurance is in force. Please read and review the insurance carefully and discuss the coverage with your Hartford Agent or Broker. The L!mits of Insurance stated in this Declarations will be reduced, and may be completely exhausted, by the payment of"defense expense" and, in such event, The Company will not be obligated to pay any further"defense expense" or sums which the insured is or may become legally obligated to pay as "damages" BUSINESS LIABILITY OPTIONAL COVERAGES HIRED/NON-OWNED AUTO LIABILITY $1,000, 000 —� FORM: SS 01 70 i� Form SS 00 0212 06 Page 003 (CONTINUED ON NEXT PAGE) Process Date: 09/17/12 Policy Expiration Date: 11/01/13 , SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 BUSINESS LIABILITY OPTIONAL COVERAGES LIMITS OF INSURANCE (Continued) EMPLOYERS LIABILITY AND STOP GAP BODILY INJURY BY ACCIDENT EACH ACCIDENT $1,000, 000 BODILY INJURY BY DISEASE EACH EMPLOYEE $1,000, 000 BODILY INJURY BY DISEASE POLICY LIMIT $1,000, 000 APPLICABLE TO LOCATIONS IN THE FOLLOWING STATE(S) : WASHINGTON WAIVER OF SUBROGATION: FORM SS 12 15 LOCATION: 001 BUILDING: 001 NAME: IF ANY Form SS 00 02 12 06 Page 004 (CONTINUED ON NEXT PAGE) Process Date: 09/17/12 Policy Expiration Date: 11/01/13 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 TYPE MANAGER LESSOR 0 NAME SEE FORM IK 12 00 0 M a-I , c-I 0 Ln N O Ln cV LO CV O O -I Form SS 00 02 12 06 Page 005 (CONTINUED ON NEXT PAGE) Process Date: 09/17/12 Policy Expiration Date: 11/01/13 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 Form Numbers of Forms and Endorsements that apply: SS 00 01 04 93 SS 00 05 12 06 SS 00 08 04 05 SS 00 45 12 06 SS 01 28 10 OB SS 01 70 09 09 SS 41 02 04 05 SS 41 62 06 11 SS 41 63 06 11 SS 05 03 03 00 SS 05 47 09 01 SS 09 01 10 08 SS 09 25 10 08 SS 09 42 07 99 SS 10 04 09 98 SS 12 15 03 00 SS 50 19 03 12 IH 99 40 04 09 IH 99 41 04 09 SS 83 76 03 12 IH 12 00 11 85 ADDITIONAL INSURED - MANAGER/LESSOR Form SS 00 02 12 06 Page 006 Process Date: 09/17/12 Policy Expiration Date: 11/01/13 SPECTRUM POLICY DECLARATIONS Continued POLICY NUMBER: 52 SBM UK5025 SUPPLEMENTAL DECLARATIONS: A service fee of $ 0006.00 is charged for each installment when your premium is paid in installments. The service fee is $ 0006.00 per withdrawal when you select an electronic fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement. 0 M C3 0 Ln N 0 Ln N N LO N O O .-1 m Form SS 00 45 12 06 Process Date: 09/17/12 Policy Expiration Date: 11/01/13 CV o a Ln N O L1 cq N 04 N 0 O (n ic COMMON POLICY CONDITIONS �I Form SS 00 05 12 06 Cod 2006 The Hartford QUICK REFERENCE - SPECTRUM POLICY DECLARATIONS and COMMON POLICY CONDITIONS I. DECLARATIONS Named Insured and Mailing Address Policy Period Description and Business Location Coverages and Limits of Insurance II. COMMON POLICY CONDITIONS Beginning on Page A. Cancellation 1 B. Changes 1 C. Concealment, Misrepresentation Or Fraud 2 D. Examination Of Your Books And Records 2 E. Inspections And Surveys 2 F. Insurance Under Two Or More Coverages 2 G. Liberalization 2 H. Other Insurance- Property Coverage 2 1. Premiums 2 J. Transfer Of Rights Of Recovery Against Others To Us 2 K. Transfer Of Your Rights And Duties Under This Policy 3 L. Premium Audit 3 Form SS 00 05 12 06 COMMON POLICY CONDITIONS All coverages of this policy are subject to the following conditions. A. Cancellation (5) Failure to: 1. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except cancellation. during a period of seasonal n 2. We may cancel this policy by mailing or unoccupancy, or CD, delivering to the first Named Insured written (b) Pay property taxes that are owing notice of cancellation at least and have been outstanding for en H a. 5 days before the effective date of more than one year following the LO cancellation if any one of the following date due, except that this N conditions exists at any building that is provision will not apply where you Ln Covered Property in this policy are in a bona fide dispute with the taxing authority regarding payment C, (1) The budding has been vacant or of such taxes 'n unoccupied 60 or more consecutive days. This does not apply to b. 10 days before the effective date of C3 cancellation if we cancel for nonpayment (a) Seasonal unoccupancy, or of premium (b) Buildings in the course of c. 30 days before the effective date of construction; renovation or cancellation if we cancel for any other addition. reason Buildings with 65% or more of the rental 3. We will mad or deliver our notice to the first units or floor area vacant or unoccupied Named Insured's last mailing address known are considered unoccupied under this to us. provision. 4. Notice of cancellation will state the effective (2) After damage by a Covered Cause of date of cancellation The policy period will end Loss, permanent repairs to the on that date budding 5. If this policy is canceled, we will send the first (a) Have not started; and Named Insured any premium refund due (b) Have not been contracted for, Such refund will be pro rata The cancellation within 30 days of initial payment of will be effective even if we have not made or loss offered a refund. (3) The building has: 6. If notice is mailed, proof of mailing will be sufficient proof of notice (a) An outstanding order to vacate, 7. If the first Named Insured cancels this policy, (b) An outstanding demolition order, we will retain -no less than $100 of the or premium (c) Been declared unsafe by B. Changes —= governmental authority This policy contains all the agreements between you ._ (4) Fixed and salvageable items have and us concerning the insurance afforded The first been or are being removed from the Named Insured shown in the Declarations is budding and are not being replaced authorized to make changes in the terms of this policy This does not apply to such removal with our consent This policys terms can be that is necessary or incidental to any amended or waived only by endorsement issued renovation or remodeling by us and made a part of this policy Form SS 00 05 12 06 Page 1 of 3 © 2006 The Hartford -- COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud 1. Premiums This policy is void in any case of fraud by you as it 1. The first Named Insured shown in the relates to this policy at any time. It is also void if you Declarations- or any other insured, at any time, intentionally conceal a. Is responsible for the payment of all or misrepresent a material fact concerning- premiums; and 1. This policy; b. Will be the payee for any return premiums 2. The Covered Property; we pay 3. Your interest in the Covered Property; or 2. The premium shown in the Declarations was 4. A claim under this policy. computed based on rates in effect at the time D. Examination Of Your Books And Records the policy was issued If applicable, on each renewal, continuation or anniversary of the We may examine and audit your books and effective date of this policy, we will compute records as they relate to the policy at any time the premium in accordance with our rates and during the policy period and up to three years rules then in effect afterward. 3. With our consent, you may continue this policy E. Inspections And Surveys in force by paying a continuation premium for We have the right but are not obligated to: each successive one-year period The 1. Make inspections and surveys at any time; premium must be: a. Paid to us prior to the anniversary date;and 2. Give you reports on the conditions we find, and b. Determined in accordance with Paragraph 3. Recommend changes. 2. above Any inspections, surveys, reports or Our forms then in effect will apply If you do recommendations relate only to insurability and the not pay the continuation premium, this policy premiums to be charged We do not make safety will expire on the first anniversary date that we inspections We do not undertake to perform the duty have not received the premium of any person or organization to provide for the health or safety of any person. And we do not represent or 4. Changes exposures or changes u your o warrant that conditions. business operation, acquisition or use of locations that are not shown in the Declarations 1. Are safe or healthful, or may occur during the policy period If so,we may 2. Comply with laws, regulations, codes or require an additional premium That premium will standards be determined in accordance with our rates and This condition applies not only to us, but also to rules then in effect. any rating, advisory, rate service or similar J. Transfer Of Rights Of Recovery Against Others organization which makes insurance inspections, To Us surveys, reports or recommendations Applicable to Property Coverage. F. Insurance Under Two Or More Coverages If any person or organization to or for whom we If two or more of this policy's coverages apply to make payment under this policy has rights to the same loss or damage, we will not pay more recover damages from another, those rights are than the actual amount of the loss or damage. transferred to us to the extent of our payment G. Liberalization That person or organization must do everything If we adopt an revision that would broaden the necessary to secure our rights and must do p Y nothing after loss to impair them But you may coverage under this policy without additional waive your rights against another party in writing premium within 45 days prior to or during the policy period, the broadened coverage will immediately 1. Prior to a loss to your Covered Property. apply to this policy. 2. After a loss to your Covered Property only d, at H. Other Insurance -Property Coverage time of loss,that party is one of the following* If there is other insurance covering the same loss a. Someone insured by this insurance; or damage, we will pay only for the amount of b. A business firm covered loss or damage in excess of the amount (1) Owned or controlled by you; or due from that other insurance, whether you can collect on it or not. But we will not pay more than (2) That owns or controls you, or the applicable Limit of Insurance Page 2 of 3 Form SS 00 05 12 06 COMMON POLICY CONDITIONS c. Yourtenant. L Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers accordance with our rules and rates This will not restrict your insurance b. The premium amount shown in the K. Transfer Of Your Rights And Duties Under This Declarations is a deposit premium only At the Policy close of each audit period we will compute the earned premium for that period Any Your rights and duties under this policy may not be additional premium found to be due as a result transferred without our written consent except in of the audit are due and payable on notice to the case of death of an individual Named Insured the first Named Insured If the deposit If you die, your rights and duties will be transferred premium paid for the policy term is greater to your legal representative but only while acting than the earned premium, we will return the within the scope of duties as your legal excess to the first Named Insured representative Until your legal representative is c. The first Named Insured must maintain all appointed, anyone having proper temporary records related to the coverage provided by custody of your property will have your rights and this policy and necessary to finalize the o duties but only with respect to that property. premium audit, and send us copies of the N same upon our request. 0 in CN CN Ln CV O ,-ii Our President and Secretary have signed this policy Where required by law,the Declarations page has also been +C countersigned by our duly authorized representative Terence Shields Secrets ( �( ry Mdri A Napoli,President Fnrm SR nn 05 19 nA Paae 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following' ui W BUSINESS LIABILITY COVERAGE FORM o OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM SPECIAL PROPERTY COVERAGE FORM STANDARD PROPERTY COVERAGE FORM UMBRELLA LIABILTY PROVISIONS 0 in ry 0 in A. Disclosure Of Federal Share Of Terrorism 3. The act is a violent act or an act that is Losses dangerous to human life, property or N The United States Department of the Treasury will infrastructure and is committed by an individual o reimburse insurers for 85% of that portion of insured or individuals acting as part of an effort to 1-1 losses attributable to "certified acts of terrorism"that coerce the civilian population of the United rn * exceeds the applicable insurer deductible. States or to influence the policy or affect the However, if aggregate industry insured losses under conduct of the United States Government by coercion. the federal Terrorism Risk Insurance Act, as amended ("TRIA") exceed $100 billion In a Program If aggregate industry insured losses attributable to Year (January 1 through December 31), the "certified acts of terrorism" under TRIA exceed $100 Treasury shall not make any payment for any billion in a Program Year (January 1 through portion of the amount of such losses that exceeds December 31), and we have met, or will meet, our $100 billion. The United States government has not insurer deductible under TRIA, we shall not be liable charged any premium for their participation In for the payment of any portion of the amount of such covering terrorism losses. losses that exceed $100 billion In such case, your B. Cap On Insurer Liability for Terrorism Losses coverage for terrorism losses may be reduced on a pro-rata basis in accordance with procedures A "certified act of terrorism" means an act that is established by the Treasury, based on its estimates certified by the Secretary of the Treasury, In of aggregate industry losses and our estimate that concurrence with the Secretary of State and the we will exceed our insurer deductible In Attorney General of the United States to be an act accordance with the Treasury's procedures, of terrorism under TRIA The criteria contained in amounts paid for losses may be subject to further TRIA for a "certified act of terrorism" include the adjustments based on differences between actual following losses and estimates 1. The act results in insured losses in excess of$5 C. Application Of Exclusions million in the aggregate, attributable to all types The terms and limitations of any terrorism exclusion, of insurance subject to TRIA, and the inapplicability or omission of a terrorism 2. The act results in damage within the United exclusion, or the inclusion of terrorism coverage, do States, or outside the United States in the case not serve to create coverage for any loss which of certain air carriers or vessels or the premises would otherwise be excluded under this Coverage of an United States mission, and Form or Policy, such as losses excluded by the Nuclear Hazard Exclusion or the War And Military Action Exclusion Form SS 50 19 03 12 Page 1 of 1 © 2012, The Hartford llnrinrioc nrinwinhiarl mnfonal of Incnranro CPR/Iroc nffira Inr wdh rtc narmmcinn% POLICY NUMBER: 52 SBM UK5025 A"A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGER/LESSOR i THE CITY OF KENT PUBLIC WORKS ENGINEERING O 222 FOURTH AVE. SO. KENT WA 98032 m 0 Ln N O Ln x CN N 04 N O O r-1 m Form IH 12 0011 85 T SEO.NO. 002 Printed in U.S.A. Page 001 Process Date: 0 9/17/12 Expiration Date: 11/01/13 INSURED COPY THE HARTFORD Named Insured: ARNOLD TOMAC DBA A & M Policy Number: 52 SBM UK5025 Effective Date: 11/01/12 Expiration Date- 11/01/13 ko Company Name: AJ GALLAGHER RSK MGMT SVCS INC/PHS 0 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. Ln TRADE OR ECONOMIC SANCTIONS ENDORSEMENT LnLn N N o This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to, the payment of claims. All otherterms and conditions remain unchanged Form IH 99 41 04 09 Page 1 of 1 POLICY NUMBER: 52 SBM UK5025 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSURE PURSUANT TO TERRORISM RISK L Ln INSURANCE ACT 0 r, SCHEDULE 0 Ln N O Ln NTerrorism Premium (Certified Acts): Ln Cq o $ $5.00 0 rn 4c A. Disclosure Of Premium C. Cap On Insurer Liability for Terrorism Losses _ In accordance with the federal Terrorism Risk If aggregate industry insured losses attributable to Insurance Act, as amended ("TRIA"), we are "certified acts of terrorism" under TRIA exceed $100 required to provide you with a notice disclosing the billion in a Program Year (January 1 through portion of your premium, if any, attributable to December 31) and we have met, or will meet, our coverage for certified acts of terrorism under TRIA. insurer deductible under TRIA, we shall not be liable The portion of your premium attributable to such for the payment of any portion of the amount of such o coverage is shown in the Schedule of this losses that exceed $100 billion. In such case, your endorsement coverage for terrorism losses may be reduced on a B. Disclosure Of Federal Share Of Terrorism pro-rata basis in accordance with procedures Losses established by the Treasury, based on its estimates T of aggregate Industry losses and our estimate that The United States Department of the Treasury well we will exceed our Insurer deductible In accordance reimburse insurers for 85% of that portion of insured with the Treasury's procedures, amounts paid for losses attributable to "certified acts of terrorism" losses may be subject to further adjustments based under TRIA that exceeds the applicable insurer on differences between actual losses and estimates deductible. D. All other terms and conditions remain the same. However, if aggregate industry insured losses under TRIA exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion The United States government has not charged any premium for their participation in covering terrorism losses Form SS 83 76 03 12 Page 1 of 1 © 2012, The Hartford (Inrluriac nnnvrinhtari mafanal of thin Inciirmnra Rannrac r')ffira Inr with itc narmiccinn 1 .- _ Policy Number: 52 SBM UK5025 IMPORTANT NOTICE TO POLICYHOLDERS DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT Ln 0 SCHEDULE cn C) 0 LO o Terrorism Premium (Certified Acts): Ln $ $5.00 N Ln N O 0 r-I M ae A. Disclosure Of Premium C. Cap On Insurer Liability for Terrorism Losses In accordance with the federal Terrorism Risk If aggregate industry insured losses attributable to Insurance Act, as amended ("TRIA"), we are "certified acts of terrorism" under TRIA exceed $100 required to provide you with a notice disclosing the billion in a Program Year (January 1 through portion of your premium, if any, attributable to December 31), and we have met, or will meet, our coverage for certified acts of terrorism under TRIA insurer deductible under TRIA, we shall not be liable The portion of your premium attributable to such for the payment of any portion of the amount of such -= coverage is shown in the Schedule of this losses that exceed $100 billion In such case, your endorsement coverage for terrorism losses may be reduced on a B. Disclosure Of Federal Share Of Terrorism pro-rata basis in accordance with procedures Losses established by the Treasury, based on its estimates The United States Department of the Treasury will of aggregate industry losses and our estimate that reimburse insurers for 85% of that portion of insured we will exceed our insurer deductible In accordance with the Treasury's procedures, amounts paid for losses attributable to "certified acts of terrorism" lasses may be subject to further adjustments based under TRIA that exceeds the applicable insurer on differences between actual losses and estimates. _— deductible D. All other terms and conditions remain the same. However, if aggregate industry insured losses under TRIA exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion The United States government has not charged any premium for their participation in covering terrorism losses Form SS 83 80 03 12 Page 1 of 1 © 2012, The Hartford (Includes copyrighted material of the Insurance Services Office, Inc , with its permission.) Process Date: 09/17/12 Policv Expiration Date: 11/01/13