Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
PK14-044 - Original - Washington Tent & Awning, Inc. - Remove & Replace Municipal Court Awning - 03/31/2014
Records Mqp,, emK ENT _ ��''" Document WA 9 H�nOTON � 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: Washington Tent & Awning Inc. Vendor Number: JD Edwards Number Contract Number: PV 14 - 044 This is assigned by City Clerk's Office Project Name: Remove & Replace Awning at Kent Municipal Court Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 04/03/14 Termination Date: 05/03/14 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Nancy Clary Department: Facilities Management Detail: (i.e. address, location, parcel number, tax id, etc.): 5 Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 • \S: KENT W A NI N 0 T 0 N PUBLIC WORKS AGREEMENT between City of Kent and Washington Tent & Awning Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Washington Tent & Awning Inc. organized under the laws of the State of Washington, located and doing business at P.O. Box 98809, Lakewood, WA 98469-9809, Barney Ruff, 253 581-7177 (hereinafter the "Contractor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications: Washington Tent & Awning Inc. will take down existing retractable awning and will fabricate & install standing seam metal awning at the City of Kent Municipal Court, 1220 Central Avenue South, Kent 98032, in accordance with the Quotation dated March 4, 2014, which is attached as Exhibit A. Contractor further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time such services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon execution of this Agreement. Upon the effective date of this Agreement, Contractor shall complete the work described in Section I within 30 days. III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed $6,964.20, including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor the following amounts according to the following schedule: a PUBLIC WORKS AGREEMENT - 1 (Under$IOK - OPTIONAL PROCESS) Vendor shall invoice upon completion and acceptance of work by City; Net 30. A. No Payment and Performance Bond. Because this contract is under $10,000, the City has elected to waive both the performance/payment bond and retainage requirements of Chapter 39.08 RCW. B. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City's written approval. If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. C. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Contractor maintains and pays for its own place of business from which Contractor's services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Contractor's services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. PUBLIC WORKS AGREEMENT - 2 (Under$10K - OPTIONAL PROCESS) D. The Contractor is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor's failure to complete the work within the time specified in this Agreement. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor's breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor's possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. Contractor shall file a "Statement of Intent to Pay Prevailing Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract work. Contractor shall pay prevailing wages in effect on the date the b Contractor, and comply with Chapter 39.12 of the Revised Code bid is accepted orexecuted y p y P of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change PUBLIC WORKS AGREEMENT - 3 (under$IDK - OPTIONAL PROCESS) increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VIII. CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Contractor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 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 Contractor is asserting a schedule change or disruption. B. Records. The Contractor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Contractor's records needed for evaluating the protest. PUBLIC WORKS AGREEMENT - 4 (Under$IOK - OPTIONAL PROCESS) The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. X. WARRANTY. Upon acceptance of the contract work, Contractor must provide the City a one-year warranty bond in a form and amount acceptable to the City. The Contractor shall correct all defects in workmanship and materials within one (1) year from the date of the City's acceptance of the Contract work. In the event any parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for one (1) year from the date such correction is completed and accepted by the City. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. XI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XII. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in PUBLIC WORKS AGREEMENT - 5 (Under$1OK - OPTIONAL PROCESS) connection with the Contractor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24,115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Contractor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor's part, then Contractor shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Contractor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XIII. INSURANCE. The Contractor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Contractor's own risk, and Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XV. MISCELLANEOUS PROVISIONS. 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. PUBLIC WORKS AGREEMENT - 6 (Under$10K - OPTIONAL PROCESS) 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 attorne y's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; ,provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Contractor. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. PUBLIC WORKS AGREEMENT - 7 (Under$IOK - OPTIONAL PROCESS) J. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONTRACTOR: CITY OF KENT: By: IAwk By: (signature) (signature Print Name: S-CfrP-1,C* S-co"--s Pr t Na e: Jeff Watling Its 0TT-kCk M m- Pjh& 4z Its: Director, Parks (title) DATE: DATE: 3 C 4: PUBLIC WORKS AGREEMENT - 8 (Under$10K - OPTIONAL PROCESS) NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Barney Ruff Nancy Clary Washington Tent & Awning Inc. City of Kent P.O. Box 98809 220 Fourth Avenue South Lakewood, WA 98469-9809 Kent, WA 98032 253 581-7177 (telephone) (253) 253 856-5084 (telephone) 253 581-7088 (facsimile) (253) 253 856-6080 (facsimile) Washington Tent®Awning bw--PW Agmemenrt-ALTERNATE-UnEer10K Pdf PUBLIC WORKS AGREEMENT - 9 (Under$1OK - OPTIONAL PROCESS) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal al"Id 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. By: r For: 4, N6-CtQN 'TENT NIN.(�, � hlC. Title: ©DICE "P<Nf�C�F, Date: EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 l 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. 3 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. By: For: Title: Date: 4 Y EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT A tWASHINGT°N Tent & Awning Inc. P.O. Bog 98809 * Lakewood,WA 98496-9809 253-581-7177 Lakewood * 206-622-1160 Seattle * 253-581-7088 Fax March 4, 2014 City of Kent Parks, Recreation & Community Services 400 West Gowe Kent, WA 98032 Attn: Tony Thiessen Dear Tony, In regards to your inquiry about replacing your existing retractable awning with a stationary awning, Washington Tent &Awning, Inc proposes the fallowing- - e0ooTake down existing retractable awning......$360.00 +$34.90 sal==— $394.2:0 :) Fabricate & install fabric awning 2' x 6' x 3 V-10........$4,500.00 +Permit $500.00=$5,000.00 + $475.00 sales tax= $5,475.00 Optional. Fabricate & install standing seam metal awning 2' x 6' x 31'-10"... 35,500.00+Permit $500.00 = 00 + $570.00 sales tax= $6,570.00 If you have any questions, please do not hesitate to give us a call. Thank you. Sincerely, Barney Ruff C/o Starlla Stokes EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. EXHIBIT B (Continued ) C. Other In surance nsurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. 00119�11103962 City of Kent Cont;OR& License K EN T City of Kent Customer Services-220 Fourth Avenue 5 i Kent,VfA t -5895 • (253)856-5210 Fax(253)8Sb-6= 1' \ PLEA5ETYPE OR PRESS FIRMLY—BLACK OR DARK BLUE INK ON .t e, "1"W1ra�" opasinghdyl CW8114 r All licenses expire December 31.Renewal invokes mailed in 1anilary. %is $S1 GU�� Date: C��T- 'c�c�i y 1. Name of Business: W MoA l NV ON TENT j h+VW 14k N 6 Business Address: u a CH P 57, 5 O City: A YLt f`A o nt> state: WA zif, 9�A C) Mail"Address: i`-d ui e)0 xci y b o(� G City: 1 �c -� � State: {A z1P:� 6149(U z. WA stew uBl#: (9 0 Q" C5 2)©— -;1 1-7`11 3. WA State TRN(Tax Registration Number). .V R'Str I TA );)La 4. Ll Indiv. ()Partnership Q LLC if Corporation Provldsownasbipkdb madan kxkWesupplanentdbtdfneeded Owners)Name(s): A V Address: q?—15 CO i�l7, ` -r. city: TA-i.Q M P state: W A zip-C1bL4 (o Phone.4Z323 :30-7-c�L4d5 FAX 5F51- -103t7 s. Contact Person: 5' A 1, L1 F-U f- Phone(rt'j c5 bI` I 1 -1-1 t; D.sviption of Business: M 1=b AW Pi!N fps/C. N O O F5 I N S T A L L 7. is your Business subject to the State of Washington BW Tax(Chapter 82.04 Revised Code of Washington)? ■ Yes ❑ No Is your Business subject to City of Kent B&OTax(please reference the list of exemptions noted on page 2 of the Business Activities Questionnaire)? d Yes ❑ No Exemption Number thereby cerrhfy that the statements andmformation furnished by me on this appiicatton are true and complete to the best ofmy knowledge I also acknowledge that the statements and information furnished by me on this application arepublicrecords and areavatiabieforpubllc Inspection pursuant to State of Washington RCW 42.h 7.2ti0. I understand that issuance of this license is carx0doned upon compliance atoll times with all applicable ordinances,regulations andstatutes of the City of Kent and the State of Washingtom The issuance ofthis business license does not imply compliance with the Zoning,Uniform Fire and Building Codex Signature: �-- PriettName: F��cyEs�i�' �C�✓ T(tle: FOR OFFICE USE ONLY: BLOC N V Date Recd 3A►/_�] Date Mailed T.R.$ Amt.Palh Jo p Other AcsWl17541-3 13 Whltrei.cne CwawpApplcwt%P4 .lttCWy Intent Details Page 1 of 2 Washington State Department of Labor & Industries Printer Fnendly Intent Details Document Received Date 3/20/2014 Intent ID 621047 Affidavit ID Status Approved On 3/21/2014 Company Details Company Name: WASHINGTON TENT Bt AWNING Address: PO BOX 98809 LAKEWOOD,WA,98496 Contractor Registration No. WASHITA1221-2 WA UBI Number 600580217 Phone Number 253-572-8237 Industrial Insurance Account ID 50172500 Email Address wtaCaMtegraonline.com Filed By Ruff, Bernard Prime Contractor Company Name WASHINGTON TENT B AWNING Contractor Registration No. WASHITA122LZ WA UBI Number 600580217 Phone Number 253-572-8237 Project Information Awarding Agency KENT,CRY OF 220-4TH AVE S KENT,WA-98032-5895 Awarding Agency Contact Alex Ackley Awarding Agency Contact Phone Number 253-856-5081 Contract Number Project Name Kent Municipal Court Contract Amount $6,964 20 , Bid due date 3/17/2014 Award Date 3/17/2014 Project Site Address or Directions 1220 Central Ave So Kent,WA 98032 t Payment Details Check Number: Transaction id: 104270413 Intent Details Expected project start date: (MM-DD-YYYY) 4/30/2014 In what county(or counties)will the work be performed? King https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 3/29/2014 Intent Details Page 2 of 2 In what city(or nearest city)will the work be performed? Kent What is the estimated contract amount?OR is this a time and materials $6,964.20 estimate? Will this project utilize American Recovery and Reinvestment Act(ARRA) No funds? Specifically,will this project utilize any weatherization or energy efficiency No upgrade funds(ARRA or otherwise)? Does your company intend to hire ANY subcontractors? No Does your company intend to hire subcontractors to perform ALL work? No Will your company have employees perform work on this project? Yes Do you intend to use any apprentices? (Apprentices are considered No employees.) How many owner/operators performing work on the project own 30%or 0 more of the company? journey Level Wages County Trade Occupation Wage Fringe #Workers King Sign Makers @ Installers (Non- Sign Installer $27.28 $0.00 3 Electrical) Public Notes L-Show/Hide Existing Notes No note exists Back To Search 1 ©Washington State Dept of Labor&Industries Use of this site is subject to the laws of the state of Washington Access 15'asitin�ton� https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 3/29/2014 WASH107 OP ID NO ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE 03/19'1201DDIY YY) `...�� 0 311 9/2 01 4 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 endorsements PRODUCER CONTACT NAME Fournier Ins Solutions-CD&B PHONE FAX CD&B AIC No EMI (A/C No 5712 Orchard St West E-MAIL University Place,WA 98467 ADDRESS Comfort,Davis&Blangy HOUSE INSURERS AFFORDING COVERAGE NAIC# INSURER A American States Insurance Co 19704 INSURED Wash Tent&Awning Co.Inc. INSURER B Mutual of Enumclaw 14761 PO Box 98809 Lakewood,WA 98496 INSURER C 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 7ypE OF INSURANCE ADEL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYV MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 01C169802710 06/14/2013 06114/2014 DAMAGE TO RENTED 200,00 PREMISES Ea occurrence $ CLAIMS-MADE 1XI OCCUR MED EXP(Anyone person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP)OP ASS $ 2,000,00 X POLICY 71 PRO LOG1 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1000,000 Ea accident $ , B JX ANY AUTO X BAP000141902 06/14/2013 06114/2014 BODILY I NJURY(Per person) $ ALLOWNED SCHEDULEDBODILY INJURY(Par acadenq $ AUTOS AUTOS $HIRED AUTOS X NON-OWNED PER ACCIDENTRTY AGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- ANOEMPLOYERS'LIABILITY TCRY LIMITS ER A ANY PROPRIETORlPARTNER/EXECUTIVE Y)N 01CI69802710 O6/14/2013 06l1412014 EL EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED ❑ NIA (Mandatory in NH) (STOP GAP) E L DISEASE-EA EMPLOYEE $ 1,000,00 If yes describe under 2 000 00 DESCRIPTION OF OPERATIONS bell% EL DISEASE-POLICY LIMIT $ , , DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Operations of the Named Insured in connection with the Dob - Kent Municipal Court See attached form CG8674 (12-07) for additional insured wording See attached form CG7680 (10-02) for Additional Insured Primary/Non-Contributory wording See attached form CG2503 for Per Pro3ect Wording See attached form EA9910 (05-13) for Additional Insured for Auto 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 ACCORDANCE WITH THE POLICY PROVISIONS 220 4th Ave.So. Kent,WA 98032 AUTHORIZED REPRESENTATIVE o�. tiajL ©1988-2010 ACORD CORPORATION All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD L+brrti COMMERCIAL GENERAL LIABILITY Nnrih4vrst. CG 26 03 05 09 POLICY NUMBER: 01—CI-698027-1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally Construction Project General Aggregate obligated to pay as damages caused by Limit for that designated construction project, "occurrences" under Section I — Coverage A, Such payments shall not reduce the General and for all medical expenses caused by acci- Aggregate Limit shown in the Declarations dents under Section I — Coverage C, which can not shall they reduce any other Designated be attributed only to ongoing operations at a sin- Construction Project General Aggregate gle designated construction project shown in the Limit for any other designated construction Schedule above: project shown in the Schedule above. 1. A separate Designated Construction Project 4. The limits shown in the Declarations for General Aggregate Limit applies to each Each Occurrence, Damage To Premises designated construction project, and that Rented To You and Medical Expense con- limit is equal to the amount of the General tinue to apply. However, instead of being Aggregate Limit shown in the Declarations. subject to the General Aggregate Limit 2. The Designated Construction Project Gen- shown in the Declarations, such limits will be eral Aggregate Limit is the most we will pay subject to the applicable Designated Con- z for the sum of all damages under Coverage Con- struction Project General Aggregate Limit. A, except damages because of `bodily B. For all sums which the insured becomes legally injury" or 'properly damage" included +n the obligated to pay as damages caused by "products-completed operations hazard", 'bccurrences" under Section 1 — Coverage A and for medical expenses under Coverage and for all medical expenses caused by acci- C regardless of the number of: dents under Section I — Coverage C, which a. Insureds; cannot be attributed only to ongoing operations at a single designated construction project shown b. Claims made or "suits" brought; or in the Schedule above: c. Persons or organizations making claims 1. Any payments made under Coverage A for or bringing "suits". damages or under Coverage C for medical 3. Any payments made under Coverage A for expenses shall reduce the amount available damages or under Coverage C for medical under the General Aggregate Limit or the expenses shall reduce the Designated Products-completed Operations Aggregate Limit, whichever is applicable; and ®Insurance Services Office,Inc., 2008 Safeco and the Safeco logo are registered tfodemarks of 5afioo Corporetloa CG 25 03 05 09 Page 7 of 2 EP I Such payments shall not reduce any Desig- Aggregate Limit nor the Designated Construction nated Construction Project General Aggre- Project General Aggregate Limit. gate Limit. D. M the applicable designated construction project C. When coverage for liability arising out of the has been abandoned, delayed,or abandoned and "products-completed operations hazard" is pro- than restarted, or if the authonzed contracting vided, any payments for damages because of parties deviate from plans, blueprints, designs, "bodily injury" or "propery damage" included in specifications or timetables, the project will still the `products-completed operations hazard" will be deamed to be the same construction project. reduce the Products-completed Operations Aggregate Limit, and not reduce the General E. The provisions of Section III — Limits of Insur- ance not otherwise moditiod by this endorsement shall continue to apply as stipulated. t IM C i� Page 2 of 2 I,,t rity CG 76 80 10 02 Noxth�ccst. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT, PERMIT OR AGREEMENT TO PROVIDE A PRIMARY AND NON— CONTRIBUTORY ADDITIONAL INSURED ENDORSEMENT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION If — WHO IS AN INSURED Is amended you. Coverage shall be limited to the extent of your to include as an additional insured the person or negligence or fault according to the applicable princi- organization shown in the Schedule subject to the ples of comparative fault. following provisions. 1. The additional insured is an insured but only for The insurance provided will not exceed the lesser of: liability directly resulting from: a. The coverage and/or limits of this policy, or a. your ongoing operations for the additional in- b. The coverage and/or limits required by the sured whether the work is performed by you contract, agreement or permit. or for you; or With respect to the insurance afforded the additional b. the general supervision of your ongoing op- insured, paragraph 4. of SECTION IV — COMMER- orations by the additional insured CIAL GENERAL LIABILITY CONDITIONS is de- 2, This insurance does not apply to: toted and replaced by the following: a. "Bodily injury" or "property damage" arising 4. Other Insurance out of any act or omission of, or for defects a. This insurance is primary and noncontrib- in design furnished by or for, the additional utory, and our obligations are not affected by insured or any other insurance where the additional in- b. "Bodily injury" or "property damage" in- sured is the Named Insured, whether pri- cluded within the "products-completed oper- mary, excess, contingent, or on any other ations hazard." basis; however, the defense of any claim or "suit" must be tendered as soon as practi- A person's or organization's status as an additional cable to all other insurers which potentially insured under this endorsement ends when your op- provide insurance for such claim or "suit". erations for that insured are completed. b. This additional provision applies only to the additional insured shown in the Schedule No coverage will be provided if, in the absence of this and the coverage provided by this endorse- endorsement, no liability would be imposed by law on Mont, CG 76 80 10 02 EP LiUett�, COMMERCIAL GENERAL LIABILITY Nnrkh�rcyt. CG 86 74 12 07 +I.mhr•{r�nrlbul q.yr,, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS LIABILITY PLUS ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: DUTY TO DEFEND or B or medical expenses under COV- ERAGE C. Paragraph a. of SECTION I — COVERAGE A and No other obligation or liability to pay sums or COVERAGE B Is replaced by the following. perform acts or services Is covered unless ex- a. We will pay those sums that the Insured be- plicitly provided for under SUPPLEMENTARY comes legally obligated to pay as damages PAYMENTS — COVERAGES A AND B. because of "bodily injury", "property damage" or "personal Injury and advertising EMPLOYERS LIABILITY injury" to which this insurance applies. We will have the right and duty to defend the in- The last paragraph of exclusion e. of SECTION 1 — sured against any "suit" seeking those dam- COVERAGE A is replaced by the following: ages. Our duty to defend begins once you This exclusion does not apply to liability assumed notify us of a "suet" as In SEC- by the insured under an "Insured contract" ex- cept for that part of a contract or agreement that ABILITY CONDITIONS, 2.b. However, we will have no duty to defend the Insured indemnifies any person or organization for their against any "suit" seeking damages for sole liability. "bodily injury", "property damage", or "personal injury or advertising Injury" to WRONGFUL EVICTION which this Insurance does not apply We may, at our discretion, investigate any The following exclusion Is added to SECTION 1 — "occurrence" and settle any claim or "suit" COVERAGE B: that may result But: The wrongful eviction from, wrongful entry into, e (1) The amount we will pay for damages is or Invasion of the right of private occupancy of a limited as described in SECTION III — room, dwelling or premises arising out of any: LIMITS OF INSURANCE; and (1) "property damage" to the room, dwell- (2) Our right and duty to defend ends when ing or premises; or we have used up the applicable limit of (2) "bodily injury" sustained through occu- insurance in the payment of judgments pancy of a room, dwelling or premises or settlements under COVERAGES A Safeco and the Safece iogo are registered trademarks of Safeco Corporation CO 86 74 12 07 Page 1 of 5 EP C•AG44PRINTOM-M 7-0021J ADDITIONAL INSURED — BY WRITTEN CON- This insurance does not apply to "bodily TRACT, AGREEMENT OR PERMIT, OR SCHED- injury", "property damage", or ULE "personal and advertising injury" arising out of operations performed for the state The following paragraph is added to SECTION II — or municipality; WHO 1S AN INSURED: c. The Insurance with respect to any architect, 4. Any person or organization shown in the Sched- engineer, or surveyor added as an Insured ule or for whom you are required by written con- by this endorsement does not apply to tract, agreement or permit to provide insurance "bodily injury", "property damage", or is an insured, subject to the following additional "personal and advertising injury" arising out provisions: of the rendering of or the failure to render any professional services by or for you, in- a. The contract, agreement or permit must be cluding; in effect during the policy period shown in the Declarations, and must have been exe- (1) The preparing, approving, or fading to cuted prior to the "bodily injury", "property prepare or approve maps, drawings, damage", or "personal and advertising opinions, reports, surveys, change or- injury", ders, designs or specifications; and b. The person or organization added as an in- (2) Supervisory, inspection or engineering sured by this endorsement is an Insured only services. to the extent you are held liable due to- d. This Insurance does not apply to "bodily (1) The ownership, maintenance or use of injury" or "property damage" included within that part of premises you own, rent, the "products-completed operations lease or occupy, subject to the following hazard". additional provisions: e. A person's or organization's status as an in- (a) This insurance does not apply to sured under this endorsement ends when any "occurrence" which takes place your operations for that insured are corn- after you cease to be a tenant in pleted. any premises leased to or rented to f. No coverage will be provided if, in the ab- you, sence of this endorsement, no liability would (b) This insurance does not apply to be imposed by law on you. Coverage shall any structural alterations, new con- be limited to the extent of your negligence struction or demolition operations or fault according to the applicable principles performed by or on behalf of the of comparative fault. person or organization added as an g. The defense of any claim or "suit" must be insured; tendered as soon as practicable to all other (2) Your ongoing operations for that in- insurers which potentially provide insurance sured, whether the work is performed for such claim or "suit". by you or for you, h. The insurance provided will not exceed the (3) The maintenance, operation or use by lesser of: you of equipment leased to you by such (1) The coverage and/or limits of this policy, person or organization, subject to the or following additional provisions; (2) The coverage and/or limits required by (a) This insurance does not apply to said contract, agreement or permit. any "occurrence" which takes place after the equipment lease expires, NON-OWNED WATERCRAFT AND NON-OWNED (b) This insurance does not apply to AIRCRAFT LIABILITY "bodily injury" or "property damage" arising out of the sole Exclusion g. of SECTION I — COVERAGE A is re- negligence of such person or or- placed by the following: ganization; g. "Bodily injury" or "property damage" arising (4) Permits issued by any state or political out of the ownership, maintenance, use or subdivision with respect to operations entrustment to others of any aircraft, "auto" performed by you or on your behalf, or watercraft owned or operated by or rented subject to the following additional pro- vision: Page 2 of 5 CAr-14PRIWO01-%17.00224 or loaned to any insured. Use includes oper- "Property damage" to: ation and "loading or unloading" (1) Property you own, rent, or occupy, in- This exclusion applies even if the claims cluding any costs or expenses Incurred against any insured allege negligence or by you, or any other person, organiza- other wrongdoing in the supervision, hiring, tion or entity, for repair, replacement, employment, training or monitoring of others enhancement, restoration or mainte- by that insured, if the "occurrence" which nance of such property for any reason, caused the "bodily injury" or "property including prevention of injury to a per- damage" involved the ownership, mainte- son or damage to another's property; nance, use or entrustment to others of any aircraft "auto" or watercraft that is owned (2) Premises you sell, give away aban- or operated by or rented or loaned to any in- of anyy don, the "property damage" arises out part of those premises; sured This exclusion does not apply to: (3) Property loaned to you; (1) A watercraft while ashore on premises (4) Personal property in the care, custody you own or rent, or control of the insured; (2) A watercraft you do not own that is: (5) That particular part of real property on which you or any contractors or sub- (a) Less than 52 feet long; and contractors working directly or indirectly (b) Not being used to carry persons or on your behalf are performing oper- property for a charge; ations, if the "property damage" arises out of those operations, or (3) Parking an "auto" on, or on the ways next to, premises you own or rent, pro- (6) That particular part of any property that must be restored, repaired or replaced vided the "auto" is not owned by or because "your work" was incorrectly rented or loaned to you or the insured; performed on it (4) Liability assumed under any "insured Paragraphs y t (3" and"property of this exclusion contract" for the ownership, mainte- nance or use of aircraft or watercraft; or than not apply to property damage (other than damage by fire) to premises, including (5) "Bodily injury" or "property damage" the contents of such premises, rented to arising out of: you. A separate limit of insurance applies to (a) the operation of machinery or Damage To Premises Rented To You as equipment that is attached to, or described in SECTION III — LIMITS OF part of, a land vehicle that would INSURANCE. Paragraph (2) of this exclu- qualify under the definition of sion does not apply if the premises are your work" and were never occupied, rented or "mobile equipment" if it were not subject to a compulsory or financial held for rental by you. 5i responsibility law or other motor ve- Paragraphs (3), (4), (5) and (6) of this exclu- hicle insurance law in the state sion do not apply to liability assumed under where it is licensed or principally a sidetrack agreement. garaged; or Paragraph (6) of this exclusion does not ap- (b) the operation of any of the machin- ply to "property damage" included in the ery or equipment listed in Paragraph "products-completed operations hazard". f.(2) or f.(3) of the definition of "mobile equipment". Paragraph 6. of Section III is replaced by the follow- (6) An aircraft you do not own provided it is ing. not operated by any insured. 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we TENANTS' PROPERTY DAMAGE LIABILITY will pay under COVERAGE A for damages be- cause of "property damage" to any one prom- When Damage To Premises Rented To You Limit is ises, while rented to you, or in the case of shown in the Declarations, SECTION I — COVER- damage by fire, while rented to you or temporar AGE A, exclusion j., is replaced by the following: ily occupied by you with permission of the owner. j. Damage To Property CO 86 7412 07 Page 3 of 5 EP UG-/4PA I NTOG1-3517-002N The Damage To Premises Rented To You Limit is the a. "Bodily injury" or "property damage" ex- higher of $200,000 or the amount shown in the Dec- pected or intended from the standpoint of the larations as Damage To Premises Rented To You insured. This exclusion does not apply to Limit. "bodily injury" or "property damage" result- ing from the use of reasonable force to pro- WHO IS AN INSURED — MANAGERS tect persons or property. The following is added to Paragraph 2.a, of SECTION INCREASED MEDICAL EXPENSE LIMIT 11 — WHO 1S AN INSURED: The medical expense limit is amended to $10,000. Paragraph (1) does not apply to executive officers, or to managers at the supervisory level or above. KNOWLEDGE OF OCCURRENCE SUPPLEMENTARY PAYMENTS — COVERAGES A The following is added to Paragraph 2. SECTION IV AND B — BAIL BONDS — COMMERCIAL GENERAL LIABILITY CONDITIONS Duties In The Event Of Occurrence, Paragraph 1.b. of SUPPLEMENTARY PAYMENTS Offense, Claim Or Suit of* — COVERAGES A AND B is replaced by the follow- ing: Knowledge of an "occurrence", claim or "suit" by b. Up to $3,000 for cost of bad bonds required your agent, servant or employee shall not in itself because of accidents or traffic law violations constitute knowledge of the named insured unless an arising out of the use of any vehicle to which officer of the named insured has received such notice the Bodily Injury Liability Coverage applies. from the agent, servant or employee. We do not have to furnish these bonds. INSURED CONTRACT SUPPLEMENTARY PAYMENTS — COVERAGES A The following definition is added to SECTION V — AND B — INDEMNITEES AND ADDITIONAL IN- DEFINITIONS, Definition 9. "insured contract" par- SUREDS agraph f.; Paragraph 2.f.(1) (d) of SUPPLEMENTARY PAY- (4) That part of any contract or agree- MENTS — COVERAGES A AND B is replaced by ment that indemnifies any person the following or organization for the indemnitee's (d) Cooperate with us with respect sole tort liability. to coordinating other applicable OTHER INSURANCE insurance and self-insured retention available to the m- The first paragraph of Other Insurance of SECTION demnitee, and IV — COMMERCIAL GENERAL LIABILITY CON- EMPLOYEES AS INSUREDS — HEALTH CARE DITIONS is replaced with the following. x SERVICE h If other valid and collectible insurance, or any self-in- Paragraph 2.a.(1) d. of SECTION Il — WHO IS AN sured retention, is available to the insured for a loss INSURED is deleted, unless excluded by separate `A1e cover under COVERAGE A or B of this Coverage endorsement. Part, our obligations are limited as follows: EXTENDED COVERAGE FOR NEWLY ACQUIRED METHOD OF SHARING ORGANIZATIONS The second paragraph of 4.c. Method of Sharing of Paragraph 3.a. of SECTION 11 — WHO IS AN IN- SECTION IV — COMMERCIAL GENERAL LIABIL- SURED is replaced by the following. ITY CONDITIONS is replaced with the following: a. Coverage under this provision is afforded If any of the other insurance does not permit contri- only until the end of the policy period. bution by equal shares or is subject to a self-insured retention, we will contribute by limits Under this EXTENDED "PROPERTY DAMAGE" method, each insurer's share is based on the ratio of its applicable limit of insurance or self-insured re- Exclusion a. of SECTION I — COVERAGE A is tention or both combined to the total applicable limits amended to read: Page 4 of 5 GAW4PHINT001-%I7.ON44 of insurance of all insurers and the amount of any our right to collect additional premium or exercise our self-insured retention. right of cancellation or non-renewal UNINTENTIONAL FAILURE TO DISCLOSE ALL LIBERALIZATION CLAUSE HAZARDS The following paragraph is added to SECTION IV — The following is added to Paragraph 6. Representa- COMMERCIAL GENERAL LIABILITY CONDI- tions of SECTION IV — COMMERCIAL GENERAL TIONS: LIABILITY CONDITIONS: 10. If a revision to this Coverage Part, which would If you unintentionally fail to disclose any hazards ex- provide more coverage with no additional isting at the inception date of your policy, we will not premium, becomes effective during the policy deny coverage under this Coverage Form because of period in the state shown in the Declarations, such failure However, this provision does not affect your policy will automatically provide this addi- tional coverage on the effective date of the re- vision. N CG 86 74 12 07 Page 5 of 5 EP C-AD-14-PRI NTODI,%l 7-002W COMMERCIAL AUTO EA 99 10 05 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies Insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement The following changes revise SECTION I — COVERED The coverage that applies is the same as the AUTOS coverage provided for the vehicle being replaced Paragraph C.I. is deleted and replaced with the Physical Damage Coverage is extended to the following temporary substitute auto for the lesser of the 1. Trailers following number of days a. "Trailers" with a load capacity of 2,000 1. The number of days reasonably required to pounds or less designed primarily for travel repair or replace the covered "auto" that is out on public roads, or of service, or b. "Trailers" designed primarily for travel on 2. 30 days public roads when The following changes revise SECTION 11 — LIABILITY (1) Pulled by an owned private passenger COVERAGE auto specifically described in Item The following is added to Paragraph A.1. Three of the Declarations as a covered d. Blanket Additional Insured "auto" for Liability Coverage under this Coverage Form, and Any person or organization that you are (2) Not used for business, farming or required to include as an additional insured ranching purposes on this Coverage Form in a written contract or agreement that is signed and executed Private passenger auto means a four (4) by you before the 'bodily injury" or"property wheeled motor vehicle of the private damage" occurs and that is in effect during passenger, station wagon, pickup or van the policy period is an "insured" for Liability type designed for use on public highways Coverage, but only for damages to which and subject to motor vehicle registration this insurance applies The following is added A person's or organization's status as an D. Temporary Substitute Autos—Physical Damage additional insured under this endorsement ends when your contract or agreement with If Physical Damage Coverage is provided by this such person or organization ends Coverage Form, the following types of vehicles are also covered "autos' for Physical Damage The Limits of Insurance applicable to the Coverage Additional Insured are those specified in the written contract or agreement but not more Any "auto" you do not own while used with the than the Limits of Insurance specified in the permission of its owner as a temporary substitute Declarations of this policy The Limits of for a covered "auto" you own that is out of service Insurance applicable to the Additional because of its Insured are inclusive of and not in addition 1. Breakdown; to the Limits of Insurance shown in the 2. Repair, declarations for the Named Insured 3. Servicing, This Coverage does not apply to lessors of leased "autos" 4. "Loss", or 5. Destruction. EA 99 10 05 13 Includes copyrighted material of Insurance Services Office,Inc,with its permission Page 1 of 4 e. Broadened Named Insured under this policy No deductible applies to Any business entity newly acquired or this coverage formed by you during the policy period (1) We will pay only for those expenses provided you own 51% or more of the incurred as a result of a covered "loss" business entity and the business is not occurring during the policy period separately insured for Business Auto beginning 24 hours after the "loss" and Coverage Coverage is extended up to a ending, regardless of the policy's maximum of 90 days following acquisition expiration, with the lesser of the or formation of the business entity or until following number of days the end of the policy period, whichever (a) The number of days reasonably comes first required to repair or replace the f. Employee Hired Auto covered "auto" If "loss" is caused An"employee"of yours is an"insured"while by theft, this number of days Is operating an "auto" hired or rented under a added to the number of days it contract or agreement in that "employee's" takes to locate the covered "auto" name, with your permission, while and return it to you, or performing duties related to the conduct of (b) 10 days your business (2) Our payment under this Coverage Paragraphs A 2.a.(2) and A 2.a (4) are deleted and Extension (4.a.) is limited to the lesser replaced with the following of the necessary and actual expenses 2. Coverage Extensions incurred or the maximum amount a. Supplementary Payments shown, $250 2 U to $2,500 for cost of bail bonds (3) Coverage under this Coverage O P Extension (4.a.) does not apply while (including bonds for related traffic law there are spare or reserve "autos" violations) required because of an available to you for your operations "accident" we cover We do not have to furnish these bonds The following is added to Paragraph A.4. (4) All reasonable expenses incurred by c Transportation Expenses - Theft of a the 'insured" at our request, including Private Passenger Auto actual loss of earnings up to$300 a day In the event of "loss" to a covered private because of time off from work passenger type "auto" caused by a total The following changes revise SECTION III— PHYSICAL theft which is covered by Comprehensive or DAMAGE COVERAGE Specified Causes of Loss Coverage on this policy, we will pay up to $25 per day to a This coverage applies only for a covered "auto" for maximum of $500 for transportation which Physical Damage Coverage is provided for on expenses incurred by you as a result of that this policy "Ioss" The following is added to Paragraph A.3 (1) We will pay for transportation expenses Glass Repair—Waiver of Deductible incurred during the period beginning No deductible will apply to glass breakage if such 264 hours (11 days) after the"loss" glass is repaired in a manner acceptable to us (2) Regardless of the policy's expiration, rather than replaced our reimbursement of your Paragraph A.4.a is deleted and replaced with the transportation expenses under this following Coverage Extension will end when the covered "auto" is returned to your use 4. Coverage Extensions or we pay for its "loss" a. Limited Rental Reimbursement or Travel (3) No deductible applies to this Coverage Expense Extension We will pay up to $25 per day to a d. Tapes, Records and Discs maximum of $250 for rental reimbursement We will pay for "loss" to tapes, records, expenses for the rental of an "auto" or other transportation expense Incurred by you compact discs, or other similar devices because of"loss" to a covered "auto" which used with audio, visual or data electronic is covered by Comprehensive, Specified devices Causes of Loss, or Collision coverage (1) We will pay only if the tapes, records, compact discs, or other similar devices EA 99 10 05 13 Includes copyrighted material of Insurance Services Office,Inc,with its permission Page 2 of 4 (a) Are your property or that of a family (d) Animals, private passenger "autos," member, or motorcycles, aircrafts, boats or any (b) Are the property of an "employee" other motorized vehicles or their using a covered "auto" in your equipment, furnishings or business affairs at the time of the appurtenances "loss", and (e) Equipment or accessories while (c) Are in a covered "auto" which your Travel Trailer, "Camper" or sustains other covered "loss" under Motor Home is leased or rented to Comprehensive or Collision any organization or any person coverage at the time of the "loss"to other than you or a family member tapes, records, compact discs, or (2) The maximum we will pay for "loss" is other similar devices the lesser of (2) The most we will pay for "loss" under (a) The actual cash value of the this Coverage Extension (4.d.) is $200. personal property at the time of (3) Physical Damage Coverage provisions "loss', apply to this coverage, except that any (b) The cost of repairing the damage, deductible applicable to or Comprehensive or Collision coverage (c) The cost of replacing the damaged $ " does not apply to this Coverage Extension (4 d ) personal property with other personal property of like kind, The exclusion referring to tapes, records, condition, quality and value discs or other similar audio, visual or data g. Vacation Expense Allowance electronic devices designed for use with audio, visual or data electronic equipment We will pay you $50 per day to a maximum does not apply of $500 for extra expenses when a Travel e. Camper Bodies Trailer, "Camper" or Motor Home is a scheduled auto for physical damage In the event of a "loss" to a detached coverage, and the Travel Trailer, "Camper" "camper," physical damage coverage will or Motor Home apply as if it were part of the covered "auto" (1) Is damaged or destroyed and is on which it is rated uninhabitable, and f. Contents of a Travel Trailer, Camper or (2) While being used for vacation purposes Motor Home within the policy period When a Travel Trailer, "Camper" or Motor Extra expenses must be supported by Home is a scheduled auto for physical receipts or other valid evidence damage coverage, we will pay up to $1,000 for "loss" to personal property belonging to The following is added to Paragraph A. you or a family member that is within the 5. Extra Expense—Broadened Coverage Travel Trailer, "Camper" or Motor Home We will pay for the direct expense of the We will pay up to $250 for"loss"to personal returning of a stolen covered "auto" to you We property belonging to you or a family will pay only for those covered "autos"for which member that is outside the Travel Trailer, you carry Comprehensive or Specified Causes "Camper"or Motor Home of Loss Coverage This coverage will only (1) We will not pay for"loss"to apply to vehicles recovered inside the 48 (a) Articles carried or held for sale, contiguous United States This coverage does storage or repairs, or for later not apply to an "auto"we deem a total "loss" delivery, goods kept to show or sell, The following is added to Paragraph B.3.a. or theatrical wardrobes Airbag Coverage—Accidental Deployment (b) Business, store of office furniture or However, this exclusion does not apply to the equipment unintended inflation of an airbag if the inflation (c) Records or accounts, money, is caused by mechanical or electrical bullion, deeds, contracts, evidences breakdown of debt, securities, tokens or tickets, stamps in current use or manuscripts EA 99 10 05 13 Includes copyrighted material of Insurance Services Office,Inc,with its permission Page 3 of 4 The following changes revise SECTION IV — The following changes revise SECTION V — BUSINESS AUTO CONDITIONS DEFINITIONS The following is added to Paragraph A.2.a.• The following is added Amended Duties in the Event of an Accident, Q. "Camper" means a portable dwelling unit without Claim, Lawsuit or Loss axles or wheels that has been manufactured for However, this duty is only required when the attachment on the bed of a pickup truck to be used "accident" is known to for casual travel or camping (1) You, if you are an Individual, (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company, or (4) An executive officer or Insurance manager, if you are a corporation The following is added to Paragraph A. 6. Blanket Waiver of Subrogation t _ We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" because of payments we make for damages under this coverage form The following is added to Paragraph B 2 Unintentional Failure to Disclose Hazards Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery Paragraph B.5.b. is deleted and replaced with the following b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own (1) Any covered "auto" you lease, hire, rent or borrow, and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" The following is added to Paragraph B.S. e. To the extent required by an "insured contract", this insurance is primary on behalf of the additional insured, and any other insurance maintained by the additional insured is excess and not contributory with this insurance If the "insured contract" does not require this provision,then Paragraph a above will apply EA 99 10 05 13 Includes copyrighted material of Insurance Services Office,Inc,with its permission Page 4 of 4 ordinance na3962 �� City of Kent Cont 'or License :...... City of Kent Customer Services•220 Fourth Avenue S.• Kent,VA 60-58895 • 1253)856-5210 Fax(253)856-6200 1 �.' nYAPd�n opaYag 3uyt«aRs PLEASE TYPE OR PRESS FIRMLY—BLACK OR DARK BLUE INK ONVj All licenses expire December 31.Renewal Invokes marled in January- �\i Of Ct? ,'A Date ate-2-I 01(4 1. Name of Business: W XVI N&Mri 1"T Business Address 13LAI011 CN 145 City,: (.�C 'c�lfJ SOD State: y vA_ZIP. U`1 Phone.-P 1 Mailing Address: P.d • E�ox u��� City: 1•kK w oot> State:WA ZIP: $q9(o 2. WA State UBttt o O- c5 rb o- .�L)l 3. WA State TRN(Tax Reglsmtion Number): \A hSO I-CA 1,22L2 4. Q Indio Q Partnership ❑LLC ■Corporation fmW&ownaslrl kdbmwAam-kxh+de rpaW tffnaeded Owner(s)Name(s): F z A y K\) Address: City: —rPrLn(,N4 P State:�L A ZIP:c1b gC14 Phone:4R55. ,O 7-a t{b 5 FAX 053 S. Contact Person: IE�PTV'N yq �U Phone(;`), 6. Dascription of Business: M r-b• A��)(`��7S/�. i QI I N S TAeLL 7. Is your Business subject to the State of Washington B&O Tax(Chapter 82.04 Revised Code of Washington)? ■ Yes ❑ No Is your Business subject to City of Kent B&OTax(please reference the fist of exemptions noted on page 2 of the Business Activities Questionnaire)? 0 Yes ❑ No Exemption Number /hereby certify that the statements and information furnished by me on this application are tare and complete to dwbestofmylmawledge. t also acknowledge that the statements and information furnished by me on this application are publicrecords and are available for public inspection pursuant to State of Washington RCW4Z.17.26a I understand that issuance ofthis license is Conditioned upon compliance atoll times with al/applkable ordinances,regulations and statutes of the City of Kentand theStatieofWashington.The issuance of this business license does not imply compliance with the Zoning,Uniform Fire and Building Codes Signature: PrintNartee: Tate• 5 O t — Date: 3/ Z-O T FOR OFFICE USE ONLY: BLOC it glq ✓ V Dategecd + r Date Mailed Tq,il Amt.Paij�d? 10 •©t? Other flcsW07541_3_13 Whitt-BLflle Canary:Applkont'1RetaiptCM