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HomeMy WebLinkAboutPK14-229 - Original - Environmental Specialties - Panther Lake Area Hazmat Inspections - 09/26/2014 g " Records M y-} wr erne KENT Document W A9 HINOTON 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: Environmental Specialties - CMSI Vendor Number: 221616 ]D Edwards Number Contract Number: "Wwwnl This is assigned by City Clerk's Office Project Name: 3 Hazmat Inspections Panther Lake area Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 9/26/14 Termination Date: 10/31/14 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Brian Levenhagen Department: Parks Planning & Dev. i Contract Amount: $3,620.00 - Approval Authority: (CIRCLE ONE) �C._epartment Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Inspect for and report on asbestos and lead in buildings & structures prior to eventual demolition. Huse property: 13427 SE 216 St and 13525 SE 216 St in Kent O'Connor property: 20834 132id Ave SE in Kent Division Contract #PPD14-24 As of: 08/27/14 KE IrT� W. .,„ara„ CONSULTANT SERVICES AGREEMENT between the City Of Kent and Environmental Specialties THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Environmental Specialties organized under the laws of the State of Washington, located and doing business at 4227 S. Meridian, Ste C-625, Puyallup, Wa 98373; Robert Simons (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: Conduct asbestos and lead paint sampling & inspection at 3 properties, and provide report. Address 1: 13427 SE 216" St, Kent Address 2: 13525 SE 216t" St,:Kent Address 3: 20834 132od Ave SE, Kent Consultant 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 those services are performed. II, TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Consultant shall complete the work described in Section I by October 31, 2014. III. COMPENSATION, A, The City shall pay the Consultant, based on time and materials, an amount not to exceed Three Thousand, Six Hundred Twenty Dollars and No Cents ($3,620.00), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit one single payment invoice to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of CONSULTANT SERVICES AGREEMENT- 1 (Under$10,000) I I an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant 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. 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 Consultant 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 Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C, The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant 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 Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant 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. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data Is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor 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. Consultant 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. i CUNSUi T ANT SERVICES AGREEMENT- 2 (Under$10,000) VII. INDEMNIFICATION. Consultant 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 Consultant'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 Consultant'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 Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'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 Consultant 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 Consultant's part, then Consultant 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 Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant 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. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. i X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The City's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. CONSULTANT SERVICES AGREEMENT- 3 (Under$10,000) XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant 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 Consultant's own risk, and Consultant 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. XIII. 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 VII 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. i 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 Consultant. I 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 CONSULTANT SERVICES AGREEMENT- 4 (Under$10,000) the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. 3. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONSULTANT: CITY OF KENT: By: "cd By; (sign urn �.e, { (signature) Print Name: ) '>IKtC22?`3 Print Name: Hope Gibson Its: Its: Mgr, Parks Planning & Devopment (tkte) DATE: DATE:/ NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Robert Simons Brian Levenhagen, Parks Department Environmental Specialties City of Kent 4227 S. Meridian, Ste C-625 220 Fourth Avenue South Puyallup, WA 98373 Kent, WA 98032 (253) 683-1144 (telephone) (253) 856-5116 (telephone) rscrosi@hotmail.com bjlevenhagen@kentwa.gov 1 P;\PlanningVcquis[tlons\PanHiertoke\PSLMst-Hose&O'Connor 1t1zV ton$-00W Cr.dacx f ill CONSULTANT SERVICES AGREEMENT- S (Under.$10,000) i 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. i 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. For: VLSI Title: �� / f I Date: 9 h, 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. i 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 ' i EEO COMPLIANCE DOCUMENTS _ 2 I 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 &ai Company, hereby acknowledge and declare/ that the before--me tioned company was the prime contractor f r the greement known as�% Pfa !lPa 1t was entered into on the C (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: 'L��lh 9 _ r- For: Title: c s d Date: i I, I EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT Environmental Specialties 4227 S Meridian,STE C,4625 a Puyallup,WA 99373 •(253)683-1144 September 9,2014 Brian Levcailiagen Kent Parks City of Kent 220 4"'Ave S Kent,WA 98032 Subject: Asbestos&Lcad Paint Inspection House&Outbuildings 13427 SE 216'St 13525 SE 216"'St 20934 132'Ave SR Kent,WA 98042 Door Mr. Lcvonliagen: Thank you for requesting a proposal from Environmental-Specialties.--We can provide you.with an asbestos inspection and also collect paint samples for analysis at the above listed addresses.Asa pre-demolition inspection we will need to do destructive sampling that usually includes opening small holes in several locations to verify die typo of building materials used. These structures do likely have some lead based paint. Lead paint samples that characterize the quantity of lead in the paint are highly recommended. if the lead content of a waste stream is to high the materials will not likely be recyclable. The inspector will not know,how many samples are needed until the inspection is underway. This site has outbuildings and due to the sampling protocol each building is treated differently. The number of samples proposed is based on previous inspections of similar structures. You will only be charged for the Samples collected. Should additional samples or additional set vices be needed the inspector will contact yen as seen as is possible. Below is an estimate of costs for your inspection project. Inspection&report,3 reports for Asbestos &Lead Paint $1820 90 bulk asbestos samples�$18 each 1620 9 lead Paint 180 Total $ 3620 Om hourly rate for inspection is$95. If additional services are needed we can operate on the hourly rate, the proposed unit costs and cost plus 15%for non-listed samples. it usually takes a week to ten days to turn around aroport. Lot me know when you want to start. Sincerely Robert F,Simons Project Manager EXHIBIT INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant 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 Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant 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 City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 1185 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the Consultant's profession. i B. Minimum Amounts of Insurance Consultant 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. i 2. Commercial General Liabiiity insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,OOOgeneral i i i i EXHIBIT B (Continued) aggregate and a $1,000,000 products-completed operations aggregate limit. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. 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 Consultant'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 Consultant's insurance and shall not contribute with it, 2. The Consultant'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 theCity, 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 Consultant 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 Consultant'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 AX Best rating of not less than A:VII. E. Verification of Coverage Consultant 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 Consultant 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 Consultant. j CMSISPE-01 JRQSE CERTIFICATE OF LIABILITY INSURANCE DA9125/2014 ) 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 endorsement{s). PRODUCER CONTACT NAME: HUB International Northwest LLC PHON's Ext:(425)489-4500 FAArc Na: (425)485-8489 12100 NE 195th St. E-MAIL Suite 200 ADDRESS: Bothell,WA 98011 INSURER IS)AFFORDING COVERAGE NAIC N INSURER A:Westchester Surplus LIneslnsuranceCo. INSURED INSURER B: CMSI-Environmental Specialties INSURER C: Robert Simons 2810 29th St Ct BE INSURER D: Puyallup,WA 98374 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 SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY E%P LIMITS LTR TYPE OF INSURANCE POLICY NUMBER Mrs"'YYV MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE � OCCUR X X G27163130001 03109/2014 03/09/2015 E T RE r 50,00 PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,00 _. PERSONAL&ADV INJURY.. $ 1,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY❑PRO- ❑ECT LOC PRODUCTS-COMPIOP AGO $ 2,000,00 OTHER: Professional $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident _ A ANY AUTO G27163130001 03/09/2014 03109/2015 BODILY INJURY(Per person) IT ALL OWNED SCHEDULED BODILY INJURY(Par accident) $ AUTOS AUTOS NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS X AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ PER $ WORKERS COMPENSATION STATUTE EORH AND EMPLOYERS'LIABIUTY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA EL EACH ACCIDENT $ OFFICERIMEMBER EXCLUOED9(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under On RIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ ! DESCRIPTION OF OPERATIONS I LOCATIONSI VEHICLES (ACORD 104,Additional Remarks Schedule,may be attached if more space is required) The City of Kent is additional insured per policy provisions and endorsements attached. Professional liability aggregate is$1,000,000;deductible Is$5,000. Pollution limit is$1,000,000 each claim;deductible Is$2,600. Transportation limit is$1,000,000 each occurrence;deductible is$2,600. Washington Stop Gap(employer's liability)limit Is$1,000,000. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Ave.South Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Named Insured Endorsement Number CMSI-Environmental Specialties Policy symbol Policy Number Policy Period Effective Date of Endorsement ECP G27163130 001 03/09/2014 to 03/09/2015 03/0912014 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insed the policy number. The remainderof the Information Is to be completed only when this endorsement is issued subsequent to the preparation of the policy. ',.. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT-OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE I SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations,or a contractor on whose behalf you are performing operations,and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II -WHO IS AN INSURED is amended to include: A. SECTION II - WHO IS AN INSURED is amended to include as an Insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily Injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the site of the covered operations has been completed;or I (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. III i ENV-3101 (08-04) Includes copyrighted material of Insurance Services office, Inc,with its permission Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT—PRODUCTS-COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number CMSI-Environmental Specialties Policy Symbol Policy Number Policy Period Effective Date of Endorsement ECP G27163130 001 031)9/2014 to 03/09/2015 03/09/2014 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING- COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are performing operations,or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you,wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II—Who is An Insured is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products-completed operations hazard. All other terms and conditions remain the same. i ENV-3225(10-08) Copyright 02o0A Page 1 of 1 Named Insured Endorsement Number CMSI-Environmental Specialties Policy Symbol Policy Number Policy Period Effective Date of Endorsement ECP I G27163130 001 03/09/2014 to 03/09/2015 03/09/2014 Issued By(Name or Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number- The remainder of the Information Is to be completed only when this endorsement is Issued subsequent to the preparation ofthe PAW, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT OWNERS, LESSEES OR CONTRACTORS—SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations,or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you,wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or I (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. i ENV-3100(08-04) Includes copyrighted material of Insurance Services Office, Inc.with its permission Page 1 of 1 Named Insured Endorsement Number CMSI-Environmental Specialties Policy Symbol Policy Number Policy Period Effective Date of Endorsement ECP G27163130 001 03/09/2014 to 03/09/2015 03/09/2014 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the Information Is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. '.,.. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations,or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard, This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. I ENV-3143(03.05) Includes copyrighted material of Insurance Services Office, Inc.with its permission Page 1 of i