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HomeMy WebLinkAboutPW13-011 - Original - AmTest, Inc. - Bacteriological Sampling - 02/20/2013 Records Management� KENT Document WASH INOTON x t CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: AmTest, Inc. Vendor Number: JD Edwards Number Contract Number: f w 13-©ll This is assigned by City Clerk's Office Project Name: Bacteriological Sampling Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: Date of the Mayor's signature Termination Date: 3/1/14 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Sean Bauer Department: PW Operations Detail: (i.e. address, location, parcel number, tax id, etc.): Collect and analyze the City's state mandated routine coliform bacteria samples. S*Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT WASHINGTON GOODS & SERVICES AGREEMENT between the City of Kent and AmTest, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and AmTest, Inc. organized under the laws of the State of Washington, located and doing business at 13600 NE 1261h Place, Suite C, Kirkland, WA 98034, Phone: (425) 885-1664/Fax: (425) 820-0245, Contact: Aaron Young (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 collect and analyze the City's state mandated routine coliform bacteria samples. For a description, see the attached Scope of Work and Vendor's December 19, 2012 quote which is attached as Exhibits A and B 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 3/1/14. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Twenty Three Thousand, Eight Hundred Sixty Five Dollars ($23,865.00), 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 (Over $10,000.00, Including WSST) Sampling shall occur on the first four (4) Tuesdays of every month for twelve months. Vendor shall be paid after submittal of invoice. 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. GOODS & SERVICES AGREEMENT - 2 (Over$10,000.00, including WSST) 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 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 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 GOODS & SERVICES AGREEMENT - 3 (Over$10,000.00, including WSST) 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 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 GOODS & SERVICES AGREEMENT - 4 (Over$10,000.00, including WSST) 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. 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 Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract 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 C 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. GOODS & SERVICES AGREEMENT - 5 (Over $10,000,00, including WSST) 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. 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 (Over$10,000.00, including 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: IN �_ By: (signat re) I signature) Print Name: /+o- YN- w "IOtA Prin am Su to Cooke Its Lakora,�lovv VRCuK-aderT Its Mayor �t/e) DATE: `-t l 3 DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Aaron Young Timothy J. LaPorte, P.E. AmTest, Inc. City of Kent 13600 NE 126th Place, Suite C 220 Fourth Avenue South Kirkland, WA 98034 Kent, WA 98032 (425) 885-1664 (telephone) (253) 856-5500 (telephone) (425) 820-0245 (facsimile) (253) 856-6500 (facsimile) APPROVED AS TO FO M: Kent Law Department AmTest-Sampling/Bauer GOODS & SERVICES AGREEMENT - 7 (Over$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. 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 -1 day of lnk&ay 'w , 2013. By: w For: Anji + Title: 4bora-arN wuma %, Date: 1 ILj 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 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 of 3 EXHIBIT A Scope of work: AmTest, Inc. will collect and analyze the City of Kent's state mandated routine coliform bacteria samples. Sampling consists of eighteen (18) coliform and free chlorine residual samples per week, at City designated sampling locations, the first four (4) Tuesdays of every month, for twelve (12) months. AmTest, Inc. will also submit all necessary sample result paperwork to the Washington State Department of Health Office of Drinking Water as required by the City in chapter 246.290.300 WAC, as well as copies to the City of Kent Water Department. i i I I I I EXHIBIT B December 19, 2012 l To: Sean Bauer City of Kent Public Works/Water Section 220 Fourth Ave S Kent, WA 98032 Re: Price Quote for Laboratory Analysis and Sampling Sean Heie are two separate price quotes. One for AmTest to pick up the samples at your facility and perform the purity analyses, and one for AmTest to perform the sampling and analyses. Please let me know if you have any questions or comments. 1. AmTest will pick up the samples at your facility and bring them to our laboratory for analysis at a rate of$14 per sample. Considering 18 samples per Tuesday four times per month the total for this would be: $12,096 per year(18 samples per week, four times per month, 12 months per year= 864 samples per year). Any additional samples would be charged at$14 per sample as well. 2. AmTest will perform all sampling at designated City of Kent sampling stations and/or �i city facilities at the same quantity as 41 for an additional $200 per week. All mileage, gas and hourly wage for our employee would be included in the flat rate of$200. This works out to an additional $9600 per year for a total of$21,696. I If you have any question or comments please feel free to contact me at 425-885-1664 or by email at aarony@amtestlab.com Sincerely, Aaron W. Young Lab Manager i ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D 1 8 201013 PRODUCER THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ISU INS.SERV. -BC ENV.BROKERAGE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1037 SUNCAST LANE, SUITE 103 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EL DORADO HILLS, CA 95762 INSURERSAFFORDING COVERAGE 939-1080 INSURED AM TEST, INC. INSURER A LIBERTY SURPLUS INS. CORP. # 10725 13600 NE 126th PLACE, STE. C INSURERB GREAT AMERICAN INS CO OF NY #39896 KIRKLAND, WA 98034 INSURER C INSURER D INSURER E COVERAGES 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 TOALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR rypE OF POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MMIDDIYY DATE MMIDDIYY GENERAL LIABILITY EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 100, 000 CLAIMS MADE ©OCCUR MED EXP(Anyone person) $ 10, 000 A X CONT.POLLUTION UVEDE104873112 10/19/12 10/19/13 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $2 000 000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOP AGG $ X POLICY PELT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGELIABILITY AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG S EXCESS LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND VNC STATU- OTH TORY LIMITS ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ EL DISEASE-EA EMPLOYEE $ EL DISEASE-POLICY LIMIT $ A OTHER PROF.LIAB. UVEDE104873112 10/19/12 10/19/13 $1,000, 000 OCCURRENCE INC.IN GL ABOVE RETRO: 10/1/94 $2, 000, 000 AGGREGATE DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: ALL OPERATIONS THE CITY OF KENT HAS BEEN NAMED AS ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY. PRIMARY COVERAGE APPLIES. SEVERABILITY OF INTEREST APPLIES. (BLNAKET ENDORSEMENTS ATTACHED) CERTIFICATE HOLDER ADDITIONAL INSURED, INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF KENT DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1 0 DAYS WRITTEN ATTN: NANCY YOSHITAKE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 400 WEST GOWE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR KENT, WA 98032 REPRESENTATIVES AUTHORIZED REPR7IVEOMUJ C ACORD 25-S (7/97) 0 ACORD CORPORATION 1988 Liberty_ 10� sttt Yltts Itistxrance TAU Environmental AdvantageTM cMcMb�or�M�WCrmp LIBERTY SURPLUS INSURANCE CORPORATION fA New I lampshar Stuck Ini r nec('ompan%,hereinafter the"Compan)1 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. ADDITIONAL INSURED/PRIMARY COVERAGE ENDORSEMENT Effective Date- October 19,2012 Expiration Date: October 19,2013 Pohcv Number: UN'EDE104873112 Endorsement No: 10 Issued To- All Test,Inc It is hereby agreed that the following is included as an Additional Insured as respects Coverages A,B and D but only as respects habihty ansing out of"your work"for the Additional Insured by or for you, Additional Insured. Blanket where required by written contract. 11us does not apply to"bodily injury","property damage"or"environmental damage"arising out of the sole negligence or wilful misconduct of,or for defects in design furnished by,the Additional Insured As respects the coverage afforded the .Adihuonal Insured, this insurance is primary and non-contributory, and our obligations are not affected by any other insurance carried by such .Additional Insured whether primary, excess, contingent,or on any other basis This endorsement does not increase the company's limits of liability as specified in the Declarations of this policy. .All other terms,conditions and exclusions shall remain the same. E-UV-49(08/0S) Liberty Surplus ttra 10� 't,0 Insrice Col PO LIU Environmental Advantage TM Mccib"or]abdcry MWuni Ci p LIBERTY SURPLUS INSURANCE CORPORATION (A New Flampshue Stml,Insurance(.ompam,hercinaficr the"Compan)') THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS-COMPLETED OPERATIONS Effective Date October 19,2012 Expiration Date October 19,2013 Pohcv Number U%'EDE104873112 Endorsement No.: 5 Issued To. AM Test,Inc. SCHEDULE Name Of Person or Organization: Blanket where required by written contract. Location and Description of Completed Operations: Blanket where required by written contract for all work performed by or on behalf of the Named Insured. It is hereby agreed that the following is included: (If no entry appears above, information required to complete this endorsement will be shown in the Declaranons as applicable to this endorsement) A. Section II —Who Is An Insured is amended as respects Coverages A and B only, to include as an insured the person(s)or organization(s)shown in the Schedule,but only with respect to liability for "bodily injury","property damage" or"personal and advertising injury"caused,in whole or in part by 1. four acts or omissions,or 2. The acts or omissions of those acting on your behalf, In the performance of your ongoing operations for the additional msured(s)at the location(s)designated above B. Section II —Who Is An Insured is amended as respects Coverage D only,to include as an insured the person(s) or organization(s) shown in the Schedule, but solely with respect to "loss" ansing from "pollution conditions" caused by "covered operations" performed by you and not covered for any "loss" ansing from the additional insured(s)schedaled in this endorsement C. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply- 1. This insurance does not apply to"bodily injury"or"proper damage"occurring after- a. All work,including materials,parts or equipment furnished in connection with such wod,, on the project (other than service,maintenance or repairs) to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or E•Ln'-7(11/08) r i•�1 AMTES-1 OP ID:ZCMS AIC�ORL7" CERTIFICATE OF LIABILITY INSURANCE DAT01111DYYYY) 01l11l13 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 425-258-2300 CONTACT NAME Whitfield's United Insurance 425-258-9363 AIC NNo Ext AC No Commercial Lines Department PO Box 1127/3425 Broadway E MAILss Everett,WA 98206 John Reynolds INSURER(S)AFFORDING COVERAGE NAM# INSURER Ohio Casualty Insurance Co 24074 INSURED AM Test INSURER B 13600 NE 126th PI Ste C Kirkland,WA 98034-8720 INSURERC -INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADD L SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER fMMIDDiYYYY1 (MMIDDrYYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENT COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,0DO,DDO Ee accident A X ANY AUTO X BAS1354637297 10/21/12 10/21/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Pera_ccident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION$ i $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I I ER ANY PRCPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' ❑ NIA (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The City of Kent is named additional insured in regards to auto liability perform CA8810 per written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent Engineering ACCORDANCE WITH THE POLICY PROVISIONS Nancy Yoshitake 400 West Gowe AUTHORIZED REPRESENTATIVE Kent,WA 98032 ©1988-2010 ACORD CORPORATION All rights reserved ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO CA88100110 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement,the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUITOR LOSS 18 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 21 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 22 EXTRA EXPENSE- BROADENED COVERAGE 10 GLASS REPAIR -WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN/ LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 19 SECTION II-LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more then 50 percent of the voting stock during the policy period.However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy;or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form,other than a partnership or joint venture,of which you own more than 50 percent of the voting stock.This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; 02010 Liberty Mutual Insurance Company All rights reserved. CA 88 10 0110 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement,or permit issued to you by governmental or public authority,to add such person,or organization,or governmental or public authority to this policy as an "insured". However,such person or organization is an "insured" (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract,agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs(2)and(4)are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic 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 earn- ings up to$500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law,fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION 11 - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire, SECTION III- PHYSICAL DAMAGE COVERAGE is amended as follows: 0. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own,then the Physical Damage coverages provided are extended to "autos". a. You hire,rent or borrow; or 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for"loss" in any one "accident" or"loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the"loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality,minus a deductible B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered"auto"you own. D. Subject to a maximum of$750 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto"that is hired,rented or borrowed with a driver; or (2) Any "auto"that is hired,rented or borrowed from your"employee". For the purposes of this provision,SECTION V-DEFINITIONS is amended by adding the following. "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2.Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled a. For private passenger type vehicles,we will pay up to$50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight(GVW)of 10,000 pounds or less c. For "medium trucks" ,we will pay up to$150 per disablement. "Medium trucks"are trucks that have a gross vehicle weight(GVW)of 10,001 -20,000 pounds. However,the labor must be performed at the place of disablement. B. PHYSICAL DAMAGE-ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of$50 per day and a maximum limit of$1,500 02010 Liberty Mutual insurance Company.All rights reserved. CABS 1001 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 3 of 7 8. RENTAL REIMBURSEMENT SECTION III- PHYSICAL DAMAGE COVERAGE,A.COVERAGE, is amended by adding the following: a. We will pay up to$75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto " b. Rental Reimbursement will be based on the rental of a comparable vehicle, which In many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to$500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type,we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4.Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE- BROADENED COVERAGE Under SECTION 111 - PHYSICAL DAMAGE COVERAGE,A.COVERAGE,we will pay for the expense of returning a stolen covered "auto"to you.The maximum amount we will pay is$1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the fotlowing: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided underthis provision is excess over any other collectible insurance. B. SECTION V- DEFINITIONS is amended by adding the following. For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment,jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 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 cov- erage or warranty. 13. AUDIO,VISUAL AND DATA ELECTRONIC EOUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c.and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual Insurance Company.All rights reserved CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission Page 4 of 7 Exclusion 4.c.and 4.d.do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto", or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a$100 deductible. 14. LOAN I LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of. a. Overdue payments and financial penalties associated with those payments as of the date of the"loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", I. Any amount representing taxes, J. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the"loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss".This adjustment is not applicable in Texas. S. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral,or lease written on the covered "auto"that incurred the loss. C. SECTION V- DEFINTIONS is changed by adding the following: As used in this endorsement provision,the following definitions apply: "Total loss" means a "loss" in which the cast of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan,thereby requiring a large final payment. 02010 Liberty Mutual Insurance Company AN rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 5 of 7 15. GLASS REPAIR-WAIVER OF DEDUCTIBLE I Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: 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 lbs.or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked, and c. Unoccupied. The"loss" must be reported to the 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 SECTION IV-BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form,the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery,and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT,OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You,if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company, 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How,when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 02010 Liberty Mutual insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV- BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period,Coverage Territory, is amended by the addition of the following: f. For "autos" hired 3D days or less,the coverage territory is anywhere In the world,provided that the insured's responsibility to pay for damages is determined in a "suit",on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or In a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased,rented or borrowed with a driver. SECTION V-DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS,definition C. is replaced by the following: "Bodily injury" means physical injury,sickness or disease sustained by a person, including mental anguish,mental injury,shock,fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation.This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. i 02010 Liberty Mutual Insurance Company /UI rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 7 of 7 ;I► REQUEST FOR MAYOR'S SIGNATURE KENT Please Fill in All Applicable Boxes w.I�I..... 'viewed by Director Originator's Name: Sean Bauer Dept/Div. PW Operations xtension: 5616 Date Sent: Date Required: a Return to: Nancy Yoshitake CONTRACT TERMINATION DATE: 3/1/14 VENDOR: AmTest, Inc. DATE OF COUNCIL APPROVAL: 2/19/13 ATTACH THE COUNCIL MOTION SHEET FOR THE MAYOR - if applicable Brief Explanation of Document: The attached agreement is for AmTest to collect and analyze the City's state mandated routine coliform bacteria samples. For additional information, see the attached Council motion sheet. All Contracts Must Be Routed Through The Law Department RECEIVED (This area to be completed by the Law Department) Received: FrB 15 2013 b Approval f Law Dept.: j KENT LAW DEPT. Law Dept. Comments. RECEIVE D Date Forwarded to Mayor: 2` col � y� 17 19 2013 { sty of Kent Shaded Areas To Be Completed By AdministQtlka a4ft Mayor Received RECEIVED Recommendations and Comments: FEB Disposition: Z/�O// CiYYOFKEIVI' � Crry CLERK Date Returned: KENT hns. G'ON Agenda Item: Consent Calendar — 6H TO: City Council DATE: February 19, 2013 SUBJECT: Routine Bacteriological Water Sample Collection Contract w/AmTest, Inc. - Authorize MOTION: Authorize the Mayor to sign a Goods and Services Agreement with AmTest, Inc. for routine bacteriological water sample collection in an amount not to exceed $23,865.00 subject to final terms and conditions acceptable to the City Attorney and Public Works Director. SUMMARY: Pursuant to WAC 246-290-300 the City routinely collects and analyzes seventy-two bacteriological water samples per month at predetermined monitoring locations in the distribution system. Sampling and analysis ensures the drinking water is free of coliform bacteria to protect public health. EXHIBITS: Goods and Services Agreement with AmTest, Inc. RECOMMENDED BY: Public Works Committee BUDGET IMPACTS: This is an annual cost which is budgeted out of the Water Utility operating budget.