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HomeMy WebLinkAboutPW14-041 - Supplement - #1 - GeoEngineers, Inc. - Kent Regional Trail Connector - 06/06/2014 } f t t 3 F Records Man Y I emei 't } KENT Document�� WASHINGTON f. T} f CONTRACT COVER SHEET j 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: GeoEngineers Inc. Vendor Number: JD Edwards Number Contract Number: PW 14 P This is assigned by City Clerk's Office Project Name: Kent Regional Trail Connector Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Amendmen4 44 1 Contract Effective Date: Date of the Mayor's signature Termination Date: 12/31/14 it Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Nick Horn Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time for completion to December 31, 2014 so the consultant can continue to provide consultation services up to construction of the project. S:Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 Washington State ® Department of Transportation Organization a AddressSupplemental Agreement GeoEngineers, Inc. Number 1 1101 S.Fawcett Ave., Suite 200 Tacoma, WA 98402 Original Agreement Number LA 8128 Phone: (253) 383-4940 Project Number Execution Date Completion Date CM-0615(008) 2/27/2014 ]2/31/2014 Project Title New Maximum Amount Payable Kent Regional Trail Comiector $ 12,559.00 Description of Work The scope of work remains the same,however an extension in time is necessary to allow for continued consultation services to construction of the project. The Local Agency of City of Kent desires to supplement the agreement entered into with GeoEngineers,Inc. and executed on 2/27/2014 and identified as Agreement No. LA 8128 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: I Section 1, SCOPE OF WORK, is hereby changed to read: The qrnpu or ,...L......., ins the same � I I I Section IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read: 12/31/14 III Section V. PAYMENT, shall be amended as follows: The,•mixinmm amrnint pay^ale remains the sarne. as set forth in the attached Exhibit A, and by this reference made a part of this supplement. If you concur with this supplement and agree to the changes as stated above, please sign in the appropriate spaces below and retui;r�tq this 16e for final action B By: - v Consultant Signature AloRroviril Signature f f j DOT Form 140-063 EF ,f �Date Revised 9/2005 i GEOEINC-01 TAYLORJE CERTIFICATE OF LIABILITY INSURANCE 3128128l oaT2201414 r MS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS .ERTIFICATE 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 Ileu of such endorsement(s). PRODUCER CONTACT NAME: Willis G Seattle,Inc. PHONE FA% 888 467-2378 AIC No Ext:(877)945-7376 _ (AIC,N�:_l � P.O.26 Centurryy 1 E-MAIL P. Box 305191 ADDRESS: Nashville,TN 37230-5191 _ —" INSURERS)AFFORDING COVERAGE __ � NA_ICp I INSURER A:Travelers Property Casualty Company of America 25674 INSURED INSURER B;Travelers Indemnity Company 25658 GeoEngineers,Inc. INSURER C:Liberty Mutual Fire Insurance_ Company 23035 8410 154th Ave.NE INSURER D: Redmond,WA 98052 INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN RrEDUCED BY PAID CLAIMS. INBR TYPE OF INSURANCE ADD SUBR POLICY NUMBER MMFDDY,YErn MMID�/YYYY LIMITS R GENERAL LIABILITY j EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X P-660-533 D1564-TIL-14 3/31/2014 3/31/2015 pREMlses Ea occurrence E 100,00 CLAIMS-MADE FRIOCCUR MEO EXP(Any one person) $ 5,00 PERSONAL a ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY X PIFICT RO LOG $ AUTOMOBILE LIABILITY EsacIN"D SINGLE LIMIT $ 1,000,00 B X ANY AUTO X P-810-532D8375-IN DA4 3/31/2014 3/31/2015 BODILY INJURY(Per person) S A OWNED SCHEDULED BODILY INJURY(Per acGtlenQ 5 AUTOS I AUTOS j NON-OVdNEO PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accitlent S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE 5 DED RETENTIONS S WORKERS COMPENSATION X VJC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER C ANY PROPRIETORIPARTNERIEXECUTIVE YIN❑ NIA C2-Z91-451667.014 313112014 3/3112015 E.L.EACH ACCIDENT $ 1,000.000 OFFICERIMEMBER EXCLUDED? iMandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) GEI File No.0 041 0-1 8 6-00 Re:Kent Regional Trail Connector WA Stop Gap,USLB,H and Maritime Employers Liability coverage is Included under Workers'Compensation coverage evidenced above. City of Kent is included as an Additional Insured as respects to General Liability and Automobile Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Kent AUTHORIZED REPRESENTATIVE Attn:Nancy Yoshitake 400 West Gowe Kent WA 98032 ©1988.2010 ACORD CORPORATION. All rights reserved, ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: P-660-533D1564-TIL-14 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II —WHO IS plies only to such "bodily injury" or "property ',... AN INSURED: damage"that occurs before the end of the pe- Any person or organization that you agree in a riod of time for which the "written contract re- written contract requiring insurance"to include as quiring insurance" requires you to provide an additional insured on this Coverage Part, but: such coverage or the and of the policy period, whichever is earlier. a. Only with respect to liability for"bodily injury", "property damage"or"personal injury" and 2• The following is added to Paragraph 4.a, of SEC- TION IV — COMMERCIAL GENERAL LIABILITY b. If, and only to the extent that, the injury or CONDITIONS: damage is caused by acts or omissions of you or your subcontractor in the performance The insurance provided to the additional insured of "your work" to which the "written contract is excess over any valid and collectible "other in- requiring insurance" applies. The person or surance", whether primary, excess, contingent or organization does not qualify as an additional on any other basis, that is available to the addi- Insured with respect to the independent acts tional insured for a loss we cover. However, if you or omissions of such person or organization. specifically agree in the "written contract requiring o insurance" that this insurance provided to the ad- The insurance provided to such additional insured ditional insured under this Coverage Part must is limited as follows: apply on a primary basis or a primary and non- c. In the event that the Limits of Insurance of contributory basis, this insurance is primary to this Coverage Part shown in the Declarations 'other insurance" available to the additional in- exceed the limits of liability required by the sured which covers that person or organization as "written contract requiring insurance", the in- a named insured for such loss, and we, will not surance provided to the additional insured share with that "other insurance". But this insur- shall be limited to the limits of liability required ante provided to the additional insured still is ex- by that "written contract requiring insurance". cess over any valid and collectible "other insur- This endorsement shall not increase the limits ance", whether primary, excess, contingent or on of insurance described in Section III — Limits any other basis, that is available to the additional Of Insurance. . insured when that person or organization is an d. This insurance does not apply to the render- additional insured under any "other insurance". ing of or failure to render any "professional 3. The following is added to SECTION IV — COM- services" or construction management errors IAERCIAL GENERAL LIABILITY CONDITIONS: or omissions. Duties Of An Additional Insured e. This insurance does not apply to "bodily in- As a condition of coverage provided to the addi- jury" or "property damage" caused by "your tional insured: work' and included in the "products- completed operations hazard" unless the a. The additional insured must give us written "written contract requiring insurance" specif- notice as soon as practicable of an "occur- tally requires you to provide such coverage rence" or an offense which may result in a forthat additional insured, and then the insur- claim. To the extent possible, such notice ance provided to the additional insured ap- should include: CG D4 14 04 08 ©2008 The Travelers Companies,Inc. Page 1 of 2 oaseos COMMERCIAL GENERAL LIABILfIY 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 ii. The names and addresses of any injured cover. However, this condition does not affect persons and witnesses; and whether this insurance provided to the addi- ional insured is primary to that other insur- t iii. The nature and location of any injury or ance available to the additional insured which damage arising out of the "occurrence" or ',. offense. covers that person or organization as a b. If a claim is made or"suit" is brought against named insured. 'I the additional insured, the additional insured 4. The following is added to the DEFINITIONS Sec- must: tion: I. Immediately record the specifics of the "written contract requiring insurance" means that claim or"suit"and the date received; and part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- The additional insured must see to it that we age Part, provided that the "bodily injury" and receive written notice of the claim or"suit" as "property damage" occurs and the "personal in- soon as practicable. jury"is caused by an offense committed: c. The additional insured must immediately send a. Afterthe signing and execution of the contract us copies of all legal papers received in con- or agreement by you; nection with the claim or"suit", cooperate with b. While that part of the contract or agreement is us in the investigation or settlement of the in effect; and claim or defense against the "suit", and oth- erwise comply with all policy conditions. c. Before the end of the policy period, d. The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 ©2008 The Travelers Companies, Inc. CG D4 14 04 08 i I COMMERCIAL AUTO POLICY NUMBER: P-810-532D8375-IND-14 ISSUE DATE: :3/31/2014 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name of Person(s)or Organization(s): ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE FORM IN A WRITTEN CONTRACT DR AGREEMENT j THAT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS AND THAT IS IN EFFECT DURING THE POLICY PERIOD. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations o� as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent — that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 oo�ass i Terra Insurance Company TERRA (A Risk Retention Group) v INSURANCE COMPANY Two Fifer Avenue, Suite 100 Corte Madera, CA 94925 CERTIFICATE OF INSURANCE DATE 02/05/14 NAME AND ADDRESS OF INSURED GeoEngineers,Inc. 1101 Fawcett Avenue, Suite 200 Tacoma, WA 98402 This certifies that the"claims made"insurance policy(described below by policy number)written on forms in use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a matter of information only,and confers no rights upon the certificate holder. This certificate does not alter, amend or extend the coverage afforded by this policy. The policy of insurance listed below has 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 policy described herein is subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been reduced by paid claims. TYPE OF INSURANCE Professional Liability POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 214019 01/01/14 12/31/14 LIMITS OF LIABILITY $1,000,000 EACH CLAIM $1,000,000 ANNUALAGGREGATE PROJECT DESCRIPTION [Cent Regional Trail Connector, GEIFile No. 00410-186-00 CANCELLATION: If the described policy is cancelled by the Company before its expiration date, ! the Company will mail written notice to the certificate holder thirty(30) days in advance, or ten (10) days in advance for non-payment of premium. If the described policy is cancelled by the insured before its expiration date, the Company will mail written notice to the certificate holder within thirty(30) days of the notice to the Company from the insured. CERTIFICATE HOLDER ISSUING COMPANY: TERRA INSURANCE COMPANY City of Kent (A Risk Retention Group) Attn: Nancy Yoshitake 400 West Gowe Kent, WA 98032 President REQUEST FOR MAYOR'S SIGNATURE T Please Fill in All Applicable Boxes ,( dr8wed by Director Originator's Name: Nick Horn Dept/Div. Engineering Extension: 5529 Date Sent: 61yi, - Date Required: 4.11f U, Return to: Nancy Yoshitake _ CONTRACT TERMINATION DATE; 12/31/14 VENDOR: GeoEnqineers,,Inc. DATE OF COUNCIL APPROVAL: 12/10/13 ATTACH THE COUNCIL MOTION SHEET FOR THE MAYOR - if applicable Brief Explanation of Document: The attached Supplemental Agreement 1 is for GeoEngineers to continue to provide consultation services to construction of the Kent Regional Trail Connector Project. l All Contracts Must Be Routed Through The Law Department {Th{s area to be completed by the Law Department) Received: Approval of p ' 3r . Law Dept. Comments: Date Forwarded to Mayor: 1i Shaded Areas To ministration Staff Received: `}°� RE C �� � .±c nx• xrsnti i Recommendations and Comments; CITY OF' ;✓"7NT ju CITY CLERKc Disposition: ', t% 1 ,< f/ r 6 „ Date Returned: