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PW15-011 - Amendment - #1 - Integra Realty Resources - S 224th St Improvements - 12/15/2015
f ecr lutarageex KENT Documentf WASHINGTON Wit= fS d.. 3 4 Y t 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: Integra Realty Resources Vendor Number: JD Edwards Number Contract Number: FINV5 - 2 -- 00? This is assigned by City Clerk's Office Project Name: S. 224th St. Improvements Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/15/15 Termination Date: 12/31/16 I Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Ingrid Willms-Dixon Department: Engineering Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2016 because the parcels on the east side of the project are still being worked on. As of: 08/27/14 KENT AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Integra Realty Resources CONTRACT NAME & PROJECT NUMBER: S. 224th St. Improvements ORIGINAL AGREEMENT DATE: January 15, 2015 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The scope of work remains the same, however an amendment is needed to extend the time of completion to December 31, 2016 because parcels on the east side of the project are still being worked on. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $19,500.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $19,500.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $19,500.00 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/15 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'[ Days Required (f) for this 366 calendar days Amendment Revised Time for Completion 12/31/16 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTA /VENDOR: CITY OF KENT: (slgna ure) ✓ (signature) Print ame: d t S Print Name: Timothy J. LaPorte, P.E. Its 5� Its Public Works Director tie) _ / (title) DATE: iz-/� �O DATE: 18 %f APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Integra-220 Amd I/W I I.m-Dixon AMENDMENT - 2 OF 2 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrYYYY) 2/27/2015 'IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS .RTIFICATE 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(Ics) 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). CONPRODUCER rncr Mike Freeman P Conover Insurance PHONE , (425)455-5000 FA% (4251 454-5550 ?AID,No: 155 108th Avenue NE, Suite 725 E-MAIL Mike£®conoverinsurance.com D AIL P.O. BOX 90007 INSURERS AFFORDING COVERAGE NAIL II _ Bellevue WA 98004 _ INSURERAMutual of Enumclaw Insurance 14761 INSURED INSURER B: Integra Washington, Inc. INSURER C: DBA: Integra Realty Resources-Seattle INSURER D: 600 University Street, Suite 310 INSURER E: Seattle WA 98101 INSURER F: COVERAGES C ERTIFICATE NU M BE R:15-16 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, TLRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IMTH 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 ADM SUER TYPE OF INSURANCE POLICY NUMBER MMIMIYVYY EFF LTR MNJDDIYYVY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 DAMAGE TO RENTED S 100,OOO X COMMERCIAL GENERAL LIABILITY PREMISES{Ea occurrence A CIAIMS-MADE OCCUR X OPOD0138304 /14/2015 /14/2016 MEO EXP(Any one person) S 101000 PERSONALS AUVINJURY $ GENERAL AGGREGATE S 4,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ 2,000,000 X I POLICY PRO TOO S AUTOMOBILE LIABILITY Ea aCOMcccidentSlNGL LIMIT 2,000 000 ANY AUTO BODILY INJURY(Per person) 5 A ALL OWNED SCHEDULED X OPOD0130304 /14/2U15 3/14/2016 AUTOS AUTOS BODILY INJURY(Per acudenl) 5 NON OWNEDPROPERTY DAMAGE § X HIRED AUTOS X AUTOS Peraccldent § X UMBRELLA LIAB Lj OCCUR FACT I OCCURRENCE S _ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE D. RETENTION$ CD00055509 /14/2015 /14/2016 $ A WORKERS COMPENSATION X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YINI NIA EL EACH ACCIDENT $ __- 2,_000,000 OFFICERNFMBER EXCLUDED9 J OP0 /14/2015 3/14/2016 00138304 IMandelnry in NH) E.L.OIBEASE-EA EMPLOYE S 2,000,000 If yas,descdb under A STOP GAP E.L.DISEASE'POLICY LIMIT S 2,000,000 DESCRIP110N OF OPERATIONS below - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedulo,it mare space R required) City of Kent are included as Additional Insureds. The following attached form applies: Additional Insured per form BP 04 48 01. 06. I i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Kent 220 Fourth Avenue South Kent, WA 96032 AUTHORIZED REPRESENTATIVE Mike Freeman/NATASH ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r,n,noslm Tho AcnAn„>,.,o>.,d Inns>rP — He�of AnnRn POLICY NUMBER: BOP 0001383 04 BUSINESSOWNERS BP 04 48 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED ® DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF KENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured in Section II —Liability: 3. Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf in the performance of your ongoing operations or in connection with your premises owned by or rented to you. BP 04 48 01 06 ISO Properties, Inc.,2004 Page 1 of 1 ❑ ® DATE(MMUDOIYYYY) 4�ca�ra® CERTIFICATE OF LIABILITY INSURANCE 02/25/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES SLOW. 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 1-818-539-2300 CONTACT NAME: LARealEe tateCerta@aj g.com Arthur J. Gallagher & Co. PHONE Insurance Brokers of California, Inc. License #0726293 A/C N 1-816-539-1247 IAtC Na): 1-818-539-1804_ 505 North Brand Boulevard, Suite 600 q DRIEse: LARealEstateCerts@ajg.com Glendale, CA 912 03-3 944 INSURER(S)AFFORDING COVERAGE NAG# LARealEstateCerts@ajg.Ccm _ INSURER A: LLOYD'S OF LONDON SYNDICATE 3624 INSURED INSURER B: APPRAISAL GUARDIAN SERIES OF FORTRESS Integra Washington, Inc. INSURER C: _ 600 University Street INSURER D: _. #310 INSURER E: Seattle, WA 98101 INSURER F: COVERAGES CERTIFICATE NUMBER: 43105023 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. IryBR� TYPE OF 'iADDLiSUBR - POLICY EFF POLICY EXP LIMITS LTft POLICY NUMBER MMUDDIYYYY MMIDDffVYV GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISESiEa ocmnence $ CLAIMS-MADE �L_1 OCCUR MED EXP(Any oneperson) S PERSONAL B AOV INJURY $ _ _GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGO $ POLICY 7 jE 0 LOG $ COMBINED SINGLE LIMIT .UTDMOBILE LIABILITY Ea arddent j$... .. ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED II SCHEDULED BODILY INJURY(Per acciden) $ ADIOS HIRED AUTOS AUTOS — �_{NON-OWNED PROPFRTY DAMAGE $ AUTOS (Pelaoddenl) UMBRELLA HAS OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE _ $ DED RETENTION$ $ WORKERS COMPENSATION TORYWC LIMITTATUS OER EACH CCIDE_. ER AND EMPLDVERS'LIABILITY YIN ANY PROP RIETCRR'ARTN E RIF%ECU HVE❑ NIA E.L.EACH ACCIDENT $ OFPICERIMEMBER E%CLUDEDi BF.SE E.L.DISEASE EMPLOYEE $ (Mandatory In NH) S _. . If yes,desodbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Error. & Omissions MPLI53119915 03/14/1 03 19 16 Eac Claim 2,D00,000 A Errors & Omissions MPLI53119915 03/14/1 03/14/16 Aggregate 10,000,000 A rE&O Deductible Reimbursemen 11 *PRFDR46APP20030692201ST 03/14/1 03/14/161 Maximum Deductible 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,i(inore space IS required) Location: 600 University Street, Ste 310, Seattle, WA 9B101 Evidence only. *ProfeBsional Liability Deductible Reimbursement policy subject to 025,000 SIR payable by local office. This certificate of insurance is not a policy of insurance and does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy to which the certificate of insurance makes reference. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2. Ourth Avenue AUTHORIZED REPRESENTATIVE Kent, WA 98032 Culey LaRrialllet'mldra Glickman i USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ana lame 43105023