HomeMy WebLinkAboutPW15-243 - Original - The Eastman Company - Moore Property Appraisal - 07/15/2015 f
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Document
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: The Eastman Company
Vendor Number:
JD Edwards Number
�,ra�-
Contract Number: � .
This is assigned by City Clerk's Office
Project Name: Moore Property Appraisal
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 7/15/15 Termination Date: 12/31/15
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Sean Bauer Department: Operations
Contract Amount: $1 400.00
Approval Authority: (CIRCLE ONE Department Directo Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Provide appraisal services for the Moore property.
As of: 08/27/14
KEN'T
W�S"I".T0"
PROFESSIONAL SERVICES AGREEMENT
between the City of Kent and
The Eastman Company
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and The Eastman Company organized under the laws of the State of Washington,
located and doing business at 6206 351h Ave NE, Seattle, WA 98115, Phone: (206) 363-6611, Contact:
Donald Melton (hereinafter the "Contractor").
I. DESCRIPTION OF WORK.
Contractor shall perform the following services for the City:
The Contractor shall provide appraisal services for the property located at
26726 262"d Avenue SE in Ravensdale, WA. For a description, see the
Contractor's Scope of Work which is attached as Exhibit A and incorporated by
this reference.
Contractor further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices within the Puget Sound region in effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement, and Contractor shall complete the
work by December 31, 2015.
III. COMPENSATION. The City shall pay Contractor a total amount not to exceed One
Thousand Four Hundred Dollars ($1,400.00) for the services described in this Agreement. The Contractor
shall invoice the City monthly based on time and materials incurred during the preceding month. The
hourly rates charged for Contractor's services shall be as delineated in the attached and incorporated
Exhibit A. All hourly rates charged shall remain locked at the negotiated rates throughout the term of this
Agreement.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Contractor has the ability to control and direct the performance and details of its
work, the City being Interested only in the results obtained under this Agreement.
B. The Contractor maintains and pays for its own place of business from which
Contractor's services under this Agreement will be performed.
C. The Contractor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Contractor's services, or the Contractor is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
D. The Contractor is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
PROFESSIONAL SERVICES AGREEMENT - 1
(Under$10,000)
E. The Contractor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Contractor's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Contractor 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 seven (7) calendar days written notice at its address set forth on the signature
block of this Agreement.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Contractor, its subcontractors, or any person acting on behalf of the
Contractor or subcontractor shall not discriminate against any person who is qualified and available to
perform the work to which the employment relates as provided for by the City of Kent's Equal
Employment Opportunity Policy. Contractor shall execute the attached City of Kent Equal Employment
Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the
contract work, file the attached Compliance Statement.
VII. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Contractor's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence. The City's inspection or acceptance of any of Contractor's work when completed shall not be
grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive
the expiration or termination of this Agreement.
In the event Contractor refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor's part, then
Contractor shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful
refusal on the Contractor's part.
VIII. INSURANCE. The Contractor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by
this reference.
XII. CONTRACTOR'S WORK AND RISK. The Contractor agrees to comply with all federal,
state, and municipal laws, rules, and regulations that are now effective or in the future become applicable
to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those services. All work shall be done at Contractor's own risk, and
Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held
for use in connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
PROFESSIONAL SERVICES AGREEMENT - 2
(Under$10,000)
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C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, Including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Contractor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. Should any language in any of the exhibits to this
Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall
prevail.
H. 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.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below.
CONTRACTOR:, f CITY OF KENT,
By� it LGln tG tt/ tom By:
(signature) f (signature)
Print N me: F- �`` sL Print Name: Mark Howlett, P.E.
Its: �`iI'a_;c� Its: Design Engineering Manager
(title)
DATE: ni DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
PROFESSIONAL SERVICES AGREEMENT - 3
(Under$10,000)
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Contractor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. Should any language in any of the exhibits to this
Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall
prevail.
H. 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.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below.
CONTRACTOR: CITY OF KENT:
(signature) (signature)
Print Name: Print Name: David A. Brock, P.E.
Its: Its: Operations Manager
(title)
DATE: DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
PROFESSIONAL SERVICES AGREEMENT - 3
(Under$10,000)
Donald Melton Timothy J. LaPorte, P.E.
The Eastman Company City of Kent
6206 351h Ave NE 220 Fourth Avenue South
Seattle, WA 98115 Kent, WA 98032
(206) 363-6611 (telephone) (253) 856-5500 (telephone)
N/A (facsimile) (253) 856-6500 (facsimile)
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PROFESSIONAL SERVICES AGREEMENT - 4
(Under$10,000)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of t Lt'i 201�.
i
For: cU� CN " \11,CNAA
Title:
Date: 1 f f?r
EEO COMPLIANCE DOCUMENTS - I
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
i
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
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.
Dated this day of 20 .
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
EXHIBIT
fhe Eastman Company
Real Estcit9 Appralsers/Analysts/Consultants Phohe(206)343-6611
6206—3VA Avenue NE . don@wavalue.com
Seattle,WA 96116
June 22, 2015
1
Mr, Bean Hauer,Water Superintendent
%tex Section Puhlie Works Department
City of Kent
220 Fourth avenue South
Kent, WA 980.32
Re: Appraisal Bid Vernier Moore Parcel (APN--252206.9107) located at
{ �6726 100 Avenue SE,Ravew&16,Washington
5
Dear MT. Bauer>
Thank'you for the opportunity to bid on the above-referenced assigarma, We are Interested in
providing appraisal services for the above referenced property, There are two appraisal reporting
options; The first is a"Restricted Appraisal report'"and the other is the"Appraisal Report". The
essential difference betweeq these two options is in the content and level of information
provided, The "Restricted Appraisal Report" is for the client (City of Kent) use only. Do
appraisal fee for a restricted format, US PAP compliant, appraisal report will not exceed One
Thousand Four Hundred Dollars ($1,400), Our appraisal fee fag.the other format, USPAP
compliant,appraisal report will not exceed Two Thousand Five Hundred Dollars
The specific completion date.depends on when the assignment is actually awarded, and when all
necessary information is provided to us (legal description, maps, easement documents, if aqy,
and contact information of person that will provide access to the building). We can have the
assibtlnaent Completed in about 18-2i days after receiving wveltten notifleatiorl to proceed, Ifyou
have any questions about this bid, inclgding the differences between the two potential appraisal
formats,please do nat hesitate to call me at 206-856-9242.
Sincerely,
Donald K, Melton
The Eastman Company
I
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
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The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for Injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below;
1. Auutomoblle Liability insurance covering all owned, non-owned,
hired and leased vehicles. Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage. If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, Independent contractors, products-completed
operations, personal Injury and advertising injury, and liability.
assumed under an insured contract. The City shall be named as an
Insured under the Consultant's Commercial General Llabillty
Insurance policy with respect to the work performed for the City
using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
i
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
4. Professional Llabllity insurance appropriate to the Consultant's
profession.
B. Minimum Amounts of Insurance
Consultant shall maintain the following Insurance limits;
1. Automoblie Liability Insurance with a minimum combined single
limit for bodily Injury and property damage of$1,000,000 per
accident.
2. ,Commercial General Liability insurance shall be written with limits
no less than $1,000,000 each occurrence, $2,000,000 general
aggregate and a $1,000,000 products-completed operations
aggregate limit,
II
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EXHIBIT B (Continued)
3. Professional Liability insurance shall be written with limits no less
than $1,000,000 per claim and $1,000,000 policy aggregate limit.
C, Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
Insurance:
1, The Consultant's insurance coverage shall be primary insurance as
respect the City, Any Insurance, self-insurance, or Insurance pool
coverage maintained by the City shall be excess of the Consultant's
Insurance and shall not contribute with It.
2. The Consultant's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified mall, return receipt requested, has
been given to the City,
3. The City of Kent shall be named as an additional Insured on all
policies (except Professional Liability) as respects work performed
by or on behalf of the Consultant and a copy of the endorsement
naming the City as additional Insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required insurance policies. The Consultant's
Commercial General Liability Insurance shall also contain a clause
stating that coverage shall apply separately to each Insured against
whom claim Is made or suit is brought, except with respects to the
limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than AWII.
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional Insured endorsement, evidencing the Insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as Insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
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A� CERTIFICATE OF LIABILITY INSURANCE D6/12/2015
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 NAME:ONTACT Shari Lofquist
C Don Filer Agency PHONE
p,Eaf,. (206)545-4800 IND. (206)545-4849
4201 Roosevelt Way NE ADDRESS:elofquiet8filerinsurance.corn
INSURERIS A) FFORDING COVERAGE NAIC 1/_
Seattle _ WA _98105-6608 _ INSURER A:Traveler_s Cas Ina of America _ 19046
INSURED INSURER B:
G2mz LLC dba The Eastman Company INSURER C:
6206 35th Ave NU INSURERD;
INSURER E
Seattle WA 98115 INSURER F:
COVERAGES CERTIFICATE NUMBER:Master GL 2015-16 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADOL 6 BR POLICY EFf POLICYEXP -
LTR TYPE OF INSURANCE POLICY NUMBER I LIMITS
X COMMERCIALaENERALUABILITY EACH OCCURRENCE $ 2,000,000
A CLAIMS-MADE OCCUR DAMAGETORENTED
_DAMA SE TO Rgocunance) 300,000_.. $ .___
X 680-72721300-15-42 6/19/2015 6/19/2016 MED EXP(Any One person) $ 5,000
PERSONAL&ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 'i
X POLICY❑JECTPRCT ❑ $ 4,000,000
LOC PRODUCTS-COMPIOPA00
10- _
OTHER: New d 3 2,000,000
AUTOMOBILE LIABILITY OMBINe JINGLE LIMIT $ —_2,000,000
AIANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED AUTOS X 6BO-79721300-15-42 6/19/2015 6/19/2016 BODILY INJURY(Per accident) $
HIRED
AUTOSAUTOS X NON OWNED PROPERTY DAMAGE $
AUTOS Poraakla 1
3
UMBRELLA LIAa HOCCUR EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
DEe RE E $
M94XdSRY ` ti(0, ' IX4( PER T OTW
J((✓Jj�MPLOYERS'LIABILITY YIN
ANY
OFFICERIMEIMBER EXCLUDED?ECUTIVE ❑ NIA E.L.EACH ACCIDENT S
(Mandatory In NH) C.L.DISEASE•EA EMPLOYE $
Dyes decalbe under I---
pES RIPTION OF OPERATIONS balmy E.L DISEASE-POLICY LIMA' S '.
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD tot,Additional Remarks Schedule,may be attached It mom apace Is mqulred)
Certificate holder is hereby named additional insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent, Dept. of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Engineering ACCORDANCE WITH THE POLICY PROVISIONS,
Attn: Nancy Yoshitake
220 4th Ave S AUTHORIZED REPRESENTATIVE
Kent, WA 98032-3994 , tip tom'. �B
Shari Lofquist/SIIARI
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025 I=4o1)
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Policy N 680-713721300-15-42 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES
OR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS:
1. WHO IS AN INSURED(SECTION 11)is amended in a written contract for this Insurance to
to Include as an Insured any person or organize- apply on a primary or contributory basis.
lion (called hereafter "additional Insured") whom 3, This Insurance does not apply:
you have agreed in a written contract, executed a. on any basis to any person or organization
prior to loss, to name as additional Insured, but
only with respect to liability arising out of"your for whom you have purchased an Owners
work" or your ongoing operations for that addl- and Contractors Protective policy.
tional Insured performed by you or for you, b. to "bodily injury," "property damage," "per-
2. With respect to the insurance afforded to Addl- sonal Injury," or "advertising Injury" arising
tional insureds the following conditions apply: out of the rendering of or the failure to render
an
a. Limits of Insurance- The following limits of eludinrofessional aervlcea by or for you, In.
9
liability apply: 1, The preparing, approving or failing to
1. The limits which you agreed to provide; prepare or approve maps, drawings,
or opinions, reports, surveys, change or-
2. The limits shown on the declarations, ders,designs or speciflcalions;and
whichever is less. 2. Supervisory, Inspection or engineering
b. This Insurance Is excess over any valid and services.
collectible Insurance unless you have agreed
CG 0105 04 94 Copyright,The Travelers Indemnity Company, 1994, Page 1 of 1
Includes Copyrighted Material from Insurance Services Office, Inc.
I