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HomeMy WebLinkAboutPW14-237 - Original - Hayre McElroy & Associates, LLC - Riverview Park - 09/09/2014 nn Records ana erns r, �, KET!T DOCument W ASMINaTaN �� r }:.? k41 "I f 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: Hayre McElroy & Associates LLC Vendor Number: JD Edwards Number Contract Number: ---9W 14 U-10SI This is assigned by City Clerk's Office Project Name: Riverview Park Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 919114 Termination Date: 12/31/14 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment I Contract Manager: Chris Wadsworth Department: Engineering j Contract Amount: $5 150.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Provide a geotechnical engineering study for existing drainage issues at Riverview Park. i As of: 08127j14 i KE�T wns"ixcrou '. CONSULTANT SERVICES AGREEMENT between the City of Kent and Hayre McElroy & Associates, LLC THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Hayre McElroy & Associates, LLC organized under the laws of the State of Washington, located and doing business at 2757 152nd Ave. NE, Redmond, WA 98052, Phone: (425) 869-6750/Fax: (425) 869-6761, Contact: Jim McElroy (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: The Consultant shall provide a geotechnical engineering study for existing drainage issues at Riverview Park. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. 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 December 31, 2014. i III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Five Thousand, One Hundred Fifty Dollars ($5,150.00), 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 monthly payment invoices 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 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. CONSULTANT SERVICES AGREEMENT - 2 (Under$10,000) i 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. i 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. I 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. i 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. l 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. I CONSULTANT SERVICES AGREEMENT - 3 (Under$10,000) i 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. 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. 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) i 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. 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. CONSULTANT: CITY OF KENT: (signature) signature) Print Name: L = Print Name: Michael Mactutis, P.E. Its: DAUCiPkL- Its: Environmental Engineering Manager (tote) DATE: �z1.zw! { DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Jim McElroy Timothy J. LaPorte, P.E. Hayre McElroy & Associates, LLC City of Kent 2757 152`` Ave. NE 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (425) 869-6750 (telephone) (253) 856-5500 (telephone) 425 869-6761 facsimile (253) 856-6500 (facsimile) I Hayre Mc£Imy-W veMew]J Wedsvrorth CONSULTANT SERVICES AGREEMENT 5 (Under$10,000) 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. i ! By: 611 }' J For: ---p �e Title: , I Date: I i EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 I 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 i i EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT Ili 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 I 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: II I I II EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT A hayremCelroy m I 2757 152nd Avenue NE j Redmond,WA 98052 July 8,2014 p (425)869-6750 f (425)869-6761 City of Kent Environmental Engineering,Public Works Department Attn: Mr. Chris Wadsworth 220 Fourth Avenue South Kent,WA 98032 Subject: Proposal for Geotechnical Engineering Services I Evaluation of Site Infiltration Rate and Drainage Evaluation Riverview Park Dent,Washington Hayre McElroy & Associates, LLC (PIMA) is pleased to present this proposal to provide a geotechnieal engineering study for existing drainage issues at Riverview Park in Kent, Washington. Our understanding of the project was developed through recent conversations and review of a site plan. The following sections of this proposal contain a brief description of the project and our proposed scope of services, schedule,and fee estimate. PROJECT DESCRIPTION I Certain areas of Riverview Park are experiencing poor surface drainage of storm water. The site experienced construction activity in recent past, which may have modified the near surface conditions via densification of soil. The project is intended to evaluate the existing conditions, test the subsurface soil for drainage characteristics, and provide a summary of findings and recommendations for drainage improvements. PURPOSE AND SCOPE OF INVESTIGATION The purpose of our investigation will be to study the near surface and subsurface soils in areas of poor drainage and pending water, and provide practical recommendations for construction alternatives which provide the most benefit relative to construction and maintenance cost. I Field Exploration = I Due to concern for further densification and disturbance of surficial soil and grass, HMA will conduct two hand pit excavations to ovaluate subsurface soil conditions and for performance of percolation testing to evaluate soil infiltration rates. Visual evaluation of soil type, density and consistency, groundwater conditions, and other pertinent data will be logged by our geoteehnical representative.Percolation testing will be conducted in the two hand pits to a deptli of 2 feet, Copyright 2014 Hayre McElroy&Associates, LLC Page 1 of 3 i Nuclear densometer testing will be conducted at the location of each test pit near the ground surface and at varying depth to evaluate the existing soil density for comparison with laboratory proctor compaction tests to identify the existing delncc of compaction. Samples will be obtained at each test pit location, bagged, and returned to our laboratory for further evaluation,identification, and testing. Laboratory Testine i Laboratory tests will be performed on selected samples to evaluate pertinent engineering properties for classification and design purposes. Laboratory tests that we anticipate performing may include moisture,gradation, and Modified Proctor. Engineering Analysis The results of our field explorations, laboratory tests and engineering analyses will be summarized for the site in a single written report prepared by a Registered Professional.Engineer. The written report will summarize the results of our findings and analyses for the proposed project, At this time,we anticipate that our final report will include the following: • Vicinity Map showing locations of explorations; • Logs of Test Pits; • Results of Field Percolation Tests; • Results of laboratory tests; • Discussion of general site conditions; • Discussion of general subsurface conditions, as encountered in our test pits; • Recommended improvements to address drainage issues; and, • Construction cost estimate ranges for recommended improvements. Additionally,we anticipate attending two meetings or conference calls. FEE AlZRANGEMENTS We propose our work be compensated on a time and expense basis with a not to exceed budget of$5,150. A detailed summary table presenting our quantities and rates is attached. Should we anticipate costs in excess of our proposed budget, we will alert City of Dent with a revised estimate and propose prior to incurring additional fees. SCIIEDULE We are prepared to begin our work within one week upon signed authorization. We anticipate approximately 1 week to conduct our field study and laboratory testing. Our final report will be provided within I to 2 weeks following completion of our field study. III I Copyright 2014 Hayre McElroy&Associates,LLC page 2 of 3 AUTHORIZATION Our Professional Services maybe authorized by providing a City of Kent task order. If there is a need for any change in the scope of services or schedule described in the proposal, please call us immediately. Changes may require revision of the proposed budget(fee). I LIMITATIONS I Acceptance of this proposal indicates City of Kent is in agreement with the proposed study and j that our proposed study meets the objectives desired. HMA will perform its services in a manner consistent with the standards of cue and skill ordinarily exercised by members of the profession practicing under similar conditions in the geographic vicinity and at the time the services will be performed. This Agreement neither makes nor intends a warranty or guarantee, express or implied,nor does it create a fiduciary responsibility to City of Kent by HMA. CLOSURE Information gathered by HMA will be considered confidential and will be disclosed to third parties only upon City of Kent's written authorization or as required by law. We appreciate the opportunity to submit this proposal and look forward to working with you on this project. If you have questions or comments regarding this proposal, please feel free to contact the undersigned at(425)869-6750. Respectfully submitted, i HAYRE MCELROY&ASSOCIATES,LLC Jaynes A.McElroy,P.S. Gee S. Hayre,C.B.O. Principal Principal I I I I i i Copyright 2014 1layre McElroy&Associates, LLC Page 3 of 3 hayf'emcelroy —{t,.� 2757152nd Ave NE a,nnny.�:>. un Y Redmond,WA 98052 (425)969-6750 Estimated Fee For Geotechnical Services Evaluation of Site Infiltration Rate and Drainage Evaluaton I j Riverview Park City of Kent Public Works Department Kent,Washington 30-Jun-14 cry noun art cosuueit Total Task 1:Review Existing Site Data and Construction Documentation Principal Engineer 2 hour $14000 $280 Subtotal; $280 Task 2:Site Visit to Observe Existing Conditions and Site Meeting Principal Engineer 3 hour $14000 $420 Task 3•Field infiltration and Existing Conditions Study Subtotal: $420 Staff Engineer-Nuclear Donsometer Testing and Material Sampling 3 hour $85.00 $255 Staff Engineer-Hand Pit Infiltration Testing 5 hour $85.00 $425 Proctor Maximum Dry Density Testing(ASTM D1357) 2 each $235.00 $470 Grain Size Analyses(ASTM D422) 2 each $110.00 $220 Principal Engineer 3 hpur $14000 $420 Subtotal: $1,790 Task 4:Prepare Letter Report Summarizing Observed Conditions Recommendations and Preliminary Cost Estimates Staff Engineer 4 hour $85.00 $340 Principal Engineer 10 hour $140.00 $1,400 Drafting/word Processing 2 hour $70 00 $140 Task 5:MeotingslCnnference Calls Subtotal: $1,540 Princi al Engineer-2 Meetings 5 hour $140.00 $700 Subtotal: $700 Task 6:Protect Management&Expenses Principal Engineer 2 hour $140.00 $280 Administration 2 flour $7000 $140 Mileage 180 each $0 55 $99 Subtotal: $420 Total Estimated Fee: $5,160 *Services beyond those presented will be charged at the rates shown and documented with a change order request within 5 business days of conducting the additional services, -Access to water required for infiltration testing I i i i III I Copyright 2014 Hayre McElroy Associates,LLC EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS I Insurance i 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 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. 4. Professional Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: I 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 $1,000,000 products-completed operations aggregate limit. I i EXHIBIT B (Continued) I 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 i 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 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 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 A.M. Best rating of not less than AWII. 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. I 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. ! I i OP ID: IDS CERTIFICATE OF LIABILITY INSURANCE081010 DATE 11l1414 ! 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 j 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 poUcy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 206-623-7035 CONTACT Sprague Israel Giles PHONE FAX ' 1501 Fourth Avenue,Suite 730 Fax:206-682.4993 ac No Ext: I uc No: Seattle,WA 98101-3225 E-MAIL j John M.Railcar ADDRESS: PRODUCER HAYRE-1 CUSTOMER ID, I INSURER($)AFFORDING COVERAGE NAICA INSURED Hayre McElroy&Associates LLC INSURER A:Ohio Security Ins.Co. 24082 2757152nd Ave. NE Redmond,WA 98052 INSURER e:American Fire&Casualty Co 24066 WSURERC:U.S.Specialty Insurance CO. INSURER D: INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMCFS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSft UDL UBR LICY POLICY EXP EFF I LTR TYPE OF INSURANCE POLICY NUMBER M PMOIDOIYYW MMIDDP/YYV LIMITS GENERAL-LIABILITY EACH OCCURRENCE $ 2,000,00 ""-"-- A X COMMERCIAL GENERAL LIABILITY X BZS56170651 06/27/14 06/27/15 DAMAGE PO RENTED PREMISES(Ea occurrence) S 2,000,00 _._ CLAIMS MADE I X.I OCCUR MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ Include _ GENERAL AGGREGATE $ 4,000,00 GEN'LAGGREGATE LIMITAPPLES PER: PRODUCTS-COMPtOP AGG S 4,000,00 POLICY X I PRI- JECT I LOG S AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,00 B X ANY AUTO BAA66170651 06127/14 06/27/15 (Ea anddent) X ALL OWNED AUTOS BODILY I NJURY(Per person) $ BODILY I NJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X IUSED AUTOS (Pernodden) $ NON-ONMED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ _ DEDUCTIBLE RETENI ION $ $ WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS'LIA8ILITY YIN TORY I IMITS ER A ANY PROPRIETORIPARTNERIFXECUTIVE BZS56170651 06127114 06/27115 E 1 EACH ACCIDENT S 2,000,00 ! OFRCERIMFMBF.R EXCLUDED➢ ❑ NIA (Mandatory in NH) WA STOP GAP E L DISEASE-FA EMPLOYEE $ 2,000,00 If yes,d0scdbe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT S 2,000,000 C !Professional USS1425020 06127/14 06127/15 'Ea.Claim 2,000,000 Liability $35,000 DED EACH CLAIM Aggregate 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,AddiNonxl Remarks Schedule,If more egace Is required) RE: Geotech engineering study for existing drainage issues at Riverview Park City of Kent is included as Additional Insured with regards to general liability and auto liability as required by written contract or agreement. General liability is primary and non contributory. 30 days notice of cancellation j I 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 ---- Kent,WA 98032 AUTHORIZED REPRESENTATIVE John M. Policar ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Coverage is Provided In: Policy Number: Lib Mutualerty Ohio Security Insurance Company BZS (15) 5617 06 51 . Policy Period: INSURANCE From 06/27/2014 To 06/27/2015 Policy Change Endorsement Endorsement Period: From 06/27/2014 to 0 612 7/2 0 1 5 12:01 am Standard Time at Insured Mailing Location Named Insured Agent HAYRE MCELROY &ASSOCIATES (206) 623-7035 SPRAGUE, ISRAEL, GILES, INC. #1 SUMMARY OF LOCATION(S) AND PREMIUM(S) 0001 2755-57 152nd Ave NE 57, Redmond, WA 98052-5555 $1,087.00 POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE BP 00 03 07 13 Businessowners Coverage Form BP 01 06 07 13 Washington Changes BP 04 73 Ol 06 Washington Changes -Domestic Abuse *BP 04 97 Ol 06 Waiver Of Transfer Of Rights Of Recovery Against Others To Us BE 05 18 Ol 08 Washington - Amendment of Terrorism Exclusions BP 05 23 Ol 08 Cap On Losses From Certified Acts Of Terrorism BP 05 65 01 07 Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical. Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) BP 06 69 Ol 06 Washington Fungi Or Bacteria Exclusion (Liability) BE 06 74 07 13 Washington Stop Gap - Employer's Liability Coverage *BP '14 88 07 13 Primary And.Noncontributory - Other Insurance Condition BP 79 74 07 13 Amendment of Pollution Exclusion (Premises) BP 79 82 Ol 07 Employee Benefits Liability Coverage Endorsement BP 79 96 07 13 Businessowners Liability Extension Endorsement BP 80 32 01 07 Consulting Errors and Omissions Exclusion BP 8044 01 07 Inspection and Appraisal Services Exclusion BP 81 15 03 11 Exclusion - Asbestos BP 82 37 Ol 07 Equipment Breakdown Enhancement Endorsement BP 8246 06 09 Employment -Related Practices Liability Coverage I3P 82 89 01 07 Washington Exclusion - Asbestos BP 88 04 03 12 Exclusion - Professional Services BP 88 16 06 09 Business Income Changes - 24 Hour Time Period BP 88 27 02 11 Limited Cyber Liability -Amendment of Personal and Advertising Injury BP 88 77 07 13 Identity Theft Administrative Services and Expense Coverage BP 88 84 07 13 Washington -Businessowners Property Extension Endorsement Servicing Office Western Washington and Issue Date Authorized Representative To report a claim, call your Agent or 1-800-362.0000 i DS 70 27 01 08 56170651 N0112864 235 INSURED COPY 002819 PAGE 2 OF 8 i BUSINESSOWNERS BP 79 96 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM I SUBJECT PAGE j AGGREGATE LIMITS OF INSURANCE 3 AMENDMENT OF INSURED CONTRACT DEFINITION 4 BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 2 BODILY INJURY 4 BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU 2 DUTIES IN THE EVENT OF OCCURRENCE,OFFENSE,CLAIM OR SUIT 4 INCIDENTAL MEDICAL MALPRACTICE 2 MOBILE EQUIPMENT 2 NEWLY FORMED OR ACQUIRED ORGANIZATIONS 3 PERSONAL AND ADVERTISING INJURY 4 SUPPLEMENTARY PAYMENTS 2 Bail Bonds Loss Of Earnings a it O 2013 Liberty Mutual Insurance.All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 4 Section 11 - Liability is amended as follows: I. SUPPLEMENTARY PAYMENTS Paragraph f.(1)(b) of A Coverages is replaced by the following; i (b) Up to $3000 for cost of bail bond required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish the bonds. Paragraph 11(1)(d) of A Coverages is replaced by the following; (d) All reasonable expenses incurred by the insured at our request to assist us in the Investigation or — defense of the claim or "suit", including actual lass of earnings up to $500 a day because of time off ®_ from work. It. BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU With respect to the coverage provided under this endorsement, Section II -Liability is amended as follows: ® j ® 1. The final paragraph of B.I. Exclusions - Applicable To Business Liability Coverage is deleted and replaced by the following: With respect to the premises which are rented to you or temporarily occupied by you with the permis- sion of the owner, Exclusions c., d., a., g., h., It., I., m., n. and o. do not apply to "property damage". 2. Paragraph D.2. Liability And Medical Expenses Limits Of Insurance is deleted and replaced by the ®_ following: a ®_ The most we will pay under this endorsement for the sum of all damages because of all "property damage" to premises while rented to you or temporarily occupied by you with the permission of the owner is the Limit of Insurance shown in the Declaration. 3. Paragraph D.3. Liability And Medical Expenses Limits Of Insurance is deleted. III. INCIDENTAL MEDICAL MALPRACTICE Exclusion 1.j.(4) does not apply to Incidental Medical Malpractice Injury coverage. The following is added to F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS: 23. "Incidental Medical Malpractice Injury" means bodily injury arising out of the rendering of or failure to render, during the policy period, the following services: a. medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or bev- erages in connection therewith; or b. the furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. This coverage does not apply to: 1. expenses incurred by the insured for first- aid to others at the time of an accident and the Duties in the Event of Occurrence, Claim or Suit Condition is amended accordingly; 2. any insured engaged in the business or occupation of providing any of the services described under a. and b. above; 3. injury caused by any indemnitee if such indemnitee is engaged in the business or occupation of providing any of the services described under a. and b. above. IV. MOBILE EQUIPMENT 1. Section C. Who is An Insured is amended to include any person driving "mobile equipment' with your permission. V. BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 1. Section C. Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must be: a, currently in effect or becoming effective during the term of this policy; and b. executed prior to the "bodily injury", "property damage", "personal and advertising injury". O 20131-iberty Mutual Insurance.All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 4 i 2. The insurance provided the additional insured is limited as follows: a. The person or organization is only an additional insured with respect to liability arising out of (1) Real property, as described in a written contract or written agreement, you own, rent, lease, maintain or occupy; I (2) Caused in whole or in part by your ongoing operations performed for that insured. b. The limits of insurance applicable to the additional insured are those specified in the written contract or written agreement or the limits available under this policy, as stated in the Declara- tions, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. c. The insurance provided the additional insured does not apply to: (1) Liability arising out of the sole negligence of the additional insured; (2) "Bodily injury", "property damage", "personal and advertising injury"; or defense coverage under the Supplementary Payments section of the policy arising out of an architect's, en- gineer's or surveyor's rendering of or failure to render any professional services including: (a) The preparing, approving maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (3) Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Declarations; or (4) Structural alterations, new construction or demolition operations performed by or for the person or organization designated in the Declarations. 3. Any coverage provided hereunder shall be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary or you request that it apply on a primary basis. VI. NEWLY FORMED OR ACQUIRED ORGANIZATIONS The following is added to C.Who Is An Insured: 3. Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However, a. Coverage under this provision is afforded only until the 180th day after the entity was acquired or incorporated or organized by you or the end of the policy period, whichever is earlier; b. Coverages A. Paragraph 1. Business Liability, does not apply to: (1) "Bodily injury" or "property damage" that occurred before the entity was acquired or incor- porated or organized by you; and (2) "Personal and advertising injury" arising out of an offense committed before the entity was acquired or incorporated or organized by you; and c. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. VIL AGGREGATE LIMITS The following is added to Aggregate Limits Paragraph 4. of D. Liability and Medical Expenses Limits of Insurance: The Aggregate Limits apply separately to each of "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. The Aggregate Limits also apply separately to each of your projects away from premises owned by or rented to you. For the purpose of this endorsement only, "location" means premises involving the same or connect- ing lots, or premises whose connection is interrupted only by a street, roadway, waterway or right- of-way of a railroad. © 20131-iberty Mutual Insurance.All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 4 Vill. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE,CLAIM OR SUIT 1. The requirement in E. Liability And Medical Expenses General Conditions paragraph 2.a. that you must see to it that we are notified of an "occurrence" or offense which may result in a claim applies only when the "occurrence" is known to any insured listed in Paragraph C.I. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. 2. The requirements in E. Liability And Medical Expenses General Conditions paragraph 2.b. that you must see to it that we receive notice of a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to any insured listed under Paragraph CA. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. IX. BODILY INJURY ® Paragraph 3. of F. Liability And Medical Expenses Definitions is replaced by the following: 3. "Bodily Injury" means: a. Bodily injury, sickness, disease, or incidental medical malpractice injury sustained by a person, ® and includes mental anguish resulting from any of these; and including death resulting from any of these at any time. X. AMENDMENT OF INSURED CONTRACT DEFINITION Paragraph 9. of F. Liability And Medical Expenses Definitions is replaced by the following: 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition oper- ations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indem- nification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be considered an "insured contract" to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construc- tion or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. XI. PERSONAL AND ADVERTISING INJURY Paragraph 14. b. of F. Liability And Medical Expenses Definitions is replaced by the following: b. Malicious prosecution or abuse of process. © 20131-iberty Mutual Insurance.All rights reserved. BP 79 96 07 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 4 BUSINESSOWNERS BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph H. Other In- 2. You have agreed in writing in a contract surance of Section III - Common Policy Condi- or agreement that this insurance would tions and supersedes any provision to the con- be primary and would not seek contribu- trary: tion from any other insurance available Primary And Noncontributory Insurance to the additional insured. This insurance is primary to and will not seek contribution from any other insurance avail- able to an additional insured under your poli- cy provided that: 1. The additional insured is a Named In- sured under such other insurance; and i I I I it BP 14 88 07 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BAS (15) 55 96 09 33 Mutual. Policy Period: INSURANCE From 03/01/2014 To 03/0112015 Common Policy Declarations 12:01 am Standard Time at Insured Mailing Location Named Insured Agent I-IAY;RE MCELROY AND ASSOCIATES, LLC (206) 623-7035 SPRAGUE, ISRAEL, GILES, INC. #1 i POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CA 00 Ol 03 06 Business Auto Coverage Form CA 01 35 01 08 Washington Changes CA 21 34 01 08 Washington Underinsured Motorists Coverage CA 23 93 01 06 Washington Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism. CA 85 47 12 93 Temporary Substitute Auto - Physical Damage Insurance CA 85 53 12 93 Recreational Trailers and Boat Trailers CA 88 1001 10 Business Auto Coverage Enhancement Endorsement CA 99 03 03 06 Auto Medical Payments Coverage IL Ol 46 08 10 Washington Common Policy Conditions IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) e In witness whereof, we have caused this policy to be signed by our authorized officers. DvA e. �jj *T— Dexter Legg Paul Condrin Secretary President To report a claim, call your Agent or 1-800-362-0000 DS 70 21 01 08 02/17/14 55960933 N0112864 235 NCXFPPNO INSURED COPY 000496 PAGE 10 OF 54 COMMERCIAL AUTO CA 88 10 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM i _ With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGEINDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 o ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 21 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 22 EXTRA EXPENSE- BROADENED COVERAGE 10 GLASS REPAIR-WAIVER OF DEDUCTIBLE 15 a HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN (LEASE GAP 14 PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 19 SECTION II - LIABILITY COVERAGE is amended as follows: s 1. BROAD FORM INSURED s SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; 1�12010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or 'property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto'; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto' you own or hire. SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph AA. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE,is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto' you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or p2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $750 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V-DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. „ 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE,paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For"medium trucks" ,we will pay up to $150 per disablement. "Medium trucks" are trucks that have agross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. s 8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 " Q2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III -PHYSICAL DAMAGE COVERAGE,A. COVERAGE,is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident' or 'loss", to an "auto" for which we also pay a 'loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident' or 'loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If 'loss" results from the total theft of a covered "auto' of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRAEXPENSE-BROADENED COVERAGE Under SECTION III -PHYSICAL DAMAGE COVERAGE,A. COVERAGE,we will pay for the expense of returning a stolen covered "auto' to you. The maximum amount we will pay is $1,000, 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto' you own and that "auto' is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V-DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. $ 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for " 'loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual Insurance Company.All rights reserved, CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a$100 deductible. 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the S date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a"Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, In. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto', 1. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual a cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V-DEFINITIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value, A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 5 of 7 15. GLASS REPAIR^WAIVER OFDEDUCTIBLE Paragraph D. Deductible of SECTION ||| ' PHYG|CAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass io repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE(WAIVER OFDEDUCTIBLE) Paragraph D. Deductible of SECTION U| ' PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible duon not apply to "loss" caused by collision to such covered "auto" of the private passenger type ur light weight truck with a gross vehicle weight of10.000 |hs. or less au defined by the manufacturer as maximum loaded weight the "auto" io designed to carry while itis: a. In the charge ofoo "!nounod"; Id. Legally parked; and o. Unoccupied. The "loss" must ho reported io the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision dnon not apply to any "loss" if the covered "auto" ishthe charge of any person or organization engaged in the automobile business. SECTION K/ ^BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAUURETD DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: |f you unintentionally fall \o disclose any hazards, exposures ur material facts existing anof the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not baprejudiced. However, you must report the undisclosed hazard of exposure an soon an practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 18, AMENDED DUTIES |0 THE EVENT 0F ACCIDENT, CLAIM, SUIT, ORLOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a |n the event of "oncidrnt,, claim, "suit" or "loss", you must promptly notify uo when Kin known to: 1. You, if you are unindividual; 2. A partner, if you are mpartnership; 1 Member, if you are e limited liability company; � * 4. xo executive officer o, the 'emy/nyoo" designated hy the Named Insured tn give such notice, if you are acorporation. To the extent possible, notice touo should include: m (1) How, when and where the ''acrident" or '|oss` took place; (2) The '|nnurodo" name and address; and (S) The names and addresses of any injured persons and witnesses. 19. WAIVER 0F TRANSFER RF RIGHTS OF RECOVERY AGAINST OTHERS TOUG SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others tn Us, |n amended by the addition nf the following: If the person nr organization has waived those rights before un "moddon(" or "|oos''. our rights are waived also, m2010 Liberty Mutual Insurance Company.All rights reserved. CA88100110 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 6nf7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV- BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For"autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- =_ lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. x s i I it @2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 7 of 7