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HomeMy WebLinkAboutPW14-129 - Original - HD Supply Waterworks, Ltd, - Prospect Ave Water Main Replacement - 05/23/2014 f a sy Records l�ta:nageme'nt KENT Document W/SHINGTGN 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: HD Supply Waterworks, Ltd. Vendor Number: JD Edwards Number Contract Number: VW ILI This is assigned by City Clerk's Office Project Name: Prospect Ave. Water Main Replacement Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment. ® Contract ❑ Other: Contract Effective Date: Date of the Mayor's signature Termination Date: 90 days Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Paul Johnson Department: PW Operations ! Detail: (i.e. address, location, parcel number, tax id, etc.): Supply_pipe and appurtenances for the project. S:Public RecordsMana ement Forms ContractCover adcc7832 1 11 o8 KENT w„s"I"�r"" GOODS & SERVICES AGREEMENT between the City of Kent and HD Supply Waterworks, Ltd. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and HD Supply Waterworks, Ltd. organized under the laws of the State of Washington, located and doing business at 602 Valley Ave. NE, Puyallup, WA 98372, Phone: (253) 840-8558/Fax: (253) 840-1141, Contact: Larry Deford (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 supply pipe and appurtenances for the City's Prospect Avenue Water Main Replacement Project. For a description, see the Scope of Work and Vendor's bid which is attached as Exhibit A and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services within ninety (90) days. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Fourteen Thousand, Seven Hundred Sixty Four Dollars ($14,764.00), 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) I i - I Vendor shall be paid after delivery of supplies and submittal of invoice. i 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) I 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 B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. 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. 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. 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. VENDOR: CITY OF KENT: By: l By: tur ,l (signature) Print Name: Print afn.e,�. Suzette Cooke Its dc i o iJ - Its-- Mayor (tl DATE: Y�(=� tle) DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Larry Deford Timothy J. LaPorte, P.E. HD Supply Waterworks, Ltd. City of Kent 602 Valley Ave. NE 220 Fourth Avenue South Puyallup, WA 98372 Kent, WA 98032 (253) 840-8558 (telephone) (253) 856-5500 (telephone) (253) 840-1141 (facsimile) (253) 856-6500 (facsimile) APPROV D AYTOF RM: Kent Law Depa - HD Supply Waterviorks-ProspeR WM Repl/Raeburn 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 be ow, I agree to fulfill the five requirements referenced above. ... For: i1s4 � aKt ll `'_ Title: Date; I� 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. l 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. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 EXHIBIT A Scope Of Work HD Supply will provide all pipe and appurtenances for the City's Prospect Ave, water main replacement project in the amount not to exceed $14,764. Parts list and bids are attached as exhibit A. i Run1D to 5/06/14 HD SUPPLY WATERWORKS, LTD. Entered by: 8JD CITY OF KENT PUYALLUP WA PUYALLUP BRANCH 602 Valley Ave NE ACCOUNTS PAYABLE Puyallup WA 98372 220 4TH AVE S Telephone: 253-840-8558 KENT WA 98032 Fax: 253-840-1141 Telephone : 253--856-5230 EXHIBIT A Fax: 253-856-6200 i 5/06/14 Bid ID: 3819526 PROSPECT AVE. JOB Page 1 Sell Net Extended Line Quantity Per Description Price Price 10 399 FT 8 TJ CL52 DI PIPE C/L 19 .27 7, 688 . 73 30 4 RA F500-4-NL 1 CORP STOP MIPXMIP 34 .25 137 . 00__ NO LEAD 40 4 EA 202-0905 RM 8X1IP BODY ONLY 18 .50 74 . 00 8 . 63-9 . 05 OD - - �50 8 EA RM 8" U-BOLT & NUr 8 . 00 - 9 . 05 9 . 80 78 .40 70 4 EA C16 -44NL 1" FIPXPJIPS CPL 19 .,55 78 . 20 NO LEAD 80 4 EA C86-34NL 3/4X1 CPLG MIPXPJ(PE) 25 .50 102 . 00 ' (NO LEAD) 90 8 EA #53 - #72 SS INSERT 1" IPS 7. . 65 13 . 20 SDR-7 OR 1-1/4 CIS SDR9 - INSERT-53-72 1'10 1 EA 6X6 FLC TEE (I) C/L DI C110 - 159. 33 1.59 . 33 120 1 _ EA 8X6 FLO CONC REDUCER.(I) C/L DI 122 . 31 1.22 , 31 C110 130 1 EA 8X6 MJXHL 55 TEE (I) CP DI C153 124 , 46 1 . 140 1 EA 6 MJ L/P. SLEEVE (I) CP DI C153 55 . '79 . 79 150 . 1 EA 8 MJ L/P SLEEVE (I) CP DI C153 91. 20 91 , 20 170 3 EA 6 F6106 MJXFLG RW GV OL L/ACC 538 , 71 1, 61.6 . 13 CLOW GATE VALVE EPDXY COATED - - W/STAINLESS STEEL BOLTS & NUTS ISO 1 EA 8 F6106 MJXFLG RW GV OL L/ACC 841. 80 841. 80 CLOW GATE VALVE EPDXY COATED - W/STAINLESS STEEL BOLTS & NUTS 200 6 EA 6 MJ DI LUGGED RESTR PACK (1) 34, 04 204 .24 2.10 5 EA 8 MJ DI LUGGED RESTR PACK (I) 46 . 20 231. 00 230 1 EA 8 MJ PLUG (I) CP DI C153 48 . 82 48 . 82 240 1 EA 4 MJ PLUG (I) CP DI C1-53 16 . 64 16 . 64 260 100 FT LX100 ' SIDR- 7 IPS PE TUBING ' 50 50 .00 280 4 EA 1220-12/1320 CARSON BOX&RDRLID 44 . 00 176 . 00 12201134 300 4 EA 940 VALVE BOX LID WATER 9 . 75 39 ,00 ' III I late 5/06/14 HD SUPPLY WATERWORKS, LTD. Entered by: 8JD r CITY OF KENT - PUYALLUP WA PUYALLUP BRANCH 602 Valley Ave NE ACCOUNTS PAYABLE Puyallup _WA 98372 220 4TH AVE S Telephone: 253-840-8558 KENT WA 98032 Fax: 253-840-1141 Telephone: 253-856 5230 Fax: 253-856-6200 5/06/3.4 Bid ID; 3819526 PROSPECT AVE. JOB Page 2 - Sell Net Extended Line Quantify Per . Description Price Price 310 4 EA 1K 940B VALVE BOX TOP 25 .25 101 . 00 320 4 EA 24 VALVE BOX BTM DEEP 24 . 25 v97. 00 340 1 EA 4 MJ CAP (I) CP DI C153 s 13 . 95 13 . 95 350 1 EA 4 MJ DI LUGGED RESTR PACK (I) 27 .37 27 .37 '370 4 EA 6 ZINC PLTD HEX BOLT. & NUT KIT 6 . 08 -24 .32 380 4 EA 6X1/8 FLG RING RR GASKET 1 . 13 4 . 52 390 1 EA 8 ZINC PLTD HEX BOLT & NUT KIT 6 .36 6 .36 400 1 EA 8X1/8 FLG RING RR GASKET 1 . 60 1 . 60 Subtotal: 12,224.37 Tax: 1,161.31 Bid Total: 13,385 .68 K I 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. Commercial General Liabilitv 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 City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 2. 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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. i B. Minimum Amounts of Insurance j Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $2,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident, EXHIBIT B (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. i A CERTIFICATE OF LIABILITY INSURANCE DAJ22J20 OD YYYI 0 512 7/2 014 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(les) 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 CONTACT NAME: MARSH USA,INC. PHONE - - -SAX TWO ALLIANCE CENTER AIc rvo.E.q:_ _.. _ felt NDI: _.-.... 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30305 ADDRESS: _. Attn:HD$Upply.cenregaesl@mafah.Wm or fa%212.946,1142 INSURER(S)AFFORDING COVERAGE NAIC9 776978-HD-GAWX-13-14 _ WATER INSURER A:Illinois National Insurance Company 23817 '.. INSURED INSURER B:NBW Hampshlre Ins Company 23641 HD SUPPLY,INC. — _ - CUMBERLAND CENTER II INSURER C:NIA NIA 3100 CUMBERLAND BOULEVARD INSURER D:National Union Fire Ins Cc Pittsburgh PA 19445 ATLANTA,GA 30339 ---- INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003196472-05 REVISION NUMBER:2 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. ILTR ADOELSUBR - - POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICYNUMBER MMIDD/Y1'1'Y MMIOD/YYYY D BENERALLIABILITY GL5302603 08/3012013 08130/2014 EACH OCCURRENCE S 2,000,000 X AMAGE TO RENTED 1000,000 COMMERCIAL GENERAL LIABILITY PREMISES E occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $- 60,000 PERSONAL&ADV INJURY $ 2,000,000 Ali GENERALAGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 4,000,0W X POLICY -- PRO- LOC $ till D AUTOMOHILELIABILITY CA 6403848(AOS) 08130/2013 08/30/2014 COMBINED SINGLE LIMIT $ 5,000,000 B 1 X ANY AUTO CA 64D3849(MA) 08/30/2013 08/3012014 BODILY INJURY(Per person) I$ D ALLOWNEO 'SCHEDULED CA 6403850 IVA) 08/30/2013 0813012014 BODILY INJURY(Per accident) $ AUTOS AUTOS - --- NON OWNEDPROPERTY DAMAGE $ HIRED AUTOS AUTOS Pera e 1 _ -.. Self Insured Phy Dmg S UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S _ EXCESS LIAB CI-AIMS MADEAGGREGATE S _ OED RETENTION S S B 1 WORKERS COMPENSATION WC 079331602(AOS) 08/3012013 DM012014 I X 'CST MITS.- CDT- AND EMPLOYERS'LIABILITY WC 079331603 CA 08/3012013 0813012014 �I 1,00D'000 D (ANY PROPRIETOR/PARTNER/EXECUTIVE YIN ( ) EL EACH ACCIDENT $ A OFF ICERIMEMBER Excw0e0v NIA WC 079331604(FL) 0813012013 0813012014 EL DISEASE-EA EMPLOYE 5 1,000,000 (Mandatory In NH) B If yes desaibe under WC 079331608(MA,WI&MONO EL) 0813012013 0813012014 E.L DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS belmv --F DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CITY OF KENT IS INCLUDED AS AN ADDITIONAL INSURED IF REQUIRED BY WRITTEN CONTRACT ON THE ABOVE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICIES,BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED. THIS INSURANCE IS PRIMARY AND NONCONTRIBUTING ONLY IF REQUIRED BY WRITTEN CONTRACT,WITH RESPECTS TO GENERAL LIABILITY ONLY. CERTIFICATE HOLDER CANCELLATION CITY OF KENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 400 WEST GOWE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KENT,WA 98032 ACCORDANCE WITH THE POLICY PROVISIONS, i AUTHORIZED REPRESENTATIVE of Marsh USA Inc. i I Manashl Mukherjea ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i AGENCY CUSTOMER ID: 775978 LOC#: Atlanta A`(:>Ra ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC. HD SUPPLY,INC. CUMBERLAND CENTER II POLICY NUMBER 3100 CUMBERLAND BOULEVARD '.. ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance '.. Workers Commensalism Carriers Continued: Carder:New Hampshire Insurance Company Policy 11:WC 079331605 Effective Oates:0813012013-08/3012014 Workers Compensation Limits:Statutory EL Each Accident-V,000,000 EL Disease-Policy Limit-$1,000,000 EL Disease-Each Employee-$1,0001000 States Covered:AK,AZ,CA,VA Carder:Now Hampshire Insurance Company Policy#:WC 079331606 Effective Oates:08/3012013�0813012014 Workers Compensation Limits:Stehltary EL Each Accident-$1,000,000 EL Disease-Policy Limit $1,000,000 EL Disease-Each Employee-$1,000,000 States Covered:IL,KY,INC,NH,UT,VT Carder:New Hampshire Insurance Company Policy#:WC 079331607 Effective Dates:0813012013-086012014 '.. Workers Compensation Limits:Statutory EL Each Accident-$1,000p00 EL Disease-Policy Limit-$1,000,000 EL Disease-Each Employee-81,000,000 States Covered:NJ,PA —HD SUPPLY INSUREDS" HD Supply,Inc.Entity List ADS Holding Corporation HD Supply,Inc. HD Supply Holdings,U.0 HD Supply CP B Management,Inc. HD Supply Management,Inc. HD Supply Support Services,Inc. Bmfasco Holdings II,Inc. Brafasco Holdings,Inc. LBM Holdings,LLC. Creative Touch Interlors,Inc. HD Supply Interior Solutions HD Supply Canada Inc. HD Supply Industrial Solutlons II ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 775978 LOC#: Atlanta A�® ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY NAMED INSURED MARSH USA,INC. HD SUPPLY,INC. CUMBERLAND CENTER II POLICY NUMBER 3100 CUMBERLAND BOULEVARD ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, li FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance HD Supply Charitable Fund,Inc, ICI HD Supply Construction Supply Group,Inc HD Supply Construction Supply,Ltd. HD Supply Construction&Industrial HD Supply Distributed Services,LLC HD Supply Hardware Soluttons HD Supply Facilities Maintenance Group,Inc. HD Supply Facilities Maintenance,Ltd. HD Supply Facilities Maintenance HD Supply MuKtamlty,Solutions HD Supply Maintenance Solutions HD Supply Hospitality Solutions HD Supply Healthcare Solutions HD Supply Government SolutionsI. HDS Power Solutions,Inc. HD Supply Power Solutions Group,Inc. HD Supply Repair&Remodel,LLC HD Supply Home Improvement Solutions Contrecors Warehouse HD Supply UtilWes Group,Inc HD Supply Power Solutions,Lto HD Supply Power Solutions HD Supply Waterworks Group,Inc. HD Supply Waterworks,Ltd. HD Supply Waterworks HD Supply Fire Protection HD Supply Fusible Piping HD Bulger Solutions Group,LLC ADS IF Harding,LLC HSI IP,Inc. HD Supply Panama,SA NHDSA LLC NHDSA Holding,LLC ProValue,LLC White Cap Ceostruclan Supply,Inc. HD Supply International Holdings,Inc. HD Supply International Holdings II,LLC HD Supply(Hang Kong)Limited HD Supply India Private Limped HD Supply(Shenzhen)Company Limited Pro Canadian Holdings I,ULC Solbell Supply Southwest,S.A.de C.V. HD Supply FM Servb e,LLC ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENT# This endorsement, effective 12r01 A.M, 08/3012013 forms a part of Policy No. CA 640-38-4B issued to HD SUPPLY, INC i By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA ADDITIONAL INSURED • WHERE REQUIRED UNDER CONTRACT OR AGREEMENT . This endorsement madifles insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE '. ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND BY A WRITTEN CONTRACT OR AGREEMENT TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A.COVERED "AUTO". I, SECTION 11-LIABILITY COVERAGE, A. aaVeraga, 1- — Who Is insured, is amended to add: i d. Any person or organization, shown in the schedule above, to whom You become obligated to include as an additional insured under this policy, as a result of any contract Or agreement you enter Into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only wlth'respeci to liability arising out of use of a covered "auto".., However, the insurance provided will not exceed the lesser oft (1) The coverage and/or limits of this policy, or (2} The coverage and/or limits required by said contract or agreement. �( uthoozed Hipresentative a7A50 n0(06) POLICY NUMBER: GL 530-26-03 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Df Additional Insured Personlsl Or Or anization s Locotionisl Of Covered Operations ANY PERSON OR ORGANIZATION FOR WHOM YOU PER THE CONTRACT OR AGREEMENT. ARE PERFORMING OPERATIONS WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT THAT SUCH PERSON OR ORGANIZA71ON BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. Information_required to complete this Schedule, if not shown above, will he shown In the Declarations. it CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Pago1 of 2 ❑ i I A. Section II - Who Is An Insured is amended to or `property damage" occurring after: include as an additional insured the person(s)or 1. All work, including materials, parts or organization(s) shown in the Schedule, but only equipment furnished in connection with such with respect to liability for "bodily injury", work,. on the project (other than service, "property damage" or "personal and advertising maintenance or repairs) to be performed by injury" caused, in whole or in part, by: or on behalf of the additional insured(sl at 1. Your acts or omissions; or the location of the covered operations has been completed; or 2. The acts or omissions of those acting on 2. That portion of "your work" out of which your behalf; the injury or damage arises has been put to in the performance of your ongoing operations its intended use by any person or for the additional insured(s) at the locationls) organization other than another contractor or designated above. subcontractor engaged in performing However: operations for a principal as a part of the 1. The insurance afforded to such additional same project. insured only applies to the extent permitted C. With respect to the insurance afforded to these by law; and additional insureds, the following is added to 2. If coverage provided to the additional Section III - Limits Of Insurance: insured is required by a contract or If coverage provided to the additional insured is agreement, the insurance afforded to such required by a contract or agreement, the most additional insured will not be broader than we will pay on behalf of the additional insured that which you are required by the contract is.the amount of insurance: or agreement to provide for such additional 1. Required by the contract or agreement; or insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is leas. exclusions apply: This insurance does not apply to "bodily injury" This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. it III it i' i 1 l: Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13 CI I • I� POLICY NUMBER: GL530.26.03 COMMERCIAL GENERAL LIABILITY CG 20 370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ Ization s Location And Description Of Completed O erations ANY PERSON OR ORGANIZATION FOR WHOM PER THE CONTRACT OR AGREEMENT YOU ARE PERFORMING OPERATIONS WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE. AGREED IN WRITING IN A CONTRACT OR AGREEMENT THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II —Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the parson(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for 'bodily injury' or If coverage provided to the additional Insured is "property damage"caused, In whole or In part,by required by a contract or agreement, the most we 'your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional Insured and included In the "products-completed operations 1. Required by the contract or agreement;or hazard'. 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever Is less, insured only applies to the extent permitted This endorsement shall not Increase the applicable by law;and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional Insured Is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional Insured. I CG 20 37 0413 0 Insurance Services Office,trio.,2012 Page i of 1 i 'THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENT# i This endorsement, effective 12:01 A.M. 08/30/2013 forms a part of j Policy No. CA 640-38-40 issued to HO SUPPLY,INC By: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA LIMITED ADVICE OF CANCELLATION PROVIDED VIA EMAIL l TO ENTITIES OTHER THAN THE FIRST NAMED INSURED This policy is.amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of I premium, and j 1. the cancellation effective date is prior to this policy's expiration date; 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy Is canceled (hereinafter, the "Certificate Holderls)") and has provided to the Insurer, either directly or through its broker of record,the ®mall address of a contact at each such entity; and i 3. the Insurer received this Information after the First Named Insured receives notice of ,cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation fthe "Advice") via e-mail to each such Certificate Holders within [301 days after the.First Named Insured provides such Information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holderls) as soon as reasonably' l practicable after the First Named Insured provides such Information to the Insurer. I Proof of the Insurer amaffing the Advice, using the Information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied.its obligations under this andorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, bor shall this endorsement invest any rights in any entity not insured under this policy. The following Definitions apply to this endorsement: 1, First Named Insured means the Named Insured shown on the Declarations Page of this policy. 2. Insurer means the insurance company shown in the header on the Declarations page of this policy. I, 1074.14 f03(111 All other terms, conditions and exclusions shall remain tha name. Authorized R'epresentative I i 107414 (0311 1) i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I ENDORSEMENT # This endorsement, effective 12:01 A.M. 08/30/2013 forms a part of Policy No. GL 530-26-03 _ issued to HD SUPPLY, INC 13y: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA LIMITED ADVICE OF CANCELLATION PROVIDED VIA EMAIL TO ENTITIES OTHER THAN THE FIRST NAMED INSURED This policy is amended as follows: In the event that the Insurer cancels tills policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the First Named Insured is under an existing contractual obligation to notify e certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)"I and has provided to the insurer, either directly or through its broker of record, the email address of a contact at each such entity; and .3. the Insurer received'this information after the First Named Insured 'receives notice of cancellation of this policy and prior to this policy's canoollation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within f,.,30 ) days after the Flrst Named Insured provides such Information to the Insurer; provided, however, that If a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer, Proof of the Insurer smelling the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied Its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following Definitions apply to this endorsement: 1. First Named insured means the Named Insured shown on the Declarations Page of this policy. 2. Insurer means the insurance company shown In the header on the Declarations page of this policy. All other terms, conditions and exclusions shall remain the same. 107414 (03/11) Aiithtepr� eecive f I 107414 (03/11) THIS ENDORSEMENT CHANGBS THE POLICY. PLEASE READ IT CAREFULLY. This endorsement changes the policy to which it is attached effective on the ineeptlon date of the policy unless a different date Is indicated below. (The following"attaching chase" need be completed only when this ondorsemeni is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 08130/201 3 forms a part of Policy No. WC 079-33-1602 Issued to HD SUPPLY, INC. By NEW HAMP SHIRE INSURANCE COMPANY LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL TO ENTITIES OTHER THAN THE NAMED INSURED (WORKERS' COMPENSATION ONLY) This policy is amended as follows: I In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, If applicable, any other employers named in Item 1 of the Information Page is under on existing contractual obligation to notify a certificate holder when this policy Is canceled (hereinafter, the "Certificate Holders)") and the Named Insured has provided to the Insurer, either directly or through its broker of record, the emall address of a contact at each such entity; and 3. the Insurer received this information after the Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days .after the Named Insured provides such information 10 the Insurer; provided, however, (hat If a specific number of days is not stated above, then the Advice will be provided to such Certlflcate Holder(s) as soon as reasonably practicable after the Named Insured provides such information to the insurer. Proof of the Insurer omaigng the Advice, using the Information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfled its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement Invest any rights in any entity net Insured under this policy. The following definitions apply to this endorsement: 1. Named Insured means the insured first named employer in Item 1 of the Information Page of this policy. 2. Insurer means the Insurance company shown In the header on the Information Pago of this policy. All other terms, conditlons and exclusions shall remain the same, AUTHORIZED REPRESENTATIVE WC 09 00 56 (Ed. 04111) PUBLIC w6RKS Tim LaPorte, Director OPERATIONS DIVISION �400� [r��� Dare Brock, Interim Manager TENT Phone: 253 856 5656 WgSHINGTGN - Fax: 253-856-6600 Mailing Address: 220 Fourth Avenue South Kent, WA 98032-5895 Location Address: 5821 South 240th I Date: May 12, 2014 To: Sean Bauer, Water Superintendent From: Paul Johnson, Acting Water Supervisor CC: Andrew Raeburn, Acting Water Lead The Public Works Operations Warehouse orders approximately $150,000.00 in miscellaneous water materials to repair or replace infrastructure for the Water Utility each year. On May 6, 2014, in accordance with the City's Administrative 1.1 (Procurement Policy) the Warehouse solicited three written bids to be used for replacement of the water infrastructure on Prospect Ave. Bids were required to be faxed or emailed back by 4:00 PM on May 8, 2014. All bids were received on time. The bid results were as follows: HD Supply $12,224.37 Ferguson $12,281.63 H-.D. Fowler $12,823.01 I have reviewed the bids and determined that HD Supply is the lowest responsive bidder. i _- I i ,47 REQUEST FOR MAYOR'S SIGNATURE KEPI 1 Please Fill in All Applicable Boxe j i y Rev ewe by➢12ectpt$ " Originator's Name: Paul Johnson De t/Div. PW Operations Extension: 6 Date Sent: a73 e Date Required: Return to: Nancy Yoshitake CONTRACT TERMINATION DATE: 9QYd .a VENDOR: HD Supply Waterworks, Ltd. DATE OF COUNCIL APPROVAL: ff ATTACH THE COUNCIL MOTION SHEET FOR THE MAYOR - if applicable �, 'Brief Explanation of Document: I The attached agreement is for HD Supply Waterworks to provide pipe and ; '{ appurtenances for the City's Prospect Ave. Water Main Replacement Project.j Fri fi)br information, see the attached memo from Paul Johnson. ' s n Y ttf a s{ .5. All Contracts Must Be Routed Through The Law Department , } (This area to be completed by the Law Department). Received; r Approval of Law Dept.: Law Dept. Comments: + ' of v' ai n t t ht Date Forwarded to Mayor: _ Shaded Areas .To Be Completed By Administration Staff , ully ulp,�TA F i Received: of bT � MBlly { i. Recommendations and Comments: + � ; '. DispositionAVY : yF Date Retu ned: •� � , t Y; r CCif " OfTYti