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HomeMy WebLinkAboutPK14-143 - Original - Holt Services, Inc. - Clark Lake-Rockwell Property Abandonment - 04/25/2014 � /���� Records M1 $s '�eme� � Z� KENT ...... WA9NINOTON Document u'� �I t �', „� CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Holt Services Inc. Vendor Number: 442597 JD Edwards Number Contract Number. This is assigned by City Clerk's Office Project Name: Clark Lake - Rockwell Property Well Abandonment Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ® Contract ❑ Other: Contract Effective Date: 4/25/2014 Termination Date: 7/10/14 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Brian Levenhagen Department: Parks Planning & Dev. Detail: (i.e. address, location, parcel number, tax id, etc.): Property address 12608 SE 248th Street Original PW Agmt and Amendment #1 for time extension to 7/10/14. PPD Contract # PPD14-10 S:Publlc\RecordsManagement\Forms\Contractcover\adcc7832 1 11/08 KENT WASHIN GT� PUBLIC WORKS AGREEMENT between City of Kent and Holt Services Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington , municipal corporation (hereinafter the "City"), and Holt Services Inc. organized under the laws of the State of Washington, located and doing business at 10621 Todd Road E, Edgewood, WA 98372; Randy Holt, (253) 604-4878 (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: As Described in Attachment A: Abandon well at the Rockwell House at Clark Lake, 12608 SE 248th St. in Kent 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 thirty (30) days. III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed Five Thousand Five Hundred Eighty-four Dollars and fifty cents ($5,584.50), 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: I PUBLIC WORKS AGREEMENT - 1 (Under$1OK - OPTIONAL PROCESS) Single Invoice 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 bid is accepted or executed by Contractor, and comply with Chapter 39.12 of the Revised Code 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$1OK - 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$10K - 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$10K - 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 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 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$10K - OPTIONAL PROCESS) I 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: (s'g ature) Jf �= (signature),,. Print Name -r t � PrinCNam : Jeff Watling Its tL ; , , , Its: Parks, Recreation and Community 1 (title) Services Director -31LIi DATE: m• —T DATE: P� E i PUBLIC WORKS AGREEMENT - 8 (Under$10K - OPTIONAL PROCESS) NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Randy Holt Brian Levenhagen, Project Manager Holt Services Inc. City of Kent 10621 Todd Road E 220 Fourth Avenue South Edgewood, WA 98372 Kent, WA 98032 I (253) 604-4878 (telephone) (253) 856-5116 (telephone) rholt@holtservicesinc.com bjlevenhagen@kentwa.gov P:Planning/Acqulsitio a/Clark Lake/Rockweg/Holt Svcs-Rockwell Well Abandonment-CONT"U.pdf it III I, l PUBLIC WORKS AGREEMENT 9 (Under$10K - OPTIONAL PROCESS) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. 7 By: � For: sv > C„% ,i .A . rf V,c_ Title: 'lrr`F Ut r Date: k 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. I EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT i This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of 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: 1 I EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT A Osborn, Lynn From: Levenhagen, Brian Sent: Wednesday, March 12,201412:35 PM To: Osborn, Lynn Cc: Gibson, Hope Subject: FW:abandonment ROCKWELL Property 12608 SE 248th St. Hi Lynn, Can you draw up a contract for this project? Thanks, Brian Brian Levenhagen, Park Planner Planning and Development I Parks, Recreation, &community services 220 Fourth Avenue South, Kent, WA 98032 - Direct Line 253-856-5116 1 Fax 253-856-6050 bilevenhagen@KentWA aov i CITY OF KENT,WASHINGTON KentWA.gov Facebook Twittew YouTube PLEASE CONSIDER THE ENVIRONMENT BEFORE PRINTING THYS E-MAIL From: Randy Holt rmailto:rholtCglholtserviceslnc.coml Sent:Thursday, March 06, 2014 11:29 AM To: Levenhagen, Brian Subject: RE: abandonment Hi Brian Rocky went out to the site and evaluated the well and here is the cost to abandon the well: Lump Sum pull pump,perforate and grout per DOE regulations. Provide intent to DOE and well report at completion. 5100.00. Price does not include tax. Please let me know if this is acceptable and you would like to schedule the abandonment. $5,100.00 Subtotal Randy Holt Holt Services Inc 484 F,f1 Tax @ 9.5% 10621 Todd Road h. $5,584.50 TOTAL Edgewood VTA 98372 (PH) 253.604.4878 (PX) 258.604.4063 Ple:use visit our vvebsil e,.. www.lioltsen,icesiiic.com From: Levenhagen, Brian [mailto BJLevenhaoenCg�kentwa aov] Sent: Wednesday, March 05, 2014 2:02 PM To: Randy Holt Subject: RE: abandonement Hi Randy, The address is 12608 SE 2481h St Kent,WA 98030. Please let me know if you need anything else. 1 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. i 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. ® DATE(MMIDD/YYYYI ACC)Ro CERTIFICATE OF LIABILITY INSURANCE 3/25/2014 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 0 TACT NAME: turn _.. Arthur J. Gallagher Risk Management Services, Inc. PHONE _ _ _ P.O. Box 2925 E--MAIL BI 12 A/C No Tacoma WA 98401-2925 ADOREss:' INSURERS.AFFORDING COVERAGE NAIC If INSURER A: Cc of AmeriQa 26666 INSURED INSURER B:The Travelers Indemnity Qon an 5682 Holt Services, Inc. INSURERC:Ohio Casualty InSUranCe Com 4074 10621 Todd Road East INSURER D'Al8Ska National Insurance Company 8733 _ Edgewood,WA98372 - INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1024456320 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 TYPE OF INSURANCE INSR SUER -POLICY EFF POLICY EXP LIMITS LTR IN VND POLICY NUMBER MM/DO/Y'/YY MMIDDM/YY A GENERAL LIABILITY V Y DT003E585091 /18/2014 /18/2015 EACH OCCURRENCE $1,000,000 -DAMAGE TCrREEqTED x COMMERCIAL GENERAL LIABILITY PREMSES Ee occurrence $100,000 CLAIMS-MADE OCCUR ME D E%P(Any ane erson $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ - B pUTOM061LE LIABILITY V pT8103E585091 /18/2014 118/2015 Ea accident _ $1,000,000 x ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per amicfent) $ AUTOS AUTOS -- NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS .(PeraWdent) 5 C X UMBRELLALIAB X OCCUR US01354436874 /18/2014 /18/2016 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS MADE AGGREGATE _ $4,000,000 DED x RETENTION$10 000 $ , p WORKERS COMPENSATION 14AWU06695 1/15/2014 /15/2015 WC STATU- OTH- ANDEMPLOYERS'LIABILITY YIN _E ANY PROPRIETORIPARTNEWEXECUTIVE❑ E.L.EACH ACCIDENT $1,000,000 lip OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT $1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) RE: Clark Lake Property Well Abandonment. City of Kent has been added an additional insured as per written contract per attached forms. Coverage Shall be primary and non-contributory,waiver of subrogation shall apply per attached forms. 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 Fourth Avenue South Kent WA 98032 USA AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any Injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- j age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased B. Damage To Premises Rented To You Equipment C. Increased Supplementary Payments I. Blanket Additional Insured — States Or Political Subdivisions—Permits D. Incidental Medical Malpractice J. Knowledge And Notice Of Occurrence Or Offense E. Who Is An Insured — Newly Acquired Or Formed Organizations K. Unintentional Omission F. Who Is An Insured — Broadened Named Insured L. Blanket Waiver Of Subrogatlon —Unnamed Subsidiaries M. Amended Bodily Injury Definition G. Blanket Additional Insured — Owners, Managers N. Contractual Liability—Railroads Or Lessors Of Premises PROVISIONS INJURY AND PROPERTY DAMAGE LI- A, AIRCRAFT CHARTERED WITH PILOT ABILITY: The following is added to Exclusion g., Aircraft, Exclusions c. and g. through n, do not apply Auto Or Watercraft, in Paragraph 2,of SECTION to "premises damage", Exclusion C(1)(a) I — COVERAGES — COVERAGE A BODILY IN- does not apply to "premises damage" caused JURY AND PROPERTY DAMAGE LIABILITY: by: This exclusion does not apply to an aircraft that a. Fire; is; b. Explosion; (a) Chartered with a pilot to any Insured; c. Lightning; (b) Not owned by any Insured; and d. Smoke resulting from such fire, explosion, (c) Not being used to carry any person or prop- or lightning; or erty for a charge. a. Water; B. DAMAGE TO PREMISES RENTED TO YOU unless Exclusion f. of Section I—Coverage A 1. The first paragraph of the exceptions in Ex- —Bodily Injury And Property Damage Liability clusion J., Damage To Property, in Para- is replaced by another endorsement to this graph 2, of SECTION I — COVERAGES — Coverage Part that has Exclusion —All Pollu- COVERAGE A BODILY INJURY AND tion Injury Or Damage or Total Pollution Ex- PROPERTY DAMAGE LIABILITY is deleted. clusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — Premises damage" as described in Para- COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 ©2g11 The Travelers Indemnity Company.All fights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- C. INCREASED SUPPLEMENTARY PAYMENTS TION III—LIMITS OF INSURANCE: 1. The following replaces Paragraph 1.b. of Subject to 6. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS — COVER- ises Rented To You Limit is the most we will AGES A AND B of SECTION I — COVER. pay under Coverage A for damages because AGE: of "premises damage" to any one premises. b. Up to $2,500 for the cost of bail bonds The Damage To Premises Rented To You required because of accidents or traffic Limit will apply to all "property damage" law vlolations arlsing out of the use of any proximately caused by the same 'occur- vehicle to which the Bodily Injury Liability renee", whether such damage results from: Coverage applies. We do not have to fur- fire; explosion; lightning; smoke resulting from nish these bonds. such fire, explosion, or lightning; or water; or y, The following replaces Paragraph 1.d. of any combination of any of these causes. SUPPLEMENTARY PAYMENTS — COVER- The Damage To Premises Rented To You AGES A AND B of SECTION I — COVER- Limit will be: AGES; a. The amount shown for the Damage To d. All reasonable expenses incurred by the Premises Rented To You Limit on the Insured at our request to assist us in the Declarations of this Coverage Part; or investigation or defense of the claim or b. $3001000 If no amount is shown for the "suit", including actual loss of earnings up Damage To Premises Rented To You to $500 a day because of time off from Limit on the Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following replaces Paragraph a. of the 1. The following is added to the definition of"oc- definition of"insured contract" in the DEFINI- currence" in the DEFINITIONS Section: TIONS Section: "Occurrence" also means an act or omission a. A contract for a lease of premises. How- committed in providing or failing to provide ever, that portion of the contract for a "incidental medical services", first aid or lease of premises that indemnifies any "Good Samaritan services"to a person. person or organization for "premises 2. The following Is added to Paragraph 2.a.(1)of damage"is not an"insured contract"; SECTION 11—WHO IS AN INSURED: 6. The following is added to the DEFINITIONS paragraph (1)(d) above does not apply to Section: "bodily Injury" arising out of providing or fail- "Premises damage" means "property dam- ing to provide: age"to: a. An remises while rented to you or ter- (i} "Incidental medical services" by any of Y p Y your "employees" who is a nurse practi- porarily occupied by you with permission tioner, registered nurse, licensed practical j of the owner; or nurse, nurse assistant, emergency medi- b. The contents of any premises while such cal technician or paramedic;or premises Is rented to you, if you rent such (if) First aid or"Good Samaritan services" by premises for a period of seven or fewer any of your "employees" or "volunteer consecutive days. workers", other than an employed or vol- 6. The following replaces Paragraph 4.b.(1)(b) unteer doctor. Any such "employees" or of SECTION IV— COMMERCIAL GENERAL "volunteer workers" providing or failing to LIABILITY CONDITIONS: provide first aid or "Good Samaritan ser- (b) That is insurance for"premises damage"; vices during their work hours for you will or be deemed to be acting wlthln the scope 7. Paragraph 4.b.(1)(c) of SECTION IV — of their employment by you or performing COMMERCIAL GENERAL LIABILITY CON- duties related to the conduct of your busk DITIONS is deleted. ness. Page 2 of 0 0 2011 The Travelers Indemnity Company.All rights reserved- CG D3 16 1111 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph S. of 4. Any organization you newly acquire or form, SECTION III—LIMITS OF INSURANCE: other than a partnership, joint venture or lim- For the purposes of determining the applica- Red liability company, of which you are the ble Each Occurrence Limit, all related acts or sole owner or in which you maintain the me- omissions committed in providing or failing to jority ownership interest, will qualify as a provide "incidental medical services", first aid Named Insured If there is no other insurance or"Good Samaritan services" to any one per- which provides similar coverage to that Or- son will be deemed to be one"occurrence". ganlzation. However: 4. The following exclusion is added to Para- a. Coverage under this provision is afforded graph 2., Exclusions, of SECTION I—COV- only: ERAGES—COVERAGE A BODILY INJURY (1) Until the 180th day after you acquire or AND PROPERTY DAMAGE LIABILITY: form the organization or the end of the Sale Of Pharmaceuticals policy period, whichever is earlier, if you "Bodily injury" or "property damage" arising do not report such organization in writing out of the willful violation of a penal statute or to us within 180 days after you acquire or ordinance relating to the sale of pharmaceuti- form it;or cats committed by, or with the knowledge or consent of,the insured. (2) Until the end of the policy period, when that date is later than 180 days after you 5. The following is added to the DEFINITIONS acquire or form such organization, if you Section: report such organization in writing to us "Incidental medical services"means: within 180 days after you acquire or form a. Medical, surgical, dental, laboratory,x-ray it, and we agree in writing that it will con- or nursing service or treatment, advice or tlnue to be a Named Insured until the end instruction, or the related furnishing of of the policy period; food or beverages; or b. Coverage A does not apply to "bodily injury" b. The furnishing or dispensing of drugs or or "property damage" that occurred before medical, dental, or surgical supplies or you acquired or formed the organization;and appliances. c. Coverage B does not apply to "personal in- "Good Samaritan services" means any emer- jury" or "advertising injury" arising out of an gency medical services for which no compen- offense committed before you acquired or sation is demanded or received. formed the organization. 6. The fallowing Is added to Paragraph 4.b., Ex- F. WHO IS AN INSURED— BROADENED NAMED cess Insurance, of SECTION IV — COM- INSURED—UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY CONDI- TIONS: The following is added to SECTION II —WHO IS AN INSURED: The insurance is excess over any valid and collectible other Insurance available to the in- Any of your subsidiaries, other than a partnership, sured,whether primary, excess, contingent or joint venture or limited liability company, that is on any other basis, that Is available to any of not shown as a Named Insured In the Declara- your "employees" or "volunteer workers" for tions is a Named Insured if you maintain an own- "bodily injury" that arises out of providing or ership interest of more than 50% in such subsidi- failing to provide "incidental medical ser- ary on the first day of the policy period. vices", first aid or"Good Samaritan services" No such subsidiary is an insured for"bodily injury" to any person to the extent not subject to or "property damage" that occurred, or "personal Paragraph 2.a.(1) of Section II — Who Is An Injury" or "advertising injury" caused by an of- Insured. fense committed after the date, if any, during the E. WHO IS AN INSURED — NEWLY ACQUIRED policy period, that you no longer maintain an OR FORMED ORGANIZATIONS ownership interest of more than 50% in such sub- The following replaces Paragraph 4. of SECTION sidiary. II—WHO IS AN INSURED: I CG D3 16 11 11 ©2011 The Travelers Indemnity Cmnpany.All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED —OWNERS, H. BLANKET ADDITIONAL INSURED— LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following is added to SECTION 11 —WHO IS The following is added to SECTION 11 —WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that Is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con- agreed in a written contract or agreement to in- tract or agreement to Include as an insured on elude as an additional insured on this Coverage this Coverage Part is an Insured, but only with re- Part Is an insured, but only with respect to liability spect to liability for "bodily injury", "property dam- for "bodily injury", "property damage", "personal age","personal injury" or"advertising injury"that: injury"or"advertising injury"that: a. Is "bodily injury" or "property damage" that a. Is "bodily injury" "property damage" that occurs, or is "personal injury" or "advertising occurs, or is "personal injury" or "advertising Injury" caused by an offense that Is commit- injury" caused by an offense that is commit- ted, subsequent to the execution of that con- ted, subsequent to the execution of that con- tract or agreement;and tract or agreement;and b. Arises out of the ownership, maintenance or b Is caused, in whole or in part, , your acts or omissions in the maintenance, operation or use of that part of any premises leased to use of equipment leased to you by such you. equipment lessor. The insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessor is subject to the following pro- is subject to the following provisions: visions: a. The limits of insurance provided to such a. The limits of insurance provided to such equipment lessor will be the minimum limits premises owner, manager or lessor will be which you agreed to provide in the written the minimum limits which you agreed to pro- contract or agreement, or the limits shown on vide In the written contract or agreement, or the Declarations,whichever are less. the limits shown on the Declarations, which- everare less. b, The insurance provided to such equipment lessor does not apply to any"bodily injury'or b. The insurance provided to such premises .,property damage" that occurs, or "personal owner,manager or lessor does not apply to: injury"or"advertising injury"caused by an of- (1) Any "bodily Injury" or "property damage" fense that is committed, after the equipment that occurs, or"personal injury"or"adver- lease expires. tising injury" caused by an offense that is c, The insurance provided to such equipment committed, after you cease to be a tenant lessor is excess over any valid and collectible In that premises;or other insurance available to such equipment (2) Structural alterations, new construction or lessor, whether primary, excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager, that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any In which case this insurance will be primary valid and collectible other Insurance available to, and non-contributory with, such other in- to such premises owner, manager or lessor, surance. whether primary, excess, contingent or on h BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS—PERMITS the written contract or agreement that this in- The following is added to SECTION 11—WHO IS surance must be primary to, or non- AN INSURED: contributory with, such other Insurance, in which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance. you or on your behalf and that you are required Page 4 of 6 ©2011 The Travelers Indemnity company.All rights reserved. CG D3 16 11 11 i COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include (11) A manager of any limited liability as an additional insured on this Coverage Part is company; or an insured, but only with respect to liability for (ill)An executive officer or director of "bodily injury", "property damage", "personal in- any other organization; jury" or"advertising injury" arising out of such op- that Is your partner, joint venture erations. member or manager; or The insurance provided to such state or political (b) Any "employee" authorized by such subdivision does not apply to: partnership, joint venture, limited li- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury" or"advertising injury" arising out to give notice of an 'Occurrence" or of operations performed for that state or po- offense. litical subdivision; or (3) Notice to us of such"occurrence" or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as cluded in the "products-completed operations soon as practicable if it is given in good hazard" faith as soon as practicable to your work- J. KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation Insurer. This applies RENCE OR OFFENSE only if you subsequently give notice to us of the "occurrence" or offense as soon as The following is added to Paragraph 2., Duties In practicable after any of the persons de- The Event of Occurrence, Offense, Claim or scribed in Paragraphs e. (1) or(2) above Suit, of SECTION IV — COMMERCIAL GEN- discovers that the"occurrence" or offense ERAL LIABILITY CONDITIONS: may result in sums to which the insurance e. The following provisions apply to Paragraph provided under this Coverage Part may a. above, but only for the purposes of the in- apply, surance provided under this Coverage Part to However, if this Coverage Part includes an en- you or any insured listed in Paragraph 1,or 2. dorsement that provides limited coverage for of Section II—who is An Insured: "bodily Injury" or "property damage" or pollution (1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of"pollutants" which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is number of days after its abrupt commencement, an Individual (if you are a partnership or this Paragraph e, does not affect that require- joint venture), any of your managers who ment. is an Individual(if you are a limited liability K. UNINTENTIONAL OMISSION company), any of your "executive offi- cers" or directors (if you are an organize- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture sentations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployed, authorized by you to give notice The unintentional omission of, or unintentional of an"occurrence"or offense. error In, any information provided by you which (2) If you are a partnership, joint venture or we relied upon in issuing this policy will not preju- limited liability company,and none of your dice your rights under this insurance. However, partners. joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence"or offense is known by: L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (1) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV— COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed In a contract or agree- 3. "Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock, fright, disability, against any person or organization,we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY— RAILROADS i curs;or 1. The following replaces Paragraph c. of the b. "Personal injury" or "advertising injury" definition of"insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement; agreement. 2. Paragraph C(1) of the definition of "insured M, AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section is de- The following replaces the definition of "bodily leted. Injury"in the DEFINITIONS Section: i I I Page 6 of 6 02011 The Travelers Indemnity Company.All rights reserved. CG D3 16 11 11 i COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section 11) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage' caused by your work" to include as an additional insured on this Cover- and included In the "products-completed op- age Part, but erations hazard" unless the "written contract requiring insurance" specifically requires you a) Only with respect to liability for"bodily injury", to provide such coverage for that additional "properly damage" or"personal injury"; and insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ante" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The Insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement Is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that Is this Coverage Part shown in the Declarations available to the additional Insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this Insurance is primary to "other insurance" surance This endorsement shall not in- available to the additional insured which covers that person or organization as a named insured crease the limits of insurance described in Section III—Limits Of Insurance. for such loss, and we will not share with that ;he insurance". But the insurance provided to b) The Insurance provided to the additional in- the additional Insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arlsing out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or Sur- tional insured when that person or organization is veying services, Including: an additional Insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, a) The additional insured must give us written approving, or failing to prepare or ap-prove, drawings and specifications; and notice as soon as practicable of an "occur- rence" or an offense which may result in a 1{, Supervisory, inspection, architectural or claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 I COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we i cover under this endorsement. However, this i. The names and addresses of any injured condition does not affect whether the insur- persons and witnesses; and ance provided to the additional insured by Ill. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. 1. Immediately record the specifics of the —DEFINITIONS; claim or"suit"and the date received; and "Written contract requiring Insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we person or organization as an additional in- receive written notice of the claim or"suit" as sured on this Coverage Part, provided that soon as practicable. the"bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the"personal injury"is caused by an send us copies of all legal papers received In offense committed: connection with the claim or"suit", cooperate a, After the signing and execution of the with us In the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and b. While that part of the contract or otherwise comply with all policy conditions. agreement is in effect; and d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05