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HomeMy WebLinkAboutPK15-158 - Original - Fountain Works, LLC - Town Square Plaza Fountain Replacement Parts - 04/28/2015 e= { . a �z; ;a KENT Document WASHINGTON y 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: Fountain Works LLC Vendor Number: JD Edwards Number Contract Number: K,is s ` This is assigned by City Clerk's Office Project Name: Town Square Plaza Foutain Replacement Parts Purchase Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 4/15/15 Termination Date: Contract Renewal Notice (Days): 0 Number of days required notice for termination or renewal or amendment Contract Manager: Brian Levenhagen Department: Parks Planning & Dev. Contract Amount: $47,719.70 Approval Authority: ❑ Department Director ❑Mayor ®City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Lights & Nozzles for embedded can fountains at TSP. Division Contract #PPD15-09 adccW10877 8 14 I 0 KENT GOODS & SERVICES AGREEMENT between the City of Kent and Fountain Works LLC THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Fountain Works organized under the laws of the State of Texas, located and doing business at 7126 Oaklawn Drive, San Antonio, TX 78229 (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City: As Described in Exhibit A, attached: Provide and ship new lights, sprayheads, and fittings for the ground-embedded fountains at Town Square Plaza in Kent, Washington. No labor is included in this agreement. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services within 90 days of the latest signature date on page seven of this agreement. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Forty- seven Thousand, Seven Hundred Nineteen dollars and Seventy cents ($47,719.70), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: GOODS & SERVICES AGREEMENT - 1 (Over$10,000.00, including WSST) Vendor will send a single invoice If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Vendor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Vendor maintains and pays for its own place of business from which Vendor's services under this Agreement will be performed. I C. The Vendor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. GOODS & SERVICES AGREEMENT - 2 (Over$10,000,00, including WSST) E. The Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY GOODS & SERVICES AGREEMENT - 3 (Over$10,000,00, including WSST) I CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Vendor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED, THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect. In i GOODS & SERVICES AGREEMENT - 4 (Over$10,000.00, including WSST) the event any part of the goods are repaired, only original replacement parts shall be used— rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that GOODS & SERVICES AGREEMENT - 5 (Over$10,000.00, including WSST) shall be done at Vendor's own risk and Vendor shall be responsible for an purpose. All work p Y loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XI of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to'this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. GOODS & SERVICES AGREEMENT - 6 (Over$10,000.00, including WSST) H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations, I. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code, J. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below, VENDOR: CITY OF KENT: By; fly/ By:_ d _ �` AA��/f(sl;�nature) (signCoo Print Name: 1&C z Prim 1Vary#el'` S zette Cooke Its Its ayor ((t__t�ie) ` DATE: © 5 �'o1 DATE:, � � NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Michael Perry Brian Levenhagen Fountain Works City of Kent 7126 Oaklawn Drive 220 Fourth Avenue South San Antonio, TX 78229 Kent, WA 98032 (210) 858-8903 (telephone) (253) 856-5116 (telephone) michael@fountain-works.com bjlevenhagen@kentwa,gov APPROVED AS TO FORM: Kent Law Department 0:\Plannin9\Town S,u.,c Nn.\2015 T~$q.19 F...WM Repay-COMMC.d.,X ill l GOODS &SERVICES AGREEMENT- 7 (Over$10,000,00, including NSST) 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, 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. By: �2 A ti For: Title: Date: � y// J�/��/fir ' I EEO COMPLIANCE DOCUMENTS - I of 3 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer, 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers . subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 of 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: Fo r: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 I EXHIBIT A o � o u m � p 0 0 0 0 0 0 O O Ci G 0, 0, Oi ci oli ® !b F U U Y O n.� O 0 0 0 0 m Op G p < U 0 0 0 0 m 0 o O N O O ° p p o m n rn � � � v > .a a '0 ° L r O ° N Q U P, C3 b[1 fi N r! GC III NNNNN p i� ^° � v o N N ICJ 0 d' 7 d' V N 'cd ,n •� 'b Z O R O 0 O E cJ bn +1 c o o '¢ Gl c N o o CO v co qi 0 L o N G ¢ m Ira m N Z n ��, C'+ U R a X O N .Y — c ui0. O .y f6 O O E ,6 ti Z N H' 'U m UIcn -0 1 j0 Q Li dl 0000 3 IS4 m y d " ; N ` z ° Z ° Y G = ZmZ d ` r N `LI OF ;W s a o C7 7 >• G j O N NN > O O O �Z�,00 '� N td 1+ d 'G C O O C CC O F-t LL d d7 Z 2 .7 m a N O V i W N U a�-f- I, EXHIBIT A(Continued) Quote #38 From Fountain Works LLC, If 210-858-8903 sales@fountain-works.com FOUNTAIN www.fountain-works.com 7126 Oaklawn Drive San Antonio,Texas 78229 Bill To 220 4th Ave.South Kent,WA 98032-5895 City Of Kent Sent On 12/24/2014 220 4th Ave.South Kent,WA 98032-5695 Job Materials New Stainless Steel lids to retrofit for new lights and 40 $390.00. $15,600.00* nozzles . .. Job Materials New Ring Lights to fit Into can and attach to nozzle 40 $310,00 $12,400A0* ' Job Materials Replacement fountain nozzle 40 $170.00 $6,800.00* Job Materials Nozzle Adapter to attach nozzle to valve in can 40 $192A0 $7,680.00* Underwater Pump Splice Underwater Plastic Splice for submersible lights 40 $i9,99 $799.60 Travel Time to Job Site for 2 people both directions 4 $800.00 - $8'R H0* ,lie eta GaH6enwak4nsl Control panel and Electrical Programming and installation 160 $95.00 ®mig* of the equipment 3 -'27 j. 6D t i Total — 6Y639:Fi Non-taxable Installation of the parts can be Installed by the city. Technical support can be provided and changing the programming can be done with additional charges. 8 weeks to make all the parts and mock ups provided at an additional charge. This is our low end throw away light with a 1 year warranty, This quote is valid forihe next 30 days,after which values may be subject to change. This quote may or may not include sales tax. Signature: Date: I EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance I Contractor shall obtain insurance of the types described below: 1. 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 Contractor'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. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after I EXHIBIT B (Continued) thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. i AC®® CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDIYYYY) 4/8/2015 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 Wortham Insurance& Risk Management CONTACT _ P.O. Box 795008 PHONE o E t);_ A C Not: San Antonio, TX 78279 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICN www.worthamsa.com INSURER A: Cincinnati Insurance Company 10677 INSURED INSURER B: Texas Mutual Insurance Company 22945 Fountain-Works LLC 7126 Oaklawn Drive INSURER C: San Antonio TX 78229-3021 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 24189953 REVISION NUMBER: ii 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 WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - TYPE OF INSURANCE POLICY NUMBER MM/DDMW MMIDD/YY1/Y INSR ADDL SUBR POLICYEFF POLICYEXP LIMITS LTR COMMERCIALGENERAL LIABILITY EPP0266712 7114/2014 7l1412015 EACH OCCURRENCE $ 1,000,000 DAMAGE T NTED _ CLAIMS-MADE 7/1 OCCUR PREMISES En occurrence 5 1,000,000 MED EXP(Any one person) S 16,600 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,006JECT I,I POLICY ✓❑Pro- LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: S A AUTOMOBILE LIABILITY EBA0266712 7114/2014 7/14/2015 EOMaBIN DSINGLE LIMIT $ 1 000000 ANY AUTO BODI LY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NONOS OWNED PROPERTY DAMAGE S HIREDAUTOS H AUTOS ePeracciden9-_ A UMBRELLA LIAB ,/ OCCUR EPP0266712 7/14/2014 7114/2015 EACH OCCURRENCE $ 1,000.00 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$0 $ B WORKERS COMPENSATION TSF0001259969 ,• 10/25/2014 10/25/2015 ,/ SPER TATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN NIA E.L.EACH ACCIDENT $ 1,000,000 RIM OFFICEEMBER EXCLUDED? -- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES IACORD 101,Addlllonal Remarks Schedule,maybe affached if more space Is required) RE: Fountain Maintenanceli I j CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE G'ty of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Ave. South ACCORDANCE WITH THE POLICY PROVISIONS. Kent WA 98032 AUTHORIZED REPRESENTATIVE (SA)Katherine Loftin 5 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT No.: 291E9953 CLlrrnl CODE: 22fo .It of CA) Sandra Russell 1/e/2015 2:50:59 PM (CDT) Pave 1 0`- 21 rl XM M © WORKERS' COMPENSATION AND EMPLOYERS �} .. LIABILITY INSURANCE POLICY Insurancel(Comppaanyy, WC 42 06 01 TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancellation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule.The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Number of days advance notice: 30 2. Notice will be mailed to: ALL CERTIFICATE HOLDERS This endorsement changes the policy to which it is attached effective on the Inception date of the policy unless a different date Is Indicated below. i (The following"attaching clause'need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement,effective on 4/8/2015 at 12:01 A.M.standard time,forms a part ofI Policy NO.TSF0001259969 of the Texas Mutual Insurance Company Issued to Fountain-Works LLC Endorsement No. 1 Premium$ 0.00 A(/- l am Authorized Representative WC420601(ED.1-94) WASENDRS 1-06-2012 CERT NO.: 24189951 CL= CODE: 22fo ntwor (.) senora Rowell 4/8/2o15 2:58:59 erc (CDT) Page 2 of 21 EPP0266712 Fountain-Works LLC 4/8/2015 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. C111GIPIUS BUSINESS AUTO EXPANDED COVERAGE (XCO) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply un- less modified by this endorsement. A. Who is an Insured-Amended personal affairs, provided you do not SECTION II - LIABILITY COVERAGE, A. own, hire or borrow that"auto". Coverage, 1. Who is an Insured is amended B. Liability Coverage Extensions - Supple. by adding the following: mentary Payments -Higher Limits The following are "insureds": SECTION II - LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Sup- 1. Any subsidiary which is a legally incorpo- plementary Payments is amended by: rated entity of which you own a financial interest of more than 50% of the voting 1. Replacing the $2,000 Limit of Insurance stock on the effective date of this cover- for bail bonds with$4,000 in (2); and age form. 2. Replacing the $250 Limit of Insurance for However, the insurance afforded by this reasonable expenses with $500 in (4). provision does not apply to any subsidi- ary that is an "insured" under any other automobile liability policy, or would be an SECTION II - LIABILITY COVERAGE, B. Ex- "insured" under such policy but for termi- clusions, 5.Fellow Employee is amended by nation of such policy or the exhaustion of adding the following: such policy's limits of insurance. 2. An organization that is newt acquired or But this exclusion does not apply if the Y 9 Y 9 bodily injury" results from the use of a formed by you and over which you covered "auto" you own or hire. Cover- maintain majority ownership, age is excess over any other collectible The insurance provided by this provision: insurance. a. Is effective on the date of acquisition D. Hired Auto-Physical Damage or formation, and is afforded for 180 If hired "autos" are covered "autos" for Liabil- days after such date; ity Coverage, then Comprehensive and Colli- b. Does not apply to "bodily injury" or sion Physical Damage Coverages as pro- "property damage" resulting from an vided under SECTION III - PHYSICAL DAM- "accident" that occurred before you AGE COVERAGE of this Coverage Part are acquired or formed the organization; extended to "autos" you hire of the private passenger type or light truck (10.000 pounds c. Does not apply to any newly ac- or less gross vehicle weight) type, subject to quired or formed organization that is the following: a joint venture or partnership; and 1. The most we will pay for "loss" to any d. Does not apply to an insured under hired "auto" is $35,000 or the actual cash any other automobile liability policy, value or cost to repair or replace, which- or would be an insured under such a ever is the least, minus a deductible. policy but for the termination of such policy or the exhaustion of such pol- 2. The deductible will be equal to the largest icy's limits of insurance. deductible applicable to any owned "auto" of the private passenger type or 3. Any of your "employees" while using a light truck type for that coverage, or covered "auto" in your business or your $1,000,whichever is less, Includes copyrighted material of ISO AA 265 03 06 Properties, Inc.,with its permission. Page 1 of 3 CERT NO.: 24IB9353 CLIEM' COUE: 22[ou"cwos (SA) Sandra Russell 4/8/2015 2:58:57 W (CET) Page 3 as 21 3. Hired Auto - Physical Damage coverage 5. We will pay under this coverage only that is excess over any other collectible insur- amount of your rental reimbursement ex- ance. penses which is not already provided for under SECTION III - PHYSICAL DAM- 4. Subject to the above limit,deductible, and AGE COVERAGE, A. Coverage, 4. Cov- excess provisions we will provide cover- erage Extensions. age equal to the broadest coverage ap- plicable to any covered "auto' you own of F. Transportation Expense- Higher Limits the private passenger type or light truck type insured under this policy. SECTION III - PHYSICAL DAMAGE COVER- AGE, A. Coverage, 4. Coverage Extensions Coverage includes loss of use of that hired is amended by replacing $15 per day with $50 auto, provided it results from an "accident' for per day, and $450 maximum with $1,500 which you are legally liable and as a result of maximum in Extension a. Transportation which a monetary loss is sustained by the Expenses. leasing or rental concern. The most we will pay for any one "accident' is$1,000. G. Airbag Coverage If a limit for Hired Auto - Physical Damage is SECTION III - PHYSICAL DAMAGE COVER. shown in the Schedule, then that limit re- AGE, B. Exclusions, 3.a, is amended by places, and is not added to, the $35,000 limit adding the following: indicated above. However, the mechanical and electrical E. Rental Reimbursement breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. SECTION III - PHYSICAL DAMAGE is This coverage for airbags is excess over any amended by adding the following: other collectible insurance or warranty. 1. We will pay for rental reimbursement ex- H. Loan or Lease Gap Coverage penses incurred by you for the rental of a 1. SECTION III - PHYSICAL DAMAGE private passenger type "auto' because of a 'loss" to a covered private passenger COVERAGE, C. Limit of Insurance is type "auto'. Payment applies in addition deleted in its entirety and replaced by the to the otherwise applicable amount of following, but only for private passenger each coverage you have on a covered type "autos' with an original loan or private passenger type "auto'. No de- lease, and only in the event of a "total ductible applies to this coverage, loss" to such a private passenger type auto': 2. We will pay only for those expenses in- curred during the policy period beginning a, The most we will pay for"loss" in any 24 hours after the 'loss" and ending, re- one "accident'is the greater of: gardless of the policy's expiration, with (1) The amount due under the the lesser of the following number of terms of the lease or loan to days: which your covered private pas- a. The number of days reasonably re- senger type "auto' is subject, quired to repair the covered private but will not include: passenger type "auto'. If 'loss" is (a) Overdue lease or loan caused by theft, this number of days payments; is added to the number of days it takes to locate the covered private (b) Financial penalties imposed passenger type "auto' and return it under the lease due to high to you; or mileage, excessive use or abnormal wear and tear; b. 30 days. Our 3. payment is limited to the lesser of the (c) Security deposits not re- P Y funded by the lessor; following amounts: a. Necessaryand actual expenses in- (d) Costs for extended warran- P ties, Credit Life Insurance, curred; or Health, Accident or Disabil- p b. $40er day. ity Insurance purchased with the loan or lease; and 4. This coverage does not apply while there are spare or reserve private passenger (e) Carry-over balances from type "autos" available to you for your op- previous loans or leases, or erations. Includes copyrighted material of ISO AA 265 03 06 Properties, Inc.,with its permission. Page 2 of 3 cERx NO.: 211e9953 CLIENT CODE: zztoun:wor (SA) Sandra Russell 4/e/2015 2ae:h9 eM (CDT) cage 4 of 21 (2) Actual cash value of the stolen 1. You, if you are an individual; or damaged property. 2. A partner, if you are a partnership; b. An adjustment for depreciation and physical condition will be made in 3. An executive officer or insurance man- determining actual cash value at the ager, if you are a corporation; or time of"loss". 4. A member or manager, if you are a lim- 2. SECTION V - DEFINITIONS is amended ited liability company. by adding the following, but only for the K. Unintentional Failure to Disclose Hazards purposes of this Loan or Lease Gap Coverage: SECTION IV - BUSINESS AUTO CONDI- "Total loss" means a "loss" in which the TIONS, B. General Conditions is amended by adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value. If you unintentionally fail to disclose any haz- ards existing on the effective date of this Cov- p erage Form, we will not deny coverage under SECTION III - PHYSICAL DAMAGE COVER- this Coverage Form because of such failure. AGE, D. Deductible is amended by adding L. Mental Anguish Resulting from Bodily In- the following: jury No deductible applies to glass damage if the SECTION V - DEFINITIONS, C. "Bodily in- glass is repaired in a manner acceptable to us jury" is deleted in its entirety and replaced by rather than replaced, the following: J. Duties in the Event of an Accident, Claim, "Bodily injury"means bodily injury, sickness or Suit or Loss-Amended disease sustained by a person, including SECTION IV - BUSINESS AUTO CONDI- mental anguish and death sustained by the TIONS, A. Loss Conditions, 2. Duties in the same person that results from such bodily in- Event of Accident, Claim, Suit or Loss, a. is jury, sickness or disease. Bodily injury" does amended by adding the following: not include mental anguish or death that does not result from bodily injury, sickness or dis- This condition applies only when the "acci- ease. dent" or"loss" is known to: I Includes copyrighted material of ISO AA 265 03 06 Properties, Inc„with its permission. Page 3 of 3 CERT NO.: 24189953 CLIEW COM 22`-oun[wai )SA) Sandra Russell 4/9/2015 2:58;57 PM (CM Page 5 of 21 EBA0266712 Fountain-Works LLC 4/8/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION OR NONRENEWAL BY US NOTIFICATION TO A DESIGNATED ENTITY This endorsement modifies insurance provided under the following: BUSINESSOWNERS PACKAGE POLICY CLAIMS-MADE EXCESS LIABILITY COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART DENTIST'S PACKAGE POLICY EXCESS LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART-CLAIMS-MADE SCHEDULE Name and mailing address of person(s)or organlzation(s): 1. For whom you are required in a written contract that was executed on or after the earlier of the following dates: a. the effective date of this policy, or b. the effective date of the original policy of which this policy is a renewal or replacement, and 2 . for whom you are required in that same written contract as referred to in 1. above to provide cancellation notice. Number of days notice(other than nonpayment of premium): 30 A If we cancel or nonrenew this policy for any statutorily permitted reason other than nonpayment of premium we will mail notice to the person or organization shown in the Schedule.We will mail such notice at least the number of days shown in the Schedule before the effective date of cancellation or nonrenewal. I B. If we cancel this policy for nonpayment of premium, we will mail notice to the person or organization shown in the Schedule.We will mail such notice at least 10 days before the effective date of cancellation. C. If notice is mailed, proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. D. In no event will coverage extend beyond the actual expiration,termination or cancellation of the policy. III IA 4087 08 11 CBRT NO.: 24189953 CLIEVF CODE; 222ountwor (SAS Sandma Russell 9/8/2015 2:56:57 PM (CDT) Page 6 of 21 EPP0266712 Fountain-Works LLC 4/8/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage ..................................................................................................2 2. Unintentional Failure to Disclose Hazards..........................................................................................7 3. Damage to Premises Rented to You................................................................................................... 8 4. Supplementary Payments ...................................................................................................................9 5. Medical Payments................................................................................................................................9 6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage (Coverage b.).........................................................................................................9 7, 180 Day Coverage for Newly Formed or Acquired Organizations......................................... ........ 10 8. Waiver of Subrogation .....................:.................................................................................................10 9. Automatic Additional Insured -Specified Relationships: 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions- Permits Relating to Premises; • State or Political Subdivisions -Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property......................................... 14 11. Property Damage to Borrowed Equipment....................................................................................... 14 12. Employees as Insureds -Specified Health Care Services: ................ .........____.......................... 14 • Nurses; • Emergency Medical Technicians; and • Paramedics 13. Broadened Notice of Occurrence...................................................................................................... 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5, Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 1 of 15 CERT NO.: 2418M3 CLIENT CODE: 22fountwoa (SA) Sandia RUe-11 4/A/2015 2:50:57 CUI (CDT) Page 7 of 21 6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a. $250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales d Units e Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable1. Employee Benefit Liability Coverage anein limit of in t of Y 9 ante in the payment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- ror (b) This insurance applies to , omission of the in- damages only if the act, er- ror or omission, is negli- gently sured or of any other per- son for whose acts the in- gently committed in the sured is legally liable, to "administration" of your which this insurance ap- "employee benefit pro- plies. We will have the right gram"; and and duty to defend the in- sured against any "suit" 1) Occurs during the pol- seeking those damages, icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC. deemed to have TION III - LIMITS OF knowledge of a INSURANCE; and claim or suit' when any 2) Our right and duty to authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 I CERT NO,: 24189953 CLIENT CODE: 22fountwo (SA) Sandra Ruesell 4/8/2015 2:58:57 PR (C.T) Vey. 8 of 21 i i) Reports all, or formance of investment any part, of the vehicles; or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because Workers Compensation of the act, er- (fl ' ror or omis- and Similar Laws sion; and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance, any workers' compensation, unemployment compensa- (2) Exclusions tion insurance, social secu- rity or disability benefits law apply or any similar law. to: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of injury", "property liability imposed on a fiduci- "Bodil Y 1 ry", ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reck- able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- (1) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to (j) Employment-Related meet any obligations under Practices any plan included in the "employee benefit pro- Any liability arising out of gram", any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment I Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, 1 Failure of an invest- evaluation, reassign- ) Y ment, discipline, defa- mentto perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 3 of 15 CERT NO.: 24189953 CLIENT CODE: 22`-ountwor (SR) Sandra RusSall 4/8/2515 2:5S:57 PM (CDT) Page 9 of 21 � ment-related practices, (a) A trust, you are an.insured. acts or omissions;or Your trustees are also in- 4 Consequential liability in- sureds, but only with re- ( ) q y spect to their duties as as a result of(1), (2) or trustees. (3) above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury, or 'employees" having proper temporary authori- (3) Supplementary Payments zation to administer your SECTION I - COVERAGES, "employee benefit program" SUPPLEMENTARY PAY- if you die, but only until your MENTS - COVERAGES A AND legal representative is ap- B also apply to this Coverage. pointed. (c) Your b. Who is an Insured you die abut representative with ref As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II - WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tiestirety and replaced by the following: under this Coverage Part. (1) If you are designated in the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint ven- age under this provision: ture, you are an insured. Your members, your part- (a) Is afforded only until the ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business, whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in- c. Limits of Insurance sureds, but only with re- spect to their duties as your As respects Employee Benefit Liabil- managers. ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 4 of 15 CHRT NO.: 24189953 CL1SN'f COO.: 22Eountwoz (8A) Sandra Russell 4/8/2015 2:58:57 PM (CUT) Page 10 of 21 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations c Persons or organizations applies to all damages O g sustained by any one "em- making claims or bringing ployee", including such "suits"; "employee's" dependents (d) Acts,errors or omissions; or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all damages because of acts, er- against any "suits" rors or omissions negligently seeking those dam- committed in the "administra- ages; and tion" of your "employee benefit 2) Your duties, and the program'. duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act, error or Limit shown in Section B. Limits omission,or claim, of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission; or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rors or omissions, regard- of the deductible amount as less of the amount of time we have paid. that lapses between such d. Additional Conditions acts,errors or omissions, committed in the As respects Employee Benefit Li- negligently ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties In the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit a Our obligation to a dam- a. You must see to it that we are noti- ( ) 9 pay fied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred; and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 CENT NO.: 24189953 CLIENT CODE: 22£ovn£vor (SA) Sandra Russ 11 4/8/2015 2:58:59 PM (C➢T) Page 11 0: 21 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured, you must: If all of the other insur- (1) Immediately record the specifics ante permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this 2 Notify us as soon as practicable. method also. Under O fY P this approach each in- I You must see to it that we receive surer contributes equal written notice of the claim or"suit" as amounts until it has soon as practicable, paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit'; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its Cooperate with us in the investi- applicable limit of in- (3) p surance to the total ap- gation or settlement of the claim plicable limits of insur- or defense against the "suit"; ance of all insurers. and (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. ance in force previous d. No insured will, except at that in- to the effective date of this Coverage Part. sured's own cost, voluntarily make a payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent, As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Otherinsurance added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams";or other insurance by the d. Effecting, continuing or method described in b, terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 CBRT NO.: 24109953 C11BN'L CODE: 22fo,mc (SA) band=a Russell 4/0/2015 2:50:51 W (Clfl Page. 12 0`_ 21 in any benefit included benefits, workers' com- in the "employee bene- pensation and disability fit program", benefits; and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll sence programs, in- ductions; or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transpor- coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re benefits, workers' com- placed by the following: pensation and disability benefits, 21. "Suit" means a civil pro- ceeding in which money 2. "Cafeteria P damages because of an plan authorized by applica- act, error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit" includes: tain benefits with pre-tax dollars. a. An arbitration pro- ceeding3. "Employee benefit pro- in which such P damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent; through a "cafeteria plan" or otherwise: b. Any other alternative a. Grouplife insurance; dispute resolution pro- ceeding in which such group accident or damages are claimed health insurance; den- and to which the in- tal, vision and hearing sured submits with our plans; and Flexible consent; or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed, on leave those "employees" who of absence or disabled, or satisfy the plan's eligi- retired, "Employee" in- bility requirements; cludes a "leased worker". "Employee" does not in- b. Profit sharing plans, clude a "temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz, ownership plans, pen- ards sion plans and stock SECTION IV- COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em. tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 7 of 15 CERT NO.: 2AI89953 CLIENT CODE: 22f0vn[w0i (SPA) Sandfa Rcaeell 4/8/2815 2;58:57 PM (CDT) Page 13 of 21 3. Damage to Premises Rented to You e) Settling, cracking, of Paragraph shrinking or ex- a. The last Subparagraph 9 p pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or Exclusions c.through do not apply secretions, , in- 9 q• pp Y sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- b. The insurance provided under SEC- ing: TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move- to "property damage" arising out of ment; water damage to premises that are 2 Water that backs up or both rented to and occupied by you. overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in Paragraph 3,b. above: 3) Water under the ground surface press- The exclusions under SECTION ing on, or flowing or I . COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than 1. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not; or to: c) Doors, windows or (a) 'Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire sulting from any of the protection systems caused following: by or resulting from freez- a) Wear and tear; ing, unless: 1) You did your best to b) Rust, corrosion, maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained, self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances; or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 CERT MD.: 24169953 CLIENT CODE: 22Eountwoz (SA) Sandra Ruasell 4/8/2015 2:":57 PM (CDT) Page 14 of 21 caused by or resulting 5, Medical Payments from rain, snow, sleet or ice, whether driven The Medical Expense Limit of Any One by wind or not. Person as stated in the Declarations is amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5, Medical Pay- ments of this endorsement. The Damage to Premises Rented to You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cov- LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for"property damage" to property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured; or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault, you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY, 2, (3) The amount we will pay is lim- Exclusions,j. Damage to Property, ited as described in Section B. Subparagraphs (3), (4) and (5) do Limits of Insurance, 3, Dam- not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement. therein. 4, Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION I - COVERAGE, SUP- [owing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. is replaced by the fol- its designated in Section B. Limits of lowing: Insurance, 6. Voluntary Property U to the limit shown in Section B. Damage and Care. Custody or P Control Liability Coverage of this Limits of Insurance, 4.a, Bail Bonds endorsement with respect to cover- of this endorsement for cost of bail age provided by this endorsement. bonds required because of accidents These limits are inclusive of and not or traffic law violations arising out of in addition to the limits being re- the use of any vehicle to which the placed. The Limits of Insurance Bodily Injury Liability Coverage ap- shown in Section B. Limits of Insur- plies. We do not have to furnish ance, 6. Voluntary Property Dam- these bonds, age and Care, Custody or Control b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of (1) Insureds; the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 9 of 15 CENT NO.: 24189353 CLIENT CODE: 22EDUntWOr (SA) Sand[a Russell 4/8/2015 2;SA:57 WTI (CDT) Page 15 of 21 b. Deductible Clause 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fied Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II -WHO IS AN INSURED: "occurrence" which are in ex- cess of the deductible amount (1) Any person or organization de- stated in Section B, Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below (hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement; or (2) Condition 2.Duties in the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of or Suit, applies to each claim or insurance showing that per- "suit" irrespective of the amount. son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations riod; and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence" or offense to wch this Subparagraph a, of Paragraph 4, is would apply; andurance hereby deleted and replaced by the fol- lowing: (b) They are not specifically provision is af- named as an additional in- a. Insurance under this P sured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; B. Waiver of Subrogation (2) Only the following persons or organizations are additional in- SECTION IV- COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or "your work" done un- Paragraph 9.a.(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability aris- and included in the "products-completed ing out of the ownership, operations hazard". However, our rights maintenance or use of that may only be waived prior to the "occur- part of a premises leased to rence" giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request, the insured will bring "suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights, which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 CERT NO.: 24189951 CLIEM CODE: 22`-auntwan ISA) Sandia Russell 4/8/2015 2,58:59 PM (COT) Page 16 of 21 ill you cease to be a ten- c) Any physical or ant in that premises, chemical change in the product 2) Structural alterations, made intentionally new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose of inspection, (b) Any person or organization demonstration, from which you lease testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- takes to make in (c) Any person or organization the usual course (referred to below as ven- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a,(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of"your products" which stallation, servic- are distributed or sold in the ing or repair op- regular course of the ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: ::Bodily injury" or g) Products which, a Y J rY' after distribution or "property damage" sale by you, have for which the ven- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of liabil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- tract or agree- a) From whom you ment; have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 11 of 15 CER'1' NO.: 24199953 CLIENT CODE: 22founfwoi (S&) Sandra Nueeell 4/P/2015 2:S8:59 M (CDT) Pave 17 of 21 companying or 2) This insurance does containing such not apply to "bodily in- products; or jury", "property Jam- b When liabilityin- age" or "personal and advertising injury' aris- cluded within the ing out of operations "products- performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9,a.(1) spect to such above to provide insurance, products, but only with respect to li- d An state or political subdi- ability arising out of "your O Y P work" performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide (n- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of with respect to the following time required by the written hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- piration date of this Cover- tion with premises you own, age Part. If there is no rent or control and to which written contract or agree- this insurance applies: ment, or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, under Paragraph 9.a,(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures; or injury"or"property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators; or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, or use of any (e) and (f) does not apply to elevators covered by bodily injury', 'property this insurance, damage" or "personal and advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9,a,(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured; or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 12 of 15 i CERT NO.: 24189953 CLIENT CODE: 22Ew"Ig.r (SA1 Sandia Ruflflell 4/8/2015 2:58:57 PM (CDV Page 16 of 21 of the additional in- spects any other insurance sured; or policy issued to the addi- tional insured, and such g , or other insurance policy shall failure to render, any be excess and / or noncon- professional architec- tributing, whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS, 5. Other and specifications; Insurance, b. Excess and Insurance; or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities, tional insured as an 3 "Your work"for which a additional insured by attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved, cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph if) above, SECTION III - LIMITS OF INSURANCE is amended 11, Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described In Para- the Declarations of this Coverage graph 9.a.(2)(f) above only: Part,whichever are less. If no limits are specified in the written contract If a written contract or or agreement, or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicabie to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part, The limits of in- a. Be provided by the In- surance are inclusive of and not in surance Services Of- addition to the limits of insurance fice additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this 'your work"; insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 13 of 15 CE3T So.: 24139953 eLi3Mr CuDE: 22fountx r (SA) Sandia Ru .11 4/0/2015 2:s8;s' MM (cox) 2a9e 19 of 21 tional insured is more re- 11, of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs (a) Insureds; 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought; or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages on your behalf applies ment is attached. If, how- only to the amount of dam- ever, the written contract or ages for each 'occurrence" agreement specifies the In- which are in excess of the surance Services Office Deductible amount stated in additional insured form Section B. Limits of Insur- number CG 20 10 but does ante, 11. of this endorse- not specify which edition, or ment, The limits of insur- specifies an edition that ante will not be reduced by does not exist, Paragraphs the application of such De- 9,a.(3)(a) and 9.a.(3)(b) of ductible amount. this endorsement shall not apply and Paragraph 9.b. of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- ply. fense, Claim or Suit, ap- 10. Broadened Contractual Liability -Work plies to each claim or "suit' Within 50' of Railroad Property irrespective of the amount. It is hereby agreed that Paragraph f.(1) of (c) We may pay any part or all Definition 12. "Insured contract' (SEC- of the deductible amount to TION V-DEFINITIONS) is deleted. effect settlement of any claim or suit' and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us. Paragraph 2., Exclusions of SEC- TION 1 - COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not apply to your "em- ment loaned to you, provided they ployees" who provide professional health are not being used to perform opera- care services on your behalf as duly li- tions at the time of loss. tensed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an 'occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this endorsement. These limits are Paragraph a- of Condition 2. Duties in the Event of Occurrence, Offense, inclusive of and not in addition to Claim or Suit (SECTION IV - COMMER- Limits of Insurance shown in the limits being replaced, The CIAL GENERAL LIABILITY CONDI- Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 CSRT M. 24169953 CL13Mr CODE: 22fo,mtwot (SA) Sandia Russell 4/8/2015 2;58:57 PM (COT) Page 20 of 21 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to it that we are noti- nesses; and fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense, possible, notice should include: This requirement applies only when (1) How, when and where the "oc- the "occurrence" or offense is known currence" or offense took place; to an "authorized representative". i i III i Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 15 of 15 CERT NO.: 24189953 CLIENT CODE: 22tou"twor (SA) Sauara Russell 4/e/2015 2:58:57 ?A (Cuf) Page 21 of 21 ilk KENT W.sHi"'.o Agenda Item: Consent TO: City Council DATE: April 7, 2015 SUBJECT: Goods and Services Agreement with Fountain Works LLC for Fountain Equipment at Town Square Plaza MOTION: Move authorize the Mayor to sign the goods and services agreement with Fountain Works LLC in the amount of $47,719.70, including Washington State Sales Tax, to purchase and deliver equipment to repair the fountain at Town Square Plaza, subject to final terms and conditions acceptable to the City Attorney and the Parks Director. SUMMARY: The 40 lights that light up the individual fan-shaped spray heads embedded in the concrete around the granite ball at Town Square Plaza have reached the end of their useful life. They are being replaced with a new style of light, along with new fountain spray heads. These new parts will upgrade the performance, durability, and water efficiency of the fountain, in addition to accomplishing needed life cycle maintenance. This agreement is to purchase the required parts, so that repairs & installation can be performed by Parks Department staff to keep the fountain operational. EXHIBITS: Goods & Services Agreement, Sole Source Memo RECOMMENDED BY: Parks and Human Services Committee YEA: Ranniger - Higgins - Fincher NAY: BUDGET IMPACTS: Budgeted in the Parks Lifecycle Budget in the General Fund Budget. i REQUEST FOR MAYOR'S SXGNATURE T Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) a, t Approved by Directory `I. s Originator: Lynn Osborn Phone (Originator): 5111 Date Sent: 4/20/15 Date Required: Return Signed Document to: Lynn Osborn Contract Termination Date: 90 days from sign. VENDOR NAME: Date Finance Notified: (Only required on contracts 10 000 and over or on any Grant DATE OF COUNCIL APPROVAL: Date Risk Manager Notified: 4/7/15 (Required on Non-City Standard Contracts A reements Has this Document been Specifically Account Number: P20510 Authorized in the Budget? (j) YES © NO Brief Explanation of Document: A good and services agreement with Fountain Works LLC, in the amount of $47,719.70, for replacement lights and spray nozzles for ground-embedded fountains at Town Square Plaza. This agreement is for parts only, no labor. All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: 4-' Approval of Law Dept.: Law Dept. Comments: t . Date Forwarded to Mayor: Shaded Areas To Be Completed By Administration Staff Received: Recommendations and Comments: r= €� y� a���� -�?.'°� �,�.�,�y 06 tom' I Disposition: Date Returned: a:cmnrmms oom e .vro sngweqsiior:a r ' sgonwaaarr __